Mental Health Final

Josie, a 27 year old patient, complains that most of the staff do not like her or care what happens to her, but you are special and she can tell that you are a caring person. She talks with you about being unsure of what she wants to do with her life and her "mixed-up feelings" about relationships. When you tell her that you will be on vacation next week, she becomes very angry. Two hours later, she is found using a curling iron to burn her underarms and explains that it "makes the numbness stop." Given this presentation, which personality disorder would you suspect? a. obsessive-compulsive b. borderline c. antisocial d. schizotypal

b. borderline

A client is participating in a therapy group and focuses on viewing all team members as equally important in helping the clients to meet their goals. The nurse is implementing which therapeutic approach? 1. Milieu therapy 2. Interpersonal therapy 3. Behavior modification 4. Support group therapy

1. Milieu therapy

She says to the nurse who offers her breakfast. "Oh no, I will wait for my husband. We will eat together" The therapeutic response by the nurse is: A. "Your husband is dead. Let me serve you your breakfast." B. " I've told you several times that he is dead. It's time to eat." C. "You're going to have to wait a long time." D. "What made you say that your husband is alive?"

A. "Your husband is dead. Let me serve you your breakfast."

When considering community suicide prevention programs, what population should the nurse plan to service with regular suicide screenings? Select all that apply A. 10-34 year olds B. Males C. College -educated adults D. Rural populations E. Native Americans

A. 10-34 year olds B. Males E. Native Americans

Em has been overweight all of her life. Now an adult, he has health problems related to her excessive weight. Seeking weight loss assistance at a primary care facility EM is surprised when the nurse practitioner suggests: A. A trial of SSRI antidepressant therapy B. Mild exercise to start, increasing an intensity over time C. Removing snacks foods from the home D. Medication treatment for hypertension

A. A trial of SSRI antidepressant therapy

Which characteristic in an adolescent female is sometimes associated with the prodromal phase of schizophrenia? A. Always afraid another student will steal her belongings B. An unusual interest in numbers and specific topics C. Demonstrates no interest in athletics or organized sports D. Appears more comfortable around males

A. Always afraid another student will steal her belongings

Which intervention (s) should the nurse implement when helping a patient expresses anger in an inappropriate manner? Select all that apply A. Approach the patient in a calm, reassuring manner B. Provide suggestions regarding acceptable ways of communicating anger C. Warn the patient that being angry is not a healthy emotional state D. Set limits on the angry behavior that will be tolerated E. Allow an expression of anger as long as no one is hurt

A. Approach the patient in a calm, reassuring manner B. Provide suggestions regarding acceptable ways of communicating anger D. Set limits on the angry behavior that will be tolerated

A client with borderline personality disorder tells the nurse, "You're the only one I trust around here. The others don't know what they are doing and they don't care about anyone other than themselves. I only want to talk to you." What is the priority action for the clients nursing care plan? A. Assign different staff members to care for the client each day. B. Continue assigning the clients stated preferred nurse to care for the client C. Frequently reassure the client that all staff members are competent in their jobs D. Reinforce unit rules and consequences inappropriate behaviors

A. Assign different staff members to care for the client each day.

A client is unwilling to go to his church because his ex-girlfriend goes there and he feels that she will laugh at him. Because of his hypersensitivity to a reaction from her, the client remains home bound. The home care nurse develops a plan of care that addresses which personality disorder? A. Avoidant B. Borderline C. Schizotypal D. Obsessive-compulsive

A. Avoidant

The activity of gamma-aminobutyric acid (GABA) contributes to a slowing of neural activity. Which of the following drugs facilitates the action of GABA? A. Benzodiazepines B. Antihistamines C. Anticonvulsants D. Noradrenergic

A. Benzodiazepines

Which treatment is typically prescribed for primary insomnia? Select all that apply A. Cognitive behavioral therapy B. IV medication for sedation C. Stimulus control D. Sleep restriction E. Sleep hygiene measures

