mental final

A client's wife has been making excuses for her alcoholic husband's work absences. In family therapy, she states, "I just need to work harder to get him there on time." Which is the appropriate nursing response? a. "Your husband needs to deal with the consequences of his drinking." b. "Why do you assume responsibility for his behaviors?" c. "Do you understand what the term enabler means?" d. "Codependency is a typical behavior of spouses of alcoholics."

a. "Your husband needs to deal with the consequences of his drinking." The nurse is using the technique of confrontation with caring by stating, "Your husband needs to deal with the consequences of his drinking." In Stage I (The Survival Stage) of recovery from codependency, the codependent person must begin to let go of the denial that problems exist or that his or her personal capabilities are unlimited.

Which client should a nurse identify as a potential candidate for involuntarily commitment? a. A client who eats waste out of a garbage can b. A client verbalizing intent to commit suicide c. A client living under a bridge in a cardboard box d. A homeless client refusing to bathe

b. A client verbalizing intent to commit suicide The client verbalizing intent to commit suicide is eligible for involuntary commitment. The suicidal client who refuses treatment is a danger to self and requires emergency treatment.

The patient has schizophrenia, residual type. A nursing care plan should give priority to which nursing diagnosis? a. Self-Care Deficit b. Social Isolation c.Anxiety d.Impaired Verbal Communication

b. Social Isolation Social Isolation is correct. Residual-type schizophrenia manifests with socially withdrawn behavior, an inappropriate affect, and an absence of prominent psychotic symptoms. The most likely and common nursing diagnosis would be Social Isolation. Impaired Verbal Communication, Self-Care Deficit, and Anxiety are less likely to be seen in a patient with residual schizophrenia than is social isolation

A kindergarten student is frequently violent toward other children. The school nurse notices bruises and burns on the child's face and arms. Which other symptom should indicate to the nurse that the child might have been physically abused? a. The child is frequently absent from school. b. The child shrinks at the approach of adults. c. The child begs or steals food or money. d. The child is delayed in physical and emotional development

b. The child shrinks at the approach of adults. A child who shrinks at the approach of adults and has bruises and burns might be a victim of abuse. Maltreatment is considered whether the caretaker intended to cause harm, or even if the injury resulted from overdiscipline or physical punishment.

Which medication should the nurse be prepared to educate patients on when they are prescribed a selective serotonin reuptake inhibitor (SSRI) for panic attacks? a. zolpidem (Ambien) b. fluoxetine (Prozac) c. eszopiclone (Lunesta) d. penicillin

b. fluoxetine (Prozac) Fluoxetine (Prozac) is an SSRI; Zolpidem (Ambien) is a Nonbenzodiazepine Receptor Agonist; Penicillin us an antibiotic; Eszopiclone (Lunesta) is a Nonbenzodiazepine Receptor Agonist

A client diagnosed with Somatic Symptom Disorder is most likely to exhibit which personality disorder characteristics? a. Is socially irresponsible, exploitative, and guiltless and disregards rights of others b. Expresses heightened emotionality, seductiveness, and strong dependency needs c. Uses "splitting" and manipulation in relationships d. Uncomfortable in social situations; perceived as timid, withdrawn, cold, and strange

b.Expresses heightened emotionality, seductiveness, and strong dependency needs A client with somatic symptom disorder would most likely exhibit heightened emotions, seductiveness, and strong dependency.

A recent immigrant from Honduras comes to the clinic with a family member who has been a U.S. resident for 10 years. The family member says, "The immigration to America has been very difficult." Considering cultural background, which expression of stress by this patient would the nurse expect? a.Memory deficiencies b.Somatic complaints c. Motor restlessness d. Sensory perceptual alterations

b.Somatic complaints Honduras is in Central America. Many people from Central American cultures express distress in somatic terms. The other options are not specific to this patient's cultural background and are less likely to be observed in persons from Central America.

Which client should be assigned to a newly-graduated nurse who has just started on the acute psychiatric unit? a. A client who is frequently admitted for borderline personality disorder and suicidal gesture b. A client admitted yesterday for disorganized schizophrenia and psychosis c. A client newly diagnosed with major depression and rumination about loss and suicide d. A client newly admitted to determine differential diagnosis of depression, dementia, or delirium

c. A client newly diagnosed with major depression and rumination about loss and suicide Although the client is ruminating about suicide, major depression usually leaves the client with minimal energy to act. The danger for suicide will increase as the medication and therapy begin to help. A new nurse is more likely to be manipulated by a borderline patient. Psychotic clients can seem very threatening to new nurses. Depression, dementia, and delirium have some common behavior and symptom overlap; this client is best assigned to an experienced nurse until delirium is treated or ruled out.

