Final Psych Nur131

6.10 The nurse is determining the success of a patient's plan of care by evaluating outcome indicators. The nurse understands that these indicators are usually determined initially at which time? A) On the day of discharge B) During the assessment process C) At the initial interview D) With goal-setting process

B) During the assessment process

2. A nurse is caring for a client who has bipolar disorder and a new prescription for Valproate. Which of the following instructions should the nurse give the client about the use of this medication? 1. thyroid function tests should be performed every 6 months 2. a pretreatment electroencephalogram (EEG) will be done 3. liver function tests must be monitored 4. high serum sodium levels can cause toxic levels of Valproate

3. liver function tests must be monitored

1. A nurse is caring for a client who has bipolar disorder and is running around the unit asking people to dance with her. Which of the following interventions should the nurse take?: 1. turn on a dance video so the client can burn off excess energy 2. offer the client a low-calorie snack in return for stopping the behavior 3. take the client outside and sit with her in the garden area 4. observe the client closely for the development of aggressive behavior

3. take the client outside and sit with her in the garden area

7.15 The nurse is counseling a family with a child who has been abused by adult family friend in the past. When explaining about the child's needs, which of the following would be most important for the nurse to stress? A) A supportive relationship with an adult B) Long-term psychotherapy C) Antidepressant medications D) Short-term separation from the parents

A) A supportive relationship with an adult

11.10 A nurse is performing a biopsychosocial assessment of a patient with depression. Which of the following would the nurse assess as part of the psychological domain? Select all that apply. A) Abstract reasoning B) Medication use C) Mood D) Orientation E) Self-care

A) Abstract reasoning C) Mood D) Orientation

4.17 While assessing an older adult, the nurse allows ample time for the patient to respond based on the understanding of which of the following? A) Ample time ensures that the correct answer is given. B) The patient is most likely experiencing irreversible memory impairment. C) The patient is experiencing decreased cerebral oxygen flow from reduced activity. D) Ample time is needed to weigh the pros and cons of the perceived risk for answering.

A) Ample time ensures that the correct answer is given.

16.17 A group of nursing students is reviewing risk and protective factors associated for mental disorders in the older adult population. The students demonstrate understanding of the information when they identify which of the following as a protective factor? A) Poverty B) Education C) Loss D) Chronic illness

B) Education

7. A nurse engaged in an interaction with a patient recognizes body space zones. Which of the following would the nurse identify as the individual's personal zone? A) Beginning at the boundary of the intimate zone and ending at the social zone B) Extending outward from the border to the public zone C) Surrounding and protecting an individual from others, especially outsiders D) The most distant boundary that can be used for recognizing intruders

A) Beginning at the boundary of the intimate zone and ending at the social zone

9.10 A home health nurse is making a home visit to a psychiatric patient who was recently discharged from a mental health unit. During the visit, the nurse plans on clarifying with the patient when she will return for the next home visit. During which stage would the nurse discuss the next home visit with the patient? A) Closure stage B) Service implementation C) Greeting stage D) Focus establishment

A) Closure stage

16. A group of nursing students are preparing a class presentation on therapeutic and nontherapeutic techniques of communication. The students demonstrate understanding of the information when they select which techniques to demonstrate as therapeutic? Select all that apply. A) Confrontation B) Open-ended statements C) Reflection D) Reassurance E) Agreement F) Challenges

A) Confrontation B) Open-ended statements C) Reflection

16.15 After teaching a class about childhood and adolescent mental health, the instructor determines that additional teaching is needed when the class identifies which of the following as promoting mental health in children? A) Difficult temperament B) Age-appropriate physical development C) Secure attachment D) Normal psychosocial development

A) Difficult temperament

14.17 A nurse is preparing to conduct an assessment of a 79-year-old woman who has come to the clinic for evaluation. When performing this assessment, which of the following would be most appropriate for the nurse to do? Select all that apply. A) Dim any lights that appear too bright. B) Face the patient from the side. C) Use short, simple sentences. D) Focus on one topic at a time. E) Speak slowly in a shouting tone.

A) Dim any lights that appear too bright. C) Use short, simple sentences. D) Focus on one topic at a time.

11. When engaged in a nontherapeutic relationship, which of the following would the nurse identify as occurring first? A) Failure to recognize the patient as a person with a need B) Patient avoiding the nurse C) The nurse being perceived as rude D) Patient feeling hopeless and frustrated

A) Failure to recognize the patient as a person with a need

14. A group of students are reviewing the process of verbal communication. The students demonstrate understanding of the information when they identify which of the following as the first component of the process? A) Formulation of an idea B) Message encoding C) Transmission of message D) Message reception

A) Formulation of an idea

11.20 A group of nursing students is reviewing information about the types of crisis. The students demonstrate understanding of the information when they identify which of the following as a developmental crisis? A) Going away to college B) Obtaining a job promotion C) Loss of a pet D) Earthquake

A) Going away to college

4.9 A patient who is hospitalized with depression tells the nurse, I don't want to take the medication because I'm afraid I'll become suicidal. Which response by the nurse would be most appropriate? A) Have you ever thought about hurting yourself? B) It's important that you take this medication. C) I agree with you. I wouldn't want to take this medication either. D) Another patient took that medication, and he really felt better.

