Psych final

27. Which question should you as a nurse, ask first to asses for suicide potential when client is brought to an emergency department by police where you work, after threatening to jump off a bridge? P 242

"Are you currently thinking about harming yourself"

90. Know what the appropriate nursing reply is to a son who recently brought his extremely confused parent to a nursing home for admission reports of guilt

"Support groups are held here on Mondays for children of residents in similar situations."

78. Know when you are assessing a client diagnosed with pedophilia; what would differentiate this sexual disorder from a sexual dysfunction. P 704

A disorder is an act or behavior that is described as sexual deviancy; dysfunction is an occurrence during the act of sex that has become problematic for one or both partners.

79. Know what initial intervention you should expect a physician to implement when a newly married woman comes to a gynecology clinic reporting anoxia, insomnia, and extreme dyspareunia that have affected her intimate relationship. P 722 a. A. A thorough physical to include gynecological examination b. B. Referral to a sex therapist c. C. Assessment of sexual history and previous satisfaction with sexual relationships d. D. Referral to the recreational therapist for relaxation therapy

A thorough physical to include gynecological examination

97. Know which grieving behavior you as a school nurse should expect to see when assessing a teenager how has recently lost a parent. P 947

Acting-out behaviors, exhibited in aggression and defiance

54. An elderly African American client is admitted with a preliminary diagnosis of Alzheimer's dementia after 1 week of continuous mental confusion, know which information should cause you to question this diagnosis. (Know the criteria for this diagnosis)?

Alzheimer's dementia does not develop suddenly

31. What type of behavior would you recognize as a nurse when a client who continually waits more than an hour before being seen at the mental health clinic and who finally approaches you and states that when he has to wait for more than an hour to be seen, he feels like his time is not important.

Assertive behavior

35. If your client is in restraints, you that you must observe them how often? P 301

At least every 15 minutes

53. During a 24 hour period at what time should you expect clients diagnosed with Alzheimer's dementia to exhibit more pronounced symptoms?

At twilight

2. If a student confided in you, the school nurse, about conflicts related to attending college, or working to add needed financial support to their family, which coping strategy is most appropriate for you to recommend to the student at this time. A) "People use defense mechanisms every day, though they are not aware of it." B) "Defense mechanisms are not helpful and must be challenged." C) "Primitive and early-formed defenses would be stronger and more difficult to challenge." D) "Defense mechanisms are used when you feel threatened or anxious."

B) "Defense mechanisms are not helpful and must be challenged."

100. Know which of the following clients you should recommend for a structured day program. [Select all that apply - this is a multiple answer question] P 901 a. An acutely suicidal teenager b. A severely mentally ill woman with history of medication noncompliance c. A socially isolated elderly individual d. A depressed individual who is able to contract for safety

B,C,D,

50. Which behavioral approach should you utilize when caring for children diagnosed with disruptive behavior disorders?

Behavior therapy

48. If a child has recently been diagnosed with mild retardation (MR), what information about this diagnosis should you include when teaching the child's mother?

Capable of independent living, with assistance during times of stress, capable of academic skills to 6th grade. As an adult can achieve vocational skills for minimum self-support, capable of developing social skills, functions well in a structured, sheltered setting. Psychomotor skills usually not effected although might have slight problems with coordination.

36. Knowing that for select clients, physical restraints is considered to be a beneficial intervention. Which premise is this idea based on? P 301

Clients with limited internal control over their behavior need external controls to prevent harm to themselves and others..

95. Know which nursing action would maintain the proper chain of evidence when as a forensic nurse you are collecting a semen sample from a rape victim. P 924

Collective evidence must remain on the person of the nurse, in plain view, or in a secure location. Sealed and correctly labeled

32. Which action is an example of which assertive technique when you the nurse turns off the TV and asks two clients who get into a heated argument regarding TV program selection, to go to their rooms to cool off after which they will discuss and attempt to resolve the problem?

Delaying assertively

52. When teaching about donepezil (Aricept), what would be your best reply to a student how asks how it works?

Donepezil is used to treat Alzheimer's disease, a disorder of decreased acetylcholine levels in the brain. Donepezil is an indirect-acting anticholinesterase drug.

