Mental Health Davis Edge Exam 2

A nurse is caring for a client with suicidal tendencies. Which client outcome would be the best indicator of the effectiveness of the nursing interventions? 1. The client has avoided self-harm. 2. The client sleeps without any difficulty. 3. The client interacts appropriately with others. 4. The client has good perceptions about himself or herself.

answer: 1

Which behavior set describes cluster A personality disorders? 1. Odd and eccentric 2. Anxious or fearful 3. Violent and aggressive 4. Dramatic, emotional, or erratic

answer: 1

While caring for a client with paranoia, the nurse implements the family-style serving of food to the client. What does the nurse expect out of this intervention? 1. The client will have decreased suspiciousness. 2. The client will have improved self-esteem. 3. The client will have improved concrete thinking. 4. The client will have an improved functional communication pattern.

answer: 1 A client with paranoia may believe that the food or medication provided is being poisoned. A creative approach such as the family-style serving may help in developing trust in the client, and thereby help decrease the suspiciousness.

The nurse is caring for an 8-year-old child with a psychiatric illness. According to Erikson, which behavior indicates maladaptive development in the child? 1. Unable to gain self-confidence 2. Unable to keep up the promises made to peers 3. Unable to integrate the tasks mastered in the previous developmental stages 4. Unable to maintain lasting relationships

answer: 1 According to Erikson, a child between 6 and 12 years of age achieves a sense of self-confidence by learning, competing, and performing successfully. Therefore, a failure to develop self-confidence indicates developmental delay.

Which developmental events occur during the rapprochement phase, according to Mahler's theory of object relations? 1. The child wants his mother during stressful events as an emotional refueling. 2. The child has the ability to explore the environment independently. 3. The psychic fusion is established between the mother and the child. 4. The child learns to relate to objects in an effective and constant manner.

answer: 1 According to Mahler's theory, the child wants the mother to provide an emotional refueling to maintain the feelings of security during the rapprochement phase.

Which statement would the nurse include in teaching about the psychodynamic theory of conversion disorder? 1. "The emotions associated with traumatic events are transformed into physical symptoms." 2. "The physical symptoms occur as a result of a defense mechanism against guilt." 3. "The fear of recurring illness results in an exaggerated response to minor physical changes." 4. "The clients pretend to be ill in order to gain the attention of family members."

answer: 1 According to the psychodynamic theory of conversion disorder, the emotions associated with traumatic events are converted to physical symptoms in clients with conversion disorder.

Which effect can be seen in a client who uses "happy dust" in high doses? 1. Pulmonary hemorrhage 2. Respiratory depression 3. Sexual dysfunction 4. Nosebleeds

answer: 1 Adolescents with depression, anxiety, and substance-related disorder are recommended to have inpatient nursing care as a secondary level of prevention.

Which nursing intervention is appropriate for an adolescent with depression, anxiety, and substance-related disorder? 1. Recommending hospitalization of the adolescent 2. Discussing and validating emotions about which there are concerns 3. Suggesting an educational seminar that informs about the use of alcohol and drugs 4. Providing anticipatory guidance

answer: 1 Adolescents with depression, anxiety, and substance-related disorder are recommended to have inpatient nursing care as a secondary level of prevention.

A client with multiple sclerosis has depression. Which symptoms can indicate underlying depression in this client? 1. Agitation and restlessness 2. Hopelessness and worthlessness 3. Weight loss and poor muscle tone 4. Gastrointestinal complaints and jaundice

answer: 1 Agitation and restlessness usually represent an underlying depression in a client with multiple sclerosis.

A nurse instructs the client to take an antidepressant medication along with food. Which drug complication is the nurse trying to control in the client? 1. Nausea 2. Amnesia 3. Lethargy 4. Hypomania

answer: 1 Antidepressant drugs may cause gastric distress and nausea as side effects. These effects can be reduced by taking the drug along with food.

Which is the goal of behavior therapy? 1. Establishing self-sufficiency and independence in the client 2. Providing social support and interaction to the client 3. Achieving practical solutions for the client's difficulties 4. Challenging feelings of unreality in the client

answer: 1 Behavioral therapy helps in establishing self-sufficiency and independence in the client in instances when secondary gain is prominent.

Which medication regulates the influx and outflow of calcium from the cells through the expression of CACNA1C protein? 1. Verapamil 2. Bupropion 3. Atomoxetine 4. Lithium carbonate

answer: 1 Calcium channel blocking agents such as verapamil regulate influx and outflow of calcium from the cells through the expression of CACNA1C protein.

A nurse is assessing a client who is on monoamine oxidase inhibitor (MAOI) therapy. Which suggestion provided by the nurse prevents a hypertensive crisis in the client? 1. Avoid consuming red wine 2. Avoid cottage cheese on food 3. Use soy sauce topping on food 4. Include raisins in the regular diet plan

answer: 1 Clients on MAOIs are contraindicated for tyramine-containing food products due to risk of a hypertensive crisis. Red wine has high tyramine content, and the client on MAOIs is advised to avoid it.

Which symptom does the nurse notice in a client with paranoid personality disorder according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)? 1. Persistent grudges 2. Emotional coldness 3. Eccentricities of behavior 4. Exaggerated expression of emotions

answer: 1 Clients with paranoid personality disorder do not forgive others who have insulted or injured them. They persistently hold grudges.

The nurse is explaining the side effects of electroconvulsive therapy (ECT) to the guardian of a client with depression. Which relevant information would the nurse provide? 1. The client may exhibit confusion for a short period of time. 2. The client will experience short-term memory loss. 3. The client may develop photosensitivity for a certain time. 4. The client may have hypertensive crisis after the therapy.

answer: 1 Confusion and memory loss for a short time are the major side effects of ECT.

The nurse is caring for a client who has suicidal thoughts. Which would be the primary intervention by the nurse? 1. The nurse would create a safe environment for the client. 2. The nurse should make frequent rounds at irregular intervals. 3. The nurse should take special care while administering medications. 4. The nurse should take a promise from the client that he or she will seek out help from the staff members if thoughts of suicide emerge.

answer: 1 Creating a safe and calm environment for the client should be the primary intervention by the nurse. This helps decrease the risk of violence in the client.

Which statement explains the difference between maturational and situational crises? 1. Maturational crises are associated with various stages of growth and development. Situational crises are acute responses to an external circumstantial stressor. 2. Maturational crises occur anytime between age 35 and 65 years. Situational crises occur during various developmental periods and life-cycle events. 3. Maturational crises need anticipatory guidance. Situational crises are explained as identity versus role confusion. 4. Maturational crises occur when an individual encounters traumatic experiences. Situational crises in females produce physical symptoms such as hot flashes, vaginal dryness, insomnia, headaches, and minor memory disturbances.

answer: 1 Crucial experiences that individuals have during various stages of growth and development are termed maturational crises. Situational stressors such as poverty and trauma put individuals at risk of mental illness.

Which is the outcome of neurodegeneration in the nigrostriatal pathway? 1. Parkinson's disease 2. Endocrine abnormalities 3. Neuroleptic malignant syndrome 4. Positive symptoms of shizophrenia

answer: 1 Degeneration in the nigrostriatal pathway is associated with Parkinson's disease and involuntary psychomotor symptoms of schizophrenia.

The nurse is caring for a client with depression. Which is the primary nursing intervention for this client? 1. Develop a trusting relationship with the client. 2. Help the client openly express his or her feelings. 3. Help discharge pent-up anger in the client. 4. Tell the client that crying is acceptable and relieves depression.

answer: 1 Developing a trusting relationship with the client would be the primary intervention by the nurse.

The wife of a client complains that her husband has been found wandering far from home and is sometimes unable to recall information about himself. Which would the nurse suspect as a diagnosis for this client? 1. dissociative fugue 2. conversion disorder 3. somatic symptom disorder 4. dissociative identity disorder

answer: 1 Dissociative fugue is characterized by sudden unexpected travel from customary places, and the individual may not be able to recall his identity. Therefore, the nurse would suspect dissociative fugue in the client.

Which statement best defines the term "empty nest syndrome"? 1. It describes the adjustment period parents experience when the last child leaves home to establish an independent residence. 2. It describes the interventions used to help new parents understand what they might expect from the birth of the new child. 3. It describes the eight crisis stages of the life cycle during which individuals struggle with developmental tasks. 4. It describes the sense of loss that middle-aged individuals feel, understanding that some of the goals established in their youth will be unmet.

answer: 1 Empty nest syndrome describes the adjustment period parents experience when the last child leaves home to establish an independent residence. The crisis is often more profound in the mother.

