Psych Midterm
A nurse is teaching a client about stress-reduction techniques. Which of the following client statements indicates understanding of the teaching? A. "Cognitive reframing will help me change my irrational thoughts to something positive." B. "Progressive muscle relaxation uses a mechanical device to help me gain control over my pulse rate." C. "Biofeedback causes my body to release endorphins so that I feel less stress and anxiety." D. Mindfulness allows me to prioritize the stressors that I have in my life so that I can have less anxiety."
A. "Cognitive reframing will help me change my irrational thoughts to something positive."
A nurse is assessing a client who has major depressive disorder. the nurse should identify which of the following client statements as an overt communication about suicide? (Select all that apply) A. "My family will be better off if I'm dead." B. "The stress in my life is too much to handle." C. "I wish my life was over." D. "I don't feel like I can ever be happy again." E. "If I kill myself then my problems will go away."
A. "My family will be better off if I'm dead." C. "I wish my life was over." E. "If I kill myself then my problems will go away."
A nurse is caring for a client who is screaming at staff members and other clients. Which of the following is a therapeutic response by the nurse to the client? A. "Stop screaming and walk with me outside." B. "Why are you so angry and screaming at everyone?" C. "You will not get your way by screaming." D. "What was going through your mind when you started screaming?"
A. "Stop screaming and walk with me outside."
A charge nurse is discussing Mirtazapine with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates understanding? A. "This medication increases the release of serotonin and norepinephrine." B. "I should tell the client about the likelihood of insomnia while talking this medication." C. "This medication is contraindicated for clients who have an eating disorder." D. "Sexual dysfunction is a common adverse effect of this medication."
A. "This medication increases the release of serotonin and norepinephrine."
A charge nurse is discussing mental status examinations with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching? (Select all that apply) A. "To assess cognitive ability, I should ask the client to count backwards by sevens" B. To assess affect, I should observe the client's facial expression" C. To assess language ability, I should instruct the client to write a sentence" D. To assess remote memory, I should have the client repeat a list of objects" E. To assess abstract thinking, I should ask the client to identify our most recent president"
A. "To assess cognitive ability, I should ask the client to count backward by sevens" B. "To assess affect, I should observe the client's facial expression" C. " To assess language ability, I should instruct the client to write a sentence"
A nurse is caring for a client who has substance-induced psychotic disorder and is experiencing auditory hallucinations. The client states, "The voices won't leave me alone!" Which of the following statements should the nurse make? (Select all that apply) A. "When did you start hearing these things?" B. "The voices are not real, or else we would both hear them." C. "It must be scary to hear voices." D. "Are the voices telling you to hurt yourself?" E. "Why are the voices talking to only you?"
A. "When did you start hearing these things?" C. "It must be scary to hear voices." D. "Are the voices telling you to hurt yourself?"
A nurse is discussing routine follow-up needs with a client who has a new prescription for valproate. The nurse should inform the client of the need for routine monitoring of...? A. AST/ALD and LDH B. Creatinine and BUN C. WBC and granulocyte counts D. Blood sodium and potassium
A. AST/ALD and LDH these are liver function tests, they are necessary due to the risk of hepatotoxicity
A nurse is caring for a client who is experiencing extreme mania due to bipolar disorder. Prior to administration of lithium carbonate, the client's lithium blood level is 1.2 mEq/L. Which of the following actions should the nurse take? A. Administer the next dose of lithium carbonate as scheduled B. Prepare for administration of aminophylline C. Notify the provider for a possible increase int he dosage of lithium carbonate D. Request a stat repeat of the client's lithium blood leve
A. Administer the next dose of lithium carbonate as scheduled During a manic episode, the lithium level is expected to be raised (0.8-1.4), therefore it is appropriate to administer the next dose as scheduled
A charge nurse is discussing manifestation of schizophrenia with a newly licensed nurse. Which of the following manifestations should the charge nurse identify as being effectively treated by an FGA? (Select all that apply) A. Auditory hallucinations B. Withdrawal from social situations C. Delusions of grandeur D. Severe agitation E. Anhedonia
A. Auditory hallucinations C. Delusions of grandeur D. Severe agitation
A nurse is completing an admission assessment for a client who has schizophrenia. Which of the following findings should the nurse document as positive symptoms? (Select all that apply) A. Auditory hallucinations B. Lack of motivation C. Use of clang associations D. Delusion of persecution E. Constantly waving arms F. Flat affect
A. Auditory hallucinations C. Use of clang associations D. Delusion of persecution E. Constantly waving arms
A nurse is caring for a client who has a new prescription for disulfiram for treatment of alcohol use disorder. The nurse informs the client that this medication can cause nausea and vomiting if he drinks alcohol. Which of the following types of treatment is this method an example of? A. Aversion therapy B. Flooding C. Biofeedback D. Dialectical behavior therapy
A. Aversion therapy
A nurse is assisting with the development of protocols to address the increasing number of suicide attempts in the community. Which of the following interventions should the nurse include as a primary intervention? (Select all that apply) A. Conducting a suicide risk screening on all new patients B. Creating a support group for family members of clients who completed suicide C. Educating high school teens about suicide prevention D. Indicating one-to-one observation for a client who has current suicidal ideation E. Teaching middle school educators about warning indicators of suicide