42. Which nursing reply would assist a student to see a broader range of possibilities when a high school basketball player sustains a serious knee injury states to you the school nurse that they will never get to college if they don't receive a basketball scholarship?

Generating alternatives

33. How should you the nurse, encourage a 40-year-old client to improve his or her self-esteem base on Erickson's theory? P 283

Generativity Versus Stagnation, explore with the client how they can or have contributed to society or their family.

51. If a client is diagnosed with late-stage Alzheimer's dementia, in order to address the client's symptoms, know which nursing intervention should take priority.

Promote dignity by providing comfort, safety, and self-care measures.

96. Know which documentation on Axis I, when as a prison nurse who is reviewing an inmate's health record, would indicate a dual diagnosis. P 928

Schizophrenia, bipolar disorder, major depression, substance use disorders and personality disorder on the same line

75. Know that when you see a client who is diagnosed with somatization disorder which personality disorder characteristic they are most likely to exhibit.

Self-dramatizing, attention seeking, overly gregarious, and seductive/pain

76. Know what is example of systemized amnesia.

Systematized amnesia is characterized by a loss of memory for a specific category of information. A person with this disorder might, for example, be missing all memories about one specific family member.

94. Know what was a deterring factor to the proper implementation of the Community Health Centers Act of 1963? P 881

The construction of comprehensive community health centers, the cost of which would be shared by federal and state governments; they were lacking funds.

47. What is the best explanation for the weight loss after an adolescent diagnosed with attention deficit-hyperactivity disorder (ADHD) begins methylphenidate (Ritalin) therapy and you note as their nurse that they have lost 10 pounds in a 2-month period? P 396

The pharmacological action of Ritalin causes a decrease in appetite.

91. Know what student statement indicates that learning has occurred when you have taught them about reminiscent therapy.

Thinking about the past and reflecting on it may promote better mental health in old age.

93. A college student was sexually assaulted when out on a date. After several weeks of crisis intervention therapy, which client statement should indicate to a nurse that the student is handling this situation in a healthy manner? a. "I know that it was not my fault." b. "My boyfriend has trouble controlling his sexual urges." c. "If I don't put myself in a dating situation, I won't be at risk." d. "Next time I will think twice about wearing a sexy dress."

a. "I know that it was not my fault."

46. A nursing student having no knowledge of alternative treatments states, "Aren't these therapies 'bogus' and, like a fad, will eventually fade away?" Which is an accurate nursing reply? a. "Like nursing, complementary therapies take a holistic approach to healing." b. "The American Nurses Association is researching the effectiveness of these therapies." c. "It is important to remain nonjudgmental about these therapies." d. "Alternative therapy concepts are rooted in psychoanalysis."

a. "Like nursing, complementary therapies take a holistic approach to healing."

17. A nurse is assessing a client diagnosed with schizophrenia for the presence of hallucinations. Which therapeutic communication technique used by the nurse is an example of making observations? a. "You appear to be talking to someone I do not see." b. Please describe what you are seeing." c. "Why do you continually look in the corner of this room?" d. "If you hum a tune, the voices may not be so distracting."

a. "You appear to be talking to someone I do not see."

5. When you hear that a 10-year-old child wins the science fair competition and is chosen as a cheerleader for the basketball team, you recognize that this child is in the process of successfully accomplishing which stage of Erikson's developmental theory? P 39 a. A. Industry versus inferiority b. B. Identity versus role confusion c. C. Intimacy versus isolation d. D. Generativity versus stagnation

a. A. Industry versus inferiority

41. Which client's thinking is reflective of cognitive error when they are a successful business executive but continually think that their job accomplishments are not adequate? P 335 a. A. Minimization b. B. Dichotomous thinking c. C. Arbitrary inference d. D. Personalization

a. A. Minimization

6. Which personality structure should you identify as predominantly driving a husband's action when his wife complains that he only meets his sexual needs and never her needs? P33 a. A. The id b. B. The superid c. C. The ego d. D. The superego

a. A. The id

99. Know which of the following symptoms the client who is diagnoses with hypochondriasis would most likely to exhibit, [Select all that apply - this is a multiple answer question] P 673

