nursing exam 1 practice questions

d

A nurse in a long-term care facility is caring for a resident who has major neurocognitive disorder and attempts to wander out of the building. The client states, "I have to get home." Which of the following is an appropriate response by the nurse? A. "You have forgotten that this is your home." B. "You cannot go outside without a staff member." C. "Why would you want to leave? Aren't you happy with your care?" D. "I am your nurse. Let's walk together to your room."

b

A nurse is conducting chart reviews of multiple clients at a community mental health facility. Which of the following would be an example of client experiencing a maturational crisis? A) Rape B) Marriage C) Severe Physical Illness D) Job Loss

4

A nurse is developing a plan of care for a client admitted to the mental health unit with a diagnosis of obsessive-compulsive disorder (OCD). What is the nurse's first priority in the plan of care? 1. Monitor for repetitive behavior. 2. Demand active participation in care. 3. Educate the client about self-care needs. 4. Establish a trusting nurse-client relationship.

a

Amanda's mobile home was destroyed by a tornado. Amanda received only minor injuries, but is experiencing disabling anxiety in the aftermath of the event. This type of crisis is called: a. Crisis resulting from traumatic stress. b. Maturational/developmental crisis. c. Dispositional crisis. d. Crisis of anticipated life transitions.

ce

An example of a treatable (reversible) form of NCD is one that is caused by which of the following? Select all that apply. a. multiple sclerosis b. multiple small brain infarcts c. Electrolyte imbalances d. HIV disease e. folate deficiency

b

John tells the nurse "I think lights out at 10 o'clock on a weekend is stupid. We should be able to watch TV until midnight!" Which of the following is the most appropriate response from the nurse on the milieu unit? a. John, you were told the rules when you were admitted. b. You may bring it up before the others at the community meeting, John. c. Some people want to go to bed early, John. d. You are not the only person on this unit, John. You must think of the others.

c

Nurse Jones is the leader of a bereavement group for widows. Nancy is a new member. She listens to the group and sees that Jane has been a widow for 5 years now. Jane has adjusted well and Nancy thinks maybe she can too. This is an example of which curative factor? a. Universality. b. Imitative behavior. c. Installation of hope. d. Imparting of information.

b

Sandra is the nurse leader of a supportive/therapeutic group for individuals with anxiety disorders. In this group, Nancy talks incessantly. When someone else tries to make a comment, she refuses to allow him or her to speak. What type of member role is Nancy assuming in this group? a. Aggressor. b. Monopolizer. c. Blocker. d. Seducer.

2

The nurse is assessing a client in the coronary care unit (CCU) who seems to fluctuate in his ability to focus during the day. On the basis of this assessment, which client problem should the nurse suspect? 1. Dementia as a result of isolation 2. Acute confusion as a result of CCU psychosis 3. Dementia as a result of substance intoxication 4. Interruption in the family as a result of alcohol withdrawal

1

The nurse is performing an assessment on a client with dementia. Which data gathered during the assessment indicates a manifestation associated with dementia? 1. Uses confabulation 2. Improvement in sleeping 3. Absence of sundown syndrome 4. Presence of personal hygienic care

c

Theresa is hospitalized following a suicide attempt after breaking up with her boyfriend. Theresa says to the nurse, "When I get out of here, I'm going to try this again, and next time I'll choose a no-fail method." Which is the best response by the nurse? a. "You are safe here. We will make sure nothing happens to you." b. "You're just lucky your roommate came home when she did." c. "What exactly do you plan to do?" d. "I don't understand. You have so much to live for."

4

What is the most appropriate nursing action to help manage a manic client who is monopolizing a group therapy session? 1. Ask the client to leave the group for this session only. 2. Refer the client to another group that includes other manic clients. 3. Tell the client to stop monopolizing in a firm but compassionate manner. 4. Thank the client for the input, but inform the client that now others need a chance to contribute.

cde

A charge nurse is discussing the characteristics of a nurse-client relationship with a newly licensed nurse. Which of the following are appropriate to include in the discussion? (SATA) A. The needs of both participants are met. B. An emotional commitment exists between the participants. C. It is goal-directed. D. Behavioral change is encouraged. E. A termination date is established.

4

A client admitted to the mental health unit with depression states to the nurse, "My life has been such a failure. Nothing I do turns out right." Which therapeutic response should the nurse make? 1. "You are certainly entitled to your own opinion." 2. "I know just how you feel. I have those days myself once in a while." 3. "I disagree with you; we all have some value and accomplishments in life." 4. "You seem very discouraged. Can you think of anything recently that went as you planned?"

4

A client admitted to the mental health unit with major depression 3 days ago could hardly get out of bed without coaxing and needed constant encouragement to get dressed and participate in unit activities. Today the client appears in the dayroom dressed and well groomed, without any guidance from the staff. The client appears to be calm and relaxed, yet more energetic than before. Which initial action should the nurse take after noting this client's behavior? 1. Continue to monitor the client's behavior from a distance. 2. Document that the client is adapting to the unit and is feeling safe. 3. Notify the staff of these observations at the team meeting, which will begin in 3 hours. 4. Speak to the client personally about the nurse's observations, and ask if the client is thinking about suicide.

3

A client comes to the emergency department after an assault and is extremely agitated, trembling, and hyperventilating. What is the priority nursing action for this client? 1. Begin to teach relaxation techniques. 2. Encourage the client to discuss the assault. 3. Remain with the client until the anxiety decreases. 4. Place the client in a quiet room alone to decrease stimulation.

2

A client diagnosed with delirium becomes disoriented and confused at night. Which intervention should the nurse implement initially? 1. Move the client next to the nurse's station. 2. Use an indirect light source and turn off the television. 3. Keep the television and a soft light on during the night. 4. Play soft music during the night, and maintain a well-lit room.

3

A client has consented to participate in Alcoholics Anonymous (AA) community groups after discharge from the hospital. The nurse is monitoring the client's response to the substance abuse sessions. Which statement by the client best reflects the development of an effective coping response style and effective processing of information for self-use? 1. "I know I'm ready to be discharged. I feel like I can say 'no' and leave a group of friends if they are drinking. No problem." 2. "I'll keep all my appointments and go to all my AA groups; I'll do everything I'm supposed to. Nothing will go wrong that way." 3. "I'm looking forward to leaving here. I will miss all of you. So, I'm happy and I'm sad, I'm excited, and I'm scared. I know that I have to work hard to be strong and that everyone isn't going to be as helpful as you people." 4. "This group has really helped a lot. I know it will be different when I go home. But I'm sure that my family and friends will all help me like the people in this group have.... They'll all help me.... I know they will.... They won't let me go back to old ways."

