Psy. Chp. 14,15,16,17
The nurse is preparing for outpatient placement of the client with OCD. Which of the following treatment modalities is most effective for OCD? A) Behavioral techniques B) Medication C) Behavioral techniques and medication D) Ignoring it
c
The student nurse correctly identifies that which of the following are characteristics of hoarding disorder? Select all that apply. A) Excessive acquisition of animals or apparently useless things B) Cluttered living spaces that become uninhabitable C) Significant distress or impairment for the individual D) Obsessive cleaning of environment E) Disposing of articles that are of no value
a b c
Which of the following are cognitive-behavioral therapy techniques that may be used effectively with anxious clients? Select all that apply. A) Positive reframing B) Decatastrophizing C) Assertiveness training D) Humor E) Unlearning
a b c
Which of the following statements about the assessment of persons with anxiety and anxiety disorders is most accurate? A) When an elder person has an onset of anxiety for the first time in his or her life, it is possible that the anxiety is associated with another condition. B) Panic attacks are the most common late-life anxiety disorders. C) An elder person with anxiety may be experiencing ruminative thoughts. D) Agoraphobia that occurs in late life
a
Which of the following theories about anxiety is based upon intrapsychic theories? A) A person's innate anxiety is the stimulus for behavior. B) Anxiety is generated from problems in interpersonal relationships. C) A nurse can help the client to achieve health by attending to interpersonal and physiologic needs. D) Anxiety is learned through experiences.
a
The nurse correctly identifies that which of a client with OCD's self-soothing behaviors may involve self-destruction of the body? Select all that apply. A) Dermatillomania B) Trichotillomania C) Onychophagia D) Kleptomania E) Oniomania
a b c
A client experiences panic attacks when confronted with riding in elevators. The therapist is teaching the client ways to relax while incrementally exposing the client to getting on an elevator. This technique is called which of the following? A) systematic desensitization B) flooding C) cognitive restructuring D) combination therapy
a
A client is learning to cope with anxiety and stress. The expected outcome is that the client will... A) change reactions to stressors. B) ignore situations that cause stress. C) limit major stressors in his or her life. D) avoid anxiety at all costs.
a
A client states, "I will just die if I don't get this job." The nurse then asks the client, "What will be the worst that will happen if you don't get the job?" The nurse is using this response to... A) appraise his situation more realistically. B) assist the client to make alternative plans for the future. C) assess if the client has health problems compounded by stress. D) clarify the client's meaning.
a
A client who has suspicion has been placed in a room with a roommate. The night nurse assesses the situation and reports that this client has been awake for the past three nights. The likely explanation for his wakefulness is which of the following? A) He is fearful of what his roommate might do to him while he sleeps. B) He is a light sleeper and unaccustomed to a roommate. C) He is watching for an opportunity to escape. D) He is worrying about his family problems.
a
A client with schizophrenia reads the advice column in the newspaper daily. When asked why the client is so interested in the advice column, the client replies, "This person is my guide and tells me what I must do every day." The nurse would best describe this type of thinking as which of the following? A) Referential delusion B) Grandiose delusion C) Thought insertion D) Personalization
a
A college freshman is admitted to the hospital with a diagnosis of schizophrenia. Friends reported that she had been in her room for 2 days in a trance-like state, not eating nor speaking to anyone. Which of the following is the highest priority for this client? A) Assessing fluid intake and output B) Completing an assessment of mental status C) Obtaining more data about her college experiences D) Providing for adequate rest
a
All of the following are included in the plan of care for a client with schizophrenia. Which nursing intervention should the nurse perform first when caring for this client? A) Observe for signs of fear or agitation. B) Maintain reality through frequent contact. C) Encourage client to participate in the treatment milieu. D) Assess community support systems.
a
One evening, a client with schizophrenia leaves his room and begins marching in the hall. When approached by the nurse, the client says, "God says I'm supposed to guard the area." Which of the following responses would be best? A) "I understand you hear a voice. You and I are the only ones in the hall, and I don't hear a voice." B) "The voices are part of your illness, and they will leave in time." C) "This guarding responsibility can make you tired. You rest for now, and I'll guard a while." D) "You are just imagining these things. Do not pay any attention to the voices."