a. Anxiety, depression, and obsessive compulsive disorder

71. A client has a history of excessive fear of water. What is the term that a nurse should use to describe this specific phobia, and under what subtype is this phobia identified? a. Aquaphobia, a natural environment type of phobia b. Aquaphobia, a situational type of phobia c. Acrophobia, a natural environment type of phobia d. Acrophobia, a situational type of phobia

a. Aquaphobia, a natural environment type of phobia

4. A nurse understands that "financial and legal difficulties" are to Axis IV of the DSM-IV-TR as "bipolar disorder" is to which axis? a. Axis I b. Axis II c. Axis III d. Axis IV

a. Axis I

3. A new psychiatric nurse states, "This client's use of defense mechanisms should be eliminated." Which is a correct evaluation of this nurse's statement? a. Defense mechanisms can be appropriate responses to stress and need not be eliminated. b. Defense mechanisms are a maladaptive attempt of the ego to manage anxiety and should always be eliminated. c. Defense mechanisms, used by individuals with weak ego integrity, should be discouraged and not eliminated. d. Defense mechanisms cause disintegration of the ego and should be fostered and encouraged.

a. Defense mechanisms can be appropriate responses to stress and need not be eliminated.

45. A client has been taking 1,200 mg/day of St. John's wort during the past year for symptoms of depression. Recently, the client complains of side effects from this herbal remedy. What symptom should the nurse expect the client to report? a. Photosensitivity b. Insomnia c. Hirsutism d. Restlessness

a. Photosensitivity

70. A client is diagnosed with bipolar disorder: manic phase. Which nursing intervention would be implemented to achieve the outcome of "Client will gain 2 lbs by the end of the week?" a. Provide client with high-calorie finger foods throughout the day. b. Accompany client to cafeteria to encourage adequate dietary consumption. c. Initiate total parenteral nutrition to meet dietary needs. d. Teach the importance of a varied diet to meet nutritional needs.

a. Provide client with high-calorie finger foods throughout the day.

55. What should be the priority nursing diagnosis for a client experiencing alcohol withdrawal? a. Risk for injury R/T central nervous system stimulation b. Disturbed thought processes R/T tactile hallucinations c. Ineffective coping R/T powerlessness over alcohol use d. Ineffective denial R/T continued alcohol use despite negative consequences

a. Risk for injury R/T central nervous system stimulation

40. A mother states, "You are old enough to clean your own bedroom." Later inspection finds the floor clear, but with everything stacked in a chair. The mother praises the child for clearing the floor. This is consistent with which technique of behavior modification? a. Shaping b. Extinction c. Stimulus generalization d. Reciprocal inhibition

a. Shaping

56. A lonely, depressed divorcée has been self-medicating with cocaine for the past year. Which term should a nurse use to best describe this individual's situation? a. The individual is experiencing psychological dependency. b. The individual is experiencing physical dependency. c. The individual is experiencing substance dependency. d. The individual is experiencing social dependency.

a. The individual is experiencing psychological dependency.

23. In defiance of parental wishes, a Japanese teenager succumbs to peer pressure and gets a tattoo. According to Bowen's family systems theory, how should the community health nurse interpret the teenager's action? a. The teenager is attempting to differentiate self. b. The teenager is triangulating self. c. The teenager is cutting self off emotionally. d. The teenager is exhibiting antisocial traits.

a. The teenager is attempting to differentiate self.

13. Which cultural considerations should a nurse identify with Western European Americans? a. They are present-time oriented and perceive the future as God's will. b. They value youth, and older adults are commonly placed in nursing homes. c. They are at high risk for alcoholism due to a genetic predisposition. d. They are future oriented and practice preventive health care.

a. They are present-time oriented and perceive the future as God's will.

64. A nurse reviews the laboratory data of a client suspected of having major depressive disorder. Which laboratory value would potentially rule out this diagnosis? a. Thyroid-stimulating hormone (TSH) level of 6.2 U/mL b. Potassium (K+) level of 4.2 mEq/L c. Sodium (Na+) level of 140 mEq/L d. Calcium (Ca2+) level of 9.5 mg/dL

a. Thyroid-stimulating hormone (TSH) level of 6.2 U/mL

15. What is the most essential task for a nurse to accomplish prior to forming a therapeutic relationship with a client? a. To clarify personal attitudes, values, and beliefs b. To obtain thorough assessment data c. To determine the client's length of stay d. To establish personal goals for the interaction

a. To clarify personal attitudes, values, and beliefs

14. A nursing instructor is teaching about cultural characteristics. Which statement by the student indicates the need for further instruction? a. "All cultures communicate freely within their group." b. "All cultures embrace light therapeutic touch." c. "All cultures view the importance of timeliness differently." d. "All cultures display biological variations."

b. "All cultures embrace light therapeutic touch."

