Psych Comprehensive

A nursing instructor is developing a class lecture that compares and contrasts schizoaffective disorder with schizophrenia. When describing one of the differences between these two diagnoses, which of the following would the instructor include as reflecting schizoaffective disorder? A) It is episodic in nature. B) It involves difficulties with selfcare. C) It has less severe hallucinations. D) It is associated with a lower suicide risk.

A

A patient is scheduled for a challenge test. Which of the following would the nurse include when explaining this test to the patient? A) Intravenous administration of a substance to induce symptoms B) Application of electrodes to the scalp for monitoring C) Evaluation electrical impulses recorded on graph paper D) Exposure to a flashing strobe light to elicit abnormal activity

A

The nurse is caring for a client who was diagnosed with schizoaffective disorder. Based on the nurse's understanding of this disorder, the nurse develops a plan of care to address which issue as the top priority? A) Suicide B) Aggression C) Substance abuse D) Eating disorder

A

The nurse is caring for a client with schizoid personality trait. When developing the plan of care for the client, which of the following would the nurse most likely include? A) Social skills training B) Anger management training C) Relaxation techniques D) Coping skills training

A

The nurse is caring for a hospitalized patient who has a disorder of the hypothalamus. When developing the patient's plan of care, in which of the following areas would the nurse anticipate a problem? A) Sleep B) Constipation C) Speech D) Motor activity

A

A nurse is preparing an inservice program about substance abuse and its etiology. Which of the following would the nurse most likely include in the presentation when discussing possible psychologic etiologies? A) Low selfesteem B) Genetic predisposition C) Dysfunctional family D) Peer influence

A

A nurse is working with a client who is addicted to heroin. The nurse engages in harm reduction by teaching the client about which of the following? A) Using bleach solution to disinfect dirty needles B) Problem solving C) Healthy coping skills D) Proper use of naltrexone (Trexan)

A

A nurse is conducting an assessment of a patient's social network. Which of the following would the nurse assess? Select all that apply. A) "How big is your network of contacts?" B) "What benefits do you receive from these people?" C) "Who is responsible for providing the support?" D) "Do any of the members know one another?" E) "What services do you think might be helpful?"

A,B,C,D

A nurse is reading a journal article about the various theories associated with the development of antisocial personality disorder. The article mentions difficult temperament as a possible theory. The nurse demonstrates understanding of this concept when identifying which of the following as a key behavior associated with a difficult temperament? Select all that apply. A) Aggression B) Inattention C) Hyperactivity D) Impulsivity E) Depression F) Paranoia

A,B,C,D

A client with panic disorder who has been prescribed sertraline in conjunction with alprazolam comes to the clinic for a followup. The client states, "I stopped taking the alprazolam about 2 days ago. I was feeling really sleepy and tired." Which of the following would alert the nurse to suspect possible withdrawal? Select all that apply. A) Metallic taste B) Irritability C) Dry, flushed skin D) Tremor E) Muscle flaccidity

A,B,D

A nurse is observing a client diagnosed with borderline personality disorder on the inpatient unit. Which of the following would the nurse most likely note? A) Actively participating in several different groups B) Openly verbalizing feelings C) Participating in relationships in which the client has control D) Adhering to the personal boundaries of others

C

A nurse is reading a journal article about psychoneuroimmunology. Which information would the nurse most likely find? Select all that apply. A) Neurotoxin's role in receptor site damage B) Hypothalamic-pituitary-thyroid axis disruption C) Static activity of natural killer cells in response to stress D) Hypothalamic damage leading to immune dysfunction E) Interruption in the typical circadian rhythm cycle

A,B,D

A client with schizoaffective disorder is having difficulty adhering to the medication regimen that requires the use of several agents. The client also is experiencing several side effects contributing to this nonadherence. The physician plans to change the client's medication. Which agent would the nurse anticipate that the physician would prescribe? A) Lithium B) Aripiprazole C) Clozapine D) Olanzapine

B

A nurse is working with the family of a client who has been diagnosed with antisocial personality disorder. Which of the following would be most important for the nurse to focus on when teaching the family about this disorder? A) Anger management B) Boundary setting C) Medication therapy D) Selfresponsibility

B

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

B

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

B,C,D

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

C

A nurse is assessing a patient and the patient's social networks. When evaluating this area, the nurse integrates knowledge that which of the following is an important component? A) Blood relationships B) Bonding with one another C) Reciprocity D) Emotional support

C

A nurse is involved in gathering information about the inheritance of mental disorders using population genetics. Which of the following would the nurse be least likely to be evaluating? A) Concordance rates B) Occurrence in firstdegree relatives C) Risk factor analysis D) Adoptions studies

C

A group of students is reviewing information about the etiology of generalized anxiety disorder (GAD). The students demonstrate understanding of this information when they identify which of the following as representing the psychoanalytic theory for this disorder? A) Inaccurate environmental danger assessment B) Exposure to multiple stressful life events C) Kindling caused by overstimulation D) Unresolved unconscious conflicts

D

A hospitalized patient who has been taking an antipsychotic medication for 2 weeks begins pacing and walking throughout the unit. He tells the nurse that he "cannot sit still." The nurse documents this finding as which of the following? A) Akinesia B) Dystonia C) Pseudoparkinsonism D) Akathisia

D

A nurse administers a prescribed dose of lithium at 8 PM. The nurse would schedule a specimen to be obtained for a blood level at which time? A) 10 PM B) 12 AM C) 4 AM D) 8 AM

D

A nurse has completed an assessment of a patient who is experiencing significant stress. The assessment revealed intense anger and acting out behaviors along with statements of negative emotions. Which nursing diagnosis would be most appropriate? A) Disturbed though processes B) Low selfesteem C) Hopelessness D) Ineffective coping

D

A nurse is assessing a child who is suspected of having attention deficit hyperactivity disorder. Which of the following would the nurse identify as reflecting impulsiveness in the child? A) Inability to wait his turn B) Restlessness C) Difficulty completing a task D) Risktaking behavior

D

A nurse is assessing a patient and uses the Recent Life Changes Questionnaire as part of the assessment. The nurse determines that the patient has experienced major life crisis with which score on the questionnaire? A) 150 B) 250 C) 350 D) 450

D

A program that should not be included in reference to the objectives of Healthy People 2020

Single substance abuse treatment programs

Describe the current status of mental health services in the US?

mental health care services are inadequate and fragmented

How did psych nursing play an overall role in nursing history?

the importance of using therapeutic communication was stressed by Nightingale

A nurse is interviewing a client and suspects that the client may have narcissistic personality disorder. Which client statement would help support the nurse's suspicions? A) "I have a very important position in life; everyone I know wants to be like me." B) "My wife is poisoning my food so she can get rid of me and marry her boss." C) "I like to work alone because then I can let my thoughts wander." D) "I'm always the life of the party, making new friends all the time."

A

A nurse is caring for a psychiatric patient who is receiving an antacid that contains aluminum salts. Which action by the nurse would be most appropriate? A) Give the antacid 1 hour before the antipsychotic medication. B) Give the antacid at the same time as the antipsychotic medication. C) Administer the antacid 1 hour after the antipsychotic medication. D) Administer the antacid just before the patient goes to sleep.

A

A 10yearold child with Tourette's disorder is receiving haloperidol as part of his treatment plan. When assessing the child at a follow up visit, which statement by the child would lead the nurse to suspect that he is experiencing a side effect of the drug? A) "Sometimes I feel like I'm so sleepy." B) "I'm eating about the same amount as before." C) "My muscles seem pretty flexible lately." D) "I think I'm much more alert with this drug."

A

A 20yearold man arrives at the emergency department by ambulance. He is unconscious, with slow respirations and pinpoint pupils. There are "tracks" visible on his arms. The friend who came with him reports that the client had just "shot up" heroin when he became unconscious. Which medication would the nurse most likely expect to administer? A) Naloxone B) Naltrexone C) Bupropion D) Varenicline

A

A client is brought into the emergency department because he was involved in an automobile accident. His blood alcohol level (BAL) is 0.10 mg %. Based on this finding, the nurse would expect to assess which of the following? A) Difficulty with coordination B) Stupor C) Emotional lability D) Ataxia

A

A client tells the nurse that he is committed to trying to quit smoking. When teaching the client about smoking cessation, which of the following would the nurse include? A) Success usually involves more than one type of intervention. B) Relapse is fairly rare within the first year of quitting. C) Ear acupressure is a highly proven method for quitting. D) Education is key for smoking cessation.

