psych questions

A nurse is performing a follow-up teaching session with a client discharged 1 month ago who is taking fluoxetine (Prozac). What information would be important for the nurse to gather regarding the adverse effects related to the medication? 1. Cardiovascular symptoms 2. Gastrointestinal dysfunctions 3. Problems with mouth dryness 4. Problems with excessive sweating

2. adverse effect of prozac in CNS and GI dysfunction

A manic client annonces to everyone in the dayroom that a stripper is coming to perform that evening. When the psychiatric nurse's aide firmly states that the client's behavior is not appropriate, the manic client becomes verbally abusive and threatens physical violence to the nurse's aide. Based on the analysis of this situation, the nurse determines that the appropriate action would be to: 1. Escort the manic client to his or her room 2. Orient the client to time, person, and place. 3. Tell the client that the behavior is not appropriate 4. Tell the client that smoking privileges are revoked for 24 hours

1. the patient imposed threat others and needs to be escorted.

A nurse collects data on a client with a diagnosis of bipolar affective disorder - mania. The finding that requires the nurse 's immediate intervention is: 1. The client's outlandish behaviors and inappropriate dress 2. The client's nonstop physical activity and poor nutritional intake 3. The client's grandiose delusions of being a royal descendant of King Arthur 4. The client's constant, incessant talking that includes sexual innuendoes and teasing the staff

2. Mania is a mood characterized by excitement, euphoria, hyperactivity, excessive energy, decreased need for sleep, and impaired ability to concentrate or complete a single train of though. It is a period when the mood is predominantly elevated, expansive, or irritable.

A client with a diagnosis of anorexia nervosa, who is in a state of starvation, is in a two-bed hospital room. A newly admitted client will be assigned to this client's room. Which client would be an appropriate choice as this client's roommate? 1. A client with pneumonia 2. A client receiving diagnostic tests 3. A client who thrives on managing others 4. A client who could benefit from the client's assistance at mealtime

2. anorexia nervosa patients are most like to experience hematological complications. It is the most appropriate to room a diagnostic test patient with anorexia nervosa patient.

A nurse is caring for a client with severe depression. Which of the following activities would be appropriate for this client? 1. A puzzle 2. Drawing 3. Checkers 4. Paint by number

2. drawing has no right or wrong, it promotes concentration

A nurse is caring for a client who has a history of opioid abuse and is monitoring the client for signs of withdrawal. Which clinical manifestations are specifically associated with withdrawal from opioids? 1. Dilated pupils, tachycardia, and diaphoresis 2. Yawning, irritability, diaphoresis, cramps, and diarrhea 3. Tachycardia, hypertension, sweating, and marked tremors 4. Depressed feelings, high drug craving, fatigue, and agitation

2. opioids withdrawal effects include: yawning, insomnia, irritability, rhinorrhea, diaphoresis, ramps, nausea and vomiting, muscle aches, chills, fever, lacrimation, and diarrhea. Withdrawal is treated by methadone tapering or medication detoxification.

A nurse is preparing to care for a dying client, and several family members are at the client's bedside . Select the therapeutic techniques that the nurse will use when communicating with the family. Select all that apply. 1. Discourage reminiscing. 2. Make the decisions for the family. 3. Encourage expression of feelings, concerns, and fears. 4. Explain everything that is happening to all family members. 5. Extend touch and hold the client's or family member's hand if appropriate. 6. Be honest and truthful and let the client and family know that you will not abandon them.

3, 5, 6 not option 4, a spoke person of the family must be determined; the nurse should ask the family how much the family wants to know.

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

1. safety for others and the client is the first priority

A hospitalized client is started on phenelzine sulfate (Nardil) for the treatment of depression. The nurse instructs the client to avoid consuming which foods while taking this medication? Select all that apply. 1. Figs 2. Yogurt 3. Crackers 4. Aged cheese 5. Tossed salad 6. Oatmeal cookies

1, 2, 4

A nurse reviews the activity schedule for the day and determines that the best activity that the manic client could participate in is: 1. Ping-pong 2. A paint-by-number activity 3. A brown bag lunch and a book review 4. A deep breathing and progressive relaxation group