a
The client and nurse have interacted for several months. Which of the following is the most important variable in determining the likelihood of success in improving life for a client with OCD? A) The client must be willing to make changes in his or her behavior. B) The client must acknowledge that the behavior is not in his or her control. C) The client must allow the nurse to decide the appropriate intervention for him or her. D) The client must be willing to try all new relaxation techniques.
a
The client with schizophrenia tells the nurse that rats have started to eat his brain. The best response by the nurse would be... A) 'Have you discussed this with your physician?" B) "How could that be possible?" C) "You cannot have rats in your brain." D) "You look OK to me."
a
The nurse is working with a young client with anxiety. Which of the following best explains the etiology of anxiety disorders from an interpersonal perspective? A) Anxiety is learned in childhood through interactions with caregivers. B) Anxiety is learned throughout life as a response to life experiences. C) Anxiety stems from an unconscious attempt to control awareness. D) Anxiety results from conforming to the norms of a cultural group.
a
The nurse observes a client with schizophrenia sitting alone, laughing occasionally, and turning his head as if listening to another person. The nurse assesses this behavior to indicate that the client is experiencing auditory hallucinations and says... A) "Are you hearing something?" B) "It's a beautiful day, isn't it?" C) "Would you like to go to your room to talk?" D) "Would you like to take some of your PRN medication?"
a
When teaching a client with generalized anxiety disorder, which is the highest priority for the nurse to teach the client to avoid? A) Caffeine B) High-fat foods C) Refined sugars D) Sodium
a
Which of the following interventions by the nurse will increase the client's sense of security? A) Allowing the client to perform the rituals B) Distracting the client from rituals with other activities C) Encouraging the client to talk about the purpose of the rituals D) Stopping the client from performing the rituals
a
Which of the following are important for the nurse to remember when teaching relaxation and behavioral techniques to a client with OCD? Select all that apply. A) It is important to teach the client to use relaxation techniques when the client's anxiety is low. B) The nurse may teach the client about relaxation techniques when the client is experiencing anxiety. C) The client must be willing to engage in exposure and response prevention. D) The client must be forced to use relaxation techniques. E) It is unnecessary to assess the baseline of ritualistic behaviors in the client with OCD.
a b c
Which of the following questions would best help the nurse to evaluate the effectiveness of antipsychotic medications for a client who has schizophrenia? Select all that apply. A) Have the symptoms you were experiencing disappeared? B) If the symptoms have not disappeared, are you able to carry out your daily life despite the persistence of some psychotic symptoms? C) Are you committed to taking the medication as prescribed? D) Are you satisfied with your quality of life? E) Do you have access to community agencies that will help you to live successfully in this community?
a b c d
1. The nurse knows that which of the following are stages in Selye's general adaptation syndrome? Select all that apply. A) Alarm reaction stage B) Resistance stage C) Coping stage D) Exhaustion stage E) Panic Stage
a b d
A person suffering from schizophrenia has little emotional expression when interacting with others. The nurse would document the client's affect as which of the following? Select all that apply. A) Flat B) Blunt C) Bright D) Inappropriate E) Pleasant
a b d
The nurse is teaching on the effects of antipsychotic medications to the client and family. Which of the following disorders are extrapyramidal symptoms that may be caused by antipsychotic drugs? Select all that apply. A) Akathisia B) Pseudoparkinsonism C) Neuroleptic malignant syndrome D) Dystonia E) Anticholinergic effects F) Breast tenderness in men and women
a b d
The nursing student correctly identifies that which of the following statements is true of the etiology of OCD? Select all that apply. A) The cognitive model for OCD etiology focuses on childhood and environmental experiences of growing up. B) The etiology of OCD is not definitively explained at this time. C) OCD is caused by immune dysfunction. D) The primary etiology of OCD is genetics. E) Cognitive models may partially explain why people develop OCD.
