Exam 3 Psych

Which anorexia nervosa symptom is physical in nature? 1. Dry, yellow skin. 2. Perfectionism. 3. Frequent weighing. 4. Preoccupation with food.

1. Dry, yellow skin

A nursing diagnosis of self-care deficit R/T memory loss AEB inability to fulfill activities of daily living (ADLs) is assigned to a client diagnosed with Alzheimer's disease. Which is an appropriate short-term outcome for this individual? 1. The client participates in ADLs with assistance by discharge. 2. The client accomplishes ADLs without assistance after discharge. 3. By time of discharge, the client will exhibit feelings of self-worth. 4. The client will not experience physical injury.

1. The client participates in ADLs with assistance by discharge.

Which intervention describes an important component in the treatment of clients diagnosed with personality disorders? 1. Psychotropic medications are prescribed to reduce hospitalizations. 2. Self-awareness by the nurse is necessary to ensure a therapeutic relationship. 3. Group therapy, not individual therapy, is the preferred approach. 4. Addressing comorbid issues is not indicated.

2. Self awareness by the nurse is necessary to ensure a therapeutic relationship

A client diagnosed with borderline personality disorder ingratiatingly requests diazepam (Valium). When the emergency department physician refuses, the client becomes angry and demands to see another physician. What defense mechanism is the client using? 1. Undoing. 2. Splitting. 3. Altruism. 4. Reaction formation.

2. Splitting

Which etiology for anorexia nervosa is from a neuroendocrine perspective? 1. Anorexia nervosa is more common among sisters and mothers of clients with the disorder than among the general population. 2. Dysfunction of the thalamus is implicated in the diagnosis of anorexia nervosa. 3. There is a higher than expected frequency of mood disorders among first-degree relatives of clients diagnosed with anorexia nervosa. 4. Clients diagnosed with anorexia nervosa have elevated cerebrospinal fluid cortisol levels and possible alterations in the regulation of dopamine.

4. Clients diagnosed with anorexia nervosa elevated cerebrospinal fluid cortisol

Define agnosia

Agnosia is the loss of sensory ability to recognize objects

Define aphasia.

Aphasia is the loss of language ability

Define apraxia

Apraxia is the loss of purposeful movement in the absence of motor or sensory impairment *may put arms in trousers or put a jacket on upside down.

What are some characteristics of avoidant personality disorder?

Avoidant personality disorder is characterized by low self esteem that is associated with functioning in social situations, feelings of inferiority compared to peers, and a reluctance to engage in unfamiliar activities involving new people.

Describe anorexia nervosa.

Individuals with anorexia nervosa refuse to maintain a minimally normal weight for height and express intense fear of gaining weight.

Describe bulimia nervosa

Individuals with bulimia nervosa engage in repeated episodes of binge eating followed by inappropriate compensatory behaviors such as self-induced vomiting; misuse of laxatives, diuretics, or other medications; fasting; or excessive exercise.

What are some later symptoms of AD?

Late in AD, the following symptoms may occur: agraphia (inability to read or write), hyperorality (the need to taste, chew, and put everything in one's mouth), blunting of emotions, visual agnosia (loss of ability to recognize familiar objects), and hypermetamorphosis (manifested by touching of everything in sight)

Are there any drugs approved for the treatment of bulimia?

Limited research suggests that the SSRIs and tricyclic antidepressants helped reduce binge eating and vomiting over short terms. *CBT is the most effective treatment for bulimia nervosa.

How is planning affected when a patient has anorexia?

Planning is affected by the acuity of the patient's situation. When a patient with anorexia is experiencing extreme electrolyte imbalance or weights below 75% of ideal body weight, the plan is to provide immediate medical stabilization, most likely in an inpatient unit.

What are the cardinal symptoms of delirium?

The cardinal symptoms of delirium are an alteration in level of consciousness, which manifests as altered awareness and an inability to direct, focus, sustain, and shift attention; an abrupt onset with clinical features that fluctuate; and disorganized thinking and poor executive functioning. Other characteristics include disorientation, anxiety, agitation, poor memory, delusional thinking and hallucinations, usually visual.

What are some risk factors for Alzheimers?

The greatest risk factor for Alzheimers advanced age, cardiovascular disease, social engagement, diet, head injury and TBI.

What are the three main eating disorders?

The three main eating disorders are anorexia nervosa, bulimia nervosa, and binge eating disorder.

What would you expect to see in a general assessment of a person with anorexia?

You can expect that the patient will also have mottled, cool skin on the extremities and low blood pressure, pulse, and temperature readings, consistent with a malnourished, dehydrated state.

Are there any drugs approved for the treatment of anorexia nervosa?

.....not really. The SSRI fluoxetine (Prozac), however, has proven useful in reducing OCD behavior after the patient has reached a maintenance weight.

Irresponsible, guiltless behavior is to a client diagnosed with cluster B personality disorder as avoidant, dependent behavior is to a client diagnosed with a: 1. Cluster A personality disorder. 2. Cluster B personality disorder. 3. Cluster C personality disorder. 4. Cluster D personality disorder.

