Mental health exam 6
A 4-year-old cries for 5 minutes when the parents leave the child at preschool. The parents ask the nurse, "What should we do?" What is the nurse's best response? a. "Ask the teacher to let the child call you at play time." b. "Withdraw the child from preschool until maturity increases." c. "Remain with your child for the first hour of preschool time." d. "Give your child a kiss before you leave the preschool program."
d. "Give your child a kiss before you leave the preschool program."
Which nursing diagnosis is universally applicable for children diagnosed with autism spectrum disorders? a. Impaired social interaction related to difficulty maintaining relationships b. Chronic low self-esteem related to excessive negative feedback c. Deficient fluid volume related to abnormal eating habits d. Anxiety related to nightmares and repetitive activities
a. Impaired social interaction related to difficulty maintaining relationships
A parent who is very concerned about a 3-year-old son says, "He likes to play with girls' toys. Do you think he is homosexual or mentally ill?" Which response by the nurse most professionally describes the current understanding of gender identity? a. "A child's interest in the activities of the opposite gender is not unusual or related to sexuality. Most children do not carry cross-gender interests into adulthood." b. "It's difficult to say for sure because the research is incomplete so far, but chances are that he will grow up to be a normal adult." c. "The research is incomplete, but many boys play with girls' toys and turn out normal as adults." d. "I am sure that whatever happens, he will be a loving son, and you will be a proud parent."
a. "A child's interest in the activities of the opposite gender is not unusual or related to sexuality. Most children do not carry cross-gender interests into adulthood."
A man who regularly experiences premature ejaculation tells the nurse, "I feel like such a failure. It's so awful for both me and my partner." What is the nurse's most therapeutic response? a. "I sense you are feeling frustrated and upset." b. "Tell me more about feeling like a failure." c. "You are too hard on yourself." d. "What do you mean by awful?"
a. "I sense you are feeling frustrated and upset."
A nurse is anxious about assessing the sexual history of a client who is considerably older than the nurse is. Which statement would be most appropriate for obtaining information about the client's sexual practices? a. "Some people are not sexually active, others have a partner, and some have several partners. What has been your pattern?" b. "Sexual health can reflect a number of medical problems, so I'd like to ask if you have any sexual problems you think we should know about." c. "It's your own business, of course, but it might be helpful for us to have some information about your sexual history. Could you tell me about that, please?" d. "I would appreciate it if you could share your sexual history with me so I can share it with your health care provider. It might be helpful in planning your treatment."
a. "Some people are not sexually active, others have a partner, and some have several partners. What has been your pattern?"
Family members ask the nurse, "What can we say when our loved one says, 'Death is coming soon?'" To promote communication, which response could the nurse suggest for family members? a. "We feel sad when we think about life without you." b. "We have not given up on getting you well." c. "We think you will be around for a long time yet." d. "Let's talk about the good memories we have."
a. "We feel sad when we think about life without you."
A terminally ill client says, "I know I will never get well, but," and the patient's voice trails off. Select the most therapeutic response by the nurse. a. "What do you hope for?" b. "Do you have questions about what is happening?" c. "You are not going to get well. It is healthy that you accept that." d. "When you have questions, it is best to talk to the health care provider."
a. "What do you hope for?"
