week 5 quiz
A client reports to the nurse, "My wife left me. No one else will ever love me. I'm going to be alone for the rest of my life." Which action by the nurse reflects an appropriate, cognitive-focused response? a. "What contributes to your thinking that you will be alone for the rest of your life?" b. "You're just overgeneralizing." c. "Why did your wife leave you?" d. "I'm sure there are other people that love you."
a. "What contributes to your thinking that you will
The physician orders lithium carbonate 600 mg tid for a newly diagnosed patient with bipolar I disorder. There is a narrow margin between the therapeutic and toxic levels of lithium. The therapeutic range for acute mania is: a. 0.5 to 1.5 mEq/L b. 10 to 15 mEq/L c. 0.5 to 1.0 mEq/L d. 5 to 10 mEq/L
a. 0.5 to 1.5 mEq/L
Which of the following individuals is at highest risk for a suicide attempt? a. A client who reports he is in deep emotional pain, feels hopeless, and says "No one is there for me." b. A client who has been seeing a doctor for chronic, intractable pain and is taking pain medication. c. An American Indian client who just graduated from high school with honors. d. A physician who reports feeling "burnt out" and is considering retirement.
a. A client who reports he is in deep emotional pain, feels hopeless, and says "No one is there for me."
A client with depression asks the nurse, "Why would they be checking my thyroid function when I clearly have depression and I'm not overweight?" Which of these is an accurate response? a. An underactive thyroid gland can manifest as depression. b. Depression has been proven to be a hormonal illness. c. Thyroid hormone replacement is a first-line treatment for most clients with depression. d. All of the above.
a. An underactive thyroid gland can manifest as depression.
A client with major depression, who has not responded to antidepressant medication, has been referred for a course of ECT treatments. The client says to the nurse on admission, "I don't want to end up like McMurphy in One Flew Over the Cuckoo's Nest! I'm scared!" What is Sam's priority nursing diagnosis at this time? a. Anxiety related to deficient knowledge about ECT b. Risk for injury related to risks associated with ECT c. Deficient knowledge related to negative media presentation of ECT d. Acute confusion related to side effects of ECT
a. Anxiety related to deficient knowledge about ECT
A client whose husband died from cancer 1 month ago attends a grief support group being conducted by the hospice nurse. During the group this client states, "Sometimes I wish I could go be with my husband. I just want to die." Which action by the nurse is a priority? a. Ask the client if she is having thoughts of harming or killing herself. b. Instruct the client and the other group members that this is a normal part of the grieving process. c. Make arrangements for the client to be evaluated by a psychiatrist. d. Elicit support from other group members by asking them if any of them have had similar feelings.
a. Ask the client if she is having thoughts of harming or killing herself.
A client who lost his wife after 35 years of marriage presents at his primary care physician's office 10 months later. He has lost 20 pounds and tells the nurse, "I just don't want to eat or do anything else for that matter." Which of these actions by the nurse is a priority? a. Assess the client for depression and suicide risk. b. Ask the physician to order gastrointestinal studies. c. Encourage the client to talk about his relationship with his deceased wife. d. Instruct the client that the doctor will be in shortly, but right now the physical assessment must be completed
a. Assess the client for depression and suicide risk.
The nurse in the emergency department encounters a client who is expressing suicide ideation. The nurse recognizes that which of the following considerations are important to good suicide risk assessment? (Select all that apply.) a. Collaborating with the patient b. Asking specific questions about leisure activities c. Establishing trust and open communication with the patient d. Asking the patient specific questions about the strength of his intention to die e. Identifying whether the patient has thought about a plan for trying to kill himself
a. Collaborating with the patient c. Establishing trust and open communication with the patient d. Asking the patient specific questions about the strength of his intention to die e. Identifying whether the patient has thought about a plan for trying to kill himself
Which of the following is most likely to initiate a grief response in an individual? (Select all that apply.) a. Death of a pet dog b. Being told by her doctor that she has begun menopause c. Failing an exam d. Losing a spouse through divorce
a. Death of a pet dog b. Being told by her doctor that she has begun menopause c. Failing an exam d. Losing a spouse through divorce
The goal of cognitive behavior therapy with depressed clients is to: a. Identify and change dysfunctional patterns of thinking. b. Resolve the symptoms and initiate or restore adaptive family functioning. c. Alter the neurotransmitters that are creating the depressed mood. d. Provide feedback from peers who are having similar experiences.
a. Identify and change dysfunctional patterns of thinking.
The thought recording (two-column and three-column) cognitive therapy techniques help clients: a. Identify automatic thoughts. b. Modify automatic thoughts. c. Identify rational alternatives. d. All of the above.
a. Identify automatic thoughts.