The worried mother of an adolescent girl with psychiatric illness says, "She injures her little brother and brings him to me, as if she is very concerned about him." Which psychiatric illness could be suspected in this client? 1. Factitious disorder 2. Illness anxiety disorder 3. Somatic symptom disorder 4. Functional neurological symptom disorder

answer: 1 Factitious disorder is a psychiatric complication in which the client may inflict injuries on self or others to gain the attention of family members or peers.

Which occurrence tends to decrease a person's ability to deal with stress and may result in physical or emotional illness? 1. Changes in life patterns occurring in close proximity 2. Tornados 3. Loss of a sense of self-worth 4. Inadequate living conditions

answer: 1 Frequent changes in life patterns occurring in close proximity decrease a person's ability to deal with stress and may result in physical or emotional illness. Miller and Rahe in1997 described this phenomenon.

Which describes the purpose of group therapy? 1. To improve reality testing and sense of cohesiveness 2. To improve vocational expectations 3. To stimulate interest in family intervention programs 4. To improve disturbing and deviant behaviors

answer: 1 Group therapy mainly aims at improving reality testing for clients and at increasing the sense of cohesiveness, which reduces social isolation.

Which agency is charged with the responsibility for mental health care in the United States? 1. National Institute of Mental Health 2. Joint Commission on Mental Health and Illness 3. Medicaid 4. United States Congress

answer: 1 In 1949, the National Institute of Mental Health (NIMH) was established as an outgrowth of the National Mental Health Act. The United States government charges this agency with the responsibility for mental health care in the United States.

Which statement made by the client's family may suggest the presence of dissociative amnesia with dissociative fugue in the client? 1. "My son assumed a new identity after the accident." 2. "My son is intentionally harming himself." 3. "My son is disoriented and detached from the environment." 4. "My son developed negative feelings about his capabilities."

answer: 1 In dissociative fugue, which is a subtype of dissociative amnesia, the client forgets his or her personality identity and may assume a new identity.

A client is diagnosed with disturbed personal identity in which one of the personalities is suicidal. Which nursing intervention would protect the client from self-harm? 1. Seeking assistance from a strong-willed personality 2. Helping the client understand the existence of subpersonalities 3. Helping the client identify stressful situations 4. Helping the subpersonalities understand that their existence will not be destroyed

answer: 1 In disturbed personal identity, if one personality is suicidal it may be possible to seek assistance from another subpersonality that is strong-willed to control the behavior of the suicidal personality.

Which situational crisis is mostly likely to be identified in a homeless, unemployed individual with nutritional deficiency? 1. Poverty 2. Trauma 3. Altered perception of time 4. Achieving self-esteem

answer: 1 Inadequate or crowded living conditions, nutritional deficiencies, medical neglect, unemployment, or homelessness is considered a consequence of poverty.

The nurse is caring for clients who have experienced an earthquake. Which nursing intervention would be appropriate for this group? 1. The nurse establishes at the outset what is acceptable and what is not and maintains consistency. 2. The nurse encourages explanations and rationalizations of the situation. 3. The nurse provides positive feedback for feelings of anger, guilt, helplessness, and powerlessness. 4. The nurse provides support and accurate information to ease the difficult developmental transition the clients are undergoing.

answer: 1 Individuals experiencing situational crises such as a natural disaster have high levels of anxiety. The behavior of such victims is likely to be impulsive and regressive. The nurse would establish at the outset what is acceptable and what is not and maintain consistency.

Which nursing intervention will the nurse provide to reduce the anxiety and maladaptive behavior of a client with somatic symptom disorder? 1. Initially fulfilling the client's most urgent dependency needs 2. Helping the client identify ways to achieve recognition from others 3. Providing pain medication to the client as prescribed 4. Accepting that the physical complaint is real, even though it is inaccurate

answer: 1 Initially fulfilling the client's most urgent dependency needs would provide a feeling of comfort to the client. This would reduce the client's anxiety and maladaptive behavior. The nurse will gradually withdraw attention to physical symptoms.

Which is believed to be the most frequent immediate precipitant to adolescent suicide? 1. Threat of loss of parents 2. Drug and alcohol use 3. Physical appearance 4. Sexuality and sexual experimentation

answer: 1 It is believed that the most frequent immediate precipitant to adolescent suicide is loss of, or the threat of loss of or abandonment by, parents or close peers.

A client has been in multiple abusive relationships yet stays with the significant other because the client feels he or she cannot leave. Which theory can best explain the client's depression? 1. Learning theory 2. Cognitive theory 3. Object loss theory 4. Psychoanalytical theory

answer: 1 Learning theory suggests that the client learns helplessness and feels a lack of control over his or her life.

Which are the anticholinergic side effects associated with novel antipsychotic medications? 1. Tremors 2. Drowsiness 3. Weight loss 4. Bradycardia

answer: 1 Novel antipsychotic medications may cause tremors as a side effect. This is because of their anticholinergic effect on the motor control of the body.

How might preschoolers behave in response to the deployment of a parent to combat? 1. Believe they are to blame for the parent leaving 2. Develop difficulty sleeping, exhibit temper tantrums, or become tearful 3. Lose weight, have no appetite, and become irritable and apathetic 4. May become regressed and fearful about parent's safety

answer: 1 Preschoolers between the ages of 3 and 6 years may believe they are to blame for their parent leaving.

Which description applies to the concept of primary prevention in a community-based mental health-care system? 1. Services aimed at reducing the incidence of mental disorders within the population 2. Interventions aimed at minimizing early symptoms of psychiatric illness 3. Interventions directed toward reducing the prevalence and duration of a psychiatric illness 4. The services aimed at reducing the residual defects that are associated with severe and persistent mental illness

answer: 1 Primary prevention reduces the incidence of mental disorders within the population by diminishing the stressors within the environment and by assisting individuals to increase their ability to cope effectively with stress.

Which is a severe symptom of a traumatic brain injury (TBI)? 1. Profound confusion 2. Nausea 3. Blurred vision 4. Changes in sleep patterns

answer: 1 Profound confusion is a severe symptom of TBI.

A client in a psychiatric ward has severe psychotic episodes and talks to self. On assessing the behavior of the client, the nurse talks to the client about place, time, and current activity. What is the nurse trying to do by implementing this intervention? 1. Orienting the client toward reality 2. Distracting the client from hallucinations 3. Assessing the client's level of cognitive impairment 4. Facilitating trust and understanding with the client

answer: 1 Talking to the client about place, time, and current activity reminds the client about reality. The nurse is trying to orient the client toward reality by differentiating between what is real and not real.

Whose concepts form the basis of the public health model? 1. Gerald Caplan 2. Dorothea Dix 3. Ronald Reagan 4. Erik Erikson

answer: 1 The basis of the model of public health that includes primary, secondary, and tertiary prevention primarily pertains to the concepts set forth by Gerald Caplan in 1964 during the initial movement of community-based mental health care.

The registered nurse is evaluating a student nurse who is caring for a client with borderline personality disorder. Which action of the student nurse does the registered nurse correct during the evaluation? 1. Leaving the client alone to work out stressful feelings 2. Observing the client's behavior frequently 3. Encouraging the client to talk about his or her feelings 4. Removing dangerous objects from the client's environment

answer: 1 The client with borderline personality disorder would not be left alone during stressful times because it may cause an acute rise in anxiety and agitation levels.

A client with mania who is extremely hyperactive and intensely agitated is admitted into the psychiatric ward. During client care, the nurse instructs the client to perform slow exercises. Which risks does the nurse intend to prevent in the client? 1. Risk of physical injury 2. Risk of weight gain 3. Risk of harming other individuals 4. Risk of insomnia

answer: 1 The client with intense agitation and extreme hyperactivity is at risk for injury. Providing the client calming physical activities or exercises will help reduce agitation in the client. Therefore, the nurse tries to prevent the risk of physical injury.

Which statement of the client supports the nurse's suspicion that the client has schizotypal personality disorder? 1. "I have had sixth sense since I was young." 2. "I always like to move with high-status people because I am special and unique." 3. "I feel very uncomfortable when I am not the center of attention." 4. "I don't have many close friends to share my emotions."

answer: 1 The client with schizotypal personality disorder will believe in clairvoyance, telepathy, or sixth sense. Therefore, the nurse suspects schizotypal personality disorder when the client talks about his or her sixth sense.

A postpartum mother begins to cry during a checkup and reports to the nurse, "I feel so sad and tired after caring for my baby. I can't concentrate on anything." How would the nurse respond to the client? 1. "These symptoms last only for a couple of weeks if you interact with your child." 2. "Contact the primary health-care provider to get some medications." 3. "Consider supportive psychotherapy with continuous assistance until the symptoms subside." 4. "Don't worry. Take the medications as prescribed because they will help you to overcome this feeling."

answer: 1 The mother is experiencing the symptoms of "maternity blues" that will usually subside within 2 weeks. Therefore, the nurse would assure the client not to worry about the symptoms of maternity blues.