a b e
Which of the following are reasons that the nurse must understand why and how anxiety behaviors work? Select all that apply. A) To provide better care for the client B) To help understand the role anxiety plays in performing nursing responsibilities C) To help the nurse to mask his or her own feelings of anxiety D) So the nurse can identify that his or her own needs are more important than the clients E) To help nurses to function at a high level
a b e
he nurse is educating a client and family about managing panic attacks after discharge from treatment. The nurse includes which of the following in the discharge teaching? Select all that apply. A) Continued development of positive coping skills B) Weaning off of medications as necessary C) Lessening the amount of daily responsibilities D) Continued practice of relaxation techniques E) Development of a regular exercise program
a b e
Which techniques would be most effective for a client who has situational phobias? Select all that apply. A) Flooding B) Reminding the person to calm down C) Systematic desensitization D) Assertiveness training E) Decatastrophizing
a c
Which of the following statements about the use of defense mechanisms in persons with anxiety disorders is accurate? Select all that apply. A) Defense mechanisms are a human's attempt to reduce anxiety. B) Persons are usually aware when they are using defense mechanisms. C) Defense mechanisms can be harmful when overused. D) Defense mechanisms are cognitive distortions. E) The use of defense mechanisms should be avoided. F) Defense mechanisms can control the awareness of anxiety.
a c d f
A client with schizophrenia has returned to the clinic because of an increase in symptoms. The client reports he stopped taking his medication because he did not like the side effects. The nurse educates the client about managing uncomfortable side effects. Which of the following is included in the teaching plan? Select all that apply. A) Suck on hard candy as desired B) Spend at least 30 minutes outside in the sun daily C) Use stool softeners as needed D) Decrease the amount of daily fluid intake E) Maintain a balanced calorie-controlled diet
a c e
When performing discharge planning for a client who has schizophrenia, the nurse anticipates barriers to adhering to the medication regimen. The nurse assesses which of the following as improving the likelihood that the client will follow the prescribed medication regimen? Select all that apply. A) Short-term memory intact B) History of missing appointments C) Receives monthly disability checks D) Walking is primary mode of transportation E) States location of pharmacy nearest his residence
a c e
When a client is experiencing a panic attack while in the recreation room, what interventions are the nurse's first priorities when considering the client's safety? Select all that apply. A) Remain with the client to assess needs B) Request a prescription for an antianxiety agent. C) Offer the client therapy to calm down D) Turn off any televisions or radios in the immediate area E) Engage the client in recreational activities.
a d
The nurse is assessing for negative symptoms of schizophrenia in a newly admitted client. The nurse would note which behavior as indicative of a negative symptom? A) Difficulty staying on subject when responding to assessment questions B) Belief of owning a transportation device allowing for travel to the center of the Earth C) Hesitant to answer the nurse's questions during the assessment interview D) Mimicking the postural changes made by the nurse during the assessment interview
c
A client who suffers from frequent panic attacks describes the attack as feeling disconnected from himself. The nurse notes in the client's chart that the client reports experiencing... A) hallucinations B) depersonalization C) derealization D) denial
b
A client with schizophrenia is seen sitting alone and talking out loud. Suddenly, the client stops and turns as if listening to someone. The nurse approaches and sits down beside the client. Which of the following is the best initial response by the nurse? A) "You must be pretty bored to be sitting here talking to an invisible person." B) "I don't hear or see anyone else; what are you hearing and seeing?" C) "I can tell you are hearing voices, but they are not real." D) "How long have you known the person you are talking to?"
b
A nurse is caring for a client who has been diagnosed with OCD. The nurse is preparing a plan of care. Which is a safety priority for the nurse to observe? A) antisocial behaviors and demeanor B) eating, drinking, and elimination C) demeanor with other clients D) daily routines and habits
b
A nurse is visiting an elderly client at home. The client has been seen hoarding, and the smell is offensive when the nurse comes to visit. Which is an indicator of hoarding? A) a collection of magazines scattered in the living room B) a single path throughout the yard and house C) an untidy house and yard D) a complaint from the neighbors about the ca
b
A nurse is working with a client to develop assertive communication skills. The nurse documents achievement of treatment outcomes when the client makes a statement such as which of the following? A) "I'm sorry. I'm not picking this up very quickly." B) "I feel upset when you interrupt me." C) "You are pushing me too hard." D) "I'm not going to listen to other people anymore."