Which patients meet criteria for hospice services? (Select all that apply.) a. A 92-year-old diagnosed with acute pneumonia and late-stage Alzheimer's disease b. A 54-year-old diagnosed with glioblastoma and life expectancy of 8 to 10 weeks c. A 16-year-old with type 1 diabetes, multiple infections, and substance abuse d. A 74-year-old newly diagnosed with chronic obstructive pulmonary disease (COPD) and life expectancy of 2 years e. A 36-year-old diagnosed with multiple sclerosis complicated by major depressive disorder and pain associated with muscle spasms
a. A 92-year-old diagnosed with acute pneumonia and late-stage Alzheimer's disease b. A 54-year-old diagnosed with glioblastoma and life expectancy of 8 to 10 weeks
A client with a new diagnosis of cancer says, "My father died of pancreatic cancer. I took care of him during his illness, so I know what is ahead for me." Which nursing diagnosis applies? a. Anticipatory grieving b. Ineffective coping c. Ineffective denial d. Spiritual distress
a. Anticipatory grieving
A child diagnosed with attention deficit hyperactivity disorder (ADHD) will begin medication therapy. The nurse should prepare a plan to teach the family about which classification of medications? a. CNS stimulants b. Tricyclic antidepressants c. Antipsychotics d. Anxiolytics
a. CNS stimulants
A nurse assesses a client diagnosed with a paraphilic disorder. Which findings are most likely? (Select all that apply.) a. Childhood history of attention deficit hyperactivity disorder (ADHD) b. A poorly managed endocrine disorder c. History of brain injury d. Cognitive distortions e. Grandiosity
a. Childhood history of attention deficit hyperactivity disorder (ADHD) c. History of brain injury d. Cognitive distortions
An adult experienced a myocardial infarction six months ago. At a follow-up visit, this adult says, "I haven't had much interest in sex since my heart attack. I finished my rehabilitation program but having sex strains my heart. I don't know if my heart is strong enough." Which nursing diagnosis applies to this client concern? a. Deficient knowledge related to faulty perception of health status b. Disturbed self-concept related to required lifestyle changes c. Disturbed body image related to treatment side effects d. Sexual dysfunction related to self-esteem disturbance
a. Deficient knowledge related to faulty perception of health status
A nurse on an adolescent psychiatric unit assesses a newly admitted 14-year-old. An impulse control disorder is suspected. Which aspects of the patient's history support the suspected diagnosis? (Select all that apply.) a. Family history of mental illness b. Allergies to multiple antibiotics c. Long history of severe facial acne d. Father with history of alcohol abuse e. History of an abusive relationship with one parent
a. Family history of mental illness d. Father with history of alcohol abuse e. History of an abusive relationship with one parent
An adolescent was arrested for prostitution and assault on a parent. The adolescent says, "I hate my parents. They focus all attention on my brother, who's perfect in their eyes." Which type of therapy might promote the greatest change in the adolescent's behavior? a. Family therapy b. Bibliotherapy c. Play therapy d. Art therapy
a. Family therapy
Which actions by a nurse are most appropriate when caring for a hospice patient? (Select all that apply.) a. Giving choices b. Fostering personal control c. Explaining curative options d. Supporting the patient's spirituality e. Offering interventions that convey respect f. Providing answers to the patient's questions about spirituality
a. Giving choices b. Fostering personal control d. Supporting the patient's spirituality e. Offering interventions that convey respect
Which assessment findings present familial risks for a child to develop a psychiatric disorder? (Select all that apply.) a. Having a mother diagnosed with schizophrenia b. Being the oldest child in a family c. Living with an alcoholic parent d. Being an only child e. Living in an urban community
a. Having a mother diagnosed with schizophrenia c. Living with an alcoholic parent
A 10-year-old boy is diagnosed with gender dysphoria. Which assessment finding would the nurse expect? a. Having tea parties with dolls b. A compromised sexual response cycle c. Identifying with boys who are athletic d. Intense urges to watch his parents have sex
a. Having tea parties with dolls
A man says, "I enjoy watching women when I am out in public. I like to go to places where I can observe women crossing their legs in hopes of seeing something good." Which statement about this behavior is most accurate? a. It is a sexual disorder. The behavior is socially atypical. It could disrupt relationships and could be insulting to others. b. It is not a sexual disorder. These events occur in public, where those he observes do not have a reasonable expectation of privacy. c. It is not a sexual disorder. Because it occurs in public areas, this behavior does not hurt others or involve intrusion into the personal space of those observed. d. An action is or is not a sexual disorder depending on applicable local laws, so whether this meets the definition of a sexual disorder depends on the location.
a. It is a sexual disorder. The behavior is socially atypical. It could disrupt relationships and could be insulting to others.
Which assessment findings support a diagnosis of oppositional defiant disorder (ODD)? a. Negative, hostile, and spiteful toward parents. Blames others for misbehavior. b. Exhibits involuntary facial twitching and blinking; makes barking sounds. c. Violates others' rights; cruelty toward people or animals; steals; truancy. d. Displays poor academic performance and reports frequent nightmares.
a. Negative, hostile, and spiteful toward parents. Blames others for misbehavior.