A) Have you ever thought about hurting yourself?

1.15 While caring for a family who lost a 10-year-old son in a car accident, the nurse should instruct the parents to tell the 4-year-old sister which of the following about her brother? A) He died and is not coming back. B) He passed on to the other side. C) He departed on a long journey. D) He has gone to see the Lord above.

A) He died and is not coming back

10. The nurse is reviewing the assessment data of a patient diagnosed with a mental illness. The patient is to be prescribed medication to treat the illness. The nurse would identify changes in which laboratory values as being the least significant? A) Hemoglobin B) Alanine aminotransferase (ALT) C) Blood urea nitrogen (BUN) level D) Serum creatinine

A) Hemoglobin

6.20 A Red Cross nurse is working with tornado victims. The nurse is interviewing a woman whose house was totally destroyed during the night by the tornado; the woman's pet poodle died as a result of the tornado. Which of following would the nurse most likely expect to hear from the woman? A) I don't know. I can't feel anything right now. Nothing seems real. B) Devastated. . . . I just feel totally devastated. I don't know how I can go on living. C) I just want my insurance man to get here so I can file a claim. Everything I had is gone. D) I always thought my dog would die peacefully in my arms. Now I'll never be able to hold her again.

A) I don't know. I can't feel anything right now. Nothing seems real.

10.15 While engaging in a discussion with a group of teens about risk behaviors, one of the teens says, That will never happen to me. The nurse interprets this as which of the following? A) Invincibility fable B) Formal operations C) Egocentric thinking D) Relational aggression

A) Invincibility fable

5. A staff nurse on a psychiatric unit knows that patients often have trouble sleeping because of their psychiatric conditions. Which of the following would reflect a psychiatric nursing intervention to appropriately address this problem? A) Limiting amounts of evening snacks and beverages B) Involving patients in a volleyball game immediately before bedtime C) Enforcing the rule that all patients be in bed with lights out by 10:30 PM D) Encouraging patients to take short naps in the afternoons

A) Limiting amounts of evening snacks and beverages

10.20 A nurse is working as part of a community disaster response team. When responding to a community disaster, the nurse integrates understanding of individuals' responses, anticipating which of the following? A) People can become aggressive and violent when their basic needs are threatened. B) People involved in the disaster will always put the welfare of others before their own. C) Losses incurred during the disaster have little, if any, long-term effect on victims. D) The psychological distress associated with disasters is felt immediately.

A) People can become aggressive and violent when their basic needs are threatened.

12.20 As part of a community program on crisis prevention, a nurse is describing the phases of crisis. Which of the following would the nurse identify as occurring first? A) Problem stimulating usual problem solving B) Trial and error attempts to alleviate problem C) Automatic relief behaviors take over D) Serious personality disorganization

A) Problem stimulating usual problem solving

17.17 The nurse is working as part of a team to help reduce the stigma attached to mental health treatment for the older adult population. Which of the following would be most appropriate to do to achieve this outcome? A) Provide education about mental health and mental disorders. B) Initiate screening programs for symptoms. C) Ensure older adults received integrated community care. D) Institute a wide range of social support services.

A) Provide education about mental health and mental disorders.

2.17 A group of nursing students is reviewing the physical changes that occur in older adults. The students demonstrate understanding of the information when they identify which of the following as contributing the patient's risk for drug toxicity? A) Reduced liver function B) Reduce brain gray matter volume C) Lower metabolic rate at rest D) Decreased body water

A) Reduced liver function

3.9 A hospitalized patient diagnosed with depression asks the nurse, Should I go home this weekend? Which response by the nurse uses the technique of reflection? A) Should you go home for the weekend? B) Home means what to you? C) It sounds as if you don't want to go home this weekend. D) I doubt that you really should go home this weekend.

A) Should you go home for the weekend?

6. A patient is talking to the nurse about the recent death of her grandmother. She is obviously very sad, and a tear rolls down her cheek as she talks. The nurse remembers how she felt when her own grandmother died the previous summer. The nurse puts her hand on the patient's shoulder and says, This must be very difficult for you. The nurse is demonstrating empathy based on which of the following? A) The response comment reflects an attempt to communicate understanding of patient's feelings. B) The nurse's response and use of reassuring touch reinforce the nurse's concern for the patient. C) The nurse demonstrates understanding of how the patient feels because of her own grandmother's death. D) The nurse's statement expresses compassion and kindness toward the patient.

