Mental Health Exam 1 Questions

1

A 10-week, prenuptial counseling group composed of five couples is terminating. At the last group meeting, a nurse notices that the two most faithful and participative couples are absent. When considering concepts of group development, what might explain this behavior? 1. They are experiencing problems with termination, leading to feelings of abandonment. 2. They did not think any new material would be covered at the last session. 3. They were angry with the leader for not extending the length of the group. 4. They were bored with the material covered in the group.

group

A ______________________ is a collection of individuals whose association is founded on shared commonalities of interest, values, norms, or purpose.

4

A client comes to a psychiatric clinic experiencing sudden extreme fatigue and decreased sleep and appetite. The client works 12 hours a day and rates anxiety as 8/10 on a numeric scale. What long-term outcome is realistic in addressing this clients crisis? 1. The client will change his type A personality traits to more adaptive ones by one week. 2. The client will list five positive self-attributes. 3. The client will examine how childhood events led to his overachieving orientation. 4. The client will return to previous adaptive levels of functioning by week six.

3

A client diagnosed with a gambling disorder asks the nurse about medications that may be ordered by the clients physician to treat this disorder. The nurse would give the client information on which medications? 1. Escitalopram (Lexapro) and clozapine (Clozaril) 2. Citalopram (Celexa) and olanzapine (Zyprexa) 3. Lithium carbonate (Lithobid) and sertraline (Zoloft) 4. Naltrexone (ReVia) and ziprasidone (Geodon)

2

A client diagnosed with alcohol use disorder experiences a first relapse. During an AA meeting, another group member states, I relapsed three times, but now have been sober for 15 years. Which of Yaloms curative group factors does this illustrate? 1. Imparting of information 2. Instillation of hope 3. Catharsis 4. Universality

1

A client diagnosed with chronic alcohol addiction is being discharged from an inpatient treatment facility after detoxification. Which client outcome, related to AA, would be most appropriate for a nurse to discuss with the client during discharge teaching? 1. After discharge, the client will immediately attend 90 AA meetings in 90 days. 2. After discharge, the client will rely on an AA sponsor to help control alcohol cravings. 3. After discharge, the client will incorporate family in AA attendance. 4. After discharge, the client will seek appropriate deterrent medications through AA.

1

A client diagnosed with major depressive episode and substance use disorder has an altered sleep pattern and demands that a psychiatrist prescribe a sedative. Which rationale explains why a nurse should encourage the client to first try nonpharmacological interventions? 1. Sedative-hypnotics are potentially addictive, and their effectiveness will be compromised owing to tolerance. 2. Sedative-hypnotics are expensive and have numerous side effects. 3. Sedative-hypnotics interfere with necessary REM (rapid eye movement) sleep. 4. Sedative-hypnotics are known not to be as effective in promoting sleep as antidepressant medications.

2

A client diagnosed with post-traumatic stress disorder related to a rape is admitted to an inpatient psychiatric unit for evaluation and medication stabilization. Which therapeutic communication technique might a nurse use that is an example of broad openings? 1. What occurred prior to the rape, and when did you go to the emergency department? 2. What would you like to talk about? 3. I notice you seem uncomfortable discussing this. 4. How can we help you feel safe during your stay here?

3

A client exhibiting dependent behaviors says, Do you think I should move from my parents house and get a job? Which nursing response is most appropriate? 1. It would be best to do that in order to increase independence. 2. Why would you want to leave a secure home? 3. Lets discuss and explore all of your options. 4. Im afraid you would feel very guilty leaving your parents.

