Psych End of Chapter Questions

Clients from other countries who suffered traumatic oppression in their native country may develop PTSD. Which of the following is least helpful in dealing with their PTSD? A) Assimilating quickly into the culture of their current country of residence. B) Engaging in their native religious practices. C) Maintaining a strong cultural identity. D) Social support from an interpreter or fellow countryman.

A) Assimilating quickly into the culture of their current country of residence.

Clients with OCD often have exposure/response prevention therapy. Which of the following statements by the client would indicate positive outcomes for this therapy? A "I am able to avoid obsessive thinking." B "I can tolerate the anxiety caused by obsessive thinking." C "I no longer have any anxiety when I have obsessive thoughts." D "I no longer feel a compulsion to perform rituals."

B "I can tolerate the anxiety caused by obsessive thinking."

The best goal for a client learning a relaxation technique is that the client will A) confront the source of anxiety directly. B) experience anxiety without feeling overwhelmed. C) report no episodes of anxiety. D) suppress anxious feelings.

B) experience anxiety without feeling overwhelmed.

Which of the four classes of medications used for panic disorder is considered the safest because of low incidence of side effects and lack of physiologic dependence? A) Benzodiazepines B) Tricyclics C) Monoamine oxidase inhibitors D) Selective serotonin reuptake inhibitors

D) Selective serotonin reuptake inhibitors

Confidentiality means respecting the client's right to keep their information private. When can the nurse share information about the client? a. the client threatens to harm a family member b. sharing the information is in the client's best interest c. the client gives written permission d. the client's legal guardian asks for information e. the client is discharged to the parent's care f. the client admits to domestic abuse

a, c, d

The advantages of assertive communication are a. all person's rights are respected b. it gains approval from others c. it protects the speaker from being exploited d. the speaker can say no to another person's request e. the speaker can safely express thoughts and feelings f. the speaker will get their needs met

a, c, d, e

Which of the following is a concrete message? a. "Help me put this pile of books on M.'s desk." b. "Get this out of here." c. "When is she coming home?" d. "They said it is too early to get in."

a. "Help me put this pile of books on M.'s desk."

The nurse is teaching a client taking an MAOI about foods with tyramine that they should avoid. Which statement indicates that the client needs further teaching? a. "I'm so glad I can have pizza as long as I don't order pepperoni." b. "I will be able to eat cottage cheese without worrying." c. "I will have to avoid drinking nonalcoholic beer." d. "I can eat green beans on this diet."

a. "I'm so glad I can have pizza as long as I don't order pepperoni."

Women in battering relationships often remain in those relationships as a result of faulty or incorrect beliefs. Which of the following beliefs is valid? a. If she tried to leave, she would be at increased risk for violence b. If she would do a better job of meeting his needs, the violence would stop c. No one else would put up with her dependent clinging behavior d. She often does things that provoke the violent episodes

a. If she tried to leave, she would be at increased risk for violence

The personality structures of id, ego, and superego were described by a. Sigmund Freud b. Hildegard Peplau c. Frederick Perls d. Harry Stack Sullivan

a. Sigmund Freud

The client with OCD has counting and checking rituals that prolong attempts to perform activities of daily living. The nurse knows that interrupting the client's ritual to assist in faster task completion will likely result in a. a burst of increased anxiety b. gratitude for the nurse's assistance c. relief from stopping the ritual d. symptoms of depression or suicidality

a. a burst of increased anxiety

Which would be an appropriate intervention for a client with OCD who has a ritual of excessive constant cleaning? a. a structured schedule of activities throughout the day b. intense psychotherapy sessions daily c. interruption of rituals with distracting activities d. negative consequences for ritual performance

a. a structured schedule of activities throughout the day

Actions for a client with panic disorder would include a. encouraging the client to verbalize feelings b. helping the client avoid panic producing situations c. reminding the client to practice relaxation when anxiety level is low d. teaching the client reframing techniques e. teaching relaxation techniques to the client f. telling the client to ignore any anxious feelings

a. encouraging the client to verbalize feelings c. reminding the client to practice relaxation when anxiety level is low d. teaching the client reframing techniques e. teaching relaxation techniques to the client