A. Cognitive behavioral therapy C. Stimulus control D. Sleep restriction E. Sleep hygiene measures

Melanie is a 38 year old female admitted to the hospital to rule out a neurological disorder. The testing was negative, yet she is reluctant to be discharged. Today she has added lower back pain and stabbing sensation in her abdomen. The nurse suspects a factitious disorder in which Melanie may: A. Consciously be trying to maintain her role of a sick patient B. Not recognize her unmet needs to be cared for C. Protect her child from illness D. Recognize physical symptoms as a coping mechanism

A. Consciously be trying to maintain her role of a sick patient

The emergency department registered nurse is triaging a client for the risk of suicide. The client had thoughts of self injury yesterday but is not sure today. Which of the following would be considered a known risk factor for suicide in this client? Select all that apply A. Constantly hearing voices saying client is worthless B. Deliberately took an overdose 1 year ago C. Has a gun at home D. Married with 3 children E. Participation in religious activities F. Unemployed and unable to find a job

A. Constantly hearing voices saying client is worthless B. Deliberately took an overdose 1 year ago C. Has a gun at home F. Unemployed and unable to find a job

A client admitted voluntarily for treatment of anxiety problem demands to be released from the hospital. Which action should the nurse take initially? A. Contact the health care provider (HCP) B. Call the client's family to arrange for transportation. C. Attempt to persuade the client to stay "for only a few more days" D. Tell the client that leaving would likely result in an involuntary commitment

A. Contact the health care provider (HCP)

Which patient has an increased risk for the development of anxiety and will require frequent assessment by the nurse? Select all that apply A. Exacerbation of asthma signs and symptoms B. History of peanut and strawberry allergies C. History of chronic obstructive pulmonary disease D. Current treatment for unstable angina pectoris E. History of traumatic brain injury

A. Exacerbation of asthma signs and symptom C. History of chronic obstructive pulmonary disease D. Current treatment for unstable angina pectoris E. History of traumatic brain injury

Nurses caring for patients who have neruocognitive disorders are exposed to stress on many levels. Specialized skills training and continuing education are helpful to diffuse nursing stress as well as: select all they apply A. Expressing emotions by journaling B. Describing stressful events on Facebook C. Engage in exercise and relaxation techniques D. Having realistic patient expectations E. Happy hour after work to blow off steam

A. Expressing emotions by journaling C. Engage in exercise and relaxation techniques D. Having realistic patient expectations

The nurse manager on a psychiatric unit notices that one of her nurses avoids a 75 year old patient. Which factor should the nurse manager identify as being the MOST likely cause of the nurses discomfort with older patients? A. Fears and conflict about aging B. Dislike oh physical contact with elderly C. A desire to be surrounded by beauty and youth D. Recent experiences with her mother's older adult friends

A. Fears and conflict about aging

Tammy, a 28 year old with major depressive disorder and bulimia nevrosa, is ready for discharge from the county hospital after 2 weeks of inpatient therapy. Tammy take citalopram (celexa) and reports that it has made her more hopeful. With a secondary diagnosis of bulimia nervosa, what is an alternative antidepressant to consider? A. Fluoxetine (Prozac) B. Isocarboxazid (Marplan) C. Amitriptyline D. Duloxetine (Cymbalta)

A. Fluoxetine (Prozac)

Safety measures are of concern in eating-disorder treatments. patients with anorexia nervosa are supervised closely to monitor: Select all that apply A. Foods that are eaten B. Attempts at self-induced vomiting C. Relationships with other patients D. Weight

A. Foods that are eaten B. Attempts at self-induced vomiting D. Weight

What side effects should the nurse monitor for when caring for a patient prescribed donepezil (Aricept)? Select all that apply A. Insomnia B. Constipation C. Bradycardia D. Signs of dizziness E. Reports of headache

A. Insomnia C. Bradycardia D. Signs of dizziness E. Reports of headache

A patient with a history of alcohol use disorder has been prescribed disulfram (Antabuse). Which physical effects support the suspicion that the patient has relapsed? Select all that apply A. Intense nausea B. Diaphoresis C. Acute paranoia D. Confusion E. Dyspnea

A. Intense nausea B. Diaphoresis D. Confusion E. Dyspnea

Which guidelines should direct nursing care when deescalating an angry patient? Select all that apply A. Intervene as quickly as possible B. Identify the trigger for the anger C. Behave calmly and respectfully D. Recognize the patient's need for increased personal space E. Demands are agreed to as long as they won't result in harm to anyone