3

A client presents with symptoms of alcohol withdrawal and states, I havent eaten in three days. A nurses assessment reveals BP 170/100 mm Hg, P 110, R 28, and T 97F (36C) with dry mucous membranes and poor skin turgor. What should be the priority nursing diagnosis?1. Knowledge deficit 2. Fluid volume excess 3. Imbalanced nutrition: less than body requirements 4. Ineffective individual coping

2

A client with a history of heavy alcohol use is brought to an emergency department (ED) by family members who state that the client has had nothing to drink in the last 48 hours. When the nurse reports to the ED physician, which client symptom should be the nurses first priority? 1. Hearing and visual impairment 2. Blood pressure of 180/100 mm Hg 3. Mood rating of 2/10 on numeric scale 4. Dehydration

3

A clients wife has been making excuses for her alcoholic husbands work absences. In family therapy, she states, His problems at work are my fault. Which is the appropriate nursing response? 1. Why do you assume responsibility for his behaviors? 2. I think you should start to confront his behavior. 3. Your husband needs to deal with the consequences of his drinking. 4. Do you understand what the term enabler means?

1, 2, 4, 5

A clinic nurse is about to meet with a client diagnosed with a gambling disorder. Which of the following symptoms and/or behaviors is the nurse likely to assess? (Select all that apply.) 1. Stressful situations precipitate gambling behaviors. 2. Anxiety and restlessness can only be relieved by placing a bet. 3. Winning brings about feelings of sexual satisfaction. 4. Gambling is used as a coping strategy. 5. Losing at gambling meets the clients need for self-punishment.

4

A college student who was nearly raped while jogging, completes a series of appointments with a rape crisis nurse. At the final session, which client statement most clearly suggests that the goals of crisis intervention have been met? 1. Youve really been helpful. Can I count on your for continued support? 2. I work out in the college gym rather than jogging outdoors. 3. Im really glad I didnt go home. It would have been hard to come back. 4. I carry mace when I jog. It makes me feel safe and secure.

4

A combative adolescent client has been placed in seclusion after all other interventions have failed. Which protocol would apply in this situation? 1. The physician or other licensed independent practitioner must reissue a new order for restraints every 24 hours. 2. The physician or other licensed independent practitioner must reissue a new order for restraints every 8 hours. 3. The physician or other licensed independent practitioner must reissue a new order for restraints every 3 to 4 hours. 4. The physician or other licensed independent practitioner must reissue a new order for restraints every 1 to 2 hours.

2

A despondent client who has recently lost her husband of 30 years tearfully states, Ill feel a lot better if I sell my house and move away. Which nursing response is most appropriate? 1. Im confident you know whats best for you. 2. This may not be the best time for you to make such an important decision. 3. Your children will be terribly disappointed. 4. Tell me why you want to make this change.

3

A high school student has learned that she cannot graduate. Her boyfriend will be attending a college out of state that she planned to attend. She is admitted to a psychiatric unit after overdosing on Tylenol. Which is the priority nursing diagnosis for this client? 1. Ineffective coping R/T situational crisis AEB powerlessness 2. Anxiety R/T fear of failure 3. Risk for self-directed violence R/T hopelessness 4. Risk for low self-esteem R/T loss events AEB suicidal ideations

1

A lonely, depressed divorce has been self-medicating with small amounts of cocaine for the past year. Which term should a nurse use to best describe this individuals situation? 1. Psychological addiction 2. Physical addiction 3. Substance induced disorder 4. Social induced disorder

b

A mother rescues two of her four children from a house fire. In an emergency department, she cries, "I should have gone back in to get them. I should have died, not them." What is the nurse's best response? A."The smoke was too thick. You couldn't have gone back in." B. "Are you experiencing feelings of guilt, because you weren't able to save your children?." C. "Focus on the fact that you could have lost all four of your children." D. "It's best if you try not to think about what happened. Try to move on."

2

A mother rescues two of her four children from a house fire. In an emergency department, she cries, I should have gone back in to get them. I should have died, not them. What is the nurses best response? 1. The smoke was too thick. You couldnt have gone back in. 2. Youre experiencing feelings of guilt, because you werent able to save your children. 3. Focus on the fact that you could have lost all four of your children. 4. Its best if you try not to think about what happened. Try to move on.

d

A mother who is notified that her child was killed in a tragic car accident states, "I can't bear to go on with my life." Which nursing statement is best at this time? a. "This situation is very sad, but time is a great healer." b. "You are sad, but you must be strong for your other children." c. "Once you cry it all out, things will seem so much better." d. "It must be horrible to lose a child, and I'll stay with you until your husband arrives."

