all 435 EOC questions

8. Which grief reaction can the nurse anticipate in a 10-year-old child? a. Statements that the deceased person will soon return b. Regressive behaviors, such as loss of bladder control c. A preoccupation with the loss d. Thinking that they may have done something to cause the death

8. c

8. Certain family dynamics often predispose adolescents to the development of conduct disorder. Which of the following patterns is thought to be a contributing factor? a. Parents who are overprotective b. Parents who have high expectations of children c. Parents who consistently set limits on their children's behavior d. Parents who are alcohol dependent

8. d

4. The nurse is caring for a client with schizophrenia. Orders from the physician include 100 mg chlorpromazine IM STAT and then 50 mg PO bid; 2 mg benztropine PO bid prn. Because benztropine was ordered on a prn basis, which of the following assessments by the nurse would convey a need for this medication? a. The client's level of agitation increases. b. The client complains of a sore throat. c. The client's skin has a yellowish cast. d. The client develops tremors and a shuffling gait.

d

16. Intervention with Andrew (from question 15) would include a. encouraging expression of feelings. b. antianxiety medications. c. participation in a support group. d. a and c. e. all of the above.

e. all of the above.

1. Which of the following represents a nursing intervention at the primary level of prevention? a. Teaching a class in parent effectiveness training. b. Leading a group of adolescents in drug rehabilitation. c. Referring a married couple for sex therapy. d. Leading a support group for battered women.

1. a

1.Lorraine has been diagnosed with Somatic Symptom Disorder. Which of the following symptom profiles would you expect when assessing Lorraine? 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 her body is deformed or defective in some way

1. a

1. Margaret, a 68-year-old widow, is brought to the emergency department by her sister-in-law. Margaret has a history of bipolar disorder and has been maintained on medication for many years. Her sister-in-law reports that Margaret quit taking her medication a few months ago, thinking she didn't need it anymore. She is agitated, pacing, demanding, and speaking very loudly. Her sister-in-law reports that Margaret eats very little, is losing weight, and almost never sleeps. "I'm afraid she's going to just collapse!" Margaret is admitted to the psychiatric unit. The priority nursing diagnosis for Margaret is 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.

1. b

1.John, a veteran of the war in Iraq, is diagnosed with PTSD. He says to the nurse, "I can't figure out why God took my buddy instead of me." From this statement, the nurse assesses which of the following in John? a. Repressed anger b. Survivor's guilt c. Intrusive thoughts d. Spiritual distress

1. b

1. Margaret, age 68, is a widow of 6 months. Since her husband died, her sister reports that Margaret has become socially withdrawn, has lost weight, and does little more each day than visit the cemetery where her husband was buried. She told her sister today that she "didn't have anything more to live for." She has been hospitalized with Major Depressive Disorder. The priority nursing diagnosis for Margaret would be a. imbalanced nutrition: less than body requirements. b. complicated grieving. c. risk for suicide. d. social isolation.

1. c

1. Ms. T. has been diagnosed with Agoraphobia. Which behavior would be most characteristic of this disorder? a. Ms. T. experiences panic anxiety when she encounters snakes. b. Ms. T. refuses to fly in an airplane. c. Ms. T. will not eat in a public place. d. Ms. T. stays in her home for fear of being in a place from which she cannot escape.

1. d

1. Some obese individuals take amphetamines to suppress appetite and help them lose weight. Which of the following is an adverse effect associated with use of amphetamines that makes this practice undesirable? a. Bradycardia b. Amenorrhea c. Tolerance d. Convulsions

1. C

1. In an effort to help the child with mild to moderate intellectual disability develop satisfying relationships with others, which of the following nursing interventions is most appropriate? a. Interpret the child's behavior for others. b. Set limits on behavior that is socially inappropriate. c. Allow the child to behave spontaneously, for he or she has no concept of right or wrong. d. This child is not capable of forming social relationships.

1. b

1. Sharon, a woman with multiple cuts and abrasions, arrives at the emergency department (ED) with her three small children. She tells the nurse her husband inflicted these wounds on her. She says, "I didn't want to come. I'm really okay. He only does this when he has too much to drink. I just shouldn't have yelled at him." The best response by the nurse is, a. "How often does he drink too much?" b. "It is not your fault. You did the right thing by coming here." c. "How many times has he done this to you?" d. "He is not a good husband. You have to leave him before he kills you."

1. b

Chapter 15- 20 review questions 1. Tony, age 21, has been diagnosed with Schizophrenia. He has been socially isolated and hearing voices telling him to kill his parents. He has been admitted to the psychiatric unit from the emergency department. The initial nursing intervention for Tony is to a. give him an injection of Thorazine. b. ensure a safe environment for him and others. c. place him in restraints. d. order him a nutritious diet.

1. b

1.Stanley, age 72, is admitted to the hospital for depression. His son reports that he has periods of confusion and forgetfulness. In her admission assessment, the nurse notices an open sore on Stanley's arm. When she questions him about it he says, "I scraped it on the fence 2 weeks ago. It's smaller than it was." How might the nurse analyze these data? a. Consider that Stanley may have been attempting self-harm. b. The delay in healing may indicate that Stanley has developed skin cancer. c. A diminished inflammatory response in the elderly increases healing time. d. Age-related skin changes and distribution of adipose tissue delay healing in the elderly.

1. c

1. Kim has a diagnosis of Borderline Personality Disorder. She often exhibits alternating clinging and distancing behaviors. The most appropriate nursing intervention with this type of behavior would be to a. encourage Kim to establish trust in one staff person, with whom all therapeutic interaction should take place. b. secure a verbal contract from Kim that she will discontinue these behaviors. c. withdraw attention if these behaviors continue. d. rotate staff members who work with Kim so that she will learn to relate to more than one person.

1. d

1. Which of the following is most likely to initiate a grief response in an individual? a. Death of the pet dog b. Being told that she began menopause c. Failing an examination d. Answer a only e. All of the above.

1. e

chap 2: 1. Mr. J. is a new client on the psychiatric unit. He is 35 years old. Theoretically, in which level of psychosocial development (according to Erikson) would you place Mr. J.? a. Intimacy vs. isolation b. Generativity vs. self-absorption c. Trust vs. mistrust d. Autonomy vs. shame and doubt

1.b

chap 7: 1. The nurse is using nursing process to care for a suicidal client. Which of the following nursing actions is apart of the assessment step of the nursing process? a. Identifies nursing diagnosis: Risk for suicide b. Notes that client's family reports recent suicide attempt c. Prioritizes the necessity for maintaining a safe environment for the client d. Obtains a short-term contract from the client to seek out staff if feeling suicidal

1.b

chap 1: 1. Three years ago, Anna's dog Lucky, whom she had had for 16 years, was run over by a car and killed.Anna's daughter reports that since that time, Anna has lost weight, rarely leaves her home, and just sits and talks about Lucky. Anna's behavior would be considered maladaptive because: a. it has been more than 3 years since Lucky died. b. her grief is too intense over just the loss of a dog. c. her grief is interfering with her functioning. d. people in this culture would not comprehend such behavior over the loss of a pet.

1.c

chap 5: 1. Miss Lee is an Asian American on the psychiatric unit. She tells the nurse, "I must have the hot ginger root for my headache. It is the only thing that will help." What meaning does the nurse attach to this statement by Miss Lee? a. She is being obstinate and wants control over her care. b. She believes that ginger root has magical qualities. c. She subscribes to the restoration of health through the balance of yin and yang. d. Asian Americans refuse to take traditional medicine for pain.

1.c

chap 6: 1. Nurse Mary has been providing care for Tom during his hospital stay. On Tom's day of discharge, his wife brings a bouquet of flowers and box of chocolates to his room. He presents these gifts to Nurse Mary saying,"Thank you for taking care of me." What is a correct response by the nurse? a. "I don't accept gifts from patients." b. "Thank you so much! It is so nice to be appreciated." c. "Thank you. I will share these with the rest of the staff." d. "Hospital policy forbids me to accept gifts from patients."

1.c

10. Janet has a diagnosis of Generalized Anxiety Disorder. Her physician has prescribed buspirone 15 mg daily. Janet says to the nurse, "Why do I have to take this every day? My friend's doctor ordered Xanax for her, and she only takes it when she is feeling anxious." Which of the following would be an appropriate response by the nurse? a. "Xanax is not effective for generalized anxiety disorder." b. "Buspirone must be taken daily in order to be effective." c. "I will ask the doctor if he will change your dose of buspirone to prn so that you don't have to take it every day." d. "Your friend really should be taking the Xanax every day."

10. B

10. A child with bipolar disorder also has attention-deficit/hyperactivity disorder (ADHD). How would these comorbid conditions most likely be treated? a. No medication would be given for either condition. b. Medication would be given for both conditions simultaneously. c. The bipolar condition would be stabilized first before medication for the ADHD would be given. d. The ADHD would be treated before consideration of the bipolar disorder.

10. C

11. After receiving three ECT treatments, a client says to the nurse, "I feel so much better, but I'm having trouble remembering some things that happened this last week." The nurse's best response would be: a. "Don't worry about that. Nothing important happened." b. "Memory loss is just something you have to put up with in order to feel better." c. "Memory loss is a side effect of ECT, but it is only temporary. Your memory should return within a few weeks." d. "Forget about last week, Mr. C. You need to look forward from here."

11. c

10. Carol, age 16, has recently been diagnosed with Diabetes Mellitus. She must watch her diet and take an oral hypoglycemic medication daily. She has become very depressed, and her mother reports that Carol refuses to change her diet and often skips her medication. Carol has been hospitalized for stabilization of her blood sugar. The psychiatric nurse practitioner has been called in as a consult. Which of the following nursing diagnoses by the psychiatric nurse would be a priority for Carol at this time? a. Anxiety related to hospitalization, evidenced by noncompliance b. Low self-esteem related to feeling different from her peers, evidenced by social isolation c. Risk for suicide related to new diagnosis of Diabetes Mellitus d. Risk-prone health behavior related to denial of seriousness of her illness, evidenced by refusal to follow diet and take medication

10. D

10. Lucille has a diagnosis of Somatic Symptom Disorder, Predominantly Pain. Which of the following medications would the psychiatric nurse practitioner most likely prescribe for Lucille? a. Chlorpromazine (Thorazine) b. Diazepam (Valium) c. Carbamazepine (Tegretol) d. Duloxetine (Cymbalta)

10. D

10. A depressed client is receiving an ECT treatment. In the treatment room, the anesthesiologist administers methohexital sodium (Brevital) followed by IV succinylcholine (Anectine). The purposes of these medications are to a. decrease secretions and increase heart rate. b. prevent nausea and induce a calming effect. c. minimize memory loss and stabilize mood. d. induce anesthesia and relax muscles.

10. d

10. Which of the following behavioral patterns is characteristic of individuals with schizotypal personality disorder? a. Belittling themselves and their abilities b. A lifelong pattern of social withdrawal c. Suspicious and mistrustful of others d. Overreacting inappropriately to minor stimuli

10. B

10. According to the literature, which of the following is most important for individuals to maintain a healthy, adaptive old age? a. To remain socially interactive b. To disengage slowly in preparation of the last stage of life c. To move in with family d. To maintain total independence and accept no help from anyone

10. a

10. The binging episode is thought to involve a. a release of tension, followed by feelings of depression. b. feelings of fear, followed by feelings of relief. c. unmet dependency needs and a way to gain attention. d. feelings of euphoria, excitement, and self-gratification.

10. a

10. Three predominant client populations have been identified as benefiting most from psychiatric home health care. Which of the following is not included among this group? a. Elderly individuals b. Individuals living in poverty c. Individuals with severe and persistent mental illness d. Individuals in acute crisis situations

10. b

10. Which of the following medications is used to treat Tourette's disorder? a. Methylphenidate (Ritalin) b. Haloperidol (Haldol) c. Imipramine (Tofranil) d. Phenytoin (Dilantin)

10. b

10. Which of the following is not true regarding grieving by an adolescent? a. Adolescents may not show their true feelings about the death. b. Adolescents tend to have an immortal attitude. c. Adolescents do not perceive death as inevitable. d. Adolescents may exhibit acting out behaviors as part of their grief.