A. Intervene as quickly as possible B. Identify the trigger for the anger C. Behave calmly and respectfully D. Recognize the patient's need for increased personal space

A male arrested for inappropriate sexual contact in a subway car denies the allegation. Upon interviewing the man, the nurse suspects frotteuristic disorder due to his: A. Lack of relationships B. Overall aggressive nature C. Criminal history including robbery D. Intense hatred of women

A. Lack of relationships

The stage of sleep known as rapid eye movement or REM sleep is characterized by atonia and myoclonic twitches in addition to the actual rapid movement of the eyes. Atonia is thought to be protective mechanism as it: A. Limits physical movements B. Prevents nightmares C. Enhances the dream state D. Regulates the autonomic nervous system

A. Limits physical movements

Which intervention should the nurse implement when caring for a patient demonstrating manic behavior? Select all that apply A. Monitor the patients vital signs frequently B. Keep the patient distracted with group- oriented activities C. Provide the patient with frequent milkshakes and protein drinks D. Reduce the volume on the television and dim bright lights in the environment E. Use a firm but calm voice to give specific concise directions to the patient

A. Monitor the patients vital signs frequently C. Provide the patient with frequent milkshakes and protein drinks D. Reduce the volume on the television and dim bright lights in the environment E. Use a firm but calm voice to give specific concise directions to the patient

Which chronic medical diagnosis is a common trigger for major depressive disorder? A. Pain B. Hypertension C. Hypothyroidism D. Crohn's Disease

A. Pain

The nurse observes that a client is pacing, agitated and presenting aggressive gestures. The clients speech pattern is rapid and affect is belligerent. Based on these observations what is the nurses IMMEDIATE PRIORITY of care? A. Provide safety for the client and other clients on the unit B. Provide clients in unit with a sense of comfort and safety C. Assist the staff in caring for the client in a controlled environment D. Offer the client a less stimulating area in which to calm down and gain control.

A. Provide safety for the client and other clients on the unit

Which assessment data confirm the suspicion that a patient is experiencing opioid withdrawal? Select all that apply A. Pupils are dilated B. Pulse rate is 62 beats/min C. Slow movements D. Extreme anxiety E. Sleepy

A. Pupils are dilated D. Extreme anxiety

Which mediations are currently approved for the treatment of male erectile disorder? Select all that apply A. Sildenafil (viagra) B. Fibanserin ( addyi) C. Tadalafil (Cialis) D. Vardenafil ( Levitra) E. Avanafil ( Stendra)

A. Sildenafil (viagra) C. Tadalafil (Cialis) D. Vardenafil ( Levitra) E. Avanafil ( Stendra)

For a female client with anorexia nervosa, Nurse Jimmy is aware that which goal takes the highest priority? A. The client will establish adequate daily nutritional intake b. The client will make a contract with the nurse that sets a target weight C. The client will identify self-perceptions about body size as unrealistic D. The client will verbalize the possible physiological consequences of self-starvation

A. The client will establish adequate daily nutritional intake

Kevin is remanded by the courts for psychiatric treatment. His police record, which dates to his early teenage years, includes delinquency, running away, auto theft, and vandalism. He dropped out of school at age 16 and has been living on his own since then. His history suggests maladaptive coping, which is associated with: A. antisocial personality disorder B. borderline personality disorder C. obsessive-compulsive personality disorder D. narcissistic personality disorder

A. antisocial personality disorder

The characteristic manifestation that will differentiate bulimia nervosa from anorexia nervosa is that bulimic individuals A. have episodic binge eating and purging B. have repeated attempts to stabilize their weight C. have peculiar food handling patterns D. have threatened self-esteem

A. have episodic binge eating and purging

When reviewing the admission assessment, the nurse notes that a client was admitted to the mental health unit involuntarily. Based on this type of admission, the nurse should provide which interventions for this client? A. monitor closely for harm to self or others B. Assist in completing an application for admission C. Supply the client with written information about his or her mental health problem D. Provide an opportunity for the family to discuss why they felt the admission was needed