4

A mother who is notified that her child was killed in a tragic car accident states, I cant bear to go on with my life. Which nursing statement conveys empathy? 1. This situation is very sad, but time is a great healer. 2. You are sad, but you must be strong for your other children. 3. Once you cry it all out, things will seem so much better. 4. It must be horrible to lose a child, and Ill stay with you until your husband arrives.

4

A new mother is concerned about her ability to perform her parental role. She is quite anxious and ambivalent about leaving the postpartum unit. To offer effective client care, a nurse should be familiar with what information about this type of crisis? 1. This type of crisis is precipitated by unexpected external stressors. 2. This type of crisis is precipitated by preexisting psychopathology. 3. This type of crisis is precipitated by an acute response to an external situational stressor. 4. This type of crisis is precipitated by normal life-cycle transitions that overwhelm the client.

4

A newly admitted client, diagnosed with obsessive-compulsive disorder (OCD), washes his hands continually. This behavior prevents unit activity attendance. Which nursing statement best addresses this situation? 1. Everyone diagnosed with OCD needs to control their ritualistic behaviors. 2. It is important for you to discontinue these ritualistic behaviors. 3. Why are you asking for help, if you wont participate in unit therapy? 4. Lets figure out a way for you to attend unit activities and still wash your hands.

2

A nurse evaluates a clients patient-controlled analgesia (PCA) pump and notices 100 attempts within a 30-minute period. Which is the best rationale for assessing this client for substance addiction? 1. Narcotic pain medication is contraindicated for all clients with active substance use disorders. 2. Clients who are addicted to alcohol or benzodiazepines may develop cross-tolerance to analgesics and require increased doses to achieve effective pain control. 3. There is no need to assess the client for substance addiction. There is an obvious PCA malfunction, because these clients have a higher pain tolerance. 4. The client is experiencing alcohol withdrawal symptoms and needs accurate assessment.

4

A nurse holds the hand of a client who is withdrawing from alcohol. What is the nurses rationale for this intervention?1. To assess for emotional strength 2. To assess for Wernicke-Korsakoff syndrome 3. To assess for tachycardia 4. To assess for fine tremors

1

A nurse is assessing a pathological gambler. What would differentiate this clients behaviors from the behaviors of a non-pathological gambler? 1. Pathological gamblers have abnormal levels of neurotransmitters, whereas non-pathological gamblers do not. 2. Pathological gambling occurs more commonly among women, whereas non-pathological gambling occurs more commonly among men. 3. Pathological gambling generally runs an acute course, whereas non-pathological gambling runs a chronic course. 4. Pathological gambling is not related to stress relief, whereas non-pathological gambling is related to stress relief.

4

A nurse is interviewing a client in an outpatient addiction clinic. To promote success in the recovery process, which outcome should the nurse expect the client to initially accomplish? 1. The client will identify one person to turn to for support. 2. The client will give up all old drinking buddies. 3. The client will be able to verbalize the effects of alcohol on the body. 4. The client will correlate life problems with alcohol use.

2

A nurse is reviewing the stat laboratory data of a client in the emergency department. At what minimum blood alcohol level should a nurse expect intoxication to occur?1. 50 mg/dL 2. 100 mg/dL 3. 250 mg/dL 4. 300 mg/dL

2

A nurse maintains an uncrossed arm and leg posture when communicating with a client. This nonverbal behavior is reflective of which letter of the SOLER acronym for active listening? 1. S 2. O 3. L 4. E 5. R

4

A nurse says to a client, Things will look better tomorrow after a good nights sleep. This is an example of which communication technique? 1. The therapeutic technique of giving advice 2. The therapeutic technique of defending 3. The nontherapeutic technique of presenting reality 4. The nontherapeutic technique of giving reassurance

1, 3, 5

A nursing counselor is about to meet with a client suffering from codependency. Which of the following data would further support the assessment of this dysfunctional behavior? (Select all that apply.) 1. The client has a long history of focusing thoughts and behaviors on other people. 2. The client, as a child, experienced overindulgent and overprotective parents. 3. The client is a people pleaser and does almost anything to gain approval. 4. The client exhibits helpless behaviors but actually feels very competent. 5. The client can achieve a sense of control only through fulfilling the needs of others.