3. Cluster C personality disorder

After a routine dental examination on an adolescent, the dentist reports to the parents that bulimia nervosa is suspected. On which of the following assessment data would the dentist base this determination? Select all that apply. 1. Extreme weight loss. 2. Amenorrhea. 3. Discoloration of dental enamel. 4. Bruises of the palate and posterior pharynx. 5. Dental enamel dysplasia.

3. Discoloration of dental enamel 4. Bruises of the palate and posterior pharynx 5. Dental enamel dysplasia

A client diagnosed with paranoid personality disorder is prescribed risperidone (Risperdal). The client is noted to have restlessness and weakness in lower extremities and is drooling. Which nursing intervention would be most important? 1. Hold the next dose of risperidone, and document the findings. 2. Monitor vital signs, and encourage the client to rest in room. 3. Give the ordered PRN dose of trihexyphenidyl (Artane). 4. Get a fasting blood sugar measurement because of potential hyperglycemia.

3. Give the orders PRN dose of trihexyphenidyl (Artane)

Which structure of the brain contains the appetite regulation center? 1. Thalamus. 2. Amygdala. 3. Hypothalamus. 4. Medulla.

3. Hypothalamus

A client diagnosed with antisocial personality disorder states, "My kids are so busy at home and school they don't miss me or even know I'm gone." Which nursing diagnosis applies to this client? 1. Risk for injury. 2. Risk for violence: self-directed. 3. Ineffective denial. 4. Powerlessness.

3. Ineffective denial

In writing a plan of care for a client diagnosed with dementia, the nurse would consider which tertiary prevention intervention? 1. Administer mini-mental status examination and document. 2. Maintain routine to prevent further confusion and disorientation. 3. Obtain occupational therapy consultation to slow further physical decline. 4. Encourage socialization to prevent isolation and further confusion.

3. Obtain occupational therapy consultation to slow further physical decline.

A client diagnosed with a personality disorder tells the nurse, "When I was a waiter I use to spit in the dinners of annoying customers." This statement would be associated with which personality disorder? 1. Paranoid personality disorder. 2. Schizoid personality disorder. 3. Passive-aggressive personality disorder. 4. Antisocial personality disorder.

3. Passive aggressive personality disorder

An instructor is teaching a nursing student facts related to clients diagnosed with a personality disorder. Which student statement indicates that learning has occurred? 1. "Clients diagnosed with personality disorders need frequent hospitalizations." 2. "Clients perceive their behaviors as uncomfortable and disorganized." 3. "Personality disorders cannot be cured or controlled successfully with medication." 4. "Practitioners have a good understanding about the etiology of personality disorders."

3. Personality disorders cannot be cured or controlled successfully with medicaiton.

A client diagnosed with a dependent personality disorder has a nursing diagnosis of social isolation R/T parental abandonment AEB fear of involvement with individuals not in the immediate family. Which nursing intervention would be appropriate? 1. Address inappropriate interactions during group therapy. 2. Recognize when client is playing one staff member against another. 3. Role-model positive relationships. 4. Encourage client to discuss conflicts evident within the family system.

3. Role model positive relationships

On a 24-hour assessment, the nurse documents that a client diagnosed with Alzheimer's disease presents with aphasia. Which client behavior supports this finding? 1. The client is sad and has no ability to experience pleasure. 2. The client is extremely emaciated and appears to be wasting away. 3. The client is having difficulty in forming words. 4. The client is no longer able to speak.

3. The client is having difficulty in forming words

An emaciated client diagnosed with delirium is experiencing sleeplessness, auditory hallucinations, and vertigo. Meclizine (Antivert) has been prescribed. Which client response supports the effectiveness of this medication? 1. The client no longer hears voices. 2. The client sleeps through the night. 3. The client maintains balance during ambulation. 4. The client has an improved appetite.

3. The client maintains balance during ambulation.

client diagnosed with an avoidant personality disorder has the nursing diagnosis of social isolation R/T severe malformation of the spine AEB "I can't be around people, looking like this." Which short-term outcome is appropriate for this client's problem? 1. The client will see self as straight and tall by the time of discharge. 2. The client will see self as valuable after attending assertiveness training courses. 3. The client will be able to participate in one therapy group by end of shift. 4. The client will join in a charade game to decrease social isolation.

3. The client will be able to participate in one therapy group by end of shift.

A client with a long history of bulimia nervosa is seen in the emergency department. The client is seeing things that others do not, is restless, and has dry mucous membranes. Which is most likely the cause of this client's symptoms? 1. Mood disorders, which often accompany the diagnosis of bulimia nervosa. 2. Nutritional deficits, which are characteristic of bulimia nervosa. 3. Vomiting, which may lead to dehydration and electrolyte imbalance. 4. Binging, which causes abdominal discomfort.

3. Vomiting, which may lead to dehydration and electrolyte imbalance.

A client diagnosed with antisocial personality disorder demands, at midnight, to speak to the ethics committee about the involuntary commitment process. Which nursing statement is appropriate? 1. "I realize you're upset; however, this is not the appropriate time to explore your concerns." 2. "Let me give you a sleeping pill to help put your mind at ease." 3. "It's midnight, and you are disturbing the other clients." 4. "I will document your concerns in your chart for the morning shift to discuss with the ethics committee."