A female client comes to an urgent care clinic and says, "I've just been raped." What should the nurse do? a. allow the client to express whatever she wants b. asks the client if staff can call a friend or family member for her c. offer the client coffee, tea, or whatever she likes to drink d. get the examination completed quickly to decrease trauma to the client e. provide the client with privacy; let her go to a room to make phone calls f. stay with the client until someone else arrives to be with her

a. allow the client to express whatever she wants b. asks the client if staff can call a friend or family member for her f. stay with the client until someone else arrives to be with her

A client has a prescription for haloperidol, 5 mg orally two times a day, as ordered by the physician. The client is suspicious and refuses to take the medication. The nurse says, "If you don't take this pill, I'll get an order to give you an injection." The nurse's statement is an example of a. assault b. battery c. malpractice d. unintentional tort

a. assault

Hospitals established by Dorothea Dix were designed to provide a. asylum b. confinement c. therapeutic milieu d. public safety

a. asylum

Education for clients with PTSD should include which information? a. avoid drinking alcohol b. discuss intense feelings only during counseling sessions c. eat well-balanced, nutritious meals d. find and join a support group in the community e. get regular exercise, such as walking f. try to solve an important problem independently

a. avoid drinking alcohol c. eat well-balanced, nutritious meals d. find and join a support group in the community e. get regular exercise, such as walking

Examples of child maltreatment include a. calling the child stupid for climbing on a fence and getting injured b. giving the child a time-out for misbehaving by hitting a sibling c. failing to buy a desired toy for Christmas d. spanking an infant who won't stop crying e. watching pornographic movies in a child's presence f. withholding meals as punishment for disobedience

a. calling the child stupid for climbing on a fence and getting injured d. spanking an infant who won't stop crying e. watching pornographic movies in a child's presence f. withholding meals as punishment for disobedience

Which elements are necessary to prove liability in a malpractice lawsuit? a. client is injured b. failure to conform to standards of care c. injury caused by breach of duty d. injuries must be visible and verified e. nurse intended to cause harm f. recognized relationship between client and nurse

a. client is injured b. failure to conform to standards of care c. injury caused by breach of duty f. recognized relationship between client and nurse

Which elements are essential in a clinicians duty to warn? a. client makes threatening statements b. history of violence c. potential victims are identifiable d. potential victim is easy to locate e. threat is not a delusion f. threat of harm is serious

a. client makes threatening statements c. potential victims are identifiable f. threat of harm is serious

Psychiatric rehabilitation focuses on a. client's strengths b. medication compliance c. social skill deficits d. symptom reduction

a. client's strengths

A group that was designed to meet weekly for 10 sessions to deal with feelings of depression would be a(n) a. closed group b. educational group c. open group d. support group

a. closed group

Identify components of a cultural assessment. a. communication b. control of environment c. family structure d. language e. socioeconomic status

a. communication b. control of environment c. family structure

Assessment of sensorium and intellectual processes includes which? a. concentration b. emotional feelings c. memory d. judgement e. orientation f. thought process

a. concentration c. memory e. orientation

"Earlier today you said you were concerned that your son was still upset with you. When I stopped by your room about an hour ago, you and your son seemed relaxed and smiling as you spoke to each other. How did things go between the two of you?" This is an example of which therapeutic communication technique? a. consensual validation b. encouraging comparison c. accepting d. general lead

a. consensual validation

When a nurse develops feelings toward a client that are based on the nurse's past experience, it is called a. countertransference b. role reversal c. transference d. unconditional regard

a. countertransference

A client with OCD is admitted to the hospital owing to ritualistic hand washing that occupies several hours each day. The skin on the client's hand is red and cracked, with evidence of minor bleeding. The goal for this client is a. decreasing the time spent washing hands b. eliminating the hand washing rituals c. providing milder soap for hand washing d. providing good skin care

a. decreasing the time spent washing hands

The client who believes everyone is out to get him or her is experiencing a(n) a. delusion. b. hallucination. c. idea of reference. d. loose association.

a. delusion.

