JH personality disorder
Delusion of grandeur (grandiose)
"I am invincible. No one can beat me!" This is example of a______________
Delusion of reference
"I will receive my next mission through a message on the radio." This is an example of a________ (or idea)___________.
Which client is a nurse most likely to admit to an inpatient facility for self-destructive behaviors? A. A client diagnosed with antisocial personality disorder B. A client diagnosed with borderline personality disorder C. A client diagnosed with schizoid personality disorder D. A client diagnosed with paranoid personality disorder
B
A client is diagnosed with schizoaffective disorder and severe depression is being treated with antipsychotic medications. The client tells the nurse about difficulty with self-care activities. With which of the following interventions should the nurse respond? A. establish a routine and set goals B. outline the side effects of the medication C. contact the physician for a change in medications D. gain assistance from family members
A
A client tells the nurse, "My mother spent many years in a mental institution, and my father would abuse me when my mother was not around." Based on this information, the client is at greatest risk for developing which of the following conditions? A) A personality disorder B) Poor relationships with individuals of the opposite sex C) An eating disorder D) Substance abuse
A
A client who was admitted for treatment of a personality disorder is observed pulling another client's hair and pushing clients out of their chairs. What is the priority nursing intervention for this client? A) Removing the client from the room and addressing the behavior privately B) Establishing a therapeutic nurse-client relationship C) Placing the client in a jacket restraint D) Asking the client what purpose is served by disrupting others
A
A family member asks you, "As both of my siblings have schizophrenia, why are my brother's symptoms so different from my sister's? He withdraws when there's a change in his environment or routine. She starts cursing and yelling about the Mafia and the CIA when I do something that's less than perfect." Based on your knowledge, your response should address: A The many differences in the presentation of schizophrenia. B The significance of paranoid content in the differential diagnosis of paranoid schizophrenia. C The typical progression of symptoms within an individual over time. D The effect of gender on clinical presentation in schizophrenia.
A
A nurse is developing a plan of care for a client diagnosed with delusional disorder. Which of the following would the nurse need to keep in mind? A. clients with delusional disorder typically have problems with medication adherence B. female clients with delusional disorder often act on their delusions C. the delusions have probably just recently developed D. psychopharmacologic agents are quite helpful in alleviated the delusions
A
Clients receiving clozapine (Clozaril) must get white blood cell counts every... A. week for the first 6 months B. 6 months C. 3 months D. year
A
Family members of a client ask a nurse to explain the difference between schizoid and avoidant personality disorders. Which is the appropriate nursing reply? A. "Clients diagnosed with avoidant personality disorder desire intimacy but fear it, and clients diagnosed with schizoid personality disorder prefer to be alone." B. "Clients diagnosed with schizoid personality disorder exhibit odd, bizarre, and eccentric behavior, while clients diagnosed with avoidant personality disorder do not." C. "Clients diagnosed with avoidant personality disorder are eccentric, and clients diagnosed with schizoid personality disorder are dull and vacant." D. "Clients diagnosed with schizoid personality disorder have a history of psychotic thought processes, while clients diagnosed with avoidant personality disorder remain based in reality."
A
Which nursing approach should be used to maintain a therapeutic relationship with a client diagnosed with borderline personality disorder? A. Being firm, consistent, and empathic, while addressing specific client behaviors B. Promoting client self-expression by implementing laissez-faire leadership C. Using authoritative leadership to help clients learn to conform to society norms D. Overlooking inappropriate behaviors to avoid promoting secondary gains
A
Which of the following statements best reflects schizoaffective disorder? A. clients are often misdiagnosed as having schizophrenia B. mood symptoms must occur consistently with positive symptoms C. the symptoms typically run a fairly constant course D. delusions are present but hallucinations are absent
A
AUDIT Screening Tool
A 10-item screen can quickly identify substance abuse problems (known as Alcohol Use Disorders Identification Test) to catch risky drinkers to open their eyes
SBIRT stands for what? a. Screening b. brief interrogation c. referral to hospital d. brief intervention e. referral to treatment
A, D, E
Schizophrenia is associated with negative symptoms. in the assessment of a client with schizophrenia, which symptoms are classified as negative symptoms? select all that apply: a. lack of energy b. poor grooming c. illogical speech d. ideas of reference e. agitated behavior
A,B
While assessing a man during a physical examination for work, you suspect alcohol use. Which assessment tool is appropriate in this situation?