1. "I realize you're upset; however, this is not the appropriate time to explore your concerns

The nurse suspects a client is experiencing delirium. Which specific assessment information would support this suspicion? 1. A decreased level of consciousness with intermittent hypervigilance. 2. Slow onset of confusion and agitation. 3. Onset is insidious and relentless. 4. The symptoms last for 1 month or longer

1. A decreased level of consciousness with intermittent hypervigilance.

Which individual would be at highest risk for obesity? 1. A poor black woman. 2. A rich white woman. 3. A rich white man. 4. A well-educated black man.

1. A poor black woman

In working with clients with late-stage Alzheimer's dementia, which is a priority intervention? 1. Assist the client to consume fluids and food to prevent electrolyte imbalance. 2. Reorient the client to place and time frequently to reduce confusion and fear. 3. Encourage the client to participate in own activities of daily living to promote selfesteem. 4. Assist with ambulation to avoid injury from falls.

1. Assist the client to consume fluids and food to prevent electrolyte imbalance.

A client diagnosed with a personality disorder states, "You are the very best nurse on the unit and not at all like that mean nurse who never lets us stay up later than 9 p.m." This statement would be associated with which personality disorder? 1. Borderline personality disorder. 2. Schizoid personality disorder. 3. Passive-aggressive personality disorder. 4. Paranoid personality disorder.

1. Borderline personality disorder

A client diagnosed with obsessive-compulsive personality disorder is admitted to a psychiatric unit in a highly agitated state. The physician prescribes a benzodiazepine. Which medication is classified as a benzodiazepine? 1. Clonazepam (Klonopin). 2. Lithium carbonate (lithium). 3. Clozapine (Clozaril). 4. Olanzapine (Zyprexa).

1. Clonazepam (klonopin)

A client diagnosed with antisocial personality disorder is observed smoking in a nonsmoking area. Which initial nursing intervention is appropriate? 1. Confront the client about the behavior. 2. Tell the client's primary nurse about the situation. 3. Remind all clients of the no smoking policy in the community meeting. 4. Teach alternative coping mechanisms to assist with anxiety.

1. Confront the client about the behavior

An 80-year-old client admitted to the emergency department is experiencing fever, dysuria, and urinary frequency. The client is combative and seeing things others do not see. Which nursing diagnosis reflects this client's problem? 1. Disturbed sensory perceptions R /T infection AEB visual hallucinations. 2. Risk for violence: self-directed R /T disorientation. 3. Self-care deficit R /T decreased perceived need AEB disheveled appearance. 4. Social isolation R /T decreased self-esteem.

1. Disturbed sensory perceptions R/T infection AEB visual hallucinations

A client on an in-patient psychiatric unit has been diagnosed with borderline personality disorder. Using intrapersonal theory, which intervention would assist the client in understanding how the client's feelings affect relationships? 1. Encourage the client to keep a journal. 2. Set limits to assist client in developing healthy ego. 3. Hold a family education session about personality disorders. 4. On the client's admission, discuss consequences for acting out in group therapy.

1. Encourage the client to keep a journal

The nurse is teaching about factors that influence eating patterns. Which statements indicate that learning has occurred? Select all that apply. 1. "Factors such as taste and texture can affect appetite." 2. "The function of my digestive organs affects my eating behaviors." 3. "High socioeconomic status determines nutritious eating patterns." 4. "Social interaction contributes little to eating patterns." 5. "Society and culture influence eating patterns."

1. Factors such as taste and texture can affect appetite. 2. The function of my digestive organs affects my eating behaviors. 3. Society and culture influence eating patterns

Although there are differences among the three personality disorder clusters, there also are some traits common to all individuals diagnosed with personality disorders. Which of the following are common traits? Select all that apply. 1. Failure to accept the consequences of their own behavior. 2. Self-injurious behaviors. 3. Reluctance in taking personal risks. 4. Copes by altering environment instead of self. 5. Lack of insight.

1. Failure to accept the consequences of their own behavior. 4. Copes by altering environment instead of self

A client presents in the emergency department with an acute decrease in cognitive ability. The nurse's assessment should include which of the following? Select all that apply. 1. Family history and a mini-mental status examination. 2. Laboratory tests and vital signs. 3. Toxicology screen for illegal substances. 4. Open-ended questions to obtain information. 5. Familiarizing the client with the milieu.

1. Family history and a mini mental status examination. 2. Laboratory tests and vital signs. 3. Toxicology screen for illegal substances.

Peculiarities of ideation, appearance, and behavior and deficits in interpersonal relationships is to schizotypal personality disorder as a pervasive pattern of excessive emotionality and attention-seeking behavior is to: 1. Borderline personality disorder. 2. Histrionic personality disorder. 3. Paranoid personality disorder. 4. Passive-aggressive personality disorder.

2. Histrionic personality disorder

Studies have indicated that drastically reduced levels of acetylcholine are available in the brains of individuals diagnosed with Alzheimer's disease. Which cognitive deficit is primarily associated with this reduction? 1. Loss of memory. 2. Loss of purposeful movement. 3. Loss of sensory ability to recognize objects. 4. Loss of language ability.

