Mental Health ATI Adaptive Quizzes

A nurse is teaching a client who has seasonal affective disorder (SAD) about the use of light teherapy. Which of the following statements should the nurse make? A. "Light therapy suppresses the natural nighttime release of melatonin". B. "You should plan your light therapy session before going to bed". C. "You should begin with 2-minute light therapy sessions and gradually progress to 10-minute sessions." D. "Light therapy is less effective at treating SAD than antidepressant medications".

A. "Light therapy suppresses the natural nighttime release of melatonin". Melatonin is produced nocturnally by the pineal gland; larger amounts are produced during months containing more hours of darkness. These large amounts of melatonin seem to cause SAD in clients who are susceptible to this disorder. Light therapy is thought to improve depression by suppressing melatonin production and increasing serotonin production.

A nurse is providing teaching to a client who has anxiety and a new prescription for diazepam. Which of the following statements should the nurse make? A. "Feelings of sedation should resolve in about 1 week." B. "There is no risk of physical dependence with this medication." C. "You can increase the dose when you feel especially anxious". D. It will take you several months for you to feel the maximum benefit of the medication."

A. Adverse effects of diazepam and other benzodiazepines are sedation and psychomotor slowing. The nurse should inform the client that these effects should subside in 7-10 days.

A nurse on an inpatient unit is assessing a client who has claustrophobia. The nurse determines the client's condition has improved when he can perform which of the following tasks? A. Ride in an elevator B. Attend a class where several service animals are present C. Sit in a large room with several people he does not know D. Go for a swim in an outdoor pool

A. Claustrophobia is an intense anxiety or fear of being in an enclosed space such as an elevator. Riding in an enclosed elevator is in indication that this client's condition is improving.

A nurse is caring for a client who has a substance use disorder and was involuntarily admitted by court order for 90 days. When the nurse attempts to administer prescribed oral lorazepam to decrease the manifestations of withdrawal, the client aggressively refuses. Which of the following actions should the nurse take? A. Place the lorazepam on hold. B. Request a prescription for IM lorazepam C. Request that another nurse attempt to administer the lorazepam. D. Place the lorazepam in the client's food.

A. Client's who are in a health care facility due to an involuntary admission retain the right to refuse treatment, including prescribed medications. Therefore, the nurse should hold the medication, document the client's wishes in the medical record, and notify the provider of the refusal.

A nurse is caring for a client who has post-traumatic stress disorder (PTSD). Which of the following actions by the client indicates the current treatment plan is effective? A. Client reports techniques she uses to promote sleep. B. Client shows limited emotion when witnessing a traumatic event. C. Client asks the nurse's opinion about the clothes she is wearing. D. The client avoids situations that might trigger memories of past trauma.

A. Clients who have PTSD often experience disrupted sleep; therefore, reporting the use of techniques that promote sleep indicates the current treatment plan is effective

A nurse is providing discharge teaching to the parent of an adolescent client who has bulimia nervosa and has been hospitalized for several weeks. Which of the following statements should the nurse identify as an indication that the parent understands the teaching? A. "I should allow my child to make independent decisions." B. "I should give my child a laxative every evening." C. "I should make sure my child takes the antipsychotic medication several times daily." D. "I should discourage my child from exercising."

A. Clients who have bulimia nervosa often demonstrate low self-esteem. The family should support the client emotionally and should encourage increasing independent decision making.

A nurse is assessing a newly admitted client who has generalized anxiety disorder and states, "I drink alcohol to forget the pain." The client is exhibiting a maladaptive response to which of the following defense mechanisms? A. Compensation B. Conversion C. Projection D. Suppression

A. Compensation is a defense mechanism by which a person covers a real or perceived problem or weakness. This client is temporarily attempting to block the constant worry of generalized anxiety disorder by drinking alcohol, which is a maladaptive method of increasing self-esteem. An example of an adaptive use of compensation would be if a person who had an anxiety disorder worked hard to excel in some way to avoid being defined by the anxiety disorder.

A nurse is establishing a therapeutic relationship with a client who has hallucinations. Which of the following actions should the nurse take during the orientation phase? A. Identify the client's perception of the reason for therapy B. Ask the client to provide a detailed description of the hallucinations C. Assist the client with the development of problem-solving skills D. Explore the client's relationship with family members

A. In the initial orientation phase of the nurse-client relationship, the nurse should establish a rapport and confidentiality with the client. To do this, the nurse should assess the client's beliefs about the reason for therapy.