Which of the following conditions increases the risk of adverse events associated with ECT? (Select all that apply.) a. Increased intracranial pressure b. Recent myocardial infarction c. Severe underlying hypertension d. Congestive heart failure e. Breast cancer
a. Increased intracranial pressure b. Recent myocardial infarction c. Severe underlying hypertension d. Congestive heart failure
A negative reinforcer: a. Increases the probability that a behavior will recur. b. Decreases the probability that a behavior will recur. c. Has nothing to do with modifying behavior. d. Always results in unacceptable behavior.
a. Increases the probability that a behavior will recur.
A positive reinforcer: a. Increases the probability that a behavior will recur. b. Decreases the probability that a behavior will recur. c. Has nothing to do with modifying behavior. d. Always results in positive behavior.
a. Increases the probability that a behavior will recur.
What is the ultimate goal of therapy for a client with dissociative identity disorder? a. Integration of the personalities into one b. The ability to switch from one personality to another voluntarily c. The ability to select one personality as the dominant self d. Recognition that the various personalities exist
a. Integration of the personalities into one
A client expresses interest in alternative treatments for depression with seasonal variations and asks the nurse about light therapy. Which of the following are evidence-based teaching points that the nurse may share with the client? (Select all that apply.) a. Light therapy has demonstrated effectiveness that is comparable to antidepressants. b. Light therapy should be used regularly until the season changes. c. Light therapy should be used only when electroconvulsive therapy has proven to be ineffective. d. Side effects such as headache, nausea, or agitation, when they occur, are usually mild and transient. e. Light therapy causes sedation, so the best time to use it is before bedtime.
a. Light therapy has demonstrated effectiveness that is comparable to antidepressants. b. Light therapy should be used regularly until the season changes. d. Side effects such as headache, nausea, or agitation, when they occur, are usually mild and transient.
Which of the following symptom profiles would you expect when assessing a client with somatic symptom disorder? a. Multiple somatic symptoms in several body systems b. Fear of having a serious disease c. Loss or alteration in sensorimotor functioning d. Belief that his or her body is deformed or defective in some way
a. Multiple somatic symptoms in several body systems
Although historically lithium has been the medication of choice for mania, several others have been used with good results. Which of the following are used in the treatment of bipolar disorder? (Select all that apply.) a. Olanzapine (Zyprexa) b. Oxycodone (OxyContin) c. Carbamazepine (Tegretol) d. Gabapentin (Neurontin) e. Tranylcypromine (Parnate)
a. Olanzapine (Zyprexa) c. Carbamazepine (Tegretol) d. Gabapentin (Neurontin)
When Jack is not accepted at the law school of his choice, he thinks, "I'm so stupid. No law school will ever accept me." What automatic thought does this statement represent? a. Overgeneralization b. Magnification c. Selective abstraction d. Minimization
a. Overgeneralization
A psychiatric nurse has been asked to lead an educational group on anger management for patients admitted to the psychiatric unit. Which of these actions by the nurse is the most important priority? a. Provide information and handouts on anger management. b. Ask patients how long they would like the group to last. c. Restrict the group to only those who have been complying with unit rules and expectations. d. Ask the patients if they would rather have a group on something else.
a. Provide information and handouts on anger management.
Which of the following interventions are appropriate for a client on suicide precautions? (Select all that apply) a. Remove all sharp objects, belts, and other potentially dangerous articles from the client's environment. b. Accompany the client to off-unit activities. c. Reassess intensity of suicidal thoughts and urges on a regular basis. d. Put all of the client's possessions in storage and explain to her that she may have them back when she is off suicide precautions.
a. Remove all sharp objects, belts, and other potentially dangerous articles from the client's environment. b. Accompany the client to off-unit activities. c. Reassess intensity of suicidal thoughts and urges on a regular basis.
Situation: B.J. has been out with his friends. He is late getting home. He knows his wife will be angry and will yell at him for being late. He stops at the florist and buys a dozen red roses for her. Which of the following behaviors represents negative reinforcement on the part of the wife? a. She meets him at the door, accepts the roses, and says nothing further about his being late. b. She meets him at the door, yelling that he is late, and makes him spend the night on the couch. c. She meets him at the door, expresses delight with the roses, and kisses him on the cheek. d. She meets him at the door and says, "How could you? You know I'm allergic to roses!"
a. She meets him at the door, accepts the roses, and says nothing further about his being late.