A

A client with bipolar disorder having experienced a depressive episode is prescribed lamotrigine. After teaching the client about this medication, the nurse determines that the teaching was successful when the client states which of the following? A) "I need to notify my physician if I develop a skin rash." B) "I need to have my blood tested about once a month." C) "I have to watch how much salt I use every day." D) "This drug can affect my liver function."

A

A group of nursing students are reviewing the various neurotransmitters. The students demonstrate understanding when they identify which of the following as a neuropeptide? A) Melatonin B) Serotonin C) Glutamate D) Gammaaminobutyric acid

A

A group of nursing students is reviewing information about maladaptive anger. The students demonstrate a need for additional study when they identify which condition as being linked to suppressed anger? A) Coronary heart disease B) Arthritis C) Hypertension D) Breast cancer

A

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

A

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

A

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

A

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

A

A patient visits the clinic and tells the nurse about being under a great deal of stress on the job for the past month. Applying the factors that determine the stress response, which question would be most appropriate for the nurse to ask? A) "What effect is the stress having on your job performance?" B) "How would you describe the social network within your family?" C) "What is the specific event that you find most stressful?" D) "When did you first become aware of experiencing this stress?"

A

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

A

A woman with borderline personality disorder has been admitted to the inpatient unit because she has been engaging in wrist cutting. The client's sister is visiting, and the sister asks the nurse to explain why her sister sometimes does this to herself. Which response by the nurse would be most appropriate? A) "Sometimes the selfinjurious behavior is undertaken to relieve stress." B) "Selfinjurious behavior often calms and sedates people with this diagnosis." C) "Sometimes they do it to avoid the onslaught of delusional thinking." D) "The selfmutilation often slows the mood swings your sister experiences."

A

After interviewing a patient about social supports, the nurse determines that the patient is experiencing emotional support from these social supports based on which statement? A) "I'm glad I have someone that I can talk to." B) "The person who cut my lawn was great!" C) "I received a small community grant for groceries." D) "The senior center gave me a booklet about my medications."

A

After teaching a class about the biochemical theories associated with panic disorder, the instructor determines a need for additional teaching when the students identify which neurotransmitter as being implicated? A) Dopamine B) Serotonin C) Norepinephrine D) Gammaaminobutyric acid (GABA)

A

After teaching a patient who is prescribed imipramine about the drug, the nurse determines that the teaching was effective when the patient states which of the following? A) "I need to be careful because the drug can make me sleepy." B) "I don't have to worry about getting dizzy when I get up from lying down." C) "I might notice some excess saliva in my mouth at different times." D) "I need to avoid foods with fiber because diarrhea can occur."

A

After teaching the parents of a child diagnosed with ADHD about the disorder and its treatment, the nurse determines that the teaching has been effective when the parents state which of the following? A) "We need to remember that our son is not a bad kid; he just has difficulty with impulse control and attention." B) "We need to be careful so he doesn't develop a substance abuse problem as he grows older." C) "We should stop the medication after 2 months to see how effective it is in really controlling his symptoms." D) "We should set up regular routines for him but not worry if he violates the limits once in a while."

A

An advanced practice psychiatric nurse is preparing to conduct a support group for psychiatric-mental health nurses who have been assaulted by patients. Which of the following would the nurse need to keep in mind with this group? A) Nurses experience a conflict between the role of caregiver and victim. B) Nurses who are victims often go on to prosecute the patient attackers. C) Nurses actively express the feelings associated with patient assaults. D) Nurses as victims of patient assaults rarely experience guilt or shame.

A

As part of an interdisciplinary team, a nurse is assisting in developing the plan of care for a client with a delusional disorder. Which of the following would the team be least likely to include in the plan? A) Insightoriented therapy B) Psychoeducation C) Cognitive therapy D) Support therapy

A

During an interview, a patient states, "I feel so guilty, and I'm so ashamed of what I did." The nurse interprets this as which of the following? A) Negative emotion B) Positive emotion C) Borderline emotion D) Nonemotion

A

The nurse is assessing a client who has borderline personality disorder. Which of the following would be a priority? A) Nutrition patterns B) Personal hygiene practices C) Physical functioning D) Somatic complaints

A

The nurse is assessing a client who is diagnosed with borderline personality disorder. Which client statement indicates the client is at risk for self injurious behavior? A) "I have felt so down lately. I don't enjoy doing anything anymore." B) "I do what I do because others tell me to do so." C) "When I feel extremely anxious, it is like my mind goes somewhere else." D) "It is almost as if as soon as I think of doing something, I immediately do it."

A

The nurse is caring for a client diagnosed with borderline personality disorder. The nurse has instructed the client about using the communication triad. The nurse determines that the client has understood this technique when he states which of the following? A) "I should start by stating my feelings as an 'I' statement." B) "Maybe I should start by describing the situation that has me upset." C) "I should first tell the other person what I'd like to be different about the situation." D) "I should begin by telling the other person what has triggered my emotion."

A

The nurse is caring for a client in the outpatient setting who has been diagnosed with a depressive disorder. Before the client is given a prescription for a tricyclic antidepressant, assessment for which of the following would be most important? A) Suicide B) Hypersomnia C) Cardiac arrhythmia D) Erectile dysfunction

A

The nurse is caring for a patient who has been under severe stress while caring for her elderly mother who is in the advanced stages of Alzheimer's disease. The nurse explains that the patient is adapting to the stress is she is experiencing because of which of the following? A) Ability to survive in the midst of severe stress B) Acceptance of others' help in caring for her mother C) Success at being able to solve problems D) Capability in setting reasonable personal goals

A

The nurse is caring for a patient with chronic stress for the past month because of job loss and financial difficulties. When evaluating the patient's assessment findings, the nurse would anticipate finding an elevated antibody titer to which of the following? A) Herpes simplex viruses B) Herpes zoster viruses C) Acquired immune deficiency viruses D) Influenza viruses

A

The nurse is preparing to assess a client with a paranoid personality trait. The nurse integrates knowledge of this condition, anticipating that the client's affect and behavior will most likely be which of the following? A) Angry and hostile B) Flirtatious and seductive C) Fearful and anxious D) Friendly and open

A

The nurse is preparing to care for a patient under severe stress resulting from caring for her elderly aunt diagnosed with leukemia. When assessing the patient's psychological domain, which question would the nurse ask first? A) "Let's talk about what you have been feeling." B) "Tell me about your depressed moods." C) "How long have you been caring for your aunt?" D) "Are you feeling overwhelmed by caring for your aunt?"

A

The nurse is reviewing the medical record of a client diagnosed with antisocial personality disorder. The nurse notes that the client has had numerous episodes involving irritability, aggressiveness, and impulsivity and has exhibited callousness toward others. Based on this information, which nursing diagnosis would the nurse most likely identify as a priority? A) Risk for Other Directed Violence B) Risk for SelfInjury C) Risk for Suicide D) Risk for SelfDirected Violence

A

The nurse is working with a patient who will be signing a commitment to treatment statement. After teaching the patient about this statement, the nurse determines the need for additional instruction when the patient states which of the following? A) "Signing this statement means that I will not commit suicide." B) "I am agreeing to get emergency treatment if I have suicidal thoughts." C) "I will be open and honest about my feelings about treatment." D) "I am agreeing to participate in the necessary treatment for my condition"

A

The nurse makes a home visit to a client who has dysthymic disorder. Which of the following would the nurse expect to assess? A) Low energy B) Intense concentration C) Agitation D) Normal appetite

A

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

A

While talking with a patient who has been experiencing aggression and intense anger, the nurse identifies that the patient feels isolation and anxious. Which statement by the nurse would be most appropriate? A) "This must be scary for you." B) "Once you relax, things will improve." C) "I really understand how you feel." D) "If you calm down, I can help you."

A

What was a common belief about mental illness during the medieval period?