b
A nurse is working with the family of a client with obsessive-compulsive disorder (OCD). Which concept should the nurse incorporate in the teaching plan? A) The thoughts, images, and impulses are voluntary. B) The thoughts, images, and impulses tend to worsen with stress. C) The family should pay immediate attention to symptoms. D) OCD is a chronic disorder that does not respond to treatment.
b
A student is preparing to give a class presentation. A few minutes before the presentation is to begin, the student seems nervous and distracted. The student is looking at, and listening to, the peer speaker and occasionally looking at note cards. When the peer speaker asks a question of the group, the student is able to answer correctly in a high pitched voice. The professor understands that the student is likely experiencing which level of anxiety? A) Mild B) Moderate C) Severe D) Panic
b
Before eating a meal, a client with obsessive-compulsive disorder must wash her hands for 14 minutes, comb her hair for 114 strokes, and switch the light off and on 44 times. When evaluating the progress of the client, what is the most important objective for this client? A) Allow ample time for completion of all rituals before each meal. B) Gradually decrease the amount of time spent for performing rituals. C) Increase the client's acceptance of the need for medication to control rituals. D) Omit one ritualistic behavior every 4 days until all rituals are eliminated.
b
During the nursing assessment, a client describes constantly hearing voices mumbling in the background. The client denies that the voices are telling him to do anything harmful. The nurse documents that the client is experiencing which of the following? A) Command hallucinations B) Auditory hallucinations C) Olfactory hallucinations D) Gustatory hallucinations
b
The client was conversing with the nurse when noticeable changes occurred with the client. Which of the following is a term used to describe the occurrence of the eye rolling back in a locked position, which occurs with acute dystonia? A) Opisthotonus B) Oculogyric crisis C) Torticollis D) Pseudoparkinsonism
b
The client with schizophrenia believes the student nurses are there to spy on the clients. The client is suffering from which of the following symptoms? A) Hallucinations B) Delusions C) Anhedonia D) Ideas of reference
b
The nurse is preparing a client with schizophrenia for discharge. The nurse asks the client, "How are you going to care for yourself at home?" The purpose of the nurse's question is to assess the client's... A) self concept. B) judgment. C) insight. D) social support system.
c
The nurse enters the room of a client with schizophrenia the day after he has been admitted to an inpatient setting and says, "I would like to spend some time talking with you." The client stares straight ahead and remains silent. The best response by the nurse would be... A) "I can see you want to be alone. I'll come back another time." B) "You don't need to talk right now. I'll just sit here for a few minutes." C) "I've got some other things I can do now. I hope you'll feel like talking later." D) "You would feel better if you would tell me what you're thinking."
b
The nurse has a student with her today and is teaching assessment skills. The student nurse correctly identifies that which one of the following statements is true regarding clients with OCD? A) Since the client is aware that his or her behavior is bizarre, the client should just stop the behavior. B) Clients with OCD seem normal on the outside but suffer from overwhelming fear and anxiety. C) Once a person is successfully treated for OCD, he or she has been cured. D) Persons with OCD must avoid stress.
b
The nurse is aware that a person who repeatedly seeks cosmetic surgery to correct a perceived flaw in his or her appearance may have which of the following disorders? A) Hoarding disorder B) Body dysmorphic disorder C) Pyromania D) Body identity integrity disorder
b
The nurse is caring for clients in the out-patient unit. Which of the following would be key points for the nurse to remember when working with persons who are suffering from anxiety disorders? A) It is important for the nurse to "fix" the client's problems. B) Remember to practice techniques to manage stress and anxiety in your own life. C) If you have any uncomfortable feelings, do not tell anyone about them. D) Remember that only people who suffer from anxiety disorders have stress that can interfere with daily life and work.
b
The nurse is working with a client who has schizophrenia, disorganized type. It is time for the client to get up and eat breakfast. Which of the following statements by the nurse would be most effective in helping the client prepare for breakfast? A) "I'll expect you in the dining room in 20 minutes." B) "It's time to put your dress on now." C) "Stay right there and I'll get your clothes for you." D) "Why don't you stay here and I'll get your tray for you."