Which advice by the community nurse is targeted for the newly married couple as a primary preventive measure? 1. Encourages the couple to engage in honest communication 2. Advises the couple regarding sexuality, pregnancy, contraception, and sexually transmitted diseases 3. Informs the couple that husband-wife bonding does not occur immediately 4. Supports satisfaction with current living arrangements

answer: 1 The nurse encourages the newly married couples to engage in honest communication. This is a primary preventive measure to minimize conflict.

The nurse is caring for a client with schizophrenia who reports auditory hallucinations. The nurse teaches the client to say "Leave me alone" whenever the voices are speaking. What is the specific outcome of this nursing intervention? 1. The client gains conscious control over the hallucinations. 2. The client demonstrates trust over the surrounding environment. 3. The client perceives fewer hallucinations and involves himself or herself in interpersonal activities. 4. The client will show interest in discussing the content of hallucinations.

answer: 1 The nurse is performing the intervention known as voice dismissal with the client who reports auditory hallucinations. This helps the client dismiss and gain control over the hallucinations.

The nurse is caring for a client who suffers from post-traumatic stress disorder (PTSD) after serving abroad in a combat zone. While caring for the client, the client notes that he has had suicidal thoughts. Which nursing intervention is most appropriate for the nurse to implement with this client first? 1. Ask the client if he has a plan to carry out his suicidal thoughts. 2. Ask the client if he has thoughts about inflicting physical harm on other people. 3. Teach the client to incorporate deep breathing and meditation into his daily routine. 4. Carefully assess and report any cognitive changes in the client.

answer: 1 The nurse needs to assess if the client has a plan in place for committing suicide and if the client plans to implement the suicidal plan. This is to ensure the client's safety from self-harm.

The nurse is caring for a group of clients. Which client would the nurse identify as being at highest risk for suicide? 1. A divorced white middle-aged male 2. A married Hispanic elderly female 3. A single Asian young male 4. A divorced black middle aged female

answer: 1 This client is at highest risk for suicide. Being divorced, being white, and being middle-aged are all high risk factors.

Which scenario describes the cause of anomic suicide, according to Durkheim? 1. A man's wife leaves him and his three children for her husband's best friend. 2. A man is not accepted by his family or church community for his sexuality. 3. A woman is extremely devoted to her religion and would give her life for their cause. 4. A woman has been a victim of human trafficking for the past 4 years.

answer: 1 This describes an example of the cause of anomic suicide (divorce, loss of job).

The nurse is caring for a client who is at high risk for violence. While caring, the nurse offers an empathetic response to the client's feelings. Which outcome does the nurse expect from this intervention? 1. The client develops trust. 2. The client develops self-esteem. 3. The client develops a less anxious nature. 4. The client develops a feeling of some control.

answer: 1 When the nurse offers an empathetic response to the client's feelings, the client develops trust in the nurse. This is because the client feels that the nurse has an understanding nature.

When would the nurse ascertain that an individual can accept compromise? 1. While counseling newly married couples 2. While counseling a couple expecting to be parents 3. While counseling individuals who are transitioning into young adulthood 4. While counseling individuals who recently went through a traumatic experience

answer: 1 While counseling individuals who have just married or are planning to marry, the nurse would ascertain whether each individual can accept compromise.

Which nursing interventions are best suited for war veterans who are at risk of suicide? Select all that apply. 1. Identify the seriousness of the threat, existence of a plan, and the lethality of the means. 2. Ensure the safety of the client's environment. 3. Evaluate the client's mental status, including the client's thought processes. 4. Monitor the client's medication regimen. 5. Assist the client in understanding how substance abuse delays healing.

answer: 1, 2 When the nurse is caring for a war veteran who is at risk of suicide, the nurse needs to determine the seriousness of the threat, existence of a plan, and the lethality of the means. The nurse would ensure environmental safety when any client is at risk of committing suicide.

In an educational program targeted for adolescents, which points will the nurse discuss? Select all that apply. 1. Instructional information about emotional volatility that may occur 2. Information about sexuality, pregnancy, contraception, and sexually transmitted diseases 3. Information about the abuse of alcohol and drugs 4. Discussion about the ability to compromise 5. Discussion of the effects of nutritional deficiencies

answer: 1, 2 ,3 Adolescence is a volatile stage of human development during which the child transforms into a young adult through physical and mental transitions. The nurse would discuss and validate these physical and mental changes. Adolescents would be given adequate information about sexuality, pregnancy, contraception, and sexually transmitted diseases. Clear concepts in such areas help in healthy transition to adulthood. Alcohol and drug abuse have a negative impact on family life. Adolescents may be made aware of the negative effects of drug and alcohol abuse.

Which side effects are usually observed in a client who is administered fluoxetine? Select all that apply. 1. Insomnia 2. Agitation 3. Impotence 4. Weight gain 5. Photophobia

answer: 1, 2, 3 Fluoxetine (Prozac) is a selective serotonin reuptake inhibitor (SSRI) that causes insomnia as a side effect. SSRIs cause agitation as a side effect. Sexual dysfunction is a side effect of SSRIs.

Which of these are diagnostic criteria of a client with functional neurological symptom disorder? Select all that apply. 1. Seizures 2. Paralysis 3. Blindness 4. Seductiveness 5. Impressionistic speech

answer: 1, 2, 3 Functional neurological symptom disorder is called a conversion disorder. Seizures are the signs of functional neurological symptom disorder. Paralysis is a diagnostic criterion of conversion disorder. Blindness is a diagnostic criterion of conversion disorder.

Which symptoms in a client indicate the persecutory type of delusional disorder? Select all that apply. 1. The feeling of being spied on 2. The feeling of being poisoned 3. The feeling of being plotted against 4. The feeling of a famous person being in love with him or her 5. The feeling of being in a relationship with a religious leader

answer: 1, 2, 3 The client's feeling of being spied on indicates that the client is experiencing a persecutory type of delusional disorder. The client's feeling of being poisoned indicates that the client is experiencing a persecutory type of delusional disorder. The client's feeling of being plotted against indicates that the client is experiencing a persecutory type of delusional disorder.

Which individuals in transitional periods need support from the community nurse to increase their ability to cope effectively with stress? Select all that apply. 1. Widowers 2. New retirees 3. Women entering the workforce in middle life 4. Unemployed individuals 5. Homeless individuals

answer: 1, 2, 3 Widowers are individuals in a transitional period in need of support from the community nurse to increase their ability to cope effectively with stress. New retirees are individuals in a transitional period in need of support from the community nurse to increase their ability to cope effectively with stress. Women entering the workforce in middle life are individuals in a transitional period in need of support from the community nurse to increase their ability to cope effectively with stress.

Which are possible fears a woman in the military may experience when considering whether to report incidents of sexual assault to their commanding officers? Select all that apply. 1. They may be removed from duty. 2. The commanding officer may not take action or acknowledge the incident occurred. 3. They may be passed over for promotions. 4. They may be transferred to a remote location. 5. Their commanding officers may make them feel they were perpetrators, not the victims, of the incidents.

answer: 1, 2, 3, 4, 5 One of the greatest fears for women in the military for reporting a sexual incident to a superior involves removal from duty. There are reports that some women in the military who have reported sexual assault have been asked to forget about it by their superiors. Another fear of women in the military in terms of reporting sexual incidents to superiors involves them being passed over for well-deserved promotions. Being transferred to a remote location is another fear for women in the military when reporting sexual incidents to superiors. Women in the military who have reported sexual assaults against them have been made to feel they have been the perpetrators, rather than the victims.

Which disorders are categorized as somatic symptom disorders? Select all that apply. 1. Factitious disorder 2. Conversion disorder 3. Dissociative amnesia 4. Illness anxiety disorder 5. Depersonalization-derealization disorder

answer: 1, 2, 4

The nurse is conducting a suicide prevention event at a conference for working women. Which occupations does the nurse identify at highest risk for suicide for women? Select all that apply. 1. Lawyer 2. Firefighter 3. Journalist 4. Architect 5. Police officer

answer: 1, 2, 5

The family of a client who has attempted suicide and is to be discharged home from a psychiatric unit asked the nurse what they can do to prepare for the client's return home. Which instructions would the nurse include in the teaching for the family? Select all that apply. 1. Provide the telephone number of a counselor 2. Ensure the home environment is safe from dangerous items 3. Ignore any discussion the client makes about suicide 4. Ensure the client avoids taking any medications 5. Be a good listener for the client

answer: 1, 2, 5 The family or friend should be provided with the number of a counselor, suicide hotline, and an emergency number. The friends or family members should ensure the home is safe from any dangerous items before the client returns home. It is important to "be there" and allow the client to talk.

