N203 Psych midterm (first 147 Q's)/Final practice quiz

A client diagnosed with schizophrenia has been prescribed clozapine. Which is a potentially fatal side effect of this medication? 1) Agranulocytosis 2) Dystonia 3) Neuroleptic malignant syndrome 4) Tardive dyskinesia

1) Agranulocytosis

Abstract standards that provide a person with his or her code of conduct are 1) values. 2) attitudes. 3) beliefs. 4) personal philosophy.

1) values

A patient diagnosed with agoraphobia is scheduled for a functional magnetic resonance imaging (fMRI) study of the brain. The healthcare provider anticipates that the scan will show increased activity in which of the following areas of this patient's brain? Choose 1 answer: 1) Parietal lobe 2) Amygdala 3) Medulla 4) Cerebellum

2) Amygdala

Client: "I had an accident." Nurse: "Tell me about your accident." This is an example of which therapeutic communication technique? 1) Making observations 2) Offering self 3) General lead 4) Reflection

3) General lead

Ideas that one holds as true are 1) values. 2) attitudes. 3) beliefs. 4) personal philosophy.

3) beliefs.

When working with a client with moderate anxiety, the nurse would expect to see 1) inability to complete tasks. 2) failure to respond to redirection. 3) increased automatisms or gestures. 4) narrowed perceptual field. 5) selective attention. 6) inability to connect thoughts independently.

3) increased automatisms or gestures. 4) narrowed perceptual field. 5) selective attention. 6) inability to connect thoughts independently.

A patient is diagnosed with agoraphobia. Which of the following would the healthcare identify as a characteristic of this disorder? Choose 1 answer: 1) Avoids being in the presence of clowns 2) Avoids interacting with strangers 3) Refuses to use a public restroom 4) Fears the use of public transportation

4) Fears the use of public transportation

Which medication classification is considered first-line drug therapy for bipolar disorder? 1) Antidepressants 2) Anticonvulsants 3) Antipsychotics 4) Mood stabilizers

4) Mood stabilizers

A client has been diagnosed with major depression and placed on amitriptyline. Which is a side effect of amitriptyline (Elavil)? 1) Excessive salivation 2) Weight loss 3) Diarrhea 4) Orthostatic hypotension

4) Orthostatic hypotension

Which of the following defense mechanisms may be observed in a patient diagnosed with obsessive-compulsive disorder (OCD)? Choose 1 answer: 1) Projection 2) Regression 3) Denial 4) Undoing

4) Undoing

Nursing interventions for hospitalized clients with PTSD include 1) Encouraging a thorough discussion of the original trauma. 2) Providing private solitary time for reflection. 3) Time-out during flashbacks to regain self-control. 4) Use of deep breathing and relaxation techniques.

4) Use of deep breathing and relaxation techniques.

When assessing a client with anxiety, the nurse's questions should be 1) avoided until the anxiety is gone. 2) open ended. 3) postponed until the client volunteers information. 4) specific and direct.

4) specific and direct

1. Which one of the following is true regarding mental health and mental illness? a.) Behaviors that may be viewed as acceptable in one culture is always unacceptable in other cultures b.) It is easy to determine if a person is mentally healthy or mentally ill c.) In most cases, mental health is a state of emotional, psychological, and social wellness evidence by satisfying interpersonal relationships, effective behavior and coping, positive self-concepts, and emotional stability. d.) Persons who engage in fantasies are mentally ill.

c.) In most cases, mental health is a state of emotional, psychological, and social wellness evidence by satisfying interpersonal relationships, effective behavior and coping, positive self-concepts, and emotional stability.

The nurse initiating a therapeutic relationship with a client should explain the purpose, which is to... a.) Alleviate stressors in life b.) Allow the client to know the nurse's feelings c.) Establish a relationship d.) Facilitate a positive change

d.) Facilitate a positive change

Which of the following is a concrete message? 1) "Help me put this pile of books on Marsha's desk." 2) "Get this out of here." 3) "When is she coming home?" 4) "They said it is too early to get in."

1) "Help me put this pile of books on Marsha's desk."

The nurse who is assessing a client with PTSD would expect the client to report which of the following? 1) Inability to relax 2) Increased alcohol consumption 3) Insomnia even when very fatigued 4) Suspicion of strangers 5) Talking about problems to friends 6) Wanting to sleep all the time

1) Inability to relax 2) Increased alcohol consumption 3) Insomnia even when very fatigued 4) Suspicion of strangers

A client has been taking neuroleptic medications for many years as a treatment for schizophrenia. The client is exhibiting tongue protrusion, facial grimacing, and excessive blinking. These manifestations are characteristic of which extrapyramidal side effects (EPS)? 1) Tardive dyskinesia 2) Dystonia 3) Neuroleptic malignant syndrome 4) Akathisia

1) Tardive dyskinesia Unusual movements of the tongue, neck, and arms suggest tardive dyskinesia, an adverse reaction to neuroleptic medication. Dystonia is characterized by cramps and rigidity of the tongue, face, neck, and back muscles. Neuroleptic malignant syndrome causes rigidity, fever, hypertension, and diaphoresis. Akathisia causes restlessness, anxiety, and jitteriness.