A. Conducting a suicide risk screening on all new patients C. Educating high school teens about suicide prevention E. Teaching middle school educators about warning indicators of suicide
A nurse is planning care for the termination phase of a nurse-client relationship. Which of the following actions should the nurse include in the plan of care? A. Discussing ways to use new behaviors B. Practicing new problem-solving skills C. Developing goals D. Establishing boundaries
A. Discussing ways to use new behaviors
A nurse is preparing an educational seminar on stress for other nursing staff. Which of the following information should the nurse include in the discussion? A. Excessive stressors cause the client to experience distress B. the body's initial adaptive response to stress is denial C. Absence of stressors results in homeostasis D. Negative, rather than positive, stressors produce a biological response
A. Excessive stressors cause the client to experience distress
The child with autism has difficulty with trust. With this in mind, which of the following nursing actions would be most appropriate? A. Let the child know in advance if there is any change in his caregiver's schedule B. Assign different staff member each day to the child learns that everyone can be trusted C. Allow for flexibility in the daily schedule D. Encourage the staff to hold the child as often as possible, conveying trust through touch
A. Let the child know in advance if there is any change in his caregiver's schedule
An aggressive client was placed in 4 point restraints and given an IM dose of anxiolytic med. Systematic assessment to guide interventions during the period of restrain should include: (Select all that apply) A. Level of awareness B. Elimination needs C. Nutritional needs D. Hydration E. ROM and comfort needs F. Vital signs
A. Level of awareness B. Elimination needs C. Nutritional needs D. Hydration E. ROM and comfort needs F. Vital signs
A nurse is communicating with a client who was just admitted for treatment of a substance use disorder. Which of the following communication techniques should the nurse identify as a barrier to therapeutic communication? A. Offering advise B. Reflecting C. Listening attentively D. Giving information
A. Offering advise
A nurse is caring for a client who takes ziprasidone. The client reports difficulty swallowing the oral medication and become extremely agitated with injectable administration. The nurse should contact the provider to discuss a change to which of the following medications? (Select all that apply). A. Olanzapine (Zyprexa) B. Quetiapine (Seroquel) C. Aripiprazole (Abilify) D. Clozapine (Clozaril) E. Asenapine (Saphris)
A. Olanzapine (Zyprexa) C. Aripiprazole (Abilify) D. Clozapine (Clozaril) E. Asenapine (Saphris)
A nurse working on an acute mental health unit is admitting a client who has a major depressive disorder and co-morbid anxiety disorder. Which of the following actions is the nurse's priority? A. Placing the client on one-to-one observation B. Assisting the client to perform ADLs C. Encouraging the client to participate in counseling D. Teaching the client about medication adverse effects
A. Placing the client on one-to-one observation
Which patient behavior is a criterion for mechanical restraints? A. Spitting at a family member during visiting hours B. Refusing a medication dose C. Throwing a pillow at another patient D. Assaulting a staff person E. Screaming profanities
D. Assaulting a staff person
A nurse is preparing to implement cognitive reframing techniques for a client who has an anxiety disorder. Which of the following techniques should the nurse include in the plan of care? (Select all that apply) A. Priority restructuring B. Monitoring thoughts C. Diaphragmatic breathing D. Journal keeping E. Meditation
A. Priority restructuring B. Monitoring thoughts D. Journal keeping
A client is admitted for psychiatric observation after being arrested for breaking windows in the home of his ex-gf, who has refused to see him. His history reveals abuse as a child by a punitive father, torturing family pets, and one arrest for disorderly conduct. The nursing diagnosis that should be considered for development is: A. Risk for other-directed violence B. Risk for injury C. Disturbed thought process D. Post-traumatic syndrome
A. Risk for other-directed violence
A nurse is told during change-of-shift that a client is stuporous. When assessing the client, which of the following findings should the nurse expect? A. The client arouses briefly in response to a sternal rub B. The client has a Glasgow Coma Score less than 7 C. The client exhibits decorticate rigidity D. The client is alert but disoriented to time and place
A. The client arouses briefly in response to a sternal rub
A nurse is teaching a client who has a new prescription for Imipramine how to minimize anticholinergic effects. Which of the following instructions should the nurse include in the teaching? (Select all that apply) A. Void before taking the medication B. Increase the dietary intake of potassium C. Wear sunglasses when outside D. Change positions slowly when getting up E. Chew sugarless gum
A. Void before taking the medication C. Wear sunglasses when outside E. Chew sugarless gum Imipramine is a TCA Not D because orthostatic hypotension is not an anticholinergic effect
A nurse is caring for a client who is in mechanical restraints. Which of the following statements should the nurse include in the documentation? (Select all that apply) A. "Client ate most of his breakfast" B. "Client was offered 8oz of water every hour" C. "Client shouted obscenities at the assistive personnel" D. "Client received chlorpromazine 5mg by mouth at 1000" E. "Client acted out after lunch"
B. "Client was offered 8oz of water every hour" C. "Client shouted obscenities at the assistive personnel" D. "Client received chlorpromazine 5mg by mouth at 1000"
A nurse is caring for a client who has bipolar disorder. The client states, "I am very rich and I feel I must give my money to you." Which of the following responses should the nurse make? A. "Why do you think you feel the need to give money away?" B. "I am here to provide you with care and cannot accept this from you." C. "I can request that your case manager discuss appropriate charity options with you." D. "You should know that giving away your money is inappropriate."