2

A nursing instructor is teaching about psychodrama, a specialized type of therapeutic group. Which student statement indicates that further teaching is necessary? 1. Psychodrama provides a safe setting in which to discuss painful issues. 2. In psychodrama, the client is the protagonist. 3. In psychodrama, the client observes actor interactions from the audience. 4. Psychodrama facilitates resolution of interpersonal conflicts.

3

A nursing instructor is teaching about the Roberts Seven-Stage Crisis Intervention Model. Which nursing action should be identified with Stage IV? 1. Collaboratively implement an action plan. 2. Help the client identify the major problems or crisis precipitants. 3. Help the client deal with feelings and emotions. 4. Collaboratively generate and explore alternatives.

2

A nursing instructor is teaching about the impaired nurse and the consequences of this impairment. Which statement by a student indicates that further instruction is needed? 1. The state board of nursing must be notified with factual documentation of impairment. 2. All state boards of nursing have passed laws that, under any circumstances, do not allow impaired nurses to practice. 3. Many state boards of nursing require an impaired nurse to successfully complete counseling treatment programs prior to a return to work. 4. After a return to practice, a recovering nurse may be closely monitored for several years.

1

A nursing instructor is teaching nursing students about cirrhosis of the liver. Which of the following statements about the complications of hepatic encephalopathy should indicate to the nursing instructor that further student teaching is needed? (Select all that apply.) 1. A diet rich in protein will promote hepatic healing. 2. This condition results from a rise in serum ammonia, leading to impaired mental functioning. 3. In this condition, an excessive amount of serous fluid accumulates in the abdominal cavity. 4. Neomycin and lactulose are used in the treatment of this condition. 5. This condition is caused by the inability of the liver to convert ammonia to urea.

4

A nursing instructor is teaching students about self-help groups like Alcoholics Anonymous (AA). Which student statement indicates that learning has occurred? 1. There is little research to support AAs effectiveness. 2. Self-help groups used to be the treatment of choice, but their popularity is waning. 3. These groups have no external regulation, so clients need to be cautious. 4. Members themselves run the group, with leadership usually rotating among the members.

2, 3, 4, 5

A nursing supervisor is about to meet with a staff nurse suspected of diverting client medications. Which of the following assessment data would lead the supervisor to suspect that the staff nurse is impaired? (Select all that apply.) 1. The staff nurse is frequently absent from work. 2. The staff nurse experiences mood swings. 3. The staff nurse makes elaborate excuses for behavior. 4. The staff nurse frequently uses the restroom. 5. The staff nurse has a flushed face.

1, 3, 5

A nursing supervisor is offering an impaired staff member information regarding employee assistance programs. Which of the following facts should the supervisor include? (Select all that apply.) 1. A hotline number will be available in order to call for peer assistance. 2. A verbal contract detailing the method of treatment will be initiated prior to the program. 3. Peer support is provided through regular contact with the impaired nurse. 4. Contact to provide peer support will last for one year. 5. One of the program goals is to intervene early in order to reduce hazards to clients.

4

A single, pregnant teenager in a parenting class discloses her ambivalence toward the pregnancy and the subsequent guilt that these thoughts generate. A mother of three admits to having felt that way herself. Which of Yaloms curative group factors does this illustrate? 1. Imparting of information 2. Instillation of hope 3. Altruism 4. Universality

crisis

A sudden event in ones life that disturbs homeostasis, during which usual coping mechanisms cannot resolve the problem, can be defined as a ______________________.