The healthcare provider is counseling a patient who is diagnosed with depression. Which of the following statements made by a patient should the healthcare provider recognize as a sign of transference? Choose 1 answer: 1) "I'm glad I lost my job because now I don't have to commute." 2) "It's amazing how much you remind me of my favorite teacher." 3) "I may not be good looking, but I get really good grades." 4) "I drink so I can deal with the difficult situation at work."

2) "It's amazing how much you remind me of my favorite teacher."

The emotional frame of reference by which one sees the world is created by 1) values. 2) attitudes. 3) beliefs. 4) personal philosophy.

2) attitudes

"How does Jerry make you upset?" is a nontherapeutic communication technique because it 1) gives a literal response. 2) indicates an external source of the emotion. 3) interprets what the client is saying. 4) is just another stereotyped comment.

2) indicates an external source of the emotion.

Which of the following are specific tasks of the working phase of a therapeutic relationship? 1) Begin planning for termination. 2) Build trust. 3) Encourage expression of feelings. 4) Establish a nurse-client contract. 5) Facilitate behavior change. 6) Promote self-esteem.

3) Encourage expression of feelings 5) Facilitate behavior change 6) Promote self-esteem

The client tells the nurse "My biggest problem right now is trying to deal with a divorce. I didn't want a divorce and I still don't. But it is happening anyway!" Which of the following responses by the nurse will convey empathy? 1) Can you tell me about it? 2) I'm so sorry. No wonder you're upset. 3) Sounds like it has been a difficult time. 4) You must be devastated.

3) Sounds like it has been a difficult time.

Which is a true statement regarding depressive disorders? 1) They are more prevalent in men than women. 2) Depression in older adults is easier to diagnose. 3) The neurotransmitters norepinephrine, dopamine, and serotonin have been implicated. 4) It is the fourth leading cause of years lost because of disability.

3) The neurotransmitters norepinephrine, dopamine, and serotonin have been implicated. The neurotransmitters norepinephrine, dopamine, and serotonin have been associated with depression. Individuals between the ages of 18 to 29 years have a three times higher prevalence rate than those age 60 and older. The prevalence rates for females and males differ with females experiencing "a 1.5 - 3-fold higher rate than males beginning in early adolescence." Depressive symptomatology in older adults is more difficult to diagnose because it may be confused with symptoms of dementia or cerebrovascular accidents. Depression is the leading cause of years lost because of disability.

Which of the following is true about touching a client who is experiencing a flashback? 1) The nurse should stand in front of the client before touching. 2) The nurse should never touch a client who is having a flashback. 3) The nurse should touch the client only after receiving permission to do so. 4) The nurse should touch the client to increase feelings of security.

3) The nurse should touch the client only after receiving permission to do so.

In working with a rape victim, which intervention is most important? 1) continuing to encourage the client to report the rape to the legal authorities 2) recommending that the client resume sexual relations with her partner as soon as possible 3) periodically reminding the client that she did not deserve and did not cause the rape 4) telling the client that the rapist will eventually be caught, put on trial, and jailed

3) periodically reminding the client that she did not deserve and did not cause the rape Guilt and self-blame are common feelings that need to be addressed directly and frequently. The client needs to be reminded periodically that she did not deserve and did not cause the rape. Continually encouraging the client to report the rape pressures the client and is not helpful. In most cases, resuming sexual relations is a difficult process that is not likely to occur quickly. It is not necessarily true that the rapist will be caught, tried, and jailed. Most rapists are not caught or convicted.

A patient is receiving care after being diagnosed with generalized anxiety disorder (GAD). Which of these statements made by the patient indicate to the healthcare provider that the patient is beginning to show signs of improvement? Choose 1 answer: 1) "Situations that cause anxiety can always be avoided." 2) "Now I know that my anxiety is caused by a lack of sleep." 3) "As long as I take my medication, I can deal with anxiety." 4) "I can tell when I'm beginning to experience anxiety."

4) "I can tell when I'm beginning to experience anxiety."

Which of the following are examples of a therapeutic communication response? 1) "Don't worry—everybody has a bad day occasionally." 2) "I don't think your mother will appreciate that behavior." 3) "Let's talk about something else." 4) "Tell me more about your discharge plans." 5) "That sounds like a great idea." 6) "What might you do the next time you're feeling angry?"

4) "Tell me more about your discharge plans." 6) "What might you do the next time you're feeling angry?"

A client with anxiety is beginning treatment with lorazepam (Ativan). It is most important for the nurse to assess the client's 1) motivation for treatment. 2) family and social support. 3) use of coping mechanisms. 4) use of alcohol.

4) use of alcohol.