10. c

10. A woman who was sexually assaulted six months ago by a man with whom she was acquainted has since been attending a support group for survivors of rape. From this group, she has learned that the most likely reason the man raped her was that a. because he had been drinking, he was not in control of his actions. b. he had not had sexual relations with a girl in many months. c. he was predisposed to become a rapist by virtue of the poverty conditions under which he was reared. d. he was expressing power and dominance by means of sexual aggression and violence.

10. d

chap 3: 10. Which of the following hormones has been implicated in the etiology of mood disorder with seasonal pattern? a.Increased levels of melatonin b.Decreased levels of oxytocin c.Decreased levels of prolactin d. Increased levels of thyrotropin

10.a

chap 5: 10.Maria is an Italian American who is in the hospital after having suffered a miscarriage at 5 months' gestation. Maria's mother says to the nurse, "If only Maria had told me she wanted the biscotti. I would have made them for her." What is the meaning behind Maria's mother's statement? a. Some Italian Americans believe a miscarriage can occur if a woman does not eat a food she craves. b. Some Italian Americans think biscotti can prevent miscarriage. c. Maria's mother is taking the blame for Maria's miscarriage .d. Maria's mother believes the physician should have told Maria to eat biscotti.

10.a

chap 7: 10.Which of the following describe advantages to electronic health records (EHRs)? Select all that apply. a.EHRs reduce redundancy of information. b.EHRs reduce issues regarding privacy. c.EHRs decrease charting time. d.EHRs facilitate communication between disciplines.

10.a, c, d

chap 1: 10.Which of the following statements by Anna might suggest that she is achieving resolution of her grief over Lucky's death? a."I don't cry anymore when I think about Lucky." b."It's true. Lucky didn't always mind me. Sometimes he ignored my commands." c."I remember how it happened now. I should have held tighter to his leash!" d."I won't ever have another dog. It's just too painful to lose them."

10.b

chap 2: 10.The nurse has just admitted Nancy to the psychiatric unit. The psychiatrist has diagnosed Nancy with Major Depressive Disorder. The nurse says to Nancy, "Some changes will have to be made in your behavior. I care about what happens to you." Which nursing role described by Peplau is the nurse fulfilling in this instance? a.Counselor b.Surrogate c.Technical expert d.Resource person

10.b

chap 6: 10.Which of the following tasks are associated with the orientation phase of relationship development?Select all that apply. a.Promoting the client's insight and perception of reality. b.Creating an environment for the establishment of trust and rapport. c.Using the problem-solving model toward goal fulfillment. d.Obtaining available information about the client from various sources.e.Formulating nursing diagnoses and setting goals.

10.b, e

chap 4: 10.Attempting to calm an angry client by using "talk therapy" is an example of which of the following clients' rights? a.The right to privacy b.The right to refuse medication c.The right to the least-restrictive treatment alternative d.The right to confidentiality

10.c

chap 5: 11.Joe, who has come to the mental health clinic with symptoms of depression, says to the nurse, "My father is dying. I have always hated my father. He physically abused me when I was a child. We haven't spoken for many years. He wants to see me now, but I don't know if I want to see him." With which spiritual need is Joe struggling? a. Forgiveness b. Faith c. Hoped. Meaning and purpose in life

11.a

chap 3: 11. Psychotropic medications that block the re-uptake of serotonin may result in which of the following side effects? a.Dry mouth b.Constipation c.Blurred vision d.Sexual dysfunction

11.d

12. A nurse is preparing a client who is a potential candidate for ECT and providing information about the treatments. The nurse may do which of the following? Select all that apply. a. Encourage the client to express fears about getting ECT. b. Discuss with the client and family the possibility of short-term memory loss. c. Remind client and family that injury from the induced seizure is common. d. Monitor for any cardiac alterations (current and past) to avoid possible negative outcomes. e. Ensure the client that he will be awake during the entire procedure.

12. a, b, d

chap 3: 12. Psychotropic medications that block the acetylcholine receptor may result in which of the following side effects? a.Dry mouth b.Sexual dysfunction c.Nausea d.Priapism

12.a

chap 5: 12.As a child, Joe was physically abused by his father. The father is now dying and has expressed a desire to see his son before he dies. Joe is depressed and says to the mental health nurse, "I'm so angry! Why did God have to give me a father like this? I feel cheated of a father! I've always been a good person. I deserved better. I hate God!" From this subjective data, which nursing diagnosis might the nurse apply to Joe? a. Readiness for enhanced religiosity b. Risk for impaired religiosity c. Readiness for enhanced spiritual well-being d. Spiritual distress

12.d

13. ECT is thought to effect a therapeutic response by a. stimulation of the CNS. b. decreasing the levels of acetylcholine and monoamine oxidase. c. increasing the levels of serotonin, norepinephrine, and dopamine. d. altering sodium metabolism within nerve and muscle cells.

13. C

chap 3: 13. Psychotropic medications that are strong blockers of the D2receptor may result in which of the following side effects? a.Sedation b.Urinary retention c.Extrapyramidal symptoms d.Hypertensive crisis

13.c

chap 4: 6.Joe is very restless and is pacing a lot. The nurse says to Joe, "If you don't sit down in the chair and bestill, I'm going to put you in restraints!" With which of the following legal actions might the nurse becharged because of this nursing action? a.Defamation of character b.Battery c.Breach of confidentiality d.Assault

6.d

2. The physician orders sertraline (Zoloft) 50 mg PO bid for Margaret, a 68-year-old woman with Major Depressive Disorder. After 3 days of taking the medication, Margaret says to the nurse, "I don't think this medicine is doing any good. I don't feel a bit better." What is the most appropriate response by the nurse? a. "Cheer up, Margaret. 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, Margaret. Maybe he will order something different." d. "Try not to dwell on your symptoms, Margaret. Why don't you join the others down in the dayroom?"

2. b

2. 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

2. b

2. John, a veteran of the war in Iraq, is diagnosed with PTSD. He experiences a nightmare during his first night in the hospital. He explains to the nurse that he was dreaming about gunfire all around and people being killed. The nurse's most appropriate initial intervention is to a. administer alprazolam as ordered prn for anxiety. b. call the physician and report the incident. c. stay with John and reassure him of his safety. d. have John listen to a tape of relaxation exercises.

2. c

2. Margaret, age 68, is diagnosed with Bipolar I Disorder, Current episode manic. She is extremely hyperactive and has lost weight. One way to promote adequate nutritional intake for Margaret is to a. sit with her during meals to ensure that she eats everything on her tray. b. have her sister-in-law bring all her food from home because she knows Margaret's likes and dislikes. c. provide high-calorie, nutritious finger foods and snacks that Margaret can eat "on the run." d. tell Margaret that she will be on room restriction until she starts gaining weight.

2. c

2. Which of the following is the most appropriate therapy for a client with agoraphobia? a. 10 mg Valium qid b. Group therapy with other agoraphobics c. Facing her fear in gradual step progression d. Hypnosis

2. c

2. Kim, a client diagnosed with Borderline Personality Disorder, manipulates the staff in an effort to fulfill her own desires. All of the following may be examples of manipulative behaviors in the borderline client except a. refusal be in room alone, stating, "It's so lonely." b. asking for a break 30 minutes, knowing the assigned nurse has explained she must wait 1 hour. c. stating to Nurse Jones, "I really like having you for my nurse. You're the best one around here." d. cutting arms with razor blade after discussing dismissal plans with physician.

2. a

2. Psychoanalytically, the theory of obesity relates to the individual's unconscious equation of food with a. nurturance and caring. b. power and control. c. autonomy and emotional growth. d. strength and endurance.

2. a

2. Which of the following represents a nursing intervention at the secondary level of prevention? a. Teaching a class about menopause to middle-aged women. b. Providing support in the er room to a rape victim. c. Leading a support group for women in transition. d. Making monthly visits to the home of a client with schizophrenia to ensure medication compliance.

2. b

2. Nancy, 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

2. c

2. Sharon, a woman with multiple cuts and abrasions, arrives at the ED with her three small children. She tells the nurse her husband inflicted these wounds on her. In the interview, Sharon tells the nurse, "He's been getting more and more violent lately. He's been under a lot of stress at work the last few weeks, so he drinks a lot when he gets home. He always gets mean when he drinks. I was getting scared. So I just finally told him I was going to take the kids and leave. He got furious when I said that and began beating me with his fists." With knowledge about the cycle of battering, what does this situation represent? a. Phase I. Sharon was desperately trying to stay out of his way and keep everything calm. b. Phase I. A minor battering incident for which Sharon assumes all the blame. c. Phase II. The acute battering incident that Sharon provoked with her threat to leave. d. Phase III. The honeymoon phase where the husband believes that he has "taught her a lesson and she won't act up again."

2. c

2. The child with autism spectrum disorder has difficulty with trust. With this in mind, which of the following nursing actions would be most appropriate? a. Encourage all staff to hold the child as often as possible, conveying trust through touch. b. Assign a different staff member each day so child will learn that everyone can be trusted. c. Assign same staff person as often as possible to promote feelings of security and trust. d. Avoid eye contact, because this is extremely uncomfortable for the child and may even discourage trust.

2. c

2. What is the most appropriate way to communicate with an elderly person who is deaf in his right ear? a. Speak loudly into his left ear. b. Speak to him from a position on his left side. c. Speak face-to-face in a high-pitched voice. d. Speak face-to-face in a low-pitched voice.

2. d

chap 4: 2. Nurse Jones decides to respect family wishes and not tell the client of his terminal status because that would bring the most happiness to the most people. Which of the following ethical theories is considered in this decision? a. Utilitarianism b. Kantianism c. Christian ethics d. Ethical egoism

2.a

chap 6: 2. Nancy says to the nurse, "I worked as a secretary to put my husband through college, and as soon as he graduated, he left me. I hate him! I hate all men!" Which is an empathetic response by the nurse? a. "You are very angry now. This is a normal response to your loss." b. "I know what you mean. Men can be very insensitive." c. "I understand completely. My husband divorced me, too." d. "You are depressed now, but you will feel better in time."

2.a

chap 7: 2. The nurse is using nursing process to care for a suicidal client. Which of the following nursing actions is apart of the diagnosis step of the nursing process? a. Identifies nursing diagnosis: Risk for suicide b. Notes that client's family reports recent suicide attempt c. Prioritizes the necessity for maintaining a safe environment for the client d. Obtains a short-term contract from the client to seek out staff if feeling suicidal

2.a

chap 2: 2. Mr. J. has been diagnosed with Schizophrenia. He refuses to eat, and told the nurse he knew he was"being poisoned." According to Erikson's theory, in what developmental stage would you place Mr. J.? a. Intimacy vs. isolation b. Generativity vs. self-absorption c. Trust vs. mistrust d. Autonomy vs. shame and doubt

2.c

chap 1: 2. Based on the information in Question 1, Anna's grieving behavior would most likely be considered to be: a. delayed. b. inhibited. c. prolonged. d. distorted.

2.d

chap 3: 2. Which of the following parts of the brain is concerned with visual reception and interpretation? a. Frontal lobe b. Parietal lobe c. Temporal lobe d. Occipital lobe

2.d

chap 5: 2. Miss Lee, an Asian American on the psychiatric unit, says she is afraid that no one from her family will visit her. On what belief does Miss Lee base her statement? a. Many Asian Americans do not believe in hospitals. b. Many Asian Americans do not have close family support systems. c. Many Asian Americans believe the body will heal itself if left alone. d. Many Asian Americans view psychiatric problems as bringing shame to the family.

2.d

chap 7: 3. The nurse is using nursing process to care for a suicidal client. Which of the following nursing actions is apart of the outcome identification step of the nursing process? a. Prioritizes the necessity for maintaining a safe environment for the client b. Determines if nursing interventions have been appropriate to achieve desired results c. Obtains a short-term contract from the client to seek out staff if feeling suicidal d. Establishes goal of care: Client will not harm self during hospitalization

3.d

3. John, a veteran of the war in Iraq, is diagnosed with PTSD. Which of the following therapy regimens would most appropriately be ordered for John? a. Paroxetine and group therapy b. Diazepam and implosion therapy c. Alprazolam and behavior therapy d. Carbamazepine and cognitive therapy

3. a

3. The physician orders lithium carbonate 600 mg tid for a newly diagnosed client with Bipolar I Disorder. There is a narrow margin between the therapeutic and toxic levels of lithium. Therapeutic range for acute mania is a. 1.0 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.

3. a

3.The goal of cognitive 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.