Which type of child abuse can be most difficult to treat effectively? a. emotional b. neglect c. physical d. sexual

a. emotional

The nurse who is assessing a client with PTSD would expect the client to report which data? a. inability to relax b. increased alcohol consumption c. insomnia even when fatigued d. suspicion of strangers e. talking about problems to friends f. wanting to sleep all the time

a. inability to relax b. increased alcohol consumption c. insomnia even when fatigued d. suspicion of strangers

Assessment of suicidal risk includes which? a. intent to die b. judgement c. insight d. method e. plan f. reason

a. intent to die d. method e. plan f. reason

Which of the following characteristics describe the obsessional thoughts experienced by clients with OCD? a. intrusive b. realistic c. recurrent d. uncontrollable e. unwanted f. voluntary

a. intrusive c. recurrent d. uncontrollable e. unwanted

Building trust is important in a. orientation phase of the relationship b. the problem identification subphase of the relationship c. all phases of the relationship d. the exploitation subphase of the relationship

a. orientation phase of the relationship

The client who is involuntarily committed to an inpatient psychiatric unit loses which of the following? a. right to freedom b. right to refuse treatment c. right to sign legal documents d. the client loses no rights

a. right to freedom

Abstract standards that provide a person with their code of conduct are a. values b. attitudes c. beliefs d. personal philosophy

a. values

Which statements are examples of unacceptable behaviors under the JCAHO standards for a culture of safety? a. "According to your performance evaluation, you must decrease your absenteeism." b. "Don't page me again, I'm very busy." c. "If you tell my supervisor, you'll never hear the end of it." d. "I don't deserve to be yelled at." e. "I haven't seen such stupid behavior since grade school." f. "I request a different assignment today."

b. "Don't page me again, I'm very busy." c. "If you tell my supervisor, you'll never hear the end of it." e. "I haven't seen such stupid behavior since grade school."

Which is an example of assertive communication? a. "I wish you would stop making me angry." b. "I feel angry when you walk away when I'm talking." c. "You never listen to me when I'm talking." d. "You make me angry when you interrupt me."

b. "I feel angry when you walk away when I'm talking."

Which client statement would indicate self-efficacy? a. "I like to get several opinions before deciding a course of action." b. "I know if I can learn to relax, I will feel better." c. "I'm never sure if I'm making the right decision." d. "No matter how hard I try to relax, something always comes up."

b. "I know if I can learn to relax, I will feel better."

The nurse is caring for a client with schizophrenia who is taking haloperidol (Haldol). The client complains of restlessness, cannot sit still, and has muscle stiffness. Of the following prn medications, which would the nurse administer? a. Haloperidol (Haldol), 5mg PO b. Benztropine (Cogentin) 2mg PO c. Propanolol (Inderal) 20mg PO d. Trazodone, 50mg PO

b. Benztropine (Cogentin) 2mg PO

Identify interpersonal factors of a client's response. a. Cultural beliefs b. Family support c. Sense of belonging d. social networks e. Spirituality

b. Family support c. Sense of belonging d. social networks

Assessment data about the client's speech patterns are categorized in which areas? a. History b. General appearance and motor behavior c. Sensorium and intellectual process d. Self-concept

b. General appearance and motor behavior

Which states the naturalistic view of what causes illness? a. Illness is a natural part of life and therefore unavoidable b. Illness is caused by cold, heat, wind, and dampness c. Only natural agents are effective in treating illness d. Outside agents, such as evil spirits, upset the body's natural balance

b. Illness is caused by cold, heat, wind, and dampness

A client who has been depressed and suicidal started taking a tricyclic antidepressant 2 weeks ago and is now ready to leave the hospital to go home. Which is a concern for the nurse as discharge plans finalized? a. The client may need a prescription for diphenhydramine (Benadryl) to use for side effects. b. The nurse will evaluate the risk for suicide by over-dose of the tricyclic antidepressant. c. The nurse will need to include teaching regarding the signs of neuroleptic malignant syndrome. d. The client will need regular laboratory work to monitor therapeutic drug levels.

b. The nurse will evaluate the risk for suicide by over-dose of the tricyclic antidepressant.

Which is an example of an open-ended question? a. Who is the current president of the United States? b. What concerns you the most about your health? c. What is your address? d. Have you lost any weight recently

b. What concerns you the most about your health?