67. What tool should a nurse use to differentiate occasional spontaneous behaviors of children from behaviors associated with bipolar disorder? a. "Risky Activity" tool b. "FIND" tool c. "Consensus Committee" tool d. "Monotherapy" tool

b. "FIND" tool

89. A nursing instructor is teaching students about clients diagnosed with histrionic personality disorder and the quality of their relationships. Which student statement indicates that learning has occurred? a. "Their dramatic style tends to make their interpersonal relationships quite interesting and fulfilling." b. "Their interpersonal relationships tend to be shallow and fleeting, serving their dependency needs." c. "They tend to develop few relationships because they are strongly independent but generally maintain deep affection." d. "They pay particular attention to details which can frustrate the development of relationships."

b. "Their interpersonal relationships tend to be shallow and fleeting, serving their dependency needs."

82. Which individual would most likely be diagnosed with intermittent explosive disorder? a. A client diagnosed with antisocial personality disorder who attacks the nursing staff b. A client diagnosed with diabetes mellitus who has a history of multiple severe assaultive acts c. A client diagnosed with schizophrenia who sets fires because of command hallucinations d. A client diagnosed with alcohol dependence who severely beats wife while intoxicated

b. A client diagnosed with diabetes mellitus who has a history of multiple severe assaultive acts

19. A client diagnosed with schizophrenia is exhibiting nonverbal behaviors indicating that the client is hearing things that others do not. Which nursing diagnosis accurately reflects this client's problem? a. Altered thought process b. Altered sensory perception c. Anxiety d. Chronic confusion

b. Altered sensory perception

11. You, as the nursing manager of an inpatient psychiatric unit, have a policy that the client can make a choice about whether or not to attend group therapy. Which ethical principle are you preserving? P 87 a. Justice b. Autonomy c. Veracity d. Beneficence

b. Autonomy

84. When you see a client who has been extremely nervous ever since a person died as a result of their drunken driving and you are assessing them for the diagnosis of adjustment disorder, know according to the DSM-IV-TR know what is the criteria of the timeframe that you should expect that client to exhibit these symptoms. P 764 a. A. To meet the DSM-IV criteria for adjustment disorder, the client should exhibit symptoms within 1 year of the accident. b. B. To meet the DSM-IV criteria for adjustment disorder, the client should exhibit symptoms within 3 months of the accident. c. C. To meet the DSM-IV criteria for adjustment disorder, the client should exhibit symptoms within 6 months of the accident. d. D. To meet the DSM-IV criteria for adjustment disorder, the client should exhibit symptoms within 9 months of the accident.

b. B. To meet the DSM-IV criteria for adjustment disorder, the client should exhibit symptoms within 3 months of the accident.

62. Which nursing behavior will enhance the establishment of a trusting relationship with a client diagnosed with schizophrenia? a. Establishing personal contact with family members b. Being reliable, honest, and consistent during interactions. c. Sharing limited personal information. d. Sitting close to the client to establish rapport.

b. Being reliable, honest, and consistent during interactions.

65. What is the rationale for a nurse to perform a full physical health assessment on a client admitted with a diagnosis of major depressive disorder? a. The attention during the assessment is beneficial in decreasing social isolation. b. Depression can generate somatic symptoms that can mask actual physical disorders. c. Physical health complications are likely to arise from antidepressant therapy. d. Depressed clients avoid addressing physical health and ignore medical problems.

b. Depression can generate somatic symptoms that can mask actual physical disorders.