A person was removed from a contaminated environment to protect him or her

A nurse is reviewing information about a psychiatric medication that describes the amount of the drug that actually reaches systemic circulation unchanged. The nurse identifies this as which of the following? A) Firstpass effect B) Bioavailability C) Solubility D) Biotransformation

B

A nurse is reviewing the medical record of a patient who has attempted suicide. Which of the following would the nurse identify as relating to a psychological cause? A) History of childhood trauma B) Cluster B personality disorder C) Social isolation D) Suicide contagion

B

A group of nursing students is reviewing possible risk factors for development of borderline personality disorder. The students demonstrate understanding of the information when they identify which of the following as a risk factor? Select all that apply. A) Childhood sexual abuse B) Parental loss C) Substance abuse D) Family history E) Genetics

A,B

A nurse is acting as the leader of a newly formed group that is in the beginning stage of development. Which of the following would the nurse expect to do? Select all that apply. A) Develop rapport with the group members B) Anticipate members testing one another C) Work with members to develop norms D) Promote sharing of feelings E) Facilitate verbal and nonverbal communication

A,B

A nurse is assessing a client diagnosed with avoidant personality disorder. Which of the following would the nurse most likely expect to find? Select all that apply. A) Shyness B) Feelings of inadequacy C) Feelings of superiority D) Perfectionism E) Detail oriented

A,B

The nurse is developing a teaching plan for a client who is prescribed escitalopram. Which of the following side effects would the nurse include in this plan? Select all that apply. A) Weight gain B) Decreased sexual interest C) Sedation D) Blurred vision E) Urinary retention F) Dry mouth

A,B

When assessing a client with delusional disorder, the nurse would most likely expect to find impairment in which of the following? Select all that apply. A) Social functioning B) Marital functioning C) Intellectual functioning D) Occupational functioning E) Mental status functioning

A,B

A client is to receive lithium therapy as part of the treatment plan for bipolar disorder. When reviewing the client's medication history, which agents would alert the nurse to the possibility that a decrease in lithium dosage may be needed? Select all that apply. A) Lisinopril B) Hydrochlorothiazide C) Indomethacin D) Caffeine E) Aspirin

A,B,C

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

A,B,C

A nurse is obtaining a history from a client who drinks about 6 cups of coffee and several diet cola drinks per day. The client states, "I just cut down my coffee and soda intake to one per day." Which of the following would the nurse most likely expect to assess? Select all that apply. A) Headache B) Fatigue C) Yawning D) Flushing E) Diuresis

A,B,C

A 12yearold child is brought to the mental health clinic by his parents because of a court-ordered evaluation. When assessing the child, which of the following would lead the nurse to suspect that the child has a conduct disorder? Select all that apply. A) Destruction of neighbor's car on two separate occasions B) Arrests for petty larceny several times C) Repetitive disobedience of parents D) Blaming of others for problems E) Evidence of overt lying

A,B,E

A unit in an inpatient psychiatric facility is experiencing an increase in violence episodes by patients. A group of nurses working on this unit is developing a plan to address this issue. When developing this plan which of the following would the nurses most likely address as the problem areas? Select all that apply. A) Inconsistent unit activities B) Medication power struggles C) Empathetic staff response D) Clear set boundaries E) Little patient participation in treatment plan

A,B,E

The nurse is completing the admission of a client who is seeking treatment for alcoholism. He tells the nurse that the last time he had any alcohol to drink was at 10:00 AM before he left for the hospital. The nurse closely monitors the client. Which of the following would lead the nurse to suspect that the client is experiencing stage 1 of alcohol withdrawal syndrome? Select all that apply. A) Slight diaphoresis B) Hand tremors C) Intermittent confusion D) Heart rate of 135 beats/min E) Normal blood pressure

A,B,E

A nurse is developing a plan of care for a client diagnosed with an antisocial personality disorder who has been admitted to the inpatient psychiatric unit. Which of the following would the nurse most likely include? Select all that apply. A) Developing a therapeutic relationship B) Bargaining about the unit rules C) Holding the client responsible for behavior D) Discouraging client from discussing thoughts E) Using a firm, lecturelike approach for teaching

A,C

A nurse is preparing a continuing education presentation for a group of psychiatric-mental health nurses about various psychopharmacologic agents. The nurse is planning to discuss selective serotonin reuptake inhibitors. Which agents would the nurse include in this group? Select all that apply. A) Fluoxetine B) Duloxetine C) Sertraline D) Venlafaxine E) Bupropion F) Amoxapine

A,C

A client is brought into the emergency department because of complaints from the neighbors that the client was acting strangely. The nurse assesses the client and suspects schizotypal personality disorder based on assessment of which of the following? Select all that apply. A) Magical beliefs B) Hallucinations C) Paranoia D) Avoidance of eye contact E) Meticulous dress

A,C,D

A client is diagnosed with obsessivecompulsive disorder (OCD) and is to receive medication therapy. Which of the following agents might the nurse expect to be prescribed? Select all that apply. A) Clomipramine B) Lithium C) Sertraline D) Fluvoxamine E) Paroxetine F) Alprazolam

A,C,D,E

A nursing instructor is preparing a class discussion on personality disorders and characteristics. Which term would the instructor include to differentiate personality disorders from normal personality? Select all that apply. A) Inflexible B) Short term C) Pervasive D) Unstable over time E) Distressing

A,C,D,E

A nurse is preparing a patient for electroconvulsive therapy. Which of the following would the nurse include in the patient's plan of care? Select all that apply. A) Ensuring that there is a signed informed consent on the patient's chart B) Telling the patient he can have fluids but no food before the procedure C) Alerting the patient to the possibility of confusion after the treatment D) Informing the patient that he can leave his dentures in place for the treatment E) Ensuring that the patient is closely supervised for at least the first 12 hours afterward

A,C,E

The nurse is reviewing the medical record of a patient who is experiencing aggressive and violent behavior for possible risk factors. Which of the following would the nurse identify? Select all that apply. A) Damage to the frontal lobe of the brain B) Low testosterone levels C) Family history of aggression D) Gender E) High level of competitiveness

A,C,E

When leading a group, the nurse determines that several of the group members have assumed roles that may be interfering with the group's function. Which roles might be involved? Select all that apply. A) Selfconfessor B) Follower C) Dominator D) Elaborator E) Playboy F) Compromiser

A,C,E

A client with bipolar disorder has a lithium drug level of 1.2 mEq/L. Which of the following would the nurse expect to assess? Select all that apply. A) Metallic taste B) Ataxia C) Diarrhea D) Slurred speech E) Fasciculations F) Muscle weakness

A,C,F

A nursing instructor is preparing a teaching plan for a class of nursing students about antisocial personality disorder. Which of the following would the nurse include as a term often used to describe the behaviors associated with this condition? Select all that apply. A) Psychopath B) Manipulator C) Criminality D) Sociopath E) Psychotic

A,D

A group of students is reviewing information about social phobia in preparation for an oral class presentation on this topic. Which of the following would the students expect to include when describing a person with this condition? Select all that apply. A) Fear that others will judge them negatively B) Openly speak up in crowds to reduce fear C) Are insensitive to other's criticism D) Demonstrate a distorted view of their own strengths E) Exaggerate personal flaws

A,D,E

When assessing a patient experiencing aggression, the nurse applies the general aggression model. Which of the following would the nurse assess as the person factors? Select all that apply. A) Patient's personality traits B) Insult initiating the behavior C) Previous behavior patterns D) Patient's shouting E) Patient's mood F) Patient's gender

A,F

A 52yearold male client who has a history of alcohol dependence is admitted to a detoxification unit. He has tremors, he is anxious, his pulse has risen from 98 to 110 beats/min, his blood pressure has risen from 140/88 to 152/100 mm Hg, and his temperature is six tenths of a degree above normal. He is slightly diaphoretic. Which nursing diagnosis would be the priority? A) Disturbed Thought Processes B) Risk for Injury C) Ineffective Coping D) Ineffective Denial

B

A child diagnosed with autism is hospitalized in an inpatient mental health unit. When developing the plan of care for this child, which of the following would the nurse most likely include? A) Ensuring that a variety of caregivers are available for the child B) Providing a consistent, structured environment with predictable routines C) Allowing the child frequent visits off the unit to provide stimulation D) Sending the child to the "time out" area if the child repeats phrases continually

B

A client diagnosed with bipolar disorder and experiencing mania is admitted to the inpatient psychiatric setting. During the acute phase of mania, which medication would the nurse expect to most likely administer? A) Lithium carbonate (Lithium) B) Haloperidol lactate (Haldol) C) Fluoxetine (Prozac) D) Paroxetine (Paxil)

B

A client is prescribed disulfiram as part of his alcohol treatment program to prevent relapse. The client asks the nurse, "How will this drug help me?" Which response by the nurse would be most appropriate? A) "It will help to cure your alcoholism." B) "It can help to prevent you from drinking." C) "It makes the withdrawal symptoms less troublesome." D) "It helps to clear the alcohol out of your body."

B

A client is receiving methadone maintenance therapy. After teaching the client about this treatment, the nurse determines that the teaching was successful when the client states which of the following? A) "I can have a glass of wine with dinner if I choose." B) "I should eat small frequent meals if I get nauseated." C) "I should take the drug on an empty stomach." D) "I might experience diarrhea with this drug."