Which statement about anger is true? a. expressing anger openly and directly usually leads to arguments b. anger results from being frustrated, hurt, or afraid c. suppressing anger is a sign of maturity d. angry feelings are a negative response to a situation

b. anger results from being frustrated, hurt, or afraid

Clients taking which type of psychotropic medications need close monitoring of their cardiac status? a. antidepressants b. antipsychotics c. mood stabilizers d. stimulants

b. antipsychotics

The emotional frame of reference by which one sees the world is created by a. values b. attitudes c. beliefs d. personal philosophy

b. attitudes

Which type of drugs requires cautious use with potentially aggressive clients? a. antipsychotic medications b. benzodiazepines c. mood stabilizers d. lithium

b. benzodiazepines

Client: "I was so upset about my sister ignoring my pain when I broke my leg." Nurse: "When are you going to your next diabetes education program?" This is a nontherapeutic response because the nurse has a. used testing to evaluate the clients insight b. changed the topic c. exhibited an egocentric focus d. advised the client what to do

b. changed the topic

The nurse observes a client muttering to themself and pounding their fist in their other hand while pacing in the hallway. Which principle should guide the nurse's action? a. Only one nurse should approach an upset client to avoid threatening the client b. clients who can verbalize angry feelings are less likely to become physically aggressive c. talking to a client with delusions is not helpful, because the client has no ability to reason. d. verbally aggressive clients often calm down on their own if staff members don't bother them

b. clients who can verbalize angry feelings are less likely to become physically aggressive

Correcting how one thinks about the world and oneself is the focus of a. behaviorism b. cognitive therapy c. psychoanalysis d. reality therapy

b. cognitive therapy

Which is the best action for the nurse to take when assessing a child who might be abused? a. confront the parents with the facts, and ask them what happened. b. consult with a professional member of the health team about making a report c. ask the child which parent caused this injury d. say or do nothing; the nurse has only suspicions, not evidence

b. consult with a professional member of the health team about making a report

"Why do you always complain about the night nurse? She is a nice woman and a fine nurse and has five kids to support. You're wrong when you say she is noisy and uncaring." This example reflects which nontherapeutic technique? a. requesting an explanation b. defending c. disagreeing d. advising

b. defending

Which assessment indicates positive growth and development for a 30-year-old adult? a. is dissatisfied with body image b. enjoys social activities with three or four close friends c. frequently changes jobs to "find the right one" d. plans to move from parental home in near future

b. enjoys social activities with three or four close friends

Mental health parity laws ensure a. better quality mental health treatment b. equality in insurance coverage for mental illness c. mental health treatment without stigma d. that persons receiving treatment really need it

b. equality in insurance coverage for mental illness

A hospitalized client is delusional yelling "The world is coming to an end. We must all run to safety." When other clients complain that this client is loud and annoying, the nurse decides to put the client in seclusion. The client has made no threatening gestures or statements to anyone. The nurse's action is an example of a. assault b. false imprisonment c. malpractice d. negligence

b. false imprisonment

Which assessment finding might indicate older adult self-neglect? a. hesitancy to talk openly with the nurse b. inability to manage personal finances c. missing valuables that are not misplaced d. unusual explanations for injuries

b. inability to manage personal finances

"How does T. make you upset?" is a nontherapeutic communication technique because it a. gives a literal response b. indicates an external source of the emotion c. interprets what the client is saying d. is just another stereotyped comment

b. indicates an external source of the emotion

The primary purpose of the Community Mental Health Center Act of 1963 was to a. get better treatment in larger, more urban areas. b. move clients to their home communities for treatment. c. provide former clients with employment opportunities. d. remove the stigma of living in an institution

b. move clients to their home communities for treatment.

The client tells the nurse "I never do anything right. I make a mess of everything. Ask anyone; they'll tell you the same thing." The nurse recognizes these statements as examples of a. emotional issues b. negative thinking c. poor problem solving d. relationship difficulties

b. negative thinking

Client teaching for lamotrigine (Lamictal) should include which instructions? a. eat a well-balanced diet to avoid weight gain b. report any rashes to your doctor immediately c. take each dose with food to avoid nausea d. this drug may cause psychological dependence.

b. report any rashes to your doctor immediately

When the nurse is assessing whether the client's ideas are logical and make sense, the nurse is examining which areas? a. thought content b. thought process c. memory d. sensorium

b. thought process

Which are specific tasks of the working phase of a therapeutic relationship? a. begin planning for termination b. build trust c. encourage expression of feelings d. establish a nurse client-contract e. facilitate behavior change f. promote self-esteem

c, e, f

Which statement would cause concern for achievement of developmental tasks of a 55 year-old woman? a. "I feel like I'm taking care of my parents now." b. "I really enjoy just sitting around visiting with friends." c. "My children need me now just as much as when they were young." d. "When I retire, I want a smaller house to take care of."

c. "My children need me now just as much as when they were young."