The nurse is caring for a client whose husband is on active military duty. The client's husband has just been deployed. Which defining characteristics may indicate the client is at risk of complicated grieving related to military deployment of the spouse? Select all that apply. 1. Depression 2. Rebelliousness 3. Fear 4. Guilt and self-blame 5. Promiscuity

answer: 1, 3 Depression can happen when a spouse leaves for a period of military deployment. The client may experience fear when a spouse is deployed. The remaining spouse will fear that something may happen to his or her spouse and experiences complicated grieving.

The nurse is teaching a class about suicide prevention. Which statement made by an event attendee requires correction regarding suicide? Select all that apply. 1. "Suicide happens without any warning." 2. "Not everyone who commits suicide has a mental illness." 3. "Once someone attempts suicide, they won't do it again." 4. "Most people kill themselves by taking pills." 5. "People who talk about killing themselves are trying to get attention."

answer: 1, 3, 4, 5 This statement requires correction. Eight out of 10 people who kill themselves have given definite clues and warnings of their intentions. This statement requires correction. Between 50 and 80 percent of people who kill themselves had a history of a previous attempt. This statement requires correction. Gunshot wounds are the leading cause of death among suicide victims. This statement requires correction. Suicidal ideation is a cry for help, not attention.

The nurse would monitor which clients closely for suicide risk? Select all that apply. 1. A client who recently began taking antidepressants 2. A client who gets 7 hours of sleep each night 3. A client who drinks alcohol with barbiturates 4. A client who is being titrated off of stimulants slowly 5. A client with chronic illness

answer: 1, 3, 5 A client who recently began taking antidepressants is at risk for suicide because the client now has the energy to carry out the plan for suicide. This client is at increased risk of suicide. Chronic illness places a client at risk for suicide.

According to the National Institute on Drug Abuse (NIDA), which substance abuse disorders have increased over time in war veterans? Select all that apply. 1. Prescription drug abuse 2. Illicit drug abuse 3. Tobacco abuse 4. Heavy alcohol use 5. Antidepressants abuse

answer: 1, 4 Prescription drug abuse has increased over time. Heavy alcohol use has increased over time.

Which statements about the report "Action for Mental Health" are correct? Select all that apply. 1. It made recommendations for treatment of clients with mental illness. 2. It helped identify the nation's mental health needs. 3. It made recommendations for improvements in psychiatric care. 4. It made recommendations for the training of the caregivers of the clients. 5. It made recommendations for improvements in education and research related to mental illness.

answer: 1, 4, 5 "Action for Mental Health" is a report published by the Joint Commission on Mental Health and Illness. In this report, recommendations were made for treatment of clients with mental illness. In the report "Action for Mental Health," recommendations were made regarding the need for the training of caregivers. The report "Action for Mental Health" made recommendations for improvements in education and research related to mental illness.

The nurse is caring for a client who is diagnosed with hypomania. Which behavior does the nurse find in the client? Select all that apply. 1. The client is cheerful and expansive with an underlying irritability. 2. The client shows extreme fluctuating emotions. 3. The client tries to maintain a close friendship with the nurse. 4. The client neglects personal hygiene and grooming. 5. The client talks and laughs very loudly while communicating with the nurse.

answer: 1, 5 Social and occupational functioning are not severely affected in a client with hypomania. Therefore, the mood of a hypomanic client is cheerful and expansive with an underlying irritability. The client with hypomania talks and laughs, typically very loudly, and often inappropriately.

The mother of an adolescent client says, "My child keeps talking about calling the U.S. President to give him suggestions." The nurse also finds that the client has increased libido. Which does the nurse interpret from these findings? 1. The client is experiencing psychosis. 2. The client is experiencing hypomania. 3. The client is experiencing acute mania. 4. The client is experiencing delirious mania.

answer: 2 A client experiencing hypomania has exalted self-perception and engages in inappropriate behaviors, such as phoning the President of the United States. Increased libido is also common in a hypomanic client.

Which response of the client diagnosed with antisocial personality disorder with impaired social interaction and defensive coping indicates that psychotherapy is effective? 1. The client ridicules a manic client in the psychiatric unit. 2. The client plays a leading role in a group activity without expressing grandiosity. 3. The client requests the nurse to excuse him or her from a particular task. 4. The client declares that his family is responsible for his condition.

answer: 2 A client with antisocial personality disorder shows impaired social interaction and defensive coping. A client who plays a leading role in a group activity indicates improvement of the symptoms, which may be the result of effective treatment. This is because the client cooperates with others and interacts well.

Which feature can be observed in a client with obsessive-compulsive personality disorder? 1. Difficulty in problem-solving 2. Difficulty in expressing emotions 3. Difficulty in paying attention to detail 4. Difficulty in maintaining long-lasting relationships

answer: 2 A client with obsessive-compulsive disorder has difficulty in expressing emotions due to anxiety regarding uncertainty about the future.

Which medication would the nurse prepare to administer to reverse extrapyramidal effects associated with antipsychotic therapy? 1. Warfarin 2. Amantadine 3. Epinephrine 4. Haloperidol

answer: 2 Amantadine is a dopamine agonist that helps treat the extrapyramidal effects in clients with psychotic disorders.

A primary health-care provider infers from a test that a client's depression is somatically treatable. The elevated level of which parameter might be the reason for reaching such a conclusion? 1. Calcium 2. Serum cortisol 3. Sodium bicarbonate 4. Thyroid-stimulating hormone

answer: 2 An elevated level of serum cortisol is determined in a dexamethasone suppression test. This test is sometimes used to determine if the client's depression is somatically treatable.

While educating a client diagnosed with bipolar disorder, the nurse teaches the client to avoid excessive exposure to very high or low temperatures. Which category of medications might be present on the medication list of the client? 1. Antimanic 2. Antipsychotic 3. Anticonvulsant 4. Calcium channel blocker

answer: 2 Antipsychotics may increase skin sensitivity toward extreme temperatures. Therefore, the nurse teaches the client to avoid excessive exposure to very high or low temperatures.

The nurse is visiting with a client admitted to the psychiatric unit with depression and a history of suicide attempts. Which question by the nurse is appropriate? 1. "How often do you feel sad?" 2. "Are you having thoughts of harming yourself?" 3. "Do you think you might go ahead and kill yourself?" 4. "Are you attempting suicide for attention?"

answer: 2 Assessing risk for suicide for a client with a history of attempts and admitted for depression is most important.

Which behavior does the nurse observe in the client with anxious or fearful personality disorder? 1. The client has a long-term distrust of his or her family. 2. The client feels shy and is sensitive to rejection. 3. The client has an extreme sense of self-importance. 4. The client manipulates others to fulfill self-desires.

answer: 2 Clients who are shy and sensitive to rejection show avoidance, which is a characteristic behavior of the fearful (group C) cluster.

The nurse observes that a client with osteoarthritis behaves rudely to the staff and refuses treatment. On assessing, the nurse learns that the client thinks that all staff members are planning to harm and deceive him. Which is the client likely to be suffering from? 1. Schizoid personality disorder 2. Paranoid personality disorder 3. Narcissistic personality disorder 4. Obsessive-compulsive personality disorder

answer: 2 Clients with paranoid personality disorder are suspicious and believe that others want to exploit, harm, and deceive them. They develop a defense system and try to counterattack the other person and reject the treatment. They behave rudely and develop jealousy toward others.

While reviewing the laboratory reports of a client with a psychotic disorder, the nurse finds abnormally high levels of prolactin in the blood. Which medication in the client's prescription might be the cause of this finding? 1. Clozapine 2. Haloperidol 3. Lurasidone 4. Risperidone

answer: 2 Conventional atypical antipsychotics, such as haloperidol, may cause hyperprolactinemia as a side effect.

After a traumatic event, a client reports paralysis in his left arm. The laboratory reports of the client indicate that there is no underlying organic pathology. Which disorder might the nurse suspect in this client? 1. Factitious disorder 2. Conversion disorder 3. Illness anxiety disorder 4. Somatic symptom disorder

answer: 2 Conversion disorder includes physical disability with no underlying organic pathology. Thus, the client may have conversion disorder.

A psychiatric client looks at cotton swabs on the nursing table and says, "These cotton swabs are as big as clouds." Which condition might be present in this client? 1. Factitious disorder 2. Derealization disorder 3. Illness anxiety disorder 4. Functional neurological symptom disorder

answer: 2 Conversion disorder is characterized by the loss of or change in body function, which cannot be explained by any known medical disorder.