A) The response comment reflects an attempt to communicate understanding of patient's feelings.

18. A nurse is developing a plan for establishing appropriate supportive community care services for older adults to promote independence. Which services would the nurse be most likely to include? Select all that apply. A) Transportation B) Homemakers C) Legal D) Housing E) Child care

A) Transportation B) Homemakers C) Legal D) Housing

3.15 The nurse is counseling a family with two parents and two children, ages 8 and 10 years. The mother complains that the children are constantly fighting and have intense sibling rivalry. When statement would be most appropriate when advising the parents about how to respond to the sibling rivalry? A) Try reacting to each as unique individuals with talents and interests distinctly their own. B) Be firm about telling the children they have to cooperate with one another. C) Slowly decrease the amount of attention and control shown to the older child. D) Make sure they have a quiet, subdued home environment to avoid stimulating conflict.

A) Try reacting to each as unique individuals with talents and interests distinctly their own

11.15 A nurse is working with a family in which the parents have just gotten divorced. After teaching the parents about measures to reduce the risk of emotional problems for the children, which statement by the parents indicates a need for additional teaching? A) We will try to alter their routines so they don't think about the past. B) We will make sure that they understand that they did not cause the divorce. C) We will develop a regular and consistent schedule for visitation. D) We will make sure that we are consistent in the limit that we set.

A) We will try to alter their routines so they don't think about the past.

1.9 A nurse has engaged in self-awareness and has come to understand his own personal beliefs and attitudes and has recognized some prejudicial ideas. Based on this understanding, which of the following would the nurse now be able to accomplish? A) Have a therapeutic relationship with a patient. B) Influence patients with certain biases. C) Change learned behaviors. D) Formulate values and morals.

C) Change learned behaviors.

1.17 The nurse is preparing to assess a 78-year-old patient who has been diagnosed with major depression. Which of the following would the nurse expect to assess as a normal finding? A) Decrease in body fat B) Increased muscle mass C) Dulled taste sensation] D) Enhanced visual acuity

C) Dulled taste sensation]

5.15 A nurse is providing care to several chronically ill children. Which of the following would the nurse identify as having the greatest risk for developing a psychiatric problem? A) 12 year-old with diabetes mellitus B) 5 year-old with cerebral palsy C) 8 year-old who has chronic renal disease D) 10 year-old with a heart murmur

B) 5 year-old with cerebral palsy

8.17 A nurse is reviewing the medical records of several older adult patients. The nurse determines that which individual would have the least chance of developing mental health problems with aging? A) A man who is single, has an eighth grade education, and walks to the mailbox and back every day B) A woman who is married with graduate education, eats nutritionally balanced meals, and exercises for 20 minutes each day C) A man who is married, has a high school education, eats mostly fast food, and walks a mile each day D) A woman who is single, has a college degree and watches what she eats but really does not exercise

B) A woman who is married with graduate education, eats nutritionally balanced meals, and exercises for 20 minutes each day

9.17 The nurse is presenting a community educational program focusing on older adults and mental health protective factors. One of the participants asks what the influence of co-parenting one's grandchild has on the mental health of the grandparent. Which response by the nurse would be most appropriate? A) The well-being of grandmothers is statistically more significant when they co-parent their grandchildren. B) Although there are stresses involved with grandparenting, the positive benefits appear to outweigh the negatives. C) White grandmothers experience less well-being when they co-parent their grandchildren. D) The perceived well-being of grandfathers who co-parent their grandchildren significantly changes in a positive direction.

B) Although there are stresses involved with grandparenting, the positive benefits appear to outweigh the negatives.

9. A patient is a successful insurance salesman; however, because of market changes, his level of sales has dropped. His boss tells him he will consequently be receiving a $2,000 per year cut in his salary. When the patient arrives home from work, the family dog runs to greet him as he always does, barking and jumping up and down and begging for attention. The patient yells at the dog, Get away from me; I can't take your barking right now. The patient's response reflects a defense mechanism because it was which of the following? A) An intentional behavior performed to let the dog know his behavior was inappropriate B) Automatic, protecting the patient from the anxiety related to his upcoming pay cut C) Implemented to keep the patient from having to cope with his upcoming pay cut D) Implemented so the patient could rationalize his upcoming pay cut

B) Automatic, protecting the patient from the anxiety related to his upcoming pay cut

20.20 A group of nursing students is reviewing information about grief and bereavement. The students demonstrate understanding of the information when they identify which of the following? A) Grief and bereavement are used interchangeably as responses to loss. B) Bereavement is the process of mourning and grief is the emotional reaction. C) Grief involves confronting the stress, but bereavement helps avoid the stresses. D) Bereavement is influenced by culture, but grief is not.

B) Bereavement is the process of mourning and grief is the emotional reaction.