1. A manic patient needs activities that allow them to use excessive energy but not endanger others during the process.

A nurse is collecting data from a client and the client's spouse reports that the client is taking donepzil hydrocholoride (Aricept). Which disorder would the nurse suspect that this client may have based on the use of this medication? 1. Dementia 2. Schizophrenia 3. Seizure disorder 4. Obsessive-compulsive disorder

1. Aricept increases acetylcholine production; therefore, increases cholinergic action; slows the progression of Alzemer's

An inebriated client is brought to the emergency department by the local police. The client is told that the physician will be in to see the client in about 30 minutes. The client becomes very loud and offensive and wants to be seen by the physician immediately. The nurse assisting to care for the client would plan for which appropriate nursing intervention? 1. Watch the behavior escalate before intervening 2. Attempt to talk with the client to de-escalate the behavior 3. Offer to take the client to an examination room until he or she can be treated 4. Inform the client that he or she will be intervened to leave if the behavior continues

3. other methods will further stimulate the patient. Option 3, isolation technique allows patient to be separated from others, which provides less stimulating environment and client could maintain dignity.

A nurse is collecting data on a client who is actively hallucinating. Which nursing statement would be therapeutic at this time? 1. "I know you feel 'they are out to get you,' but it's not true." 2. "I can hear the voice and she wants you to come to diner." 3. "Sometimes people hear things or voices others can't hear." 4 "I talked to the voices you're hearing and they won't hurt you now."

3. reinforce reality

A depressed client who is on tranylcypromine sulfate (Parnate) has been instructed on diet. The nurse feels confident that the client understands the diet when given a choice of restaurant foods if the client selects: 1. Pepperoni pizza, salad, and cola 2. Pickled herring, French fries, and milk 3. Fried haddock, baked potato, and cola 4. Roasted chicken, roasted potatoes, and beer

3. tranylcypromine sulfate (Parnate) is a MAOI. Tyramine free diet is required.

A nurse informs a client with an eating disorder about group meetings with Overeaters Anonymous. Which statement by the client indicates the need for additional information about this self-help group? 1. "The leader of this self-help group is a nurse or psychiatrist." 2. "The members of this self-help group provide support to each other." 3. "This self-help group is designed to serve people who have a common problem." 4. "In this self-help group, people who have a similar problem are able to help others."

1. The leader of a self-help group is an experienced member of the group

A nurse is assisting with the data collection on a client admitted to the psychiatric unit. The nurse reviews the data obtained and identifies which of the following as a priority concern? 1. The client's report of suicidal thoughts 2. The client's report of not eating or sleeping 3. The presence of bruises on the client's body 4. The family member is disapproving of the treatment

1. suicidal thoughts is the highest priority

A client taking buspirone (BuSpar) for 1 month returns to the clinic for a follow-up visit. Which of the following would indicate medication effectiveness? 1. No rapid heartbeats or anxiety 2. No paranoid thought processes 3. No thought broadcasting or delusions 4. No reports of alcohol withdrawal symptoms

1. buspirone (BuSpar) is recommended for treating aggression and anxiety.

A client has reported that crying spells have been a major problem over the past several weeks, and that the doctor said that depression is probably the reason. The nurse observes that the client is sitting slumped in the chair and the clothes that the client is wearing don't fit well. The nurse interprets that further data collection should focus on: 1. weight loss 2. sleep patterns 3. medication compliance 4. onset of the crying spells

1. client's wearing don't fit well indicates poor nutrition and weight change.

A nurse is providing care to a client admitted to the hospital with a diagnosis of anxiety disorder. The nurse is talking with the client and the client says, "I have a secret that I want to tell you. You won't tell anyone about it, will you?" The appropriate nursing response is which of the following? 1. "No, I won't tell anyone." 2. "I cannot promise to keep a secret." 3. "If you tell me the secret, I will tell it to your doctor." 4. "If you tell me the secret, I will need to document it in your record."

2. This is a therapeutic relationship. A nurse should not keep a client's secret. The nurse should be honest with the client that a promise can not be made to keep the secret

A nurse is assisting in a group therapy session. During this session, the members are identifying tasks and boundaries. The nurse understands that these activities are characteristic of which stage of group development? 1. Middle stage 2. Beginning stage 3. Termination stage 4. Self-awareness stage

2. beginning or initial stage: identifying tasks and boundaries. giving information and establishing group norms. middle stage: members are confronting each other, groups develop cohesiveness, and a sense of trust is established. termination stage: members may leave the group abruptly, the group decodes that its work is done, and the group members fell that they have met their goals. There is no such stage of group development called the self-awareness stage.