B. "I am here to provide you with care and cannot accept this from you."
A nurse is caring for a client who has schizoaffective disorder. Which of the following statements indicates the client is experiencing depersonalization? A. "I am a superhero and I am immortal." B. "I am no one, and everyone is me." C. "I feel monsters pinching me all over." D. "I know that you are stealing my thoughts."
B. "I am no one, and everyone is me."
A nurse is providing teaching to a client who has a new prescription for amitriptyline. Which of the following statements by the client indicates an understanding of the teaching? A. "I can expect to experience diarrhea while taking this medication." B. "I may feel drowsy for a few weeks after starting this medication." C. "I cannot eat my favorite pizza with pepperoni while taking this medication." D. "This medication will help me lose the weigh that I have gained over the last year."
B. "I may feel drowsy for a few weeks after starting this medication." Amitriptyline is a Tricyclic Antidepressant (TCA)
A nurse is caring for a client who is prescribed lithium therapy. The client plants to take ibuprofen for osteoarthritis pain relief. Which of the following statements should the nurse make? A. "That is a good choice. Ibuprofen does not interact with lithium." B. "Regular aspirin would be a better choice than ibuprofen." C. "Lithium decreases the effectiveness of ibuprofen." D. "The ibuprofen will make your lithium level fall too low."
B. "Regular aspirin would be a better choice than ibuprofen."
A nurse is teaching a client who has an anxiety disorder and is scheduled to begin classical psychoanalysis. Which of the following client statements indicates an understanding of this form of therapy? A. "Even if my anxiety improves, I will need to continue this therapy for 6 weeks" B. "The therapist will focus on my past relationships during our sessions" C. "Psychoanalysis will help me reduce my anxiety by changing my behavior" D. "This therapy will address my conscious feelings about stressful experiences"
B. "The therapist will focus on my past relationships during our sessions"
A client is pacing the hall near the nurses station, swearing loudly. An appropriate initial intervention for the nurse would be to address the client by name and say... A. "Please quiet down." B. "You seem upset, tell me about it." C. "Hey, what's up?" D. "You need to go to your room to get control of yourself."
B. "You seem upset, tell me about it."
A nurse is caring for a client who has early stage Alzheimer's disease and a new prescription for donepezil. The nurse should include which of the following statements when teasing the client about the medication? A. "You should avoid taking OTC acetaminophen while on donepezil." B. "You should take this medication before going to bed at the end of the day." C. "You will be screened for underlying kidney disease prior to starting this medication." D. "You should stop taking donepezil if you experience nausea or diarrhea."
B. "You should take this medication before going to bed at the end of the day."
A nurse is speaking with a client who has schizophrenia when the client suddenly seems to stop focusing on the nurse's questions and begins looking at the ceiling and talking to themselves. Which of the following actions should the nurse take? A. Stop the interview at this point, and resume later when the client is better able to concentrate B. Ask the client, "Are you seeing something on the ceiling?" C. Tell the client, "You seem to be looking at something on the ceiling. I see something there, too." D. Continue the interview without comment on the client's behavior