b
The nursing student answers the test item correctly when identifying which of the following statements as true? A) Anxiety and fear are the same. B) Anxiety cannot be completely eliminated from life. C) Anxiety is always harmful. D) Fear is feeling threatened by an unknown entity.
b
The nursing student understands correctly when identifying which objective is appropriate for all clients with anxiety disorders? A) The client will experience reduced anxiety and accept the fact that underlying conflicts cannot be treated. B) The client will experience reduced anxiety and develop alternative responses to anxiety-provoking situations. C) The client will experience reduced anxiety and learn to control primitive impulses. D) The client will experience reduced anxiety and strive for insight through psychoanalysis.
b
The student nurse correctly identifies that which one of the following statements applies to the parasympathetic nervous system? A) It is activated during the alarm reaction stage. B) It is activated at the end of the resistance stage. C) It is activated during the exhaustion stage. D) It is commonly referred to as the fight, flight, or freeze response.
b
Which of the following is an important part of therapeutic communication for clients who have OCD? A) To encourage the client to keep the obsession secret. B) To encourage the client to discuss his or her obsession with the nurse. C) The nurse must have the same obsession as the client. D) The nurse must instruct the client to discuss the obsession.
b
Which of the following is essential for the nurse to communicate to the client with OCD and to the client's family? A) The client's diagnosis should be kept secret from everyone outside the immediate family and friends. B) The importance of medication compliance and that it may be necessary for medication to be changed to find the one that works best. C) It is important for the client to avoid following a routine. D) It is helpful for others to give unsolicited advice about other activities the client with OCD can engage in.
b
Which of the following statements about the typical history of illness is consistent with OCD? A) OCD usually requires hospitalization. B) OCD treatment is usually outpatient. C) OCD only affects the client's ability to perform ADLs and work, not his or her leisure life. D) Most people seek treatment as soon as they observe the symptoms.
b
Which one of the following types of antipsychotic medications is most likely to produce extrapyramidal effects? A) Atypical antipsychotic drugs B) First-generation antipsychotic drugs C) Third-generation antipsychotic drugs D) Dopamine system stabilizers
b
The nurse is working with several clients with anxiety disorders. Which of the following are interpersonal theories regarding the etiologies of major anxiety disorders? Select all that apply. A) Sigmund Freud's theory B) Henry Stack Sullivan's theory C) Hildegard Peplau's theory D) Pavlov's theory
b c
The parents of a young adult male who has schizophrenia ask how they can recognize when their son is beginning to relapse. The nurse teaches the family to look for which of the following? Select all that apply. A) Excessive sleeping B) Fatigue C) Irritability D) Increased inhibition E)
b c d
Which of the following are central components of a psychiatric rehabilitation and recovery program? Select all that apply. A) Working with clients to have an improved quality of life according to society's point of view B) Working with clients to manage their own lives C) Working with clients to make effective treatment decisions D) Working with clients to have an improved quality of life according to his or her point of view. E) Working with clients to diagnose their problem early
b c d
The nurse reviews current literature and identifies that which of the following are included in current studies of biologic theories regarding the etiology of schizophrenia? Select all that apply. A) That there is a particular pathologic structure associated with the disease. B) That genetics is the cause of schizophrenia. C) Persons with schizophrenia have decreased brain volume and abnormal brain function in the frontal and temporal areas. D) The brain activity of persons with schizophrenia differs from people who do not have schizophrenia. E) That the etiology of schizophrenia may be related to the body's response to exposure of a virus.
b c d e
The client has shown much improvement for OCD. Which of the following would be appropriate outcomes for a client with OCD? Select all that apply. A) The client will stop engaging in the compulsive activity. B) The client will spend less time performing rituals. C) The client will complete daily routine activities within a realistic time frame. D) The client will conceal the behavior from all persons to avoid anxiety. E) The client will demonstrate effective use of behavior therapy techniques.
b c e
Which of the following are features of the thinking of a person who has OCD, according to the cognitive model? Select all that apply. A) The person with OCD employs a minimalist approach to all aspects of his or her life. B) The person with OCD believes one's thoughts are overly important and has a need to control those thoughts as they overestimate the threat posed by their thoughts. C) The person with OCD is always aware that his or her behavior is related to OCD. D) The person with OCD is concerned with perfectionism and has an intolerance of uncertainty. E) The person with OCD has an inflated personal responsibility.