A. monitor closely for harm to self or others

A client experiencing disturbed thought processes believes that his food is being poisoned. Which communication technique should the nurse use to encourage the client to eat? A. using open-ended questions and silence B. Sharing personal preference regarding food choices C. Documenting reasons why the client does not want to eat D. Offering opinions about the necessity of adequate nutrition

A. using open-ended questions and silence

The nurse calls security and has physical restraints applied when a client who was admitted voluntarily becomes both physically and verbally abusive while demanding to be discharged from the hospital. Which represents the possible legal ramifications for the nurse associated with these interventions? Select all that apply. A Libel B Battery C Assault D Slander E False Imprisonment

B Battery C Assault E False Imprisonment

Hugo has a fraternal twin named Franco who is unaffected by mental illness even though they were raised in the same dysfunctional household. Franco asks the nurse "Why Hugo and not me?" The nurse replies: A. "Your father was probably less abusive to you." B. "Hugo likely has a genetic vulnerability." C. "You probably ignored the situation." D. "Huge responded to perceived threats by focusing on an internal world"

B. "Hugo likely has a genetic vulnerability."

Which patient statement acknowledges the characteristic behavior associated with a diagnosis of pica? A. "Nothing could make me drink milk." B. "I'm ashamed of it, but I eat my hair." C. "I haven't eaten a green vegetable since I was 3 years old." D. "I regurgitate and re-chew my food after almost every meal."

B. "I'm ashamed of it, but I eat my hair."

An adolescent client is brought to the emergency department by the parents after being found making superficial cuts along the side of an arm with a razor blade. There are several minor cuts in various stages of healing on the client's forearms. Which statements are appropriate for the nurse to make to the client's parents? Select all that apply A. "Everything is going to be all right." B. "Tell me about when you started noticing this behavior." C. "We have the bleeding under control." D. "Why didn't you bring your child in sooner?" E. "You must be very upset after seeing this."

B. "Tell me about when you started noticing this behavior." C. "We have the bleeding under control." E. "You must be very upset after seeing this."

What assessment questions asked by the nurse demonstrates an understanding of co morbid mental health conditions associated with major depressive disorder? Select all that apply A. "Do rules apply to you?" B. "What do you do to manage anxiety?" C. "Do you have a history of disordered eating?" D. "Do you think that you drink too much?" E. "Have you ever been arrested for committing a crime?"

B. "What do you do to manage anxiety?" C. "Do you have a history of disordered eating?" D. "Do you think that you drink too much?"

Which characteristic identified during an assessment serves to support a diagnosis of disruptive mood dysregulation disorder? A. Female B. 7 years old C. Comorbid Autism diagnosis D. Outburst occur at least once a week E. Temper tantrums occur at home and in school

B. 7 years old C. Comorbid Autism diagnosis E. Temper tantrums occur at home and in school

The home health nurse visits a client at home and determines that the client is dependent on drugs. During the assessment, which action should the nurse take to plan appropriate nursing care? A. Ask the client why he started taking illegal drugs B. Ask the client about the amount of drug use and its effect C. Ask the client how long he thought that he could take drugs without someone finding out D. Do not ask any questions for fear that the client is in denial and will throw the nurse out of the home

B. Ask the client about the amount of drug use and its effect

Tatiana has been hospitalized for an acute manic episode. ON admission the nurse susbepcts lithium toxicity. What assessment findings would indicate the nurse's suspicion as correct? A. Shortness of breath, GI distress, chronic cough B. Ataxia, severe hypotension, large volume of dilute urine C. GI distress, thirst, nystagmus D. Electroencephalographic changes, chest pain, dizziness

B. Ataxia, severe hypotension, large volume of dilute urine

The nurse is caring for a client diagnosed with paranoid personality disorder who is experiencing disturbed thought process. In formulating a nursing plan of care, which BEST intervention should the nurse include? A. Increase socialization of the client with peers. B. Avoid using a whisper voice in front of the client. C. Begin to educate the client about social supports in the community D. Have the client sign a release of information to appropriate parties for assessment purpose.