B. Ask the client, "Are you seeing something on the ceiling?"
A nurse is assessing a client in an inpatient mental health unit. Which of the following findings should the nurse expect if the client is in the pre-assaultive stage of violence? (Select all that apply) A. Lethargy B. Defensive responses to questions C. Disorientation D. Facial grimacing E. Agitation
B. Defensive responses to questions D. Facial grimacing E. Agitation
A nurse is planning group therapy for clients dealing with bereavement. Which of the following activities should the nurse include in the initial phase? (Select all that apply) A. Encourage the group to work towards goals B. Define the purpose of the group C. Discuss termination of the group D. Identify informal roles of members within the group E. Establish an expectation of confidentiality within the group
B. Define the purpose of the group C. Discuss termination of the group E. Establish an expectation of confidentiality within the group
A nurse is caring for a client who smokes and has lung cancer. The client reports, "I'm coughing because I have that cold that everyone has been getting." The nurse should identify that the client is using which of the following defense mechanisms? A. Reaction formation B. Denial C. Displacement D. Sublimation
B. Denial
A nurse is discussing acute vs. prolonged stress with a client. Which of the following effects should the nurse identify as an acute stress response? (select all that apply) A. Chronic pain B. Depressed immune system C. Increased blood pressure D. Panic attacks E. Unhappiness
B. Depressed immune system C. Increased blood pressure E. Unhappiness
A nurse is discussing relapse prevention with a client who has bipolar disorder. Which of the following information should the nurse include in the teaching? (Select all that apply.) A. Use caffeine in moderation to prevent relapse B. Difficulty sleeping can indicate a relapse C. Begin taking your medication as soon as a relapse begins D. Participating in psychotherapy can help prevent a relapse E. Anhedonia is a clinical manifestation of a depressive relapse
B. Difficulty sleeping can indicate a relapse D. Participating in psychotherapy can help prevent a relapse E. Anhedonia is a clinical manifestation of a depressive relapse
A nurse is caring for a client who is experiencing moderate anxiety. Which of the following actions should the nurse take when trying to give necessary information to the client? (select all that apply) A. Reassure the client that everything will be okay B. Discuss prior use of coping mechanisms with the client C. Ignore the client's anxiety so that she will not be embarrassed D. Demonstrate a calm manner while using simple and clear directions E. Gather information from the client using closed-ended questions
B. Discuss prior use of coping mechanisms with the client D. Demonstrate a calm manner while using simple and clear directions
A nurse is assessing a client who is currently taking perphenazine. Which of the following findings should the nurse identify as an EPS? (Select all that apply) A. Decreased LOC B. Drooling C. Involuntary arm movements D. Urinary retention E. Continual pacing
B. Drooling C. Involuntary arm movements E. Continual pacing
A nurse decides to put a client who has a psychotic disorder in the seclusion room overnight because the unit is very short staffed, and the client frequently gets in fights with other clients. The nurses actions are an example of which of the following torts? A. Invasion of privacy B. False imprisonment C. Assault D. Battery
B. False imprisonment
A nurse is performing an admission assessment for a client who has delirium related to an acute UTI. Which of the following findings should the nurse expect? (Select all that apply) A. History of gradual memory loss B. Family report of personality changes C. Hallucinations D. Unaltered LOC E. Restlessness
B. Family report of personality changes C. Hallucinations E. Restlessness
2 hours after a client lost control and required restraints and PRN meds, she is out of restraints, calm, and sitting in her room reading. The post-intervention debriefing process should include: (Select all that apply) A. Suggesting that the client may wish to apologize B. Helping the client identify the precipitating event C. Avoid mentioning the incident D. Reviewing possible alternative coping strategies E. Reestablishing therapeutic communication and rapport with the client
B. Helping the client identify the precipitating event D. Reviewing possible alternative coping strategies E. Reestablishing therapeutic communication and rapport with the client
A nurse is caring for a client who has major depressive disorder. Which of the following should the nurse identify as a risk factor for depression? (Select all that apply.) A. Male sex B. History of chronic bronchitis C. Recent death in client's family D. Family history of depression E. Personal history of panic disorder
B. History of chronic bronchitis C. Recent death in client's family D. Family history of depression E. Personal history of panic disorder
A nurse in an outpatient mental health clinic is preparing to conduct an initial client interview. When conducting the interview, which of the following actions should the nurse identify as the priority? A. Coordinate holistic care with social services B. Identify the client's perception of her mental health status C. Include the client's family in the interview D. Teach the client about her current mental health disorder
B. Identify the client's perception of her mental health status
A nurse is caring for a client on an acute mental health unit. The client reports heading voices that are stating, "kill your doctor." Which of the following actions should the nurse take first? A. Encourage the client to participate in group therapy B. Initiate one-to-one observation C. Focus the client on reality D. Notify the provider of the client's statement
B. Initiate one-to-one observation
Which statement about aggression would serve as the rational for care planning using behavioral techniques? Aggression... A. Runs in families and is manifested as early as infancy B. Is motivated by rewards received for previous aggression C. Results from low levels of the neurotransmitter serotonin D. Results from abnormalities in the temporal lobe
B. Is motivated by rewards received for previous aggression
A nurse is caring for a client who states, "I plan to commit suicide." Which of the following assessments should the nurse identify as the priority? A. Client's educational and economic background B. Lethality of method and availability of means C. Quality of the client's social support D. Client's insight into the reasons for the decision