B

A client with a history of alcohol abuse is participating in a 12step Alcoholics Anonymous (AA) program. The nurse determines that the client is at step two when he states which of the following? A) "I've admitted to myself and others the wrongdoings I've done." B) "I realize that there is a higher power that can help me." C) "I know now that I am powerless over alcohol." D) "I am making amends to all those that I've harmed."

B

A client with a panic disorder has been prescribed a benzodiazepine medication. Which of the following would the nurse emphasize as a risk associated with using this medication? A) Dietary restrictions B) Withdrawal symptoms C) Agitation D) Fecal impaction

B

A client with borderline personality disorder tells the nurse, "I'm afraid to get on a train because we'll probably get into a wreck." Which response by the nurse would be most appropriate? A) "Have you had a bad experience riding a train?" B) "What are the chances of that actually happening?" C) "Now you know that won't happen." D) "Have you thought about going by automobile?"

B

A family member of a client diagnosed with schizoaffective disorder asks a nurse what causes the disorder. Which response by the nurse would be most appropriate? A) "Dysfunctional family dynamics has been identified as a strong link." B) "Research has suggested that the cause is predominately genetic." C) "Dopamine, a substance in the brain, appears to be underactive." D) "Studies have indicated that birth order is strongly associated with this disorder."

B

A group of nurses is reviewing medications used to treat attention deficit hyperactivity disorder. The students demonstrate understanding of the information when they identify methylphenidate as which of the following? A) Selective serotonin reuptake inhibitor B) Psychostimulant C) Noradrenergic reuptake inhibitor D) Alpha agonist

B

A group of nursing students are reviewing information related to drug therapy for mood disorders. The students demonstrate understanding of the information when they identify which agent as the gold standard for treating bipolar disorder? A) Carbamazepine B) Lithium C) Valproate D) Lamotrigine

B

A group of nursing students is reviewing information about antisocial personality disorder. The students demonstrate understanding of this disorder when they state which of the following? A) The disorder occurs more frequently in women. B) The individual must be at least 18 years of age. C) The disorder is found primarily in Asian individuals. D) Alcohol abuse disorder rarely accompanies this disorder.

B

A group of students are reviewing the events associated with the fightorflight response. They demonstrate understanding of the information when they identify which of the following results from sympathetic nervous stimulation? A) Hypoglycemia B) Tachycardia C) Hypotension D) Hypercoagulability

B

A nurse is assessing a client with borderline personality disorder. Which question would be most appropriate to assess the client's level of impulsivity? A) "What things bother you and make you feel happy?" B) "Have you ever felt sorry after acting as you did on the spur of the moment?" C) "How do you view other people around you?" D) "Have you ever felt like you were separated from your body?"

B

A nurse is assessing an 8yearold girl with a mood disorder. Which of the following would the nurse most likely expect to assess? A) Statement from the child that she feels sad B) Behavioral problems C) Recurrent obsessions D) Ritualistic behavior

B

A nurse is assisting a client with borderline personality disorder in how to manage transient psychotic episodes that involve auditory hallucinations. The teaching is planned for times when the client is free of these symptoms. Which of the following would the nurse instruct the client to do first? A) Use skills to tolerate painful feelings. B) Practice deep abdominal breathing. C) Identify early internal cues of distress. D) Refer to cards listing potential symptoms.

B

A nurse is developing a plan of care for a patient diagnosed with schizophrenia. The nurse integrates knowledge of this disorder, identifying which neurotransmitter as being primarily involved? A) Acetylcholine B) Dopamine C) Norepinephrine D) Serotonin

B

A nurse is developing a plan of care for a patient experiencing expressive aphasia. The nurse incorporates knowledge that the patient most likely has sustained damage to which of the following? A) The postcentral gyrus B) Broca's area C) Basal ganglia D) The hippocampus

B

A nurse is developing a teaching plan for a client with an impulse control disorder. The nurse is planning to explain the emotional aspects associated with the behavior as part of the plan. Which of the following would the nurse describe as occurring first before the individual commits the act? A) Remorse B) Tension C) Regret D) Pleasure

B

A nurse is developing the plan of care for a client with panic disorder that will include pharmacologic therapy. Which of the following would the nurse most likely expect to administer? A) Benzodiazepine B) Selective serotonin reuptake inhibitor (SSRI) C) Monoamine oxidase inhibitor (MAOI) D) Tricyclic antidepressant (TCA)

B

A nurse is implementing a brief intervention with a client who is abusing alcohol. The nurse most likely would be involved with which of the following? A) Asking the client questions about alcohol use B) Negotiating a conversation with the client to reduce use C) Pointing out the inconsistencies in thoughts, feelings, and action D) Helping the client change the way he thinks about a situation

B

A nurse is performing an admission assessment. The patient complains that it has been taking larger and larger amounts of medication to get the desired effect. Based on this information, the nurse interprets this as suggesting which of the following? A) Desensitization B) Tolerance C) Therapeutic index D) Toxicity

B

A nurse is performing an assessment interview with a patient. The patient tells the nurse that he has a type A personality. Based on the nurse's interpretation, the nurse would expect which behavior by the patient? A) Appearing relaxed and easygoing throughout the interview B) Wanting the interview to be over as quickly as possible C) Being pleased with the overall pace of the interview D) Speaking slowly, requiring time to consider his answers

B

A nurse is preparing an inservice presentation about panic disorders and associated theories related to the cause. When describing the cognitive-behavioral concepts associated with panic disorders, which of the following would the nurse expect to address? A) Personal losses B) Conditioned response C) Early separation D) Dysfunctional family communication

B

A nurse is providing parent training for parents of a child diagnosed with a disruptive behavior disorder involving the use of time out. When describing how to implement this, which of the following would the nurse identify as the first step? A) Having the child recount the reason for the time out B) Clearly identifying what is required for the child C) Informing the child what will happen because of the behavior D) Placing the child in a designated area removed from others

B

A nurse is reading an article about a young girl who developed gastrointestinal symptoms from a hair ball because of a ritual that she engaged in. The girl would pull out hair over several hours to relieve tension and anxiety and then eat the hair. The nurse most likely is reading an article about which of the following? A) Kleptomania B) Trichotillomania C) Pyromania D) Intermittent explosive disorder

B

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

B

A patient is experiencing hallucinations and delusions. The nurse would expect the physician to order which class of drug? A) Mood stabilizer B) Antipsychotic C) Antianxiety agent D) Stimulant

B

A patient is prescribed medication for a psychiatric disorder. After 3 days, the patient tells the nurse that he or she has been constipated. Which instruction would the nurse give the patient? A) "You need to eat more high protein foods such as meat and peanut butter." B) "You need to eat more fruits and vegetables and drink more water." C) "Ask your psychiatrist to prescribe a stool softener for you." D) "This side effect should disappear within a week or so."

B

A patient is talking to the nurse about her friendship with another person. She comments, "That person is always there for me, and I am always there for her. We help each other out; sometimes she's helping me, and sometimes I am helping her." The nurse interprets the patient's statements about her social network as reflecting which of the following? A) Denseness B) Reciprocity C) Social support D) Constraints

B

A patient who is scheduled to undergo a sleep deprivation electroencephalogram (EEG) in the morning is experiencing moderate anxiety about the procedure. Based on an understanding of this test, which of the following would the nurse avoid? A) Explaining in depth what to expect during the upcoming procedure B) Administering a benzodiazepine medication prescribed for anxiety C) Taking a thorough history of her use of prescribed and illicit drugs D) Giving her a noncaffeinated beverage of her choice

B

A patient with depression asks the nurse about possible herbal supplements. Which of the following would the nurse identify as being commonly used? A) Valerian B) St. John's wort C) Kava D) Melatonin

B

A patient with depression tells the nurse that he is to "have a test that involves the recording of an electroencephalogram (EEG) throughout the night." The nurse most likely identifies this testing as which of the following? A) Sleep deprivation EEG B) Polysomnography C) Evoked potentials D) Functional magnetic resonance imaging

B

After teaching a group of students about the epidemiology of schizoaffective disorder, the instructor determines that the teaching was successful when the students state which of the following? A) "The disorder occurs often in children." B) "It is more likely to occur in women." C) "Most persons are African Americans." D) "The disorder is rare in family relatives."