The nurse is providing medication education to a cliient on lithium. Which of the following are important points to include? (Select all that apply.) a. Significant reductions in sodium intake increase the risk for lithium toxicity. b. Weight loss is a common side effect of lithium. c. Serum lithium levels will need to be checked at regular intervals throughout treatment. d. Lithium therapy should be continued even during periods when the patient feels well.
a. Significant reductions in sodium intake increase the risk for lithium toxicity. c. Serum lithium levels will need to be checked at regular intervals throughout treatment. d. Lithium therapy should be continued even during periods when the patient feels well.
A client has just been admitted to the psychiatric unit with a diagnosis of major depressive disorder. Which of the following behavioral manifestations might the nurse expect to assess? (Select all that apply) a. Slumped posture b. Hallucinations c. Feelings of despair d. Appears to have boundless energy e. Anorexia
a. Slumped posture c. Feelings of despair e. Anorexia
A staff nurse on a surgical unit is the leader of a newly established group of staff nurses organized to determine ways to decrease the number of medication errors occurring on the unit. At each meeting, he addresses the group to convince the members to adopt his ideas. Which type of group and style of leadership is described in this situation? a. Task group, autocratic leadership b. Teaching group, autocratic leadership c. Self-help group, democratic leadership d. Supportive-therapeutic group, laissez-faire leadership
a. Task group, autocratic leadership
A client is admitted to the hospital with major depressive disorder and repeatedly makes negative statements about herself. Which of the following interventions are identified as those that will promote positive self-esteem in the client? (Select all that apply) a. Teach assertive communication skills. b. Make observations to the client when she completes a goal or task. c. Instruct the client that you will not talk with her unless she stops talking negatively about herself. d. Offer to spend time with the client using a nonjudgmental, accepting approach.
a. Teach assertive communication skills. b. Make observations to the client when she completes a goal or task. d. Offer to spend time with the client using a nonjudgmental, accepting approach.
Which of the following is thought to facilitate the grief process? a. The ability to grieve in anticipation of the loss b. The ability to grieve alone without interference from others c. Having recently grieved for another loss d. Taking personal responsibility for the loss
a. The ability to grieve in anticipation of the loss
The nurse identifies the primary nursing diagnosis for a client as Risk for suicide related to feelings of hopelessness from loss of relationship. Which is the outcome criterion that would be most appropriate for this diagnosis? a. The client has experienced no self-harm. b. The client sets realistic goals. c. The client expresses some optimism and hope for the future. d. The client has reached a stage of acceptance in the loss of the relationship.
a. The client has experienced no self-harm.
An acutely depressed client isolates herself in her room and just sits and stares into space. Which of these is the best example of an active communication approach with this client? a. "Do you like exercise?" b. "Come with me. I will go with you to group therapy." c. "Would you like to go to group therapy, stay in bed, or come out to the day lounge for some activities?" d. "Why do you stay in your room all the time?"
b. "Come with me. I will go with you to group therapy."
A client tells the therapist, "I thought I would just die when my husband told me he was leaving me. If I had been a better wife, he wouldn't have fallen in love with another woman. It's all my fault." The therapist wants to use the technique of "examining the evidence." Which of the following statements reflects this technique? a. "How do you think you could have been a better wife?" b. "Okay, you say it's all your fault. Let's discuss why it might be your fault, and then we will look at why it may not be." c. "Let's talk about what would make you a happier person." d. "Would you have wanted him to stay if he didn't really want to?"
b. "Okay, you say it's all your fault. Let's discuss why it might be your fault, and then we will look at why it may not be."
A client who has been taking sertraline (Zoloft) 50 mg PO bid for depression tells the nurse, "I've been on this medication for almost a week and I don't feel a bit better." What is the most appropriate response by the nurse? a. "Cheer up. You have so much to be happy about." b. "Sometimes it takes a few weeks for the medicine to bring about an improvement in symptoms." c. "I'll report that to the physician. Maybe he will order something different." d. "Try not to dwell on your symptoms. Why don't you join the others down in the dayroom?"
b. "Sometimes it takes a few weeks for the medicine to bring about an improvement in symptoms."
A client has been ordered ECT and asks the nurse, "Exactly how does ECT work?" Which of the following is the most accurate response by the nurse? a. "I'm not allowed to tell you that because that would be informed consent." b. "The exact mechanism is unknown, but there are several ways that ECT may have antidepressant effects." c. "The administration of a shock to the brain induces memory loss, which will make you forget you are depressed." d. "The neuroplasticity affected by seizure activity prevents further brain damage."
b. "The exact mechanism is unknown, but there are several ways that ECT may have antidepressant effects."