B. Lethality of method and availability of means
A nurse is conducting a family therapy session. The adolescent son tells the nurse that he plans ways to make his sister look bad so his parents think he's the better sibling, which he believes will give him more privileges. The nurse should identify this dysfunctional behavior as which of the following? A. Placation B. Manipulation C. Blaming D. Distraction
B. Manipulation
A nurse is reviewing the medical records of multiple clients at a community mental health facility. Which of the following events is an example of a client experiencing a maturational crisis? A. Rape B. Marriage C. Severe physical illness D. Job loss
B. Marriage
A nurse is providing pre-op teaching for a client who was just informed that she requires emergency surgery. The client, has a respiratory rate of 30/min, and says, "This is difficult to comprehend. I feel shaky and nervous." The nurse should identify that the client is experiencing which of the following levels of anxiety? A. Mild B. Moderate C. Severe D. Panic
B. Mild
A nurse is planning care for a client who has bipolar disorder and is experiencing a manic episode. Which of the following interventions should the nurse include in the plan of care? (Select all that apply) A. Provide flexible client behavior expectations B. Offer concise explanations C. Establish consistent limits D. Disregard client concerns E. Use a firm approach with communication
B. Offer concise explanations C. Establish consistent limits E. Use a firm approach with communication
A nurse is caring for a client who is taking phenelzine. For which of the following manifestation should the nurse monitor as an adverse effect of this medication? (Select all that apply) A. Elevated blood glucose level B. Orthostatic hypotension C. Priapism D. Hypomania E. Bruxism
B. Orthostatic hypotension D. Hypomania Phenelzine is an MAIO Antidepressant
A nurse is caring for a client who is experiencing a crisis. Which of the following medications might the provider prescribe? (Select all that apply) A. Lithium carbonate B. Paroxetine C. Risperidone D. Haloperidol E. Lorazepam
B. Paroxetine (SSRI) E. Lorazepam (Benzodiazepine)
A nurse is discussing early indications of toxicity with a client who has a new prescription for lithium carbonate for bipolar disorder. The nurse should include which of the following manifestations in the teaching? (Select all that apply) A. Constipation B. Polyuria C. Rash D. Muscle weakness E. Tinnitus
B. Polyuria D. Muscle weakness
A nurse is caring for a client in active alcohol withdrawals on a med-surg unit. The client is observed speaking in a loud voice, using profanity with clenched fists. Which of the following actions should the nurse take? A. Walk away from the client B. Request that other staff members remain close by C. Insist that the client stop yelling D. Move as close to the client as possible
B. Request that other staff members remain close by
A nurse is caring for a client who is speaking in a loud voice with clenched fists. Which of the following actions should the nurse take? A. Insist that the client stop yelling B. Request that other staff members remain close by C. Move as close to the patient as possible D. Walk away from the client
B. Request that other staff members remain close by
A nurse hears a newly licensed nurse discussing a client's hallucinations in the hallway with another nurse. Which of the following actions should the nurse take first? A. Notify the nurse manager B. Tell the nurse to stop discussing the behavior C. Provide an in-service program about confidentiality D. Complete an incident report
B. Tell the nurse to stop discussing the behavior
A nurse is planning a peer group discussion about the DSM-5. Which of the following information is appropriate to include in the discussion? (select all that apply) A. The DSM-5 includes client education handouts for mental health disorders B. The DSM-5 establishes diagnostic criteria for individual mental health disorders C. The DSM-5 indicates recommended pharmacological treatment for mental health disorders D. The DSM-5 assists nurses in planning care for clients who have mental health disorders E. The DSM-5 indicates expected assessment findings of mental health disorders
B. The DSM-5 establishes diagnostic criteria for individual mental health disorders D. The DSM-5 assists nurses in planning care for clients who have mental health disorders E. The DSM-5 indicates expected assessment findings of mental health disorders
A nurse is in the working phase of a therapeutic relationship with a client who has a methamphetamine use disorder. Which of the following actions indicates transference behavior? A. The client asks the nurse whether she will go out to dinner with him B. The client accuses the nurse of telling him what to do just like this ex-girlfriend C. The client reminds the nurse of a friend who died from substance overdose D. The client becomes very angry and threatens to harm himself
B. The client accuses the nurse of telling him what to do just like this ex-girlfriend
The client on the mental health unit who should be assessed as being highest risk for directing violent behavior towards others is... A. The client who has completed alcohol withdrawal and is beginning rehab B. The client who has paranoid delusions that she is being followed by members of the mafia C. The client who has OCD and performs many rituals D. The client who has severe depression with delusions of worthlessness
B. The client who has paranoid delusions that she is being followed by members of the mafia
A nurse is talking with a client who reports experiencing increased stress because a new partner is "pressuring me and my kids to go live with him. I love him, but I'm not ready to do that." Which of the following recommendations should the nurse make to promote a change in the client's function? A. Learn to practice mindfulness B. Use assertive techniques C.Exercise regularly D. Rely on the support of a close friend
B. Use assertive techniques
A nurse is teaching a newly licensed nurse about the use of electroconvulsive therapy for the treatment of bipolar disorder. Which of the following statements by the newly licensed nurse indicates understanding? A. "ECT is the recommended initial treatment for bipolar." B. "ECT is contraindicated for clients who have suicidal ideation." C. "ECT is effective for clients who are experiencing severe mania." D. "ECT is prescribed to prevent a relapse of bipolar disorder."
