Mental Health Exam 4 Practice Questions

9. Amy's husband of 1 year left 2 weeks ago for a year-long deployment in Afghanistan. Amy makes an appointment with the psychiatric nurse practitioner at the community mental health clinic. She tells the nurse that she can't sleep, has no appetite, is chronically fatigued, thinks about her husband constantly, and fears for his life. Which of the following might the nurse suggest/prescribe for Amy? (Select all that apply.) a. A prescription for sertraline, 50 mg/day b. Participation in a support group c. Resume involvement in usual activities d. Perform regular relaxation exercises

All of the above

An individual w/ a history of antisocial personality disorder was arrested for driving under the influence of alcohol and causing a serious car accident. Which comment on this behavior would be expected? a. "Its not my fault" b. "Im too ashamed to talk about it" c. "I just don't remember doing it" d. "I'm really sorry about all the people I've hurt"

a. "Its not my fault"

1. Dana's husband, who was deployed to Afghanistan a year ago, is returning home this week. Which of the following postdeployment situations may be likely to occur during the first few months of his return? (Select all that apply.) a. A honeymoon period of physical reconnection b. Resistance from the spouse regarding possible loss of autonomy c. Rejection by the children for perceived abandonment d. A period of adjustment to reconnect emotionally

a. A honeymoon period of physical reconnection b. Resistance from the spouse regarding possible loss of autonomy d. A period of adjustment to reconnect emotionally

3. Shane, a veteran of the war in Iraq, has been diagnosed with post-traumatic stress disorder (PTSD). He is a client of a VA outpatient clinic. He tells the nurse that he experiences panic attacks. Which of the following medications may be prescribed for Shane to treat his panic attacks? a. Alprazolam b. Lithium c. Carbamazepine d. Haldol

a. Alprazolam

7. A school nurse notices bruises and scars on Jana's body. The nurse suspects that the child is being physically abused. How should the nurse proceed with this information? a. As a healthcare worker, report the suspicion to child protective services. b. Check Jana again in a week and see if there are any new bruises. c. Meet with Jana's parents and ask them how Jana got the bruises. d. Initiate paperwork to have Jana placed in foster care.

a. As a healthcare worker, report the suspicion to child protective services.

7. Mike, a veteran of combat in Afghanistan, has a diagnosis of mild traumatic brain injury (TBI). The psychiatric home health nurse from the VA medical center is assigned to make home visits to Mike and his wife, Marissa, who is his caregiver. Which of the following would be an appropriate nursing intervention by the home health nurse? (Select all that apply.) a. Assess for use of substances by Mike or Marissa. b. Encourage Marissa to do everything for Mike to prevent further deterioration in his condition. c. Assess Marissa's level of stress and potential for burnout. d. Encourage Marissa to allow Mike to be as independent as possible. e. Suggest that Marissa ask the physician for a nursing home placement for Mike.

a. Assess for use of substances by Mike or Marissa. c. Assess Marissa's level of stress and potential for burnout. d. Encourage Marissa to allow Mike to be as independent as possible.

7. Annie has hair-pulling disorder. She is receiving treatment at the mental health clinic with HRT. Which of the following elements would be included in this therapy? (Select all that apply.) a. Awareness training b. Competing response training c. Social support d. Hypnotherapy e. Aversive therapy

a. Awareness training b. Competing response training c. Social support

4. Which of the following medications have been indicated for improvement in cognitive functioning in mild to moderate Alzheimer's disease? (Select all that apply.) a. Donepezil (Aricept) b. Rivastigmine (Exelon) c. Risperidone (Risperdal) d. Sertraline (Zoloft) e. Galantamine (Razadyne)

a. Donepezil (Aricept) b. Rivastigmine (Exelon) e. Galantamine (Razadyne)

9. Shane, a patient diagnosed with PTSD tells the nurse that his social worker is recommending EMDR and asks the nurse to describe this treatment. Which of these is the most accurate response? a. EMDR is a therapy designed to help you process thoughts and emotions related to the trauma you've experienced. b. EMDR is a treatment to cure insomnia using hypnosis. c. EMDR is a treatment that uses electrical stimulation to induce a seizure and is beneficial in relieving depression associated with PTSD. d. EMDR is an acronym that stands for Emotional Motivation to Decrease Responsiveness and it will help you forget the trauma.

a. EMDR is a therapy designed to help you process thoughts and emotions related to the trauma you've experienced.