3. a

3. Nursing care for a client with somatic symptom disorder would focus on helping the client to a. eliminate the stress in his or her life. b. discontinue his or her numerous physical complaints. c. take his or her medication only as prescribed. d. learn more adaptive coping strategies.

3. d

3. With implosion therapy, a client with phobic anxiety would be a. taught relaxation exercises. b. subjected to graded intensities of the fear. c. instructed to stop the therapeutic session as soon as anxiety is experienced. d. presented with massive exposure to a variety of stimuli associated with the phobic object/situation.

3. d

3. Why is it important for the nurse to check the temperature of the water before an elderly individual gets into the shower? a. The client may catch cold if the water temperature is too low. b. The client may burn himself because of a higher pain threshold. c. Elderly clients have difficulty discriminating between hot and cold. d. The water must be exactly 98.6° F.

3. B

3. A battered woman presents to the ED with multiple cuts and abrasions. Her right eye is swollen shut. She says that her husband did this to her. The priority nursing intervention is a. tending to the immediate care of her wounds. b. providing her with information about a safe place to stay. c. administering the prn tranquilizer ordered by the physician. d. explaining how she may go about bringing charges against her husband.

3. a

3. Which of the following nursing diagnoses would be considered the priority in planning care for the child with autism spectrum disorder? a. Risk for self-mutilation evidenced by banging head b. Impaired social interaction evidenced by unresponsiveness to people c. Impaired verbal communication evidenced by absence of verbal expression d. Disturbed personal identity evidenced by inability to differentiate self from others

3. a

3. Which of the following represents a nursing intervention at the tertiary level of prevention? a. Serving as cm for a mentally ill homeless client. b. Leading a support group for newly retired men. c. Teaching prepared childbirth classes. d. Caring for a depressed widow in the hospital.

3. a

3. Splitting by the client with borderline personality disorder denotes a. evidence of precocious development. b. a primitive defense mechanism in which the client sees objects as all good or all bad. c. a brief psychotic episode in which the client loses contact with reality. d. two distinct personalities within the borderline client.

3. b

3. Gloria, 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

3. c

3. The nurse is caring for a client with schizophrenia. Orders from the physician include 100 mg chlorpromazine IM STAT and then 50 mg PO bid; 2 mg benztropine PO bid prn. Why is chlorpromazine ordered? a. To reduce extrapyramidal symptoms b. To prevent neuroleptic malignant syndrome c. To decrease psychotic symptoms d. To induce sleep

3. c

chap 3: 3. Which of the following parts of the brain is associated with voluntary body movement, thinking and judgment, and expression of feeling? a. Frontal lobe b. Parietal lobe c. Temporal lobe d. Occipital lobe

3.a

chap 5: 3. Joe, a Native American, appears at the community health clinic with an oozing stasis ulcer on his lower right leg. It is obviously infected, and he tells the nurse that the shaman has been treating it with herbs. The nurse determines that Joe needs emergency care, but Joe states he will not go to the emergency department(ED) unless the shaman is allowed to help treat him. How should the nurse handle this situation? a. Contact the shaman and have him meet them at the ED to consult with the attending physician. b. Tell Joe that the shaman is not allowed in the ED. c. Explain to Joe that the shaman is at fault for his leg being in the condition it is in now. d. Have the shaman try to talk Joe into going to the ED without him.

3.a

chap 6: 3. Which of the following behaviors suggests a possible breach of professional boundaries? Select all that apply. a. The nurse repeatedly requests to be assigned to a specific client. b. The nurse shares the details of her divorce with the client. c. The nurse makes arrangements to meet the client outside of the therapeutic environment. d. The nurse shares how she dealt with a similar difficult situation.

3.a, b, c

3. From a physiological point of view, the most common cause of obesity is probably a. lack of nutritional education. b. more calories consumed than expended. c. impaired endocrine functioning. d. low basal metabolic rate.

3.b

chap 1: 3. Anna is diagnosed with Major Depressive Disorder. She is most likely fixed in which stage of the grief process? a. Denial b. Anger c. Depression d. Acceptance

3.b

chap 4: 3. Nurse Jones decides to tell the client of his terminal status because she believes it is her duty to do so.Which of the following ethical theories is considered in this decision? a. Natural law theories b. Ethical egoism c. Kantianism d. Utilitarianism

3.c

chap 2: 3. Janet, a psychiatric client diagnosed with Borderline Personality Disorder, has just been hospitalized for threatening suicide. According to Mahler's theory, Janet did not receive the critical "emotional refueling"required during the rapprochement phase of development. What are the consequences of this deficiency? a. She has not yet learned to delay gratification. b. She does not feel guilt about wrongdoings to others. c. She is unable to trust others. d. She has internalized rage and fears of abandonment.

3.d

4. A client with OCD spends many hours each day washing her hands. The most likely reason she washes her hands so much is that it a. relieves her anxiety. b. reduces the probability of infection. c. gives her a feeling of control over her life. d. increases her self-concept.

4. a

4.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. Olanzepine (Zyprexa) b. Paroxetine (Paxil) c. Carbamazepine (Tegretol) d. Gabapentin (Neurontin) e. Tranylcypromine (Parnate)

4. a, c, d

4. Lorraine, a client diagnosed with Somatic Symptom Disorder, states, "My doctor thinks I should see a psy chiatrist. I can't imagine why he would make such a suggestion?" What is the basis for Lorraine's statement? a. She thinks her doctor wants to get rid of her as a client. b. She does not understand the correlation of symptoms and stress. c. She thinks psychiatrists are only for "crazy" people. d. She thinks her doctor has made an error in diagnosis.

4. b

4. Education for the client who is taking monoamine oxidase inhibitors (MAOIs) should include which of the following? a. Fluid and sodium replacement when appropriate, frequent blood drug levels, signs and symptoms of toxicity. b. Lifetime of continuous use, possible tardive dyskinesia, advantages of an injection every 2 to 4 weeks. c. Short-term use, possible tolerance to beneficial effects, careful tapering of the drug at end of treatment. d. Tyramine-restricted diet, prohibitive concurrent use of over-the-counter medications without physician notification.

4. d

4. Which of the following may be influential in the predisposition to PTSD? a. Unsatisfactory parent-child relationship b. Excess of the neurotransmitter serotonin c. Distorted, negative cognitions d. Severity of the stressor and availability of support systems

4. d

4. Mr. B, age 79, is admitted to the psychiatric unit for depression. He has lost weight and has become socially isolated. His wife died 5 years ago and his son tells the nurse, "He did very well when Mom died. He didn't even cry." Which would be the priority nursing diagnosis for Mr. B? a. Complicated grieving b. Imbalanced nutrition: less than body requirements c. Social isolation d. Risk for injury

4. a

4. Nancy, age 14, has just been admitted to the psychiatric unit for anorexia nervosa. She is emaciated and refusing to eat. What is the primary nursing diagnosis for Nancy? a. Complicated grieving b. Imbalanced nutrition: Less than body requirements c. Interrupted family processes d. Anxiety (severe)

4. b

4. Which of the following activities would be most appropriate for the child with ADHD? a. Monopoly b. Volleyball c. Pool d. Checkers

4. b

4. John, a homeless person, has just come to live in the shelter. The shelter nurse is assigned to his care. Which of the following is a priority intervention on the part of the nurse? a. Referring John to a social worker. b. Developing a plan of care for John. c. Conducting a behavioral and needs assessment on John. d. Helping John apply for Social Security benefits.

4. c

6. 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. Delusional thinking c. Feelings of despair d. Feels best early in the morning and worse as the day progresses e. Anorexia

6. a, b, c, e

4. A woman who has a long history of being battered by her husband is staying at the woman's shelter. She has received emotional support from staff and peers and has been made aware of the alternatives open to her. Nevertheless, she decides to return to her home and marriage. The best response by the nurse to the woman's decision is, a. "I just can't believe you have decided to go back to that horrible man." b. "I'm just afraid he will kill you or the children when you go back." c. "What makes you think things have changed with him?" d. "I hope you have made the right decision. Call this number if you need help."

4. d

4. According to Margaret Mahler, predisposition to borderline personality disorder occurs when developmental tasks go unfulfilled in which of the following phases? a. Autistic phase, during which the child's needs for security and comfort go unfulfilled b. Symbiotic phase, during when child fails to bond c. Differentiation phase, during which the child fails to recognize a separateness between self and mother d. Rapprochement phase, during which the mother withdraws emotional support in response to the child's increasing independence

4. d

4. 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

4. d

chap 1: 4. Anna, who is 72 years old, is of the age when she may have experienced many losses coming close together. What is this called? a. Bereavement overload b. Normal mourning c. Isolation d. Cultural relativity

4.a

chap 7: 4. The nurse is using nursing process to care for a suicidal client. Which of the following nursing actions is apart of the planning step of the nursing process? a. Prioritizes the necessity for maintaining a safe environment for the client b. Determines if nursing interventions have been appropriate to achieve desired results c. Obtains a short-term contract from the client to seek out staff if feeling suicidal d. Establishes goal of care: Client will not harm self during hospitalization

4.a

chap 2: 4. John is on the Alcohol Treatment Unit. He walks into the day room where other clients are watching a program on TV. He picks up the remote and changes the channel, saying, "That's a stupid program! I want to watch something else!" In what stage of development is John fixed according to Sullivan's interpersonal theory? a. Juvenile. He is learning to form satisfactory peer relationships. b. Childhood. He has not learned to delay gratification. c. Early adolescence. He is struggling to form an identity. d. Late adolescence. He is working to develop a lasting relationship.

4.b

chap 3: 4. Which of the following parts of the brain integrates all sensory input (except smell) on the way to the cortex? a. Temporal lobe b. Thalamus c. Limbic system d. Hypothalamus

4.b

chap 4: 4. The nurse assists the physician with electroconvulsive therapy on his client who has refused to give consent.With which of the following legal actions might the nurse be charged because of this nursing action? a. Assault b. Battery c. False imprisonment d. Breach of confidentiality

4.b

chap 6: 4. A client states, "I refuse to shower in this room. I must be very cautious. The FBI has placed a camera inhere to monitor my every move." Which of the following is the therapeutic response? a. "That's not true." b. "I have a hard time believing that is true." c. "Surely you don't really believe that." d. "I will help you search this room so that you can see there is no camera."

4.b

chap 5: 4. Joe, a Native American, goes to the emergency department (ED) because he has an oozing stasis ulcer on his leg. He is accompanied by the tribal shaman, who has been treating Joe on the reservation. As a greeting, the physician extends his hand to the shaman, who lightly touches the physician's hand, then quickly moves away. How should the physician interpret this gesture? a. The shaman is snubbing the physician. b. The shaman is angry at Joe for wanting to go to the ED. c. The shaman does not believe in traditional medicine. d. The shaman does not feel comfortable with touch.

4.d

5. Margaret, a 68-year-old widow experiencing a manic episode, is admitted to the psychiatric unit after being brought to the ED by her sister-in-law. Margaret yells, "My sister-in-law is just jealous of me! She's trying to make it look like I'm insane!" This behavior is an example of a a. delusion of grandeur. b. delusion of persecution. c. delusion of reference. d. delusion of control or influence.

5. b

5. Nina recently left her husband of 10 years. She was very dependent on her husband and is having difficulty adjusting to an independent lifestyle. She has been hospitalized with a diagnosis of Adjustment Disorder with Depressed Mood. The priority nursing diagnosis for Nina would be a. risk-prone health behavior related to loss of dependency. b. complicated grieving related to breakup of marriage. c. ineffective coping related to problems with dependency. d. social isolation related to depressed mood.

5. b

5. The initial care plan for a client with OCD who washes her hands obsessively would include which of the following nursing interventions? a. Keep the client's bathroom locked so she cannot wash her hands all the time. b. Structure the client's schedule so that she has plenty of time for washing her hands. c. Place the client in isolation until she promises to stop washing her hands so much. d. Explain the client's behavior to her, since she is probably unaware that it is maladaptive.

5. b

5. In teaching a client about his antidepressant medication, fluoxetine, which of the following would the nurse include? Select all that apply. a. Don't eat chocolate while taking this medication. b. Keep taking this medication, even if you don't feel it is helping. It sometimes takes a while to take effect. c. Don't take this medication with the migraine drugs "triptans." d. Go to the lab each week to have your blood drawn for therapeutic level of this drug. e. This drug causes a high degree of sedation, so take it just before bedtime.