Which antidepressant drug acts as a serotonin-norepinephrine reuptake inhibitor? 1. Phenelzine 2. Desvenlafaxine 3. Bupropion 4. Isocarboxazid

answer: 2 Desvenlafaxine is an antidepressant drug that acts as a serotonin-norepinephrine reuptake inhibitor.

Why is the dose of antidepressant drug decreased in elderly clients? 1. Brain receptor sensitivity is high in elderly people. 2. Elderly people have decreased elimination of drugs. 3. Elderly people will experience only transient depression. 4. The primary treatment includes psychosocial and biological approaches.

answer: 2 Elderly people have decreased elimination of drugs, resulting in high plasma levels of drugs, even with moderate doses. Therefore, the dose of antidepressant drugs is reduced to minimize side effects.

Which is a probable cause for dissociative identity disorder (DID) in a client? 1. Alcohol abuse 2. History of abuse as a child 3. Drug abuse and overmedication 4. Detachment with respect to surroundings

answer: 2 In DID, the client may have a history of childhood abuse.

The nurse is making rounds at different times on different days to the individuals who are at high risk for suicide. Which rationale explains the need for this nursing intervention? 1. It provides more frequent observation. 2. It prevents staff surveillance from becoming predictable. 3. It alleviates the shortage of nurses. 4. It keeps nurses from getting bored with the same routine.

answer: 2 Irregular rounding prevents staff surveillance from becoming predictable and diverts clients from attempting suicide at a time they feel a nurse may typically round.

Which event can initiate post-traumatic stress disorder (PTSD) in a service member? 1. Severe blows to the head of the individual with shrapnel or debris 2. Sustaining an accident or suffering an act of violence 3. Blasts from explosive devices hitting the head of the individual 4. Penetrating wounds

answer: 2 PTSD happens when a person suffers an accident or an act of violence. This act can lead to death or injury.

The registered nurse is teaching a group of nurses about psychological trauma. Which statement would the registered nurse include in the lesson? 1. "Dissociative amnesia may be related to neurological amnesia." 2. "Traumatic experiences overcome the capacity to cope by any means other than dissociation." 3. "Repressing distressed mental contents from conscious awareness may lead to dissociative behaviors." 4. "Genetic factors of pathological and nonpathological dissociative capacity may be associated with dissociative identity disorder."

answer: 2 Psychological trauma explains that traumatic experiences overcome the capacity to cope by any means other than dissociation.

The nurse is reviewing statistics of leading causes of death among Americans ages 10 to 34 years. Which action is the second leading cause of death? 1. Homicide 2. Suicide 3. Unintentional injury 4. Heart disease

answer: 2 Suicide is the second leading cause of death among Americans 10 to 34 years of age.

Which part of the brain mediates the symptoms of psychomotor retardation? 1. Amygdala 2. Cerebellum 3. Hypothalamus 4. Frontal cortex

answer: 2 The cerebellum mediates the symptoms of psychomotor retardation or agitation.

Which findings in the client support the nurse's expectation that a psychiatric client is showing symptoms of histrionic personality disorder? 1. The client does not talk to the caregivers in the hospital. 2. The client is usually extroverted and excited. 3. The client is highly suspicious of the nurse's activities. 4. The client exaggerates when the nurse praises him or her for an achievement.

answer: 2 The client with histrionic personality disorder displays rapidly shifting and shallow expression of emotions. The client will be extroverted and excited most of the time.

The nurse is preparing the client with schizophrenia for an examination procedure to assess abnormal involuntary movements. Which action of the client needs correction during examination? 1. Removing the shoes and socks 2. Sitting in the chair with legs crossed 3. Keeping the legs slightly apart while sitting 4. Sitting in the chair with both hands on knees

answer: 2 The client would sit in the chair with his or her feet flat on the floor. Therefore, the nurse corrects this action of the client during examination.

Which specialist is trained in the medical specialty of physical medicine and rehabilitation? 1. Occupational therapist 2. Physiatrist 3. Physical therapist 4. Neuropsychologist or psychiatrist

answer: 2 The physiatrist is a physician who undergoes training to work with clients who require physical medicine and rehabilitation.

Which statement made by the student nurse indicates an understanding of Joiner's theory of suicide? 1. "The move from suicide ideation to attempts is viewed as an impulsive act." 2. "Individuals work up to the act of suicide by first attempting self-harm." 3. "Having a low feeling of burden increases suicidal thoughts." 4. "Only psychological factors are critical to understanding suicide risk."

answer: 2 This statement is accurate and does not require correction. Individuals may become fearless by attempting self-harm first and then build up to suicide.

After coming back from combat in Afghanistan, a veteran has been diagnosed with a mild traumatic brain injury (TBI). A psychiatric home health nurse visits the veteran and instructs the spouse, who is the caregiver. What would be an appropriate intervention for the nurse to include in the care plan? 1. Instruct the spouse to keep a journal of experiences and feelings of being a caregiver. 2. Encourage the spouse to express any feelings and participate in a support group. 3. Involve the spouse in mutual goal-setting to plan for the future. 4. Encourage the spouse to participate in a multidisciplinary team conference or group therapy.

answer: 2 When the spouse is a caregiver, the nurse should encourage the spouse to express any feelings and to participate in a support group.

Which medications are the most potent antagonists of the serotonin-type 2A receptors? Select all that apply. 1. Loxapine 2. Ziprasidone 3. Risperidone 4. Aripiprazole 5. Fluphenazine

answer: 2, 3, 4

While caring for a client with schizophrenia, the nurse finds that the client has aggressive body language, catatonic excitement, and command hallucinations. Which interventions would the nurse implement to ensure the safety of this client? Select all that apply. 1. Restrain and monitor the client closely 2. Use a calm attitude with the client 3. Engage the client in activities like punching a bag 4. Maintain a low level of lighting and simple decor in the client's room 5. Assess the client's understanding about the content of hallucinations

answer: 2, 3, 4 Aggressive body language, catatonic excitement, and command hallucinations indicate a risk of violence in the client. Therefore, the nurse would maintain a calm attitude to prevent anxiety and the risk of violence in the client. Activities such as punching a bag and physical exercise help the client avoid the risk of harming others or self-directed violence. Therefore, this intervention ensures the safety of the client. Simple decor and a low level of lighting ensure a calm environment, which helps minimize the anxiety and reduce the risk of violence in the client.

Which are the primary causes of post-traumatic stress disorder (PTSD) in midlife for a veteran? Select all that apply. 1. Experiencing the death of a friend in war 2. Going through the process of divorce 3. Experiencing the death of a friend due to old age 4. Suffering from an accidental head injury 5. Watching his or her health deteriorate

answer: 2, 3, 5 Going through the process of divorce can act as a precipitant for PTSD in midlife for a veteran. The death of a friend due to old age is a precipitant for PTSD in midlife for a veteran. Watching his or her health deteriorate due to age is a precipitant for PTSD for a veteran in midlife.

A client with mania reports an inability to sleep. Which appropriate actions does the nurse take to help the client sleep better? Select all that apply. 1. Provide a low-protein diet 2. Administer sedative agents as prescribed 3. Reduce lighting in the room 4. Provide tea or coffee before sleep 5. Help perform relaxation exercises before sleep

answer: 2, 3, 5 The client with mania suffers from sleep deprivation due to hyperactivity. Administering sedative agents helps the client achieve sleep until a normal sleep pattern is restored. Reducing lighting in the room can promote sleep. The manic client must be provided frequent periods of rest to prevent sleep deprivation. Helping the client perform relaxation exercises before sleep contributes to a more calming environment conducive to sleep.

A client with bipolar disorder is at high risk of self-harm. The nurse finds that the client perceives actions of others as threatening. What does the nurse do to ensure the safety of this client? Select all that apply. 1. Uses mechanical restraints 2. Places the client on 1-1 precautions 3. Provides additional care by adding new staff 4. Maintains low level of stimuli in the client environment 5. Notifies the primary health-care provider

answer: 2, 4 If a patient may self-harm, it may be necessary to assign a nurse for one-on-one client care. This intervention is not necessary if mechanical restraints are not used to control the actions of the client. Maintaining low levels of stimuli, such as low lighting and low noise levels, will reduce the perception of threats in the client; anxiety will rise with a high level of stimuli.

Which personality disorders are characterized by exploitative behaviors? Select all that apply. 1. Schizoid personality disorder 2. Antisocial personality disorder 3. Borderline personality disorder 4. Schizotypal personality disorder 5. Narcissistic personality disorder

answer: 2, 5

Which intervention would the nurse perform to prevent drowsiness and dizziness in a client who is on verapamil therapy? 1. Encourage the client to eat a fiber-rich diet 2. Advise the client to take verapamil along with food 3. Instruct the client not to operate heavy machinery 4. Record the client's blood pressure before administration of the medication

answer: 3 A client who is on verapamil therapy will be drowsy and dizzy. The nurse would advise the client not to operate heavy machinery.