8. The physician orders sertraline (Zoloft) for a client who is hospitalized with adjustment disorder with depressed mood. What is this medication intended to do? a. Increase energy and elevate mood b. Stimulate the central nervous system c. Prevent psychotic symptoms d. Produce a calming effect

a. Increase energy and elevate mood

9. Which of the following factors is not associated with increased incidence of NCD due to Alzheimer's disease? a. Multiple small strokes b. Family history of Alzheimer's disease c. Head trauma d. Advanced age

a. Multiple small strokes

11. Trauma-informed care is a philosophical approach that includes which of the following principles? (Select all that apply.) a. Nurses need to be aware of the potential for trauma in any patient and provide care that minimizes the risk of revictimization or retraumatization. b. Medications need to be given before any other interventions are considered. c. Trauma-informed care highlights the importance of providing care that protects the physical, psychological, and emotional safety of the patient. d. Trauma-informed care is based on the principle that traumas are not correlated with depression or increased risk for suicide.

a. Nurses need to be aware of the potential for trauma in any patient and provide care that minimizes the risk of revictimization or retraumatization. c. Trauma-informed care highlights the importance of providing care that protects the physical, psychological, and emotional safety of the patient.

3. John, a veteran of the war in Iraq, is diagnosed with PTSD. Which of the following therapy regimens would most appropriately be ordered for John? a. Paroxetine and group therapy b. Diazepam and implosion therapy c. Alprazolam and behavior therapy d. Carbamazepine and cognitive therapy

a. Paroxetine and group therapy

6. In addition to disturbances in cognition and orientation, individuals with Alzheimer's disease may also show changes in which of the following? (Select all that apply.) a. Personality b. Vision c. Speech d. Hearing e. Mobility

a. Personality c. Speech e. Mobility

A client diagnosed w/ a personality disorder is cold, aloof, and avoids others on the unit. The nurse recognizes that this behavior os symptomatic of which personality disorder? a. Schizoid PD b. Dependent PD c. Borderline PD d. Antisocial PD

a. Schizoid PD

9. Tina, who is experiencing a panic attack, has just arrived at the emergency department. Which is the priority nursing intervention for this patient? a. Stay with Tina and reassure her of her safety. b. Administer a dose of diazepam. c. Leave Tina alone in a quiet room so that she can calm down. d. Encourage Tina to talk about what triggered the attack.

a. Stay with Tina and reassure her of her safety.

3. A battered woman presents to the emergency department with multiple cuts and abrasions. Her right eye is swollen shut. She says that her husband did this to her. Which of the following is the priority nursing intervention? a. Tending to the immediate care of her wounds b. Providing her with information about a safe place to stay c. Administering the prn tranquilizer ordered by the physician d. Explaining how she may go about bringing charges against her husband

a. Tending to the immediate care of her wounds

4. A patient with OCD spends many hours each day washing her hands. What is the most likely reason she washes her hands so much? a. To relieve her anxiety b. To reduce the probability of infection c. To gain a feeling of control over her life d. To increase her self-concept

a. To relieve her anxiety

Two months ago, Ms. T was sexually assaulted while jogging in an isolated park. She is hospitalized for suicidal ideation at this time. She awakens in the middle of the night screaming about having nightmares of the incident. Which of the following is the most appropriate initial nursing intervention? a) Call the doctor to report the incident b) Stay with Ms. T until the anxiety has subsided c) Administer prn alprazolam d) Allow her some privacy to work through the emotions

b) Stay with Ms. T until the anxiety has subsided

10. Jareth has a diagnosis of generalized anxiety disorder. His physician has prescribed buspirone 15 mg daily. Jareth says to the nurse, "Why do I have to take this every day? My friend's doctor ordered Xanax for her, and she only takes it when she is feeling anxious." Which of the following would be an appropriate response by the nurse? a. "Xanax is not effective for generalized anxiety disorder." b. "Buspirone must be taken daily in order to be effective." c. "I will ask the doctor if he will change your dose of buspirone to prn so that you don't have to take it every day." d. "Your friend really should be taking the Xanax every day."

b. "Buspirone must be taken daily in order to be effective."