A client receiving a tricyclic antidepressant arrives at the mental health clinic. Which observation indicates that the client is correctly following the medication plan? 1. Reports not going to work for this past week 2. Complains of not being able to "do anything" anymore 3. Arrives at the clinic neat and appropriate in appearance 4. Reports sleeping 12 hours per night and 3 to 4 hours during the day

3. depressed clients sleep for a long period of time and do not have energy to work and feels like can not "do anything". Once there is improvements, clients have reduced above symptoms and shows more appropriate appearance.

A nurse is preparing a client for the termination phase of the nurse-client relationship. Which nursing task would the nurse appropriately plan for this phase? 1. Plan short-term goals. 2. Identify expected outcomes. 3. Assist in making appropriate referrals. 4. Assist in developing realistic solutions.

3. During termination stage of the nurse-client relationship: evaluating client performance, evaluating client achievement of expected outcomes, evaluating future needs, making appropriate referrals, and dealing with common behavior associated with termination.

A nurse is caring for a client with anorexia nervosa. The nurse is monitoring the behavior of the client and understands that the client with anorexia nervosa manages anxiety by: 1. Engaging in immoral acts 2. Always reinforcing self-approval 3. Observing rigid rules and regulations 4. Having the need to always make the right decision

3. anorexia nervosa patients have the desire to please others.

A nurse is caring for a hospitalized client who has been taking clozapine (Clozaril) for the treatment of a schizophrenic disorder. Which laboratory study prescribed for the client will the nurse specifically review to monitor for an adverse effect associated with the use of this medication? 1. Platelet count 2. Cholesterol level 3. White blood cell count 4. Blood urea nitrogen level

3. clozapine (Clozaril) Can cause hematologic changes

A nurse is caring for a client diagnosed with catatonic stupor. The client is lying on the bed with the body pulled into a fetal position. The appropriate nursing intervention is which of the following? 1. Ask direct questions to encourage talking 2. Leave the client alone and intermittently check on him. 3. Sit beside the client in silence an d verbalize occasional open-ended questions. 4. Take the client into the dayroom with other clients so they can help watch him.

3. need consistent persistent approach should not leave the patient alone

A nurse is monitoring a client who abuses alcohol for signs of alcohol withdrawal delirium. The nurse monitors for which of the following? 1. Hypotension, ataxia, vomiting 2. Stupor, agitation, muscular rigidity 3. Hypotension, bradycardia, agitation 4. Hypertension, disorientation, hallucinations

4. The symptoms associated with alcohol withdrawal delirium typically are anxiety, insomnia, anorexia, hypertension, disorientation, visual or tactile hallucinations, agitation, fever, and delusions.

A mother of a teenage client with an anxiety disorder is concerned about her daughter's progress on discharge. She states that her daughter "stashes food, eats all the wrong things that make her hyperactive," and "hangs out with the wrong crowd." In helping the mother prepare for her daughter's discharge, the nurse suggests that the mother: 1. Restrict the daughter's socializing tie with her friends. 2. Restrict the amount of chocolate and caffeine products in the home. 3. Keep her daughter out of school until she can adjust to the school environment . 4. Consider taking time from work to help her daughter readjust to the home environment.

2. client with anxiety should stay away from caffeine, chocolate, and alcohol. These products increase anxiety.

A nurse is caring for female client who was recently admitted to the hospital for anorexia nervosa. The nurse enters the client's room and notes that the client is doing vigorous push-ups. Which nursing action is appropriate? 1. Interrupt the client and weigh her immediately. 2. Interrupt the client and offer to take her for a walk 3. Allow the client to complete her exercise program 4. Tell the client that she is not allowed to exercise vigorously

2. must provide appropriate exercise and limits.