A nurse is caring for a client who has end-stage lung cancer. Which of the following client statements should the nurse identify as an indication that the client is experiencing the bargaining stage of Kubler-Ross stages of grief? A" I would give anything to live to see my grandchild born." B. "Can you make sure there hasn't been a mistake with my test results?" C." I feel so sad that I will be leaving my partner all alone." D. "What have I done to deserve this death sentence?"

A. Kubler-Ross identified common responses of clients who experience any form of loss. These responses are divided into 5 stages. While each of these stages is experienced by clients, they are not necessarily experienced in a linear fashion or in the exact same order. Some clients can experience a stage more than once. This response shows that the client is in the bargaining stage and might be trying to make a deal with a higher power to prolong life.

A nurse is planning a staff education session about the administration of antidepressant medications to older adult clients. Which of the following pieces of information should the nurse include in the teaching? A. Older adult clients require a lower initial dose of antidepressant medication than adult clients. B. Older adult clients should not receive antidepressant medication. C. Older adult clients achieve the therapeutic effects of antidepressant medications more quickly than adult clients. D. Older adult clients have a decreased risk of experiencing adverse effects from antidepressant medication.

A. Older adult clients should start at half of the adult dose for antidepressant medications. This is due to altered rates of absorption and the increased risk for adverse effects.

A nurse is caring for a school-age client who begins wetting the bed after finding out that her parents are getting a divorce. The nurse should identify that the client is exhibiting which of the following defense mechanisms? A. Regression B. Projection C. Repression D. Splitting

A. Regression represents a dysfunctional attempt to reduce anxiety and conflict by returning to less mature behaviors that help the client better tolerate the anxiety.

A nurse is caring for a client who was brought to the clinic by her adult son, who states that his father recently died. The client repeatedly yells at her son stating "Quit lying about your father!" The nurse should recognize that the client is demonstrating which of the following defense mechanisms? A. Denial B. Identification C. Introjection D. Sublimation

A. The client is demonstrating denial through the belief that her son is lying about her partner's death.

A nurse is caring for a client who has bipolar disorder and is experiencing hypomania. During a conversation with other clients, she becomes agitated and beings speaking in a loud, angry voice. Which of the following actions should the nurse take? A. Ask the client to take a walk B. Reprimand the client for her rude behavior C. Point out inappropriate behaviors to the client D. Administer trazodone to the client

A. The client's increasing agitation demonstrates a potential for violent behavior. To maintain a safe environment, the nurse should remove the client from the situation and disperse the anger by walking and talking with her.

A nurse is teaching a parent who has admitted to verbally abusing his children about stress management techniques. Which of the following strategies is the nurse providing? A. Tertiary prevention B. Individual psychotherapy C. Family psychotherapy D. Primary prevention

A. The nurse is providing tertiary prevention methods by offering stress management techniques to the abuser after the abuse has occurred. Tertiary prevention methods facilitate the rehabilitative process for both victims of violence and those who perpetuate it.

A nurse is providing teaching to a client who has a new prescription for clozapine. Which of the following statements should the nurse include in the teaching? A. "You should have your white blood cell count checked once per week for 6 months." B. "You should check yourself every 3 days for weight loss." C. "You might experience frequent loose stools." D. "You might experience ringing in your ears".

A. The nurse should instruct the client to have laboratory testing of WBCs and neutrophils every week for 6 months.

A nurse in the emergency department is caring for a toddler who has a fractured arm. Which of the following findings should the nurse identify as a possible indication of physical abuse? A. The parent provides a history that is inconsistent with the child's injury. B. The child is brought to the emergency department immediately following the injury. C. The parent requests to remain present with the child throughout the treatment of the injury. D. The child clings to the parent when the nurse begins to assess the injury.

A. The nurse should suspect possible abuse when the child's injury conflicts with the history of the injury reported by his parent.

A nurse is caring for a client who attends family counseling with his partner and their children. The client tells the nurse that he will not attend any more sessions and states, " I don't have time for all that talking". Which of the following responses should the nurse provide? A. "It must be difficult for you to talk about family problems". B. "You should continue attending the family counseling sessions until the therapist tells you to stop". C. "If you continue to attend family counseling, I'm sure you'll be able to resolve your problems soon". D."I think you need to continue family therapy if your partner and children".