The client tells the nurse, "My biggest problem right now is trying to deal with a divorce. I didn't want a divorce and I still don't. But it is happening anyway!" Which of the following responses by the nurse will convey empathy? a. "Can you tell me about it." b. "I'm so sorry. No wonder you're upset." c. "Sounds like it has been a difficult time." d. "You must be devastated."

c. "Sounds like it has been a difficult time."

When the client says, "I met J. at the dance last week," what is the best way for the nurse to ask the client to describe her relationship with JOe? a. "J. who?" b. "Tell me about J." c. "Tell me about you and J." d. "J., you mean that blond guy with the dark blue eyes?"

c. "Tell me about you and J."

Dream analysis and free association are techniques in which modality? a. client-centered therapy b. gestalt therapy c. logotherapy d. psychoanalysis

d. psychoanalysis

Four levels of anxiety were described by a. Erik Erikson b. Sigmund Freud c. Hildegard Peplau d. Carl Rogers

c. Hildegard Peplau

Which physician order would the nurse question for a client who has stated, "I'm allergic to phenothiazines?" a. Haldol 5mg PO bid b. Navane 10mg PO bid c. Prolixin 5mg PO tid d. Risperdal 2mg bid

c. Prolixin 5mg PO tid

Ideas that one holds as true are a. values b. attitudes c. beliefs d. personal philosophy

c. beliefs

A client is pacing in the hallway with clenched fists and a flushed face. They are yelling and swearing. In which phase of the aggression cycle is this client? a. anger b. triggering c. escalation d. crisis

c. escalation

Which behavior might the nurse assess in a 3-year old child with RAD? a. choosing the mother to provide comfort b. crying when the parents leave the room c. extreme resistance to social contact with parents and staff d. seeking comfort from holding a favorite stuffed animal

c. extreme resistance to social contact with parents and staff

Client: "I had an accident." Nurse: "Tell me about your accident." This is an example of which therapeutic communication technique? a. making observations b. offering self c. general lead d. reflection

c. general lead

The client's belief that a news broadcast has special meaning for him or her is an example of a. abstract thinking. b. flight of ideas. c. ideas of reference. d. thought broadcasting.

c. ideas of reference.

When working with a client with moderate anxiety, the nurse would expect to see a. inability to complete tasks b. failure to respond to redirection c. increased automatisms or gestures d. narrowed perceptual field e. selective attention f. inability to connect thoughts independently

c. increased automatisms or gestures d. narrowed perceptual field e. selective attention f. inability to connect thoughts independently

Which action would be most helpful for a client with dissociative disorder having difficulty expressing feelings? a. distraction b. reality orientation c. journaling d. grounding techniques

c. journaling

Which is true about domestic violence between same-sex partners? a. such violence is less common than that between heterosexual partners b. the frequency and intensity of violence are greater than between heterosexual partners. c. rates of violence are about the same as between heterosexual partners. d. none of the above

c. rates of violence are about the same as between heterosexual partners.

Which would be the best intervention for a client having a panic attack? a. involve the client in a physical activity b. offer a distraction such as music c. remain with the client d. teach the client a relaxation technique

c. remain with the client

To assess the client's ability to concentrate, the nurse would instruct the client to do which? a. explain what "a rolling stone gathers no moss" means. b. name the last three presidents c. repeat the days of the week backward d. talk about what a typical day is like

c. repeat the days of the week backward

The nurse observes a male client who is becoming increasingly upset. He is rapidly pacing, hyperventilating, clenching his jaw, wringing his hands, and trembling. His speech is high-pitched and random; he seems preoccupied with his thoughts. He is pounding his fist onto his other hand. The nurse identifies his anxiety level as a. mild b. moderate c. severe d. panic

c. severe

The nursing role that involves being a substitute for another, such as a parent, is called a. counselor b. resource person c. surrogate d. teacher