2

A wife brings her husband to an emergency department after an attempt to hang himself. He is a full-time student and works 8 hours at night to support his family. He states, I cant function any longer under all this stress. Which type of crisis is the client experiencing? 1. Maturational/developmental crisis 2. Psychiatric emergency crisis 3. Anticipated life transition crisis 4. Traumatic stress crisis

d

After an episode with difficulty breathing that was treated effectively, the patients says, "What if this happens again? I stay awake at night afraid I won't be able to breath". Which is the best initial response by the nurse? A.Why do you think this will happen again? B. This problem is called stridor. C. I will see if you have an order for sleep medication. D. It sounds like it was a very frightening experience for you.

1

After threatening to jump off of a bridge, a client is brought to an emergency department by police. To assess for suicide potential, which question should a nurse ask first? 1. Are you currently thinking about harming yourself? 2. Why do you want to harm yourself? 3. Have you thought about the consequences of your actions? 4. Who is your emergency contact person?

1

An aggressive client has been placed in restraints after all other interventions have failed. Which protocol would apply in this situation? 1. An in-person evaluation by a physician or other licensed independent practitioner must be conducted within 1 hour of the initiation of the restraints. 2. An in-person evaluation by a physician or other licensed independent practitioner must be conducted within 2 hours of the initiation of the restraints. 3. An in-person evaluation by a physician or other licensed independent practitioner must be conducted within 3 hours of the initiation of the restraints. 4. An in-person evaluation by a physician or other licensed independent practitioner must be conducted within 4 hours of the initiation of the restraints.

3

An experienced psychiatric registered nurse has taken a new position leading groups in a day treatment program. Which group is this nurse most qualified to lead? 1. A psychodrama group 2. A psychotherapy group 3. A parenting group 4. A family therapy group

2

An inpatient client with a known history of violence suddenly begins to pace. Which additional client behavior should alert a nurse to escalating anger and aggression? 1. The client requests prn medications. 2. The client has a tense facial expression and body language. 3. The client refuses to eat lunch. 4. The client sits in group with back to peers.

3

An instructor is correcting a nursing students clinical worksheet. Which instructor statement is the best example of effective feedback? 1. Why did you use the clients name on your clinical worksheet? 2. You were very careless to refer to your client by name on your clinical worksheet. 3. Surely you didnt do this deliberately, but you breeched confidentiality by using names. 4. It is disappointing that after being told youre still using client names on your worksheet.

4

An involuntarily committed client when offered a dinner tray pushes it off the bedside table onto the floor. Which nursing intervention should a nurse implement to address this behavior? 1. Initiate forced medication protocol. 2. Help the client to explore the source of anger. 3. Ignore the act to avoid reinforcing the behavior. 4. With staff support and a show of solidarity, set firm limits on the behavior.

1

During a community meeting, a nurse encourages clients to present unit problems and discuss possible solutions. Which type of leadership style is the nurse demonstrating? 1. Democratic 2. Autocratic 3. Laissez-faire 4. Bureaucratic

1

During a group discussion, members freely interact with each other. Which member statement is an example of Yaloms curative group factor of imparting information? 1. I found a Web site explaining the different types of brain tumors and their treatment. 2. My brother also had a brain tumor and now is completely cured. 3. I understand your fear and will be by your side during this time. 4. My mother was also diagnosed with cancer of the brain.

2

During a group session, which client statement demonstrates that the group has progressed to the middle, or working, phase of group development? 1. Its hard for me to tell my story when Im not sure about the reactions of others. 2. I think Joes Antabuse suggestion is a good one and might work for me. 3. My situation is very complex, and I need professional, not peer, advice. 4. I am really upset that you expect me to solve my own problems.

3

During a therapeutic group, which nursing action demonstrates a laissez-faire leadership style? 1. The nurse mandates that all group members reveal an embarrassing personal situation. 2. The nurse asks for a show of hands to determine group topic preference. 3. The nurse sits silently as the group members stray from the assigned topic. 4. The nurse shuffles through papers to determine the facility policy on length of group.