1. Loss of memory

In writing a plan of care for a client diagnosed with dementia, the nurse considers which of the following secondary prevention interventions? Select all that apply. 1. Reinforce speech with nonverbal techniques by pointing to and touching items. 2. Keep surroundings simple by reducing clutter. 3. Offer family ethics consultation or hospice assistance if appropriate. 4. Place large, visible clock and calendar in client's room. 5. Talk to family members about genetic predisposition regarding dementia.

1. Reinforce speech with nonverbal techniques by pointing to and touching items. 4. Place large, visible clock and calendar in client's room.

A client diagnosed with borderline personality disorder superficially cut both wrists, is disruptive in group, and is "splitting" staff. Which nursing diagnosis would take priority? 1. Risk for self-mutilation R/T need for attention. 2. Ineffective coping R/T inability to deal directly with feelings. 3. Anxiety R/T fear of abandonment AEB "splitting" staff. 4. Risk for suicide R/T past suicide attempt.

1. Risk for self mutilation R/T need for attention

A nurse encourages an angry client to attend group therapy. Knowing that the client has been diagnosed with a cluster B personality disorder, which client response might the nurse expect? 1. Sarcastically states, "That group is only for crazy people with problems." 2. Scornfully states, "No, can't you see that I'm having a séance with my mom?" 3. Suspiciously states, "No, that room has been bugged." 4. Hesitantly states, "OK, but only if I can sit next to you."

1. Sarcastically states, "That group is only for crazy people with problems."

Which nursing intervention would directly assist a hospitalized client diagnosed with bulimia nervosa to avoid the urge to purge after discharge? 1. Locking the door to the client's bathroom. 2. Holding a mandatory group after mealtime to assist in exploration of feelings. 3. Discussing preplanned meals to decrease anxiety around eating. 4. Educating the family to recognize purging side effects.

2. Holding a mandatory group after mealtime to assist in exploration of feelings.

A client diagnosed with borderline personality disorder is admitted to a psychiatric unit with recent self-inflicted cuts to both arms. Which of the following would explain this behavior? Select all that apply. 1. Self-mutilation is a manipulative gesture designed to elicit a rescue response. 2. Self-mutilation is often attempted when a "safety" plan has been established. 3. Self-mutilation proposes that feeling pain is better than feeling nothing. 4. Self-mutilation results from feelings of abandonment following separation from significant others. 5. Self-mutilation is attempted when voices tell the client to do self-harm.

1. Self mutilation is a manipulative gesture designed to elicit a rescue response. 2. Self mutilation is often attempted when a safety plan has been established. 3. Self mutilation proposes that feeling pain is better than feeling nothing. 4. Self mutilation results from feelings of abandonment following separation from significant others.

A 15-year-old client living in a residential facility has a nursing diagnosis of ineffective coping R/T abuse AEB defiant responses to adult rules. Which of the following interventions would address this nursing diagnosis appropriately? Select all that apply. 1. Set limits on manipulative behavior. 2. Refuse to engage in controversial and argumentative encounters. 3. Obtain an order for tranquilizing medications. 4. Encourage the discussion of angry feelings. 5. Remove all dangerous objects from the client's environment.

1. Set limits on manipulative behavior. 2. Refuse to engage in controversial and argumentative encounters. 4. Encourage the discussion of angry feelings.

Which scenario would the nurse expect to observe if the client were diagnosed with paranoid personality disorder? 1. The client sits alone at lunch and states, "Everyone wants to hurt me." 2. The client is irresponsible and exploits other peers in the milieu for cigarettes. 3. The client is shy and refuses to talk to others because of poor self-esteem. 4. The client sits with peers and allows others to make decisions for the entire group.

1. The client sits alone at lunch and states, "Everyone wants to hurt me."

A client diagnosed with dementia has a nursing diagnosis of risk for injury R /T extreme psychomotor agitation. Which would be an appropriate short-term outcome related to this problem? 1. The client will remain free from injury during this shift. 2. The client will ask the nurse for assistance when becoming confused. 3. The client will verbalize staff appreciation by day 3. 4. The client will demonstrate ability to perform activities of daily living on discharge.

1. The client will remain free from injury during this shift.

A client diagnosed with anorexia nervosa has a nursing diagnosis of imbalanced nutrition: less than body requirements. Which long-term outcome indicates that the client's problem has improved? 1. The client's body mass index will be 20 by the 6-month follow-up appointment. 2. The client will be free of signs and symptoms of malnutrition and dehydration. 3. The client will use one healthy coping mechanism during a time of stress by discharge. 4. The client will state an understanding of a previous dependency role by the 3-month follow-up appointment.

1. The client's body mass index will be 20 by the 6-month follow up appointment

The family of a client diagnosed with anorexia nervosa has canceled the last two family counseling sessions. Which of the following could be reasons for this noncompliance? Select all that apply. 1. The family is fearful of the social stigma of having a family member with emotional problems. 2. The family is dealing with feelings of guilt because of the perception that they have contributed to the disorder. 3. There may be a pattern of conflict avoidance, and the family fears conflict would surface in the sessions. 4. The family may be attempting to maintain family equilibrium by keeping the client in the sick role. 5. The client is now maintaining adequate nutrition, and the sessions are no longer necessary.