5. b, c

6. Nina, who is depressed following the breakup of a very stormy marriage, says to the nurse, "I feel so bad. I thought I would feel better once I left, but I feel worse!" Which is the best response by the nurse? a. "Cheer up, Nina. You have a lot to be happy about." b. "You are grieving for the marriage you did not have. It's natural for you to feel badly." c. "Try not to dwell on how you feel. If you don't think about it, you'll feel better." d. "You did the right thing, Nina. Knowing that should make you feel better."

6. b

5. Lorraine, 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. You must leave now to be on time." 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?"

5. c

5. Mr. B, age 79, is admitted to the psychiatric unit for depression. He has lost weight and has become socially isolated. His wife died 5 years ago and he lives alone. A suicide assessment is conducted. Why is Mr. B at high risk for suicide? a. All depressed people are at high risk for suicide. b. Mr. B is in the age group in which the highest percentage of suicides occur. c. Mr. B is a white man, recently bereaved, living alone. d. His son reports that Mr. B owns a gun.

5. C

5. Jack is a new client on the psychiatric unit with a diagnosis of Antisocial Personality Disorder. Which of the following characteristics would you expect to assess in Jack? a. Lack of guilt for wrongdoing b. Insight into his own behavior c. Ability to learn from past experiences d. Compliance with authority

5. a

5. 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

5. a

5. Jana, age 5, is sent to the school nurse's office with an upset stomach. She has vomited and soiled her blouse. When the nurse removes her blouse, she notices that Jana has numerous bruises on her arms and torso, in various stages of healing. She also notices some small scars. Jana's abdomen protrudes on her small, thin frame. From the objective physical assessment, the nurse suspects that a. Jana is experiencing physical and sexual abuse. b. Jana is experiencing physical abuse and neglect. c. Jana is experiencing emotional neglect. d. Jana is experiencing sexual and emotional abuse.

5. b

5. Which of the following groups is most commonly used for drug management of the child with ADHD? a. CNS depressants (e.g., diazepam [Valium]) b. CNS stimulants (e.g., methylphenidate [Ritalin]) c. Anticonvulsants (e.g., phenytoin [Dilantin]) d. Major tranquilizers (e.g., haloperidol [Haldol])

5. b

5. Which of the following physical manifestations would you expect to assess in a client suffering from anorexia nervosa? a. Tachycardia, hypertension, hyperthermia b. Bradycardia, hypertension, hyperthermia c. Bradycardia, hypotension, hypothermia d. Tachycardia, hypotension, hypothermia

5. c

5. John, a homeless person, has a history of schizophrenia and noncompliance with medications. Which of the following medications might be the best choice for John? a. Haldol b. Navane c. Lithium carbonate d. Prolixin decanoate

5. d

chap 6: 5. Nancy, a depressed client who has been unkempt and untidy for weeks, today comes to group therapy wearing makeup and a clean dress and having washed and combed her hair. Which of the following responses by the nurse is most appropriate? a. "Nancy, I see you have put on a clean dress and combed your hair." b. "Nancy, you look wonderful today!" c. "Nancy, I'm sure everyone will appreciate that you have cleaned up for the group today." d. "Now that you see how important it is, I hope you will do this every day."

5.a

chap 1: 5. Anna, age 72, has been grieving the death of her dog, Lucky, for 3 years. She is not able to take care of her activities of daily living and wants only to make daily visits to Lucky's grave. Her daughter has likely put off seeking help for Anna because: a. Women are less likely than men to seek help for emotional problems. b. Relatives often try to "normalize" the behavior rather than label it mental illness. c. She knows that all older people are expected to be a little depressed. d. She is afraid that the neighbors "will think her mother is crazy."

5.b

chap 2: 5.Adam has Antisocial Personality Disorder. He says to the nurse, "I'm not crazy. I'm just fun-loving. I believe in looking out for myself. Who cares what anyone thinks? If it feels good, do it!" Which of the following describes the psychoanalytical structure of Adam's personality? a.Weak id, strong ego, weak superego b.Strong id, weak ego, weak superego c.Weak id, weak ego, punitive superego d.Strong id, weak ego, punitive superego

5.b

chap 5: 5. Sarah is an African American woman who receives a visit from the psychiatric home health nurse. A referral for a mental health assessment was made by the public health nurse, who noticed that Sarah was becoming exceedingly withdrawn. When the psychiatric nurse arrives, Sarah says to her, "No one can help me. I was an evil person in my youth, and now I must pay." How might the nurse assess this statement? a. Sarah is having delusions of persecution. b. Some African Americans believe illness is God's punishment for their sins. c. Sarah is depressed and just wants to be left alone. d. African Americans do not believe in psychiatric help.

5.b

chap 3: 5. Which of the following parts of the brain deals with sensory perception and interpretation? a. Hypothalamus b. Cerebellum c. Parietal lobe d. Hippocampus

5.c

chap 4: 5. A competent, voluntary client has stated he wants to leave the hospital. The nurse hides his clothes in an effort to keep him from leaving. With which of the following legal actions might the nurse be charged because of this nursing action? a. Assault b. Battery c. False imprisonment d. Breach of confidentiality

5.c

chap 7: 5. The nurse is using nursing process to care for a suicidal client. Which of the following nursing actions is apart of the implementation step of the nursing process? a. Prioritizes the necessity for maintaining a safe environment for the client b. Determines if nursing interventions have been appropriate to achieve desired results c. Obtains a short-term contract from the client to seek out staff if feeling suicidal d. Establishes goal of care: Client will not harm self during hospitalization

5.c

6. A client with OCD says to the nurse, "I've been here 4 days now, and I'm feeling better. I feel comfortable on this unit, and I'm not ill-at-ease with the staff or other patients anymore." In light of this change, which nursing intervention is most appropriate? a. Give attention to the ritualistic behaviors each time they occur and point out their inappropriateness. b. Ignore the ritualistic behaviors, and they will be eliminated for lack of reinforcement. c. Set limits on the amount of time Sandy may engage in the ritualistic behavior. d. Continue to allow Sandy all the time she wants to carry out the ritualistic behavior.

6. c

6. Ellen has a history of childhood physical and sexual abuse. She was diagnosed with Dissociative Identity Disorder (DID) 6 years ago. She has been admitted to the psychiatric unit following a suicide attempt. The primary nursing diagnosis for Ellen would be 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.

6. d

6. The most common comorbid condition in children with bipolar disorder is a. schizophrenia. b. substance disorder. c. oppositional defiant disorder. d. attention-deficit/hyperactivity disorder.

6. d

6. When Frank's wife of 34 years dies, he is very stoic, handles all the funeral arrangements, doesn't cry or appear sad, and comforts all of the other family members in their grief. Two years later, when Frank's best friend dies, Frank has sleep disturbances, difficulty concentrating, loss of weight, and difficulty performing on his jo b. This is an example of which of the following maladaptive responses to loss? a. Delayed grieving b. Distorted grieving c. Prolonged grieving d. Exaggerated grieving

6. a

6. Ann is a psychiatric home health nurse. She has just received an order to begin regular visits to Mrs. W., a 78-year-old widow who lives alone. Mrs. W.'s primary-care physician has diagnosed her as depressed. Which of the following criteria would qualify Mrs. W. for home health visits? a. Mrs. W. never learned to drive and has to depend on others for her transportation. b. Mrs. W. is physically too weak to travel without risk of injury. c. Mrs. W. refuses to seek assistance as suggested by her physician, "because I don't have a psychiatric problem." d. Mrs. W. says she would prefer to have home visits than go to the physician's office.

6. b

6. Milieu therapy is a good choice for clients with antisocial personality disorder because it a. provides a system of punishment and reward for behavior modification. b. emulates a social community in which the client may learn to live harmoniously with others. c. provides mostly one-to-one interaction between the client and therapist. d. provides a very structured setting in which the client have little input into the planning their care.

6. b

6. Nurse Jones is caring for a client who has been hospitalized with anorexia nervosa and is severely malnourishe d. The client continues to refuse to eat. What is the most appropriate response by the nurse? a. "You know that if you don't eat, you will die." b. "If you continue to refuse to take food orally, you will be fed through a nasogastric tube." c. "You might as well leave if you are not going to follow your therapy regimen." d. "You don't have to eat if you don't want to. It is your choice."

6. b

6. The child with ADHD has a nursing diagnosis of impaired social interaction. Which of the following nursing interventions are appropriate for this child? Select all that apply. a. Socially isolate the child when interactions with others are inappropriate. b. Set limits with consequences on inappropriate behaviors. c. Provide rewards for appropriate behaviors. d. Provide group situations for the child.

6. b, c, d

6. A school nurse notices bruises and scars on a child's body, but the child refuses to say how she received them. Another way in which the nurse can get information from the child is to a. have her evaluated by the school psychologist. b. tell her she may select a "treat" from the treat box (e.g., sucker, balloon, junk jewelry) if she answers the nurse's questions. c. explain to her that if she answers the questions, she may stay in the nurse's office and not have to go back to class. d. use a "family" of dolls to role-play the child's family with her.

6. d

6. Mr. B, age 79, is admitted to the psychiatric unit for depression. He has lost weight and has become socially isolated. His wife died 5 years ago and his son tells the nurse, "He did very well when Mom died. He didn't even cry." Which would be the priority nursing intervention for Mr. B? a. Take blood pressure once each shift. b. Ensure that Mr. B attends group activities. c. Encourage Mr. B to eat all of the food on his food tray. d. Encourage Mr. B to talk about his wife's death.

6. d

chap 3: 6. Which of the following parts of the brain is concerned with hearing, short-term memory, and sense of smell? a. Temporal lobe b. Parietal lobe c. Cerebellum d. Hypothalamus

6.a

chap 2: 6.Larry, who has Antisocial Personality Disorder, feels no guilt about violating the rights of others. He does as he pleases without thought to possible consequences. In which of Peplau's stages of development would you place Larry? a.Learning to count on others b.Learning to delay gratification c.Identifying oneself d.Developing skills in participation

6.b

chap 7: 6.The nurse is using nursing process to care for a suicidal client. Which of the following nursing actions isa part of the evaluation step of the nursing process? a.Prioritizes the necessity for maintaining a safe environment for the client b.Determines if nursing interventions have been appropriate to achieve desired results c.Obtains a short-term contract from the client to seek out staff if feeling suicidal d.Establishes goal of care: Client will not harm self during hospitalization

6.b

chap 5: 6.Sarah is an African American woman who lives in the rural South. She receives a visit from the public health nurse. Sarah says to the nurse, "Granny told me to eat a lot of poke greens and I would feel better." How should the nurse interpret this statement? a. Sarah's grandmother believes in the healing power of poke greens. b.Sarah believes everything her grandmother tells her. c. Sarah has been receiving health care from a "folk practitioner." d.Sarah is trying to determine if the nurse agrees with her grandmother.

6.c

chap 1: 6. Anna's dog Lucky got away from her while they were taking a walk. He ran into the street and was hit by a car. Anna cannot remember any of these circumstances of his death. This is an example of what defense mechanism? a. Rationalization b. Suppression c. Denial d. Repression

6.d

chap 6: 6. Dorothy was involved in an automobile accident while under the influence of alcohol. She swerved her car into a tree and narrowly missed hitting a child on a bicycle. She is in the hospital with multiple abrasions and contusions. She is talking about the accident with the nurse. Which of the following statements by the nurse is most appropriate? a. "Now that you know what can happen when you drink and drive, I'm sure you won't let it happen again." b. "You know that was a terrible thing you did. That child could have been killed." c. "I'm sure everything is going to be okay now that you understand the possible consequences of such behavior." d. "How are you feeling about what happened?"

6.d

7. A client with depression has just been prescribed the antidepressant phenelzine (Nardil). She says to the nurse, "The doctor says I will need to watch my diet while I'm on this medication. What foods should I avoid?" Which of the following is the correct response by the nurse? a. Blue cheese, red wine, raisins b. Black beans, garlic, pears c. Pork, shellfish, egg yolks d. Milk, peanuts, tomatoes

7. a

7. Annie has hair-pulling disorder. She is receiving treatment at the mental health clinic with habit-reversal therapy. Which of the following elements would be included in this therapy? Select all that apply. a. Awareness training b. Competing response training c. Social support d. Hypnotherapy e. Aversive therapy

7. a, b, c

7. A nurse is educating a client about his lithium therapy. She is explaining signs and symptoms of lithium toxicity. Which of the following would she instruct the client 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

7. b

7. In establishing trust with Ellen, a client with the diagnosis of DID, the nurse must a. try to relate to Ellen as though she did not have multiple personalities. b. establish a relationship with each of the personalities separately. c. ignore behaviors that Ellen attributes to the subpersonality, Beth. d. explain to Ellen that he or she will work with her only if she maintains the status of the primary personality.