C. "ECT is effective for clients who are experiencing severe mania."
A nurse is teaching a client who has a new diagnosis of premenstrual dysphoric disorder. Which of the following statements made by the client indicates understanding of the teaching? A. "I can expect my problems with PMDD to be worst when I'm menstruating." B. "I should avoid exercising when I am feeling depressed." C. "I am aware that my PMDD causes me to have rapid mood swings." D. "I should increase my caloric intake with nutritional supplement when my PMDD is active."
C. "I am aware that my PMDD causes me to have rapid mood swings."
A nurse is providing discharge teaching for a client who has schizophrenia and a new prescription for Iloperidone. Which of the following client statements indicates understanding of the teaching? A. "I will be able to stop taking this medication as soon as I feel better." B. "If i feel drowsy during the day, I will stop taking this medication and call my provider." C. "I will be careful not to gain too much weight while taking this medication." D. "This medication is highly addictive and must be withdrawn slowly."
C. "I will be careful not to gain too much weight while taking this medication." Iloperidone (Fanapt) is an SGA with a high risk of weight gain
A nurse is talking with a client who is at risk for suicide following the death of his spouse. Which of the following statements should the nurse make? A. "I feel very sorry for the loneliness you must be experiencing" B. "Suicide is not the appropriate way to cope with loss" C. "Losing someone close to you must be very upsetting" D. "I know how difficult it is to lose a loved one"
C. "Losing someone close to you must be very upsetting"
A charge nurse is discussing the care of a client who has major depressive disorder with a newly licensed nurse. Which of the following statements made by the newly licensed nurse indicates an understanding of the teaching? A. "Care during the continuation phase focuses on treating continued manifestations of MDD." B. "The treatment of MDD during the maintenance phase lasts for 6-12 weeks." C. "The client is at greatest risk for suicide during the first weeks of an MDD episode." D. "Medication and psychotherapy are most effective during the acute phase of MDD."
C. "The client is at greatest risk for suicide during the first weeks of an MDD episode."
A nurse is orientating a new client to a mental health unit. When explaining the unit's community meetings, which of the following statements should the nurse make? A. "You and a group of other clients will meet to discuss your treatment plans" B. "Community meetings have a specific agenda that is established by staff" C. "You and the other clients will meet with staff to discuss common problems" D. "Community meetings are an excellent opportunity to explore your personal mental health issues"
C. "You and the other clients will meet with staff to discuss common problems"
A nurse in an emergency mental health facility is caring for a group of clients. The nurse should identify that which of the following clients requires a temporary emergency admission? A. A client who has schizophrenia with delusions of grandeur B. A client who has manifestations of depression and attempted suicide a year ago C. A client who has borderline personality disorder and assaulted a homeless man with a metal rod D. A client who has bipolar disorder and paces quickly around the room while talking to himself
C. A client who has borderline personality disorder and assaulted a homeless man with a metal rod
A nurse is working with an established group and identified various member roles. Which of the following should the nurse identify as an individual role? A. A member who praises input from other members B. A member who follows the direction of other members C. A member who brags about accomplishments D. A member who evaluates the group's performance toward a standard
C. A member who brags about accomplishments
The nurse directs the intervention team who must take an aggressive client to seclusion. Other clients have been removed from the area. Before approaching the client, the nurse should ensure staff to: (Choose all that apply) A. Move behind the client to use the element of surprise B. Quickly approach the client and take hold of the closest arm and leg C. Appoint a person to clear a path and open, close, or lock doors D. Select the person who will communicate with the client E. Remove jewelry, glasses, and harmful items from their persons
C. Appoint a person to clear a path and open, close, or lock doors D. Select the person who will communicate with the client E. Remove jewelry, glasses, and harmful items from their persons
A nurse wants to use democratic leadership with a group whose purpose is to learn appropriate conflict resolution techniques. The nurse is correct in implementing this form of group leadership when she demonstrates which of the following actions? A. Observes group techniques without interfering with the group process B. Discusses a technique and then directs members to practice the technique C. Asks for group suggestions of techniques and then supports discussion D. Suggests techniques and asks group members to reflect on their use
C. Asks for group suggestions of techniques and then supports discussion
A nurse is assisting with systematic desensitization for a client who has an extreme fear of elevators. Which of the following actions should the nurse implement with this form of therapy? A. Demonstrate riding in an elevator, and then ask the client to imitate the behavior B. Advise the client to say "stop" out loud every time he begins to feel an anxiety response related to an elevator C. Gradually expose the client to an elevator while practicing relaxation techniques D. Stay with the client in an elevator until his anxiety response diminishes
C. Gradually expose the client to an elevator while practicing relaxation techniques
A client has, in the past had a nursing diagnosis of ineffective coping r/t impulsively acting out anger aeb striking others. An appropriate plan for forestalling such incidents would be: A. Offer one-to-one supervision to help the client maintain control B. Request that the client receive Lorazepam (Ativan) every 4 hr to reduce anxiety C. Helping a client identify incidents that trigger impulsive acting out D. Explaining that restrain and seclusion will be used if violence occurs