A client asks how his prescribed alprazolam helps his anxiety disorder. The nurse explains the teaching of medications, that antianxiety medications such as alprazolam affects of which neurotransmitter that is believed dysfunctional in anxiety disorder? a.) Serotonin b.) Norepinephrine c.) GABA d.) Dopamine

c.) GABA

Which of the following statements by the nurse to the client's family is true of treatment of people with mental illness in the United States today? a.) Substance abuse is effectively treated with brief hospitalization b.) Financial resources are reallocated from state hospitals to community programs and support c.) Only one in four people needing mental health services are receiving those services d.) Emergency department visits by persons who are acutely disturbed are declining

c.) Only one in four people needing mental health services are receiving those services

The client tells the nurse, "I don't think you can help me. Every time I talk to you, I am reminded of my mother and I hated her." The nurse should recognize this as a.) Confrontation b.) Countertransference c.) Incongruence d.) Transference

d.) Transference

On the fifth day postpartum, a woman calls her healthcare provider and reports pronounced fatigue, sadness and tearfulness. She states, "I feel so overwhelmed, I don't know what to do!" Which of the following questions is most appropriate for the healthcare provider to ask? Choose 1 answer: 1) "Do you ever think about harming yourself or your baby?" 2) "How much sleep do you get in a twenty-four hour period?" 3) "Is there a friend or relative that come and help you care for your baby?" 4) "Do you blame yourself for not being able to cope with motherhood?"

1) "Do you ever think about harming yourself or your baby?"

A patient diagnosed with depression is prescribed a monoamine oxidase inhibitor (MAOI). When teaching the patient about the medication, which statement made by the patient indicates the need for additional teaching? Choose 1 answer: 1) "I'm glad that I can have pepperoni on my pizza." 2) "I can still eat out at restaurants as long as I'm careful." 3) "I will miss putting soy sauce on my noodles." 4) "I'm glad I can still eat hamburgers and french fries."

1) "I'm glad that I can have pepperoni on my pizza."

A nurse is interacting with a client who is in recovery from date rape. The client says, "I should have stopped myself with two drinks. I thought I could handle two more. What was I thinking?" Which of the following would be a therapeutic response? 1) "You feel if you had drunk less, he wouldn't have attacked." 2) "Let's not go there. Are you taking your medication regularly?" 3) "Guessing whose mistake it was isn't going to help you. No one can change the past." 4) "So sad it happened to you! I am not surprised at the state you are in."

1) "You feel if you had drunk less, he wouldn't have attacked." Paraphrasing allows for clarification and lets the client know that the nurse has understood the message.

When caring for a patient during an acute panic attack, which of the following actions by the healthcare provider is most appropriate? Choose 1 answer: 1) Offer the patient reassurance of safety and security 2) Explore common phobias associated with panic attacks 3) Ask open-ended questions to encourage communication 4) Use distraction techniques to change the patient's focus

1) Offer the patient reassurance of safety and security

Building trust is important in 1) the orientation phase of the relationship. 2) the problem identification subphase of the relationship. 3) all phases of the relationship. 4) the exploitation subphase of the relationship.

1) the orientation phase of the relationship.

During a counseling session with a patient diagnosed with depression, the patient states, "I know my husband doesn't love me anymore." Which response by the healthcare provider demonstrates therapeutic communication? Choose 1 answer: 1) "You really should try not to dwell on something that probably isn't true." 2) "What happened to make you think your husband doesn't love you anymore?" 3) "Let's talk about what you did to cause him to stop loving you." 4) "Try not to think about it too much because it will make you depression worse."

2) "What happened to make you think your husband doesn't love you anymore?"

For maintenance therapy of mania, the therapeutic serum level of lithium is ... 1) 2.1-2.5 mEq/L. 2) 0.6-1.2 mEq/L. 3) greater than 2.6 mEq/L. 4) 1.6-2.0 mEq/L.

2) 0.6-1.2 mEq/L. For maintenance therapy, lithium serum level should be 0.6 to 1.2 mEq/L. The serum levels should be monitored every 2 months once the client's condition is stabilized. Toxicity occurs with serum lithium levels of 1.5 mEq/L or above.

"Why do you always complain about the night nurse? She is a nice woman and a fine nurse and has five kids to support. You're wrong when you say she is noisy and uncaring." This example reflects which nontherapeutic technique? 1) Requesting an explanation 2) Defending 3) Disagreeing 4) Advising

2) Defending

Low levels of the neurotransmitter serotonin lead to which of the following disease processes? 1) Parkinson's disease 2) Depression 3) Myasthenia gravis 4) Seizures

2) Depression

A patient diagnosed with an anxiety disorder is prescribed a benzodiazepine. When teaching the patient about the medication, which of the following information would the healthcare provider include? Choose 1 answer: 1) "It's important that you discontinue this medication if you begin to feel drowsy." 2) "You should avoid taking aspirin while you are taking this medication." 3) "Call our office right away if you experience increased restlessness or agitation." 4) "Decreasing your daily caffeine intake is not necessary when taking this medication.

3) "Call our office right away if you experience increased restlessness or agitation."

A patient diagnosed with bipolar disorder is prescribed lithium carbonate (Lithobid). When teaching the patient about the medication, which of these statements is a priority for the healthcare provider include? Choose 1 answer: 1) "You should avoid consuming dairy products when you are taking this medication." 2) "You should follow this low calorie, low sodium diet to prevent weight gain." 3) "Drink lots of fluids, especially if you are active during hot weather." 4) "Call our office immediately if you experience any unusual bruising or bleeding."

3) "Drink lots of fluids, especially if you are active during hot weather."