A. The nurse's response indicates empathy for the client's feelings and illustrates the therapeutic communication technique of verbalizing what the client implied. With this technique, the nurse helps the client focus on the actual reason for not wanting to continue family therapy.

A nurse is caring for a client who left the facility without permission and has had outside privileges revoked for 1 week. The client asks the nurse if she can take a short walk outside the facility. Which of the following responses should the nurse provide? A. "Your privileges have been revoked. I'd be glad to help you find something to do inside the unit." B. "I think a walk would be good for you, but your doctor has taken away your privileges." C. "You decided to leave the hospital without permission. Why are you asking to go outside today?" D. "We shouldn't discuss this. Let's talk about what you want to do when your discharged."

A. This response demonstrates the technique of offering self to the client. It reinforces the reality of the client's current situation, gives the client the option of a permitted activity, and conveys the nurse's willingness to spend quality time with the client.

A nurse is caring for a client who has bipolar disorder. The client states, "My family wants me to come home for a visit. What do you think I should do?" Which of the following responses should the nurse offer? A. "Tell me how you are feeling about their request." B. "I think it's important for you to spend some time with your family." C. "Maybe you shouldn't go if you're not sure about the visit." D. "What does your social worker think you should do?"

A. This statement is an example of a therapeutic response because the nurse is inquiring how the client feels and is using reflection to encourage independent thinking.

A nurse is assessing a client who was brought to the emergency department by a friend. The friend reports that the client inhaled a large amount of cocaine. Which of the following findings should the nurse expect? A. Depressed mood B. Hallucinations C. Severe hypotension D. Bradycardia

B. Cocaine is a CNS stimulant; therfore, the nurse should expect a client who has cocaine intoxication to have hallucinations and delirium. Other manifestations of cocaine intoxication include grandiosity, euphoria, elevated blood pressure, tachycardia, and dilated pupils

A nurse in an acute mental health facility is participating in a group therapy session during which clients enact realistic situations to help process past events. Which of following types of group therapy is occurring? A. Psychoeducational group B. Psychodrama group C. Family therapy group D. Self-help group

B. In a psychodrama group, members actually take parts and act out a client's past experiences in the present time. This experience allows a client to process and gain insight into past experiences that the client has identified as a significant emotional issue.

A nurse is assessing a client who is experiencing alcohol withdrawal. For which of the following findings should the nurse anticipate the administration of lorazepam? A. Decreased pulse rate B. Increased blood pressure C. Decreased urinary output D. Increased nausea

B. Lorazepam is a benzodiazepine that is administered to a client who is experiencing alcohol withdrawal for stabilizing vital signs, preventing seizures, and treating delirium tremens. The nurse should anticipate the provider to prescribe lorazepam for increasing blood pressure.

A mental health nurse is reviewing a process recording of a therapy session with a client. Which of the following statements should the nurse identify as an example of the communication technique of reflection? A. "I notice you are pulling on your hair when we discuss your dismissal." B. "That statement made by the other client appears to have upset you." C. "Since writing in your journal is frustrating, we should look at this activity more closely." D. "Give me an example of a time when you felt no one understood you."

B. Reflective statements are useful in assisting a client with identifying emotions and ideas. This therapeutic communication technique validates the client's emotions and encourages the client to reflect more deeply on the emotion.

A nurse is assessing a client who has major depressive disorder for suicide risk factors and protective factors. Which of the following client statements should the nurse identify as a protective factor that decreases the client's risk for suicide? A. "I am a college graduate and make a lot of money at my profession". B. " I consider myself a good problem-solver." C. "My family lives out-of state, and I spend my spare time at home." D. "I enjoy restoring antique weapons and have a nice collection."

B. The ability to problem-solve and think critically is a protective factor against suicide. Feelings of low self-esteem or hopelessness are risk factors for suicide.

A nurse is caring for a child who has a diagnosis of terminal brain cancer. The mother states, "I feel numb and can't believe this is happening to us". Which of the following interventions by the nurse is the first priority? A. Explore effective ways of family coping B. Encourage the family's expression of their feelings C. Discuss the disease and its manifestations with family members D. Instruct the family about anticipatory grieving

B. The first action the nurse should take using the nursing process is to assess the family by encouraging them to express their feelings about their child's illness. This assessment will allow the nurse to understand the particular needs of the family better as they prepare to face their child's deaht.