B. Avoid using a whisper voice in front of the client.

The care plan of a pt diagnosed with a somatic disorder includes the nursing diagnosis ineffective coping. Which patient behavior demonstrates a successful outcome for that nursing diagnosis? A. Showers and dresses in clean clothes daily B. Calls a friend to talk when feeling lonely C. Spends more time taking about pain in her abdomen D. Maintains focus and concentration

B. Calls a friend to talk when feeling lonely

Obesity can be the end result of a binge-eating disorder. The nurse understands that the best treatment option in persons with a binge-eating disorder promotes: A. Bariatric surgery B. Coping strategies C. Avoidance of public eating D. Appetite suppression medications

B. Coping strategies

The biological approach to treating depression with electrodes surgically implanted into specific areas of the brain to stimulate the regions identified to be under active in depression is: A. Transcranial magnetic stimulations B. Deep brain stimulation C. Vagus nerve stimulations D. Electroconvulsive therapy

B. Deep brain stimulation

Personality disorders often co-occur with mood and eating disorders. A young woman is undergoing treatment at an eating disorder clinic and her nurse suspect the patient may also have a Cluster B personality disorder due to the young woman's: A. Desire to avoid eating B. Dramatic response to frustration C. Excessive exercise routine D. Morose personality traits

B. Dramatic response to frustration

Which medication should the nurse be prepared to educate the patients on when they are prescribed a selective serotonin reuptake inhibitor (SSRI) for panic attacks? A. Alrpazolam (Xanax) B. Fluoxetine (Prozac) C. Clonazepam (Klonopin) D. Venlafaxine (Effexor)

B. Fluoxetine (Prozac)

A client is newly admitted to the mental health unit with a diagnosis of schizophrenia with persecutory delusions. Which nursing interventions should the nurse include in the clients plan of care with regard to delusional thinking? Select all that apply A. Explore the meaning behind the clients delusions B. Focus on reality and verbally reinforce it C. Focus on the clients feelings secondary to the delusions D. Gently confront the client about the false beliefs E. Present logical explanations to discredit the delusions

B. Focus on reality and verbally reinforce it C. Focus on the clients feelings secondary to the delusions

When planning the discharge of a client with chronic anxiety. Which is the most appropriate maintenance goal? A. Suppressing feelings of anxiety B. Identifying anxiety-producing situations C. Continued contact with a crisis counselor D. Eliminating all anxiety from daily situations

B. Identifying anxiety-producing situations

Hugo is 28 and diagnosed with schizophrenia. His history includes significant turmoil as child and adolescent. Hugo reports his father was abusive and beat him all of his siblings and his mother. Hugo's early exposure to stress most likely: A. Made him resilient to stressful situation B. Increased his future vulnerability to psychiatric disorders C. Developed strong survival skills D. Shaped his nurturing nature

B. Increased his future vulnerability to psychiatric disorders

A male patient calls to tell the nurse that his monthly lithium level is 1.7 mEq/L. Which nursing intervention will the nurse implement initially? A. Reinforce that the level is considered therapeutic B. Instruct the patient to hold the next dose of medication and contact the prescriber C. Have the patient go to the hospital emergency room D. Alert the patient to the possibility of seizures and appropriate precautions

B. Instruct the patient to hold the next dose of medication and contact the prescriber

When considering the pathophysiology responsible for both delirium and dementia, which intervention is appropriate for delirium specifically? A. Assist with needs related to nutrition, elimination, hydration and personal hygiene B. Monitor neurological status on an ongoing basis C. Place identification bracelet on patient D. Give one simple direction at a time in a respectful tone of voice

B. Monitor neurological status on an ongoing basis

Pedophilic disorder is the most common paraphilic disorder where adults who have a primary or exclusive sexual preference for prepubescent children. A subset of this disorder is termed hebephilia and is defined as attraction to: A. Infants B. Pubescent individuals C. Teens between the ages of 15-19 D. Males only

B. Pubescent individuals

The nurse notes that a client with schizophrenia and receiving an anitpsychotic medication is moving her mouth, protruding her tongue, and grimacing as she watches television. The nurse determines that the client is experiencing which medication complication? A. Parkinsonism B. Tardive dyskinesia C. Hypertensive crisis D. Neuroleptic malignant syndrome

B. Tardive dyskinesia

The client with anorexia nervosa is improving if: A. She eats meals in the dining room B. Weight gain C. She attends ward activities D. She has a more realistic self concept

B. Weight gain

The nurse is planning activities for a client diagnosed with bipolar disorder with aggressive social behavior. Which activity would be MOST APPROPRIATE for this client? A. Chess B. Writing C. Board Games D. Group exercise

B. Writing

A client says to the nurse "the federal guards were sent here to kill me!" Which is the best response by the nurse to the clients concern? A. "I don't believe this is true" B. "The guards are not out to kill you." C. "Do you feel afraid that people are trying to hurt you?" D. What makes you think the guards were sent to hurt you?