Sharon, a woman with multiple cuts and abrasions, arrives at the emergency department with her three small children. She tells the nurse that her husband inflicted these wounds on her. She says, "I didn't want to come. I'm really okay. He only does this when he has too much to drink. I just shouldn't have yelled at him." Which of the following is the best response by the nurse? a. "How often does he drink too much?" b. "It is not your fault. You did the right thing by coming here." c. "How many times has he done this to you?" d. "He is not a good husband. You have to leave him before he kills you."

b. "It is not your fault. You did the right thing by coming here."T

5. Mrs. G, who has NCD due to Alzheimer's disease, says to the nurse, "I have a date tonight. I always have a date on Christmas." Which of the following is the most appropriate response? a. "Don't be silly. It's not Christmas, Mrs. G." b. "Today is Tuesday, October 21, Mrs. G. We will have supper soon, and then your daughter will come to visit." c. "Who is your date with, Mrs. G?" d. "I think you need some more medication, Mrs. G. I'll bring it to you now."

b. "Today is Tuesday, October 21, Mrs. G. We will have supper soon, and then your daughter will come to visit."

10. Mr. Stone is a patient in the hospital with a diagnosis of vascular NCD. In explaining this disorder to Mr. Stone's family, which of the following statements by the nurse is correct? a. "He will probably live longer than if his disorder was of the Alzheimer's type." b. "Vascular NCD shows stepwise progression. This is why he sometimes seems okay." c. "Vascular NCD is caused by plaques and tangles that form in the brain." d. "The cause of vascular NCD is unknown."

b. "Vascular NCD shows stepwise progression. This is why he sometimes seems okay."

6. Nina, who is depressed following the breakup of a very stormy marriage, says to the nurse, "I feel so bad. I thought I would feel better once I left, but I feel worse!" Which is the bestresponse by the nurse? a. "Cheer up, Nina. You have a lot to be happy about." b. "You are grieving the loss of your marriage. It's natural for you to feel bad." c. "Try not to dwell on how you feel. If you don't think about it, you'll feel better." d. "You did the right thing, Nina. Knowing that should make you feel better."

b. "You are grieving the loss of your marriage. It's natural for you to feel bad."

8. Kate is an 18-year-old freshman at the state university. She was extremely flattered when Don, a senior star football player, invited her to a party. On the way home, he parked the car in a secluded area by the lake. He became angry when she refused his sexual advances. He began to beat her and finally raped her. She tried to fight him, but his physical strength overpowered her. He dumped her in the dorm parking lot and left. The dorm supervisor rushed Kate to the emergency department. Kate says to the nurse, "It's all my fault. I shouldn't have allowed him to stop at the lake." Which of the following is the nurse's best response? a. "Yes, you're right. You put yourself in a very vulnerable position when you allowed him to stop at the lake." b. "You are not to blame for his behavior. You obviously made some right decisions, because you survived the attack." c. "There's no sense looking back now. Just look forward, and make sure you don't put yourself in the same situation again." d. "You'll just have to see that he is arrested so he won't do this to anyone else."

b. "You are not to blame for his behavior. You obviously made some right decisions, because you survived the attack."

2. Which of the following is the leading cause of traumatic brain injury (TBI) in active-duty military personnel in combat? a. Military vehicle accidents b. Blasts from explosive devices c. Falls d. Blows to the head from falling debris

b. Blasts from explosive devices

5. Nina recently left her husband of 10 years. She was very dependent on her husband and is having difficulty adjusting to an independent lifestyle. She has been hospitalized with a diagnosis of adjustment disorder with depressed mood. Which of the following is the prioritynursing diagnosis for Nina? a. Risk-prone health behavior related to loss of dependency b. Complicated grieving related to breakup of marriage c. Ineffective communication related to problems with dependency d. Social isolation related to depressed mood

b. Complicated grieving related to breakup of marriage

3. Mrs. G has been diagnosed with NCD due to Alzheimer's disease. The primary nursing intervention in working with Mrs. G is which of the following? a. Ensuring that she receives food she likes to prevent hunger b. Ensuring that the environment is safe to prevent injury c. Ensuring that she meets the other patients to prevent social isolation d. Ensuring that she takes care of her own ADLs to prevent dependence

b. Ensuring that the environment is safe to prevent injury

When assessing a client diagnosed w/ narcissistic personality disorder, the nurse expects to identify which characteristic behavior? a. Odd beliefs and magical thinking b. Grandiose sense of self-importance c. Pattern of intense and chaotic relationship d. Submissive and clinging behavior

b. Grandiose sense of self-importance

10. Sheila, a nurse, served as a captain in the military and returned from active duty 3 months ago. She reports experiencing nightmares and headaches since her return but denies being engaged in active combat during her tour of duty. Which of the following should the nurse include in the psychosocial assessment? (Select all that apply.) a. Folstein's mini-mental status exam b. History of sexual trauma c. History of military promotions d. Risks for substance use disorders