1

During an inpatient educational group, a client shouts out, This information is worthless. Nothing you have said can help me. These statements indicate to a nurse leader that the client is assuming which group role? 1. The group role of aggressor 2. The group role of initiator 3. The group role of gatekeeper 4. The group role of blocker

4

During the sixth week of a 10-week parenting skills group, a nurse observes as several members get into a heated dispute about spanking. As a group, they decide to create a pros-and- cons poster on the use of physical discipline. At this time, what is the role of the group leader? 1. The leader should referee the debate. 2. The leader should adamantly oppose physical disciplining measures. 3. The leader should redirect the group to a less-controversial topic. 4. The leader should encourage the group to solve the problem collectively.

4

If a client demonstrates transference toward a nurse, how should the nurse respond? 1. Promote safety and immediately terminate the relationship with the client. 2. Encourage the client to ignore these thoughts and feelings. 3. Immediately reassign the client to another staff member. 4. Help the client to clarify the meaning of the relationship, based on the present situation.

c

Laura was diagnosed with Type 1 Diabetes earlier today. When the nurse is providing care, Laura starts to cry and says "You have no idea how awful this is. I want to be by myself. Please leave me alone!". What is the best response by the nurse? A. "I'll notify the diabetes educator that you need a visit." B. "You shouldn't be by yourself right now. I'll stay with you". C. "I'll leave you alone for now, but I will stop back by in 30 minutes." D. "You need to express your feelings. Tell me more about what you are feeling."

d

Laura was diagnosed yesterday with Type 1 Diabetes. She says, "I wish I hadn't gotten the flu. Then, this diabetes wouldn't have been discovered, and I could keep having a normal life." Which is the best initial response by the nurse? A.What do you mean when you say normal life? B. It's better to find out now before complications develop. C. Perhaps you would like to speak to someone with diabetes. D. It must be quite a shock to learn that you have diabetes.

3

On the first day of a clients alcohol detoxification, which nursing intervention should take priority? 1. Strongly encourage the client to attend 90 Alcoholics Anonymous (AA) meetings in 90 days. 2. Educate the client about the biopsychosocial consequences of alcohol abuse. 3. Administer ordered chlordiazepoxide (Librium) in a dosage according to protocol. 4. Administer vitamin B1 to prevent Wernicke-Korsakoff syndrome.

4

On which task should a nurse place priority during the working phase of relationship development? 1. Establishing a contract for intervention 2. Examining feelings about working with a particular client 3. Establishing a plan for continuing aftercare 4. Promoting the clients insight and perception of reality

3, 1, 2

Order the following leadership expectations that occur in the three phases of the group development process: _____The leader encourages members to provide feedback to each other about individual progress and to review goals and discuss outcomes. _____The leader promotes an environment of trust and ensures that rules established by the group do not interfere with fulfillment of the goals. _____The leader helps to resolve conflict and fosters cohesiveness, while ensuring that members do not deviate from the intended task.

4, 5, 2, 1, 3, 7, 6

Order the following stages of Roberts Seven-Stage Crisis Intervention Model. 1. ________ Deal with feelings and emotions. 2. ________ Generate and explore alternatives. 3. ________ Rapidly establish rapport. 4. ________ Psychosocial and lethality assessment. 5. ________ Identify the major problems or crisis precipitants. 6. ________ Follow up. 7. ________ Implement an action plan.

3, 4, 1, 2

Order the following stages of the codependency recovery process according to Cermak. ________ The Core Issues Stage ________ The Reintegration Stage ________ The Survival Stage ________ The Reidentification Stage

3

Prayer group members at a local Baptist church are meeting with a poor, homeless family whom they are supporting. Which member statement is an example of Yaloms curative group factor of altruism? 1. Ill give you the name of a friend that rents inexpensive rooms. 2. The last time we helped a family, they got back on their feet and prospered. 3. I can give you all of my baby clothes for your little one. 4. I can appreciate your situation. I had to declare bankruptcy last year.

codependency

The concept of _______________________ arose out of a need to define the dysfunctional behaviors that are evident among members of the family of a chemically dependent person.

3

The nurse is interviewing a newly admitted psychiatric client. Which of the following nursing statements is an example of offering a general lead? 1. Do you know why you are here? 2. Are you feeling depressed or anxious? 3. Yes, I see. Go on 4. Can you order the specific events that led to your admission?

rapport

The term ________________________ implies special feelings on the part of both the client and the nurse, based on acceptance, warmth, friendliness, common interest, a sense of trust, and a nonjudgmental attitude.