3

A client is admitted to the mental health unit after an attempted suicide by hanging. The nurse can best ensure client safety by which action? 1. Requesting that a peer remain with the client at all times 2. Removing the client's clothing and placing the client in a hospital gown 3. Assigning a staff member to the client who will remain with the client at all times 4. Admitting the client to a seclusion room where all potentially dangerous articles are removed

1

A client is planning to attend Overeaters Anonymous. Which statement by the client indicates a need for additional information regarding this self-help group? 1. "The leader is a nurse or psychiatrist." 2. "The members provide support to each other." 3. "People who have a similar problem are able to help others." 4. "It is designed to serve people who have a common problem."

a

A client says to the nurse, "I read an article about Alzheimer's and it said the disease is hereditary. My mother has Alzheimer's disease. Does that mean I'll get it when I'm old?" The nurse bases her response on the knowledge that which of the following factors is not associated with increased incidence of NCD due to alzheimer's disease? a. Multiple small strokes b. family history of alzheimer's c. head trauma d. advanced age

3

A client says to the nurse, "The federal guards were sent to kill me." What is the best nursing response to the client's concern? 1. "I don't believe this is true." 2. "The guards are not out to kill you." 3. "Do you feel afraid that people are trying to hurt you?" 4. "What makes you think the guards were sent to hurt you?"

4

A depressed client on an inpatient unit says to the nurse, "My family would be better off without me." What is the nurse's best response? 1. "Have you talked to your family about this?" 2. "Everyone feels this way when they are depressed." 3. "You will feel better once your medication begins to work." 4. "You sound very upset. Are you thinking of hurting yourself?"

4

A depressed client who appeared sullen, distraught, and hopeless a few days ago now suddenly appears calm, relaxed, and more energetic. Which is the nurse's best initialaction with regard to the client's altered demeanor? 1. Continue to assess the client's behaviors and document clearly in the chart. 2. Report to the health care provider that the client is adapting to the unit and is feeling safe. 3. Notify the health team of these observations and alert them to the suspicion that the client is contemplating suicide. 4. Engage the client in one-to-one supervision, share with the client the observations that have been assessed, and ask whether the client is thinking about suicide.

1

A home care nurse making an initial home visit notes that a client is taking donepezil hydrochloride (Aricept). The nurse questions the client's spouse about a history of which disorder that is treated with this medication? 1. Dementia 2. Schizophrenia 3. Seizure disorder 4. Obsessive-compulsive disorder

c

A nurse in an acute mental health facility is caring for a client who has a severe mental illness and soonwill be ready for discharge but still requires supervision much of the time. The client's wife works all day but is home by late afternoon. Which of the following should the nurse suggest as appropriate follow-up care? A.Receiving daily care from a home health aide B.Having a weekly visit from a nurse case worker C.Attending a partial hospitalization program D.Visiting a community mental health center on a daily basis

4

A nurse is assessing a client in crisis and is determining the potential for self-harm. Which assessment data would indicate that the client is at very high risk for suicide? 1. The client is impulsive. 2. The client is disorganized. 3. The client has a history of suicide attempts. 4. The client has an immediate plan for a suicide attempt.

be

A nurse is caring for a client who is experiencing a crisis. Which of the following medications might the provider prescribe? (select all that apply) A) Lithium carbonate (Lithobid) B) Paroxetine (Paxil) C) Risperidone (Risperdal) D) Haloperidol (Haldol) E) Lorazepam (Ativan)

b

A nurse is caring for a group of clients. Which of the following clients should a nurse consider for referral to an assertive community treatment (ACT) group? A.A client in an acute care mental health facility who has fallen several times while running down the hallway B.A client who lives at home and keeps "forgetting" to come in for his monthly antipsychotic injection for schizophrenia C.A client in a day treatment program who says he is becoming more anxious during group therapy D.A client in a weekly grief support group who says she still misses her deceased husband who has been dead for 3 months

4

A nurse is preparing a client for discharge who was hospitalized following a suicide attempt. The nurse evaluates that the client could benefit from further development of coping strategies if the client was overheard making which statement before discharge? 1. "I know now that I can't be all things to all people all the time." 2. "It is important for me to take my medications just as prescribed." 3. "It's been good to learn better ways to deal with the stresses in my life." 4. "I know that I won't become depressed again after the treatment I received here."

c

A nurse is working on promotion of healthy coping skills with older adult clients who had all previously been hospitalized for severe depression and are now in a residential care facility. The nurse should recognize that this is an example of which of the following? A.Primary prevention B.Secondary prevention C.Tertiary prevention D.Mental status examination

3

A nursing student is asked to identify suicide methods that are referred to as soft methods. The nursing instructor determines that the student understands the subject if he or she states that which is a soft method? 1. Hanging 2. Using a gun 3. Inhaling natural gas 4. Jumping off a bridge

4

A postsurgical client with a history of heavy alcohol intake has returned to the nursing unit. Which signs/symptoms of delirium tremens (DTs) should the nurse plan to continuously assess for? 1. Coarse hand tremor, agitation, hallucinations, and hypotension 2. Hypotension, ataxia, muscular rigidity, and tactile hallucinations 3. Hypotension, stupor, agitation, headache, and auditory hallucinations 4. Fever, hypertension, changes in level of consciousness, and hallucinations

c

Henry is a member of an Alcoholics Anonymous group. He learned about the effects of alcohol on the body when a nurse from the chemical dependency unit spoke to the group. This is an example of which curative factor? a. Catharsis. b. Altruism. c. Imparting of information. d. Universality

ace

In addition to disturbances in cognition and orientation, individuals with Alzheimer's disease may also show changes in which of the following? Select all that apply. a. personality b. vision c. speech d. hearing e. mobility

c

In determining degree of suicide risk with a suicidal client, the nurse assesses the following behavioral manifestations: severely depressed, withdrawn, statements of worthlessness, difficulty accomplishing activities of daily living, no close support systems. The nurse identifies the client's risk for suicide as: a. Low. b. Moderate. c. High. d. Unable to determine.

d

Mrs. G has been diagnosed with NCD due to Alzheimer's disease. The cause of this disorder is which of the following? a. multiple small brain infarcts b. chronic alcohol abuse c. cerebral abscess d. unknown

b

N.J. is the nurse leader of a childbirth preparation group. Each week she shows various films and sets out various reading materials. She expects the participants to utilize their time on a topic of their choice or practice skills they have observed on the films. Two couples have dropped out of the group, stating, "This is a big waste of time." Which type of group and style of leadership is described in this situation? a. Task, democratic. b. Teaching, laissez-faire. c. Self-help, democratic. d. Supportive/therapeutic, autocratic.

c

Nursing diagnoses are prioritized according to: a. Degree of potential for resolution. b. Legal implications associated with nursing intervention. c. Life-threatening potential. d. Client and family requests.

d

Paul is a member of an anger management group. He knew that people did not want to be his friend because of his violent temper. In the group, he has learned to control his temper and form satisfactory interpersonal relationships with others. This is an example of which curative factor? a. Catharsis. b. Altruism. c. Imparting of information. d. Development of socializing techniques.

abc

Sally was sexually abused as a child. She is a client on the new unit with a diagnosis of borderline personality disorder she has refused to talk to anyone. Which of the following therapies might the IDT team choose for Sally? Select all that apply. a. Music therapy b. Art therapy c. Psychodrama d. Electroconvulsive therapy

d

Sandra is the nurse leader of a supportive/therapeutic group for individuals with anxiety disorders. On the first day the group meets, Valerie speaks first and begins by sharing the intimate details of her incestuous relationship with her father. What type of member role is Nancy assuming in this group? a. Aggressor. b. Monopolizer. c. Blocker. d. Seducer.

a

Sandra is the nurse leader of a supportive/therapeutic group for individuals with anxiety disorders. Violet, who is beautiful but lacks self-confidence, states to the group, "Maybe if I became a blond my boyfriend would love me more." Larry responds, "Listen, dummy, you need more than blond hair to keep the guy around. A bit more in the brains department would help!" What type of member role is Larry assuming in this group? a. Aggressor. b. Monopolizer. c. Blocker. d. Seducer.

a

Some biological factors may be associated with the predisposition to suicide. Which of the following biological factors have been implicated? a. Genetics and decreased levels of serotonin. b. Heredity and increased levels of norepinephrine. c. Temporal lobe atrophy and decreased levels of acetylcholine. d. Structural alterations of the brain and increased levels of dopamine.

b

Success of long-term psychotherapy with Theresa (who attempted suicide following a break-up with her boyfriend) could be measured by which of the following behaviors? a. Theresa has a new boyfriend. b. Theresa has an increased sense of self-worth. c. Theresa does not take antidepressants anymore. d. Theresa told her old boyfriend how angry she was with him for breaking up with her.