The nurse finds that a client is imitating all the hand movements of a family member while communicating. Which does the nurse infer from this behavior? 1. The client is exhibiting echolalia. 2. The client is exhibiting anhedonia. 3. The client is exhibiting echopraxia. 4. The client is exhibiting neologisms.

answer: 3 A client with echopraxia purposelessly imitates movements or actions made by others.

A client tells the nurse, "Brad Pitt is in love with me and often sends me flowers." Which type of delusion does the nurse document for the client based on this statement? 1. Jealous 2. Grandiose 3. Erotomanic 4. Persecutory

answer: 3 A client with erotomanic delusions believes that someone, usually of a higher status and sometimes someone famous, is in love with him or her. Therefore, the nurse expects that the client is experiencing erotomanic delusions based on the client's statement.

Which client always chooses solitary activities and has no desire or interest in having any type of social relationships? 1. A client with antisocial personality 2. A client with paranoid personality 3. A client with schizoid personality 4. A client with avoidant personality

answer: 3 A client with schizoid personality always chooses solitary activities. He or she is unable to develop and maintain relationships with other people. He or she lacks the willingness to be involved in any close relationships and is emotionally restricted.

Which term is most appropriate to describe all people living in rural Illinois? 1. Group 2. Population 3. Community 4. Individuals

answer: 3 A group, population, or cluster of people with at least one common characteristic, such as geographic location, occupation, ethnicity, or health concern is called a community.

The nurse is caring for a client whose spouse has just been deployed. The client has been caring for their children without much help from others, and reports feeling overwhelmed and sad most days. The client also describes feeling lonely and abandoned by the deployed spouse. Which stage of the cycle of deployment is this client most likely experiencing? 1. Sustainment 2. Predeployment 3. Deployment 4. Postdeployment

answer: 3 At the deployment stage, military spouses report feeling disoriented and overwhelmed. They experience a wide variety of emotions that include numbness, sadness, loneliness, and abandonment.

Which medication in psychopharmacology treats antipanic effects in cases of post-traumatic stress disorder (PTSD)? 1. Trazodone 2. Tricyclics amitriptyline 3. Benzodiazepines 4. Propranolol

answer: 3 Benzodiazepines are sometimes prescribed for their antipanic effects during PTSD.

Which findings may be present in a client with a depressive episode of bipolar disorder? 1. Increased levels of serotonin 2. Increased levels of dopamine 3. Increased levels of acetylcholine 4. Increased levels of norepinephrine

answer: 3 Bipolar disorder will occur due to an imbalance between biogenic amines and acetylcholine. Cholinergic transmission will be excessive during depressive moods of the client due to increased levels of acetylcholine.

The nurse, while caring for a client with a gastrointestinal disorder, suspects that the client has avoidant personality disorder. Which behavior of the client enables the nurse to have this suspicion? 1. The client always suspects others. 2. The client feels adequate when given attention. 3. The client is hypersensitive to criticism. 4. The client demonstrates suicidal behavior to evoke rescue response.

answer: 3 Clients with avoidant personality disorder may have anxiety and fear of rejection or humiliation. They avoid getting involved in activities and do not make new friends. They become very sensitive to criticisms. Therefore, the client with this disorder is hypersensitive to negative evaluation.

A client is diagnosed with illness anxiety disorder. Which nursing action would help yield information about maladaptive behavior present in the client? 1. Allowing the client to discuss physical concerns 2. Monitoring laboratory reports of the client 3. Assessing the function that the client's excessive concern is fulfilling for him 4. Determining the extent to which physical complaints correlate with times of increased anxiety

answer: 3 Clients with illness anxiety disorder have unrealistic interpretations of bodily sensations, and they depend on maladaptive behaviors to fulfill their needs. Assessing the function that the clients' excessive concern is fulfilling may provide information about clients' maladaptive behaviors.

A client is diagnosed with depersonalization-derealization disorder. Which outcome would the nurse expect while planning care for this client? 1. The client can recall all events of his life. 2. The client verbalizes understanding regarding the existence of multiple personalities. 3. The client can demonstrate more adaptive coping strategies to avert dissociative behaviors. 4. The client effectively uses adaptive coping strategies during stressful situations without resorting to physical symptoms.

answer: 3 Depersonalization-derealization disorder is characterized by dissociative symptoms. The client demonstrating adaptive coping strategies to avert dissociative symptoms is the possible outcome for depersonalization-derealization disorder.

Which drug has been shown to be effective in enhancing the cognitive function in a war veteran with traumatic brain injury (TBI)? 1. Alprazolam 2. Methylphenidate 3. Donepezil 4. Trazodone

answer: 3 Donepezil has been shown to be effective for the enhancement of cognitive performance in a veteran with TBI.

Which stage of life creates a conflict between the values of the parents and the lifestyles of their children? 1. Adolescence 2. Parenthood 3. Midlife 4. Retirement

answer: 3 During midlife, a complex emotional process occurs that creates a conflict between the values of the parents and the lifestyles of their children.

Which therapy might be helpful to a client with bipolar II disorder who is not responding to lithium therapy? 1. Cognitive therapy 2. Individual therapy 3. Electroconvulsive therapy 4. Family therapy

answer: 3 Electroconvulsive therapy is an alternative therapy option for clients who are unresponsive to medication therapy or lithium therapy.

A client who suffered a head injury in an accident complains of frequent sleepiness and loss of appetite. Which part of the client's brain has most likely been affected? 1. Cerebellum 2. Hippocampus 3. Hypothalamus 4. Frontal cortex

answer: 3 If the hypothalamus is affected, the symptoms are increased or decreased sleep and altered appetite.

Which are the most common causes of traumatic brain injury (TBI) in adolescents and young adults? 1. Falls 2. Associated subdural hematomas 3. Motor vehicle accidents 4. Child abuse

answer: 3 Motor vehicle accidents are the leading cause of traumatic brain injury (TBI) in adolescents and young adults.

A client with severe depressive disorder is found to be obsessively washing hands. Which therapy would be beneficial to control this condition in the client? 1. Light therapy 2. Group therapy 3. Cognitive therapy 4. Electroconvulsive therapy

answer: 3 Obsessive hand washing is a thought distortion. In cognitive therapy, the client is taught how to control thought distortions and is also assisted in identifying dysfunctional patterns of thinking and behavior.

The nurse is caring for a client with a high risk of suicide. Which intervention would be most effective for the nurse to implement? 1. Monitor the client every 15 minutes 2. Place the client in a private room 3. Provide one-to-one observation 4. Place the client in a room near the nurses' station

answer: 3 Providing one-to-one observation reduces likelihood that the client will commit suicide.

A client who recently had a hysterectomy says, "I can feel my baby is moving around inside my womb." Which does this behavior of the client indicate? 1. Abreaction 2. Integration 3. Pseudocyesis 4. Dissociative fuge

answer: 3 Pseudocyesis is false pregnancy. In this condition, the client has a strong desire to be pregnant and behaves as though she is pregnant.

The nurse finds a war veteran suffering from post-traumatic stress disorder (PTSD) to be extremely enraged. These rage reactions are accompanied by irritability and flashbacks from war. The nurse learns that the veteran has been an alcoholic for some time. Which risk can the nurse identify from this scenario? 1. Risk of developing disturbed thought processes 2. Risk of suicide 3. Risk of other-directed violence 4. Risk of injury

answer: 3 Rage reactions, irritability, and flashbacks accompanied by substance use can lead to the risk of other-directed violence by a veteran with PTSD.

The nurse is caring for a client with impaired social interaction. The nurse sets limits on the manipulative behavior of the client. Which outcome in the client does the nurse expect from this intervention? 1. The client develops self-esteem. 2. The client develops a feeling of security. 3. The client develops appropriate interaction skills. 4. The client accepts responsibility for his or her own behavior.

answer: 3 Setting of limits on the manipulative behavior of the client will help the client eliminate manipulative behavior and develop appropriate interaction behavior.

Which act is defined as unwanted, unwelcome comments or physical contact of a sexual nature occurring in the military workplace? 1. Differential treatment and conditions 2. Sexual assault 3. Sexual harassment 4. Rape

answer: 3 Sexual harassment is defined as unwanted, unwelcome comments or physical contact of a sexual nature occurring in the workplace.

Which is the Glasgow Coma Scale criterion for severe-level traumatic brain injury (TBI)? 1. 13 to 15 2. 9 to 12 3. Less than 9 4. Less than 7

answer: 3 The Glasgow Coma Scale for a severe-level TBI is less than 9.

