Mental health practicum

A nurse selects a priority nursing diagnosis of fear related to being embarrassed in the pres ence of others for a client who exhibits symptoms of social phobia . Which outcomes , if met , would demonstrate improvement in client's symptoms Select all that apply . 1. The client manages fear in group situations . 2. The client develops a plan to avoid situations that may cause stress 3. The client verbalizes feelings that occur in stressful situations . 4. The client develops a plan for responding to stressful situations . 5. The client denies feelings that may contribute to irrational fears 6. The client uses antianxiety medication to deal with underlying fears

134 pg 322

A client is prescribed sertraline , a selective serotonin reuptake inhibitor . Which adverse effects would the nurse review when creating a medication teaching plan ? Select all that apply . 1. agitation 2. agranulocytosis 3. sleep disturbance 4. persistent cough 5. dry mouth 6. seizures

135 pg 332

A client is prescribed chlordiazepoxide as needed to control the symptoms of alcohol with drawal . Which symptoms may indicate the need for an additional dose of this medication ? Select all that apply . 1. tachycardia 2. mood swings 3. elevated blood pressure and temperature 4. piloerection 5. tremors 6. increasing anxiety

1356 pg 347

A nurse is caring for a client with borderline personality disorder . Which interventions are appropriate for clients with this disorder ? Select all that apply . 1. providing antianxiety medications 2. providing emotional consistency 3. exploring anger in appropriate ways 4. identifying a reduction in suicide risk 5. promoting gradual separation and individuation 6. ensuring the client's safety

2356 pg 346

A nurse is working with a schizophrenic client who suddenly begins experiencing auditory halluci nations Which interactions are appropriate at this time ? Select all that apply . 1. Ask the client , " What are you experiencing right now ? " 2. Encourage the client to relate the history of the hallucinations . 3. Tell the client , " I'd like to spend time with you to discuss your hallucinations . Is that okay with you ? " 4. Ask the client if he or she has recently taken any drugs or alcohol . 5. State , " Do you understand the side effects of your medication ? " 6. Notify the health care provider of hallucinations .

1234 Pg 340

During the nurse's assessment of a 15 - year old client diagnosed with bulimia nervosa , the nurse evaluates for findings that accompany binge eating . Which are most applicable ? Select all that apply 1. guilt 2. dental caries 3. self - induced vomiting 4. weight loss 5. normal weight 6. introverted behavior

1235 pg 342

A nurse is employed at an outpatient rehabilitation facility caring for clients withdrawing from opioids . When assessing clients who present for their counseling session , which findings are anticipated at this time ? Select all that apply . 1. abdominal cramps 2. dry , warm skin 3. rhinorrhea 4 . dilated pupils 5. hypersomnia 6. feelings of hunger

134 pg 344

A client , brought to the emergency department by the police , is found wandering the streets of town and appears to be disoriented . During initial contact by the nurse , the client begins to laugh inappropriately and states feeling dizzy . Which client behaviors suggest that the client is symp tomatic for huffing aerosols ? Select all that apply . 1. an unsteady gait 2. an elevated temperature 3. multiple bruises on the skin 4. impaired memory of where he or she had been 5. a slurred speech during conversation 6. hallucinations of spiders crawling on the bed

1456 pg 343

A nurse is monitoring a client who appears to be hallucinating The client is gesturing at a figure on the television and appears agitated with speech containing paranoid content . Which nursing interventions are appropriate at this time ? Select all that apply . 1. In a firm voice , instruct the client to stop the behavior . 2. Reassure the client that there is no danger 3. Acknowledge the presence of the hallucinations . 4. Instruct other team members to ignore the client's behavior 5. Delegate client assessment to a licensed practical / vocational nurse . 6. Give simple commands in a calm voice .

236 pg 337

The nurse is caring for a mental health client who exhibits passive - aggressive behavior when interacting with the nursing staff . When reporting client behaviors to the next shift , which actions are consistent with this assessment ? Select all that apply 1. The client states that problems are not his or her fault . 2. The client agrees with the staff but then complains to others . 3. The client pouts when he or she does not get his or her way . 4. The client feels angry about the group session so he or she scatters papers in the lunchroom 5. The client attacks the nurse and later cries feeling remorse .