7. b

7. Nina has been hospitalized with Adjustment Disorder with Depressed Mood following the breakup of her marriage. Which of the following is true regarding the diagnosis of an adjustment disorder? a. Nina will require long-term psychotherapy to achieve relief. b. Nina likely inherited a genetic tendency for the disorder. c. Nina's symptoms will likely remit once she has accepted the change in her life. d. Nina probably would not have experienced an adjustment disorder if she had a higher level of intelligence.

7. c

7. A school nurse notices bruises and scars on a child's body. The nurse suspects that the child is being physically abused. How should the nurse proceed with this information? a. As a health-care worker, report the suspicion to the Department of Health and Human Services. b. Check Jana again in a week and see if there are any new bruises. c. Meet with Jana's parents and ask them how Jana got the bruises. d. Initiate paperwork to have Jana placed in foster care.

7. a

7. In group exercise, Mr. B, a 79-year-old man with major depressive disorder, becomes tired and short of breath very quickly. This is most likely due to: a. age-related changes in the cardiovascular system. b. a sedentary lifestyle. c. the effects of pathological depression. d. medication the physician has prescribed for depression.

7. a

7. A major difference between normal and maladaptive grieving has been identified by which of the following? a. There are no feelings of depression in normal grieving. b. There is no loss of self-esteem in normal grieving. c. Normal grieving lasts no longer than 1 year. d. In normal grief the person does not show anger toward the loss.

7. b

7. Ann is a psychiatric home health nurse. She has just received an order to begin regular visits to Mrs. W., a 78-year-old widow who lives alone. Mrs. W.'s primary-care physician has diagnosed her as depressed. Based on a needs assessment, which of the following problems would Ann address during her first visit? a. Complicated grieving b. Social isolation c. Risk for injury d. Sleep pattern disturbance

7. c

7. In evaluating the progress of Jack, a client diagnosed with Antisocial Personality Disorder, which of the following behaviors would be considered the most significant indication of positive change? a. Jack got angry only once in group this week. b. Jack was able to wait a whole hour for a cigarette without verbally abusing the staff. c. On his own initiative, Jack sent a note of apology to a man he had injured in a recent fight. d. Jack stated that he would no longer start any more fights.

7. c

7. The nursing history and assessment of an adolescent with a conduct disorder might reveal all of the following behaviors except a. manipulation of others for fulfillment of own desires. b. chronic violation of rules. c. feelings of guilt associated with the exploitation of others. d. inability to form close peer relationships.

7. c

7. Which medication has been used with some success in clients with anorexia nervosa? a. Lorcaserin (Belviq) b. Diazepam (Valium) c. Fluoxetine (Prozac) d. Carbamazepine (Tegretol)

7. c

chap 2: 7.Danny has been diagnosed with Schizophrenia. On the unit he appears very anxious, paces back and forth, and darts his head from side to side in a continuous scanning of the area. He has refused to eat,making some barely audible comment related to "being poisoned." In planning care for Danny, which of the following would be the primary focus for nursing? a.To decrease anxiety and develop trust b.To set limits on his behavior c.To ensure that he gets to group therapy d.To attend to his hygiene needs

7.a

chap 7: 7.S.T. is a 15-year-old girl who has just been admitted to the adolescent psychiatric unit with a diagnosis of Anorexia Nervosa. She is 5'5" tall and weighs 82 lb. She was elected to the cheerleading squad for thefall but states that she is not as good as the others on the squad. The treatment team has identified thefollowing problems: refusal to eat, occasional purging, refusing to interact with staff and peers, and fearof failure. Which of the following nursing diagnoses would be appropriate for S.T.? Select all that apply. a.Social isolation b.Disturbed body image c.Low self-esteem d.Imbalanced nutrition: Less than body requirements

7.a, b, c, d

chap 4: 7.An individual may be considered gravely disabledfor which of the following reasons? (Select all that apply.) a.A person, because of mental illness, cannot fulfill basic needs. b.A mentally ill person is in danger of physical harm based on inability to care for self. c.A mentally ill person lacks the resources to provide the necessities of life. d.A mentally ill person is unable to make use of available resources to meet daily living requirements.

7.a, b, d

chap 1: 7. Lucky sometimes refused to obey Anna and indeed did not come back to her when she called to him on the day he was killed. But Anna continues to insist, "He was the very best dog. He always minded me. He always did everything I told him to do." This represents the defense mechanism : a. sublimation. b. compensation. c. reaction formation. d. undoing.

7.c

chap 5: 7.Frank is a Latino American who has an appointment at the community health center for 1:00 p.m. The nurse is angry when Frank shows up at 3:30 p.m. stating, "I was visiting with my brother." How must the nurse interpret this behavior? a. Frank is being passive-aggressive by showing up late. b. This is Frank's way of defying authority. c. Frank is a member of a cultural group that is present-time oriented. d. Frank is a member of a cultural group that rejects traditional medicine.

7.c

chap 6: 7. Judy has been in the hospital for 3 weeks. She has used Valium "to settle my nerves" for the past 15 years.She was admitted by her psychiatrist for safe withdrawal from the drug. She has passed the physical symptoms of withdrawal at this time, but states to the nurse, "I don't know if I will make it without Valium after I go home. I'm already starting to feel nervous. I have so many personal problems." Which is the most appropriate response by the nurse? a. "Why do you think you have to have drugs to deal with your problems?" b. "Everybody has problems, but not everybody uses drugs to deal with them. You'll just have to do the best that you can." c. "We will just have to think about some things that you can do to decrease your anxiety without resorting to drugs." d. "Just hang in there. I'm sure everything is going to be okay."

7.c

chap 3: 7. Which of the following parts of the brain has control over the pituitary gland and autonomic nervous system? It also regulates appetite and temperature. a. Temporal lobe b. Parietal lobe c. Cerebellum d. Hypothalamus

7.d

8. The physician orders sertraline (Zoloft) for a client who is hospitalized with adjustment disorder with depressed mood. This medication is intended to a. increase energy and elevate mood. b. stimulate the central nervous system. c. prevent psychotic symptoms. d. produce a calming effect.

8. a

8. The ultimate goal of therapy for a client with DID is a. integration of the personalities into one. b. for the client to have the ability to switch from one personality to another voluntarily. c. for the client to select which personality he or she wants to be the dominant self. d. for the client to recognize that the various personalities exist.

8. a

8. 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.

8. c

8. Joanie is a new patient at the mental health clinic. She has been diagnosed with Body Dysmorphic Disorder. Which of the following medications is the psychiatric nurse practitioner most likely to prescribe for Joanie? a. Alprazolam (Xanax) b. Diazepam (Valium) c. Fluoxetine (Prozac) d. Olanzapine (Zyprexa)

8. c

8. John is a client at the mental health clinic. He is depressed, has been expressing suicidal ideations, and has been seeing the psychiatric nurse every three days. He has been taking 100 mg of sertraline daily for about a month, receiving small amounts of the medication from his nurse at each visit. Today he comes to the clinic in a cheerful mood, much different than he seemed just 3 days ago. How might the nurse assess this behavioral change? a. The sertraline is finally taking effect. b. He is no longer in need of antidepressant medication. c. He has completed the grief response over loss of his wife. d. He may have decided to carry out his suicide plan.

8. d

8. Clara, an 80-year-old woman, says to the nurse, "I'm all alone now. My husband is gone. My best friend is gone. My daughter is busy with her work and family. I might as well just go, too." Which is the best response by the nurse? a. "Are you thinking that you want to die, Clara?" b. "You have lots to live for, Clara." c. "Cheer up, Clara. You have so much to be thankful for." d. "Tell me about your family, Clara."

8. a

8. Which of the following behavioral patterns is characteristic of individuals with narcissistic personality disorder? a. Overly self-centered and exploitative of others b. Suspicious and mistrustful of others c. Rule conscious and disapproving of change. d. Anxious and socially isolated

8. a

8. Jane is hospitalized on the psychiatric unit. She has a history and current diagnosis of Bulimia Nervos a. Which of the following symptoms would be congruent with Jane's diagnosis? a. Binging, purging, obesity, hyperkalemia b. Binging, purging, normal weight, hypokalemia c. Binging, laxative abuse, amenorrhea, severe weight loss d. Binging, purging, severe weight loss, hyperkalemia

8. b

8. Kate is an 18-year-old freshman at the state university. She was extremely flattered when Don, a senior star football player, invited her to a party. On the way home, he parked the car in a secluded area by the lake. He became angry when she refused his sexual advances. He began to beat her and finally raped her. She tried to fight him, but his physical strength overpowered her. He dumped her in the dorm parking lot and left. The dorm supervisor rushed Kate to the emergency department. Kate says to the nurse, "It's all my fault. I shouldn't have allowed him to stop at the lake." The nurse's best response is, a. "Yes, you're right. You put yourself in a very vulnerable position when you allowed him to stop at the lake." b. "You are not to blame for his behavior. You obviously made some right decisions, because you survived the attack." c. "There's no sense looking back now. Just look forward, and make sure you don't put yourself in the same situation again." d. "You'll just have to see that he is arrested so he won't do this to anyone else."

8. b

8. Mrs. W., a 78-year-old depressed widow, says to her home health nurse, "What's the use? I don't have anything to live for anymore." Which is the best response on the part of the nurse? a. "Of course you do, Mrs. W. Why would you say such a thing?" b. "You seem so sad. I'm going to do my best to cheer you up." c. "Let's talk about why you are feeling this way." d. "Have you been thinking about harming yourself in any way?"

8. d

chap 6: 8. Mrs. S. asks the nurse, "Do you think I should tell my husband about my affair with my boss?" Which is the most appropriate response by the nurse? a. "What do you think would be best for you to do?" b. "Of course you should. Marriage has to be based on truth." c. "Of course not. That would only make things worse." d. "I can't tell you what to do. You have to decide for yourself."

8.a

chap 1: 8.Anna has been a widow for 20 years. Her mal-adaptive grief response to the loss of her dog may be attributed to which of the following? Select all that apply. a. Unresolved grief over loss of her husband b. Loss of several relatives and friends over the last few years c. Repressed feelings of guilt over the way in which Lucky died d. Inability to prepare in advance for the loss

8.a, b, c, d

chap 5: 8.The nurse must give Frank, a Latino American, a physical examination. She tells him to remove his clothing and put on an examination gown. Frank refuses. How should the nurse interpret this behavior? a. Frank does not believe in taking orders from a woman. b. Frank is modest and embarrassed to remove his clothes. c. Frank doesn't understand why he must remove his clothes. d. Frank does not think he needs a physical examination.

8.b

chap 4: 8.Which of the following statements is (are) correct regarding the use of restraints? (Select all that apply.) a.Restraints may never be initiated without a physician's order. b.Orders for restraints must be reissued by a physician every 2 hours for children and adolescents. c.Clients in restraints must be observed and assessed every hour for issues regarding circulation, nutri-tion, respiration, hydration, and elimination. d.An in-person evaluation must be conducted within one hour of initiating restraints.

8.b, d

chap 2: 8.The nurse has just admitted Nancy to the psychiatric unit. The psychiatrist has diagnosed Nancy with Major Depressive Disorder. The nurse says to Nancy, "Please tell me what it was like when you were growing up." Which nursing role described by Peplau is the nurse fulfilling in this instance? a.Surrogate b.Resource person c.Counselor d.Technical expert

8.c

chap 3: 8. At a synapse, the determination of further impulse transmission is accomplished by means of: a.potassium ions. b.interneurons. c.neurotransmitters. d.the myelin sheath.

8.c

chap 7: 8.S.T. is a 15-year-old girl who has just been admitted to the adolescent psychiatric unit with a diagnosis ofAnorexia Nervosa. She is 5'5" tall and weighs 82 lb. She was elected to the cheerleading squad for thefall but states that she is not as good as the others on the squad. The treatment team has identified thefollowing problems: refusal to eat, occasional purging, refusing to interact with staff and peers, and fearof failure. Which of the following nursing diagnoses would be the priority diagnosis for S.T.? a.Social isolation b.Disturbed body image c.Low self-esteem d.Imbalanced nutrition: Less than body requirements

8.d

9. A client who is experiencing a panic attack has just arrived at the emergency department. Which is the priority nursing intervention for this client? a. Stay with the client and reassure of safety. b. Administer a dose of diazepam. c. Leave the client alone in a quiet room so that she can calm down. d. Encourage the client to talk about what triggered the attack.