A nurse is caring for a client with bipolar disorder who is experiencing mania. Which of the following actions is the nurse's priority? A. Offer the client finger foods every 2 hours B. Determine if the client is a danger to herself C. Monitor the client's vital signs every 2 hours D. Move the client to a quiet area

B. The greatest risk to this client is an injury from hyperactivity or life-threatening exhaustion. Therefore, the priority action is to determine if the client has feelings of suicide or if the client is showing manifestations of exhaustion.

A nurse in the emergency department is assessing a client who has generalized anxiety disorder. Which of the following actions should the nurse take first? A. Instruct the client to use guided imagery. B. Move the client to a quiet area C. Assist the client in identifying his coping skills D. Allow the client time to express his feelings

B. The greatest risk to this client is increased anxiety; therefore, the nurse should first move the client to a quiet area to decrease excessive stimuli.

A nurse is caring for a client who has antisocial personality disorder. Which of the following actions should the nurse take? A. Encourage the client to attend assertive behavior sessions B. Ensure staff members set limits on the client's behavior C. Tell the client to increase socialization on the unit D. Frequently implement measures to increase the client's self-esteem

B. The nurse should ensure that all staff members set limits on the client's behavior. The limits should be clear and realistic and pertain to specific behaviors. Also, the nurse should provide clear boundaries and consequences.

A nurse is performing a brief mental status examination for a client. To assess a client's ability to concentrate, the nurse should do which of the following? A. Point to 2 objects and ask the client to name them. B. Ask the client to name the months of the year in reverse C. Say 3 words and ask the client to repeat them D. Ask the client to write a sentence

B. The nurse should evaluate the client's ability to concentrate by asking the client to name the months of the year in reverse order.

A nurse is caring for a newly admitted client who is receiving treatment for alcohol use disorder. The client tells the nurse, "I have not had anything to drink for 6 hours". Which of the following findings should the nurse expect during alcohol withdrawal? A. Low body temperature B . Insomnia C. Muscle flaccidity D. Bradycardia

B. The nurse should expect a client who is experiencing alcohol withdrawal to have insomina and restlessness.

A nurse is interviewing a client who has anorexia nervosa. Which of the following findings should the nurse expect? A. Poor personal hygiene habits B. Strenuous exercise regimen C. Grandiose behaviors D. Intense fear of death

B. The nurse should expect this client who has anorexia nervosa to report a strenuous exercise regimen. The client might participate in excessive physical activity

A nurse on a rehabilitation unit is providing teaching to the partner of a client who is experiencing stimulant withdrawal. Which of the following statements by the partner indicates an understanding of the teaching? A. "Increased energy is a sign of withdrawal." B"Depression is a manifestation of withdrawal." C." Decreased appetite is a manifestation of withdrawal." D. "Delirium tremens can occur during withdrawal."

B. The nurse should explain to the partner that depression and suicidal thoughts are the most serious adverse effects of stimulant withdrawal.

A nurse is caring for a client who has alcohol use disorder and is receiving treatment for alcohol withdrawal. The client reports hand tremors 12 hours after admission. Which of the following statements should the nurse provide. A. "The tremors are permanent due to nerve damage caused by chronic alcohol use". B. "The tremors will persist for a few days as you are withdrawing from alcohol". C. "Try not to worry about the tremors. Everyone has them during alcohol withdrawal." D." These tremors are an indication of seizures that are associated with alcohol withdrawal".

B. The nurse should inform the client that tremors and other manifestations of alcohol withdrawal may peersist for several days after the last intake of alcohol.

A nurse is planning care for a client who has thoughts of suicide. Which of the following goals should the nurse include in the client's plan of care? A. The client will identify positive aspects of others. B. The client agrees to notify a staff member of thoughts of self-harm C. The client will engage in an independent diversional activity D. The client will not verbalize thoughts or feelings related to suicide.

B. The nurse should instruct the client to notify a staff member if suicidal thoughts occur so that the client's needs are immediately addressed and actions are taken to prevent self-injury or suicide.

A nurse is caring for a client who has Alzheimer's disease. The client's adult son states the client has begun wandering away from her home. Which of the following responses should the nurse offer? A. "You should plan to move your mother into your home soon". B. "Place a complex lock at the top of each door that leads outside". C. "It is time to place your mother in a long-term care facility". D. "Have you reminded your mother about the dangers of wandering away from home?"