AUDIT Screening Tool
Fluoxetine (Prozac)
Antidepressant, SSRI; used for PTSD
Which of the following personality disorders is characterized by an inability to trust others; a rigid worldview that often conspiratorial in nature; and the belief that other people's actions are based on ulterior motives? A) Obsessive-compulsive personality disorder B) Paranoid personality disorder C) Schizoid personality disorder D) Schizotypal personality disorder
B
A client diagnosed with borderline personality disorder brings up a conflict with the staff in a community meeting and develops a following of clients who unreasonably demand modification of unit rules. How can the nursing staff best handle this situation? A. Allow the clients to apply the democratic process when developing unit rules. B. Maintain consistency of care by open communication to avoid staff manipulation. C. Allow the client spokesman to verbalize concerns during a unit staff meeting. D. Maintain unit order by the application of autocratic leadership.
B
A nurse is caring for a client with schizoaffective disorder. Which of the following statements indicates the client is experiencing depersonalization? A. "I am a superhero and 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
When obtaining a client's history, a nurse determines that the client has been experiencing delusions and hallucinations for the past 3 months, which has cause some problems in his ability to function at work. He is also exhibiting catatonic excitement, echopraxia, loose associations, and pressured speech. The nurse suspects which of the following? A. schizophrenia B. schizophreniform disorder C. brief psychotic disorder D. schizoaffective disorder
B
When planning care for a client diagnosed with borderline personality disorder, which self-harm behavior should a nurse expect the client to exhibit? A. The use of highly lethal methods to commit suicide B. The use of suicidal gestures to evoke a rescue response from others C. The use of isolation and starvation as suicidal methods D. The use of self-mutilation to decrease endorphins in the body
B
Which family member statements demonstrate recognition of the effects of social pressures associated with schizophrenia? (Select all that apply.) A "If my family member would just move in with me, it would be a lot easier for me to maintain my household and care for my children." B "It would be great if my family member could identify somebody to trust and believe when that person says, 'Your symptoms are worse. Let's go to the psychiatrist.'" C "I'll attend a support group, but I'm afraid my family member will not go...s/he would rather try to 'pass' as not mentally ill." D "I'm going to help my family member figure out what to tell other family members, friends, and business associates about why he's been on medical leave." E "I used to protect my family member from a lot of the interpersonal conflicts in the family, but we need to express our emotions more openly."
B, C, D
Which of the following would the nurse recognize as signs of alcohol withdrawal? select all that apply: a. Blackouts b. Diaphoresis c. Elevated blood pressure d. Lethargy e. Nausea f. Tremulousness
B,C,E,F
A client diagnosed with antisocial personality disorder comes to a nurses' station at 11:00 p.m. requesting to phone a lawyer to discuss filing for a divorce. The unit rules state that no phone calls are permitted after 10:00 p.m. Which nursing reply is most appropriate? A. "Go ahead and use the phone. I know this pending divorce is stressful." B. "You know better than to break the rules. I'm surprised at you." C. "It is after the 10:00 p.m. phone curfew. You will be able to call tomorrow." D. "The decision to divorce should not be considered until you have had a good night's sleep."
C
A client diagnosed with paranoid personality disorder becomes violent on a unit. Which nursing intervention is most appropriate? A. Provide objective evidence, that violence is unwarranted. B. Initially restrain the client to maintain safety. C. Use clear, calm statements and a confident physical stance. D. Empathize with the client's paranoid perceptions.
C
Have you ever felt you should Cut down on your drinking? Have people Annoyed you by criticizing your drinking? Have you ever felt bad or Guilty about your drinking? Have you ever had a drink first thing in the morning to steady your nerves (Eye-opener)?
CAGE screening tool
A highly emotional client presents at an outpatient clinic appointment wearing flamboyant attire, spiked heels, and theatrical makeup. Which personality disorder should a nurse associate with this assessment data? A. Compulsive personality disorder B. Schizotypal personality disorder C. Histrionic personality disorder D. Manic personality disorder
C
A nurse is designing a relapse-prevention inpatient group for clients with schizophrenia. Which statement addresses a main category of nursing activities? A "We're going to discuss current events." B "Let's go around the room and have each person say something positive about our group." C "If you can increase your self-assessment skills, you'll be able to tell when you're getting more stressed." D "We will go around the room and each person will state a personal goal for today."