Of the lunch menus given below, which diet choice would be the best choice for a client in acute mania? a. Pork chop, rice, corn, apple pie, and coffee b. Fried shrimp, potato salad and coke. c. Corn dog, bake potato, apples, and sprite. d. Macaroni and cheese, hamburger, cake, and coke.

c. Corn dog, bake potato, apples, and sprite. The client with mania should be on a low fat diet, Avoid caffeine, high sugar, alcohol or any stimulant

Which of the following assessment findings are not included in Bleuler's classic symptoms of schizophrenia? a. Conflicting strong feelings. b. Lack of logical thought processes resulting in disorganized thinking c. Extreme suspiciousness. d. Extreme retreat from reality.

c. Extreme suspiciousness.

The case manager plans to discuss the treatment plan with a patient's family. Select the case manager's first action. a.Determine an appropriate location for the conference. b. Support the discussion with examples of the patient's behavior. c. Obtain the patient's permission for the exchange of information. d. Determine which family members should participate in the conference.

c. Obtain the patient's permission for the exchange of information.

A client is diagnosed with Terminal Cancer. Which situation should the nurse assess as reflecting Kübler-Ross's grief stage of anger? a. The client registers for an iron-man marathon to be held in 9 months. b. The client gathers family to plan a funeral and make last wishes know c.The client is a devoted Catholic but refuses to attend church and states that his faith has failed him. d.The client promises God to give up smoking if allowed to live long enough to witness a grandchild's birth.

c.The client is a devoted Catholic but refuses to attend church and states that his faith has failed him. The client's refusal to attend church and statement that his or her faith failed him or her reflect the Kubler-Ross' second stage: anger. During this stage, the reality of the situation is realized and the individual has feelings of sadness, guilt, shame, helplessness, and hopelessness. This client's behaviors reflect the third stage, bargaining, during which the individual attempts to strike a bargain with God for a second chance or for more time.

A client, experiencing lower extremity paralysis, is admitted to a medical unit. Extensive tests confirm disability but rule out any underlying organic pathology. The nurse concludes that this is most suggestive of which disorder? a. Factitious Illness by proxy b. Illness anxiety disorder c. Malingering d.Conversion disorder

d. Conversion disorder Conversion Disorder is a loss or change in body function resulting from a psychological conflict, the physical symptoms of which cannot be explained by any known medical disorder.

A patient diagnosed with schizophrenia, paranoid type, is admitted to an acute-care psychiatric hospital unit. Which nursing diagnosis should be give highest priority in the initial nursing care plan? a. Social Isolation b. Impaired Verbal Communication c. Interrupted Thought Processes d. Risk for Violence Directed at Self or Others

d. Risk for Violence Directed at Self or Others Risk for Violence is correct. Safety is always the highest priority when caring for any patient. This is particularly true when the client has paranoid schizophrenia. These patients are extremely suspicious and distrusting of the environment and feel that others have harmful intent toward them. They maintain an alert and watchful hypervigilance and are at high risk for aggression and/or violence. Interrupted Thought Processes, Social Isolation, and Impaired Verbal Communication are appropriate for the patient's care plan but are not given the highest priority, as they are not as important as safety.

A patient fearfully runs from chair to chair crying, "They're coming! They're coming!" The patient does not follow the staff's directions or respond to verbal interventions. Which nursing diagnosis has the highest priority? a. Disturbed thought processes b. Fear c. Self-care deficit d. Risk for injury

d. Risk for injury A patient experiencing panic-level anxiety is at high risk for injury related to increased non-goal-directed motor activity, distorted perceptions, and disordered thoughts. Data are not present to support a nursing diagnosis of self-care deficit or disturbed thought processes. The patient may have fear, but the risk for injury has a higher priority.

A person with a fear of heights drives across a high bridge. Which division of the autonomic nervous system will be stimulated in response to this experience? a. Limbic system b. Peripheral nervous system c. Parasympathetic nervous system d. Sympathetic nervous system

d. Sympathetic nervous system The autonomic nervous system is comprised of the sympathetic (fight or flight response) and parasympathetic nervous system (relaxation response). In times of stress, the sympathetic nervous system is stimulated. A person fearful of heights would experience stress associated with the experience of driving across a high bridge. The peripheral nervous system responds to messages from the sympathetic nervous system. The limbic system processes emotional responses but is not specifically part of the autonomic nervous system.

Which is considered an appropriate outcome when planning care for an inpatient client diagnosed with Somatic Symptom Disorder? a. The client will admit to fabricating physical symptoms to gain benefits by day 3 b. The client will openly discuss physical symptoms with staff by day 4. c. The client will comply with medical treatments for physical symptoms by day 3. d. The client will list three potential adaptive coping strategies to deal with stress by day 2.

d. The client will list three potential adaptive coping strategies to deal with stress by day 2. An appropriate outcome for a client diagnosed with Somatic Symptom Disorder would be for the client to list three potential adaptive-coping strategies to deal with stress by day 2. Because the symptoms of somatic symptom disorder are associated with psychosocial distress, increasing coping skills may help the client reduce symptoms.