Which does the catatonia specifier stupor indicate? 1. Absence of verbal response 2. No response to external stimuli 3. Absence of psychomotor activity 4. No influence of external stimuli

answer: 3 The absence of psychomotor activity indicates stupor.

Which finding in the client in the psychiatric ward enables the nurse to reach the conclusion that the client is in the premorbid phase of schizophrenia? 1. The client is anxious and irritable. 2. The client has disorganized speech. 3. The client is very shy and withdrawn. 4. The client has diminished emotional expression.

answer: 3 The client in the premorbid phase of schizophrenia exhibits symptoms such as being very shy and withdrawn.

Which intervention by the nurse may assist a client with antisocial personality disorder in learning to delay gratification? 1. Convincing the client to develop acceptable behaviors 2. Providing positive feedback for acceptable behaviors 3. Increasing the length of time required for acceptable behaviors by promising a reward to the client 4. Explaining the consequences of violation of limits on maladaptive behaviors

answer: 3 The client learns to delay gratification of his or her own desires and is able to cope adaptively when the nurse begins to increase the length of time required for acceptable behavior in order to achieve a reward.

A client who is on antidepressant therapy visits the hospital after a week and complains, "Ever since I started taking the medication I am dizzy, and moreover, I can see no improvement in my condition." Which information provided by the nurse is beneficial to the client? 1. "Stop taking the drug until the dizziness subsides and resume the course later." 2. "Avoid consuming red wine and aged cheese because they increase depression." 3. "Rest when you feel dizzy. It may take some time for your medication to work." 4. "Never stop the therapy. Take over-the-counter medications if a headache accompanies your dizziness."

answer: 3 The client on antidepressant medication may start feeling better after a few weeks of the therapy. Therefore, the nurse asks the client to continue with the therapy. Dizziness is a common side effect of the therapy; therefore, the client is asked to rest when dizzy.

Which stage of mania is associated with the behavior of manipulating others to fulfill the client's wishes? 1. Psychosis 2. Hypomania 3. Acute mania 4. Delirious mania

answer: 3 The client with acute mania may sometimes try to manipulate others to fulfill their own desires and wishes.

A client is diagnosed with disruptive mood dysregulation disorder. Which would be a nursing intervention for this client? 1. Determining the stage of grief 2. Teaching effective communication skills 3. Strengthening the client's coping and adaptive skills 4. Encouraging the client to take responsibility for self-care practices

answer: 3 The focus of intervention for disruptive mood dysregulation disorder is to strengthen the client's coping and adaptive skills.

Which personality disorder does the nurse suspect in the client who exhibits grandiosity, need for admiration, and lack of empathy? 1. Schizoid personality disorder 2. Histrionic personality disorder 3. Narcissistic personality disorder 4. Schizotypal personality disorder

answer: 3 The nurse suspects narcissistic personality disorder, which is characterized by grandiosity, need for admiration, and lack of empathy.

A client with a psychiatric illness tells the nurse, "It is very cold. I am cold and bold. The gold has been sold." Which intervention would the nurse implement in this situation? 1. Observe the client by leaving him or her alone 2. Ignore the client's statements 3. Seek clarification from the client 4. Notify the primary health-care provider

answer: 3 The nurse would try to decode the client's statement and seek clarification and validation from the client.

Which symptoms does the nurse expect to appear in the client whose serum concentration of lithium is 1.8 mEq/L? 1. Mental alertness 2. Decreased urine output 3. Persistent vomiting 4. Constipation

answer: 3 The serum level of 1.5 to 2.0 mEq/L of lithium in the client indicates the presence of lithium toxicity. Persistent vomiting, nausea, and blurred vision are some of the symptoms that occur with this lithium concentration.

Which statement made by a student nurse requires further teaching regarding religious beliefs and suicide? 1. "My client identifies as an atheist, so I expect no religion-based opposition to physician-assisted suicide." 2. "I think my client would have a religious opposition to physician-assisted suicide because she and her family are practicing Catholics." 3. "My client does not believe physician-assisted suicide is a sin because he is a Hindu." 4. "Suicide is considered a sin in the Jewish faith, so my client says physician-assisted suicide is not an option for them."

answer: 3 This statement requires further teaching; Hinduism does condemn suicide.

Which outcome is evident when somatic symptoms and emotional distress occur in a caregiver as a response to caring for a client suffering from post-traumatic stress disorder (PTSD)? 1. Depression 2. Anxiety disorder 3. Vicarious traumatization 4. Relationship difficulties

answer: 3 Vicarious traumatization, also known as secondary trauma, is a condition occurring in caregivers in which somatic symptoms and emotional distress are seen in response to caring for a PTSD client.

Which action of the nurse is said to be effective while using mechanical restraints on a child with a manic episode of bipolar disorder? 1. Observing the child every hour 2. Replacing the restraints every 4 hours 3. Providing assistance while positioning the child 4. Removing all restraints at a time when the agitation decreases

answer: 3 When the nurse uses mechanical restraints on the child, the child is unable to position himself or herself. Therefore, the nurse would assist the child while positioning in order to prevent aspiration and to facilitate comfort. According to Joint Commission rules, the nurse would observe the child every 15 minutes and not every hour. This is to ensure that circulation to the extremities is not compromised. This child requires frequent observation in order to overcome risks that may arise due to the child's condition.

Which are the signs of depression observed in a 7-year-old child? Select all that apply. 1. Morbid thoughts 2. Excessive worrying 3. Aggressive behavior 4. Lack of social interactions 5. Lack of emotional expressiveness

answer: 3, 4 Aggressive behavior is a sign of depression observed in children in the 6 to 8 year age group. Lack of social interaction is a sign of depression observed in children in the 6 to 8 year age group.

Which interventions would the nurse implement while caring for a client with altered thought process? Select all that apply. 1. Sharing the beliefs of the client 2. Denying the beliefs of the client 3. Serving family-style servings of food to the client 4. Performing mouth checks on the client when necessary 5. Being friendly with the client with an overly cheerful attitude

answer: 3, 4 Clients with disturbed thought processes may be suspicious. Therefore, the nurse can use various creative approaches such as family-style serving. Clients with disturbed thought processes believe that they are being poisoned and may discard their medications. Therefore, the nurse would perform mouth checks on the client following medication administration.

Which behaviors are present in a client with borderline personality disorder? Select all that apply. 1. Suspicious behavior 2. Exploitative behavior 3. Manipulative behavior 4. Splitting behavior 5. Self-destructive behavior

answer: 3, 4, 5 A client with borderline personality disorder is a master of manipulation. The nurse would be aware of this behavior of the client to prevent staff splitting. A client with borderline personality disorder causes staff splitting due to the fear of abandonment. Repetitive self-mutilating behaviors are classic manifestations of a client with borderline personality disorder.

A female client is on hormonal replacement therapy because of hormonal imbalance. Which disorders are more likely to appear in the client? Select all that apply. 1. Major depressive disorder 2. Persistent depressive disorder 3. Premenstrual dysphoric disorder 4. Disruptive mood dysregulation disorder 5. Medication-induced depressive disorder

answer: 3, 5 Premenstrual dysphoric disorder occurs as a result of an imbalance of the hormones estrogen and progesterone. As the client has hormonal imbalance, he or she is more likely to develop this disorder. Medication-induced depressive disorder is a depressive disorder caused by a medication. High levels of estrogen have been found to be associated with depression. Thus, clients who are on estrogen therapy, which is a hormonal replacement therapy, may experience depression.

Which behavior would the nurse most likely see in a client who is diagnosed with ineffective coping? 1. denying emotional problems 2. an unhygienic condition 3. verbalizing frustration due to lack of control 4. feigning of physical symptoms to gain attention

answer: 4

Which traits does the nurse expect in a client diagnosed with paranoid personality disorder? 1. Fear of abandonment 2. Lack of guilt for wrongdoing 3. Intense episodes of dysphoria 4. Extremely tense and irritable

answer: 4

A client says, "I am just hopeless. I hate myself. I do not have any reason to live." Which would be the best response by the nurse to this client? 1. "Don't feel that everyone will leave you. Your family will always be with you." 2. "Don't feel that you cannot do anything. You can be independent." 3. "Don't live in the past. I will be your friend." 4. "Don't think that way. I will spend time with you because you matter."

answer: 4 A person who has a risk of suicide feels hopeless and worthless and has inward anger. Thus, while caring for this client, the nurse says, "I want to spend time with you because you matter."