B

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

B

The history of a child newly diagnosed with ADHD reveals that the child is experiencing sleeping difficulties. Which agent would the nurse most likely use? A) Methylphenidate B) Atomoxetine C) Bupropion D) Clonidine

B

The nurse is assessing a patient experiencing anxiety and observes increased sweating and gooseflesh. The nurse understands that these are the result of which substance? A) Acetylcholine B) Norepinephrine C) Serotonin D) Histamine

B

The nurse is caring for a patient who has experienced damage to the parietal lobes of the brain. The nurse anticipates that the patient with have difficulty with which of the following? A) Perceiving sensory input B) Calculating a math problem C) Seeing objects in front of him D) Speaking fluently

B

The nurse is caring for an older adult who has experienced damage to the frontal lobe after an automobile accident. The nurse anticipates that the patient will have difficulty with which of the following? A) Smell B) Concept formation C) Receptive speech D) Hearing

B

The nurse is counseling a parent whose child has a communication disorder. Which of the following would the nurse emphasize when teaching the parent about this disorder? A) Providing the child with nonverbal activities B) Initiating conversations with the child frequently C) Stopping the child's conversation if stuttering begins D) Asking the physician for medication to improve the child's speech

B

The nurse is giving a presentation comparing and contrasting autism disorder and Asperger syndrome. Which of the following would the nurse include as differentiating Asperger syndrome from autism disorder? A) "Children typically do not engage in stereotypic behavior." B) "They display age appropriate intelligence." C) "The children often reverse pronouns when speaking." D) "They appear aloof and indifferent to others."

B

The nurse is preparing to initiate a behavioral treatment program for a child with encopresis. Which of the following would the nurse most likely implement first? A) Administration of mineral oil B) Bowel cleansing C) Lowfiber diet D) Toilet sitting after each meal

B

The nurse is preparing to interview a client who has a delusional disorder. Which of the following would the nurse expect? A) Cognitive impairment B) Normal behavior C) Labile affect D) Evidence of motor symptoms

B

The nurse is working with a potentially violent patient in a community clinic. Which of the following would the nurse implement to minimize personal risk? A) Using protective devices B) Staying close to a door C) Keeping the door closed to ensure privacy D) Wearing inexpensive jewelry to distract the patient

B

The parents of a child with ADHD bring the child for a followup visit. During the visit, they tell the nurse that the child receives his first dose of methylphenidate (Ritalin) at about 7:30 AM every morning before leaving for school. The teacher and school nurse have noticed a return in the child's overactivity and distractibility just before lunch. The child's second dose is scheduled for about 12 noon. Which of the following might the nurse suggest as a possible solution to control the child's symptoms a bit more effectively? A) Giving the second dose at 1 PM or later. B) Switching to a longer acting preparation. C) Splitting the early morning dose in half. D) Switching to another class of medication.

B

The plan of a care for a patient with anger includes behavioral interventions. Which of the following would the nurse be likely to find? A) Selfmonitoring of cues B) Anger management C) Relaxation training D) Response disruption

B

When assessing a client with depression, the client states, "I just feel so sad and hopeless. I just don't care anymore. I don't even enjoy doing the crossword puzzles like I used to." The nurse documents this finding as indicative of which of the following? A) Dysthymic disorder B) Anhedonia C) Delusion D) Psychosis

B

When describing neuronal transmission, an instructor describes the area where the electrical intracellular signal becomes a chemical one. The instructor is describing which of the following? A) Soma B) Synaptic cleft C) Terminal D) Receptor site

B

When describing the concept of allostatic load to a group of students, which of the following would the instructor identify as abnormalities of which of the following as indicative of the overall changes? A) Nuclear imaging studies B) Laboratory test results C) Bone radiographs D) Cardiac studies

B

When describing the various neurotransmitters, which of the following would the nurse identify as the primary cholinergic neurotransmitter? A) Dopamine B) Acetylcholine C) Norepinephrine D) Serotonin

B

When engaged in rational emotive behavior therapy, which of the following would be addressed during the activating event sequence? A) Teaching the connection between beliefs and consequences B) Assessing the consequences of the problem C) Facilitating the workingthrough process D) Preparing patient to deepen conviction in rational beliefs

B

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

B

While interviewing a patient, a nurse asks, "What do you do when you get angry?" Which patient response would indicate to the nurse that the patient engages in anger suppression? A) "I've been known to fly off the handle when I'm angry." B) "People say I withdraw and pout about the problem." C) "I usually approach the person directly to talk about it." D) "I try to discuss how I'm feeling about it with a close friend."

B

A client with a history of substance abuse is involved in a skills training group. Which of the following would the client be involved with to enhance interpersonal coping skills? Select all that apply. A) Substance refusal skills B) Problem solving C) Anger awareness D) Emergency planning E) Social support networking

B,C,D

A group of students is reviewing the signs and symptoms associated with anxiety. The students demonstrate an understanding of the information when they identify which of the following as cognitive symptoms? Select all that apply. A) Edginess B) Feelings of unreality C) Difficulty concentrating D) Tunnel vision E) Apprehensiveness F) Speech dysfluency

B,C,D

A nurse is providing an inservice presentation on coping and adaptation. Which of the following would the nurse most likely include? Select all that apply. A) Most coping strategies are similar in their approach. B) Coping when effective leads to adaptation. C) Reappraisal occurs simultaneously with coping. D) The same coping strategy is used in each situation. E) Coping is a deliberate and planned effort to mange stress.

B, E

A client is brought to the emergency department after having overdosed on cocaine. When assessing the client, which of the following would the nurse expect to find? Select all that apply. A) Euphoria B) Seizures C) Cardiac arrhythmia D) Paranoia E) Dilated pupils

B,C

A group of nursing students are reviewing the various drug classes used to treat psychiatric disorders. The students demonstrate understanding when they identify which of the following as examples of antianxiety medications? Select all that apply. A) Selegiline B) Lorazepam C) Buspirone D) Zolpidem E) Methylphenidate

B,C

A nurse is working with a client who is a compulsive gambler. Which of the following would the nurse emphasize as crucial for relapse prevention? Select all that apply A) Medication therapy B) Family involvement C) Identification of triggers D) Anger management E) Milieu management

B,C

A client with borderline personality disorder has difficulty maintaining boundaries of the professional relationship. Which of the following would be most effective for the nurse to do? Select all that apply. A) Punish the client with seclusion for violating established boundaries. B) Respond to the client's arrogance in a neutral, nonconfrontational manner. C) Discuss the purpose of the limits in the therapeutic relationship. D) State the parameters of the limits and boundaries clearly. E) Ensure that any established limits are maintained consistently.

B,C,D,E

A group of nursing students is reviewing information about the epidemiology of depressive disorders. The students demonstrate understanding of the information when they identify which of the following as possible risk factors? Select all that apply. A) History of substance abuse as a teenager B) Little social support C) Inadequate coping skills D) Prior episode of anxiety disorder E) Concomitant medical illnesses

B,C,E

A nurse is engaged in roleplaying with a client with borderline personality disorder to assist the client in learning how to communicate effectively. Which of the following would the nurse encourage the client to use? Select all that apply. A) "Me" statements B) Validating perceptions with others C) Paraphrasing before responding D) Listening passively E) Compromising

B,C,E

A nurse is presenting an inservice program about aggression and violence to a group of newly hired nurses who will be working in an inpatient psychiatric facility. When describing characteristics that may predict the risk for violence and aggression in patients, which of the following would the nurse include? Select all that apply. A) Age B) Impulsivity C) Substance withdrawal D) Gender E) Suspiciousness

B,C,E

A nursing instructor is preparing a class discussion about major depression. Which of the following would the instructor expect to include? A) Depression in children is manifested in the same manner as in adults. B) The risk for suicide is especially high during the midadolescent years. C) Response to treatment in older adults is slower than that for younger adults. D) People older than age 65 years have the lowest suicide rates of any age group. E) Episodes of depression tend to occur more frequently over time. F) Depressive disorders are most often treated in the primary care setting.

B,C,E,F

A group of nursing students is reviewing information about substances that are abused. The students demonstrate understanding of the information when they identify which of the following as stimulants? Select all that apply. A) Alcohol B) Cocaine C) Heroin D) Nicotine E) Phencyclidine

B,D

A nursing instructor is describing depressive and negativistic personality traits to a group of nursing students. The instructor determines that the teaching was successful when the students identify which of the following as characteristic of negativistic personality traits? Select all that apply. A) Anhedonia B) Hostility C) Pessimism D) Oppositionality E) Guilt

B,D,E

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

B,D,E

A group of nursing students is reviewing information about other psychotic disorders. The students demonstrate understanding of this information when they identify which disorder as involving an inducer? A) Brief psychotic disorder B) Schizophreniform disorder C) Shared psychotic disorder D) Psychotic disorder attributable to a substance

C

A group of nursing students is reviewing information about schizoid personality trait. The students demonstrate understanding of the information when they identify which disorder as the most common comorbid disorder? A) Depression B) Substance abuse C) Avoidant personality disorder D) Anxiety

C

25. A client is diagnosed with generalized anxiety disorder and is prescribed medication therapy. Which agent would the nurse expect to administer to the client to obtain the quickest relief from anxiety symptoms? A) Buspirone B) Venlafaxine C) Alprazolam D) Imipramine

C

A client diagnosed with borderline personality disorder tells the nurse that she "frequently spaces out." Which response by the nurse would be most appropriate? A) "Do you feel stressed most of the time?" B) "Does this frighten you when it happens?" C) "What's happening around you when this occurs?" D) "Do you feel as if you are out of your body?"