A client who is experiencing a manic episode is admitted to the psychiatric unit after being brought to the emergency department by a family member. The client yells, "My family is trying to make it look like I'm insane! They just want to take all my money." This behavior is an example of: a. A delusion of grandeur b. A delusion of persecution c. A delusion of reference d. A delusion of control or influence
b. A delusion of persecution
An 80-year-old client arrives at the emergency department accompanied by her daughter. The daughter tells the nurse that her mom lost her husband 2 months ago and since then her mom has complained of feeling depressed and anxious. Earlier today, she began complaining of chest pain. Which of these actions by the nurse is a priority? a. Instruct the daughter not to worry; these are common grief responses in the elderly. b. Assess vital signs and obtain an ECG. c. Refer the client to grief support groups in the area. d. Educate the client in relaxation and deep breathing exercises and evaluate whether this helps resolve the chest pain.
b. Assess vital signs and obtain an ECG.
A client who has been hospitalized following a suicide attempt is placed on suicide precautions on the psychiatric unit. She admits that she is still feeling suicidal. Which of the following interventions are most appropriate in this instance? (Select all that apply.) a. Restrict access to any item that might be harmful by placing the client in a seclusion room. b. Check on the client every 15 minutes at irregular intervals, or assign a staff person to stay with her on a one-to-one basis. c. Obtain an order from the physician to give the client a sedative to calm her and reduce suicide ideas. d. Do not allow the client to participate in any unit activities while she is on suicide precautions. e. Ask the client specific questions about her thoughts, plans, and intentions related to suicide.
b. Check on the client every 15 minutes at irregular intervals, or assign a staff person to stay with her on a one-to-one basis. e. Ask the client specific questions about her thoughts, plans, and intentions related to suicide.
An aversive stimulus or punisher: a. Increases the probability that a behavior will recur. b. Decreases the probability that a behavior will recur. c. Has nothing to do with modifying behavior. d. Always results in unacceptable behavior.
b. Decreases the probability that a behavior will recur.
The nursing supervisor asks one of the staff nurses to initiate a group with other staff nurses to identify new ways to prevent patient falls. Which of these would be the most appropriate style of leadership for the nurse to implement? a. Autocratic b. Democratic c. Laissez-faire d. Militaristic
b. Democratic
In determining the degree of suicidal risk with a client, the nurse assesses the following behavioral manifestations: severely depressed, withdrawn, statements of worthlessness, difficulty accomplishing activities of daily living, no close support systems. The nurse identifies the client's risk for suicide as which of the following? a. Low risk b. High risk c. Imminent risk d. Unable to be determined
b. High risk
A client admitted to the inpatient psychiatric unit with bipolar disorder tells the nurse, "I need to sit in on change-of-shift report because I have been appointed director of this unit." Which action by the nurse demonstrates the best clinical judgment at this point? a. Invite the client to sit in on the change-of-shift report, but do not share any confidential client information. b. Instruct the client that this is not permitted and redirect the client to other unit activities that are available. c. Tell the client that she is delusional but that these symptoms will go away with medication. d. Place the client in seclusion for protection of self and others.
b. Instruct the client that this is not permitted and redirect the client to other unit activities that are available.
A client diagnosed with somatic symptom disorder states, "My doctor thinks I should see a psychiatrist. I can't imagine why he would make such a suggestion." What is the most common basis for the client's statement? a. Lack of trust in the physician. b. Lack of understanding about the correlation of symptoms and stress. c. Lack of understanding about the role of a psychiatrist. d. Lack of financial resources.
b. Lack of understanding about the correlation of symptoms and stress.
In establishing trust with a client diagnosed with dissociative identity disorder, the nurse should: a. Respond as if the client did not have multiple personalities. b. Listen nonjudgmentally and respond empathically when the client transitions to different personality states. c. Ignore behaviors that the client attributes to other subpersonalities. d. Explain to the client that they must remain in their primary identity state while communicating with the nurse. e. All of the above
b. Listen nonjudgmentally and respond empathically when the client transitions to different personality states.
Barbara burned the toast. She thinks, "I'm a totally incompetent person." What automatic thought does this statement represent? a. Selective abstraction b. Magnification c. Minimization d. Personalization
b. Magnification
A client who was admitted to the psychiatric unit for depression tells the psychiatric nurse that he wants to engage in CBT after discharge. Which action by the nurse is most appropriate at this point? a. Offer to begin CBT with the patient while he is hospitalized. b. Offer to explore referral to a therapist for this kind of treatment. c. Educate the client that CBT can only be completed while he is hospitalized. d. Educate the client that CBT is not effective for treating depression.
b. Offer to explore referral to a therapist for this kind of treatment.