3

The emergency department nurse is caring for a client who has been identified as a victim of physical abuse. In planning care for the client, which is the priority nursing action? 1. Adhering to the mandatory abuse-reporting laws 2. Notifying the case worker of the family situation 3. Removing the client from any immediate danger 4. Obtaining treatment for the abusing family member

1

The emergency department nurse is caring for an adult client who is a victim of family violence. Which priority instruction should be included in the discharge instructions? 1. Information regarding shelters 2. Instructions regarding calling the police 3. Instructions regarding self-defense classes 4. Explaining the importance of leaving the violent situation

b

The most appropriate crisis intervention with Amanda (from question 3) would be to: a. Encourage her to recognize how lucky she is to be alive. b. Discuss stages of grief and feelings associated with each. c. Identify community resources that can help Amanda. d. Suggest that she find a place to live that provides a storm shelter.

2

The nurse in the emergency department is caring for a young female victim of sexual assault. The client's physical assessment is complete, and physical evidence has been collected. The nurse notes that the client is withdrawn, confused, and at times physically immobile. How should the nurse interpret these behaviors? 1. Signs of depression 2. Normal reactions to a devastating event 3. Evidence that the client is a high suicide risk 4. Indicative of the need for hospital admission

2

The nurse is caring for a client with Alzheimer's disease who is having difficulty recognizing objects that are well known, including people. The nurse determines that the client is experiencing which problem? 1. Ataxia 2. Agnosia 3. Apraxia 4. Aphasia

1

The nurse is conducting a group therapy session. During the session, a client diagnosed with mania consistently disrupts the group's interactions. Which intervention should the nurse initially implement? 1. Setting limits on the client's behavior 2. Asking the client to leave the group session 3. Asking another nurse to escort the client out of the group session 4. Telling the client that they will not be able to attend any future group sessions

3

The nurse is conducting an initial assessment on a client in crisis. When assessing the client's perception of the precipitating event that led to the crisis, what is the most appropriate question? 1. "With whom do you live?" 2. "Who is available to help you?" 3. "What leads you to seek help now?" 4. "What do you usually do to feel better?"

3

The nurse is developing a plan of care for a client who was experiencing anxiety after the loss of a job. The client is now verbalizing concerns regarding the ability to meet role expectations and financial obligations. What is the priority problem for this client? 1. Anxiety 2. Unrealistic outlook 3. Lack of ability to cope effectively 4. Disturbances in thoughts and ideas

4

The nurse is monitoring a hospitalized client who abuses alcohol. Which findings should alert the nurse to the potential for alcohol withdrawal delirium? 1. Hypotension, ataxia, hunger 2. Stupor, lethargy, muscular rigidity 3. Hypotension, coarse hand tremors, lethargy 4. Hypertension, changes in level of consciousness, hallucinations

2

The nurse is performing an admission assessment on a client at high risk for suicide. The nurse should prepare to ask the client which assessment question to elicit data related to this risk? 1. "What are you feeling right now?" 2. "Do you have a plan to commit suicide?" 3. "How many times have you attempted suicide in the past?" 4. "Why were your attempts at suicide unsuccessful in the past?"

1

The nurse is performing an assessment on a client with dementia. Which would be a manifestation associated with dementia? 1. Confabulation 2. Improvement in sleeping 3. Absence of sundown syndrome 4. Presence of personal hygienic care

1

The nurse is planning care for a client being admitted to the nursing unit who attempted suicide. Which priority nursing intervention should the nurse include in the plan of care? 1. One-to-one suicide precautions 2. Suicide precautions with 30-minute checks 3. Checking the whereabouts of the client every 15 minutes 4. Asking the client to report suicidal thoughts immediately

b

The nurse is using the nursing process to care for a suicidal client. Which of the following nursing actions is a part of the evaluation step of the nursing process? a. Prioritizes the necessity for maintaining a safe environment for the client. b. Determines if nursing interventions have been appropriate to achieve desired results. c. Obtains a short-term contract from the client to seek out staff if feeling suicidal. d. Establishes goal of care: Client will not harm self during hospitalization.

4

The nurse is working with a client who despite making a heroic effort was unable to rescue a neighbor trapped in a house fire. Which client-focused action should the nurse engage in during the working phase of the nurse-client relationship? 1. Exploring the client's ability to function 2. Exploring the client's potential for self-harm 3. Inquiring about the client's perception or appraisal of why the rescue was unsuccessful 4. Inquiring about and examining the client's feelings for any that may block adaptive coping

2

The police arrive at the emergency department with a client who has lacerated both wrists. What is the initial nursing action? 1. Administer an antianxiety agent. 2. Examine and treat the wound sites. 3. Secure and record a detailed history. 4. Encourage and assist the client to ventilate feelings.

2

The spouse of a client admitted to the mental health unit for alcohol withdrawal says to the nurse, "I should get out of this bad situation." What is the most helpful response by the nurse? 1. "Why don't you tell your wife about this?" 2. "What do you find difficult about this situation?" 3. "This is not the best time to make that decision." 4. "I agree with you. You should get out of this situation."

d

Theresa is hospitalized following a suicide attempt after breaking up with her boyfriend. Freudian psychoanalytic theory would explain Theresa's suicide attempt in which of the following ways? a. She feels hopeless about her future without her boyfriend. b. Without her boyfriend, she feels like an outsider with her peers. c. She is feeling intense guilt because her boyfriend broke up with her. d. She is angry at her boyfriend for breaking up with her and has turned the anger inward on herself.

2

When planning the discharge of a client with chronic anxiety, the nurse directs the goals at promoting a safe environment at home. Which is the most appropriate maintenance goal? 1. Suppressing feelings of anxiety 2. Identifying anxiety-producing situations 3. Continued contact with a crisis counselor 4. Eliminating all anxiety from daily situations

3

When the mental health nurse visits a client at home, the client states, "I haven't slept at all the last couple of nights." Which response by the nurse illustrates a therapeutic communication response to this client? 1. "I see." 2. "Really?" 3. "You're having difficulty sleeping?" 4. "Sometimes, I have trouble sleeping too."