C

A client has been prescribed naltrexone (Trexan) for treatment of alcohol dependence. The nurse has explained the drug's purpose to the client. The nurse determines that the client has understood the instructions when the client identifies which of the following about the drug? A) Causes itching if alcohol is consumed B) Produces the euphoria of alcohol C) Reduces the appeal of alcohol D) Improves appetite and nutritional status

C

A client who is receiving lithium comes to the clinic for an evaluation. During the visit, the client reports a fine hand tremor. Which action by the nurse would be most appropriate? A) Immediately obtain a specimen to determine the client's blood drug level. B) Suggest that the client take the medication with meals or snacks. C) Assist the client in minimizing exposure to stressors. D) Encourage the client to elevate the affected hand on a pillow.

C

A client with a history of opioid abuse is exhibiting manifestations of moderate withdrawal. Which of the following would the nurse expect to assess? A) Rhinorrhea B) Lacrimation C) Dilated pupils D) Dysphoria

C

A client with depression is prescribed fluoxetine. On a return visit to the clinic, the client tells the nurse that he also just started taking St. John's wort to feel better. The nurse assesses the client for which of the following? A) Water intoxication B) Increased depressive symptoms C) Serotonin syndrome D) Hypertensive crisis

C

A client with schizoaffective disorder is prescribed clozapine to treat her symptoms. Which of the following instructions would the nurse provide? A) "Keep a record of how often and how long you experience the side effect of dry mouth." B) "Monitor your urinary output and notify your doctor if your urine changes color." C) "Keep an eye on your weight, and if you gain weight rapidly, notify your doctor." D) "If you experience any drowsiness, discontinue taking this medication."

C

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

C

A group of nursing students is reviewing information about emotional responses to stress and the themes associated with them. The students demonstrate understanding of the information when they identify which emotion as associated with being moved by another's suffering and wanting to help? A) Relief B) Hope C) Compassion D) Love

C

A nurse determines that a client who is experiencing anxiety is using relief behaviors. The nurse determines that the client is experiencing which degree of anxiety? A) Mild B) Moderate C) Severe D) Panic

C

A nurse is providing care to a client with antisocial personality disorder. As part of the plan of care, the client is to participate in a problem solving group. The nurse understands that this intervention is effective based on which rationale? A) It requires the client to develop attachments. B) It sets up specific boundaries for the client. C) It helps reinforce self responsibility. D) It avoids confrontation about dysfunctional patterns.

C

A nurse is talking with a 57yearold client who has been a heavy drinker for many years. The client is being treated for alcoholism, and this is her second week as an inpatient on the psychiatric unit. It is 5:00 AM, and the client has been having difficulty sleeping. The client is an orthopedic nurse, and although she is clothed in a hospital-issued gown and robe, she is wearing a stethoscope around her neck that the nurse recognizes as belonging to one of the staff nurses. When the nurse asks her why she is wearing the stethoscope and where she got it, the client gives her a long and involved reply that basically describes how her nursing supervisor came to visit and gave it to her to wear "so she'd remember to get well." The nurse suspects that the client may be experiencing which of the following? A) Wernicke's syndrome B) Delirium tremens C) Korsakoff's psychosis D) Malignant hyperthermia

C

A nurse is teaching a medication class to a group of psychiatric patients. One of them asks the nurse why he has so much more trouble learning now when he's in his 60s than he did when he was younger. Which of the following concepts would the nurse integrate into the response? A) The extrapyramidal motor system B) The amygdala C) Neuroplasticity D) Psychoneuroimmunology

C

A nurse is working as part of a team involved with the testing of a new psychiatric medication. The drug is currently being used in multiple clinical trials at various different sites. The nurse is engaged in which phase of testing? A) Phase I B) Phase II C) Phase III D) Phase IV

C

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

C

A nursing instructor is teaching a class on the pharmacodynamics of psychiatric medications. The instructor determines that additional teaching is needed when the students identify which of the following as a site of action? A) Receptor B) Ion channels C) Neurotransmitters D) Enzymes

C

A patient has been admitted to the detoxification unit after binge drinking. Even though the patient is not currently intoxicated, he is combative and exhibits altered thought processes. Which nursing diagnosis would be the priority? A) Risk for Injury related to effects of alcohol abuse B) Risk for SelfMutilation related to alcohol withdrawal and altered thought processes C) Risk for OtherDirected Violence related to alcohol withdrawal D) Risk for Delayed Development related to chronic effects of alcohol intoxication

C

A patient has come to the clinic to discuss the stress she is experiencing because of failing two exams at school. Initially, she described her failures as "the worst thing that has ever happened to me," and she stated, "There is absolutely nothing I can do to pass this course now." In response to the nurse's questions, the nurse finds out there are three more equally weighted exams scheduled for the course in question. The nurse and patient collaborate and decide to use interventions to facilitate emotion focused coping. Which additional comment from the patient would the nurse identify as providing support for this decision? A) "You've got to figure out something for me to do to get me out of this situation!" B) "This is a waste of time because absolutely nothing you or I can do will make it any better." C) "I overreacted; surely together we can figure out something for me to do." D) "This is the worst thing that could ever happen to me. I'm nothing but a failure."

C

A patient is brought to the emergency department by her brother, who reports that the patient became very agitated and "started hallucinating." Further assessment reveals tachycardia, incoordination, vomiting, and diarrhea. The brother states that the patient is taking paroxetine for depression. Which of the following would the nurse most likely suspect? A) Neuroleptic malignant syndrome B) Acute dystonic reaction C) Serotonin syndrome D) Hypothyroidism

C

A patient receiving an antipsychotic agent develops acute extrapyramidal symptoms. Which response by the nurse would be most appropriate? A) "These symptoms are not real; the medication makes your brain think they are real." B) "You have developed an allergy to the medication, so we need to change it." C) "These are the results of the drug that can be treated; your illness is not getting worse." D) "The sunlight together with the medication has caused these symptoms; just stay indoors."

C

A son brings his father to the clinic and tells the nurse that his father has begun to act strangely in the past few days and has unprovoked outbursts of anger. After the incidents, the father expresses remorse for his outburst. The son says, "I've never seen him act this way." Which question would be most appropriate for the nurse to ask next? A) "Does your father have a history of an anxiety disorder such as panic disorder?" B) "Has your father exhibited previous problems expressing anger appropriately?" C) "Has your father suffered any traumatic injury to his brain recently?" D) "Has your father injured the back of his head or next in the past week?"

C

After teaching a patient who is receiving phenelzine, the nurse determines that the teaching was successful when the patient states the need to avoid which of the following? A) Fresh cottage cheese B) Cooked sliced ham C) Tap beers D) Soy milk

C

After working with a patient who has a history of violent behavior to identify possible clues that suggest that his behavior is escalating, the nurse and patient develop a plan for prevention. Which strategy would they be least likely to include? A) Counting to 10 B) Taking slow deep breaths C) Turning up the music loud D) Taking a voluntary time out

C

The nurse determines that a patient is at imminent risk for suicide. Which of the following would be least appropriate to include in the patient's plan of care? A) Listening intently and nonjudgmentally B) Validating the patient's feelings and experience C) Instituting strict restriction on the patient's activity D) Using cognitive interventions to foster hope

C

The nurse has explained some of the biologic theories of causation to a client diagnosed with borderline personality disorder and his family. The nurse determines that the client and family have understood the instructions when they state which of the following? A) "The disorder may be caused by increased serotonin activity." B) "The disorder is caused by decreased dopamine activity in my brain." C) "A frontal lobe dysfunction may be causing this condition." D) "A decrease in hormonal substances increases the risk for this illness."