9. a

9. The category of adjustment disorder with disturbance of conduct identifies the individual who a. violates the rights of others to feel better. b. expresses symptoms that reveal a high level of anxiety. c. exhibits severe social isolation and withdrawal. d. is experiencing a complicated grieving process.

9. a

9. The nurse is preparing a patient for an electroconvulsive therapy (ECT) treatment. About 30 minutes prior to the treatment the nurse administers atropine sulfate 0.4 mg IM. Rationale for this order is a. to decrease secretions and increase heart rate. b. to relax muscles. c. to produce a calming effect. d. to induce anesthesia.

9. a

9. The nurse is prioritizing nursing diagnoses in the plan of care for a client experiencing a manic episode. Number the diagnoses in order of the appropriate priority. ______ a. Disturbed sleep pattern evidenced by sleeping only 4 to 5 hours per night ______ b. Risk for injury related to manic hyperactivity ______ c. Impaired social interaction evidenced by manipulation of others ______ d. Imbalanced nutrition: Less than body requirements evidenced by loss of weight and poor skin turgor

9. a = 3, b = 1, c = 4, d = 2

9. The ultimate goal of therapy for a client with DID 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.

9. b

9. The physician orders trazadone (Desyrel) for Mrs. W., a 78-year-old widow with depression, 150 mg to take at bedtime. Which of the following statements about this medication would be appropriate for the home health nurse to make in teaching Mrs. W. about trazadone? a. "You may feel dizzy when you stand up, so go slowly when you get up from sitting or lying down." b. "You must be sure and not eat any chocolate while you are taking this medicine." c. "We will need to draw a sample of blood to send to the lab every month while you are on this medication." d. "If you don't feel better right away with this medicine, the doctor can order a different kind for you."

9. a

9. Which of the following is a correct statement when attempting to distinguish normal grief from clinical depression? a. In clinical depression, anhedonia is prevalent. b. In normal grieving, the person has generalized feelings of guilt. c. The person who is clinically depressed relates feelings of depression to a specific loss. d. In normal grieving, there is a persistent state of dysphori a.

9. a

9. Which of the following is least likely to predispose a child to Tourette's disorder? a. Absence of parental bonding b. Family history of the disorder c. Abnormalities of brain neurotransmitters d. Structural abnormalities of the brain

9. a

9. A young woman who has just undergone a sexual assault is brought into the ED by a friend. The priority nursing intervention would be to a. help her to bathe and clean herself up. b. provide physical and emotional support during evidence collection. c. provide her with a written list of community resources for survivors of rape. d. discuss the importance of a follow-up visit to evaluate for sexually transmitted diseases.

9. b

9. A hospitalized client with bulimia nervosa has stopped vomiting in the hospital and tells the nurse she is afraid she is going to gain weight. Which is the most appropriate response by the nurse? a. "Don't worry. The dietitian will ensure you don't get too many calories in your diet." b. "Don't worry about your weight. We are going to work on other problems while you are in the hospital." c. "I understand that you are concerned about your weight, and we will talk about the importance of good nutrition; but for now I want you to tell me about your recent invitation to join the National Honor Society. That's quite an accomplishment." d. "You are not fat, and the staff will ensure that you do not gain weight while you are in the hospital, because we know that is important to you."

9. c

9. An elderly client says to the nurse, "I don't want to go to that crafts class. I'm too old to learn anything." Based on knowledge of the aging process, which of the following is a true statement? a. Memory functioning in the elderly most likely reflects loss of long-term memories of remote events. b. Intellectual functioning declines with age. c. Learning ability remains intact, but time required for learning increases with age. d. Cognitive functioning is rarely affected in aging individuals.

9. c

9. Carol is a new nursing graduate being oriented on a medical/surgical unit by the head nurse, Mrs. Carey. When Carol describes a new technique she has learned for positioning immobile clients, Mrs. Carey states, "What are you trying to do . . . tell me how to do my job? We have always done it this way on this unit, and we will continue to do it this way until I say differently!" This is an example of which type of personality characteristic? a. Antisocial b. Paranoid c. Passive-aggressive d. Obsessive-compulsive

9. d

chap 2: 9.The nurse has just admitted Nancy to the psychiatric unit. The psychiatrist has diagnosed Nancy with Major Depressive Disorder. The nurse says to Nancy, "What questions do you have about being here on the unit?" Which nursing role described by Peplau is the nurse fulfilling in this instance? a.Resource person b.Counselor c.Surrogate d.Technical expert

9.a

chap 4: 9.Guidelines relating to "duty to warn" state that a therapist should consider taking action to warn a thirdparty when his or her client (select all that apply) a.threatens violence toward another individual. b.identifies a specific intended victim. c.is having command hallucinations. d.reveals paranoid delusions about another individual.

9.a, b

chap 3: 9. A decrease in which of the following neurotransmitters has been implicated in depression? a.GABA, acetylcholine, and aspartate b.Norepinephrine, serotonin, and dopamine c.Somatostatin, substance P, and glycine d.Glutamate, histamine, and opioid peptides

9.b

chap 5: 9.Maria is an Italian American who is in the hospital after having suffered a miscarriage at 5 months' gestation.Her room is filled with relatives who have brought a variety of foods and gifts for Maria. They are all talking,seemingly at the same time, and some, including Maria, are crying. They repeatedly touch and hug Maria and each other. How should the nurse handle this situation? a. Explain to the family that Maria needs her rest and they must all leave. b. Allow the family to remain and continue their activity as described, as long as they do not disturb other clients. c. Explain that Maria will not get over her loss if they keep bringing it up and causing her to cry so much. d. Call the family priest to come and take charge of this family situation.

9.b

chap 6: 9.Carol, an adolescent, just returned from group therapy and is crying. She says to the nurse, "All the other kids laughed at me! I try to fit in, but I always seem to say the wrong thing. I've never had a close friend.I guess I never will." Which is the most appropriate response by the nurse? a."What makes you think you will never have any friends?" b."You're feeling pretty down on yourself right now." c."I'm sure they didn't mean to hurt your feelings." d."Why do you feel this way about yourself?"

9.b

chap 1: 9.For what reason would Anna's illness be considered a neurosis rather than a psychosis? a. She is unaware that her behavior is maladaptive. b. She exhibits inappropriate affect (emotional tone). c. She experiences no loss of contact with reality. d. She tells the nurse, "There is nothing wrong with me!"

9.c

chap 7: 9.Nursing diagnoses are prioritized according to which of the following? a.Degree of potential for resolution b.Legal implications associated with nursing intervention c.Life-threatening potential d.Client and family requests

9.c

chap 3: 1. Which of the following parts of the brain is associated with multiple feelings and behaviors and is some-times referred to as the emotional brain? a. Frontal lobe b. Thalamus c. Hypothalamus d. Limbic system

CHAPTER 3.Biological Implications 1.d

chap 4: 1. Nurse Jones decides to go against family wishes and tell the client of his terminal status because that is what she would want if she were the client. Which of the following ethical theories is considered in this decision? a. Kantianism b. Christian ethics c. Natural law theories d. Ethical egoism

CHAPTER 4.Ethical and Legal Issues 1.b

5. Clint, a client on the psychiatric unit, has been diagnosed with Schizophrenia. He begins to tell the nurse about how the CIA is looking for him and will kill him if they find him. The most appropriate response by the nurse is: a. "That's ridiculous, Clint. No one is going to hurt you." b. "The CIA isn't interested in people like you, Clint." c. "Why do you think the CIA wants to kill you?" d. "I know you believe that, Clint, but it's really hard for me to believe."

a

7. Dan begins attendance at AA meetings. Which of the statements by Dan reflects the purpose of this organization? a. "They claim they will help me stay sober." b. "I'll dry out in AA, then I can have a social drink now and then." c. "AA is only for people who have reached the bottom." d. "If I lose my job, AA will help me find another."

a. "They claim they will help me stay sober."

6. In addition to disturbances in cognition and orientation, individuals with Alzheimer's disease may also show changes in which of the following? Select all that apply. a. Personality b. Vision c. Speech d. Hearing e. Mobility

a. Personality c. Speech e. Mobility

10. Sandra is the nurse leader of a supportive-therapeutic group for individuals with anxiety disorders. Violet, who is beautiful but lacks self-confidence, states to the group, "Maybe if I became a blond my boyfriend would love me more." Larry responds, "Listen, dummy, you need more than blond hair to keep the guy around. A bit more in the brains department would help!" What type of member role is Larry assuming in this group? a. Aggressor b. Monopolizer c. Blocker d. Seducer

a. Aggressor

11. 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!" This is an example of which type of "automatic thought"? a. All or nothing b. Discounting positives c. Catastrophic thinking d. Personalizing

a. All or nothing

1. Which of the following herbs is thought to be helpful in cases of nervousness, anxiety, and/or insomnia? Select all that apply. a. Chamomile b. Echinacea c. Kava-kava d. Ginseng e. Valerian f. Hops

a. Chamomile c. Kava-kava e. Valerian f. Hops

4. Which of the following medications have been indicated for improvement in cognitive functioning in mild to moderate Alzheimer's disease? Select all that apply. a. Donepezil (Aricept) b. Rivastigmine (Exelon) c. Risperidone (Risperdal) d. Sertraline (Zoloft) e. Galantamine (Razadyne)

a. Donepezil (Aricept) b. Rivastigmine (Exelon) e. Galantamine (Razadyne)

4. With which of the following conditions should massage not be performed? Select all that apply. a. High blood pressure b. Neck pain c. Arthritis d. Phlebitis e. Osteoporosis

a. High blood pressure d. Phlebitis e. Osteoporosis

5. One of the goals of therapeutic community is for clients to become more independent and accept selfresponsibility. Which of the following approaches by staff best encourages fulfillment of this goal? a. Including client input and decisions into the treatment plan. b. Insisting that each client take a turn as "president" of the community meeting. c. Making decisions for the client regarding plans for treatment.

a. Including client input and decisions into the treatment plan.

9. On the milieu unit, duties of the staff psychiatric nurse include which of the following? Select all that apply. a. Medication administration b. Client teaching c. Medical diagnosis d. Reality orientation e. Relationship development f. Group therapy

a. Medication administration b. Client teaching d. Reality orientation e. Relationship development

9. A client says to the nurse, "I read an article about Alzheimer's and it said the disease is hereditary. My mother has Alzheimer's disease. Does that mean I'll get it when I'm old?" The nurse bases her response on the knowledge that which of the following factors is not associated with increased incidence of NCD due to Alzheimer's disease? a. Multiple small strokes b. Family history of Alzheimer's disease c. Head trauma d. Advanced age

a. Multiple small strokes

10. Sally was sexually abused as a child. She is a client on the milieu unit with a diagnosis of Borderline Personality Disorder. She has refused to talk to anyone. Which of the following therapies might the IDT team choose for Sally? Select all that apply. a. Music therapy b. Art therapy c. Psychodrama d. Electroconvulsive therapy

a. Music therapy b. Art therapy c. Psychodrama

11. Which of the following interventions is most appropriate in helping a client with Alzheimer's disease with her ADLs? Select all that apply. a. Perform ADLs for her while she is in the hospital. b. Provide her with a written list of activities she is expected to perform. c. Assist her with step-by-step instructions. d. Tell her that if her morning care is not completed by 9:00 a.m., it will be performed for her by the nurse's aide so that she can attend group therapy. e. Encourage her and give her plenty of time to perform as many of her ADLs as possible independently.

a. Perform ADLs for her while she is in the hospital.

2. Which of the following food groups do the USDA/USDHHS food guidelines recommend using in moderation? Select all that apply. a. Refined carbohydrates b. Fats c. Milk and milk products d. Sodium chloride e. Whole grains

a. Refined carbohydrates b. Fats d. Sodium chloride

1. Mr. White is admitted to the hospital after an extended period of binge alcohol drinking. His wife reports that he has been a heavy drinker for a number of years. Lab reports reveal he has a blood alcohol level of 250 mg/dL. He is placed on the chemical addictions unit for detoxification. When would the first signs of alcohol withdrawal symptoms be expected to occur? a. Several hours after the last drink. b. 2 to 3 days after the last drink. c. 4 to 5 days after the last drink. d. 6 to 7 days after the last drink.

a. Several hours after the last drink.