b. History of sexual trauma d. Risks for substance use disorders

5. Jana, age 5, is sent to the school nurse's office with an upset stomach. She has vomited and soiled her blouse. When the nurse removes her blouse, she notices that Jana has numerous bruises on her arms and torso in various stages of healing. She also notices some small scars. Jana's abdomen protrudes on her small, thin frame. From the objective physical assessment, the nurse suspects that: a. Jana is experiencing physical and sexual abuse. b. Jana is experiencing physical abuse and neglect. c. Jana is experiencing emotional neglect. d. Jana is experiencing sexual and emotional abuse.

b. Jana is experiencing physical abuse and neglect.

9. A young woman who was a recent victim of a sexual assault is brought into the emergency department by a friend. Which of the following is the priority nursing intervention? a. Help her to bathe and clean herself up. b. Provide physical and emotional support during evidence collection. c. Provide her with a written list of community resources for survivors of rape. d. Discuss the importance of a follow-up visit to evaluate for sexually transmitted diseases.

b. Provide physical and emotional support during evidence collection.

4. Shane, a veteran of the war in Iraq, has been diagnosed with post-traumatic stress disorder (PTSD). He has been hospitalized after swallowing a handful of his antipanic medication. His physical condition has been stabilized in the emergency department, and he has been admitted to the psychiatric unit. In developing his initial plan of care, which is the priority nursing diagnosis for Shane? a. Post-trauma syndrome b. Risk for suicide c. Complicated grieving d. Disturbed thought processes

b. Risk for suicide

5. The initial care plan for a patient with OCD who washes her hands obsessively would include which of the following nursing interventions? a. Keep the patient's bathroom locked so she cannot wash her hands all the time. b. Structure the patient's schedule so that she has plenty of time for washing her hands. c. Place the patient in isolation until she promises to stop washing her hands so much. d. Explain the patient's behavior to her because she is probably unaware that it is maladaptive.

b. Structure the patient's schedule so that she has plenty of time for washing her hands.

1. John, a veteran of the war in Iraq, is diagnosed with PTSD. He says to the nurse, "I can't figure out why God took my buddy instead of me." From this statement, the nurse assesses which of the following in John? a. Repressed anger b. Survivor's guilt c. Intrusive thoughts d. Spiritual distress

b. Survivor's guilt

8. The night nurse finds Mrs. G, a client with Alzheimer's disease, wandering the hallway at 4 a.m. and trying to open the door to the side yard. Which statement by the nurse reflects the most patient-centered approach to the situation? a. "That door leads out to the patio, Mrs. G. It's nighttime. You don't want to go outside now." b. 'You look confused, Mrs. G. What is bothering you?" c. "This is the patio door, Mrs. G. Are you looking for the bathroom?" d. "Are you lonely? Perhaps you'd like to go back to your room and talk for a while."

c. "This is the patio door, Mrs. G. Are you looking for the bathroom?"

11. Which of the following interventions is most appropriate in helping a patient with Alzheimer's disease with her ADLs? (Select all that apply.) a. Perform ADLs for her while she is in the hospital. b. Provide her with a written list of activities she is expected to perform. c. Assist her with step-by-step instructions. d. Tell her that if her morning care is not completed by 9:00 a.m., it will be performed for her by the nurse's aide so that she can attend group therapy. e. Encourage her and give her plenty of time to perform as many of her ADLs as possible independently.

c. Assist her with step-by-step instructions. e. Encourage her and give her plenty of time to perform as many of her ADLs as possible independently.

5. Mike was injured during combat in Afghanistan. He has a diagnosis of traumatic brain injury (TBI). Which of the following medications might the physician prescribe to improve Mike's memory and thinking capability? a. Carbamazepine b. Duloxetine c. Donepezil d. Bupropion

c. Donepezil

1. An example of a treatable (reversible) form of NCD is one that is caused by which of the following? (Select all that apply.) a. Multiple sclerosis b. Multiple small brain infarcts c. Electrolyte imbalances d. HIV disease e. Folate deficiency

c. Electrolyte imbalances e. Folate deficiency

2. Which of the following is the most appropriate therapy for a client with agoraphobia? a. 10 mg Valium qid b. Group therapy with other people with agoraphobia c. Facing her fear in gradual step progression d. Hypnosis

c. Facing her fear in gradual step progression

8. Joselyn is a new patient at the mental health clinic. She has been diagnosed with Body Dysmorphic Disorder. Which of the following medications is the psychiatric nurse practitioner most likely to prescribe for Joanie? a. Alprazolam (Xanax) b. Diazepam (Valium) c. Fluoxetine (Prozac) d. Olanzapine (Zyprexa)

c. Fluoxetine (Prozac)