18.10 A patient is engaged in bibliotherapy and begins to express his feelings because he closely associates his experience with that provided by the reading material. The nurse interprets this as which of the following? A) Insight B) Catharsis C) Anxiety reduction D) Problem solving

B) Catharsis

17.15 A nurse is providing teaching to a group of parents with children and adolescents who have experienced losses. The nurse determines that the teaching was successful when the group states which of the following? A) Children grieve in similar ways regardless of their age. B) Children often use fantasy to fill in their gaps in understanding. C) Families tend to grieve at similar times after the loss. D) Children and adults grieve much in the same manner.

B) Children often use fantasy to fill in their gaps in understanding.

2.15 The nurse is counseling a family with a 10-year-old child after the death of a favorite uncle. The nurse provides guidance to the parents, informing them that the child may exhibit which of the following as a response? A) Talk about scary, morbid novels all the time. B) Complain of aches and pains, stomachaches, that sort of thing. C) Suddenly become afraid of leaving home to go to school. D) Become obsessed with religious rituals, Bible verses, and prayer.

B) Complain of aches and pains, stomachaches, that sort of thing.

17.20 After teaching a group of nursing students about crisis, the instructor determines that the teaching was successful when the students state which of the following? A) Crisis triggers maladaptive responses. B) Crisis is a time-limited event. C) Chronic crisis is a real situation. D) Events causing a crisis are similar for everyone.

B) Crisis is a time-limited event.

9.20 A nursing instructor who is lecturing to students about how to respond to individuals who are in the midst of a disaster. Which statement would be most appropriate to include about initial nursing interventions for such individuals? A) You should ask them to give you a brief medical history so their physical needs can be met. B) Focus on safety needs and provide simple, clear instructions to help them function effectively. C) Help them determine what their long-term goals will be so they can maintain a sense of hope. D) Try to redirect their attention away from the problems at hand so you can decrease their anxiety.

B) Focus on safety needs and provide simple, clear instructions to help them function effectively.

9.15 A home-health nurse is working with a poverty-stricken family that has two small children, ages 2 and 3 years. The family lives in an isolated rural area. The family's home has a dirt floor, and there are chickens living in the house with the family. Because of a recent wind storm, there is a sizeable hole in the roof that lets rain and snow into the house. Which nursing intervention would be the highest priority in this situation? A) Make immunization appointments for the children in a nearby town's public health clinic. B) Help the family find funding and manpower to patch and repair the roof of their home. C) Determine the educational readiness of the two children. D) Report the family for child abuse because of neglect.

B) Help the family find funding and manpower to patch and repair the roof of their home.

15.20 Assessment of a patient indicates complicated grief. Which statements would the nurse identify as supporting this reaction? Select all that apply. A) It's been 2 months, and I still want my son back. B) I still wait for him to come right through the door every day. C) I'm really struggling with trusting anybody anymore. D) I wish I could go back to the days before he died. E) Life seems so empty now that he's gone. What will I do?

B) I still wait for him to come right through the door every day. C) I'm really struggling with trusting anybody anymore. D) I wish I could go back to the days before he died. E) Life seems so empty now that he's gone. What will I do?

18. During an interview, a patient tells the nurse that he was recently let go from his job. As the interaction continues, the patient states, I was really overqualified for that position anyway. It was definitely below my area of expertise. The nurse interprets this information as reflecting which of the following? A) Denial B) Intellectualization C) Projection D) Passive aggression

B) Intellectualization

14.20 A nursing instructor is describing uncomplicated grief to a class. Which of the following would the instructor most likely include in the discussion? A) Uncomplicated grief differs from normal grief because it lasts longer. B) Most bereaved persons experience uncomplicated grief. C) Uncomplicated grief is primarily loss associated with death D) This type of grief is less painful and disruptive than normal grief.

B) Most bereaved persons experience uncomplicated grief.

12.15 A group of nursing students is reviewing information about the differences that occur with grieving in children, adolescents, and adults. The students demonstrate understanding of this information when they identify which of the following as characteristic of adolescents? A) View death as reversible B) Mourn by talking about the loss C) Need repeated explanations to understand the loss D) Express a time limit for socially acceptable grieving

B) Mourn by talking about the loss

15.17 A nursing instructor is preparing for a class discussion on polypharmacy and older adults. Which of the following would the instructor expect to include? A) The risk for drug abuse, although present, is fairly rare in this population. B) Older adults often experience a greater risk for adverse reactions. C) Medications are usually prescribed in higher doses initially and then gradually reduced. D) Age-related pharmacokinetic changes enhance the drug's therapeutic effectiveness.

B) Older adults often experience a greater risk for adverse reactions.