1. The family is fearful of the social stigma of having a family member with emotional problems. 2. The family is dealing with feelings of guilt because of the perception that they have contributed to the disorder 3. There may be a pattern of conflict avoidance, and the family fears conflict would surface in the sessions 4. The family may be attempting to maintain family equilibrium by keeping the client in the sick role.

A nursing student is studying delirium. Which of the following student statements indicates that learning has occurred? Select all that apply. 1. "The symptoms of delirium develop over a short time." 2. "Delirium permanently affects the ability to learn new information." 3. "Symptoms of delirium include the development of aphasia, apraxia, and agnosia." 4. "Delirium is a disturbance of consciousness." 5. "Delirium is always secondary to another condition."

1. The symptoms of delirium develop over a short time. 4. Delirium is a disturbance of consciousness. 5. Delirium is always secondary to another condition

A family member of a client experiencing dementia and being treated for normalpressure hydrocephalus asks the nurse, "Is my father's dementia reversible?" Which nursing response indicates understanding of primary and secondary dementia? 1. "Treatment sometimes can reverse secondary dementia." 2. "Unfortunately, primary dementia is not reversible." 3. "Unfortunately, secondary dementia is not reversible." 4. "Treatment sometimes can reverse primary dementia

1. Treatment sometimes can reverse secondary dementia

A client diagnosed with an antisocial personality disorder is given a nursing diagnosis of self-esteem disturbance R/T extreme poverty AEB continual boasting and grandiosity. Which nursing intervention would be appropriate? 1. Offer to remain with the client during initial interactions with others on the unit. 2. Encourage self-awareness through critical examination of feelings and behaviors. 3. Recognize when the client is "splitting" staff by playing one staff member against another. 4. Allow the client to take on responsibility for his or her own self-care practices.

2. Encourage self awareness through critical examination of feelings and behaviors.

A client has been diagnosed with a cluster A personality disorder. Which client statement would reflect cluster A characteristics? 1. "I'm the best chef on the East Coast." 2. "My dinner has been poisoned." 3. "I have to wash my hands 10 times before eating." 4. "I just can't eat when I'm alone."

2. "My dinner has been poisoned."

A client diagnosed with a narcissistic personality disorder has a grandiose sense of selfimportance and entitlement. When confronted, the client states, "Contrary to what everyone believes, I do not think that the whole world owes me a living." This client is using what defense mechanism? 1. Minimization. 2. Denial. 3. Rationalization. 4. Projection.

2. Denial

On discharge, a client diagnosed with dementia is prescribed donepezil hydrochloride (Aricept). Which would the nurse include in a teaching plan for the client's family? 1. "Donepezil is a sedative/hypnotic used for short-term treatment of insomnia." 2. "Donepezil is an Alzheimer's treatment used for mild-to-moderate dementia." 3. "Donepezil is an antipsychotic used for clients diagnosed with dementia." 4. "Donepezil is an antianxiety agent used for clients diagnosed with dementia."

2. Donepezil is an Alzheimers treatment used for mild to moderate dementia

A client diagnosed with passive-aggressive personality disorder continually complains to the marriage counselor about a nagging husband who criticizes her indecisiveness. Which nursing diagnosis reflects this client's problem? 1. Social isolation R/T decreased self-esteem. 2. Impaired social interaction R/T inability to express feelings openly. 3. Powerlessness R/T spousal abuse. 4. Self-esteem disturbance R/T unrealistic expectations of husband.

2. Impaired social interaction R/T inability to express feelings openly.

After being treated in the ED for self-inflicted lacerations to wrists and arms, a client with a diagnosis of borderline personality disorder is admitted to the psychiatric unit. Which nursing intervention takes priority? 1. Administer tranquilizing drugs. 2. Observe client frequently. 3. Encourage client to verbalize hostile feelings. 4. Explore alternative ways of handling frustration.

2. Observe client frequently.

A client diagnosed with paranoid personality disorder needs information regarding medications. Which nursing intervention would assist this client in understanding prescribed medications? 1. Ask the client to join the medication education group. 2. Provide one-on-one teaching in the client's room. 3. During rounds, have the physician ask if the client has any questions. 4. Let the client read the medication information handout.

2. Provide one on one teaching in the client room

A client diagnosed with a personality disorder insists that a grandmother, through reincarnation, has come back to life as a pet kitten. The thought process described is reflective of which personality disorder? 1. Passive-aggressive personality disorder. 2. Schizotypal personality disorder. 3. Borderline personality disorder. 4. Schizoid personality disorder.

2. Schizotypal personality disorder

A client newly diagnosed with Alzheimer's disease was admitted 72 hours ago. The client states, "Last night I went on a wonderful dinner cruise." Which type of communication is this client expressing, and what is the underlying reason for its use? 1. The client is using confabulation to achieve secondary gains. 2. The client is using confabulation to protect the ego. 3. The client is using perseveration to divert attention. 4. The client is using perseveration to maintain self-esteem.