A nurse plans an educational program for staff of a home health agency specializing in care of the elderly. Which topic is the highest priority to include? a. Pain assessment techniques for older adults b. Psychosocial stimulation for those who live alone c. Preparation of psychiatric advance directives in the elderly d. Ways to manage disinhibition in elderly persons with dementia
a. Pain assessment techniques for older adults
Parents of an adolescent diagnosed with a conduct disorder (CD) say, "We don't know how to respond when our child breaks the rules in our house. Is there any treatment that might help us?" Which therapy is likely to be helpful for these parents? a. Parent-child interaction therapy (PCIT) b. Behavior modification therapy c. Multi-systemic therapy (MST) d. Pharmacotherapy
a. Parent-child interaction therapy (PCIT)
A wife received news that her husband died of heart failure and called her family to come to the hospital. She angrily tells the nurse who cared for him, "He would still be alive if you had given him your undivided attention." What is the nurse's most therapeutic action? a. Say, "I understand you are feeling upset. I will stay with you until your family comes." b. Say, "Your husband's heart was so severely damaged that it could no longer pump." c. Say, "I will call my supervisor to discuss this matter with you." d. Hold the spouse's hand in silence until the family arrives.
a. Say, "I understand you are feeling upset. I will stay with you until your family comes."
An adolescent diagnosed with conduct disorder (CD) has aggression, impulsivity, hyperactivity, and mood symptoms. The treatment team believes this adolescent may benefit from medication. The nurse anticipates the health care provider will prescribe which type of medication? a. Second-generation antipsychotic b. Antianxiety medication c. Calcium channel blocker d. b-blocker
a. Second-generation antipsychotic
A nurse is performing an assessment for a 59-year-old man with a long history of hypertension. What is the rationale for including questions about prescribed medications and their effects on sexual function in the assessment? a. Sexual dysfunction may result from use of prescription medications for management of hypertension. b. Such questions are an indirect way of learning about the client's medication adherence. c. These questions ease the transition to questions about sexual practices in general. d. Sexual dysfunction can cause stress and contribute to increased blood pressure.
a. Sexual dysfunction may result from use of prescription medications for management of hypertension.
Soon after parents announced they were divorcing, a child stopped participating in sports, sat alone at lunch, and avoided former friends. The child told the school nurse, "If my parents loved me, they would work out their problems." Which nursing diagnosis has the highest priority? a. Social isolation b. Decisional conflict c. Chronic low self-esteem d. Disturbed personal identity
a. Social isolation
A 16-year-old diagnosed with a conduct disorder (CD) has been in a residential program for 3 months. Which outcome should occur before discharge? a. The adolescent and parents create and agree to a behavioral contract with rules, rewards, and consequences. b. The adolescent identifies friends in the home community who are a positive influence. c. Temporary placement is arranged with a foster family until the parents complete a parenting skills class. d. The adolescent experiences no anger and frustration for 1 week.
a. The adolescent and parents create and agree to a behavioral contract with rules, rewards, and consequences.
Which assessment finding would cause the nurse to consider a child to be most at risk for the development of mental illness? a. The child has been raised by a parent with recurring major depressive disorder. b. The child's best friend was absent from the child's birthday party. c. The child was not promoted to the next grade one year. d. The child moved to three new homes over a 2-year period.
a. The child has been raised by a parent with recurring major depressive disorder.
The child prescribed an antipsychotic medication to manage violent behavior is one most likely diagnosed with what disorder? a. attention deficit hyperactivity disorder (ADHD). b. posttraumatic stress disorder (PTSD). c. communication disorder. d. an anxiety disorder.
a. attention deficit hyperactivity disorder (ADHD).
An adult seeks treatment for urges involving sexual contact with children. The adult has not acted on these urges but feels shame. Which finding concerning the adult's actions best indicates that this adult is making progress in treatment? a. consistently avoids schools and shops at malls only during school hours. b. indicates sexual drive and enjoyment from sex have decreased. c. reports an active and satisfying sex life with an adult partner. d. volunteers to become a scout troop leader.
a. consistently avoids schools and shops at malls only during school hours.
A parent diagnosed with schizophrenia and 13-year-old child live in a homeless shelter. The child formed a trusting relationship with a shelter volunteer. The child says, "My three friends and I got an A on our school science project." The nurse can assess that the child demonstrating what? a. resiliency. b. a passive temperament. c. at risk for post-traumatic stress disorder (PTSD). d. intellectualization to deal with problems.
a. resiliency.
A client approaches the nurse in the clinic waiting room and says, "I want to talk to you about a sexual matter." How can the nurse best facilitate the discussion? a. saying, "Let's go my office." b. responding, "I want to help. Go ahead; I'm listening." c. telling the client, "Let's schedule another appointment." d. offering to sit in a corner of the waiting room with the client.
a. saying, "Let's go my office."