15. A nurse responds to a patient's statement with silence based on the rationale that this technique is used primarily to do which of the following? A) Allow the nurse to determine an appropriate response B) Permit the patient to gather his or her thoughts C) Encourage self-reflection by the nurse D) Demonstrate passive listening

B) Permit the patient to gather his or her thoughts

13.10 The nurse is reviewing the drawing that a patient completed as a self-portrait. The nurse observes that the drawing lacks arms and feet. The nurse interprets this as indicating which of the following? Select all that apply. A) Low self-esteem B) Powerlessness C) Insecurity D) Inadequacy

B) Powerlessness D) Inadequacy

7.10 Based on assessment data, the nurse formulates the nursing diagnosis for a patient as sleep pattern disturbance. After teaching the patient how to relax before bedtime, the nurse determines that the teaching was effective by which outcome? A) Discusses feelings about not being able to fall asleep B) Reports feeling rested on awakening in the morning within 3 days C) Requests sleeping medication each night before bedtime D) Is able to sleep for short intervals throughout the night

B) Reports feeling rested on awakening in the morning within 3 days

20. A nurse is engaged in active listening. Which of the following would the nurse use? Select all that apply. A) Changing the subject to gather more information B) Responding indirectly to statements C) Using open-ended statements D) Concentrating on what patient says E) Allowing the patient to talk as he wishes

B) Responding indirectly to statements C) Using open-ended statements D) Concentrating on what patient says

16.20 A patient is experiencing traumatic grief resulting from the suicide of a family member. In addition to the usual emotions experienced with bereavement and grief, which of the following would the person most likely exhibit? Select all that apply. A) Acceptance of the loss B) Sense of rejection C) Disgust D) Stigmatization E) Self-blame

B) Sense of rejection D) Stigmatization E) Self-blame

8.10 A patient was brought to the emergency department for an injury he received while working as a migrant worker. It soon becomes evident that the patient cannot speak English. A nurse on duty offers to find an interpreter so the patient can communicate with the medical staff. The nurse's offer is an example of which type of nursing intervention? A) Milieu therapy B) Conflict resolution C) Cultural brokering D) Structured interaction

C) Cultural brokering

14.10 A nurse identifies a nursing diagnosis of chronic low self-esteem. Which statement by a patient would support this nursing diagnosis? A) I feel so ugly.' B) No one wants to date me. C) I'm so fat, like a cow. D) I never do anything right.

D) I never do anything right.

12.17 While assessing an older adult patient for mental health issues, the nurse pays special attention to the patient's sensory function based on the understanding of which of the following? A) Most older adults follow a specific pattern of decline in functioning leading to gradual onset of problems. B) Sensory decline may affect the individual's ability to process information, possible influencing the findings of the mental status examination. C) Diminished sensory function can lead to changes in other body systems that may affect the individual's reaction to prescribed medications. D) Changes in the senses can result in changes in cognitive abilities that mimic the manifestations of mental disorders.

B) Sensory decline may affect the individual's ability to process information, possible influencing the findings of the mental status examination.

2.20 A patient's 5-year-old poodle ran in front of a car and was killed. The patient continues to be upset by her pet's death, and she explains to a community counseling center nurse that she can't stop crying because, My Precious meant the world to me, and now my world will never be the same! If the nurse were to determine that the patient was experiencing a crisis, which of the following types of crisis would it most likely be? A) Maturational B) Situational C) Traumatic D) Developmental

B) Situational

5.20 An individual is seeking employment as a nurse in a crisis center. The interviewer asks the person what he would ask someone who called the crisis hotline to determine whether the caller was experiencing a crisis. Which response would be most appropriate? A) To what extent are you involved in a crisis situation? B) Tell me about what you are experiencing and what it means to you. C) How would you rate your level of functioning on a scale from 1 to 10? D) Why do you think you are in a crisis situation?

B) Tell me about what you are experiencing and what it means to you.

19. The nurse is engaged in a therapeutic nurse patient relationship. The relationship is in the working phase. With which of the following would the patient be involved? Select all that apply. A) Beginning to identify a need B) Testing new ways for problem solving C) Testing the relationship D) Discussing problems related to needs E) Examining personal issues

B) Testing new ways for problem solving D) Discussing problems related to needs E) Examining personal issues

2.9 When engaged in therapeutic communication in a therapeutic relationship with a patient with a mental health problem, which of the following would be most important for the nurse to keep in mind? A) The nurse should self-disclose when indicated. B) The patient is the primary focus of the interaction. C) The nurse should have an empathetic relationship with the patient. D) The patient's conversations should be recorded.

B) The patient is the primary focus of the interaction.

7.20 A nurse is part of team working with hurricane victims. One of the hurricane victims is staying in a temporary shelter provided by the Red Cross. To determine the extent to which this victim can cognitively cope with his situation and how much support he needs, which question would be most appropriate for the nurse to ask? A) What kind of help do you need from us? B) What are your thoughts about what you will do during the next few days? C) How are you feeling about all that you have gone through? D) Are you feeling guilty because you survived and some of your neighbors did not?