B. The nurse should instruct the client's son to place complex lockas at the top of doors that lead outside to prevent the client from wandering away from home. The nurse should also encourage the client's son to place a nonremovable medical alert bracelet on the client that includes teh client's name, address, and telephone number.

A nurse admitted a client who has major depressive disorder states to the nurse, "I'm a failure. I can't even cope with little things anymore". Which of the following responses should the nurse provide? A. "What happened in your life to make you feel like such a failure?" B. "It sounds as if you are feeling pretty overwhelmed right now." C. "Do you feel like you don't deserve to feel good about yourself?" D. "I know you feel like that now, but you'll feel differently when you get better."

B. This response by the nurse acknowledges the client's feelings and attempts to convey the ability to understand them. This promotes a trusting relationship between the client and the nurse.

A nurse is caring for a client who has major depressive disorder and recently started taking an antidepressant. The nurse should identify which of the following client statement as the priority? A. "I hate being so helpless. I can't even manage. my own finances anymore." B. "At group therapy today, I wanted to leave. I didn't feel like being with other people." C. "I have it all figured out. Everything is going to be okay now.". D. "I don't feel like showering. I'd rather just stay in bed today."

C. "I have it all figured out. Everything is going to be okay now."

A nurse is assessing a client whose sister recently died in a motor vehicle crash. The nurse should identify that which of the following factors indicates an increased risk of a complicated grief reaction? A. The loss of a sibling B. The perception that the death was unavoidable. C. The sudden occurrence of the death D. The presence of a social support network.

C. A sudden, unanticipated death can complicate the mourning process and lead to a complicated grief reaction. Other factors include death from a lengthy illness, the loss of a child, or the perception that the death was preventable.

A nurse is assessing a client who is taking buspirone to treat generalized anxiety disorder. Which of the following findings should the nurse identify as an adverse effect of this medication? A. Arthralgia B. Photophobia C. Xerostomia D. Bradycardia

C. Buspirone can cause xerostomia or dry mouth. Other adverse effects include headache, nausea, and insomnia.

A nurse is creating a plan of care for a client who has Alzheimer's disease with moderate cognitive decline. Which of the following interventions should the nurse include to orient the client to the present? A. Discourage the client from reminiscing about the past. B. Overlook the client's frustration with communication C. Talk with the client about scheduled daily activities. D. Present multiple options when offering the client choices.

C. Discussing scheduled daily activities assists in orienting the client to time and reality throughout the day,

A school nurse is providing care to a student who is angry and states, "My parents don't know I'm gay, so I can't visit my girlfriend in the hospital while she receives cancer treatment." Which of the following forms of grief is the client experiencing? A. Chronic grief B. Uncomplicated grief C. Disenfranchised grief D. Delayed grief

C. Disenfranchised grief occurs when social expectations restrict an individual's ability to cope with grief in an expected way. This type of grief can occur when the social relationship between the client and another individual cannot be openly recognized. As a result, the client does not have the social support that may be available to another individual who has an uncomplicated form of grief.

A nurse is providing teaching about stress management to a client who is experiencing anxiety. Which of the following techniques should the nurse recommend to assist the client in identifying his stressors? A.Biofeedback B. Intellectualization C. Journaling D. Cognitive reframing

C. Journaling is a technique that can be used to identify stressors. By recording feelings and responses to events, the client can find the source of everyday stressors and being the process of stress reduction.

A nurse on an acute mental health unit is assessing a client who has obsessive-compulsive disorder (OCD). Which of the following behaviors should the nurse expect? A. Being intentionally dishonest B. Jumping rapidly between topics of conversation C. Tapping the 4 sides of a light switch D. Mimicking the movements of another person

C. Tapping the 4 sides of the light switch is an expected behavior for a client who has OCD. Clients with OCD have recurrent and persistent thoughts or urges that are suppressed by performing a compulsion or repetitive behavior.

A nurse is discussing family therapy with a client. Which of the following statements by the nurse is therapeutic? A. "Family therapy helped my family". B. "I need to sign you up for family therapy". C. "Family therapy can bring about change". D. "Why do you think you need family therapy?"

C. The nurse is using the therapeutic communication technique of providing information. By explaining what family therapy can offer, the nurse can empower the client to make a better decision about whether to pursue such therapy.