Which of the following interventions would be most helpful for a client with dissociative disorder having difficulty expressing feelings? 1) Distraction 2) Reality orientation 3) Journaling 4) Grounding techniques

3) Journaling

A patient diagnosed with obsessive-compulsive disorder (OCD) continually carries a toothbrush, and will brush and floss up to fifty times each day. The healthcare provider understands that the patient's behavior is an attempt to accomplish which of the following? Choose 1 answer: 1) Avoid interacting with others 2) Promote oral health 3) Relieve anxiety 4) Experience pleasure

3) Relieve anxiety

Which of the following would be the best intervention for a client having a panic attack? 1) Involve the client in a physical activity. 2) Offer a distraction such as music. 3) Remain with the client. 4) Teach the client a relaxation technique.

3) Remain with the client.

During a panic attack, a patient states, "I feel like I'm going to die!" The patient is hyperventilating, tachycardic, and reports feeling upper extremity numbness and tingling. Based on this patient's presentation, the healthcare provider would anticipate which additional clinical manifestation of the panic attack? Choose 1 answer: Choose 1 answer: 1) Kussmaul respirations 2) Respiratory acidosis 3) Respiratory alkalosis 4) Hypercapnia

3) Respiratory alkalosis

The nurse observes a client who is becoming increasingly upset. He is rapidly pacing, hyperventilating, clenching his jaw, wringing his hands, and trembling. His speech is high-pitched and random; he seems preoccupied with his thoughts. He is pounding his fist into his other hand. The nurse identifies his anxiety level as 1) Mild 2) Moderate 3) Severe 4) Panic

3) Severe

A client with GAD states, "I have learned that the best thing I can do is to forget my worries." How would the nurse evaluate this statement? 1) The client is developing insight. 2) The client's coping skills have improved. 3) The client needs encouragement to verbalize feelings. 4) The client's treatment has been successful.

3) The client needs encouragement to verbalize feelings.

A nurse is caring for a client who has been prescribed an antidepressent. The client states angrily, "You made high promises about these pills changing my life. I have been taking medications for 2 days, but I still can't control my bouts of crying." Which of the following would be a therapeutic response? 1) "Don't worry, the medicine should work soon." 2) "You must make efforts to control bouts of crying. Life is too short to be spending it this way." 3) "I never made any promises. You should give it some more time for results to happen." 4) "I understand your frustration. However, the medicine you are taking doesn't begin to have its full effect until about 10 to 14 days after you start."

4) "I understand your frustration. However, the medicine you are taking doesn't begin to have its full effect until about 10 to 14 days after you start." The nurse should inform the client about the time required for the medication to take effect.

A nurse is assessing a client with suicidal tendencies. Which of the following statements by the nurse indicates an effective attempt to promote active listening? 1) "I'm going to keep the door open because I may have to attend to phone calls." 2) "I think even the thought of suicide is unfair to your family." 3) "This reminds me of an incident I'd like to tell you about." 4) "You may use a pillow or lie down if you are uncomfortable."

4) "You may use a pillow or lie down if you are uncomfortable." Attending to the client's physical comfort helps the nurse set the stage for listening. Therefore, it would be correct to allow the client to use a pillow or lie down.

Which of the following statements is of empathy? Select all that apply. a.) It is the ability to place oneself into the experience of another a moment of time b.) It involves interjecting the nurse's personal experiences and interpretations of the situation c.) It is developed by gathering information from the client d.)Its results in negative therapeutic outcomes e.) The client must learn to develop empathy for the nurse

a.) It is the ability to place oneself into the experience of another a moment of time c.) It is developed by gathering information from the client

Client: "I was so upset about my sister ignoring my pain when I broke my leg." Nurse: "Where are you going to your next diabetes education program?" - This is a nontherapeutic response because the nurse has a. Used testing to evaluate the client's insight b. Changed the topic c. Exhibited an egocentric focus d. Advised the client what to do

b. Changed the topic

A client describes anxiety attacks that usually occur shortly after work when he is preparing his evening meal. Which question would be most appropriate for the nurse to ask the client first in an effort to learn how he can be helped? 1) "What are you thinking about before you start to prepare supper?" 2) "Have you tried walking to ease your anxiety?" 3) "Do you think taking several slow, deep breaths would help?" 4) "What do you do when you are anxious to help yourself feel better?"

1) "What are you thinking about before you start to prepare supper?" The nurse initially helps the client to identify a cause or event that precedes the symptoms of anxiety. Nursing care of an anxious client, however, must ultimately take into account all aspects of the client's anxiety, including what leads to attacks and what happens during an attack. Only then can the nurse help the client understand his anxiety, what personal needs may be unmet, and how to cope with his problem with more satisfactory behavior than having an anxiety attack.

The advantages of assertive communication are: 1) All persons' rights are respected. 2) It gains approval from others. 3) It protects the speaker from being exploited. 4) The speaker can say "no" to another person's request. 5) The speaker can safely express thoughts and feelings. 6) The speaker will get his or her needs met.

1) All persons' rights are respected. 5) The speaker can safely express thoughts and feelings.