A client was admitted to a medical unit with acute blindness. Many tests are performed and there seems to be no organic reason why this client cannot see. The nurse later learns that the client became blind after witnessing a hit-and-run car crash, in which a family of three was killed. The nurse suspects that the client may be experiencing a: 1. Psychosis 2. Repression 3. Conversion disorder 4. Dissociative disorder

3. conversion disorder - alteration or loss of a physical function that cannot be explained by any known pathophysiological mechanism. It is thought to be an expression of a psychological need or conflict. dissociative disorder - a disturbance or alteration in the normally integrative functions of identity, memory, or consciousness. Psychosis - a state in which a person's mental capacity to recognize reality, communicate, and relate to others is impaired, thus interfering with the person's capacity to deal with life's demands. Repression - a coping mechanism in which unacceptable feelings are kept out of awareness.

A client who is diagnosed with pedophilia and has been recently paroled as a sex offender says, "I'm in treatment and I have served my time. Now this group has posters of me all over the neighborhood telling about me with my picture on it." Which of the following is an appropriate response by the nurse? 1. "When children are hurt as you hurt them, people want you isolated." 2. "You're lucky it doesn't escalate into something pretty scary after your crime." 3. "You understand that people fear for their children, but you're feeling unfairly treated?" 4. "You seem angry, but you have committed serious crimes against several children, so your neighbors are frightened."

3. focus and verbalize the expressed concern

A nurse observes that a client with a potential for violence is agitated, pacing up and down in the hallway, and making aggressive and belligerent gestures at other clients. Which statement would be appropriate to make to this client? 1. "You need to stop that behavior now!" 2. "You will need to be placed in seclusion!" 3. "What is causing you to become agitated?" 4. "You will need to e restrained if you do not change your behavior."

3. option 1 may further agitate the patient. the best statement is to ask what's causing the client's behavior, this will help the client to be aware of the behavior and help the nurse to plan the interventions.

A woman comes into the emergency department in a severe sate of anxiety following a car accident. The most important nursing intervention is to: 1. Remain with the client 2. Put the client in a quiet room 3. Teach the client deep breathing 4. Encourage the client to talk about her feelings and concerns.

1. anxiety patient could be placed alone. He or she would feel abandoned. When the patient is placed in a quiet room, a nurse needs to remain in the room with the client.

client experiencing a severe major depressive episode is unable to address activities of daily living. The appropriate nursing intervention is to: 1. Feed, bathe, and dress the client as needed until the client can perform these activities independently. 2. Offer the client choices and consequences to the failure to comply with the expectation of maintaining activities of daily living. 3. Structure the client's day so that adequate time can b devoted to the client's assuming responsibility for the activities of daily living. 4. Have the client's peers confront the client about how the noncompliance in addressing activities of daily living affects the milieu.

1. severely depressed people may not have the interest or energy to perform activities of daily living, even the simplest tasks. The nurse assume this role and perform these tasks with client.

A nurse is assigned to care for a client at risk for alcohol withdrawal. The nurse monitors the client, knowing that the early signs of withdrawal will usually develop within how much time after cessation or reduction of alcohol intake? 1. In 7 days 2. In 14 days 3. In 21 days 4. Within a few hours

4. early signs of alcohol withdrawal usually develop within a few hours; it peaks in 24 to 48 hours.

A nursing student is asked to identify the characteristics of bulimia nervosa Which response by the student indicates a need to further research the disorder? 1. Dental erosion 2. Electrolyte imbalances 3. Enlarged parotid glands 4. Body weight well below ideal range

4. normally do not appear physically and emotionally ill. They are usually slightly below ideal range of body weight. bulimia nervous patients demonstrates: enlargement of the parotid glands with dental erosion and caries if the client has been inducing vomiting. Electrolyte imbalances are present.

Following a group therapy session, a client approaches the licensed practical nurse (LPN) and verbalizes a need for seclusion because of uncontrollable feelings. The LN reports the finings to the registered nurse (RN) and expects that the RN will take which of the following actions? 1. Call the client's family 2. Place the client in seclusion immediately 3. Inform the client that seclusion has not been prescribed 4. Get a written order from the doctor and obtain an informed consent.

4. A client may request to be secluded or restrained. Federal law require the consent of the client, unless an emergency situation exist in which an immediate risk to the client or others can be documented. The use of seclusion and restraint is permitted only on the written order of a physician, which must be reviewed and renewed every 24 hours; it must also specify the type of restraint to be used.