A nurse is creating a plan of care for a client who has borderline personality disorder and exhibits manipulative behaviors. Which of the following interventions should the nurse include to address limit-setting? A. Teach the client to use reaction formation for behavior control. B. Recommend the client attend assertiveness training. C. Establish and explain consequences for the client's behavior. D. Encourage the client to increase socialization.

C. The nurse should communicate desired behavior and expectations to the client, as well as the detailed consequences of not meeting them. When addressing limit-setting with the client, these expectations and consequences should be included in the plan of care.

A nurse is providing teaching to the parent of a school-aged child who has ADHD and a new prescription for methylphenidate IR. Which of the following pieces of information should nurse provide? A. "Have your child take the medication once daily." B. "This medication might make your child gain weight." C. "Your child's growth might slow while using this medication." D. "Avoid giving your child food when taking this medication

C. The nurse should instruct the parent that an adverse effect of methylphenidate is growth suppression related to the appetite suppression associated with the medication. Administering the medication with or after meals will help protect the child's appetite.

A nurse on a mental health unit is observing a client who has schizophrenia. Which of the following client statements should the nurse recognize as clang association? A."Her mannerologies are poor." B. "My blank a boat to supreme heights." C. "I can play the flute while wearing a suit. You are cute." D. "My joints ache. my friend is in the joint.

C. The nurse should recognize this statement is an example of clang association. Clang association refers to the use of words that are based on sound rather than meaning. A client who has schizophrenia will often use words that rhyme or have a similar beginning sound.

A nurse is interacting with a client who has a psychotic disorder. The client suddenly turns her head as if she is listening to something and says, "The boss says she is going to hit me with a stick!" Which of the following responses should the nurse make?" A. "The boss can't hurt you with that stick." B. "Why are you talking to yourself." C" I don't see anyone, but it sounds like you are frightened." D. "There isn't anyone here besides us, so you need to talk to me."

C. The nurse should respond to the client by offering personal perceptions of the client's experience and should address the client's underlying emotions about the hallucination.

A client states, "I haven't seen my child for 2 weeks." The nurse responds, "Your child has not visited you for 2 weeks?" Which of the following communication techniques is the nurse using? A. Accepting B. Making an observation C. Restating D. Voicing doubt

C. This is an example of the communication technique of restatement, which allows the nurse to verify what the client is saying and provide an opportunity for the client to clarify any misunderstanding.

A nurse on a mental health unit is caring for a client who has antisocial personality disorder and is becoming increasingly loud and belligerent. Which of the following approaches should the nurse use to manage this client's behavior? A. Confront the client for breaking the rules B. Stand near the client to offer comfort and support C. Speak to the client with clear, caring statements D. Escort the client to the nurses' station

C. To remain in control of the situation, the nurse should use clear, calm statements that are non-threatening to the client. The nurse should also set limits for clients who exhibit potentially violent behavior.

A nurse in an emergency department is assessing a client who reports recent cocaine use. Which of the following manifestations should the nurse expect? A. Hypertension B. Drowsiness C. Bradycardia D. Pinpoint pupils

Cocaine is a central nervous system stimulant. Therefore, hypertension is an expected finding in a client who has recently used cocaine.

A nurse is providing discharge teaching to the guardians of an adolescent who has bipolar disorder. Which of the following manifestations should the nurse identify as an indication of acute mania? (Select all that apply.) A. Completes school projects B. Naps during the daytime C. Eats large amounts D. Spends excessive amounts of money E. Speaks crassly using a loud voice

D, E The nurse should identify that a client who has acute mania is impulsive and at risk for spending excessive amounts of money despite financial status. Additionally, a client who has acute mania has rapid speech and quick thoughts. Other alterations in speech include speech that is vulgar or sexually explicit.

A nurse is planning care for a client who has vegetative signs of depression. Which of the following actions should the nurse include in the plan? A. Limit snacking between meals B. Schedule regular naptimes during the day C. Weigh the client monthly. D. Provide decaffeinated beverages

D. A client who has vegetative signs of depression is at a high risk for altered sleep. Because caffeinated beverages can interrupt restful sleep, the nurse should plan to offer the client decaffeinated beverages/

A nurse is caring for a client with alcohol use disorder who has undergone detoxification. Which of the following medications should the nurse expect the provider to prescribe to assist the client with maintaining sobriety. A. Varenicline B. Clonidine C. Buprenorphine D. Disulfiram

D. Disulfiram is a type of aversion therapy that helps clients abstain from alcohol. Drinking alcohol while taking this medication produces a toxic reaction that causes vomiting, confusion, headaches, breathing difficulties, and other manifestations.