In assessing a client diagnosed w/ borderline personality disorder, which characteristics would the nurse expect to observe? a. Predictability b. Controlled anger c. Little tolerance for being alone d. Stable and satisfactory relationships

c. Little tolerance for being alone

7. Nina has been hospitalized with adjustment disorder with depressed mood following the breakup of her marriage. Which of the following is true regarding the diagnosis of adjustment disorder? a. Nina will require long-term psychotherapy to achieve relief. b. Nina likely inherited a genetic tendency for the disorder. c. Nina's symptoms will likely remit once she has accepted the change in her life. d. Nina probably would not have experienced adjustment disorder if she had a higher level of intelligence.

c. Nina's symptoms will likely remit once she has accepted the change in her life.

2. Sharon, a woman with multiple cuts and abrasions, arrives at the emergency department with her three small children. She tells the nurse that her husband inflicted these wounds on her. In the interview, Sharon tells the nurse, "He's been getting more and more violent lately. He's been under a lot of stress at work the last few weeks, so he drinks a lot when he gets home. He always gets mean when he drinks. I was getting scared. So I just finally told him I was going to take the kids and leave. He got furious when I said that and began beating me with his fists." With knowledge about the cycle of battering, what does this situation represent? a. Phase I. Sharon was desperately trying to stay out of his way and keep everything calm. b. Phase I. A minor battering incident for which Sharon assumes all the blame. c. Phase II. The acute battering incident that was provoked by her threat to leave. d. Phase III. The honeymoon phase when the husband believes that he has "taught her a lesson and she won't act up again." Continued

c. Phase II. The acute battering incident that was provoked by her threat to leave.

6. Sandy, a patient with OCD says to the nurse, "I've been here four days now, and I'm feeling better. I feel comfortable on this unit, and I'm not ill-at-ease with the staff or other patients anymore." In light of this change, which nursing intervention is most appropriate? a. Give attention to the ritualistic behaviors each time they occur and point out their inappropriateness. b. Ignore the ritualistic behaviors, and they will be eliminated for lack of reinforcement. c. Set limits on the amount of time Sandy may engage in the ritualistic behavior. d. Continue to allow Sandy all the time she wants to carry out the ritualistic behavior.

c. Set limits on the amount of time Sandy may engage in the ritualistic behavior.

2. John, a veteran of the war in Iraq, is diagnosed with PTSD. He experiences a nightmare during his first night in the hospital. He explains to the nurse that he was dreaming about gunfire all around and people being killed. Which of the following is the nurse's most appropriate initial intervention? a. Administer alprazolam as ordered prn for anxiety. b. Call the physician and report the incident. c. Stay with John and reassure him of his safety. d. Have John listen to a tape of relaxation exercises.

c. Stay with John and reassure him of his safety.

6. Juan, a veteran of the war in Iraq, has been diagnosed with post-traumatic stress disorder (PTSD). He has been hospitalized on the psychiatric unit following an attempted suicide. In the middle of the night, he wakes up yelling and tells the nurse he was having a flashback to when his unit transport drove over an improvised explosive device (IED) and most of his fellow soldiers were killed. He is breathing heavily, perspiring, and his heart is pounding. The nurse's most appropriate initial intervention is which of the following? a. Contact the doctor on call to report the incident. b. Administer the prn order for chlorpromazine. c. Stay with Juan and reassure him of his safety. d. Have Juan sit outside the nurses' station until he is calm.

c. Stay with Juan and reassure him of his safety.

4. A woman who has a long history of being battered by her husband is staying at the woman's shelter. She has received emotional support from staff and peers and has been made aware of the alternatives open to her. Nevertheless, she decides to return to her home and marriage. Which of the following is the best response by the nurse to the woman's decision? a. "I just can't believe you have decided to go back to that horrible man." b. "I'm just afraid he will kill you or the children when you go back." c. "What makes you think things have changed with him?" d. "I hope you have made the right decision. Call this number if you need help."

d. "I hope you have made the right decision. Call this number if you need help."