4

What is a nurses purpose for providing appropriate feedback? 1. To give the client good advice 2. To advise the client on appropriate behaviors 3. To evaluate the clients behavior 4. To give the client critical information

4

What is the best nursing rationale for holding a debriefing session with clients and staff after a take-down intervention has taken place on an inpatient unit? 1. Reinforce unit rules with the client population. 2. Create protocols for the future release of tensions associated with anger. 3. Process client feelings and alleviate fears of undeserved seclusion and restraint. 4. Discuss the situation that led to inappropriate expressions of anger.

1

What is the most essential task for a nurse to accomplish prior to forming a therapeutic relationship with a client? 1. Clarify personal attitudes, values, and beliefs. 2. Obtain thorough assessment data. 3. Determine the clients length of stay. 4. Establish personal goals for the interaction.

2

What should be the priority nursing action during the orientation (introductory) phase of the nurse-client relationship? 1. Acknowledge the clients actions and generate alternative behaviors. 2. Establish rapport and develop treatment goals. 3. Attempt to find alternative placement. 4. Explore how thoughts and feelings about this client may adversely impact nursing care.

1

What should be the priority nursing diagnosis for a client experiencing alcohol withdrawal? 1. Risk for injury R/T central nervous system stimulation 2. Disturbed thought processes R/T tactile hallucinations 3. Ineffective coping R/T powerlessness over alcohol use 4. Ineffective denial R/T continued alcohol use despite negative consequences

2

When an individual is two-faced, which characteristic essential to the development of a therapeutic relationship should a nurse identify as missing? 1. Respect 2. Genuineness 3. Sympathy 4. Rapport

3

When planning group therapy, a nurse should identify which configuration as most optimal for a therapeutic group? 1. Open-ended membership; circle of chairs; group size of 5 to 10 members 2. Open-ended membership; chairs around a table; group size of 10 to 15 members 3. Closed membership; circle of chairs; group size of 5 to 10 members 4. Closed membership; chairs around a table; group size of 10 to 15 members

1

Which client action should a nurse expect during the working phase of the nurse-client relationship? 1. The client gains insight and incorporates alternative behaviors. 2. The client establishes rapport with the nurse and mutually develops treatment goals. 3. The client explores feelings related to reentering the community. 4. The client explores personal strengths and weaknesses that impact behavioral choices.

4

Which client statement demonstrates positive progress toward recovery from a substance use disorder? 1. I have completed detox and therefore am in control of my drug use. 2. I will faithfully attend Narcotic Anonymous (NA) when I cant control my cravings. 3. As a church deacon, my focus will now be on spiritual renewal. 4. Taking those pills got out of control. It cost me my job, marriage, and children.

4

Which client statement indicates a knowledge deficit related to a substance use disorder? 1. Although its legal, alcohol is one of the most widely abused drugs in our society. 2. Tolerance to heroin develops quickly. 3. Flashbacks from LSD use may reoccur spontaneously. 4. Marijuana is like smoking cigarettes. Everyone does it. Its essentially harmless.

3

Which client statement should a nurse identify as a typical response to stress most often experienced in the working phase of the nurse-client relationship? 1. I cant bear the thought of leaving here and failing. 2. I might have a hard time working with you, because you remind me of my mother. 3. I really dont want to talk any more about my childhood abuse. 4. Im not sure that I can count on you to protect my confidentiality.

4

Which group leader activity should a nurse identify as being most effective in the final, or termination, phase of group development? 1. The group leader establishes the rules that will govern the group after discharge. 2. The group leader encourages members to rely on each other for problem solving. 3. The group leader presents and discusses the concept of group termination. 4. The group leader helps the members to process feelings of loss.