Which of the following best describes the average number of ECT treatments given and the timing of administration? a. One treatment per month for 6 to 12 months b. One treatment every other day, three times a week, for a total of 6 to 12 treatments c. One treatment three times per week for 6 to 12 months d. One treatment every day for a total of 10 to 20 treatments
b. One treatment every other day, three times a week, for a total of 6 to 12 treatments
The ultimate goal of therapy for a client with dissociative identity disorder is most likely achieved through: a. Crisis intervention and directed association. b. Psychotherapy and hypnosis. c. Psychoanalysis and free association. d. Insight psychotherapy and dextroamphetamines.
b. Psychotherapy and hypnosis.
Which of the following ego defense mechanisms describes the underlying psychodynamics of somatic symptom disorder? a. Denial of depression b. Repression of anxiety c. Suppression of grief d. Displacement of anger
b. Repression of anxiety
A client is brought to the emergency department by a family member who reports that the client stopped taking mood stabilizer medication a few months ago and is now agitated, pacing, demanding, and speaking very loudly. Her family member reports that she eats very little, is losing weight, and almost never sleeps. What is the priority nursing diagnosis? a. Imbalanced nutrition: Less than body requirements related to not eating b. Risk for injury related to hyperactivity c. Disturbed sleep pattern related to agitation d. Ineffective coping related to denial of depression
b. Risk for injury related to hyperactivity
Situation: B.J. has been out with his friends. He is late getting home. He knows his wife will be angry and will yell at him for being late. He stops at the florist and buys a dozen red roses for her. Which of the following behaviors represents an aversive stimulus on the part of the wife? a. She meets him at the door, accepts the roses, and says nothing further about his being late. b. She meets him at the door, yelling that he is late, and makes him spend the night on the couch. c. She meets him at the door, expresses delight with the roses, and kisses him on the cheek. d. She meets him at the door and says, "How could you? You know I'm allergic to roses!"
b. She meets him at the door, yelling that he is late, and makes him spend the night on the couch.
A nurse who is leading a childbirth preparation group shows a film each week and sets out reading materials. She expects the participants to utilize their time on a topic of their choice or practice skills they have observed in the films. Which type of group and style of leadership is described in this situation? a. Task group, democratic leadership b. Teaching group, laissez-faire leadership c. Self-help group, democratic leadership d. Supportive-therapeutic group, autocratic leadership
b. Teaching group, laissez-faire leadership
A client admitted to the psychiatric unit with anger management problems encountered another client stealing food from his plate. He approaches the nurse and says, "I'm getting so angry I want to hit him, but I know I need to just walk away." Which response by the nurse would reinforce the client's response to this situation? a. Tell the client that walking away is not going to help him confront difficult situations. b. Tell the client that walking away was a healthy way to manage his anger. c. Tell the client that the staff will reprimand the other client who stole his food. d. Tell the client that his desire to lash out at someone behaving that way is normal.
b. Tell the client that walking away was a healthy way to manage his anger.
Success of long-term psychotherapy with a client (who attempted suicide following a break-up with her boyfriend) could be measured by which of the following behaviors? a. The client has a new boyfriend. b. The client has an increased sense of self-worth. c. The client does not take antidepressants anymore. d. The client told her old boyfriend how angry she was with him for breaking up with her.
b. The client has an increased sense of self-worth.
A nurse has been asked to facilitate a group in the outpatient mental health clinic that is focused on helping patients problem-solve issues with adherence to medications. Which of these decisions about group size is most appropriate? a. The group should be open to all patients who express interest. b. The optimal size for this type of group is around 7 to 8 patients. c. Patients should democratically decide on the size of the group. d. The group should be limited to the first 35 patients who sign up.
b. The optimal size for this type of group is around 7 to 8 patients.
A nurse is educating a patient about his lithium therapy and explaining the signs and symptoms of lithium toxicity. Which of the following would she instruct the patient to be on the alert for? a. Fever, sore throat, malaise b. Tinnitus, severe diarrhea, ataxia c. Occipital headache, palpitations, chest pain d. Skin rash, marked rise in blood pressure, bradycardia
b. Tinnitus, severe diarrhea, ataxia
Atropine sulfate is administered to a client receiving ECT for what purpose? a. To alleviate anxiety b. To decrease secretions c. To relax muscles d. As a short-acting anesthetic
b. To decrease secretions
A client, who has been hospitalized for ECT treatments, says to the nurse on admission, "I don't want to end up like McMurphy in One Flew Over the Cuckoo's Nest! I'm scared!" Which of the following statements would be most appropriate by the nurse in response to Sam's expression of concern? a. "I guarantee you won't end up like McMurphy, Sam." b. "The doctor knows what he is doing. There's nothing to worry about." c. "I know you are scared, Sam, and we're going to talk about what you can expect from the therapy." d. "I'm going to stay with you as long as you are scared."
c. "I know you are scared, Sam, and we're going to talk about what you can expect from the therapy."