c. surrogate

A client with GAD states, "I have learned that the best thing I can do is to forget my worries." How would the nurse evaluate this statement? a. the client is developing insight b. the client's coping skills have improved c. the client needs encouragement to verbalize feelings d. the client's treatment has been successful

c. the client needs encouragement to verbalize feelings

Which statement is true about touching a client who is experiencing a flashback? a. the nurse should stand in front of the client before touching b. the nurse should never touch a client who is having a flashback c. the nurse should touch the client only after receiving permission to do so d. the nurse should touch the client to increase feelings of security

c. the nurse should touch the client only after receiving permission to do so

The nurse gives the client quetiapine (Seroquel) in error when olanzapine (Zyprexa) was ordered. The client has no ill effects from the quetiapine. In addition to making a medication error, the nurse has committed which of the following? a) malpractice b) negligence c) tort (unintentional) d) none of the above

d) none of the above

Which of the following are examples of a therapeutic communication response? a. "Don't worry; everybody has a bad day occasionally." b. "I don't think your mother will appreciate that behavior." c. "Let's talk about something else." d. "Tell me more about your discharge plans." e. "That sounds like a great idea." f. "What might you do the next time you're feeling angry?"

d, f

Which would indicate a duty to warn a third party? a. A client with delusions states "I'm going to get them before they get me." b. A hostile client says "I hate all police." c. A client says they plan to blow up the federal government. d. A client states "If I can't have my girlfriend back, then no one can have her."

d. A client states "If I can't have my girlfriend back, then no one can have her."

Which theorist believed that a corrective interpersonal relationship with the therapist was the primary mode of treatment? a. Sigmund Freud b. William Glasser c. Hildegard Peplau d. Harry Stack Sullivan

d. Harry Stack Sullivan

Which is an example of a close-ended question? a. How have you been feeling lately? b. How is your relationship with your wife? c. Have you had any health problems recently? d. Where are you employed?

d. Where are you employed?

Behaviors observed during the recovery phase of the aggression cycle include a. angry feelings b. anxiety c. apologizing to staff d. decreased muscle tension e. lowered voice volume f. rational communication

d. decreased muscle tension e. lowered voice volume f. rational communication

The nurse is working with a client during a flashback says, "I know you're scared, but you're in a safe place. Do you see the bed in your room? Do you feel the chair you're sitting on?" The nurse is using which technique? a. distraction b. reality orientation c. relaxation d. grounding

d. grounding

Managed care is designed to a. control health care costs by limiting access to care b. keep health care costs from increasing over time. c. limit the amount of money paid to physicians and hospitals. d. maintain a balance between the quality and costs of health care.

d. maintain a balance between the quality and costs of health care.

Actions for a client with OCD would include a. encouraging the client to verbalize feelings b. helping the client avoid obsessive thinking c. interrupting rituals with appropriate distractions d. planning the the client to limit rituals e. teaching relaxation exercises to the client f. telling the client to tolerate any anxious feelings

d. planning the the client to limit rituals e. teaching relaxation exercises to the client f. telling the client to tolerate any anxious feelings

The signs of lithium toxicity include which? a. sedation, fever, and restlessness b. psychomotor agitation, insomnia, and increased thirst c. elevated WBC count, sweating, and confusion d. severe vomiting, diarrhea, and weakness

d. severe vomiting, diarrhea, and weakness

When assessing a client with anxiety, the nurse's questions should be a. avoided until the anxiety is gone b. open-ended c. postponed until the client volunteers information d. specific and direct

d. specific and direct

Hildegard Peplau is best known for her writing about a. community based care b. humane treatment c. psychopharmacology d. therapeutic nurse-client relationship

d. therapeutic nurse-client relationship

A client with anxiety is beginning treatment with lorazepam (Ativan). It is most important for the nurse to assess the client's a. motivation for treatment b. family and social support c. use of coping mechanisms d. use of alcohol

d. use of alcohol

Nursing interventions for clients with PTSD who are hospitalized include a. encouraging a thorough discussion of the original trauma b. providing private solitary time for reflection c. time-out during flashbacks to regain self control d. use of deep breathing and relaxation techniques

d. use of deep breathing and relaxation techniques