24 pg 348

A nurse is assessing a new client and notices clang associations in the speech pattern . From this assessment finding , the nurse begins to evaluate for the potential of which psychiatric conditions ? Select all that apply . 1. dissociative identity disorder 2. schizophrenia 3. narcolepsy 4. mania 5. cognitive disorders 6. intermittent explosive disorder

245 pg 336

A client with a diagnosis of schizophrenia spectrum disorder is admitted to the inpatient unit after developing water intoxication . Once the client is medically stable and no longer exhibiting the behavior of seeking water , which nursing interven tions are appropriate at this time ? Select all that apply 1. Medicate the client at night . 2. Provide gum for the client . 3. Lock the unit's kitchen and bathroom . 4. Weigh the client every day . 5. Monitor the client's intake and output . 6. Maintain a structured environment .

2456 pg 342

A nurse interviews the family of a client hospitalized with severe depression and suicidal ideation . What family assessment information is essential when formulating an effective discharge plan ? Select all that apply . 1. physical pain 2. personal responsibilities 3. employment skills 4. communication patterns 5. role expectations 6. current family stressors

456 pg 332

A client is brought to the emergency depart ment confused and agitated with aggressive behaviors toward the staff . The client is ordered haloperidol decanoate 100 mg IM STAT once the agitation escalated to include behaviors of scream ing and throwing objects . In considering the client condition and behaviors exhibited , which location is best for the nurse to administer the intramuscu lar injection ?

Ventrogluteal region pg 323

The nurse is teaching a client diagnosed with a generalized anxiety disorder how to effectively cope with severe distress . Which interventions would the nurse use to promote effective coping with anxiety ? Select all that apply . 1. Discuss previous methods that were effec tive in handling stress 2. Encourage the client to limit to a mutually decided amount of time spent on worrying . 3. Help the client to establish a goal and develop a plan to meet the goal . 4. Teach the client how to label feelings and how to express them . 5. Discuss ways to examine the reality of fears 6. Assist the client to acknowledge the major consequences of blaming others .

1234 pg 324

The nurse is assessing a client who is a polysubstance abuser , with cocaine being one of the drugs most frequently used . Which physi ological symptom is suggestive of early ( phase 1 ) cocaine intoxication ? Select all that apply . 1. Tremors 2. psychomotor agitation 3. cardiac arrhythmias 4. dilated pupils 5. flaccid paralysis 6. slurred speech

1234 pg 348

A nurse is caring for a client who has experienced frontal lobe damage in a car accident . Which psychosocial behaviors are indications of this damage ? Select all that apply . 1. a change in personality 2. overt sexual behavior 3. difficulty controlling temper 4. fewer spontaneous facial expressions 5. inability to go out in public settings 6. a disinterest in family relationships

1234 pg 349

In the emergency department , a client reveals to the nurse a lethal plan for dying by suicide and agrees to a voluntary admission to the psychiatric unit . Which information would the nurse discuss with the client to answer the question " How long do I have to stay here ? " Select all that apply . 1. " You may leave the hospital at any time unless you're suicidal or homicidal or unable to meet your basic needs . 2." Let's talk more after the health care team has assessed you 3. " Once you've signed the papers , you are required to follow the treatment plan . " 4. " Because you have stated that you want to hurt yourself , you must be safe before being discharged . " 5. " You need legal representation to help you make an informed decision . " 6. " All clients need a court hearing before leaving the hospital

124 pg 317

While assessing a client diagnosed with impulse control disorder , the nurse observes the client's violent , aggressive , and assaultive behavior when having to wait for a lunch tray to be delivered from the dietary department . Which history and assessment findings documented in the medical record is the nurse also likely to find ? Select all that apply . 1. The client functions well in other areas of life . 2. The degree of aggressiveness is out of proportion to the stressor . 3. The violent behavior is usually justified by a stressor 4. The client has a history of parental alcoholism and a chaotic , abusive family life 5. The client has no remorse about the inability to control behavior .

124 pg 346

A hospitalized client becomes angry and belligerent toward a nurse after speaking on the phone with his or her mother . The nurse learns that the mother cannot visit as expected because of her work . Which interventions will the nurse use to help the client deal with the displaced anger ? Select all that apply . 1. Explore the client's unmet needs 2.Acknowledge the client's behavior as inappropriate 3. Suggest that the client direct the anger at his or her mother's employer 4 . Invite the client to a quiet place to talk after he or she has settled down 5. Assist the client in identifying alternate ways of approaching the problem .