A client diagnosed with somatic symptom disorder tells the nurse about a pain in her side. She says she has not experienced it before. Which is the most appropriate response by the nurse? a. "I don't want to hear about another physical complaint. You know they are all in your head. It's time for group therapy now." b. "Let's sit down here together and you can tell me about this new pain you are experiencing. You'll just have to miss group therapy today." c. "I will report this pain to your physician. In the meantime, group therapy starts in 5 minutes." d. "I will call your physician and see if he will order a new pain medication for your side. The one you have now doesn't seem to provide relief. Why don't you get some rest for now?"
c. "I will report this pain to your physician. In the meantime, group therapy starts in 5 minutes."
A client whose husband died 6 months ago is given a diagnosis of major depressive disorder. She says to the nurse, "I start feeling angry that Harold died and left me all alone; he should have stopped smoking years ago! But then I start feeling guilty for feeling that way." What is an appropriate response by the nurse? a. "Yes, he should have stopped smoking. Then he probably wouldn't have gotten lung cancer." b. "I can understand how you must feel." c. "Those feelings are a normal part of the grief response." d. "Just think about the good times that you had while he was alive."
c. "Those feelings are a normal part of the grief response."
A client is hospitalized following a suicide attempt after breaking up with her boyfriend. She says to the nurse, "When I get out of here, I'm going to try this again, and next time I'll choose a no-fail method." Which is the best response by the nurse? a. "You are safe here. We will make sure nothing happens to you." b. "You're just lucky your roommate came home when she did." c. "What exactly do you plan to do?" d. "I don't understand. You have so much to live for."
c. "What exactly do you plan to do?"
A 27-year-old female client was admitted to the psychiatric unit from the medical intensive care unit where she was treated for taking a deliberate overdose of her antidepressant medication, trazodone (Desyrel). She says to the nurse, "My boyfriend broke up with me. We had been together for 6 years. I love him so much. I know I'll never get over him." Which is the best response by the nurse? a. "You'll get over him in time." b. "Forget him. There are other fish in the sea." c. "You must be feeling very sad about your loss." d. "Why do you think he broke up with you?"
c. "You must be feeling very sad about your loss."
A client, who is dying of cancer, says to the nurse, "I just want to see my new grandbaby. If only God will let me live until she is born, then I'll be ready to go." This is an example of which of Kübler-Ross's stages of grief? a. Denial b. Anger c. Bargaining d. Acceptance
c. Bargaining
Janet failed her first test in nursing school. She thinks, "Well, that's it! I'll never be a nurse." What automatic thought does this statement represent? a. Overgeneralization b. Magnification c. Catastrophic thinking d. Personalization
c. Catastrophic thinking
A generalist nurse in the outpatient mental health clinic is approached by the medical director who requests that the nurse initiate a cognitive behavior therapy group. Which of these is the most appropriate action by the nurse? a. Establish a self-help group for any patients who are interested. b. Conduct cognitive behavior therapy for a small group of 7 to 10 patients. c. Educate the medical director that according to nursing practice standards, therapy groups should be conducted by nurses who have a minimum of a master's degree in psychiatric nursing. d. Ask the nursing supervisor for approval to initiate the medical director's request.
c. Educate the medical director that according to nursing practice standards, therapy groups should be conducted by nurses who have a minimum of a master's degree in psychiatric nursing.
A 10-year-old child returns to school after the death of his mother. The school nurse becomes aware that this child is frequently talking in the classroom about fears that he will die, too. The classroom teacher is asking for recommendations about how to handle this situation. Which of these actions by the nurse is most appropriate? a. Instruct the teacher to refer the child for psychological evaluation because this is a warning sign of depression and possible suicide. b. Encourage the teacher to redirect the child to activities that are focused on school performance. c. Educate the teacher that this a common reaction in children of this age and it is best for the teacher to offer reassurance that he is safe. d. Instruct the teacher to prohibit discussion of this topic in class because children in this age-group cannot understand the finality of death.
c. Educate the teacher that this a common reaction in children of this age and it is best for the teacher to offer reassurance that he is safe.