3

Which describes the primary focus of milieu therapy? 1. A form of behavior modification therapy 2. A cognitive approach to changing behavior 3. A living, learning, or working environment 4. A behavioral approach to changing behavior

1346

Which interventions are most appropriate for caring for a client in alcohol withdrawal? Select all that apply. 1. Monitor vital signs. 2. Maintain NPO status. 3. Provide a safe environment. 4. Address hallucinations therapeutically. 5. Provide stimulation in the environment. 6. Provide reality orientation as appropriate.

4

Which is the primary goal of crisis intervention therapy? 1. Introduce new, effective coping methods to the client. 2 .Assess the client in order to identify the causative stressors. 3. Establish a sustainable therapeutic nurse-client relationship. 4. Assist the client in returning to the level of pre-crisis functioning.

1

Which statement made by a severely depressed client requires the nurse's immediate attention? 1. "Feeling better really isn't important to me anymore." 2. "No one can really understand what I've had to deal with." 3. "I really don't like the way that new depression pill makes me feel." 4. "I've not been the least bit interested in socializing since my divorce."

1

Which statement made by an unlicensed assistive personnel (UAP) indicates to the registered nurse that the UAP understands the concepts related to suicide? 1. "Discussing suicide with a client is not harmful." 2. "Those clients who talk about suicide never do it." 3. "Depressed clients are the only persons who commit suicide." 4. "When a person talks about making suicide threats, the only thing the person wants is attention from family and friends."

1

Which type of therapeutic approach has the characteristic that all team members are seen as equally important in helping clients meet their goals? 1. Milieu therapy 2. Interpersonal therapy 3. Behavior modification 4. Rational emotive therapy

c

a nurse is orienting a new client to a mental health unit. When explaining the unit's community meetings, which of the following statements should the nurse make? A. you and a group of other clients will meet to discuss your treatment plans B. community meetings have a specific agenda that is established by staff C. you and the other clients will meet with staff to discuss common problems D. community meetings are an excellent opportunity to explore your personal mental health issues

d

client teaching is an important nursing function in milieu therapy. Which of the following statements by the clients indicate the need for knowledge and a readiness to learn a. Get away from me with that medicine! I'm not sick b.I don't need psychiatric treatment. It's my migraine headaches that I need help with c. I've taken Valium every day of my life for the last 20 years. I'll stop when I'm good and ready d. The doctor says I have bipolar disorder what does that really mean?

c

in prioritizing care within the therapeutic environment, which of the following nursing interventions would receive the highest priority? a. ensuring that the physical facilities are conducive to achievement of the goals of therapy b. scheduling a community meeting for 8:30 each morning c. attending to the nutritional and comfort needs of our clients d. establishing contacts with community resources

b

in the community meeting, which of the following actions is most important for reinforcing the Democratic posture of the therapy setting? a. Allowing each person a specific and equal model time to talk b. Reviewing the groups rules of behavior limits that apply to all clients c. Reading the minutes from yesterday's meeting d. Waiting until all patients are present before initiating the meaning

abde

on a milieu unit, duties of the staff psychiatric nurse includes which of the following? Select all that apply a. medication administration b. client teaching c. medical diagnosis d. reality orientation e. relationship development f. group therapy

a

one of the goal for therapeutic communities for clients is to become more independent and accept self responsibility. Which of the following approaches by staff that encourages fulfillment of this goal? a.including client input and decisions into the treatment plan b. Insisting that each client take a turn as president of the community meeting c. Making decisions for the client regarding plans for treatment d. Require that clients be bathed, dressed, and attend breakfast on time each morning

abc

which of the following are basic assumption is a milieu therapy, select all that apply? a. The client owns his or her own environment b. Each client owns his or her behavior. c. Peer pressure is useful and powerful tool. d. inappropriate behaviors are punished immediately

1

A client is preparing to attend a Gamblers Anonymous meeting for the first time. The nurse should tell the client that which is the first step in this 12-step program? 1. Admitting to having a problem 2. Substituting other activities for gambling 3. Stating that the gambling will be stopped 4. Discontinuing relationships with people who gamble

2

A client who attempted suicide by hanging is brought to the emergency department by emergency medical services. Which is the immediate nursing action? 1. Take the client's vital signs. 2. Assess the client's respiratory status and for the presence of neck injuries. 3. Perform a focused assessment, paying particular attention to the client's neurological status. 4. Call the mental health crisis team and notify them that a client who attempted suicide is being admitted to the hospital.

1

A client who has attempted suicide by overdosing with a very large number of antidepressant pills has been admitted to the psychiatric unit. Which is the priority nursing action at this time? 1. Stay with the client at all times. 2. Request that a friend of the client remain with the client at all times. 3. Have the client put on a hospital gown, and remove the client's clothing from the room. 4. Suggest placing the client in a seclusion room where all potentially dangerous articles have been removed.

4

A client with a diagnosis of depression has been meeting with the mental health nurse for therapy sessions for the past 6 weeks. During the session the client says to the nurse, "I lost my job this week, and I'm going to be evicted from my apartment if I can't pay my bill. The only person that I have is my daughter, but I don't want to burden her with my problems." Which response by the nurse would be therapeutic? 1. "Why did you lose your job?" 2. "There are homeless shelters available, and we will get you into one if you are evicted from your apartment." 3. "If you get evicted from your apartment, we will commit you to the hospital, so you will have a place to eat and sleep." 4. "Let's talk about contacting your daughter. Wouldn't you want to know if your daughter was having difficulty and try to help her if you could?"

4

A client with a diagnosis of major depression who has attempted suicide says to the nurse, "I should have died. I've always been a failure. Nothing ever goes right for me." Which response demonstrates therapeutic communication? 1. "You have everything to live for." 2. "Why do you see yourself as a failure?" 3. "Feeling like this is all part of being depressed." 4. "You've been feeling like a failure for a while?"

2

A client with a history of anxiety appears to be in the second phase of crisis response. The nurse prepares for the possibility that which will occur? 1. The client will show the initial signs that coping methods are failing. 2. The client will employ new coping methods that will resolve the problem. 3. The client will experience severe anxiety as a result of failed coping methods. 4. The client will begin to implement coping methods that have been successful in the past.

1

A client with diabetes mellitus is told that amputation of the leg is necessary to sustain life. The client is very upset and tells the nurse, "This is all my health care provider's fault. I have done everything I've been asked to do!" Which nursing interpretation is best for this situation? 1. An expected coping mechanism 2. An ineffective coping mechanism 3. A need to notify the hospital lawyer 4. An expression of guilt on the part of the client

3

A female victim of a sexual assault is being seen in the crisis center. The client states that she still feels "as though the rape just happened yesterday," even though it has been a few months since the incident. What is the most appropriate nursing response? 1. "You need to try to be realistic. The rape did not just occur." 2. "It will take some time to get over these feelings about your rape." 3. "Tell me more about the incident that causes you to feel like the rape just occurred." 4. "What do you think that you can do to alleviate some of your fears about being raped again?"

4

A homebound client confidentially discusses suicidal plans with the visiting nurse. Based on professional duty to observe confidentiality, which statement bestdescribes the nurse's obligation to the client? 1. The nurse must have the client go to the local mental health center daily for counseling. 2. The nurse must ask the client not to reveal suicidal plans if the information needs to be kept confidential. 3. The nurse cannot tell anyone what the client said and must strictly adhere to the professional duty for confidentiality. 4. The nurse must override the duty to observe confidentiality and notify the client's health care provider (HCP) about the suicidal ideation.