4

Which medication orders should a nurse anticipate for a client who has a history of benzodiazepine withdrawal delirium? 1. Haloperidol (Haldol) and fluoxetine (Prozac) 2. Carbamazepine (Tegretol) and donepezil (Aricept) 3. Disulfiram (Antabuse) and lorazepan (Ativan) 4. Chlordiazepoxide (Librium) and phenytoin (Dilantin)

1, 3, 5

Which of the following are behavior assessment categories in the Broset Violence Checklist? (Select all that apply.) 1. Confusion 2. Paranoia 3. Boisterousness 4. Panic 5. Irritability

2, 3, 4

Which of the following behavioral skills should a nurse implement when leading a group that is functioning in the orientation phase of group development? (Select all that apply.) 1. Encourage members to provide feedback to each other about individual progress. 2. Ensure that group rules do not interfere with goal fulfillment. 3. Work with group members to establish rules that will govern the group. 4. Emphasize the need for and importance of confidentiality within the group. 5. Help the leader to resolve conflicts and foster cohesiveness within the group.

2, 3, 4, 5

Which of the following characteristics should be included in a therapeutic nurse-client relationship? (Select all that apply.) 1. Meeting the psychological needs of the nurse and the client 2. Ensuring therapeutic termination 3. Promoting client insight into problematic behavior 4. Collaborating to set appropriate goals 5. Meeting both the physical and psychological needs of the client

1, 2, 3, 4

Which of the following individuals are communicating a message? (Select all that apply.) 1. A mother spanking her son for playing with matches 2. A teenage boy isolating himself and playing loud music 3. A biker sporting an eagle tattoo on his biceps 4. A teenage girl writing, No one understands me 5. A father checking for new e-mail on a regular basis

1, 2, 4

Which of the following interventions should a nurse use when caring for an inpatient client who expresses anger inappropriately? (Select all that apply.) 1. Maintain a calm demeanor. 2. Clearly delineate the consequences of the behavior. 3. Use therapeutic touch to convey empathy. 4. Set limits on the behavior. 5. Teach the client to avoid I statements related to expression of feelings.

1, 2, 3

Which of the following nursing statements and/or questions represent appropriate communication to assess an individual in crisis? (Select all that apply.) 1. Tell me what happened. 2. What coping methods have you used, and did they work? 3. Describe to me what your life was like before this happened. 4. Lets focus on the current problem. 5. Ill assist you in selecting functional coping strategies.

1, 2, 4

Which of the following nursing statements exemplify the cognitive process that must be completed by a nurse prior to caring for clients diagnosed with a substance-related disorder? (Select all that apply.) 1. I am easily manipulated and need to work on this prior to caring for these clients. 2. Because of my fathers alcoholism, I need to examine my attitude toward these clients. 3. I need to review the side effects of the medications used in the withdrawal process. 4. Ill need to set boundaries to maintain a therapeutic relationship. 5. I need to take charge when dealing with clients diagnosed with substance disorders.

2

Which situation should a nurse identify as an example of an autocratic leadership style? 1. The president of Sigma Theta Tau assigns members to committees to research problems. 2. Without faculty input, the dean mandates that all course content be delivered via the Internet. 3. During a community meeting, a nurse listens as clients generate solutions. 4. The student nurses association advertises for candidates for president.

4

Which term should a nurse use to describe the administration of a central nervous system (CNS) depressant during the substance induced disorder of alcohol withdrawal? 1. Antagonist therapy 2. Deterrent therapy 3. Codependency therapy 4. Substitution therapy

1

Which therapeutic communication technique is being used in the following nurse-client interaction?Client: My father spanked me often.Nurse: Your father was a harsh disciplinarian. 1. Restatement 2. Offering general leads 3. Focusing 4. Accepting

3

Which therapeutic communication technique is being used in the following nurse-client interaction?Client: When I am anxious, the only thing that calms me down is alcohol.Nurse: Other than drinking, what alternatives have you explored to decrease anxiety? 1. Reflecting 2. Making observations 3. Formulating a plan of action 4. Giving recognition

countertransference

___________________ refers to a nurses behavioral and emotional response to a client. These responses may be related to unresolved feelings toward significant others from the nurses past.