A nurse is planning care for a client who is scheduled to undergo electroconvulsive treatment. Which of the following interventions should the nurse include? A. Maintain a clear liquid diet for 6-8 hours prior to ECT B. Allow the client to sleep for 3-4 hours following ECT. C. Administer IM epinephrine to the client prior to ECT D. Reorient the client to the environment after ECT.

D. Due to a transient period of confusion after ECT, the nurse should plan to reorient the client following ECT.

A nurse is caring for a client who is experiencing opioid withdrawal. Which of the following manifestations should the nurse expect? A. Hyporeflexia B. Muscle spasms C. Constipation D. Decreased respiratory rate

D. Muscle spasms are a manifestation of opioid withdrawal.

A nurse is performing an admission assessment for a client who has restricting-type anorexia nervosa. The nurse should expect which of the following findings? A. Recurrent binging B. Compensatory vomiting C. Loss of appetite D. Decreased caloric intake

D. THe nurse should expect the client who has restricting-type anorexia nervosa to have a restricted and decreased caloric intake due to an intense fear of weight gain.

A nurse is caring for a client who has schizophrenia and is experiencing negative symptoms. Which of the following manifestations should the nurse expect? A. Hallucinations B. Impaired memory C. Dysphoria D. Social discomfort

D. The absence of something that should be present is considered a negative symptom of schizophrenia. Social discomfort, the inability to enjoy activities, or a lack of goal-directed behavior are negative symptoms of schizophrenia.

A nurse on a mental health unit is caring for a client who has depression. Which of the following actions should the nurse take to foster a therapeutic environment for this client? A. Tell the client that the nurse will talk to him at his request B. Allow the client to skip group activities if he chooses. C. Leave the client alone for frequent rest periods throughout the day. D. Build trust with the client by sitting quietly with him

D. The nurse should build trust with the client and convey an interest in the client's concerns. Offering self by sitting with the client and using silence promote trust, which encourages the client to speak more openly about issues and concerns.

A nurse is providing teaching to a client about cannabis use disorder. Which of the following client statements indicates an understanding of the teaching? A. "Withdrawal of cannabis occurs 3 days after cessation". B. "There are no physical manifestations of withdrawal from cannabis". C. "Drug screens can detect cannabis for up to 8 weeks after use". D. "Cannabis use can produce effects resembling the effects of alcohol use".

D. The nurse should explain to the client that, when used moderately, cannabis produces effects resembling the effects of alcohol and other CNS depressants. By depressing higher brain centers, CNS depressants release lower centers from inhibitory influences.

A nurse is providing teaching to the family of a client who has alcohol use disorder about decreasing codependent behaviors. Which of the following statements by a family member indicates an understanding of the teaching? A. "We will help he financially if she loses her job?" B. "We will not hold her responsible for her alcohol use." C. "We will routinely search for and remove any alcohol in her home." D" We will not let our moods be changed by her behavior."

D. The nurse should explain to the family that alcohol use is self-inflicted and that the client must take responsibility for her actions. The family should not allow the client's dysfunctional behavior to control their environment. Establishing boundaries with the client is the family's first step in reducing the codependent behaviors.

A client who has hypertension tells the nurse in a provider's office that she feels the considerable amount of stress at work is affecting her blood-pressure control. The nurse should instruct the client to do which of the following when the stress is unavoidable? A. Consider changing jobs to something less stressful. B. Identify the stressors at work and then try to reduce them C. Plan for periods away from work throughout the day D. Improve her ability to cope with identified stressors.

D. The nurse should help the client learn stress-management techniques to deal with stress without internalizing it.

A nurse is reviewing the health history of a young adult client who has a depressive disorder. Which of the following factors increases the client's risk of depression? A. The client is an only child B. The client lives in an urban setting C. The client is married D. The client is female

D. The nurse should identify female gender as a primary risk factor for depression. The incidence of depressive disorders is greater in women than in men by a ratio of almost 2 to 1.