3

A homeless shelter has sustained severe damage as a result of a fire, and most of the structure and people's belongings were destroyed. Ten of the individuals who are being displaced have a history of chronic mental illness. The mental health team coordinating support initially should focus their efforts on which action? 1. Assessing the clients' need for supportive therapy 2. Evaluating the clients for signs of stress overload 3. Providing the clients with shelter, clothing, and food 4. Planning means for the clients to receive their medications

3

A moderately depressed client who was hospitalized 2 days ago suddenly begins smiling and reporting that the crisis is over. The client says to the nurse, "I'm finally cured." How should the nurse interpret this behavior as a cue to modify the treatment plan? 1. Suggesting a reduction of medication 2. Allowing increased "in-room" activities 3. Increasing the level of suicide precautions 4. Allowing the client off-unit privileges as needed

c

A nurse is caring for several clients who are attending community-based mental health programs. Which of the following clients should the nurse plan to visit first? A.A client who recently burned her arm while using a hot iron at home B.A client who requests that her antipsychotic medication be changed due to some new side effects C.A client who says he is hearing a voice that tells him he is not worthy of living anymore D.A client who tells the nurse he experienced symptoms of severe anxiety before and during a job interview

b

A nurse is conducting a family therapy session. The adolescent son tells the nurse that he plans ways to make his sister look bad so his parents will think he is the better sibling, which he believes will give him more privileges. The nurse should identify this dysfunctional behavior as which of the following? A. Placation B. Manipulation C. Blaming D. Distraction

1

A nurse is having a conversation with a depressed client on an inpatient psychiatric unit. The client says to the nurse, "Things would be so much better for everyone if I just weren't around." Which appropriate response should the nurse make at this time? 1. "You sound very unhappy. Are you thinking of harming yourself?" 2. "Have you talked to anyone specifically about what is bothering you?" 3. "Those feelings will go away when your medication really takes effect." 4. "I know what you mean; everyone gets that way when they are depressed."

4

A nurse is helping to conduct a group therapy session. During the session, a client threatens to act out physically and states that he will punch another member of the group. Which is the appropriate initial nursing action? 1. Tell the client that he must leave immediately. 2. Call security to come to the session immediately. 3. Tell the client that if he hits another client, he will be restrained and placed in seclusion. 4. Tell the client that he can talk about his anger but cannot act on it in during the group session. 4

b

A nurse is in the working phase of a therapeutic relationship with a client who has methamphetamine use disorder. Which of the following indicates transference behavior? A. The client asks the nurse whether she will go out to dinner with him. B. The client accuses the nurse of telling him what to do just like his ex-girlfriend. C. The client reminds the nurse of a friend who died from substance overdose. D. The client becomes angry and threatens harm to himself.

4

A nurse is interviewing a client in crisis to assess the risk for self-harm. The nurse interprets that the client is most at risk for suicide if which is assessed? 1. Client exhibits impulsive behavior. 2. Client exhibits disorganized behavior. 3. Client has a history of suicide attempts. 4. Client has an immediate plan for a suicide attempt.

ade

A nurse is making a home visit to a client who has Alzheimer's disease to assess the home for safety. Which of the following are appropriate suggestions to decrease the client's risk for injury? SATA A. Install childproof door locks. B. Place rugs over electrical cords. C. Mark cleaning supplies with colored tape. D. Place the client's mattress on the floor. E. Install light fixtures above stairs.

c

A nurse is making a home visit to a client who is in the late stage of Alzheimer's disease. The client's spouse, who is the primary caregiver, wishes to discuss concerns about the client's nutrition and the stress of providing care. Which of the following is an appropriate action by the nurse? A. Verify that a current power of attorney document is on file. B. Instruct the client's spouse to offer finger foods to increase oral intake. C. Provide information on resources for respite care. D. Schedule the client for placement of an enteral feeding tube

bce

A nurse is performing an admission assessment for a client who has delirium related to an acute urinary tract infection. Which of the following are expected findings? (Select all that apply.) A. History of gradual memory loss B. Family report of personality changes C. Hallucinations D. Unaltered level of consciousness E. Restlessness

a

A nurse is planning care for the termination phase of a nurse-client relationship. Which of the following actions is appropriate to include in the plan of care? A. discussing ways to use new behaviors B. practicing new problem-solving skills C. developing goals D. establishing boundaries

bce

A nurse is planning group therapy for clients dealing with bereavement. Which of the following should the nurse include in the initial phase? (Select all that apply.) A. Encourage the group to work toward goals B. Define the purpose of the group C. Discuss termination of the group D. Identify informal roles of members within the group E. Establish an expectation of confidentiality within the group

1

A nurse is preparing for the arrival of a new client at a drug abusers' residential treatment center and prepares to explain to the client that the emphasis of the center is on group and social interaction, and that rules and expectations are mediated by peer pressure. Which is the most likely focus of therapy of this residential center? 1. Milieu therapy 2. Aversion conditioning 3. Systematic desensitization 4. Cognitive-behavioral therapy

2

A nurse is preparing to develop a care plan for a client admitted to the mental health unit with a diagnosis of obsessive-compulsive disorder (OCD). The nurse should plan to include which component as a priority in the nursing plan of care? 1. The medical diagnosis of the client 2. Individualized goals and objectives 3. Attendance at group therapy sessions 4. Self-care measures to improve hygiene

c

A nurse is talking with a client who is at risk for suicide following the death of his spouse. Which of the following statements by the nurse is appropriate? A. "I feel very sorry for the loneliness you must be experiencing." B. "Suicide is not the appropriate way to cope with loss." C. "Losing someone close to you must be very upsetting." D. "I know how difficult it is to lose a loved one."

abce

A nurse is working in a community mental health facility. Which of the following services are appropriate for clients to receive? (Select all that apply). A.Educational groups B.Medication dispensing programs C.Individual counseling programs D.Detoxification programs E.Crisis intervention

c

A nurse is working with an established group and identifies various members roles. Which of the following should a nurse identify as an individual role? A. A member who praises input from other members B. A member who follows the direction of other members C. A member who brags about accomplishments D. A member who evaluates the group's performance toward a standard

c

A nurse wants to use democratic leadership with a group whose purpose is to learn appropriate conflict resolution techniques. The nurse is correct in implementing this form of group leadership when she demonstrates which of the following actions? A. Observes group techniques without interfering with the group process B. Discusses a technique and then directs members to practice the technique C. Ask for group suggestions of techniques and then supports discussion D. Suggests techniques and asks group members to reflect on their use.

d

A nurse working on an acute mental health unit forms a group to focus on self-management of medications. At each of the meetings, two of the members use the opportunity to discuss their common interest in gambling on sports. This is an example of which of the following? A. Triangulation B. Group process C. Subgroup D. Hidden agenda

2

A nursing student is conducting a clinical conference and is describing the characteristics associated with milieu therapy. Which statement indicates an understanding of the focus of this form of therapy? 1. "Milieu therapy provides a cognitive approach to changing behavior." 2. "A living, learning, or working environment is the focus of milieu therapy." 3. "Milieu therapy provides a behavior modification approach type of therapy." 4. "A behavioral approach to changing behavior is the focus of milieu therapy."