C. Helping a client identify incidents that trigger impulsive acting out
A charge nurse is discussing the characteristics of a nurse-client relationship with a newly licensed nurse. Which of the following characteristics should the nurse include in the discussion? (select all that apply) A. The needs of both participants are met B. An emotional commitment exists between the participants C. It is goal-directed D. Behavioral change is encouraged E. A termination date is established
C. It is goal-directed D. Behavioral change is encouraged E. A termination date is established
A nurse is caring for a client in an inpatient facility who gets up from a chair and throws it across the room. Which of the following is the priority nursing action? A. Encourage the patient to express feelings out loud B. Maintain eye contact with the client C. Move the client away from others D. Tell the client that the behavior is not acceptable
C. Move the client away from others
A nurse is interviewing a client who has a new diagnosis of persistent depressive disorder. Which of the following findings should the nurse expect? A. Wide fluctuations in mood B. Report of a minimum of 5 clinical findings of depression C. Presence of manifestations for at least 2 years D. Inflated sense of self-esteem
C. Presence of manifestations for at least 2 years
A nurse is making a home visit to a client who is in the late stages of Alzheimer's disease. the client's partner, who is the primary care giver, wishes to discuss concerns about the client's nutrition and the stress of providing care. Which of the following actions should the nurse take? A. Verify that the current power of attorney is on file B. Instruct the client's partner to offer finger foods to increase oral intake C. Provide information on resources for respite care D. Schedule the client for placement of an enternal feeding tube
C. Provide information on resources for respite care
A nurse is caring for a client who has schizophrenia and exhibits a lack of grooming and a flat affect. The nurse should expect a prescription for which of the following medication? A. Chlorprozamine (Clozaril) B. Thiotixene (Navane) C. Risperidone (Risperdal) D. Haloperidol (Haladol)
C. Risperidone (Risperdal) Lack of grooming and flat affect are negative symptoms. Risperdal is an SGA which are effective in treating negative symptoms
A client tells a nurse, "Don't tell anyone, but I hid a sharp knife under my mattress in order to protect myself from my roommate, who is always yelling at me and threatening me." Which of the following actions should the nurse take? A. Keep the client's communication confidential, but talk to the client daily, using therapeutic communication to convince him to admit to having the knife B. Keep the client's communication confidential, but watch the client and his roommate closely C. Tell the client that this must be reported to the health care team because it concerns the health and safety of the client and others D. Report the incident to the health care team, but do not inform the client of doing so
C. Tell the client that this must be reported to the health care team because it concerns the health and safety of the client and others
A nurse is reviewing the medical record of a client who has a new prescription for Bupropion for depression. Which of the following findings is the priority for the nurse to report to the provider? A. The client has a family history of seasonal pattern depression B. The client currently smokes 1.5 packs of cigarettes per day C. The client had a motor vehicle crash last year and sustained a head injury. D. The client has a BMI of 25 and has gained 10 lb over the last year
C. The client had a motor vehicle crash last year and sustained a head injury. Bupropion is an SSRI
A nurse is caring for a client who has anorexia nervosa. Which of the following examples demonstrates the nurse's use of interpersonal communication? A. The nurse discusses the client's weight loss during a health care team meeting B. The nurse examines her own personal feelings about clients who have anorexia nervosa C. The nurse asks the client about her body image perception D. The nurse presents an educational session about anorexia nervosa to a large group of adolescents
C. The nurse asks the client about her body image perception
A nurse is admitting a client who has a new diagnosis of bipolar disorder and is scheduled to begin lithium therapy. When collecting a medical history from the client's caregiver, which of the following statements is the priority to report to the provider? A. "Current medication conditions include diabetes that is controlled by diet." B. "Recent medications include a course of prednisone for acute bronchitis" C. "Current vaccinations include a flu vaccine last month." D. "Current medications include furosemide for congestive heart failure."
D. "Current medications include furosemide for congestive heart failure."
A nurse in a long-term care facility is caring for a client who has major neurocognitive disorder and attempts to wander out of the building. The client states, "I have to get home." Which of the following statements should the nurse make? A. "You have forgotten that this is your home." B. "You cannot go outside without a staff member." C. "Why would you want to leave? Aren't you happy with your care here?" D. "I am your nurse. Let's walk together to your room.:
D. "I am your nurse. Let's walk together to your room.:
A nurse is discussing free association as a therapeutic tool with a client who has major depressive disorder. Which of the following client statements indicates understanding of this technique? A. "I will write down my dreams as soon as I wake up" B. "I may begin to associate my therapist with important people in my life" C. "I can learn to express myself in a nonaggressive manner" D. "I should say the first thing that comes to my mind"
D. "I should say the first thing that comes to my mind"
A nurse is caring for the parents of a child who has demonstrated recent changes in behavior and mood. When the mother asks the nurse for reassurance about her son's condition, which of the following responses should the nurse make? A. "I think your son is getting better. What have you noticed?" B. "I'm sure everything will be okay. It just takes time to heal" C. "I'm not sure what's wrong. Have you asked the doctor about your concerns?" D. "I understand you're concerned. Let's discuss what concerns you specifically."