2. The client is using confabulation to protect the ego.

An 18-year-old female client weighs 95 pounds and is 70 inches tall. She has not had a period in 4 months and states, "I am so fat!" Which statement is reflective of this client's symptoms? 1. The client meets the criteria for an Axis I diagnosis of bulimia nervosa. 2. The client meets the criteria for an Axis I diagnosis of anorexia nervosa. 3. The client needs further assessment to be diagnosed using the DSM-IV-TR. 4. The client is exhibiting normal developmental tasks according to Erikson.

2. The client meets the criteria for an Axis I diagnosis of anorexia nervosa.

A suicidal client is diagnosed with borderline personality disorder. Which short-term outcome is most beneficial for the client? 1. The client will be free from self-injurious behavior. 2. The client will express feelings without inflicting self-injury by discharge. 3. The client will socialize with peers in the milieu by day 3. 4. The client will acknowledge the client's role in altered interpersonal relationships.

2. The client will express feelings without inflicting self injury by discharge

A client diagnosed with dementia states, "I can't believe it's the 4th of July and it's snowing outside." Which is the nurse's most appropriate response? 1. "What makes you think it's the 4th of July?" 2. "How can it be July in winter?" 3. "Today is March 12, 2007. Look, your lunch is ready." 4. "I'll check to see if it's time for your PRN haloperidol (Haldol)."

3. "Today is March 12, 2007. Look, your lunch is ready."

A client who is delirious yells out to the nurse, "You are an idiot, get me your supervisor." Which is the best nursing response in this situation? 1. "You need to calm down and listen to what I'm saying." 2. "You're very upset, I'll call my supervisor." 3. "You're going through a difficult time. I'll stay with you." 4. "Why do you feel that my calling the supervisor will solve anything?"

3. "You're going through a difficult time. I'll stay with you."

A client is being admitted to the in-patient psychiatric unit with a diagnosis of bulimia nervosa. The nurse would expect this client to fall within which age range? 1. 5 to 10 years old. 2. 10 to 14 years old. 3. 18 to 22 years old. 4. 40 to 45 years old.

3. 18 to 22 years old

Which client situation requires the nurse to prioritize the implementation of limit setting? 1. A client making sexual advances toward a staff member. 2. A client telling a staff member that another staff member allows food in the bedrooms. 3. A client verbally provoking another patient who is paranoid. 4. A client refusing medications to receive secondary gains.

3. A client verbally provoking another patient who is paranoid.

Which statement best explains the pathophysiology associated with Parkinson's disease? 1. The disease results from atrophy in the frontal and temporal lobes. 2. A transmissible agent known as a "slow virus" or prion is associated with this disease. 3. A loss of nerve cells located in the substantia nigra is associated with this disease. 4. The disease results from damage in the basal ganglia and the cerebral cortex.

3. A loss of nerve cells located in the substantia nigra is associated with this disease.

The nurse is assessing a client with a body mass index of 35. The nurse would suspect this client to be at risk for which of the following conditions? Select all that apply. 1. Hypoglycemia. 2. Rheumatoid arthritis. 3. Angina. 4. Respiratory insufficiency. 5. Hyperlipidemia.

3. Angina 4. Respiratory insufficiency 5. Hyperlipidemia

A diabetic client admitted to a medical floor for medication stabilization has a history of antisocial personality disorder. Which documented behaviors would support this Axis II diagnosis? 1. "Labile mood and affect and old scars noted on wrists bilaterally." 2. "Appears younger than stated age with flamboyant hair and makeup." 3. "Began cursing when confronted with drug-seeking behaviors." 4. "Demands foods prepared by personal chef to be delivered to room."

3. Began cursing when confronted with drug seeking behaviors.

A client is leaving the in-patient psychiatric facility after 1 month of treatment for anorexia nervosa. Which outcome is appropriate during discharge planning for this client? 1. Client will accept refeeding as part of a daily routine. 2. Client will perform nasogastric tube feeding independently. 3. Client will verbalize recognition of "fat" body misperception. 4. Client will discuss importance of monitoring weights daily.

3. Client will verbalize recognition of fat body misperception

A client newly admitted to an in-patient psychiatric unit is diagnosed with schizotypal personality disorder. The client states, "I can't believe you are not afraid of the monsters coming after us all." Which is the most appropriate nursing response? 1. "I don't know what monsters you are talking about." 2. "The monsters? Can you please tell me more about that?" 3. "I was wondering if you want to come to group to talk about that." 4. "I can see your thoughts are bothersome. How can I help?"

4. "I can see your thoughts are bothersome. How can I help?"

An inexperienced agency nurse is assigned to an in-patient psychiatric unit. Which client should this nurse be assigned? 1. A client diagnosed with antisocial personality disorder. 2. A client diagnosed with paranoid personality disorder. 3. A client diagnosed with borderline personality disorder. 4. A client diagnosed with avoidant personality disorder.

4. A client diagnosed with avoidant personality disorder.

A client diagnosed with Alzheimer's disease is displaying signs and symptoms of anxiety, fear, and paranoia. An alteration in which area of the brain is responsible for these signs and symptoms? 1. Frontal lobe. 2. Parietal lobe. 3. Hippocampus. 4. Amygdala.