C
When planning care for clients diagnosed with personality disorders, what should be the anticipated treatment outcome? A. To stabilize pathology with the correct combination of medications B. To change the characteristics of the dysfunctional personality C. To reduce inflexibility of personality traits that interfere with functioning and relationships D. To decrease the prevalence of neurotransmitters at receptor sites
C
Which of the following manifestations would the nurse least likely observe in a client with a Cluster B personality disorder? A) Dramatic behavior B) Erratic behavior C) Extreme fearfulness D) Extremely emotionality
C
A client is admitted with behavior consistent with borderline personality disorder. Which of the following interventions should the nurse anticipate for this client? A) Exercise therapy B) Vitamin B12 injections C) Occupational therapy D) Dialectical behavior therapy
D
A client w schizophrenia is admitted to an acute care psychiatric unit. which clinical findings indicate positive signs and symptoms o schizophrenia? a. withdrawal, poverty of speech, inattentiveness b. flat affect, decreased spontaneity, asocial behavior c. hypomania, labile mood swings, episodes of euphoria d. hyperactivity, auditory hallucinations, loose associations
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 someone is following him. A history reveals that he has had these alternating symptoms before. He has also experienced time with neither of these symptoms and 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
During an interview, which client statement indicates to a nurse that a potential diagnosis of schizotypal personality disorder should be considered? A. "I really don't have a problem. My family is inflexible, and every relative is out to get me." B. "I am so excited about working with you. Have you noticed my new nail polish: 'Ruby Red Roses'?" C. "I spend all my time tending my bees. I know a whole lot of information about bees." D. "I am getting a message from the beyond that we have been involved with each other in a previous life."
D
Which of the following client statements demonstrates the major symptoms of schizophrenia? A "I had too much to drink last night, started feeling all-powerful, and stupidly drove my truck into a tree." B "I've been depressed ever since our house was destroyed by fire." C "'A stitch in time saves nine' means that prevention is easier than fixing a real problem." D "You can read my mind. This light of mine will shine, fine; blinding world will end at nine."
D
While you are employed as a charge nurse on an inpatient psychiatric unit, you recognize that you are choosing to spend less time interacting with the clients with schizophrenia. Your first action is: A Discussing your observation with your clinical supervisor. B Requesting a transfer to another unit. C Forcing yourself to interact with the clients with schizophrenia. D Reflecting on your behavior.
D
a client is to receive donepezil for treatment of dementia of the Alzheimer type. the nurse sits down with the primary caregiver and the client and reviews the purpose of the drug, its dosage, and the usual side effects. what side effect is identified by the caregiver leads the nurse to conclude that further teaching is needed? a. nausea B. dizziness C. headache D. constipation
D
a client with a diagnosis of dementia of the Alzheimer type has been taking donepezil 10 mg/day for 3 months. the client's partner calls the clinic and reports that the client has been increasing restlessness and agitation accompanied by nausea. what does the nurse advise the partner to do? a. give the med with food b. administer the med to the partner at bedtime c. omit one dose today and start with a lower dose tomorrow d. bring the client to the clinic for testing and a physical examination
D
CAGE screening tool
Screening Assessment to determine if further work-up for Alcohol Abuse is warranted; catches people experiencing severe alcohol disorders *≥ 2 positive answers is a Positive test and warrants further assessment for Alcohol Abuse*
behavioral dependence
Substance-seeking activities and related evidence of pathological use patterns; cravings, mood changes related to use
Depersonalization Disorder
________________ is a rapid-onset, persistent dissociative process in which the patient's experience of the self or perception of the reality of the self or environment is changed.
Prazosin (Minipress)
alpha 1 blocker; used for PTSD nightmares
The nurse is reviewing a plan of care for a patient diagnosed with posttraumatic stress disorder (PTSD).Which intervention should the nurse question? a. Assist the patient in reducing nightmares. b. Help the patient to discuss emotions related to the traumatic experience. c. Keep the patient free from injury or harm. d. Administer fluoxetine as ordered.
d.
physical dependence (addiction)
physiological effects of multiple episodes of substance abuse; as indicated by the presence of drug tolerance and withdrawal symptoms