3

A small rural community has experienced a hurricane that has destroyed 65% of the homes and businesses in the area. Community mental health teams recognize that in the immediate post-disaster period, the most effective means of identifying individuals experiencing difficulty coping psychologically with the disaster is to take which action? 1. Establish a centrally located mental health disaster center. 2. Ask for referrals from local health care providers and clergy. 3. Station mental health professionals at established assistance centers. 4. Distribute fliers identifying the availability of psychological counseling.

4

A woman who is a victim of family violence is now engaged in group therapy sessions. She begins yelling at another client during the therapy session and screams, "I can't listen to this. You people are no different from the ones at home." The client stands up and tips the chair over backward. What is the nurse's immediate action? 1. Inform the yelling client that she must leave the group. 2. Call security personnel to come to the group therapy session. 3. Explore the other client's responses to the woman's yelling behavior. 4. Firmly reinforce group rules to the woman, stating that aggressive yelling is not acceptable in the group.

d

Crises occur when an individual: a. Is exposed to a precipitating stressor. b. Perceives a stressor to be threatening. c. Has no support systems. d. Experiences a stressor and perceives coping strategies to be ineffective

1

During a support group session for battered women, a client says, "I was abused by my father and then my husband, so I finally stabbed my husband when he came after me, but no one on the jury believed me "cause my husband, the 'big shot,' can lie to anyone and be believed." If no one in the group responds, which statement is the therapeutic response by the nurse? 1. "A pretty horrible experience for you to undergo. Does anyone in the group want to respond?" 2. "Yes. Everyone here was ill-used and abused, but what makes you think that this is a reason to stab someone?" 3. "Your story is very much like every woman's here. I think you had other options besides violence, don't you?" 4. "Seems as if you went from one abusing man to another. Do you really think you're here because your husband is a good liar and a 'big shot'?"

d

Ginger, age 19 and an only child, left 3 months ago to attend a college of her choice 500 miles away from her parents. It is Ginger's first time away from home. She has difficulty making decisions and will not undertake anything new without first consulting her mother. They talk on the phone almost every day. Ginger has recently started having anxiety attacks. She consults the nurse practitioner in the student health center. This type of crisis is called: a. Crisis resulting from traumatic stress. b. Dispositional crisis. c. Psychiatric emergency. d. Maturational/developmental crisis.

a

J.J. is a staff nurse on a surgical unit. He has been selected as leader of a newly established group of staff nurses organized to determine ways to decrease the number of medication errors occurring on the unit. J.J. has definite ideas about how to bring this about. He has also applied for the position of Head Nurse on the unit and believes that, if he is successful in leading the group toward achievement of its goals, he can also facilitate his chances for promotion. At each meeting he addresses the group in an effort to convince the members to adopt his ideas. Which type of group and style of leadership is described in this situation? a. Task, autocratic. b. Teaching, autocratic. c. Self-help, democratic. d. Supportive/therapeutic, laissez-faire.

c

Jenny reported to the high school nurse that her mother drinks too much. She is drunk every afternoon when Jenny gets home from school. Jenny is afraid to invite friends over because of her mother's behavior. This type of crisis is called: a. Crisis resulting from traumatic stress. b. Maturational/developmental crisis. c. Dispositional crisis. d. Crisis reflecting psychopathology.

d

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

b

Marie, age 56, is the mother of five children. Her youngest child, who had been living at home and attending the local college, recently graduated and accepted a job in another state. Marie has never worked outside the home and has devoted her life to satisfying the needs of her husband and children. Since the departure of her last child from home, Marie has become more and more despondent. Her husband has become very concerned, and takes her to the local mental health center. This type of crisis is called: a. Dispositional crisis. b. Crisis of anticipated life transitions. c. Psychiatric emergency. d. Crisis resulting from traumatic stress.

b

Mr. Stone is a client in the hospital with a diagnosis of Vascular NCD. In explaining this disorder to Mr. Stone's family, which of the following by the nurse is correct? a. "He will probably live longer than if his disorder was of the Alzheimer's type." b." Vascular NCD shows step-wise progression. This is why he sometimes seems okay." c. Vascular NCD is caused by plaques and tangles that form in the brain." d. "The cause of vascular NCD is unknown."

b

Mrs. G has been diagnosed with NCD due to Alzheimer's disease. The primary nursing intervention in working with Mrs. G is which of the following? a. ensuring that she receives food she likes, to prevent hunger b. ensuring that the environment is safe, to prevent injury c. ensuring that she meets the other patients, to prevent social isolation d. ensuring that she takes care of her own ADLs, to prevent dependence

b

Mrs. G, who has NCD due to Alzheimer's Disease, says to the nurse, "I have a date tonight. I always have a date on Christmas." Which of the following is the most appropriate response? a. "Don't be silly. It's not Christmas Mrs. G" b. "Today is Tuesday, Oct. 21, Mrs. G. We will have supper soon and then your daughter will come to visit" c. "Who is your date, Mrs. G?" d. "I think you need some more medication, Mr.s G. I'll bring it to you now."

abcd

S.T. is a 15-year-old girl who has just been admitted to the adolescent psychiatric unit with a diagnosis of anorexia nervosa. She is 55 tall and weighs 82 lb. She was elected to the cheerleading squad for the fall but states that she is not as good as the others on the squad. The treatment team has identified the following problems: refusal to eat, occasional purging, refusing to interact with staff and peers, and fear of failure. Which of the following nursing diagnoses would be appropriate for S.T.? (Select all that apply.) a. Social Isolation. b. Disturbed Body Image. c. Low Self-Esteem. d. Imbalanced Nutrition: Less than body requirements.

d

S.T. is a 15-year-old girl who has just been admitted to the adolescent psychiatric unit with a diagnosis of anorexia nervosa. She is 55 tall and weighs 82 lb. She was elected to the cheerleading squad for the fall but states that she is not as good as the others on the squad. The treatment team has identified the following problems: refusal to eat, occasional purging, refusing to interact with staff and peers, and fear of failure. Which of the following nursing diagnoses would be the priority diagnosis for S.T.? a. Social Isolation. b. Disturbed Body Image. c. Low Self-Esteem. d. Imbalanced Nutrition: Less than body requirements.

2

The home health nurse visits a client at home and determines that the client is dependent on drugs. During the assessment, which action should the nurse take to plan appropriate nursing care? 1. Ask the client why he started taking illegal drugs. 2. Ask the client about the amount of drug use and its effect. 3. Ask the client how long he thought that he could take drugs without someone finding out. 4. Not ask any questions for fear that the client is in denial and will throw the nurse out of the home.

4

The mental health nurse is caring for a client with a social phobia. The nurse tells the client that a music therapy session has been scheduled as part of the treatment plan. The client tells the nurse that she cannot sing and refuses to attend. What is the appropriate nursing response? 1. "You must go. You have no choice." 2. "Why don't you want to attend? What is the real reason?" 3. "The health care provider has prescribed this therapy for you." 4. "You don't have to sing at the session. You can listen and enjoy the music."