While preparing a client for light therapy, the client asks the nurse, "I have read that ultraviolet (UV) rays are harmful. Will I get exposed to them during light therapy?" How would the nurse respond to the client's query? 1. "The fluorescent light tubes used in light therapy will not produce UV rays." 2. "UV rays are not harmful to the eyes. Therefore, it's OK to look directly at the light." 3. "You will be exposed to UV radiation for less than 10 to 15 minutes, which does not cause any harm." 4. "The plastic screen covering the fluorescent light tubes blocks UV rays. Therefore, you will not be exposed to UV rays."

answer: 4 A plastic screen is used to absorb UV rays that are produced from fluorescent light tubes. Therefore, the client will not be exposed to UV rays.

Which bodily humor is increased in a client who shows an irritable and hostile choleric personality style, according to Hippocrates? 1. Blood 2. Phlegm 3. Black bile 4. Yellow bile

answer: 4 According to Hippocrates, excess of yellow bile, which is a bodily humor, may result in an irritable and hostile choleric personality style.

During a checkup, a client verbally reports having a depressed mood and sometimes having trouble falling asleep. The nurse notices that the client fidgets and twirls a strand of hair throughout the interview. On further interaction, the nurse does not observe any additional symptoms of depression in the client. According to the Hamilton Depression Rating Scale (HDRS), which can be concluded about this client? 1. Mild depression 2. Severe depression 3. Moderate depression 4. No evidence of depressive illness

answer: 4 According to the Hamilton Depression Rating Scale, the score for verbal reporting on depressed mood is two, the score for having trouble falling asleep is one, and the agitation score for playing with hair is two. This adds up to a total score of five, which indicates that there is no evidence of depressive illness. While the client may be temporarily depressed or agitated, the condition is not lasting.

Which side effect associated with antipsychotics occurs due to the blockade of alpha1-adrenergic receptors? 1. Dry mouth 2. Constipation 3. Urinary retention 4. Orthostatic hypotension

answer: 4 Antipsychotics may cause orthostatic hypotension due to their inhibitory effect on alpha1-adrenergic receptors.

Which age group learns to develop the ability to achieve object constancy, according to Mahler's theory of object relations? 1. 1 to 5 months 2. 5 to 10 months 3. 10 to 16 months 4. 24 to 36 months

answer: 4 Between 24 and 36 months, children begin to learn to separate from their caregivers and explore the world about them. During this time, they develop a sense of object constancy, which is the knowledge that a loved person or object continues to exist even though it is out of sight.

A client with bipolar disorder is diagnosed with migraine. Which medication is effective when the primary health-care provider prefers a single medication for the treatment of both the conditions? 1. Clonazepam 2. Lamotrigine 3. Aripiprazole 4. Chlorpromazine

answer: 4 Chlorpromazine is useful for treatment of migraine and bipolar disorder. Therefore, this medication is effective in the treatment of both conditions.

Which treatment strategy would be most beneficial for the client with bipolar disorder who is experiencing severe symptoms of corticosteroid-induced psychosis? 1. Olanzapine 2. Lamotrigine 3. Clonazepam 4. Lithium carbonate

answer: 4 Corticosteroids increase the recurrence of manic symptoms. Lithium carbonate reduces the manic episodes caused by corticosteroids.

The client's mother says, "My daughter is possessed by spirits which make her act differently." Which condition may the nurse suspect in this client? 1. factitious disorder 2. conversion disorder 3. dissociative amnesia 4. dissociative identity disorder

answer: 4 Dissociative identity disorder in some cultures is described as an experience of possession. It is characterized by the presence of two or more personalities. As the client is said to behave differently, the nurse may suspect the client to be suffering from dissociative identity disorder.

Which finding in a client acts as a diagnostic criterion for schizophrenia? 1. Bipolar disorder 2. Autism spectrum disorder 3. Catatonic behavior for 1 month 4. Continuous signs of disturbance for 7 months

answer: 4 Disturbances in work, interpersonal skills, or self-care for at least 6 months is indicative of schizophrenia.

Who described the eight stages of the life cycle during which individuals struggle with developmental tasks? 1. Gerald Caplan 2. Dorothea Dix 3. Ronald Reagan 4. Erik Erikson

answer: 4 Erik Erikson described eight stages of the life cycle in 1963. During the developmental period, an individual struggles with developmental tasks.

Which statement does not explain the findings of McLeod (2010), among others, regarding emotional illness? 1. Frequent changes in life patterns such as the death of a loved one or divorce may result in illness. 2. Devastation due to environmental conditions such as tornados and floods may affect thousands of individuals and families, causing situational crises. 3. Individuals who have encountered traumatic experiences such as rape or torture may be considered at risk for emotional illness. 4. Having a nurse remain with an individual experiencing panic anxiety

answer: 4 Having a nurse remain with a patient experiencing panic anxiety is an intervention for a patient in crisis, not a cause of emotional illness.

The nurse is caring for a client with mania who is on lithium carbonate therapy. The nurse monitors the client's skin turgor daily. Which sign or symptom observed in the client supports this nursing intervention? 1. Polyuria 2. Dizziness 3. Dry mouth 4. Dehydration

answer: 4 Lithium carbonate is an antimanic agent that causes dehydration as a side effect. Therefore, the nurse monitors the client's skin turgor daily.

How many individuals who attempt or commit suicide have been diagnosed with a mental disorder? 1. Very few 2. About one-third 3. Around half 4. Most

answer: 4 More than 90 percent of individuals who commit or attempt suicide have a diagnosed mental disorder.

Which condition can be effectively treated using a combination of olanzapine and fluoxetine? 1. Schizophrenia 2. Obsessive-compulsive disorder 3. Bipolar disorder with manic episodes 4. Bipolar disorder with depressive episodes

answer: 4 Olanzapine and fluoxetine (Symbyax) is an effective combination used in the treatment of depressive episodes associated with bipolar disorder. It reduces depression by increasing the release of serotonin neurotransmitters.

In which state is physician-assisted suicide legal? 1. Texas 2. Oklahoma 3. New Mexico 4. Oregon

answer: 4 Oregon was the first state to legalize physician-assisted suicide.

Which is the most common mental disorder among veterans after returning from military combat? 1. Dysarthria 2. Parkinson's disease 3. Alzheimer's disease (AD) 4. Post-traumatic stress disorder (PTSD)

answer: 4 PTSD is the most common mental disorder among veterans returning from military combat. The disorder can occur after an individual experiences an accident, violence involving actual or threatened death, or serious injury to one's self or others.

Which of these does the psychodynamic theory of conversion disorder propose? 1. Increased incidence is seen in first-degree relatives. 2. Increased incoming sensory stimuli produce a deficiency of endorphins. 3. Aberrant behaviors associated with the disorder may be due to impairment in information processing. 4. Emotions related to a traumatic event that are not expressed due to moral unacceptability are converted into physical symptoms.

answer: 4 Psychodynamic theory proposes that emotions related to a traumatic event that are not expressed due to moral unacceptability are converted into physical symptoms.

The nurse is caring for a client who is scheduled for hypnosis therapy. Which drug would facilitate this therapy? 1. sertraline 2. venlafaxine 3. desipramine 4. sodium amobarbital

answer: 4 Sodium amobarbital is a barbiturate derivative mainly used to induce sleep during hypnosis. Therefore, this drug would facilitate hypnosis therapy.

The nurse is assessing a client's risk for suicide using the IS PATH WARM acronym. Which term does the "R" represent? 1. Respect 2. Responsibility 3. Reaction 4. Recklessness

answer: 4 The "R" in IS PATH WARM represents "recklessness." The client engages in reckless or risky behaviors with little thought of consequences.

A client is depressed because he witnessed his friend dying in a fatal accident. Ever since the accident, the client has been saying that he could not save his friend from dying and nothing seems to be in his hands anymore. Which intervention would the nurse implement for this client? 1. The nurse should teach the client about the use of "I" messages. 2. The nurse should formulate a written contract with the client. 3. The nurse should teach the importance of respecting human rights to the client. 4. The nurse should encourage the verbalization of feelings related to the loss.

answer: 4 The nurse should encourage the client to verbalize the feelings related to his or her inability to save the victim in an effort to deal with unresolved issues and accept what cannot be changed.

The nurse is assisting a client and the client's friends in developing a safety plan. Which component would the nurse include in the plan? 1. A dated signature agreeing not to harm self 2. A promise to call 9-1-1 if thoughts of suicide are present 3. A reminder that the individual agreed not to harm self 4. Internal coping strategies the client can implement

answer: 4 This component would be included on a safety plan for a client and friends/family members.

Which statement by the client indicates an automatic thought that occurs spontaneously in a client with bipolar mania? 1. "I see aliens every morning." 2. "I hear the voice of the God every day." 3. "I have attempted suicide multiple times." 4. "The mistakes I've made are not really important."

answer: 4 This statement by the client indicates that the client is discounting the negatives. Discounting negatives is an automatic thought.