B) What are your thoughts about what you will do during the next few days?

1. Which of the following questions would be most helpful in beginning an initial assessment interview for a patient who has just been admitted to a psychiatric inpatient unit? A) Have you had any previous psychiatric admissions? B) What brings you into the hospital today? C) Have you had any thoughts about trying to harm yourself? D) How would you describe your relationship with your spouse?

B) What brings you into the hospital today?

4.15 A 3-year-old child has been admitted to the hospital after an automobile accident. Which statement by the nurse would be most appropriate when discussing the type of behavior the parents can expect their child to display while hospitalized? A) Your child may not be able to accept how the injury has changed your child's appearance. B) Your child may seem unduly anxious in the presence of strangers. C) Your child may experience some guilt feelings associated with the accident. D) Your child will exhibit intermittent periodic mood swings, but these should be brief.

B) Your child may seem unduly anxious in the presence of strangers.

11.17 A nurse is reviewing the medical records of several older adult patients who have come to the clinic for evaluation. The nurse would classify a patient of which age as being in the middle-old stage? A) 66-year-old adult B) 70-year-old adult C) 78-year-old adult D) 86-year-old adult

C) 78-year-old adult

15.15 A nurse is developing a plan of care for a family who is experiencing problems related to their child's chronic illness. The nurse plans to have the family read a group of short stories written by parents of children with chronic illnesses. The nurse will be using which technique? A) Psychoeducation B) Social skills training C) Bibliotherapy D) Assertiveness training

C) Bibliotherapy

16.10 A nurse is assisting a patient in using simple relaxation techniques. Which of the following would the nurse do first? A) Have the patient assume a relaxed position. B) Advise the patient to let the sensations happen. C) Ensure a quiet, nondisrupting environment. D) Instruct the patient to take an initial slow, deep breath.

C) Ensure a quiet, nondisrupting environment.

20. The nurse is assessing a patient's immediate and short-term memory. Which of the following would be most appropriate? A) Questioning the patient about an event that has occurred within the past several months B) Giving the patient a simple scenario and having him identify what would be the best response C) Giving the patient three words and asking him to recite them now and then in 5 minutes D) Asking the patient to tell the nurse the date, time, and current location

C) Giving the patient three words and asking him to recite them now and then in 5 minutes

17.10 A group of nursing students are reviewing information about counseling interventions. The students . demonstrate a need for additional review when they identify counseling interventions as involving which of the following? A) Specific, time-limited intervention B) Focus on coping improvement C) Goal of regaining functional abilities D) Prevention of disability

C) Goal of regaining functional abilities

1.20 The nurse is assessing a 35-year-old woman who is seeking assistance at a local community counseling center. Which of the following statements made by the woman would indicate that she is experiencing a crisis? A) I'm so upset; my husband has never left me like this before. B) I'm confused and hurt; I have lost my best friend and my lover. C) I don't understand; I can't seem to function like I usually do. D) No matter what I do, I am still overcome by these sad feelings.

C) I don't understand; I can't seem to function like I usually do.

5. A female psychiatric patient is talking to the nurse about her reasons for being hospitalized. She begins to discuss her relationship with her female significant other. The patient is describing the things in her relationship that are making her uncomfortable, and she asks the nurse, Should I break up with my partner? Which response by the nurse would be most effective in building rapport between the patient and nurse? A) Of course you should; being a lesbian is just not natural. B) Yes, I think you should pursue building a relationship with a man. C) It sounds like you're beginning to be uncomfortable in this relationship. D) You need to focus on yourself rather than the relationship right now.

C) It sounds like you're beginning to be uncomfortable in this relationship.

8.15 The nurse is planning an initial therapy session with a 20-year-old patient whose parents had alcoholism. The nurse anticipates that the patient would most likely exhibit symptoms of which of the following? A) Delusions B) Paranoid delusions C) Low self-concept D) Extroversion

C) Low self-concept

3.20 A 62-year-old man experienced the loss of his 87-year-old father a week ago. The hospice nurse is making a follow-up visit to determine how he is handling his father's death. Which of the following statements made indicates to the hospice nurse that patient is in the acute mourning stage of bereavement? A) I keep thinking about my father; I have trouble believing he's dead. I feel guilty because I didn't go to the nursing home to visit him last week! B) I've been grieving my father; losing him is a tremendous loss, but I have to get on with my life. C) My father was a saint. I am so angry at God for taking him away! I'm crying all the time; I haven't been able to work for days. D) I'm going to spend the weekend with my children; they understand what I've been going through, and I can relax around them.

C) My father was a saint. I am so angry at God for taking him away! I'm crying all the time; I haven't been able to work for days.