3. J.J. is a staff nurse on a surgical unit. He has been selected as leader of a newly established group of staff nurses organized to determine ways to decrease the number of medication errors occurring on the unit. J.J. has definite ideas about how to bring this about. He has also applied for the position of head nurse on the unit and believes that if he is successful in leading the group toward achievement of its goals, he can also facilitate his chances for promotion. At each meeting he addresses the group in an effort to convince the members to adopt his ideas. Which type of group and style of leadership is described in this situation? a. Task/autocratic b. Teaching/autocratic c. Self-help/democratic d. Supportive-therapeutic/laissez-faire

a. Task/autocratic

4. A nurse who is helping a client in the preparation stage of the Psychological Recovery Model might include which of the following interventions? a. Teach about effects of the illness and how to recognize, monitor, and manage symptoms. b. Help the client identify "triggers" that cause distress or discomfort. c. Help the client establish a daily maintenance list. d. Listen actively while the client composes his or her personal story.

a. Teach about effects of the illness and how to recognize, monitor, and manage symptoms.

10. A polysubstance abuser makes the statement, "The green and whites do me good after speed." How might the nurse interpret the statement? a. The client abuses amphetamines and anxiolytics. b. The client abuses alcohol and cocaine. c. The client is psychotic. d. The client abuses narcotics and marijuana.

a. The client abuses amphetamines and anxiolytics.

1. Which of the following are basic assumptions of milieu therapy? Select all that apply. a. The client owns his or her own environment. b. Each client owns his or her behavior. c. Peer pressure is a useful and powerful tool. d. Inappropriate behaviors are punished immediately.

a. The client owns his or her own environment. b. Each client owns his or her behavior. c. Peer pressure is a useful and powerful tool.

9. In reality therapy, a primary function of the therapist is a. assisting the client to deal with getting current needs fulfilled. b. hypnotizing the client to delve into the unconscious. c. analyzing the possible meanings behind the client's dreams. d. taking a psychiatric history and establishing a diagnosis.

a. assisting the client to deal with getting current needs fulfilled.

13. John has a history of violence and is hospitalized with substance use disorder. One evening, the nurse hears John yelling in the dayroom. The nurse observes his increased agitation, clenched fists, and loud demanding voice. He is challenging and threatening staff and the other clients. The nurse's priority intervention would be to a. call for assistance. b. draw up a syringe of prn haloperidol. c. ask John if he would like to talk about his anger. d. tell John that if he does not calm down, he will have to be restrained

a. call for assistance.

3. Amanda's mobile home was destroyed by a tornado. Amanda received only minor injuries but is experiencing disabling anxiety in the aftermath of the event. This type of crisis is called a. crisis resulting from traumatic stress. b.maturational/developmental crisis. c. dispositional crisis. d.crisis of anticipated life transitions.

a. crisis resulting from traumatic stress.

5. Dan, who has been admitted to the alcohol rehabilitation unit after being fired for drinking on the job, states to the nurse, "I don't have a problem with alcohol. I can handle my booze better than anyone I know. My boss is a jerk! I haven't missed any more days than my coworkers." The defense mechanism that Dan is using is: a. denial. b. projection. c. displacement. d. rationalization.

a. denial.

7. Subluxation is a term used by chiropractic medicine to describe a. displacement of vertebrae in the spine. b. adjustment of displaced vertebrae in the spine. c. interference with the flow of energy from the brain. d. pathways along which energy flows throughout the body.

a. displacement of vertebrae in the spine.

6. The most appropriate nursing intervention with Jenny (from question 5) would be to a. make arrangements for her to start attending Al-Ateen meetings. b. help her identify the positive things in her life and recognize that her situation could be a lot worse than it is. c. teach her about the effects of alcohol on the body and that it can be hereditary. d. refer her to a psychiatrist for private therapy to learn to deal with her home situation.

a. make arrangements for her to start attending Al-Ateen meetings.

7. The nurse is interviewing a client on the psychiatric unit. The client tilts his head to the side, stops talking in midsentence, and listens intently. The nurse recognizes from these signs that the client is likely experiencing a. somatic delusions. b. catatonic stupor. c. auditory hallucinations. d. pseudoparkinsonism.

b

2. The primary goal in working with an actively psychotic, suspicious client would be to a. promote interaction with others. b. decrease his anxiety and increase trust. c. improve his relationship with his parents. d. encourage participation in therapy activities.

b 2. b

8. Nancy has been diagnosed with Dysthymic Disorder. The physician has just prescribed 20 mg/day of fluoxetine. Nancy tells the nurse that she has been taking St. John's wort, but still feels depressed. Which of the following is the appropriate response by the nurse? a. "St. John's wort is not effective for depression." b. "Do not take fluoxetine and St. John's wort together." c. "You probably just need to increase your dose of St. John's wort." d. "Go ahead and take the St. John's wort with the fluoxetine. Maybe both of them together will be more helpful."

b. "Do not take fluoxetine and St. John's wort together."

10. A fellow worker often borrows small amounts of money from you with the promise that she will pay you back "tomorrow." She currently owes you $15.00, and has not yet paid back any that she has borrowed. She asks if she can borrow a couple of dollars for lunch. Which of the following is a nonassertive response? a. "I've decided not to loan you any more money until you pay me back what you already borrowed." b. "I'm so sorry. I only have enough to pay for my own lunch today." c. "Get a life, will you? I'm tired of you sponging off me all the time!" d. "Sure, here's two dollars." Then to the other workers in the office, "Be sure you never lend Cindy any money. She never pays her debts. I'd be sure never to go to lunch with her if I were you!"

b. "I'm so sorry. I only have enough to pay for my own lunch today."

5. Mrs. G, who has NCD due to Alzheimer's disease, says to the nurse, "I have a date tonight. I always have a date on Christmas." Which of the following is the most appropriate response? a. "Don't be silly. It's not Christmas, Mrs. G." b. "Today is Tuesday, Oct. 21, Mrs. G. We will have supper soon, and then your daughter will come to visit." c. "Who is your date with, Mrs. G?" d. "I think you need some more medication, Mrs. G. I'll bring it to you now."

b. "Today is Tuesday, Oct. 21, Mrs. G. We will have supper soon, and then your daughter will come to visit."

10. Mr. Stone is a client in the hospital with a diagnosis of Vascular NCD. In explaining this disorder to Mr. Stone's family, which of the following statements by the nurse is correct? a. "He will probably live longer than if his disorder was of the Alzheimer's type." b. "Vascular NCD shows step-wise progression. This is why he sometimes seems okay." c. "Vascular NCD is caused by plaques and tangles that form in the brain." d. "The cause of vascular NCD is unknown."

b. "Vascular NCD shows step-wise progression. This is why he sometimes seems okay."

4. Dan, who has been admitted to the alcohol rehabilitation unit after being fired for drinking on the job, states to the nurse, "I don't have a problem with alcohol. I can handle my booze better than anyone I know. My boss is a jerk! I haven't missed any more days than my coworkers." The nurse's best response is: a. "Maybe your boss is mistaken, Dan." b. "You are here because your drinking was interfering with your work, Dan." c. "Get real, Dan! You're a boozer and you know it!" d. "Why do you think your boss sent you here, Dan?"

b. "You are here because your drinking was interfering with your work, Dan."

2. John tells the nurse, "I think lights out at ten o'clock on a weekend is stupid. We should be able to watch TV until midnight!" Which of the following is the most appropriate response from the nurse on the milieu unit? a. "John, you were told the rules when you were admitted." b. "You may bring it up before the others at the community meeting, John." c. "Some people want to go to bed early, John." d. "You are not the only person on this unit, John. You must think of the others."

b. "You may bring it up before the others at the community meeting, John."

3. Which of the following medications is the physician most likely to order for a client experiencing alcohol withdrawal syndrome? a. Haloperidol (Haldol) b. Chlordiazepoxide (Librium) c. Methadone (Dolophine) d. Phenytoin (Dilantin)

b. Chlordiazepoxide (Librium)

8. Which of the following activities would be a responsibility of the psychiatric clinical nurse specialist on the IDT team? a. Manages the therapeutic milieu on a 24-hour basis b. Conducts group therapies and provides consultation and education to staff nurses c. Directs a group of clients in acting out a situation that is otherwise too painful for a client to discuss openly

b. Conducts group therapies and provides consultation and education to staff nurses

3. Mrs. G has been diagnosed with NCD due to Alzheimer's disease. The primary nursing intervention in working with Mrs. G is which of the following? a. Ensuring that she receives food she likes, to prevent hunger. b. Ensuring that the environment is safe, to prevent injury. c. Ensuring that she meets the other patients, to prevent social isolation. d. Ensuring that she takes care of her own ADLs, to prevent dependence.

b. Ensuring that the environment is safe, to prevent injury.

1. Which of the following is a true statement about mental health recovery? Select all that apply. a. Mental health recovery applies only to severe and persistent mental illnesses. b. Mental health recovery serves to provide empowerment to the consumer. c. Mental health recovery is based on the medical model. d. Mental health recovery is a collaborative process.

b. Mental health recovery serves to provide empowerment to the consumer. d. Mental health recovery is a collaborative process.

8. Sandra is the nurse leader of a supportive-therapeutic group for individuals with anxiety disorders. In this group, Helen talks incessantly. When someone else tries to make a comment, she refuses to allow him or her to speak. What type of member role is Helen assuming in this group? a. Aggressor b. Monopolizer c. Blocker d. Seducer

b. Monopolizer

8. From which of the following symptoms might the nurse identify a chronic cocaine user? a. Clear, constricted pupils b. Red, irritated nostrils c. Muscle aches d. Conjunctival redness

b. Red, irritated nostrils

4. In the community meeting, which of the following actions is most important for reinforcing the democratic posture of the therapy setting? a. Allowing each person a specific and equal amount of time to talk. b. Reviewing group rules and behavioral limits that apply to all clients. c. Reading the minutes from yesterday's meeting. d. Waiting until all clients are present before initiating the meeting.

b. Reviewing group rules and behavioral limits that apply to all clients.

1. N.J. is the nurse leader of a childbirth preparation group. Each week she shows various films and sets out various reading materials. She expects the participants to utilize their time on a topic of their choice or practice skills they have observed on the films. Two couples have dropped out of the group, stating, "This is a big waste of time." Which type of group and style of leadership is described in this situation? a. Task/democratic b. Teaching/laissez-faire c. Self-help/democratic d. Supportive-therapeutic/autocratic

b. Teaching/laissez-faire

12. John, age 27, was brought to the emergency department by two police officers. He smelled strongly of alcohol and was combative. His blood alcohol level was measured at 293 mg/dL. His girlfriend reports that he drinks excessively every day and is verbally and physically abusive. The nurses give John the nursing diagnosis of Risk for other-directed violence. What would be appropriate outcome objectives for this diagnosis? Select all that apply. a. The client will not verbalize anger or hit anyone. b. The client will verbalize anger rather than hit others. c. The client will not harm self or others. d. The client will be restrained if he becomes verbally or physically abusive.

b. The client will verbalize anger rather than hit others. c. The client will not harm self or others.

14. John, who has a history of verbal and physical abuse of his girlfriend, is hospitalized with substance use disorder. One evening, during a visit from his girlfriend, she and John are overheard having a loud argument. Which behavior by John would indicate he is learning to adaptively problem solve his frustrations? a. John says to the nurse, "Give me some of that medication before I end up in restraints!" b. When his girlfriend leaves, John goes to the exercise room and punches on the punching bag. c. John says to the nurse, "I guess I'm going to have to dump that broad!" d. John says to his girlfriend, "You'd better leave before I do something I'm sorry for."

b. When his girlfriend leaves, John goes to the exercise room and punches on the punching bag.

9. Marie, age 56, is the mother of five children. Her youngest child, who had been living at home and attending the local college, recently graduated and accepted a job in another state. Marie has never worked outside the home and has devoted her life to satisfying the needs of her husband and children. Since the departure of her last child from home, Marie has become more and more despondent. Her husband has become very concerned and takes her to the local mental health center. This type of crisis is called a. dispositional crisis. b. crisis of anticipated life transitions. c. psychiatric emergency. d. crisis resulting from traumatic stress.

b. crisis of anticipated life transitions.