C. "Do you feel afraid that people are trying to hurt you?"

Which patient statement supports a diagnosis of narcolepsy? A. "My wife tells me I snore at night." B. "I sleep walk several nights a week." C. "I have no control over when I fall asleep." D. My legs feel funny and that keeps me awake."

C. "I have no control over when I fall asleep."

She tearfully tells the nurse "I can't take it when she accuses me of stealing her things." Which reponse by the nurse will be most therapeutic? A. "Don't take it personally. Your mother does not mean it." B. "Have you tried discussing this with your mother?" C. "This must be difficult for you and your mother." D. "Next time ask your mother where her things were last seen."

C. "This must be difficult for you and your mother."

The nurse visits a client at home. The client states "I haven't slept at all the last couple of nights." Which response by the nurse demonstrates therapeutic communication? A. "I see." B. "Really?" C. "You're having difficulty sleeping?" D. "Sometimes I have trouble sleeping too."

C. "You're having difficulty sleeping?"

A 33 year old female diagnosed with bipolar I disorder has been functioning well on lithium for the past 11 months. At the most recent checkup, the psychiatric nurse practitioner says "You are ready to enter the maintenance therapy stage. At this time I am going to adjust your dosage by prescribing A. A higher dosage B. once a week dosing C. A lower dosage D. A different drug

C. A lower dosage

You are caring for Yolanda a 67 year old patient who has been receiving hemodialysis for 3 months. Yolanda reports that she feels angry whenever it is time for her dialysis treatment. You attribute this to: A. Organic changes in Yolandas brain B. A glad in Yolandas personality C. A normal response to grief and loss D. Denial of the reality of a poor prognosis

C. A normal response to grief and loss

When considering facility admissions for mental health care, what characteristic is unique to a voluntary admission. A. The patient poses no substantial threat to themselves or to others B. The patient has the right to seek legal counsel C. A request in writing is required before admission D. A mental illness has been previously diagnosed

C. A request in writing is required before admission

Nancy is a nurse. After talking with her mother, she became concerned enough to drive over and check on her. Her mother's appearance is disheveled, words are nonsensical, smells strongly of urine, and there is a stain on her dressing gown. Nancy recognizes that her mother's condition is likely temporary due to: A. Early onset dementia B. A mild cognitive disorder C. A urinary tract infection D. Skipping breakfast

C. A urinary tract infection

Sleep deprivation is considered a safety issue that results in loss of life and property. Psychomotor impairment of sleep deprivation are similar to symptoms caused by: A. Sleeping in excess of 10 hours. B. Misuse of caffeine products C. Alcohol consumption D. Working more than 40 hours per week

C. Alcohol consumption

A client is admitted to a medical nursing unit with a diagnosis of acute blindness after being involved in a hit-and-run accident. When diagnostic testing cannot identify any organic reason why this client cannot see, a mental health consult is prescribed. The nurse plans care based on which mental health condition? A. Psychosis B. Repression C. Conversion Disorder D. Dissociative disorder

C. Conversion Disorder

The nurse should plan to educate the male patients prescribed a statin medication on the possible development of which commonly observed side effects? A. Impotence B. Gynecomastia C. Decreased libido D. Delayed ejaculation

C. Decreased libido

Phillip a 63 year old male, has exposed his genitals in public for all of his adult life, but the act has lost some of the former thrill. A rationale for this change in his experience may be : A. An increasing sense of shame B. Disgust over his lack of control C. Desire waning with age D. Progression into actual assault