A nurse is caring for a client who was just admitted for the treatment of anorexia nervosa. Which of the following actions should the nurse take? A. Discuss the nutritional value of foods during meal times B. Weigh the client 3 mornings per week C. Allow the client to exercise for up to 1 hr per day D. Monitor the client for 1 hr following meals and snacks

D. The nurse should monitor the client after eating meals and snacks to prevent purging.

A nurse is developing a plan of care for a client who has alcohol use disorder. Which of the following medications should the nurse plan to administer? A. Methadone B. Varenicline C. Buprenorphine D. Diazepam

D. The nurse should plan to administer diazepam to a client who has alcohol use disorder to minimize manifestations of alcohol withdrawal.

A nurse is preparing to apply wrist restraints on a client who is threatening to harm others and has not responded to less invasive interventions. Which of the following actions should the nurse plan to take? A. Obtain a PRN prescription for restraints from the client's provider. B. Visually observe the client every 10 minutes until restraints are removed. C. Ensure 3 fingers can fit between the restraint and the client's wrist. D. Document the client's behavior every 15 min while restraints are in place.

D. The nurse should plan to document the client's behavior every 15 min while restraints are in place to meet the legal requirement for use of restraints. This documentation allows prompt identification of complications related to restraint use and helps ensure that restraints are removed as soon as possible, depending on the client's behavior.

A nurse in an acute mental health facility is caring for a client who states, "This place is ridiculous. I can't stand spending another day here!" Which of the following responses should the nurse make? A. "You should focus on the good things so the bad things seem less important." B. "I'm sure tomorrow will be a better day." C. "Don't be so negative when you are young and physically healthy." D. "Let's talk about the events of your day."

D. The nurse should use focusing as a therapeutic communication technique that encourages the client to talk about their feelings.

A nurse is caring for a client who just received a diagnosis of cancer. The client states, "I just don't know what I'm going to do now." Which of the following responses should the nurse make? A. "In time you'll know the right thing to do". B. " I am sorry. Would you like me to call someone for you?" C. "There are multiple treatment options for you to consider". D. "Can you explain the concerns you're having right now?"

D. This response uses the therapeutic communication technique of asling a relevant question. By using an open-ended question to ask the client to explain any present concerns, teh nurse is encouraging the client to respond and provide additional information.

A nurse on a mental health unit is caring for a client who begins throwing objects at other clients. Which of the following actions is the priority nursing intervention? A. Attempt to restrain the client's arms B. Administer an anti-anxiety medication C. Place the client in seclusion D. Tell the client to stop the behavior

D. When providing client care, the nurse should first use the least restrictive intervention; therefore, the nurse should talk to the client to encourage her to calm down and prevent harm to others.

A nurse is performing an admission assessment for a client who has schizophrenia. The nurse notices that the client's appearance is unkempt and he appears to actively hallucinating. Which of the following should be the nurse's priority assessment?" A. Perception of reality B. Ability to follow directions C. Physical needs D. Mental status

The nurse should consider Maslow's Hierarchy of Needs, which includes 5 levels of priority. These levels are as follows: physiological needs, safety and security needs, love and belonging needs, personal achievement and self-esteem needs, and achieving full potential while problem-solving and coping with life situations. When applying Maslow's Hierarchy of Needs as a priority-setting framework, the nurse should review physiological needs first and then address client's needs by following the remaining 4 hierarchal levels. IT is important, however, for the nurse to consider all contributing client factors, as higher levels of the pyramid can compete with lower levels, depending on the specific client situation.

A nurse is assessing a client who has schizophrenia. The client suddenly states, "I'm blue, so are you, and I'm leaving on a choo, choo, choo!" The nurse should identify the client's statement as which of the following speech patterns? A. Clang association B. Word Salad C. Neologism D.Echolalia

The nurse should identify this statement as clang association, a pattern of speech often used by clients who have schizophrenia. These statements often rhyme or contain a string of words that have the same beginning sound.

A nurse at a college campus health clinic is caring for a client who reports manifestations of bulimia nervosa. The client tells the nurse, "I know my eating binges and vomiting are not normal, but I can't control them." Which of the following responses should the nurse provide? A. "Why do you think you are experiencing these behaviors of binging and vomiting?" B. "Are other students in your dorm also experiencing this behavior?" C. "You are feeling helpless about changing this behavior?" D. "You know you must stop because you are endangering your health."

The nurse should use the therapeutic communication technique of restating when responding to the feelings the client has expressed. Restating focuses on the main idea of the client's statement and helps the client understand and explore personal behaviors.