16. If an individual is "two-faced," which characteristic essential to the development of a therapeutic relationship should a nurse identify as missing? a. Respect b. Genuineness c. Sympathy d. Rapport

b. Genuineness

21. A man diagnosed with alcohol dependence experiences his first relapse. During his AA meeting, another group member states, "I relapsed three times, but now have been sober for 15 years." Which of Yalom's curative group factors does this illustrate? a. Imparting of information b. Instillation of hope c. Catharsis d. Universality

b. Instillation of hope

87. A client diagnosed with borderline personality disorder brings up a conflict with the staff in a community meeting and develops a following of clients who unreasonably demand modification of unit rules. How can the nursing staff best handle this situation? a. Allow the clients to apply the democratic process when developing unit rules. b. Maintain consistency of care by open communication to avoid staff manipulation. c. Allow the client spokesman to verbalize concerns during a unit staff meeting. d. Maintain unit order by the application of autocratic leadership.

b. Maintain consistency of care by open communication to avoid staff manipulation.

9. An instructor is teaching nursing students about neurotransmitters. Which term best explains the process of how neurotransmitters released into the synaptic cleft may return to the presynaptic neuron? a. Regeneration b. Reuptake c. Recycling d. Retransmission

b. Reuptake

10. Which mental illness should a nurse identify as being associated with a decrease in prolactin hormone level? a. Major Depression b. Schizophrenia c. Anorexia Nervosa d. Alzheimer's Disease

b. Schizophrenia

63. A client is diagnosed with major depressive disorder. Which nursing diagnosis should a nurse assign to this client to address a behavioral symptom of this disorder? a. Altered communication R/T feelings of worthlessness AEB anhedonia b. Social isolation R/T poor self-esteem AEB secluding self in room c. Altered thought processes R/T hopelessness AEB persecutory delusions d. Altered nutrition: less than body requirements R/T high anxiety AEB anorexia

b. Social isolation R/T poor self-esteem AEB secluding self in room

12. Which potential client should a nurse identify as a candidate for involuntarily commitment? a. The client living under a bridge in a cardboard box. b. The client threatening to commit suicide. c. The client who never bathes and wears a wool hat in the summer. d. The client who eats waste out of a garbage can.

b. The client threatening to commit suicide

25. What is the best rationale for including the client's family in therapy within the inpatient milieu? a. To structure a program of social and work-related activities b. To facilitate discharge from the hospital c. To provide a concrete demonstration of caring d. To encourage the family to model positive behaviors

b. To facilitate discharge from the hospital

61. A client diagnosed with schizophrenia states, "Can't you hear him? It's the devil. He's telling me I'm going to hell." Which is the most appropriate nursing reply? a. "Did you take your medicine this morning?" b. "You are not going to hell. You are a good person." c. "I'm sure the voices sound scary. The devil is not talking to you. This is part of your illness." d. "The devil only talks to people who are receptive to his influence."

c. "I'm sure the voices sound scary. The devil is not talking to you. This is part of your illness."

86. A client diagnosed with antisocial personality disorder comes to a nurses' station at 11:00 p.m. requesting to phone a lawyer to discuss filing for a divorce. The unit rules state that no phone calls are permitted after 10:00 p.m. Which nursing reply is most appropriate? a. "Go ahead and use the phone. I know this pending divorce is stressful." b. "You know better than to break the rules. I'm surprised at you." c. "It is after the 10:00 p.m. phone curfew. You will be able to call tomorrow." d. "The decision to divorce should not be considered until you have had a good night's sleep."

c. "It is after the 10:00 p.m. phone curfew. You will be able to call tomorrow."

38. A new nursing graduate asks the psychiatric nurse manager how to best classify suicide. Which is the nurse manager's best reply? a. "Suicide is a DSM-IV-TR diagnosis." b. "Suicide is a mental disorder." c. "Suicide is a behavior." d. "Suicide is an antisocial affliction."

c. "Suicide is a behavior."

18. An instructor is correcting a nursing student's clinical worksheet. Which instructor statement is the best example of effective feedback? a. "Why did you use the client's name on your clinical worksheet?" b. "You were very careless to refer to your client by name on your clinical worksheet." c. "Surely you didn't do this deliberately, but you breeched confidentiality by using the client's name." d. "It is disappointing that after being told, you're still using client names on your worksheet."

c. "Surely you didn't do this deliberately, but you breeched confidentiality by using the client's name."