Chlorpromazine is a drug in which classification? 1) Antipsychotic 2) Antimanic 3) Antianxiety 4) Antidepressant

1) Antipsychotic Thorazine is a first generation antipsychotic medication.

Clients from other countries who suffered traumatic oppression in their native country may develop PTSD. Which of the following is least helpful in dealing with their PTSD? 1) Assimilating quickly into the culture of their current country of residence. 2) Engaging in their native religious practices. 3) Maintaining a strong cultural identity. 4) Social support from an interpreter or fellow countryman.

1) Assimilating quickly into the culture of their current country of residence.

Education for clients with PTSD should include which of the following? 1) Avoid drinking alcohol. 2) Discuss intense feelings only during counseling sessions. 3) Eat well-balanced, nutritious meals. 4) Find and join a support group in the community. 5) Get regular exercise, such as walking. 6) Try to solve an important problem independently.

1) Avoid drinking alcohol 3) Eat well-balanced, nutritious meals 4) Find and join a support group in the community 5) Get regular exercise, such as walking

The psychiatric mental health nurse is planning the care of a client. What action best addresses the client's needs in the social domain? 1) Collaborating with the client's family to organize support 2) Teaching the client skills for identifying behavioral triggers 3) Administering a scheduled dose of an atypical antipsychotic 4) Dialoguing with a client about the client's feelings around a traumatic event

1) Collaborating with the client's family to organize support Family support exists within the social domain. Feelings and thoughts are within the psychological domain and medications have a biologic effect.

"Earlier today you said you were concerned that your son was still upset with you. When I stopped by your room about an hour ago, you and your son seemed relaxed and smiling as you spoke to each other. How did things go between the two of you?" This is an example of which therapeutic communication technique? 1) Consensual validation 2) Encouraging comparison 3) Accepting 4) General lead

1) Consensual validation

A patient diagnosed with depression is prescribed fluoxetine (Prozac). Which of the following would the healthcare provider most likely observe if the patient experiences an adverse effect of this medication? Choose 1 answer: 1) Decreased libido 2) Weight loss 3) Bradycardia 4) Urinary Retention

1) Decreased libido

Interventions for a client with panic disorder would include 1) encouraging the client to verbalize feelings. 2) helping the client to avoid panic-producing situations. 3) reminding the client to practice relaxation when anxiety level is low. 4) teaching the client reframing techniques. 5) teaching relaxation exercises to the client. 6) telling the client to ignore any anxious feelings.

1) Encouraging the client to verbalize feelings 3) Reminding client to practice relaxation when anxiety is low 4) teaching the client reframing techniques 5) Teaching relaxation exercises to the client

The nurse observes that a client has been pacing in the unit's common area with pursed lips and a furrowed brow for the past 15 minutes. What is the psychiatric-mental health nurse's best action? 1) Engage with the client to validate why the client is doing this 2) Redirect the client to an activity that is likely to alleviate the client's agitation 3) Assess the client to determine why the client is feeling anxious 4) Encourage the client to participate in a group activity to provide a therapeutic distraction

1) Engage with the client to validate why the client is doing this Encouraging the client to delve into understanding his or her behavior fosters a sense of well-being and allows the nurse to proceed appropriately.

The healthcare provider is caring for a patient who has undergone electroconvulsive therapy (ECT). The patient should be carefully assessed for which of the following common adverse effects of this treatment? Choose 1 answer: 1) Headache and memory loss 2) Aggression and violent behavior 3) Palpitations and cardiac arrest 4) Dizziness and blurred vision

1) Headache and memory loss

A client with schizophrenia states, "I hear the voice of King Tut." Which response by the nurse is therapeutic? 1) "King Tut has been dead for years, so that can't be his voice." 2) "I don't hear the voice, but I know you hear what sounds like a voice." 3) "You shouldn't focus on that voice, it is not real." 4) "Does the voice sound like someone you know?"

2) "I don't hear the voice, but I know you hear what sounds like a voice." This response makes a factual statement about the client's hallucination. Telling the client not to focus on the voice is judgmental. Telling the client not to worry because the voice is not real is a flippant, dismissive response. Saying "King Tut has been dead for years" is dismissive.

A nurse is providing community education about the prevention of mental illness. In response to the question, "What does it mean to be mentally healthy?" which is the nurse's best response? 1) "Mental health is difficult to define and depends on cultural norms." 2) "Mental health is marked by productivity, fulfilling relationships, and adaptability." 3) "Mental health is the absence of mental illness." 4) "Mental health is defined as behavior accepted as normal by the major cultural group."

2) "Mental health is marked by productivity, fulfilling relationships, and adaptability." Mental health means the successful performance of mental function, resulting in productive activities, fulfilling relationships, and the ability to adapt to change and cope with adversity. Mental health provides the capacity for rational thinking, communication, learning, emotional growth, resilience, and self-esteem.

When the client says, "I met Joe at the dance last week," what is the best way for the nurse to ask the client to describe her relationship with Joe? 1) "Joe who?" 2) "Tell me about Joe." 3) "Tell me about you and Joe." 4) "Joe, you mean that blond guy with the dark blue eyes?"

2) "Tell me about Joe."