4. Amygdala

A client diagnosed with anorexia nervosa is newly admitted to an in-patient psychiatric unit. Which intervention takes priority? 1. Assessment of family issues and health concerns. 2. Assessment of early disturbances in mother-infant interactions. 3. Assessment of the client's knowledge of selective serotonin reuptake inhibitors used in treatment. 4. Assessment and monitoring of vital signs and lab values to recognize and anticipate medical problems.

4. Assessment and monitoring of vital signs and lab values to recognize and anticipate medical problems.

When assessing a client diagnosed with histrionic personality disorder, the nurse might identify which characteristic behavior? 1. Odd beliefs and magical thinking. 2. Grandiose sense of self-importance. 3. Preoccupation with orderliness and perfection. 4. Attention-seeking flamboyance.

4. Attention-seeking flamboyance.

Personality disorders are grouped in clusters according to their behavioral characteristics. In which cluster are the disorders correctly matched with their behavioral characteristics? 1. Cluster C: antisocial, borderline, histrionic, narcissistic disorders; anxious or fearful characteristic behaviors. 2. Cluster A: avoidant, dependent, obsessive-compulsive disorders; odd or eccentric characteristic behaviors. 3. Cluster A: antisocial, borderline, histrionic, narcissistic disorders; dramatic, emotional, or erratic characteristic behaviors. 4. Cluster C: avoidant, dependent, obsessive-compulsive disorders; anxious or fearful characteristic behaviors.

4. Cluster C: avoidant, dependent, obsessive compulsive disorders; anxious or fearful characteristic behaviors.

According to the DSM-IV-TR, which diagnostic criterion describes schizotypal personality disorder? 1. Neither desires nor enjoys close relationships, including being part of a family. 2. Is preoccupied with unjustified doubts about the loyalty or trustworthiness of friends or associates. 3. Considers relationships to be more intimate than they actually are. 4. Exhibits behavior or appearance that is odd, eccentric, or peculiar.

4. Exhibits behavior or appearance that is odd, eccentric, or peculiar.

A client diagnosed with a borderline personality disorder is given a nursing diagnosis of disturbed personal identity R/T unmet dependency needs AEB the inability to be alone. Which nursing intervention would be appropriate? 1. Ask the client directly, "Have you thought about killing yourself ?" 2. Maintain a low level of stimuli in the client's environment. 3. Frequently orient the client to reality and surroundings. 4. Help the client identify values and beliefs.

4. Help the client identify values and beliefs

Which etiological implication for obesity is from a physiological perspective? 1. Eighty percent of offspring of two obese parents become obese. 2. Individuals who are obese have unresolved dependency needs and are fixed in the oral stage of development. 3. Hyperthyroidism interferes with metabolism and may lead to obesity. 4. Lesions in the appetite and satiety centers in the hypothalamus lead to overeating and obesity.

4. Lesions in the appetite and satiety centers in the hypothalamus lead to overeating and obesity

A client newly diagnosed with vascular dementia isolates self because of consistently poor role performance and increasing loss of independent functioning. Which nursing diagnosis reflects this client's problem? 1. Disturbed thought processes R / T decreased cerebral circulation AEB disorientation. 2. Risk for injury R /T poor role performance AEB decreased functioning. 3. Disturbed body image R /T loss of independent functioning AEB tearful, sad affect. 4. Low self-esteem R /T loss of independent functioning AEB social isolation.

4. Low self esteem R/T loss of independent functioning AEB social isolation.

A male client diagnosed with a personality disorder boasts to the nurse that he has to fight off female attention and is the highest paid in his company. These statements are reflective of which personality disorder? 1. Obsessive-compulsive personality disorder. 2. Passive-aggressive personality disorder. 3. Schizotypal personality disorder. 4. Narcissistic personality disorder.

4. Narcissistic personality disorder.

Using the DSM-IV-TR, which statement is true as it relates to the diagnosis of obesity? 1. Obesity is a diagnosis classified on Axis I similar to other eating disorders. 2. Obesity is not classified as an eating disorder because medical diagnoses are not classified in the DSM-IV-TR. 3. Obesity is currently evaluated for all clients as a "psychological factor affecting medical conditions." 4. Obesity is not classified as an eating disorder, but can be placed on Axis III as a medical condition.

4. Obesity is not classified as an eating disorder, but can be placed on Axis III as a medical condition.

A nurse is discharging a client diagnosed with narcissistic personality disorder. Which employment opportunity is most likely to be recommended by the treatment team? 1. Home construction. 2. Air traffic controller. 3. Night watchman at the zoo. 4. Prison warden.

4. Prison warden

When assessing a client diagnosed with passive-aggressive personality disorder, the nurse might identify which characteristic behavior? 1. Exhibits behaviors that attempt to "split" the staff. 2. Shows reckless disregard for the safety of self or others. 3. Has unjustified doubts about the trustworthiness of friends. 4. Seeks subtle retribution when feeling others have wronged them.