2

The mental health nurse is conducting a group therapy session and is monitoring a client with a diagnosis of agoraphobia who has been attending the sessions for several months. The nurse notes that the client is cooperative, sharing with peers, and making appropriate suggestions during group discussions. How should the nurse interpret this behavior? 1. Manipulation 2. Improvement 3. Attention seeking 4. Desire to be accepted

b

The most appropriate nursing intervention with Ginger (from question 7) would be to: a. Suggest she move to a college closer to home. b. Work with Ginger on unresolved dependency issues. c. Help her find someone in the college town from whom she could seek assistance rather than calling her mother regularly. d. Recommend that the college physician prescribe an antianxiety medication for Ginger.

a

The most appropriate nursing intervention with Jenny (from question 5) would be to: a. Make arrangements for her to start attending Alateen meetings. b. Help her identify the positive things in her life and recognize that her situation could be a lot worse than it is. c. Teach her about the effects of alcohol on the body and that it can be hereditary. d. Refer her to a psychiatrist for private therapy to learn to deal with her home situation.

d

The most appropriate nursing intervention with Marie (from question 9) would be to: a. Refer her to her family physician for a complete physical examination. b. Suggest she seek outside employment now that her children have left home. c. Identify convenient support systems for times when she is feeling particularly despondent. d. Begin grief work and assist her to recognize areas of self-worth separate and apart from her children.

c

The night nurse finds Mr.s G, a client with Alzheimer's, wandering the hallway at 4 am and trying to open the door to the side yard. Which statement by the nurse probably reflects the most accurate assessment of the situation? a. "That door leads out to the patio, Mrs. G. It's nighttime. You don't want to go outside now." b. "You look confused, Mrs. G. What is bothering you?" c. "This is the patio door, Mrs. G. Are you looking for the bathroom?" d. "Are you lonely? Perhaps you'd like to go back to your room and talk for a while"

1

The nurse determines that the wife of an alcoholic client is benefiting from attending an Al-Anon group if the nurse hears the wife make which statement? 1. "I no longer feel that I deserve the beatings my husband inflicts on me." 2. "My attendance at the meetings has helped me to see that I provoke my husband's violence." 3. "I enjoy attending the meetings because they get me out of the house and away from my husband." 4. "I can tolerate my husband's destructive behaviors now that I know they are common with alcoholics."

3

The nurse employed in a mental health unit of a hospital is the leader of a group psychotherapy session. What is the nurse's role during the termination stage of group development? 1. Acknowledging that the group has identified goals 2. Encouraging the accomplishment of the group's work 3. Acknowledging the contributions of each group member 4. Encouraging members to become acquainted with one another

a

The nurse identifies the primary nursing diagnosis for Theresa as Risk for Suicide related to feelings of hopelessness from loss of relationship. Which is the outcome criterion that would most accurately measure achievement of this diagnosis? a. The client has experienced no physical harm to herself. b. The client sets realistic goals for herself. c. The client expresses some optimism and hope for the future. d. The client has reached a stage of acceptance in the loss of the relationship with her boyfriend.

4

The nurse in a mental health clinic is reviewing the records of the clients to be seen that day. The nurse determines that which client is at highest risk for suicide? 1. An African-American male lawyer who is 47 years old and recently divorced 2. A 25-year-old housewife who is married to a widower and has one 2-year-old son and a 3-year-old stepdaughter 3. A single parent who failed the general equivalency diploma examination and whose six children are on scholarship in graduate and medical schools 4. An 18-year-old alcohol- and drug-abusing youth who must tell his parents that he failed to pass an examination required for graduation from high school

1

The nurse is caring for a client who is at risk for suicide. What is the priority nursing action for this client? 1. Provide authority, action, and participation. 2. Display an attitude of detachment, confrontation, and efficiency. 3. Demonstrate confidence in the client's ability to deal with stressors. 4. Provide hope and reassurance that the problems will resolve themselves.

1

The nurse is developing a discharge plan for the family of a client diagnosed with a mood disorder. The nurse should plan to include which priority information to the family? 1. Signs that the client may be considering suicide 2. Brain anomalies that are responsible for this disorder 3. The importance benzodiazepines play in the management of this disorder 4. The possibility that the client will experience medication-induced tinnitus

4

The nurse is developing a plan of care for a client in a crisis state. When developing the plan, the nurse should consider which factor? 1. A crisis state indicates that the client has a mental illness. 2. A crisis state indicates that the client has an emotional illness. 3. Presenting symptoms in a crisis situation are similar for all clients experiencing a crisis. 4. A client's response to a crisis is individualized and what constitutes a crisis for one client may not constitute a crisis for another client.

2

The nurse is planning to formulate a psychotherapy group. Several clients are interested in attending the session. The nurse plans the group, knowing that which is the maximum number of group members that can be included? 1. 3 2. 8 3. 14 4. 16

4

The nurse is preparing a client with a history of command hallucinations for discharge by providing instructions on interventions for managing hallucinations and anxiety. Which statement in response to these instructions suggests to the nurse that the client understands the instructions? 1. "My medications aren't likely to make me anxious." 2. "I'll go to support group and talk so that I don't hurt anyone." 3. "It's not likely that I'll get anxious or hear things if I get enough sleep and eat well." 4. "When I begin to hallucinate, I'll call my therapist and talk about what I should do."

2

The nurse is reviewing the assessment data of a client admitted to the mental health unit. The nurse notes that the admission nurse documented that the client is experiencing anxiety as a result of a situational crisis. The nurse determines that this type of crisis could be caused by which event? 1. Witnessing a murder 2. The death of a loved one 3. A fire that destroyed the client's home 4. A recent rape episode experienced by the client

b

The nurse is using the nursing process to care for a suicidal client. Which of the following nursing actions is a part of the assessment step of the nursing process? a. Identifies nursing diagnosis: Risk for suicide. b. Notes client's family reports recent suicide attempt. c. Prioritizes the necessity for maintaining a safe environment for the client. d. Obtains a short-term contract from the client to seek out staff if feeling suicidal.

a

The nurse is using the nursing process to care for a suicidal client. Which of the following nursing actions is a part of the diagnosis step of the nursing process? a. Identifies nursing diagnosis: Risk for suicide. b. Notes client's family reports recent suicide attempt. c. Prioritizes the necessity for maintaining a safe environment for the client. d. Obtains a short-term contract from the client to seek out staff if feeling suicidal.

c

The nurse is using the nursing process to care for a suicidal client. Which of the following nursing actions is a part of the implementation step of the nursing process? a. Prioritizes the necessity for maintaining a safe environment for the client. b. Determines if nursing interventions have been appropriate to achieve desired results. c. Obtains a short-term contract from the client to seek out staff if feeling suicidal. d. Establishes goal of care: Client will not harm self during hospitalization.

d

The nurse is using the nursing process to care for a suicidal client. Which of the following nursing actions is a part of the outcome identification step of the nursing process? a. Prioritizes the necessity for maintaining a safe environment for the client. b. Determines if nursing interventions have been appropriate to achieve desired results. c. Obtains a short-term contract from the client to seek out staff if feeling suicidal. d. Establishes goal of care: Client will not harm self during hospitalization.

a

The nurse is using the nursing process to care for a suicidal client. Which of the following nursing actions is a part of the planning step of the nursing process? a. Prioritizes the necessity for maintaining a safe environment for the client. b. Determines if nursing interventions have been appropriate to achieve desired results. c. Obtains a short-term contract from the client to seek out staff if feeling suicidal. d. Establishes goal of care: Client will not harm self during hospitalization.

c

The nurse leader is explaining about group "curative factors" to members of the group. She tells the group that group situations are beneficial because members can see that they are not alone in their experiences. This is an example of which curative factor? a. Altruism. b. Imitative behavior. c. Universality. d. Imparting of information.