2. Mrs. G has been diagnosed with NCD due to Alzheimer's disease. This disorder is associated with the presence of which of the following? a. Multiple small brain infarcts b. Lewy bodies c. Cerebral abscess d. Amyloid beta plaques and neurofibrillary tangles

d. Amyloid beta plaques and neurofibrillary tangles

8. Which of the following psychosocial therapies has been shown to be helpful for clients with traumatic brain injury (TBI)? a. Eye movement desensitization b. Psychoanalysis c. Reality therapy d. Cognitive behavioral therapy

d. Cognitive behavioral therapy

7. Mrs. G, who has NCD due to Alzheimer's disease, has trouble sleeping and wanders around at night. Which of the following nursing actions would be best to promote sleep in Mrs. G? a. Ask the doctor to prescribe flurazepam (Dalmane). b. Ensure that Mrs. G gets an afternoon nap so she will not be overtired at bedtime. c. Make Mrs. G a cup of tea with honey before bedtime. d. Ensure that Mrs. G gets regular physical exercise during the day.

d. Ensure that Mrs. G gets regular physical exercise during the day.

A client diagnosed w/ borderline personality disorder is admitted to a psychiatric unit. Which behavior pattern would the nurse expect to observe? a. Social isolation b. Suspiciousness of others c. Bizarre speech patterns d. Generates conflict among the staff

d. Generates conflict among the staff

10. A woman who was sexually assaulted 6 months ago by a man with whom she was acquainted has since been attending a support group for survivors of rape. From this group, she has learned that the most likely reason the man raped her was: a. Because he had been drinking, he was not in control of his actions. b. He had not had sexual relations with a girl in many months. c. He was predisposed to become a rapist by virtue of the poverty conditions under which he was reared. d. He was expressing power and dominance by means of sexual aggression and violence.

d. He was expressing power and dominance by means of sexual aggression and violence.

1. Ms. T has been diagnosed with agoraphobia. Which behavior would be most characteristic of this disorder? a. Ms. T experiences panic anxiety when she encounters snakes. b. Ms. T refuses to fly in an airplane. c. Ms. T will not eat in a public place. d. Ms. T stays in her home for fear of being in a place from which she cannot escape.

d. Ms. T stays in her home for fear of being in a place from which she cannot escape.

Which of the following medications is considered to be a first time medication of choice in the treatment of PTSD? a. Alprazolam b. Propranolol c. Carbamazepine d. Paroxetine

d. Paroxetine

3. With implosion therapy, a client with phobic anxiety would be: a. Taught relaxation exercises. b. Subjected to graded intensities of the fear. c. Instructed to stop the therapeutic session as soon as anxiety is experienced. d. Presented with massive exposure to a variety of stimuli associated with the phobic object or situation.

d. Presented with massive exposure to a variety of stimuli associated with the phobic object or situation.

10. Emma, age 16, has recently been diagnosed with diabetes mellitus. She must watch her diet and take an oral hypoglycemic medication daily. She has become very depressed, and her mother reports that Emma refuses to change her diet and often skips her medication. Emma has been hospitalized for stabilization of her blood sugar. The psychiatric nurse practitioner has been called in as a consultant. Which of the following nursing diagnoses by the psychiatric nurse would be a priority for Emma at this time? a. Anxiety related to hospitalization evidenced by noncompliance b. Low self-esteem related to feeling different from her peers evidenced by social isolation c. Risk for suicide related to new diagnosis of diabetes mellitus d. Risk-prone health behavior related to denial of seriousness of her illness evidenced by refusal to follow diet and take medication

d. Risk-prone health behavior related to denial of seriousness of her illness evidenced by refusal to follow diet and take medication

4. Which of the following may be influential in the predisposition to PTSD? a. Unsatisfactory parent-child relationship b. Excess of the neurotransmitter serotonin c. Distorted, negative cognitions d. Severity of the stressor and availability of support systems

d. Severity of the stressor and availability of support systems

6. A school nurse notices bruises and scars on a child's body, but the child refuses to say how she received them. What is another way in which the nurse can get information from the child? a. Have her evaluated by the school psychologist. b. Tell her she may select a "treat" from the treat box (e.g., sucker, balloon, junk jewelry) if she answers the nurse's questions. c. Explain to her that if she answers the questions, she may stay in the nurse's office and not have to go back to class. d. Use a "family" of dolls to role-play the child's family with her.

d. Use a "family" of dolls to role-play the child's family with her.