8. The nurse is in the orientation phase of the nurse patient relationship with a patient diagnosed with a mental disorder. When interviewing the patient during this first encounter, which information would be most important for the nurse to obtain about the patient? A) Known allergies B) Recent hospitalizations C) Perception of the problem D) Family history

C) Perception of the problem

13.15 A nurse is working with a child for which an out-of-home placement has occurred. Which of the following would the nurse anticipate as the child's initial response? A) Despair B) Withdrawal C) Protest D) Detachment

C) Protest

19.20 A nurse is working with a patient who is in crisis. Which of the following would be least appropriate for the nurse to do? A) Support the patient's cultural beliefs about expressing feelings. B) Encourage the patient to focus on one aspect at a time. C) Provide the patient with an understanding that everything will be okay. D) Explain information clearly to clarify any misconceptions or myths.

C) Provide the patient with an understanding that everything will be okay.

10.17 A nursing student is reading an article about protective factors for mental illness with older adults. The article mentions the individual's ability to adapt successfully to stress, trauma, or chronic adversity. The student identifies this as which of the following? A) Functional status B) Gerotransendence C) Resilience D) Empty nest

C) Resilience

4. After assessing a patient, the nurse noted the following: he was tearful, he tried to kill himself before coming into the hospital, he had no immediate plan for another suicide attempt, he was unable to concentrate, and he reported having trouble sleeping and having little or no appetite. The nurse also noted that the patient's appearance was unkempt, that he spoke in a low monotone, and that he was unable to establish and maintain eye contact. Based on this information, which nursing diagnoses would be the most appropriate? A) Ineffective Role Performance B) Risk for Infection C) Risk for Suicide D) Risk for Self-Mutilation

C) Risk for Suicide

13. A nursing instructor is describing the nurse patient relationship to a group of nursing students. Which of the following would the instructor emphasize as crucial for establishing and maintaining the relationship? A) Rapport B) Empathy C) Self-awareness D) Values

C) Self-awareness

17. When communicating with a patient, which of the following would the nurse use to convey positive body language? A) Sitting erect with back against the chair B) Crossing the arms over the chest C) Sitting at the patient's eye level D) Keeping the feet flat on the floor with the legs crossed

C) Sitting at the patient's eye level

2. A patient is being admitted to the psychiatric unit. While explaining his reason for seeking admission, he describes how his 32-year-old son recently died of a heart attack. Which response by the nurse would enhance the effectiveness of this interview? A) How is your wife handling your son's death? B) Do you have any other living children that can help you cope with this loss? C) This must be a very difficult time for you. D) I know exactly how you're feeling; my 23-year-old son died unexpectedly last year.

C) This must be a very difficult time for you.

18.20 The nurse is providing follow up care to victims of a disaster that occurred several months ago. Assessment of which of the following would lead the nurse to suspect that the victims are experiencing possible aftereffects of the disaster? A) Tachycardia B) Profuse perspiration C) Unexplained gastrointestinal disturbance D) Tremors

C) Unexplained gastrointestinal disturbance

7.17 After checking a patient's blood pressure, he asks the nurse what changes he should expect in himself as he grows older. Which response by the nurse would be most appropriate? A) You don't have anything to worry about; you will basically stay the same. B) Your personality will stay the same, but your intelligence level will lessen somewhat. C) Usually, you can anticipate that you will begin to react to things more slowly. D) You will become increasingly childlike, and your personality will change.

C) Usually, you can anticipate that you will begin to react to things more slowly.

12. While providing care to a patient with a mental disorder, the patient asks the nurse, Does mental illness run in your family? Which response by the nurse would be most inappropriate? A) Mental illnesses do run in families, and I've had a lot of experience caring for people with mental illness. B) It sounds like you are concerned that there may be a family connection to your current problem? C) Yes, it does. I have a sister who was diagnosed several years ago with severe major depression. D) Mental illness can be family related. Let's focus the discussion on you and how you're doing today.

C) Yes, it does. I have a sister who was diagnosed several years ago with severe major depression.

12.10 During assessment, the nurse asks a patient to explain what the following means: A penny saved is a penny earned. The nurse is assessing which of the following? A) Affect B) Attention C) Concentration D) Abstract reasoning

D) Abstract reasoning

8.20 A family has just lost their home in a fire. An on-call nurse from a community counseling center has been called in to the emergency department to help them with this traumatic event. Which of the following would the nurse identify as the priority for this family? A) Arranging for follow-up therapy to deal with the crisis B) Completing a family genogram to determine family patterns C) Assessing the impact of the loss on their lifestyle D) Arranging for emergency shelter and food supplies

D) Arranging for emergency shelter and food supplies

19.10 After teaching a group of nursing students about milieu therapy, the instructor determines that additional teaching is needed when the students identify which of the following as a key concept of milieu therapy? A) Structure interaction B) Open communication C) Validation D) De-escalation

D) De-escalation

6.17 The nurse is working with a patient whose mobility is impaired secondary to a fall that resulted in a broken hip. In addition, the patient, who has diabetes, is developing problems with vision and hearing. The patient seems increasingly withdrawn and depressed. The nurse determines that the patient is at risk for spiritual distress. Which intervention would be most appropriate? A) Encourage the patient to talk about significant childhood religious experiences. B) Offer to take the patient to a revival the nurse's church is holding in the community. C) Read to the patient Bible passages that seem particularly relevant to the patient's case. D) Explore what the mobility, sight, and hearing changes mean to the patient.