C. Desire waning with age

Ted a former executive is now unemployed due to manic episodes at work. He was diagnosed with bipolar 18 years ago. Ted has a history of IV drug abuse, which resulted in hepatitis C. He is taking lithium exactly as scheduled, a fact that Both Ted's wife and his Blood tests confirm. To reduce Teds mania the psychiatric nurse practitioner recommends: A. Clonazepam (Klonopin) B. Fluoxetine (Prozac) C. Electroconvulsive therapy (ECT) D. Lurasidone (Latuda)

C. Electroconvulsive therapy (ECT)

When considering stress, what is the primary goal of making daily entries into a personal journal? A. providing a distraction from the daily stress B. Expressing emotions to manage stress C. Identifying stress triggers D. Focusing on one's stress

C. Identifying stress triggers

When Melissa was a small child, she insisted that she was a boy, refused to wear dresses, and wanted to be called Mitch. As Melissa reached puberty, she no longer displayed a desire to be male. This change in identity is considered: A. Gender dysphoria B. Reaction formation C. Normal D. Early transgender syndrome

C. Normal

The spouse brings a client to the emergency department due to erratic behavior and expression of despair. The emergency department is extremely busy with many clients. When the triage nurse asks if the client feels suicidal now, the client shrugs the shoulders. What INITIAL action should the triage nurse take? A. ask the client to make a verbal contract to not harm self. B. Document that the client is not currently suicidal. C. Place the client in an inside hallway with a one-on-one observation D. Return the client to the waiting room with the spouse

C. Place the client in an inside hallway with a one-on-one observation

Which nursing intervention demonstrates the ethical principle of beneficence? A. Refusing to admin a placebo to a pt B. Attending an in-service on the operation of the new IV infusion pumps C. Providing frequent updates to the family of a patient currently in surgery D. Respecting the right of the patient to make decisions about whether or not to have electroconvulsive therapy

C. Providing frequent updates to the family of a patient currently in surgery

A client with severe major depressive disorder is lying in bed and has not moved for 3 hours. The client will respond slowly to "yes" and "no" questions; otherwise, the client does not respond when spoken to. The clinical manifestations exhibited by the client are known as: A. Psychogenic dystonia B. Psychogenic gait C. Psychomotor retardation D. Somatization

C. Psychomotor retardation

The nurse is caring for a client just admitted to the mental health unit and diagnoses with catatonic stupor. The client is lying on the bed in a fetal position. Which is the most appropriate nursing intervention? A. Ask direct questions to encourage talking B. Leave the client alone so as to minimize external stimuli. C. Sit beside the client in silence with simple open ended questions D. Take the client into the dayroom with other clients to provide stimulation.

C. Sit beside the client in silence with simple open ended questions

The nurse on the mental health unit receives report about a client diagnosed with schizophrenia who is experiencing a delusion of reference. Which client statement supports this symptom? A. I need for you to get of these bugs that are crawling under my skin B. Hear that? She told me to kill my father C. That song is a message sent to me in secret code D. Those Martians are trying to poison me with tap water

C. That song is a message sent to me in secret code

The nurse speaks with a client diagnosed with schizophrenia who begins to look at the door and grimace. Which statement by the nurse is MOST therapeutic at this time? A. It would be helpful if you could look at me while we talk B. We can finish our conversation later, thank you for speaking with me C. What do you see at the door D. When you don't look at me I feel like you don't trust me

C. What do you see at the door

An old woman was brought for evaluation due to the hospital for evaluation due to increasing forgetfulness and limitations in daily function. The daughter revealed that the client used her toothbrush to comb her hair. She is manifesting: A. apraxia B. aphasia C. agnosia D. amnesia

C. agnosia

A 35 year old male has intense fear of riding an elevator. He claims "As if I will die inside." This has affected his studies. The client is suffering from: A. agoraphobia B. social phobia C. claustrophobia D. xenophobia

C. claustrophobia

When assessing a patient diagnosed with a borderline personality disorder, which statement by the patient warrants immediate attention? A. "My mother died ten years ago." B. "I haven't needed medication in weeks." C. "My dad never loved me" D. "I'd really like to hurt her for hurting me."

D. "I'd really like to hurt her for hurting me."

A client with a diagnosis of depression who has attempted suicide says to the nurse, "I should have died. I've always been a failure. Nothing ever goes right for me" Which response by the nurse demonstrates therapeutic communication? A. "You have everything to live for." B. "Why do you see yourself as a failure?" C. "Feeling like this is all part of being depressed." D. "You've been feeling like a failure for awhile?"