4. Seeks subtle retribution when feeling others have wronged them

A client diagnosed with schizoid personality disorder chooses solitary activities, lacks close friends, and appears indifferent to criticism. Which nursing diagnosis would be appropriate for this client's problem? 1. Anxiety R/T poor self-esteem AEB lack of close friends. 2. Ineffective coping R/T inability to communicate AEB indifference to criticism. 3. Altered sensory perception R/T threat to self-concept AEB magical thinking. 4. Social isolation R/T discomfort with human interaction AEB avoiding others.

4. Social isolation R/T discomfort with human interaction AEB avoiding others.

A client diagnosed with an obsessive-compulsive personality disorder has a nursing diagnosis of anxiety R/T interference with hand washing AEB "I'll go crazy if you don't let me do what I need to do." Which short-term outcome is appropriate for this client? 1. The client will refrain from hand washing during a 3-hour period after admission to unit. 2. The client will wash hands only at appropriate intervals; that is, bathroom and meals. 3. The client will refrain from hand washing throughout the night. 4. The client will verbalize signs and symptoms of escalating anxiety within 72 hours of admission.

4. The client will verbalize signs and symptoms of escalating anxiety within 72 hours of admission.

Which predisposing factor would be implicated in the etiology of paranoid personality disorder? 1. The individual may have been subjected to parental demands, criticism, and perfectionistic expectations. 2. The individual may have been subjected to parental indifference, impassivity, or formality. 3. The individual may have been subjected to parental bleak and unfeeling coldness. 4. The individual may have been subjected to parental antagonism and harassment.

4. The individual may have been subjected to parental antagonism and harassment.

A nursing student is learning about narcissistic personality disorder. Which student statement indicates that learning has occurred? 1. "These clients have peculiarities of ideation." 2. "These clients require constant affirmation of approval." 3. "These clients are impulsive and are self-destructive." 4. "These clients express a grandiose sense of self-importance."

4. These clients express a grandiose sense of self importance

According to the DSM-IV-TR, which of the following diagnostic criteria define avoidant personality disorder? Select all that apply. 1. Does not form intimate relationships because of fear of being shamed or ridiculed. 2. Has difficulty making everyday decisions without reassurance from others. 3. Is unwilling to be involved with people unless certain of being liked. 4. Shows perfectionism that interferes with task completion. 5. Views self as socially inept, unappealing, and inferior.

5. Views self as socially inept, unappealing, and inferior

What is dementia associated with?

Dementia is associated with AD, frontotemporal lobar degeneration, Lewy bodies, vascular issues, traumatic brain injury, substances, HIV infection Prion disease, Parkinson's disease, and Huntington's disease.

What are some characteristics of histrionic personality disorder?

Histrionic personality disorder is characterized by emotional attention seeking behaviors, including self centeredness, low frustration tolerance, and excessive emotionality. The person with historionic personality disorder is often impulsive and melodramatic and may act flirtatiously or provocatively.

What are some characteristics of schizotypal personality disorder?

Like shizoid personality disorder, persons with schizotypal personality disorder have severe social and interpersonal deficits. They experience extreme anxiety in social situations and contributions to conversations tend to ramble with lengthy, unclear, overly detailed, and abstract content. They tend to misinterpret the motivations of others as being out to get them and blame others for their social isolation. Superstitious

How is planning affected with a patient with bulimia nervosa?

Like the patient with anorexia nervosa, the patient with bulimia may be reated for life threatening complications such as gastric rupture, electrolyte imbalance, and cardiac dysrhythmias in an acute care unit of a hopsital

What drugs treat AD?

Memantine (Namenda) and Rivastigmine (Exelon) *All of the cholinesterase inhibitors have the potential to cause nausea, diarrhea, and vomiting. In addition, they should be used with caution when patients are taking NSAIDs.

What should you expect with a patient with bulimia nervosa?

On inspection, the patient demonstrates enlargement of the parotid glands, with dental erosion and caries if the patient has been inducing vomiting

What are some characteristics of paranoid personality disorder?

Paranoid personality disorder is characterized by a longstanding distrust and suspiciousness of others based on the belief that others want to exploit, harm, or deceive the person. These individuals are hypervigilant, anticipate, hostility, and may provoke hostile response by initiating a "counterattack."

What are some characteristics of schizoid personality disorder?

Schizoid personality disorder is characterized by an exhibition of poor ability to function in everyday life. Relationships are particularly affected due to the prominenet feature of emotional detachment.

What are some characteristics of antisocial personality disorder?

Some characteristics of antisocial personality disorder are antagonistic behaviors, such as being deceitful and manipulative for personal gain or hostile if needs are blocked. The disorder is also characterized by disinhibited behaviors such as high risk taking, disregard for responsibility, and impulsivity.

What are some characteristics of obsessive compulsive personality disorder?

Some characteristics of obsessive compulsive personality disorder are rigidity and inflexible standards of self and others along with persistence to goals long after it is necessary, even if it is self defeating or relationship defeating.

What is the neurobiological component to eating disorders?

Temporary drops in dietary tryptophan may actually relieve symptoms of anxiety and dysphoria and provide a reward for caloric restriciton; however, continued mlnutrition will result in ap hysiological dysphoria. This cycle of temporary relief, followed by more dysphoria, sets up a positive feedback loop that reinforces the disordered eating behavior.