b d e
A client asks how his prescribed alprazolam helps his anxiety disorder. The nurse explains during teaching of medications, that antianxiety medications such as alprazolam affect the function of which neurotransmitter that is believed to be dysfunctional in anxiety disorders? A) Serotonin B) Norepinephrine C) GABA D) Dopamine
c
A client diagnosed with schizophrenia is laughing and talking while sitting alone. Which of the following is the best response by the nurse? A) State, "Can you share your joke with me?" B) To sit with the client quietly until the client is ready to talk C) State, "Tell me what's happening." D) State, "You look lonely here. Let's join the others in the day room."
c
A client is currently experiencing a panic attack. Which of the following is the most appropriate response by the nurse? A) "Just try to relax." B) "There is nothing here to harm you." C) "You are safe. Take a deep breath." D) "What are you feeling right now?"
c
A client says to the nurse, "I just can't talk in front of the group. I'm trembling and I feel like I'm going to pass out." The nurse assesses the client's anxiety to be at which level? A) Mild B) Moderate C) Severe D) Panic
c
A client who has schizophrenia is having a conversation with the nurse and suddenly stops talking in the middle of a sentence. The client is experiencing which type of thought disruption? A) Thought withdrawal B) Thought insertion C) Thought blocking D) Thought broadcasting
c
A client with schizophrenia is reluctant to take his prescribed oral medication. The most therapeutic response by the nurse to this refusal is... A) "I can see that you're uncomfortable now, so we can wait until tomorrow." B) "If you refuse these pills, you'll have to get an injection." C) "What is it about the medicine that you don't like?" D) "You know you have to take this medicine for your own good."
c
A nurse caring for a client with generalized anxiety disorder tells a supervisor "I find myself feeling uncomfortable and anxious when the client starts trembling and perspiring. I develop cold clammy hands and my pulse races." In such an interaction, the client will most likely develop which of the following? A) fatigue B) claustrophobia C) increased anxiety D) improved self-esteem
c
A nurse detects that a client is experiencing panic-level anxiety. Which intervention should be immediately implemented? A) teach relaxation techniques B) administer anxiolytic medication C) provide calm, brief, directive communication D) gather a show of force in preparation for physical control
c
A nurse is caring for a client who believes her feet are enormous compared with the rest of her body. She has visited an orthopedic surgeon to see if surgery is possible. She spends hours trying to buy shoes that make her feet look smaller, and she prefers social interactions where she can sit with her feet concealed under a table. The nurse assesses that the client's symptoms are consistent with which disorder? A) illness anxiety disorder B) somatoform pain disorder C) body dysmorphic disorder D) depersonalization disorder
c
A student nurse is having a first experience in an inpatient psychiatric unit and is frightened by the behaviors of the clients with schizophrenia. The student should take which of the following actions to deal with fear? A) Express fear to the psychiatrist during rounds B) Pretend to not be afraid C) Stay in an open area while talking with the clients D) Insist that the instructor accompanies the student at all times.
c
The nurse is providing education to a group of persons from several community agencies about hoarding by elder persons. Which of the following is important for the nurse to emphasize? A) Treatment will likely start to be effective in the short term. B) If the person had help to clean up his or her environment, the hoarding would be cured. C) It is not beneficial to tell the client that his thoughts and rituals interfere with his life or that his ritual actions really have no lasting effect on anxiety. D) One agency should be able to address all of the client's needs.
c
The nurse is teaching a client with an anxiety disorder ways to manage anxiety. The nurse suggests which of the following schedules for practicing stress management techniques? A) Reserve these techniques for episodes of panic. B) Use the techniques as needed when experiencing severe anxiety. C) Practice the techniques when relatively calm. D) Expect to practice the techniques when meeting with a therapist.