43. A client who is learning about electroconvulsive therapy (ECT) treatment asks a nurse "Isn't this treatment dangerous?" Which is the most appropriate nursing reply? a. "No, this treatment is side-effect free." b. "There can be temporary paralysis but full functioning returns within 3 hours of treatment." c. "There are some risks, but a thorough examination will determine your candidacy for ECT." d. "Transient ischemic attacks (TIA) can occur but are rare."

c. "There are some risks, but a thorough examination will determine your candidacy for ECT."

58. A client's wife has been making excuses for her alcoholic husband's work absences. In family therapy, she states, "His problems at work are my fault." Which is the appropriate nursing response? a. "Why do you assume responsibility for his behaviors?" b. "Codependency is a typical behavior of spouses of alcoholics." c. "Your husband needs to deal with the consequences of his drinking." d. "Do you understand what the term 'enabler' means?"

c. "Your husband needs to deal with the consequences of his drinking."

88. Which adult client should a nurse identify as exhibiting the characteristics of a dependent personality disorder? a. A physically healthy client who is dependent on meeting social needs by contact with 15 cats b. A physically healthy client who has a history of depending on intense relationships to meet basic needs c. A physically healthy client who lives with parents and relies on public transportation d. A physically healthy client who is serious, inflexible, perfectionistic, and depends on rules to provide security

c. A physically healthy client who lives with parents and relies on public transportation

83. A 13-year-old client's father has recently been deployed to Afghanistan. Since deployment, the client has begun to participate in isolative behaviors, truancy, vandalism, and fighting. The pediatric nurse practitioner should identify this behavior with which adjustment disorder? a. An adjustment disorder with anxiety b. An adjustment disorder with disturbance of conduct c. An adjustment disorder with mixed disturbance of emotions and conduct d. An adjustment disorder unspecified

c. An adjustment disorder with mixed disturbance of emotions and conduct

44. A client with cognitive deficits is extremely suicidal. The client has not responded to antidepressants and the treatment team is considering electroconvulsive therapy (ECT). What client information would determine the feasibility of this treatment option? a. Because the client is extremely suicidal, ECT is an appropriate option. b. Because antidepressant medications have been ineffective, ECT is a good alternative. c. Because informed consent is required for ECT, cognitive deficits preclude this option. d. Because of the client's cognitive deficits, a signed consent is waived.

c. Because informed consent is required for ECT, cognitive deficits preclude this option.

81. Know which dose of you should administer when a client diagnosed with bulimia nervosa is to receive fluoxetine (Prozac) by oral solution and the medication is supplied in a 100 mL bottle and the label reads 20 mg/5 mL and the doctor orders 60 mg. q day. P 756 a. A. 25 mL b. B. 20 mL c. C. 15 mL d. D. 10 mL

c. C. 15 mL

49. A preschool child diagnosed with autistic disorder has been engaging in constant head-banging behavior. Which nursing intervention is appropriate? a. Place client in restraints until the aggression subsides. b. Sedate the client with neuroleptic medications. c. Hold client's head steady and apply a helmet. d. Distract the client with a variety of games and puzzles.

c. Hold client's head steady and apply a helmet.

59. A client diagnosed with schizoaffective disorder is admitted for social skills training. Which information should be taught by the nurse? a. The side effects of medications b. Deep breathing techniques to decrease stress c. How to make eye contact when communicating d. How to be a leader

c. How to make eye contact when communicating

29. Which positive physical benefit would relaxation provide for a client who has experienced stress-related asthma? a. Decreased neurotransmitters b. Decreased blood pressure c. Increased oxygen saturation levels d. Decreased alpha brain levels

c. Increased oxygen saturation levels

72. Which treatment should a nurse identify as most appropriate for clients diagnosed with generalized anxiety disorder (GAD)? a. Long-term treatment with diazepam (Valium) b. Acute symptom control with citalopram (Celexa) c. Long-term treatment with buspirone (BuSpar) d. Acute symptom control with ziprasidone (Geodon)

c. Long-term treatment with buspirone (BuSpar)