4. The most appropriate crisis intervention with Amanda (from question 3) would be to a. encourage her to recognize how lucky she is to be alive. b. discuss stages of grief and feelings associated with each. c. identify community resources that can help Amanda. d. suggest that she find a place to live that provides a storm shelter.

b. discuss stages of grief and feelings associated with each.

8. The most appropriate nursing intervention with Ginger (from question 7) would be to a. suggest she move to a college closer to home. b. work with Ginger on unresolved dependency issues. c. help her find someone in the college town from whom she could seek assistance rather than calling her mother regularly. d. recommend that the college physician prescribe an antianxiety medication for Ginger.

b. work with Ginger on unresolved dependency issues.

6. Clint, a client on the psychiatric unit, has been diagnosed with Schizophrenia. He begins to tell the nurse about how the CIA is looking for him and will kill him if they find him. Clint's belief is an example of a a. delusion of persecution. b. delusion of reference. c. delusion of control or influence. d. delusion of grandeur.

c

8. The nurse is interviewing a client on the psychiatric unit. The client tilts his head to the side, stops talking in midsentence, and listens intently. The nurse recognizes these behaviors as a symptom of the client's illness. The most appropriate nursing intervention for this symptom is to: a. ask the client to describe his physical symptoms. b. ask the client to describe what he is hearing. c. administer a dose of benztropine. d. call the physician for additional orders.

c

9. When a client suddenly becomes aggressive and violent on the unit, which of the following approaches would be best for the nurse to use first? a. Provide large motor activities to relieve the client's pent-up tension. b. Administer a dose of prn chlorpromazine to keep the client calm. c. Call for sufficient help to control the situation safely. d. Convey to the client that his behavior is unacceptable and will not be permitted.

c

8. The night nurse finds Mrs. G, a client with Alzheimer's disease, wandering the hallway at 4 a.m. and trying to open the door to the side yard. Which statement by the nurse probably reflects the most accurate assessment of the situation? a. "That door leads out to the patio, Mrs. G. It's nighttime. You don't want to go outside now." b. "You look confused, Mrs. G. What is bothering you?" c. "This is the patio door, Mrs. G. Are you looking for the bathroom?" d. "Are you lonely? Perhaps you'd like to go back to your room and talk for a while."

c. "This is the patio door, Mrs. G. Are you looking for the bathroom?"

1. Which of the following is a correct assumption regarding the concept of crisis? a. Crises occur only in individuals with psychopathology. b. The stressful event that precipitates crisis is seldom identifiable. c. A crisis situation contains the potential for psychological growth or deterioration. d. Crises are chronic situations that recur many times during an individual's life.

c. A crisis situation contains the potential for psychological growth or deterioration.

5. A nurse who is helping a client with mental illness recovery using the WRAP Model says to the client, "First you must create a wellness toolbox." She explains to the client that a wellness toolbox is which of the following? a. A list of words that describe how the individual feels when he or she is feeling well b. A list of things the client needs to do every day to maintain wellness c. A list of strategies the client has used in the past that help relieve disturbing symptoms d. A list of the client's favorite health-care providers and phone numbers

c. A list of strategies the client has used in the past that help relieve disturbing symptoms

5. Which of the following applies to vitamin C? a. Coenzyme in protein metabolism; found in meat and dairy products b. Necessary in formation of DNA; found in beans and other legumes c. A powerful antioxidant; found in tomatoes and strawberries d. Necessary for blood clotting; found in whole grains and bananas

c. A powerful antioxidant; found in tomatoes and strawberries

7. Which of the following activities would be a responsibility of the clinical psychologist member of the IDT? a. Locates halfway house and arranges living conditions for client being discharged from the hospital b. Manages the therapeutic milieu on a 24-hour basis c. Administers and evaluates psychological tests that assist in diagnosis d. Conducts psychotherapy and administers electroconvulsive therapy treatments

c. Administers and evaluates psychological tests that assist in diagnosis

3. In prioritizing care within the therapeutic environment, which of the following nursing interventions would receive the highest priority? a. Ensuring that the physical facilities are conducive to achievement of the goals of therapy. b. Scheduling a community meeting for 8:30 each morning. c. Attending to the nutritional and comfort needs of all clients. d. Establishing contacts with community resources.

c. Attending to the nutritional and comfort needs of all clients.

3. Which of the following herbs is thought to be helpful in relieving menstrual cramping? Select all that apply. a. Feverfew b. Ginger c. Chamomile d. Black cohosh

c. Chamomile d. Black cohosh

1. An example of a treatable (reversible) form of NCD is one that is caused by which of the following? Select all that apply. a. Multiple sclerosis b. Multiple small brain infarcts c. Electrolyte imbalances d. HIV disease e. Folate deficiency

c. Electrolyte imbalances e. Folate deficiency

7. Henry is a member of an Alcoholics Anonymous group. He learned about the effects of alcohol on the body when a nurse from the chemical dependency unit spoke to the group. This is an example of which curative factor? a. Catharsis b. Altruism c. Imparting of information d. Universality

c. Imparting of information

5. Nurse Jones is the leader of a bereavement group for widows. Nancy is a new member. She listens to the group and learns that Jane has been a widow for 5 years. Jane has adjusted well, and Nancy thinks maybe she can too. This is an example of which curative factor? a. Universality b. Imitative behavior c. Installation of hope d. Imparting of information

c. Installation of hope

6. Dan has been admitted to the alcohol rehabilitation unit after being fired for drinking on the job. Dan's drinking buddies come for a visit, and when they leave, the nurse smells alcohol on Dan's breath. Which of the following would be the best intervention with Dan at this time? a. Search his room for evidence. b. Ask, "Have you been drinking alcohol, Dan?" c. Send a urine specimen from Dan to the lab for drug screening. d. Tell Dan, "These guys cannot come to the unit to visit you again."

c. Send a urine specimen from Dan to the lab for drug screening.

11. What is the desired outcome of working with an individual who has witnessed a traumatic event and is now experiencing panic anxiety? a. The individual will experience no anxiety. b. The individual will demonstrate hope for the future. c. The individual will maintain anxiety at manageable level. d. The individual will verbalize acceptance of self as worthy.

c. The individual will maintain anxiety at manageable level.

2. A nurse is assisting an individual with mental illness recovery using the Tidal Model. Which of the following is a component of this model? a. The wellness toolbox b. The daily maintenance list c. The individual's personal story d. Triggers

c. The individual's personal story

4. The nurse leader is explaining about group "curative 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. This is an example of which curative factor? a. Altruism b. Imitative behavior c. Universality d. Imparting of information

c. Universality

2. Symptoms of alcohol withdrawal include: a. euphoria, hyperactivity, and insomnia. b. depression, suicidal ideation, and hypersomnia. c. diaphoresis, nausea and vomiting, and tremors. d. unsteady gait, nystagmus, and profound disorientation.

c. diaphoresis, nausea and vomiting, and tremors.

5. Jenny reported to the high school nurse that her mother drinks too much. She is drunk every afternoon when Jenny gets home from school. Jenny is afraid to invite friends over because of her mother's behavior. This type of crisis is called a. crisis resulting from traumatic stress. b. maturational/developmental crisis. c. dispositional crisis. d. crisis reflecting psychopathology.

c. dispositional crisis.

15. Andrew, a New York City firefighter, and his entire unit responded to the terrorist attacks at the World Trade Center. Working as a team, he and his best friend, Carlo, entered the area together. Carlo was killed when the building collapsed. Andrew was injured but survived. Since that time, Andrew has had frequent nightmares and anxiety attacks. He says to the mental health worker, "I don't know why Carlo had to die and I didn't!" This statement by Andrew suggests that he is experiencing a. spiritual distress. b. night terrors. c. survivor's guilt. d. suicidal ideation.

c. survivor's guilt.

6. Client teaching is an important nursing function in milieu therapy. Which of the following statements by the client indicates the need for knowledge and a readiness to learn? a. "Get away from me with that medicine! I'm not sick!" b. "I don't need psychiatric treatment. It's my migraine headaches that I need help with." c. "I've taken Valium every day of my life for the last 20 years. I'll stop when I'm good and ready!" d. "The doctor says I have bipolar disorder. What does that really mean?"

d. "The doctor says I have bipolar disorder. What does that really mean?"

6. Paul is a member of an anger management group. He knew that people did not want to be his friend because of his violent temper. In the group, he has learned to control his temper and form satisfactory interpersonal relationships with others. This is an example of which curative factor? a. Catharsis b. Altruism c. Imparting of information d. Development of socializing techniques

d. Development of socializing techniques

7. Mrs. G, who has NCD due to Alzheimer's disease, has trouble sleeping and wanders around at night. Which of the following nursing actions would be best to promote sleep in Mrs. G? a. Ask the doctor to prescribe flurazepam (Dalmane). b. Ensure that Mrs. G gets an afternoon nap so she will not be overtired at bedtime. c. Make Mrs. G a cup of tea with honey before bedtime. d. Ensure that Mrs. G gets regular physical exercise during the day.

d. Ensure that Mrs. G gets regular physical exercise during the day.

6. Which of the following applies to calcium? a. Coenzyme in carbohydrate metabolism; found in whole grains and citrus fruits b. Facilitates iron absorption; found in vegetable oils and liver c. Prevents night blindness; found in egg yolk and cantaloupe d. Important for nerve and muscle functioning; found in dairy products and oysters

d. Important for nerve and muscle functioning; found in dairy products and oysters

9. An individual who is addicted to heroin is likely to experience which of the following symptoms of withdrawal? a. Increased heart rate and blood pressure b. Tremors, insomnia, and seizures c. Incoordination and unsteady gait d. Nausea and vomiting, diarrhea, and diaphoresis

d. Nausea and vomiting, diarrhea, and diaphoresis

9. Sandra is the nurse leader of a supportive-therapeutic group for individuals with anxiety disorders. On the first day the group meets, Valerie speaks first and begins by sharing the intimate details of her incestuous relationship with her father. What type of member role is Valerie assuming in this group? a. Aggressor b. Monopolizer c. Blocker d. Seducer

d. Seducer

2. M.K. is a psychiatric nurse who has been selected to lead a group for women who desire to lose weight. The criterion for membership is that they 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, M.K. provides suggestions as the members determine what their goals will be and how they plan to go about achieving those goals. They decided how often they wanted to meet and what they planned to do at each meeting. Which type of group and style of leadership is described in this situation? a. Task/autocratic b. Teaching/democratic c. Self-help/laissez-faire d. Supportive-therapeutic/democratic

d. Supportive-therapeutic/democratic

3. A nurse is assisting an individual with mental illness recovery using the Psychological Recovery Model. The client says to the nurse, "I have schizophrenia. Nothing can be done. I might as well die." In which stage of the Psychological Recovery Model would the nurse assess this individual to be? a. The awareness stage b. The preparation stage c. The rebuilding stage d. The moratorium stage

d. The moratorium stage

2. Mrs. G has been diagnosed with NCD due to Alzheimer's disease. The cause of this disorder is which of the following? a. Multiple small brain infarcts b. Chronic alcohol abuse c. Cerebral abscess d. Unknown

d. Unknown

10. The most appropriate nursing intervention with Marie (from question 9) would be to a. refer her to her family physician for a complete physical examination. b. suggest she seek outside employment now that her children have left home. c. identify convenient support systems for times when she is feeling particularly despondent. d. begin grief work and assist her to recognize areas of self-worth separate and apart from her children.

d. begin grief work and assist her to recognize areas of self-worth separate and apart from her children.

2. Crises occur when an individual a. is exposed to a precipitating stressor. b. perceives a stressor to be threatening. c. has no support systems. d. experiences a stressor and perceives coping strategies to be ineffective.

d. experiences a stressor and perceives coping strategies to be ineffective.

7. Ginger, age 19 and an only child, left 3 months ago to attend a college of her choice 500 miles away from her parents. It is Ginger's first time away from home. She has difficulty making decisions and will not undertake anything new without first consulting her mother. They talk on the phone almost every day. Ginger has recently started having anxiety attacks. She consults the nurse practitioner in the student health center. This type of crisis is called a. crisis resulting from traumatic stress. b. dispositional crisis. c. psychiatric emergency. d. maturational/developmental crisis.

d. maturational/developmental crisis.