C

The nurse is assessing a client with bipolar disorder who is experiencing mania. The client states, "I'm just so beautiful. Everyone just stops and stares at how gorgeous I am. Men constantly want to have sex with me." The nurse interprets these statements as indicative of which type of mood? A) Irritable B) Elevated C) Expansive D) Euphoric

C

The nurse is assessing a newly admitted client diagnosed with schizoaffective disorder. The nurse assesses the client's level of anxiety and reactions to stressful situations, obtaining this information for which reason? A) To help determine the client's outcomes after treatment B) To help identify whether or not the client's mental competency is intact C) To act as a predictor of the client's risk for a suicide attempt D) To provide a basis for evaluating the client's social skills

C

The nurse is caring for a 31⁄2yearold child with autism who has been hospitalized. The child rocks continuously without any danger present to the child's safety. Which intervention by the nurse would be most appropriate? A) Continue to monitor the child's behaviors. B) Hold the child until the child stops rocking. C) Ignore the child's rocking behavior. D) Place the child in a "time out" area until the rocking stops.

C

The nurse is caring for a 70yearold psychiatric patient who has been prescribed a number of medications. When teaching the patient about the medications, which explanation would be most appropriate? A) "Your stomach empties more quickly as you age; therefore, you may feel the effect of your medications almost immediately." B) "Your entire GI system speeds up, so your medications are digested much more quickly. Therefore, it is important that you not drive after you take your medications." C) "Because of your age and related changes in liver functioning, you may have medication levels in your system with the potential to be toxic." D) "Because of agerelated circulation changes, your body will be able to deliver therapeutic doses of your medication to select body sites more quickly."

C

The nurse is counseling a family whose 4yearold child has mild mental retardation. The nurse is working with the family on realistic longterm goals. Which of the following would be most appropriate? A) Locating suitable residential placement for the child B) Finding a foster home for the child C) Achieving independent functioning of the child as an adult D) Preventing the onset of psychiatric disorders in the child

C

The nurse is counseling a family whose child has autism. When describing this condition, which of the following would the nurse most likely include? A) Connection to ineffective parental practices B) Detection after the child enters school C) Onset before child is 2.5 years old D) Girls are more frequently affected than boys

C

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

C

The nurse is reviewing the medical records of several patients receiving antipsychotic agents. Which factors, if noted, would the nurse identify as placing a patient at greater risk for tardive dyskinesia? A) Male gender B) Age 30 to 45 years C) History of depression D) Short duration of treatment

C

The nurse observes an older adult patient who has been taking antipsychotic medications for 8 months. The patient is smacking her lips and blinking her eyes rapidly. The nurse also observes a protruding tongue. Which action by the nurse would be most appropriate? A) Ask if the patient has been experiencing side effects. B) Contact the patient's physician for a different medication order. C) Document the patient's symptoms of tardive dyskinesia. D) Instruct the patient to begin tapering off the medication.

C

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

C

While interviewing a client diagnosed with a delusional disorder, the client states, "I have this really strange odor coming out of my mouth. I stop to brush my teeth almost every hour and then rinse with mouthwash every half hour to get rid of this smell. I've seen so many doctors, and they can't tell me what's wrong." The nurse interprets the client's statement as reflecting which type of delusion? A) Erotomanic B) Grandiose C) Somatic D) Jealous

C

While interviewing a client, the client reports an intense fear of spiders, stating, "I can't be near them. I get so upset. I start to sweat and hyperventilate if I see one." The nurse documents this finding as which of the following? A) Algophobia B) Entomophobia C) Arachnophobia D) Cynophobia

C

While participating in a group therapy session, one group member consistently asks for clarification of the topic the group is discussing. The nurse leading the group interprets this behavior as reflecting which group role? A) Coordinator B) Recorder C) Information seeker D) Standard setter

C

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

C

The nurse is assessing a client with posttraumatic stress disorder (PTSD). Which of the following would the nurse categorize as reflecting intrusion? Select all that apply. A) Irritability B) Difficulty sleeping C) Flashbacks D) Shortterm memory deficits E) Dissociation

C,D

A client is brought to the emergency department by his brother. The client has a history of bipolar disorder for which he is taking divalproex. The brother reports that he watched his brother take the medication about 2 hours ago. He stated, "A little while ago, he got very disoriented and agitated." The nurse suspects toxicity based on assessment of which of the following? Select all that apply. A) Tachypnea B) Bradycardia C) Hypotension D) Nystagmus E) Vomiting

C,D,E

An adolescent is brought to the emergency department by her parents because they were concerned about their daughter's appearance. The client appears emaciated and pale. The parents tell the nurse that the client has been diagnosed with anorexia nervosa. A history and physical examination and laboratory testing are completed. Which of the following would lead the nurse to suspect that the client will be admitted to the hospital? Select all that apply. A) Blood pressure of 110/60 mm Hg B) Elevated serum potassium level C) Decreased serum magnesium level D) Heart rate of 40 beats/min E) Statements of being "hopeless"

C,D,E

A group of nursing students are reviewing the role of serotonin in psychiatric disorders. The students demonstrate a need for additional study when they identify which disorder as being associated with its dysfunction? A) Depression B) Obsessivecompulsive disorder C) Panic disorder D) Schizophrenia

D

A group of nursing students is reviewing information about disruptive behavior disorders. The students demonstrate understanding of the topic when they identify which of the following as an externalizing disorder? A) Anxiety B) Depression C) Schizophrenia D) Conduct disorder

D

A group of students are reviewing information about neurotransmitter subtypes. The group demonstrates understanding of the information when they identify which neurotransmitter as having muscarinic and nicotinic receptors? A) Serotonin B) Gammaaminobutyric acid (GABA) C) Dopamine D) Acetylcholine

D

A client diagnosed with major depression was prescribed imipramine (Tofranil) and has been taking this medication for 1 week. The client took his last dose of imipramine (Tofranil) at 9:00 PM. The client is scheduled to have blood drawn to monitor the medication level the next morning. The nurse should instruct the client to have his blood drawn as close as possible to which time? A) 6:00 AM B) 7:00 AM C) 8:00 AM D) 9:00 AM

D

A client has been diagnosed with major depression. The client reports that he often wakes up during the night and has trouble returning to sleep. The nurse interprets this finding as suggesting which of the following? A) Initial insomnia B) Terminal insomnia C) Hypersomnia D) Middle insomnia

D

A client who has a major depressive episode tells the nurse that for the past 2 weeks, he has been hearing voices and at times thinks that someone is following him. History reveals that he had these alternating symptoms before along with times when he has experienced neither of these symptoms and has been able to function adequately. The nurse interprets these findings as suggesting which of the following? A) Paranoid schizophrenia B) Undifferentiated schizophrenia C) Brief psychotic disorder D) Schizoaffective disorder

D

A client with obsessivecompulsive disorder has been taking fluoxetine for 1 month. The client tells the nurse, "These pills are making me sick. I think I'm getting a brain tumor because of the headaches." Which response by the nurse would be most appropriate? A) "Let's talk about how often you have been performing the rituals lately." B) "Tell me how many times you have washed your hands today." C) "Have you been practicing your deep breathing and relaxation exercises?" D) "These medications have side effects that can cause increased headaches."

D

A nurse is reviewing the assessment findings of several patients. Which patient would the nurse identify as having a type D personality? A) A man who threatens the receptionist in the emergency department with bodily harm if a doctor does not see him right away B) A woman who sits quietly reading in a waiting room before seeing her doctor for her annual physical examination C) A quiet teen who drinks a six pack of beer against his better judgment because of peer pressure D) A man who reacts negatively to almost everything but never discusses his feelings with anyone

D

A nurse is using motivational therapy with a female client with alcoholism. The client, who is unwilling to consider changing her drinking behavior, emphatically states, "I am not an alcoholic; you can't make me stop drinking." Which response by the nurse would be most appropriate? A) "You have to stop drinking and driving; you could kill someone." B) "You're right; you're not an alcoholic." C) "You should consider what you are doing to your marital relationship." D) "You're the only one who can make yourself stop drinking."

D

A nurse is working with an adolescent girl who describes herself as a "compulsive overeater" and presents with a history of using food to cope with stress. The nurse decides to use journaling as an intervention for this patient based on the rationale that journaling will help the patient identify which of the following? A) How often she eats compulsively in response to stress she encounters on a daily basis B) Patterns in her daily schedule that may be contributing to her compulsive eating C) Behaviors in others that trigger her compulsion to eat in when she experiences stress D) Changes in her selfperception and responses to stress that she might otherwise not notice

D

A nursing instructor asks a student to explain the influence of chronobiology on depression. Which of the following would the student include when responding? A) The exact location of genes leads to identifying the gene responsible for causing depression. B) A break in the corpus coliseum blocks information exchange between the right and left hemispheres. C) Damage to the posterior areas of the parietal lobe leads to altered discriminative sensory function. D) Internal and external triggers can elicit biologic rhythm changes indicative of clinical depression.