D. "You've been feeling like a failure for awhile?"

A client is admitted to the mental health unit with a diagnosis of depression. The nurse should develop a plan of care for the client that includes which intervention? A. Encouraging quiet reading and writing for the first few days B. Identification of physical activities that will provide exercise C. No socializing activities until the client asks to participate in milieu D. A structured program of activities in which the client can participate.

D. A structured program of activities in which the client can participate.

The nurse is providing medication education to a patient who has been prescribed lithium to stabilize mood. Which early signs and symptoms of toxicity should the nurse stress to the patient? Select all that apply. A. Increased attentiveness B. Getting up at night to urinate C. Improved vision D. An upset stomach for no apartment reasons E. Shaky hands that makes holding a cup difficult

D. An upset stomach for no apartment reasons E. Shaky hands that makes holding a cup difficult

Which comorbid condition would result in cautious use of a selective serotonin reuptake inhibitors for a patient with chronic aggression? A. Asthma B. Anxiety disorder C. Glaucoma D. Bipolar disorder

D. Bipolar disorder

Luv's family comes home one evening to find him extremely agitated and they suspect a full manic episode. The family calls emergency medical services. While one medic is with Luc and his family, the other medic is counting a thing on his desk. What is the medic most likely counting? A. Hypodermic needles B. Fast food wrappers C. Empty soda cans D. Energy drink containers

D. Energy drink containers

What precipitating emotional factor has been associated with an increased incidence of cancers? Select all that apply A. Anxiety B. Job-Related stress C. Acute Grief D. Feelings of hopelessness and despair from depression E. Prolonged, intense stress

D. Feelings of hopelessness and despair from depression E. Prolonged, intense stress

The nurse is working with a client who, despite making a heroic effort, was unable to rescue a neighbor trapped in a house fire. Which client-focused action should the nurse engage in during the working phase of the nurse-client relationship? A. Exploring the client's ability to function B. Exploring the client's potential for self harm C. Inquiring about the client's perception or appraisal of why the rescue was unsuccessful D. Inquiring about and examining the client's feelings for any that may block adaptive coping.

D. Inquiring about and examining the client's feelings for any that may block adaptive coping.

Cabot has multiple symptoms of depression including mood reactivity, social phobia, anxiety, and overreacting. With a history of mild hypertension, which classification of antidepressants dispensed as a trans dermal patch would be a safe medication? A. Tricyclic antidepressants B. Selective serotonin re-uptake inhibitors C. Serotonin and norepinephrine reuptake inhibitors D. Monoamine oxidase inhibitor

D. Monoamine oxidase inhibitor

Terry is a young male in a chemical dependency program. Recently he has become increasingly distracted and disengaged. The nurse concludes that Terry is: A. Bored B. Depressed C. Bipolar D. Not ready to change

D. Not ready to change

Which characteristic presents the greatest risk for injury to others by the patient diagnosed with schizophrenia? A. Depersonalization B. Pressured speech C. Negative symptoms D. Paranoia

D. Paranoia

Jackson has suffered from migraine headaches all of his life. Fatima, his nurse practitioner, suspects muscle tension as a trigger for his headaches. Fatima teaches him a technique that promotes relaxation by using: A. Biofeedback B. Guided Imagery C. Deep breathing D. Progressive muscle relaxation

D. Progressive muscle relaxation

A female patient diagnosed with schizophrenia has been prescribed a first generation antipsychotic medication. What information should the nurse provide to the patient regarding her signs and symptoms? A. Her memory loss should improve B. Depressive episodes should be less severe C. She will probably enjoy social interactions more. D. She should experience a reduction in hallucinations

D. She should experience a reduction in hallucinations

Which activity is most appropriate for a child with ADHD? A. reading an adventure novel B. Monopoly C. Checkers D. Tennis

D. Tennis

A client with schizophrenia has been started on medication therapy with clozapine. The nurse should assess the results of which laboratory study to monitor for adverse effects from this medication? A. Platelet count B. Blood glucose level C. Liver function studies D. White blood cell count

D. White blood cell count