In a bereavement group for widows, one of the new members hears a longer-term member describe that the group support has helped her adjust to the loss of her husband. The new member states, "Well, maybe I can get through this, too." This statement is evidence of which of the following therapeutic factors? a. Universality b. Imitative behavior c. Installation of hope d. Imparting of information
c. Installation of hope
Electroconvulsive therapy is most commonly prescribed for which of the following? a. Bipolar disorder, manic b. Paranoid schizophrenia c. Major depression d. Obsessive-compulsive disorder
c. Major depression
Opal is a 43-year-old woman who is suffering from depression and suicidal ideation. Opal says, "I'm such a worthless person. I don't deserve to live." The therapist responds, "I would like for you to think about what problems suicide would solve." The therapist is using which of the following CBT techniques? a. Imagery b. Role-play c. Problem-solving d. Thought recording
c. Problem-solving
One way to promote adequate nutritional intake for a client in an acute manic episode who is not eating is to: a. Sit with the client during meals to reinforce the importance of eating everything on the tray. b. Have family members bring food from home so the client will have only favorite foods. c. Provide high-calorie, nutritious finger foods and snacks that can be eaten "on the run." d. Restrict the client to their room until they begin to gain weight.
c. Provide high-calorie, nutritious finger foods and snacks that can be eaten "on the run."
An adolescent who recently lost his brother in a fatal accident is referred to the school nurse following a physical fight with a peer. After attending to the client's bleeding lip, the parents ask the nurse for recommendations because their son has had several physical confrontations after the death of his brother. Which of these actions by the nurse is most beneficial? a. Encourage the parents to set more limits because adolescents need more structure as they work through their grief. b. Encourage the parents to schedule an appointment with a psychiatrist because his behavior is a sign of a developing conduct disorder. c. Provide information about available support groups for adolescents who have also experienced the loss of a loved one. d. Instruct the parents that making their son accept legal consequences for his behavior will likely resolve the problem behavior.
c. Provide information about available support groups for adolescents who have also experienced the loss of a loved one.
A client experiencing a manic episode enters the milieu area dressed in a provocative and physically revealing outfit. Which of the following is the most appropriate intervention by the nurse? a. Tell the client she cannot wear this outfit while she is in the hospital. b. Do nothing, and allow her to learn from the responses of her peers. c. Quietly walk with her back to her room and help her change into something more appropriate. d. Explain to her that if she wears this outfit, she must remain in her room.
c. Quietly walk with her back to her room and help her change into something more appropriate.
A client, age 68, is a widow of 6 months. Over the last month she has become socially withdrawn, has lost weight, and told her sister today that she "doesn't have anything more to live for." She has been hospitalized with major depressive disorder. The priority nursing diagnosis for this client would be: a. Imbalanced nutrition: less than body requirements. b. Complicated grieving. c. Risk for suicide. d. Social isolation.
c. Risk for suicide.
Situation: B.J. has been out with his friends. He is late getting home. He knows his wife will be angry and will yell at him for being late. He stops at the florist and buys a dozen red roses for her. Which of the following behaviors represents positive reinforcement on the part of the wife? a. She meets him at the door, accepts the roses, and says nothing further about his being late. b. She meets him at the door, yelling that he is late, and makes him spend the night on the couch. c. She meets him at the door, expresses delight with the roses, and kisses him on the cheek. d. She meets him at the door and says, "How could you? You know I'm allergic to roses!"
c. She meets him at the door, expresses delight with the roses, and kisses him on the cheek.
A recent widow states, "I'm going to have to learn to pay all the bills. Hank always did that. I don't know if I can handle all of that." This is an example of which of the tasks described by Worden? a. Task I: Accepting the reality of the loss b. Task II: Processing the pain of grief c. Task III: Adjusting to a world without the lost entity d. Task IV: Finding an enduring connection with the lost entity in the midst of embarking on a new life
c. Task III: Adjusting to a world without the lost entity
Succinylcholine is administered to a client receiving ECT for what purpose? a. To alleviate anxiety b. To decrease secretions c. To relax muscles d. As a short-acting anesthetic
c. To relax muscles
A nurse leader is explaining about group "therapeutic factors" to members of the group. She tells the group that group situations are beneficial because members can see that they are not alone in their experiences. Which of the following therapeutic factors is the nurse describing? a. Altruism b. Imitative behavior c. Universality d. Imparting of information
c. Universality
A client reports to the mental health clinic with complaints of feeling more depressed over the last few weeks. The patient's score on the Hamilton Depression Rating Scale is 40. What is the priority nursing action at this finding? a. Assess the client's history of treatment for depression. b. Encourage the client to keep weekly follow-up appointments at the clinic. c. Educate the client about treatment options for mild, moderate, and severe depression. d. Assess the client's current risk for suicide.
d. Assess the client's current risk for suicide.
What is the most common comorbid condition in children with bipolar disorder? a. Schizophrenia b. Substance disorders c. Oppositional defiant disorder d. Attention deficit-hyperactivity disorder
d. Attention deficit-hyperactivity disorder
What is the priority nursing intervention before starting ECT therapy? a. Take vital signs and record. b. Have the patient void. c. Administer succinylcholine. d. Ensure that the consent form has been signed.
d. Ensure that the consent form has been signed.