A client with a diagnosis of schizophrenia has a history of auditory and visual hallucinations. Which intervention is most likely to minimize the client's hallucinations? 1) Providing a vivid, bright environment that provides distractions from hallucinations 2) Provide frequent contact and communication with the client 3) Ensuring that the client does not sleep more than 7 hours in any 24-hour period 4) Clustering the client's medications at 0800 hours

2) Provide frequent contact and communication with the client To prevent or minimize hallucinations, the nurse should help present and maintain reality by frequent contact and communication with the client. Limiting sleep or modifying the timing of medication administration is not likely to prevent or lessen hallucinations.

The best goal for a client learning a relaxation technique is that the client will 1) confront the source of anxiety directly. 2) experience anxiety without feeling overwhelmed. 3) report no episodes of anxiety. 4) suppress anxious feelings.

2) experience anxiety without feeling overwhelmed.

Which are the nurse's expectations of the client's responsibilities during the orientation phase of the nurse-client relationship? Select all that apply. 1) Addressing the client's need for adjustments to medication therapies 2) Demonstrating the ability to actively listen to the discussions that occur 3) Attendance is expected for each session. 4) Participation is expected during each session. 5) Sharing of feelings and needs are vital to the productivity of the session.

3) Attendance is expected for each session. 4) Participation is expected during each session. 5) Sharing of feelings and needs are vital to the productivity of the session. During the orientation phase, the nurse establishes roles, the purpose of the relationship, and the parameters of subsequent meetings; identifies the client's problems; and clarifies expectations. The nurse's fulfillment of these activities includes active listening. The client is responsible for attending agreed-upon sessions, participating during the sessions, and sharing feelings and needs.

A patient diagnosed with major depressive disorder is admitted for inpatient care. Which of the following is the primary goal during the admission assessment? Choose 1 answer: 1) Establishing desired outcomes for the patient 2) Administering antidepressant medications 3) Collecting and organizing patient data 4) Reviewing the policies for patient conduct

3) Collecting and organizing patient data

A patient is admitted to an inpatient psychiatric unit because of a plan to commit suicide by taking an overdose of medication. When administering medications to this patient, which of these interventions is the priority? Choose 1 answer: 1) Monitor the patient's vital signs before administration of medications 2) Teach the patient how to recognize adverse effects of the medications 3) Ensure that the patient is not "cheeking" the medications 4) Monitor the patient for signs of anorexia, nausea, and xerostomia

3) Ensure that the patient is not "cheeking" the medications

Which biogenic amines have been implicated in depression? 1) Epinephrine and serotonin 2) Dopamine and histamine 3) Norepinephrine and serotonin 4) Epinephrine and dopamine

3) Norepinephrine and serotonin

A mental health client insists that the client's spouse is trying to poison the client. In this instance, the client is exhibiting which type of delusion? 1) Erotomanic 2) Grandiose 3) Persecutory 4) Somatic

3) Persecutory Clients who exhibit persecutory delusions believe that they are being conspired against, spied on, poisoned, or drugged. Somatic delusions demonstrate a preoccupation with the body. A client exhibiting erotomanic delusions believes that a person of elevated social status loves him or her. Grandiose delusions are present when the client believes that he or she possesses unrecognized talent or insight or has made an important discovery.

A 13-year-old client is dying of cancer. When providing care for this client, the nurse should incorporate the developmental tasks for this age. According to Erikson's developmental model, the child normally is expected to be working on which psychosocial issue? 1) lifetime vocation 2) social conscience 3) personal values 4) sense of competence

3) Personal values According to Erikson, a child of 13 years is normally seeking to meet the need to develop personal identity. Personal values are a component of this identity. Developing a conscience is a component of achieving initiative during the preschool years. Developing a sense of competence is a component of achieving industry in the school-age years. Developing a lifetime vocation is a component of achieving generativity in adulthood.

A client in the manic phase of bipolar disorder constantly belittles other clients and demands special favors from the nurses. Which nursing intervention is most appropriate for this client? 1) Ask other clients and staff members to ignore the client's behavior. 2) Offer the client an antianxiety drug when belittling or demanding behavior occurs. 3) Set limits with consequences for belittling or demanding behavior. 4) Offer the client a variety of stimulating activities to distract him from belittling others or making demands of them.

3) Set limits with consequences for belittling or demanding behavior. To protect others from a client who exhibits belittling and demanding behaviors, the nurse may need to set limits with consequences for noncompliance. Asking others to ignore the client is likely to increase his belittling and demanding behaviors. Offering the client an antianxiety drug or stimulating activities provides no incentive for him to change his problematic behaviors.

A patient diagnosed with general anxiety disorder (GAD) reports ongoing nausea and abdominal bloating. A physical examination fails to confirm a medical illness to explain these symptoms. The healthcare provider suspects these findings are a result of which of the following? Choose 1 answer: 1) Dysthymia 2) Dissociation 3) Somatization 4) Derealization

3) Somatization

The nurse understands that with the right help at the right time, a client can successfully resolve a crisis and function better than before the crisis, based primarily on which of the following factors? 1. Relinquishment of dysfunctional coping. 2. Reestablishment of lost support systems. 3. Acquisition of new coping skills. 4. Gain of crisis prevention knowledge.