A new staff nurse tells the clinical nurse specialist, "I am unsure about my role when clients bring up sexual problems." The clinical nurse specialist should give clarification by making what statement? a. "All nurses qualify as sexual counselors. Nurses have knowledge about the biopsychosocial aspects of sexuality throughout the life cycle." b. "All nurses should be able to screen for sexual dysfunction and give basic information about sexual feelings, behaviors, and myths." c. "All nurses should defer questions about sex to other health care professionals because of their limited knowledge of sexuality." d. "All nurses who are interested in sexual dysfunction can provide sex therapy for individuals and couples."
b. "All nurses should be able to screen for sexual dysfunction and give basic information about sexual feelings, behaviors, and myths."
After the death of his wife, a man says, "I can't live without her ... she was my whole life." What is the nurse's most therapeutic reply? a. "Each day will get a little better." b. "Her death is a terrible loss for you." c. "It's important to recognize that she is no longer suffering." d. "Your friends will help you cope with this change in your life."
b. "Her death is a terrible loss for you."
A man who reports frequently experiencing premature ejaculation tells the nurse, "I feel like such a failure. It's so awful for both me and my partner. Can you help me?" Select the nurse's best response. a. "Have you discussed this problem with your partner?" b. "I can refer you to a practitioner who can help you with this problem." c. "Have you asked your health care provider for prescription medication?" d. "There are several techniques described in this pamphlet that might be helpful."
b. "I can refer you to a practitioner who can help you with this problem."
One month ago, an adult died from cancer. Family members now gather at the adult's home to dispose of the deceased's belongings. Which comments demonstrate the family member is coping with the loss in an effective way? (Select all that apply.) a. "Her possessions still have her scent. We should dispose of them." b. "Let's take turns selecting items of hers we would each like to have." c. "When I die, I hope someone who loved me goes through my things." d. "This was her favorite jacket. If we donate it to charity, someone else can enjoy it too." e. "We're violating her privacy by looking through her things. Let's call a charity to come pick up everything."
b. "Let's take turns selecting items of hers we would each like to have." c. "When I die, I hope someone who loved me goes through my things." d. "This was her favorite jacket. If we donate it to charity, someone else can enjoy it too."
A staff nurse asks a hospice nurse, "Who should be referred for hospice care?" What is the hospice nurse's best response? a. "Hospice is for terminally ill patients diagnosed with cancer." b. "Patients in the end stage of any disease are eligible for hospice." c. "Hospice is designed to care for patients experiencing end-stage renal disease." d. "Patients diagnosed with degenerative neurological diseases are eligible for hospice after paralysis occurs."
b. "Patients in the end stage of any disease are eligible for hospice."
A client diagnosed with pancreatic cancer says, "I know I am dying, but I am still alive. I want to be in control as long as I can." Which reply by the nurse shows active listening? a. "Our staff will do their best to manage your pain." b. "Your mind and spirit are healthy, although your body is frail." c. "It's important for you to let others help you to ease their own pain." d. "Are you saying you want people to stop focusing on your diagnosis?"
b. "Your mind and spirit are healthy, although your body is frail."
Which finding indicates successful completion of an individual's grief and mourning? a. For 2 years after her husband's death, a widow has kept her husband's belongings in their usual places. b. After 15 months, a widower realistically remembers both the pleasures and disappointments of his relationship with his wife. c. Three years after her husband's death, the widow talks about her husband as if he is alive and weeps when others mention his name. d. Eighteen months after a spouse's death, an adult says, "I have never cried or had feelings of loss, even though we were very close."
b. After 15 months, a widower realistically remembers both the pleasures and disappointments of his relationship with his wife.
Which event is most likely to precipitate grief across a community? a. A local bank is robbed twice in a single month b. An adolescent shoots the principal of a local high school c. The elderly pastor of the town's largest church dies of heart failure d. Concrete pilings crumble in a bridge important to movement of local traffic
b. An adolescent shoots the principal of a local high school
A woman just received notification that her husband died. She approaches the nurse who cared for him during his last hours and says angrily, "If you had given him your undivided attention, he would still be alive." Which analysis applies? a. The comment warns of a malpractice suit. b. Anger is a phenomenon experienced during grief. c. The wife had conflicted feelings about her husband. d. In some cultures, grief is expressed solely through anger.
b. Anger is a phenomenon experienced during grief.
A respected school coach was arrested after a student reported the coach attempted to have sexual contact. Which nursing action has priority in the period immediately following the coach's arrest? a. Determine the nature and extent of the coach's sexual disorder. b. Assess the coach's potential for suicide or other self-harm. c. Assess the coach's self-perception of problem and needs. d. Determine whether other children were harmed.
b. Assess the coach's potential for suicide or other self-harm.