D

A nursing instructor is teaching a class of nursing students about anger, aggression, and violence. Which statement by the instructor would be most appropriate to include? A) "Anger, aggression, and violence are points along a continuum." B) "The terms used to describe anger are very precise." C) "Anger is a kneejerk reaction to external events." D) "Women experience anger as frequently as men do."

D

A patient has been diagnosed with memory dysfunction associated with Alzheimer's disease. The nurse determines that damage to the patient's brain includes deterioration of temporal lobe structures and the nerves of which of the following? A) Basal ganglia B) Limbic system C) Frontal lobe D) Hippocampus

D

A patient has been prescribed clozapine for treatment of schizophrenia. Which of the following would the nurse include in the teaching plan for this patient and family? A) "You may experience hypertension while taking this medication." B) "One of the side effects of this medication is breast engorgement." C) "People taking this medication often experience dermatitis." D) "You may experience noticeable weight gain while taking this medication."

D

A patient who has been taking clozapine for 6 weeks visits the clinic complaining of fever, sore throat, and mouth sores. The nurse notifies the patient's physician because the nurse suspects which of the following? A) Severe anemia B) Neuroleptic malignant syndrome C) Encephalitis D) Agranulocytosis

D

After teaching a group of students about appraisal and the stress response, the instructor determines that additional teaching is needed when the students identify which of the following as part of the primary appraisal? A) Relevance of the goal B) Consistency of goal with values C) Personal commitment D) Outcome explanation

D

An adolescent client tells the nurse that he or she occasionally "sniffs airplane glue." When discussing the effects of long-term use of inhalants, which of the following would the nurse most likely include? A) Tremors and CNS arousal B) Enhanced normal heart rhythms C) Enhanced attention focus and memory D) Brain damage and cognitive abnormalities

D

An older adult is complaining of anxiety is prescribed diazepam (Valium) by a family physician. The physician asks the office nurse to explain the problematic side effects of this medication to the patient. Which instruction would be most important for the nurse to emphasize about this drug? A) "You may experience minor urine incontinence from time to time." B) "You may find that you have temporary memory disturbances." C) "You need to use this medication cautiously because it can cause dependence." D) "You may feel dizzy and be prone to falls after taking this medication."

D

As part of a client's treatment plan for borderline personality disorder, the client is engaged in dialectical behavior therapy. As part of the therapy, the client is learning how to control and change behavior in response to events. The nurse identifies the client as learning which type of skills? A) Emotion regulation skills B) Mindfulness skills C) Distress tolerance skills D) Selfmanagement skills

D

During the stabilization phase of drug therapy for a patient who is hospitalized with a psychiatric disorder, which action would be most appropriate? A) Discussing the timing of tapering the medication B) Instructing the patient about relapse prevention C) Determining if the medication is losing its effect D) Assessing the patient for target symptoms and side effects

D

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

D

The mother of a child with Asperger disorder tells the nurse that her child has few playmates. She states, "He has such poor social skills with other children, and he strongly rejects any change in his routine by throwing a tantrum." Based on this information, the nurse identifies which nursing diagnosis as the priority? A) SelfCare Deficits related to repeated tantrums B) Risk for Injury related to Asperger disorder C) Ineffective Family Coping related to having a child with Asperger disorder D) Risk for Social Isolation related to poor social skills of the child

D

The nurse is assessing a group of patients on an inpatient psychiatric unit. The patient's history for which of the following would the nurse identify as the strongest indicator of risk for violence? A) Panic disorder B) Problematic anxiety C) Somatoform disorder D) Violent behavior

D

The nurse is caring for a client diagnosed with a delusional disorder. While assessing this client, which of the following would the nurse expect to find? A) History of chronic major depression B) Consistently disrupting behavior patterns C) Verbalization of bizarre delusions D) Living with one or more delusions for a period of time

D

The nurse is caring for a client who was just admitted with a diagnosis of schizoaffective disorder with depression. Which agent would the nurse anticipate as being prescribed for this client? A) Lithium B) Haloperidol C) Chlorpromazine D) Clozapine

D

The nurse is caring for a family whose older father with dementia is living in their home. The nurse has instructed the family about how to decrease the father's agitation. The nurse determines that the son has understood the nurse's instructions when he states which of the following? A) "Restraints can help reduce my father's agitation." B) "I should place my father in the bedroom with me so I can watch him more closely." C) "It's important that he gets out shopping with me or my wife." D) "If I simplify our home environment, my father may be less agitated."

D

The nurse is caring for a family with a 3yearold child who has autism disorders. When developing the teaching plan for the parents, which of the following would the nurse most likely include? A) The child is at higher risk for seizure disorders as well. B) The child's IQ will typically be higher than that of other children. C) Dyslexia also may be a comorbid condition. D) A structured physical environment is an important aspect.

D

The nurse is caring for an older adult patient who has no history of violence but is agitated and appears ready to strike out at a staff member. The nurse would assess the patient for which of the following? A) Panic disorder B) Epilepsy C) Bipolar disorder D) Sensory losses

D

The nurse is caring for an older patient in a residential care facility. The patient has been extremely irritable the entire day. When modifying the patient's plan of care, which of the following would be an appropriate snack to offer the patient to decrease the irritability? A) Chocolate candy bar B) Handful of raisins C) Granola bar D) Glass of milk

D

The nurse is preparing to document information obtained from a client diagnosed with a delusional disorder who is experiencing somatic delusions. Which of the following would the nurse most likely document? A) Disorientation B) Reduced attention span C) Above average intelligence D) Body complaints

D

The nurse is reviewing the medical record of a client diagnosed with depression and notes that the client has been prescribed mirtazapine. The nurse interprets this information, identifying this agent as which type? A) Selective serotonin reuptake inhibitor B) Cyclic antidepressant C) Norepinephrine dopamine reuptake inhibitor D) Alpha2 antagonist

D

The school nurse is caring for a 7yearold child who has demonstrated a significantly lower than average score for mental age on standardized tests in reading. However, the child's IQ scores were within the average range. The nurse interprets this information as suggesting which of the following? A) Communication disorder B) Attention deficit hyperactivity disorder C) Asperger syndrome D) Dyslexia

D

When obtaining a client's history, the nurse determines that the client has been experiencing delusions and hallucinations for the past 3 months, which has caused some problems in his ability to function on a daily basis at work. He also is exhibiting catatonic excitement, echopraxia, loose associations, and pressured speech. The nurse suspects which of the following? A) Schizophrenia B) Schizoaffective disorder C) Brief Psychotic disorder D) Schizophreniform disorder

D

Which of the following would a nursing instructor identify when describing the area of the brain involved with verbal language function, including areas for both receptive and expressive speech? A) Right hemisphere B) Parietal lobe C) Occipital lobe D) Left hemisphere

D

While leading a student class presentation about general adaptation syndrome and its stages, which of the following would the student describe as the final stage? A) Perception of a threat B) Use of coping mechanisms C) Physiologic response D) Exhaustion

D

What event is associated with mental disorders beginning to be viewed as illnesses required treatment?

Establishment of Pennsylvania Hospital in Philly

What was a result of the Mental Health Act?

Establishment of the National Institute of Mental Health

American Nurses Association Statesment on Psych Nursing Practice (1967)- sanctioned the involvement of pysch-mental health nurses in the provision of holistic care. Who was the most strongly linked to this holistic approach?

Florence Nightingale's Notes on Nursing

Who played a major role in the development of specialty training programs for psych nursing?

Hildegarde Peplau

Whose concepts were based on the implementing the therapeutic use of self?

Hildegarde Peplau

When implementing EBP this approach is developed by doing what first?

Identifying a clinical question

Most current legislative and policy effort influencing mental health currently?

Mental Health: A Report of the Surgeon General

During WWII what key event took place that influenced mental health?

People began to view mental illness as common and acceptable

What event occurred first in the development of psych nursing?

Publication of the first pysch nursing text, Nursing Mental Disease by Harriet Bailey

Psych nursing in relation to nursing history

There is a historical link between the first nursing program to admit male students and the first training school for psych nursing

What is a goal of the New Freedom Commission on Mental Health?

consumer and family are the driving forces for mental health care

Primary goal for mental health services?

recovery from mental illness

Facts about EBP in mental health nursing:

research findings, expert opinion, clinical experiences, patient data