D) Explore what the mobility, sight, and hearing changes mean to the patient.

4.20 A 25-year-old legal secretary is seeking counseling because she recently lost her job unexpectedly. Which question would be most appropriate for the nurse to use in assessing the patient's response to losing her job? A) What happened to cause you to lose your job? B) How did you feel immediately after being told you no longer had a job? C) How do you expect yourself to be able to handle this situation? D) How have you responded to previous stressful situations?

D) How have you responded to previous stressful situations?

6.15 The nurse is planning a counseling session with a group of at-risk adolescents on the topic of drug abuse. Which teaching strategy would be most effective? A) Handing out educational pamphlets and showing slides of car accidents related to teen drug use. B) Showing informational videotapes and providing Internet addresses on the topic of drug addiction. C) Giving information by lecturing and using pre- and posttest quizzing about the information. D) Involving peers in teaching the effective group problem-solving skills.

D) Involving peers in teaching the effective group problem-solving skills.

3.17 An older patient tells the nurse that she is becoming more forgetful. The nurse explains to the patient that this is most likely related to which of the following? A) Anxiety B) Organic brain syndrome C) Plaques in the brain tissue D) Medications

D) Medications

5.17 The nurse is planning a presentation to a group of older adults on the topic of suicide in the population. One of the group participants asks who has the highest risk of suicide. Which response by the nurse would be most appropriate? A) Older adults who have multiple prescriptions from a variety of different pharmacies. B) Older adults who are experiencing a deep and profound depression. C) Older adult women who are divorced or widowed. D) Men over the age of 75 years who are divorced or widowed.

D) Men over the age of 75 years who are divorced or widowed.

13.17 A group of nursing students is reviewing information about the course of aging in future older adults and qualities that contribute to successful aging. The students demonstrate understanding of this information when they identify which of the following as least important? A) Capacity to adapt to change B) Engagement in life C) Stability with reliable social support D) Physical health

D) Physical health

14.15 The nurse is working with a child who has engaged in bullying. Which of the following would be most effective for the nurse to implement? A) Psychoeducation Test Bank - Psychiatric Nursing: Contemporary Practice (6th Edition by Boyd) 59 B) Bibliotherapy C) Early intervention program D) Social skills training

D) Social skills training

10. Termination takes place during the resolution phase of a nurse patient relationship. During the termination process, a patient brings up resolved problems and presents them as new issues to work toward. The nurse interprets the patient's action as indicating which of the following? A) The patient is angry that the nurse is abandoning him. B) The patient requires additional therapy. C) The patient is unhappy that the therapy was ineffective D) The patient is attempting to prolong the nurse patient relationship.

D) The patient is attempting to prolong the nurse patient relationship.

13.20 A nurse is assessing the parents of a 6-year-old child who has died from leukemia. The nurse is integrating the dual process model for the assessment. Which of the following would the nurse identify as reflecting the parents loss-oriented coping? A) Engaging in new activities B) Denying the grief C) Developing new relationships D) Thinking about the lost child

D) Thinking about the lost child

15.10 A nurse is assessing a patient's spirituality. Which question would be most appropriate to ask? A) Have you ever tried to harm yourself? B) How important is your family to you? C) How do you define good and evil? D) What gives your life meaning?

D) What gives your life meaning?

3. A patient was admitted to the hospital after a suicide attempt made after his daughter was killed in an automobile accident during which he had been driving and survived with only minor injuries. Even though the accident was unavoidable, he feels responsible. During the assessment interview, the patient begins to describe the last conversation he had with his daughter before he lost control of the automobile. As he speaks about his daughter, his voice trembles, and a silent tear rolls down his face. He makes a visible attempt to straighten up and smiles superficially at the nurse, stating, I'll get over this. I just need to keep a stiff upper lip. I think all I need to do is stay overnight. I'll be as good as new by tomorrow. Which response by the nurse would be most appropriate? A) Tell me about your daughter. How would you describe the relationship you had with her? B) I'm sure you are right; a good night's rest should make a big difference. C) As good as new? D) You made a serious attempt on your life; you will not be ready go home by tomorrow.

D) You made a serious attempt on your life; you will not be ready go home by tomorrow.