1245 pg 314

A nurse is assessing a client who talks freely about feeling depressed . During the interaction , the nurse hears the client state , " Things will never change . " What other indications of hopelessness would the nurse look for ? Select all that apply 1. bouts of anger 2. periods of irritability 3. preoccupation with delusions 4. feelings of worthlessness 5. self - destructive behaviors 6. reliance on family members

1245 pg 330

A nurse is assessing a client for a neurocognitive disorder such as dementia . What history findings would the nurse anticipate while talking with the client and family ? Select all that apply 1. The progression of symptoms has been slow 2. The client admits to feelings of wanting to be alone . 3. The client acts apathetic and pessimistic 4. The family cannot determine when the symptoms first appeared . 5. The client has been exhibiting basic per ' sonality changes . 6. The client has great difficulty paying atten tion to others .

12456 pg 333

When beginning a client on newly prescribed antipsychotic medications , which symptoms are commonly seen within the first few weeks of treatment ? Select all that apply . 1. acute dystonic reactions 2. akathisia 3. tardive dyskinesia 4. neuroleptic malignant syndrome 5. hearing loss 6. orthostatic hypotension

1246 Pg 340

A nurse is caring for a client recently diag nosed with cancer and experiencing moderate situational anxiety . Which interventions would the nurse include in the care plan ? Select all that apply 1. Maintain a calm , nonthreatening environment . 2. Explain relevant aspects of chemotherapy 3. Encourage the client to verbalize concerns regarding the diagnosis . 4. Encourage the client to use deep breath ing exercises and other relaxation tech niques during periods of increased stress 5. Provide positive thinking strategies for the client during periods of stress . 6. Teach the stages of grieving to the client .

134 pg 324

A client who is taking antipsychotic medication to control schizophrenia asks the nurse to explain the causes of the disorder . The nurse knows that an overactive dopamine system in the brain is one of the leading causes of schizophrenia and tells the client that excessive dopamine activity is responsible for symptoms . Which symptoms is the nurse referring to ? Select all that apply 1. hallucinations 2. withdrawn behavior 3. suspiciousness 4. delusional thinking 5. excessive tearfulness 6. hypotension

134 pg 341

A nurse has developed a therapeutic relationship with a client who has an addiction disorder . Which client behaviors would indicate that the therapeutic interaction is in the working phase ? Select all that apply . 1. The client discusses how the addiction has contributed to family distress . 2. The client reluctantly shares the family history of addiction . 3. The client verbalizes difficulty identifying personal strengths . 4. The client discusses the financial problems related to the addiction . 5. The client expresses uncertainty about what topic to discuss . 6. The client acknowledges the addiction's effects on his or her children .

1346 pg 318

A nurse is working in the emergency room when a police officer walks in with a rape victim to be examined . If the nursing goal is to reduce client anxiety , which interventions would be appropriate ? Select all that apply . 1. Admit the client to the treatment area right away 2. Begin the examination immediately in order to get it behind her . 3. Assure the client of safety in the examination room . 4. Touch the client early on demonstrating the nurse is supportive . 5. Allow a third party to be present if the client requests it 6. Ask factual questions to determine the type of assault .

1356 pg 315

A nurse is caring for a client who exhibits behaviors that test the nurse - client relationship . When discussing this behavior at a multidisci plinary team conference , which behaviors would the nurse provide as examples of this behavior ? Select all that apply . 1. placing the nurse in the role of parent 2. dressing in a flamboyant or seductive manner 3. requesting personal information from the nurse 4. displaying tattoos and piercings 5. stating information to try to shock the nurse 6. violating the nurse's personal space

1356 pg 318

A client on a mental health unit becomes increasingly agitated and barricades himself in a corner room holding another client hostage . Verbal exchanges indicate an escalation in client desperation . Which nursing actions would be taken at this time ? Select all that apply . 1. Identify one nurse to interact with the client 2. Yell for assistance to obtain help quickly . 3. Direct other clients away from the area . 4. Speak to the client in an authoritarian manner 5. Discreetly notify security to assist . 6. Identify with the client's perspective and reason for agitation .