3. Acquisition of new coping skills. Learning new coping skills is the major factor necessary for higher functioning. Better coping is likely to lead to regaining support systems, giving up dysfunctional coping, and awareness of how to prevent future crises

A nurse teaching a client about prescribed antipsychotic medication informs the client to contact a health care provider immediately if the client notices: 1) An increase in weight of 2 lbs in 1 month. 2) A feeling of dizziness when the client stands up. 3) An increase in thirst. 4) A dramatic change in temperature.

4) A dramatic change in temperature. Advise clients to contact their case coordinators or health care providers immediately if they experience dramatic changes in body temperature. The client may be at risk for neuroleptic malignant syndrome.

A client refers to the nurse by using a swear word. The nurse tells the client, "I don't want you saying that about me. You can call me by my name." Which of the following techniques did the nurse apply? 1) Confrontation 2) Decoding 3) Empathy 4) Assertiveness

4) Assertiveness Assertiveness is marked by the use of "I" statements without blaming or attacking the other person. It is important to be assertive when a client makes sexual or aggressive comments.

A client with bipolar disorder has been ordered a medication that is classified as an anticonvulsant. Which drug does the nurse know falls within this class of medications? 1) Lithium 2) Mannitol 3) Methyldopa 4) Carbamazepine

4) Carbamazepine Carbamazepine is an anticonvulsant with mood-stabilizing effects. Lithium is a mood stabilizer. Mannitol and methyldopa are not used in the treatment of bipolar disorder.

A client refuses to tell his parents that he is taking antidepressants because he is afraid that his parents will think he is crazy. The nurse responds by asking if the client is sure about his parents' views. Which of the following could be the purpose of the nurse's inquiry? 1) Convey empathy 2) Mirror the emotion in the client's message 3) Provide clues to recurring patterns 4) Encourage reconsideration

4) Encourage reconsideration The nurse is voicing a doubt and thus encouraging the client to reconsider his beliefs.

The nurse working with a client during a flashback says, "I know you're scared, but you're in a safe place. Do you see the bed in your room? Do you feel the chair you're sitting on?" The nurse is using which of the following techniques? 1) Distraction 2) Reality orientation 3) Relaxation 4) Grounding

4) Grounding

Which medication is used to prevent alcohol withdrawal symptoms? 1) Folic acid (Folate) 2) Naltrexone (ReVia) 3) Clonidine (Catapres) 4) Lorazepam (Ativan)

4) Lorazepam (Ativan) -safe withdrawal usually is accomplished with the administration of benzodiazepines, such as Ativan, Librium, or Valium, to suppress the withdrawal symptoms

Which of the following points should a nurse adhere to while using self-disclosure foe a client's therapeutic benefit? 1) Discuss painful situations from which a nurse has not recovered so that the client feels less pain about the situation. 2) Narrate the disclosure in detail to make sure the client has understood the nurse's point of view. 3) Imply that his or her experience is exactly the same as the client's so that the client can relate better. 4) Monitor the client's nonverbal behavior to determine whether he or she is receptive to the nurse's self-disclosure.

4) Monitor the client's nonverbal behavior to determine whether he or she is receptive to the nurse's self-disclosure. The nurse should monitor the client's nonverbal behavior to determine whether he or she is receptive to the nurse's self-disclosure & respect the client's needs for privacy.

After being robbed and beaten by an unknown assailant, a patient is diagnosed with post-traumatic stress disorder (PTSD). When developing a plan of care for the patient, which of these interventions will the healthcare provider plan to implement first? Choose 1 answer: 1) Ensure the patient is taking medications as prescribed 2) Assist the patient in recalling the details of the event 3) Teach the patient coping skills to deal with anxiety 4) Promote the establishment of a trusting relationship

4) Promote the establishment of a trusting relationship

The nurse is assisting a client with behavior therapy for OCD. What nursing intervention may help enhance self-esteem? 1) Interrupt the client when performing a ritualistic behavior. 2) Reduce instances of stimuli that activate compulsive behavior. 3)Ask client to perform deep breathing exercises instead of ritual behaviors. 4) Provide opportunities for the client to accomplish an activity.

4) Provide opportunities for the client to accomplish an activity.

Which of the four classes of medications used for panic disorder is considered the safest because of low incidence of side effects and lack of physiologic dependence? 1) Benzodiazepines 2) Tricyclics 3) Monoamine oxidase inhibitors 4) Selective serotonin reuptake inhibitors

4) Selective serotonin reuptake inhibitors

When assessing a patient with severe depression, which of the following would the healthcare provider identify as a cognitive alteration? Choose 1 answer: 1) Low self-esteem 2) Anxiety 3) Powerlessness 4) Somatic Delusions

4) Somatic Delusions

The nurse is caring for a client with a panic attack. Which nursing intervention is most helpful for this client? 1) Encourage the client to identify what precipitated the attack 2) Encourage the client to learn relaxation techniques 3) Encourage the client to verbalize any fears, feelings, or concerns 4) Stay with the client and remaining calm, confident, and reassuring