1. A nursing student finds that she comes down with a sinus infection toward the end of every semester. When this occurs which stage of stress is the student most likely experiencing? a. Alarm Reaction Stage b. Stage of resistance c. Stage of exhaustion d. Fight-or-flight stage

c. Stage of exhaustion

74. A client is experiencing a severe panic attack. Which nursing intervention would meet this client's immediate need? a. Teach deep breathing relaxation exercises b. Place the client in a Trendelenburg position c. Stay with the client and offer reassurance of safety d. Administer the ordered prn buspirone (BuSpar)

c. Stay with the client and offer reassurance of safety

92. In the emergency department, a raped client appears calm and exhibits a blunt affect. The client answers a nurse's questions in a monotone using single words. How should the nurse interpret this client's responses? a. The client may be lying about the incident. b. The client may be experiencing a silent rape reaction. c. The client may be demonstrating a controlled response pattern. d. The client may be having a compounded rape reaction.

c. The client may be demonstrating a controlled response pattern.

22. A nurse believes that the members of a parenting group are in the initial, or orientation, phase of group development. Which group behaviors would support this assumption? a. The group members manage conflict within the group. b. The group members use denial as part of the grief response. c. The group members compliment the leader and compete for the role of recorder. d. The group members initially trust one another and the leader.

c. The group members compliment the leader and compete for the role of recorder.

68. A client diagnosed with bipolar disorder weighs 220 lb. A physician orders lamotrigine (Lamictal) 10 mg/kg/day to a maximum of 400 mg/day for mood stabilization. Which is a true statement about this medication order? a. This calculated dosage is within the recommended dosage range. b. This calculated dosage is lower than the recommended dosage range. c. This calculated dosage is more than twice the recommended dosage range. d. This calculated dosage is four times higher than the recommended dosage range.

c. This calculated dosage is more than twice the recommended dosage range.

66. A nurse admits an older client who is experiencing memory loss, confused thinking, and apathy. A psychiatrist suspects depression. What is the rationale for performing a mini-mental status exam? a. To rule out bipolar disorder b. To rule out schizophrenia c. To rule out senile dementia d. To rule out a personality disorder

c. To rule out senile dementia

80. A potential Olympic figure skater collapses during practice and is hospitalized for severe malnutrition. Anorexia nervosa is diagnosed. Which client statement best reflects the underlying etiology of this disorder? a. "Skaters need to be thin to improve their daily performance." b. "All the skaters on the team are following an approved 1,200-calorie diet." c. "When I lose skating competitions, I also lose my appetite." d. "I am angry at my mother. I can only get her approval when I win competitions."

d. "I am angry at my mother. I can only get her approval when I win competitions."

28. At the final session for a college student who was nearly raped while jogging completes a serious of appointments with you the rape crisis nurse, which client statement most clearly suggests that the goals of crisis intervention have been met? P 244-245 a. "You've really been helpful. Can I count on your for continued support?" b. "I work out in the college gym rather than jogging outdoors." c. "I'm really glad I didn't go home. It would have been hard to come back." d. "I carry mace when I jog. It makes me feel safe and secure."

d. "I carry mace when I jog. It makes me feel safe and secure."

57. Which client statement demonstrates positive progress toward recovery from substance abuse? a. "I have completed detox and therefore am in control of my drug use." b. "I will faithfully attend Narcotic Anonymous (NA) when I can't control my carvings." c. "As a church deacon, my focus will now be on spiritual renewal." d. "Taking those pills got out of control. It cost me my job, marriage, and children."

d. "Taking those pills got out of control. It cost me my job, marriage, and children."

7. A client diagnosed with major depressive disorder asks, "What part of my brain controls my emotions?" Which nursing response is appropriate? a. "The occipital lobe governs perceptions, judging them as positive or negative." b. "The parietal lobe has been linked to depression." c. "The medulla regulates key biological and psychological activities." d. "The limbic system is largely responsible for one's emotional state."

d. "The limbic system is largely responsible for one's emotional state."

69. A nursing instructor is discussing various challenges in the treatment of clients diagnosed with bipolar disorder. Which student statement demonstrates an understanding of the most critical challenge in the care of these clients? a. "Treatment is compromised when clients can't sleep." b. "Treatment is compromised when irritability interferes with social interactions." c. "Treatment is compromised when clients have no insight into their problems." d. "Treatment is compromised when clients choose not to take their medications."

d. "Treatment is compromised when clients choose not to take their medications."