A nurse is conducting a diabetic medication education group for patients on a medical unit. Which of these actions by the nurse is the most important priority during the first meeting of this group? a. Ask the patients where they would like to begin. b. Try to identify what role each of the members is assuming. c. Conduct fingerstick blood sugars on each attendee. d. Explain how the meetings will be structured.
d. Explain how the meetings will be structured.
Lucille has a diagnosis of illness anxiety disorder. Which of the following symptoms would be consistent with this diagnosis? a. Complains of a multitude of incapacitating physical symptoms b. Manifests with pseudoseizures or pseudocyesis c. Takes substances to induce vomiting to convince the nurse that she needs treatment d. Expresses persistent fears of having life-threatening disease
d. Expresses persistent fears of having life-threatening disease
Nursing care for a client with somatic symptom disorder should focus on helping the client to: a. Eliminate stressors. b. Discontinue focusing on numerous physical complaints. c. Take medication only as prescribed. d. Learn more adaptive coping strategies.
d. Learn more adaptive coping strategies.
Nancy's new in-laws came to dinner for the first time. When Nancy's mother-in-law left some food on her plate, Nancy thought, "I must be a lousy cook." What automatic thought does this statement represent? a. Dichotomous thinking b. Overgeneralization c. Minimization d. Personalization
d. Personalization
A client with a history of childhood physical and sexual abuse was diagnosed with dissociative identity disorder 6 years ago and has been admitted to the psychiatric unit following a suicide attempt. What is the priority nursing diagnosis for this client? a. Disturbed personal identity related to childhood abuse b. Disturbed sensory perception related to repressed anxiety c. Impaired memory related to disturbed thought processes d. Risk for suicide related to unresolved grief
d. Risk for suicide related to unresolved grief
A client is hospitalized following a suicide attempt after breaking up with her boyfriend. Freudian psychoanalytic theory would explain the client's suicide attempt in which of the following ways? a. She feels hopeless about her future without her boyfriend. b. Without her boyfriend, she feels like an outsider with her peers. c. She is feeling intense guilt because her boyfriend broke up with her. d. She is angry at her boyfriend for breaking up with her and has turned the anger inward on herself.
d. She is angry at her boyfriend for breaking up with her and has turned the anger inward on herself.
A psychiatric nurse is leading a group for women who desire to lose weight. The criterion for membership is that members must be at least 20 pounds overweight. All have tried to lose weight on their own many times in the past without success. At their first meeting, the nurse provides suggestions as the members determine what their goals will be and how they plan to go about achieving those goals. They decide how often they want to meet and what they plan to do at each meeting. Which type of group and style of leadership is described in this situation? a. Task group, autocratic leadership b. Teaching group, democratic leadership c. Self-help group, laissez-faire leadership d. Supportive-therapeutic group, democratic leadership
d. Supportive-therapeutic group, democratic leadership
The parents of a 14-year-old child ask the nurse for suggestions about how to promote homework completion and less time spent on social media. The nurse believes the Premack principle may be helpful. What should the nurse suggest to the parents? a. Tell the parents to reward their son each time homework is attempted, even if it is only for 5 minutes. b. Tell the parents to ignore this behavior, and eventually the child will start completing the homework without prompting. c. Tell the parents to draw up a contract stating what the consequences will be if homework is not completed. d. Tell the parents to explain to their child that TV is only permitted after the homework is completed.
d. Tell the parents to explain to their child that TV is only permitted after the homework is completed.
The most common side effects of ECT are: a. Permanent memory loss and brain damage. b. Fractured and dislocated bones. c. Myocardial infarction and cardiac arrest. d. Temporary memory loss and confusion.
d. Temporary memory loss and confusion.
Engel identifies which of the following as successful resolution of the grief process? a. When the bereaved person can talk about the loss without crying b. When the bereaved person no longer talks about the lost entity c. When the bereaved person puts all remembrances of the loss out of sight d. When the bereaved person can discuss both positive and negative aspects about the lost entity
d. When the bereaved person can discuss both positive and negative aspects about the lost entity
A client has a fear of dogs. In helping her overcome this fear, the therapist is using systematic desensitization. List the following steps in the order in which the therapist would proceed.Have the client: a. Look at a real dog. b. Look at a stuffed toy dog. c. Pet a real dog. d. Pet the stuffed toy dog. e. Walk past a real dog. f. Look at a picture of a dog.
f. Look at a picture of a dog. b. Look at a stuffed toy dog. d. Pet the stuffed toy dog. a. Look at a real dog. e. Walk past a real dog. c. Pet a real dog.