c
The nurse is teaching about postoperative wound care. As the wound is uncovered, the client begins mumbling, breathing rapidly, and trying to get out of bed, and the client does not respond when the nurse calls his name. Which of the following should be the nurse's first action? A) Ask the client to describe his feelings. B) Proceed with wound care quickly. C) Replace the dressing on the wound. D) Get the assistance of another nurse.
c
When a psychiatrist prescribes alprazolam for acute anxiety experienced by a client with agoraphobia, health teaching should include which instructions? A) eat a tyramine-free diet B) report drowsiness C) avoid alcoholic beverages D) adjust dose and frequency of ingestion based on anxiety level
c
Which of the following attitudes would be best for the nurse when the client who has schizophrenia acts as though the nurse is not trustworthy or that his or her integrity is being questioned? A) That the client is correct and the nurse is not trustworthy B) That the client wants to insult the nurse C) That the client's behavior is a part of the illness D) That the nurse's actions have failed
c
Which of the following is the desired outcome for a client with OCD? A) That the client will no longer experience any signs or symptoms of OCD B) That the client will no longer experience anxiety C) That the OCD symptoms no longer interfere with the client's responsibilities D) To relieve the client with OCD of any responsibilities
c
A client asks the nurse upon discharge, "What should I do if I forget to take my medicine?" The nurse should explain to the client which of the following? A) "Just double the dose next time it is scheduled." B) "Skip that dose and resume your regular with the next dose." C) "Don't miss doses, or you will not maintain therapeutic drug levels." D) "If you remember within 3 to 4 hours later than it is due, take it then. If you remember more than 4 hours after it was due, do not take that dose."
d
A client asks the nurse, "Why do I have to go to counseling? Why can't I just take medications?" The best response by the nurse would be... A) "Both therapies are effective. You can eventually choose one or the other." B) "You cannot get the full effect of your medications without cognitive therapy as well." C) "As soon as your medications reach therapeutic level, you can omit the therapy." D) "Medications combined with therapy help you change how well you function."
d
A client is seeking treatment for a specific phobia. The nurse in the anxiety disorders clinic documents that the client's anxiety is related to exposure to the phobic object. Which is a realistic outcome for anxiety self-control in this situation? A) avoid the feared object whenever possible B) face the feared object without supportive assistance C) state that the fear of the object is unrealistic and inappropriate D) practice relaxation techniques and report decreased physiological sensations associated with thoughts of the feared object
d
A client is seen in the clinic with clinical manifestations of an inability to sit still and a rigid posture. As the nurse performs her assessment, which of these side effects would be correctly identified? A) Tardive dyskinesia B) Neuroleptic malignant syndrome C) Dystonia D) Akathisia
d
A client with schizophrenia is admitted to the inpatient unit. He does not speak when spoken to but has been observed talking to himself on occasion. What would be the priority objective at this time? A) The client will begin talking with other clients B) The client will express his feelings freely C) The client will increase his socialization with others D) The client will increase his reality orientation
d
A client with schizophrenia is attending a follow-up appointment at the community mental health clinic. The client reports to the nurse, "I stopped taking the antipsychotic medication because I can't get an erection with my girlfriend anymore." Which of the following should the nurse recommend to enhance the client's well-being? A) "It sounds like that is a problem for you. Don't you still find her to be sexy enough?" B) "Sexual dysfunction is a temporary side effect and should get better once your body is used to the medication." C) "You should avoid having sex with your girlfriend anyway. Do you really want her to get pregnant?" D) "It is important for you to take an antipsychotic medication. You may need a different type that will be less likely to affect your sexual functioning. I would like to call your physician about this."
d
A client with schizophrenia is being treated with olanzapine 10 mg. daily. The client asks the nurse how this medicine works. The nurse explains that the mechanism by which the olanzapine controls the client's psychotic symptoms is believed to be which of the following? A) increasing the amount of serotonin and norepinephrine in the brain B) decreasing the amount of an enzyme that breaks down neurotransmitters C) normalizing the levels of serotonin, norepinephrine, and dopamine D) blocking dopamine receptors in the brain
d
A client with severe and persistent mental illness has been taking antipsychotic medication for 20 years. The nurse observes during their therapy session that the client's behavior includes repetitive movements of the mouth and tongue, facial grimacing, and rocking back and forth. The nurse recognizes these behaviors as indicative of which of the following? A) extrapyramidal side effects B) loss of voluntary muscle control C) posturing D) tardive dyskinesia
d
A nurse is caring for a client diagnosed with body dysmorphic disorder and perceives to have a disturbed body image due to a reddened face. Which is a long-term outcome for this client? A) The client will recognize the exaggeration of a reddened face by day two of therapy. B) The client will acknowledge the link between anxiety and exaggerated perceptions. C) The client will use behavioral modification techniques to begin accepting the reddened face. D) The client will verbalize acceptance of the reddened face by the three month follow-up appointment.