D. "I understand you're concerned. Let's discuss what concerns you specifically."
A nurse is caring for a client who states, "I'm so stressed at work because of my coworker. I am expected to finish others' work because of their laziness!" When discussing effective communication, which of the following statements by the client to the coworker indicates client understanding? A. "You really should complete your own work. I don't think it's right to expect me to complete your responsibilities." B. "Why do you expect me to finish your work? You must realize that I have my own responsibilities." C. "It is not fair to expect me to complete your work. If you continue, then I will report your behavior to the supervisor." D. "When I have to pick up extra work, I feel very overwhelmed. I need to focus on my own responsibilities."
D. "When I have to pick up extra work, I feel very overwhelmed. I need to focus on my own responsibilities."
A nurse is conducting group therapy with a group of clients. Which of the following statements made by a client is an example of aggressive communication? A. "I wish you would not make me angry." B. "I feel angry when you leave me." C. "It makes me angry when you interrupt me." D. "You'd better listen to me."
D. "You'd better listen to me."
A nurse is conducting a class for a group of newly licensed nurses on caring for clients who are at risk for suicide. Which of the following information should the nurse include in the teaching? A. A client's verbal threat of suicide is attention-seeking behavior B. Interventions are ineffective for clients who really want to commit suicide C. Using the term "suicide" increases the client's risk for a suicide attempt D. A no-suicide contract decreases the client's risk for suicide
D. A no-suicide contract decreases the client's risk for suicide
The principle on which nursing intervention should be predicated when a client's aggression quickly escalates is: A. Immediately use physical containment measures B. Ask the client what will be most helpful C. Staff should match the client's affective level, tone of voice, and so on D. Begin with the least restricting measure possible
D. Begin with the least restricting measure possible
A nurse is caring for a client who is on suicide precautions. Which of the following interventions should the nurse include in the plan of care? A. Assign the client to a private room B. Document the client's behavior every hour C. Allow the client to keep perfume in her room D. Ensure that the client swallows medication
D. Ensure that the client swallows medication
The medication protocol the nurse should use to provide immediate intervention for an angry psychotic client whose aggressive behavior continues to escalate despite verbal intervention is: A. Lithium B. Trazodone C. Valproic Avid D. Haladol
D. Haladol
A nurse working on an acute mental health unit forms a group to focus on self-management of medications. At each of the meetings, 2 of the members use the opportunity to discus their common interest in gambling on sports. This is an example of which of the following concepts? A. Triangulation B. Group process C. Subgroup D. Hidden agenda
D. Hidden agenda
A charge nurse is conducting a class on therapeutic communication to a group of newly licensed nurses. Which of the following aspects of communication should the nurse identify as a component of verbal communication? A. Personal space B. Posture C. Eye contact D. Intonation
D. Intonation
A nurse is planning care for a client who has a mental health disorder. Which of the following actions should the nurse include as a psychobiological intervention? A. Assist the client with systematic desensitization therapy B. Teach the client appropriate coping mechanisms C. Assess the client for comorbid health conditions D. Monitor the client for adverse effects of medications
D. Monitor the client for adverse effects of medications
A nurse is caring for a client who has bipolar disorder. Which of the following is the priority nursing action? A. Set consistent limits for expected client behavior B. Administer prescribed medications are scheduled C. Provide the client with step-by-step instructions during hygiene activities D. Monitor the client for escalating behavior
D. Monitor the client for escalating behavior
A client who was brought into the ER intoxicated, suddenly removed a knife and threatens to kill himself or anyone who tried to stop him from leaving the room. A psychiatric emergency code is called and the client is safely disarmed and placed in restraints. The rationale for use of restraints was that the client: A. Clearly evidenced a thought disorder, rendering himself incapable of a rational decision B. Was psychotic C. Presented a clear escape risk D. Presented a clear and present danger to self and others
D. Presented a clear and present danger to self and others
A nurse in an acute mental health facility is communicating with a client. The client states, "I can't sleep. I stay up all night." The nurse response, "You are having difficulty sleeping?". Which of the following therapeutic communication techniques is the nurse demonstrating? A. Offering general leads B. Summarizing C. Focusing D. Restating
D. Restating
An effective nursing intervention for helping angry clients learn to manage anger without violence would be: A. Administer antipsychotic meds B. Providing negative reinforcement such as restraints or seclusion in response to angry outbursts, whether or not violence is present C. Administering anti-anxiety medications D. Using cognitive strategies to identify a thought that increases anger, find proof for or against the belief, and substitute reality-based thinking
D. Using cognitive strategies to identify a thought that increases anger, find proof for or against the belief, and substitute reality-based thinking
What is the team intervention used in nonviolent crisis intervention? A: ARD -- Assess, Restrain, Debrief B: CARE -- Combine, Assign, Redirect, Explain C: APT: Assess, Plan, Treat D: TIP: Team, Isolate, Plan
D: TIP: Team, Isolate, Plan