4) Stay with the client and remaining calm, confident, and reassuring Explanation: A panic-stricken client requires the assistance of a calm person who can provide support and direction. This approach is particularly important because the client already feels frightened and out of control. Having someone remain with the client helps prevent him from feeling isolated and deserted. Encouraging the client to verbalize any fears, feelings, or concerns or encouraging the client to identify what precipitated the attack is futile because the client's level of anxiety prevents him from focusing on precipitating factors. Also, encouraging the client to learn relaxation techniques is not possible at this time as the client is unable to learn new information when the anxiety level is at the panic level. Staying with the client is the best action for the nurse

5. When a client makes the statement, "I am devastated that my marriage is falling apart." The nurse can best show empathy through which of the following responses? a.) "I feel so bad for what you are going through." b.) "You feel like your world is falling apart right now." c.) "I have been divorced too, I know how hard it is." d.) "It will get better, let's talk about it."

b.) "You feel like your world is falling apart right now."

During the admission interview, the nurse asks the client what led to his hospitalization. The client responds, "they lied about me. They said I murdered my mother. You're the killers. You all killed my mother. She died before I was born." What would be the best initial response by the nurse? a.) "I just saw your mother. She's fine." b.) "You're having very frightening thoughts." c.) "We'll put you in a private room until you are better." d.) "If your mother died before you were born, you wouldn't be here."

b.) "You're having very frightening thoughts."

Which of the following behaviors by the nurse demonstrates positive regard? Select all that apply. a.) Communicating judgements about the client's behavior b.) Call the client by name c.) Spending time with the client d.) Responding openly e.) Considering the client's ideas and preferences when planning care

b.) Call the client by name c.) Spending time with the client d.) Responding openly e.) Considering the client's ideas and preferences when planning care

There are many areas of practice in psychiatric mental health nursing. One of those is advanced level practice. Which of the following is considered an advanced-level function? a.) Case management b.) Counseling c.) Evaluation d.) Health Teaching

b.) Counseling

A student appears very nervous on the first day of clinical in the psychiatric setting. The student reviews the instructor's guidelines and appropriately takes which of the following actions? Select all that apply. a.) Tells the clients about personal events and interests. b.) Discusses the anxious feelings with the instructor. c.) Assumes that the client's unwillingness to talk to a student as a personal insult or failure. d.) Build rapport with the patient before asking personal questions. e.) Consults the instructor if a shocking situation arises. f.) Gravitates to clients that the students may know personally.

b.) Discusses the anxious feelings with the instructor. d.) Build rapport with the patient before asking personal questions. e.) Consults the instructor if a shocking situation arises.

Which of the following outcomes would take priority for a client who has survived trauma or abuse? Select all that apply. a.) The client will demonstrate healthy, effective ways of dealing with the stress b.) The client will be physically safe c.) The client will establish a social support system in the community d.) The client will distinguish between ideas of self-harm and taking action on those ideas e.) The client will express emotions nondestructively

b.) The client will be physically safe d.) The client will distinguish between ideas of self-harm and taking action on those ideas

The client experienced a traumatic event in the past that has caused chronic nightmares in which the event is relived. The client may have increased levels of which of the following? a) Aldosterone b) Thyroid stimulating hormone (TSH) c) Norepinephrine d) Cytokines

c) Norepinephrine Explanation: People with chronic post-traumatic stress disorder (PTSD) have been shown to have increased levels of norepinephrine and increased activity of alpha adrenergic receptors. The other options are not increased in PTSD.

Nurses must be aware of the importance of boundaries, not only for the client but also for the nurse. Which of the following occurrences is considered a breach of professional boundaries? a) Patient asking a nurse for her phone number b) Refusing a gift from a patient c) Changing the subject in response to a patient complement d) Having a lengthy social conversation with a patient

d) Having a lengthy social conversation with a patient

A client has been making sexual comments when communicating with the nurse. The nurse wants to spend time talking with the client while respecting the client's right to privacy. Which setting would be the most appropriate setting for the nurse to talk with the client? a.) In the client's room when the client's roommate is present is 3 feet away. b.) At the nurse's station when other clients and visitors are less than a foot away c.) In an interview room in a remote section of the unit with nurse 1 foot away from the client d.) In a quiet corner of a dayroom at least 4 feet away from the client

d.) In a quiet corner of a dayroom at least 4 feet away from the client

14. The newly licensed RN has been hired at the local hospital in the Geri-Psych unit. Today is her first day of orientation to this facility. What would be the nurse's priority action if a client becomes aggressive? a.) Assist other staff on the unit to take down the client safely b.) Maintain a safe distance from the client c.) Keep the client secluded from others d.) Reinforce boundaries when aggressive is seen to maintain a safe environment

d.) Reinforce boundaries when aggressive is seen to maintain a safe environment

The nurse asks the client, "What was it like for you when you first knew you had no place to go?" The client looks down and pauses for quite some time. Which action by the nurse is most therapeutic? a.) Change the subject to something the patient will discuss b.) Encourage the patient to express any unpleasant feelings c.) Apologize for asking such a personal question d.) Sit quietly until the patient responds

d.) Sit quietly until the patient responds