d
A psychiatric nurse visits a client at home. The client tells the nurse that he or she experiences chest pain, shortness of breath, and sweating whenever leaving home. The client has been unable to go to work for six weeks. The nurse recognizes this problem as which behavior? A) mysophobia B) claustrophobia C) acrophobia D) agoraphobia
d
All of the following are nursing diagnoses identified for a client with schizophrenia. The student nurse correctly anticipates that which diagnosis will resolve when the client's negative symptoms improve? A) Impaired verbal communication B) Risk for other-directed violence C) Disturbed thought processes D) Social isolation
d
An anxiolytic agent, lorazepam, has been prescribed for the client. Which of the following statements by the client would indicate to the nurse that client education about this medication has been effective? A) "My anxiety will be eliminated if I take this medication as prescribed." B) "This medication presents no risk of addiction or dependence." C) "I will probably always need to take this medication for my anxiety." D) "This medication will relax me, so I can focus on problem solving."
d
The client has been defensive toward communication with the nurse today. Which one of the following can be a positive outcome of using defense mechanisms? A) Defense mechanisms can inhibit emotional growth. B) Defense mechanisms can lead to poor problem-solving skills. C) Defense mechanisms can create difficulty with relationships. D) Defense mechanisms can help a person to reduce anxiety.
d
The client with schizophrenia makes the following statement, "I just don't know how to count. The sky turned to fire. I have a ball in my head." What term does the nurse use to document this statement? A) flight of ideas B) ideas of reference C) delusional thinking D) associative looseness
d
The most commonly supported neuroanatomic theory of schizophrenia suggests which etiology? A) Excessive amounts of dopamine and serotonin in the brain B) Ineffective ability of the brain to use dopamine and serotonin C) Insufficient amounts of dopamine in the brain D) Decreased brain tissue in the frontal and temporal regions of the brain
d
The nurse enters the client's room and finds the client anxiously pacing the floor. The client begins shouting at the nurse, "Get out of my room!" The best intervention by the nurse would be to... A) Approach the client and ask, "What's wrong?" B) Call for help and say, "Calm down." C) Turn and walk away from the room without saying anything. D) Stand at the doorway and say, "You seem upset."
d
The nurse is caring for her first client with obsessive-compulsive disorder. During the treatment team meeting, the nurse shares her frustration as to the client's inability to stop washing his hands. The nurse manager offers which one of the following explanations? A) The hand washing represents a way to exert independence from the staff. B) The client is not aware of the excessive hand washing. C) The client does not think anything is abnormal with washing his hands repeatedly. D) The client feels terrible but cannot stop washing his hands to try to get rid of his anxiety
d
The nurse knows that which one of the following statements is true about stress and anxiety? A) All people handle stress in the same way. B) Stress is a person's reaction to anxiety. C) Anxiety occurs when a person has trouble dealing with life situations, problems, and goals. D) Stress is the wear and tear that life causes on the body.
d
The nurse plans to teach a client about dietary modifications to manage diabetes. Teaching would be most effective if the client displayed which of the following characteristics? A) Focusing only on immediate task B) Faster rate of speech C) Narrowed perceptual field D) Heightened focus
d
The student nurse correctly recognizes that which one of the following findings is best supported by genetic studies in the etiology of schizophrenia? A) If a person has schizophrenia, distant relatives are also at risk. B) That there is no relationship at all between schizophrenia and genetics. C) That there is a weak correlation between genetics and schizophrenia. D) That schizophrenia is at least partially inherited.
d