39. During a smoking cessation group, the community health nurse explains that in their effort to quit smoking, a reciprocal inhibition approach will be used. The nurse should give the group which example of this technique? a. "Before you can smoke, you must first take a half-hour walk." b. "When you have the urge to smoke, imagine being short of breath." c. "You'll receive $1 for each cigarette not smoked and forfeit $2 for each cigarette smoked." d. "When you have the urge to smoke, hold your breath, then rhythmically breathe."

d. "When you have the urge to smoke, hold your breath, then rhythmically breathe."

37. The family of a suicidal client is very supportive and requests more facts related to caring for their family member after discharge. Which information should the nurse provide? a. Address only serious suicide threats to avoid the possibility of secondary gain. b. Promote trust by verbalizing a promise to keep suicide attempt information within the family. c. Offer a private environment to provide needed time alone at least once a day. d. Be available to actively listen, support, and accept feelings.

d. Be available to actively listen, support, and accept feelings.

60. A nurse is assessing a client diagnosed with paranoid schizophrenia. The nurse asks the client, "Do you receive special messages from certain sources, such as the television or radio?" Which potential symptom of this disorder is the nurse assessing? a. Thought insertion b. Paranoid delusions c. Magical thinking d. Delusions of reference

d. Delusions of reference

73. A cab driver, stuck in traffic, suddenly is lightheaded, tremulous, diaphoretic, and experiences tachycardia and dyspnea. An extensive workup in an emergency department reveals no pathology. Which medical diagnosis is suspected, and what nursing diagnosis takes priority? a. Generalized anxiety disorder and a nursing diagnosis of fear b. Altered sensory perception and a nursing diagnosis of panic disorder c. Pain disorder and a nursing diagnosis of altered role performance d. Panic disorder and a nursing diagnosis of anxiety

d. Panic disorder and a nursing diagnosis of anxiety

24. During family counseling a husband states, "Every time my wife and I discuss child discipline, we get into shouting matches." The nurse instructs the couple to shout at each other for 2 weeks on Tuesdays and Thursdays for 30 minutes. What intervention is the nurse using? a. Reframing b. Restructuring the family c. Expressive psychotherapy d. Paradoxical intervention

d. Paradoxical intervention

30. Which should a nurse recognize as the reason that physical exercise is an effective relaxation technique? a. Physical exercise stresses and strengthens the cardiovascular system. b. Physical exercise decreases the metabolic rate. c. Physical exercise decreases levels of norepinephrine in the brain. d. Physical exercise provides a natural outlet for releasing muscle tension.

d. Physical exercise provides a natural outlet for releasing muscle tension./meditation

20. A client who has slept 6 hours the previous night reports this to the assigned psychiatric nurse. What should be the initial nursing action to address this situation? a. Provide warm milk and a backrub. b. Give a sleep medication. c. Hold a relaxation group before bedtime. d. Review the client's normal sleep pattern.

d. Review the client's normal sleep pattern.

26. In the role of milieu manager, which activity should the nurse prioritize? a. Setting the schedule for the daily unit activities b. Evaluating clients for medication effectiveness c. Conducting therapeutic group sessions d. Searching newly admitted clients for hazardous objects

d. Searching newly admitted clients for hazardous objects

8. Which types of adoption studies should a nurse recognize as providing useful information for the psychiatric community? a. Studies in which children with mentally ill biological parents are raised by adoptive parents who were mentally healthy b. Studies in which children with mentally healthy biological parents are raised by adoptive parents who were mentally ill c. Studies in which monozygotic twins from mentally ill parents were raised separately by different adoptive parents d. Studies in which monozygotic twins were raised together by mentally ill biological parents e. All of the above

e. All of the above

98. Know that according to Bowlby, when you as a nurse assigns a client the nursing diagnosis of complicated grieving, which would be the most appropriate long-term outcomes. P 941

reorganization; stage 4

85. a client with intermittent explosive disorder will take?

risperidole

77. Know which symptom exhibited by a client diagnosed with a conversion disorder would predict the poorest prognosis

seizures

34. A nursing student tells you, their instructor, that a 40-year-old female client has never experiences an intimate relationship and therefore remains in Erikson's developmental state of intimacy versus isolation, which would be your most appropriate reply?

withdrawal, social isolation, aloneness, and the inability to form lasting intimate relationships.