1

The nurse observes that a client is pacing, agitated, and presenting aggressive gestures. The client's speech pattern is rapid, and affect is belligerent. Based on these observations, what is the nurse's immediate priority of care? 1. Provide safety for the client and other clients on the unit. 2. Provide the clients on the unit with a sense of comfort and safety. 3. Assist the staff in caring for the client in a controlled environment. 4. Offer the client a less stimulating area to calm down in and gain control.

3

The nurse observes that a client with a potential for violence is agitated, pacing up and down the hallway, and is making aggressive and belligerent gestures at other clients. Which statement would be most appropriate to make to this client? 1. "You need to stop that behavior now." 2. "You will need to be placed in seclusion." 3. "You seem restless; tell me what is happening." 4. "You will need to be restrained if you do not change your behavior."

4

The nursing care plan indicates a problem of self-directed violence and the risk for suicide,related to suicidal ideations with a plan. An expected outcome of this plan of care would be that the client does which? 1. Displays less anxiety and agitation 2. Establishes a relationship with staff and peers 3. Develops adequate coping and problem-solving skills 4. Denies suicidal ideation and identifies options to deal with stressors

c

Theresa, age 27, was admitted to the psychiatric unit from the medical intensive care unit, where she was treated for taking a deliberate overdose of her antidepressant medication, trazodone (Desyrel). She says to the nurse, "My boyfriend broke up with me. We had been together for 6 years. I love him so much. I know I'll never get over him." Which is the best response by the nurse? a. "You'll get over him in time, Theresa." b. "Forget him. There are other fish in the sea." c. "You must be feeling very sad about your loss." d. "Why do you think he broke up with you, Theresa?"

b

Theresa, who has been hospitalized following a suicide attempt, is placed on suicide precautions on the psychiatric unit. She admits that she is still feeling suicidal. Which of the following interventions is most appropriate in this instance? a. Obtain an order from the physician to place Theresa in restraints to prevent any attempts to harm herself. b. Check on Theresa every 15 minutes or assign a staff person to stay with her on a one-to-one basis. c. Obtain an order from the physician to give Theresa a sedative to calm her and reduce suicide ideas. d. Do not allow Theresa to participate in any unit activities while she is on suicide precautions.

16

Which are characteristics of the termination stage of group development? Select all that apply. 1. The group evaluates the experience. 2. The real work of the group is accomplished. 3. Group interaction involves superficial conversation. 4. Group members become acquainted with each other. 5. Some structuring of group norms, roles, and responsibilities takes place. 6. The group explores members' feelings about the group and the impending separation.

1

Which behavior observed by the nurse indicates a suspicion that a depressed adolescent client may be suicidal? 1. The adolescent gives away a DVD and a cherished autographed picture of a performer. 2. The adolescent runs out of the therapy group, swearing at the group leader, and runs to her room. 3. The adolescent becomes angry while speaking on the telephone and slams down the receiver. 4. The adolescent gets angry with her roommate when the roommate borrows the client's clothes without asking.

1

Which best describes the purpose of behavioral therapy? 1. Fosters positive behavioral change 2. Develops structure and organizes time 3. Creates insight into maladaptive behavior 4. Decreases stress through relaxation training

1

Which client is most at risk for committing suicide? 1. A 75-year-old client with metastatic cancer 2. A 71-year-old client with a cardiac disorder 3. A 24-year-old client who just had an argument with her roommate 4. A 30-year-old newly divorced client who states she has custody of the children

1

Which mental health professional is responsible for the milieu in an inpatient psychiatric setting? 1. Nurse 2. Psychiatrist 3. Psychologist 4. Social worker

acd

Which of the following describe advantages to electronic health records (EHRs)? (Select all that apply.) a. They reduce redundancy of information. b. They reduce issues regarding privacy. c. They decrease charting time. d. They facilitate communication between disciplines.

b

Which of the following individuals is at highest risk for suicide? a. Nancy, age 33, Asian American, Catholic, middle socioeconomic group, alcoholic. b. John, age 72, white, Methodist, low socioeconomic group, diagnosis of metastatic cancer of the pancreas. c. Carol, age 15, African American, Baptist, high socioeconomic group, no physical or mental health problems. d. Mike, age 55, Jewish, middle socioeconomic group, suffered myocardial infarction a year ago.

abc

Which of the following interventions are appropriate for a client on suicide precautions? (Select all that apply.) a. Remove all sharp objects, belts, and other potentially dangerous articles from the client's environment. b. Accompany the client to off-unit activities. c. Obtain a promise from the client that she will not do anything to harm herself for the next 12 hours. d. Put all of the client's possessions in storage and explain to her that she may have them back when she is off suicide precautions.

ce

Which of the following interventions is most appropriate in helping a client with Alzheimer's Disease with her ADLs? Select all that apply. a. Perform ADLs for her while she is in the hospital b. Provide her with a written list of activities she is expected to perform c. Assist her with step by step instructions d. tell her that if her morning care is not completed by 9 AM, it will be performed for her by the nurse's aide so that she can attend group therapy e. encourage her and give her plenty of time to perform as many of her ADLs as possible independently

c

Which of the following is a correct assumption regarding the concept of crisis? a. Crises occur only in individuals with psychopathology. b. The stressful event that precipitates crisis is seldom identifiable. c. A crisis situation contains the potential for psychological growth or deterioration. d. Crises are chronic situations that recur many times during an individual's life.

3

Which statement, if made by a client who has recently experienced an emotional crisis, ismost likely to assure the nurse that she has returned to her pre-crisis level of functioning? 1. "My husband tells me that I'm back to my old cheerful self." 2. "When I find myself getting stressed, I immediately use the relaxation techniques I've learned." 3. "My boss tells me that I'm being considered for a promotion and a raise." 4. "I have a different perspective on life now. I'm more confident of my ability to handle any problem."

4

While being treated, a client is introduced to short periods of exposure to the phobic object while in a relaxed state. What term is used to describe this form of behavior modification? 1. Milieu therapy 2. Aversion therapy 3. Self-control therapy 4. Systematic desensitization

c

which of the following activities will be a responsibility of the clinical psychologist member of the IDT a.locate halfway house and arranges living conditions for client being discharged from the hospital b. Manages the therapeutic milieu on the 24-hour basis c. Administers and evaluate psychological test that assist in diagnosis d. Conducts psychotherapy and administers electroconvulsive therapy treatments

b

which of the following activities will be a responsibility of the psychiatric clinical nurse specialist? a. manages the therapeutic milieu on 24-hour basis b. conducts group therapies and provides consultation and education to staff nurses c. directs a group of clients in acting out a situation that is otherwise too painful for client to discuss openly d.locates a halfway house and arranges living conditions for client being discharge from the hospital