1356 pg 334

A nurse is preparing discharge instructions for a client with resistant depression who was prescribed a new medication regimen that includes phenelzine , a monoamine oxidase inhibitor ( MAO inhibitor ) . If the tea hing was successful , what foods would the client state that he or she needs to avoid ? Select all that apply . 1. aged cheese 2. cottage cheese 3. milk 4. wine 5. salami deb 6. grapefruit

145 pg 335

The nurse is reviewing the process recording of a school - aged client describing how the client felt about his or her mother's recent death by sui cide . Which nursing interventions are appropriate to add to the plan of care ? Select all that apply . " My mother's suicide made me feel alone and sad . I did not want to come out of my room . I did not want to see anyone or talk about what happened . I just went to school everyday and did what I needed to do . " 1. Refer client to a support group for kids who have lost parents . 2. Allow the client as much privacy as needed to grieve . 3. Encourage the pediatrician to prescribe an antidepressant 4. Sit directly across from and focused on the child 5. State " So you are feeling pretty sad . " 6. Offer self by sitting with the client and allowing them to express their feelings

1456 pg 331

The nurse is monitoring a client with schizo phrenia who is prescribed clozapine . During the morning mental health team meeting , which symp toms indicating adverse effects of the medication would immediately be brought to the psychiatrist's attention ? Select all that apply . 1. sore throat 2. pill - rolling movements 3. polyuria 4. fever 5. polydipsia 6. orthostatic hypotension

146 pg 338

A delusional client says to a nurse , " I am an alien from Mars , " and insists that the nurse refer to him or her as such . The belief appears to be fixed and unchanging . Which nursing interventions would the nurse implement when working with this client ? Select all that apply . 1. Consistently use the client's name in interactions 2. Kindly , but firmly , state that aliens are in movies 3. Allow the client to believe that he or she is an alien as long as there are no safety concerns 4. Logically point out why the client could not be an alien . 5. Provide an as - needed medication . 6. Redirect the client with structured activities .

16 pg 338

The nurse is meeting a client on the mental health unit . When beginning a thera peutic relationship , which nursing actions are appropriate ? Select all that apply . 1. Meet the needs and specific desires of the client . 2. Help the client explore different problem solving techniques . 3. Encourage the practice of new coping skills 4. Provide health advice to the client . 5. Exchange social media information with the client . 6. Discuss the client's feelings with family members

23 pg 316

A nurse is developing a care plan for a client with acute mania . Place the following behaviors according to the order in which they progress from normal through acute mania . All options must be used 1. has delusions of grandeur 2. uses relevant , calm speech patterns 3. shows high productivity and competitive attitude in work and leisure activities 4. becomes easily irritated 5. demonstrates poor judgment and impulse control

23451 pg 328

A client is being seen in the clinic after returning from military service abroad . The nurse documents restlessness at night with nightmares leaving the veteran irritable and fatigued during the day . When discussing the possibility of posttrau matic stress disorder ( PTSD ) , which statements about PTSD are accurate ? Select all that apply . 1. PTSD is a syndrome that is only associated with military personnel . 2. PTSD is characterized by nightmares and flashbacks 3. Hypervigilance is characteristic of clients with PTSD 4. Substance abuse is a common coping mechanism used by clients with PTSD . 5 Psychotic episodes can occur in clients with PTSD . 6. Clients with PTSD may complain of feeling empty inside .

23456 pg 321

The nurse is caring for a client with severe depression . In which conditions would the nurse anticipate the use of electroconvulsive therapy ( ECT ) as an option ? Select all that apply . 1. The client also has a neurocognitive disorder . 2. The client cannot tolerate monoamine oxidase inhibitors ( MAOIs ) 3. The client has not responded to conventional and antidepressant medication therapy . 4. The client is undergoing a stressful life change . 5.The client is having acute suicidal thoughts .

235 pg 314

A health care provider prescribes haloperidol p.o. 1 mg t.i.d. When assessing the client for extra pyramidal adverse effects , which nursing measures would be initiated ? Select all that apply . 1. Pad side rails in case of seizure activity . 2. Closely monitor vital signs , especially temperature 3. Observe for increased pacing and restlessness 4. Reorient the client during delusions . 5. Provide the client with sugar - free hard candy 6. Monitor for signs and symptoms of urticaria .

235 pg 339