A nurse prepares to lead a discussion at a community health center regarding children's health problems. The nurse wants to use current terminology when discussing these issues. Which terms are appropriate for the nurse to use? (Select all that apply.) a. Autism b. Bullying c. Mental retardation d. Autism spectrum disorder e. Intellectual development disorder
b. Bullying d. Autism spectrum disorder e. Intellectual development disorder
At the time of a home visit, the nurse notices that each parent and child in a family has his or her own personal online communication device. Each member of the family is in a different area of the home. Which nursing actions are appropriate? (Select all that apply.) a. Report the finding to the official child protection social services agency. b. Educate all members of the family about potential safety risks in online environments. c. Talk with the parents about parental controls on the children's communication devices. d. Encourage the family to schedule daily time together without communication devices. e. Obtain the family's network password and examine online sites family members have visited.
b. Educate all members of the family about potential safety risks in online environments. c. Talk with the parents about parental controls on the children's communication devices. d. Encourage the family to schedule daily time together without communication devices.
A child reports to the school nurse of being verbally bullied by an aggressive classmate. What is the nurse's best first action? a. Give notice to the chief administrator at the school regarding the events. b. Encourage the victimized child to share feelings about the experience. c. Encourage the victimized child to ignore the bullying behavior. d. Discuss the events with the aggressive classmate.
b. Encourage the victimized child to share feelings about the experience.
A 15-year-old was placed in a residential program after truancy, running away, and an arrest for theft. At the program, the adolescent refused to join in planned activities and pushed a staff member, causing a fall. Which approach by nursing staff will be most therapeutic? a. Planned ignoring b. Establish firm limits c. Neutrally permit refusals d. Coaxing to gain compliance
b. Establish firm limits
A woman consults the nurse practitioner because she has not achieved orgasm for 2 years, despite having been sexually active. This is an example of what sexual disorder? a. Paraphilic disorder. b. Female orgasmic disorder. c. Genito-pelvic pain/penetration disorder. d. Female sexual interest/arousal disorder.
b. Female orgasmic disorder.
A woman tells the nurse, "My partner is frustrated with me. I don't have any natural lubrication when we have sex." What type of sexual disorder is evident? a. Genito-pelvic pain/penetration disorder b. Female sexual interest/arousal disorder c. Hypoactive sexual desire disorder d. Female orgasmic disorder
b. Female sexual interest/arousal disorder
A child known as the neighborhood bully says, "Nobody can tell me what to do." After receiving a poor grade on a science project, this child secretly loaded a virus on the teacher's computer. These behaviors support which diagnosis? a. Conduct disorder (CD). b. Oppositional defiant disorder (ODD). c. Intermittent explosive disorder. d. Attention-deficit/hyperactivity disorder (ADHD).
b. Oppositional defiant disorder (ODD).
An adult consulted a nurse practitioner because of an inability to achieve orgasm for 2 years, despite having been sexually active. This adult was frustrated and expressed concerns about the relationship with the sexual partner. Which nursing diagnosis is most appropriate for this scenario? a. Defensive coping b. Sexual dysfunction c. Ineffective sexuality pattern d. Disturbed sensory perception, tactile
b. Sexual dysfunction
As death approaches, a client diagnosed with AIDS says, "I do not have enough energy for many visitors anymore and I am embarrassed about how I look. I only want to see my parents and sister." Which actions should the nurse take? (Select all that apply.) a. Encourage the client to reconsider this decision so that interested and caring friends can provide support. b. Support the client to share the request with the parents and sister. c. Assist family to inform the patient's friends of the request. d. Suggest that the client discuss these wishes with clergy. e. Place a "No Visitors" sign on the patient's door.
b. Support the client to share the request with the parents and sister. c. Assist family to inform the patient's friends of the request.
An 11-year-old diagnosed with oppositional defiant disorder (ODD) becomes angry over the rules at a residential treatment program and begins shouting at the nurse. What is the nurse's initial action to defuse the situation? a. Say to the child, "Tell me how you're feeling right now." b. Take the child swimming at the facility's pool. c. Establish a behavioral contract with the child. d. Administer an anxiolytic medication.
b. Take the child swimming at the facility's pool.
What are the primary distinguishing factors between the behavior of persons diagnosed with oppositional defiant disorder (ODD) and those with conduct disorder (CD)? The person diagnosed with (Select all that apply.) a. The person diagnosed with ODD relives traumatic events by acting them out. b. The person diagnosed with ODD tests limits and disobeys authority figures. c. The person diagnosed with ODD has difficulty separating from loved ones. d. The person diagnosed with CD uses stereotypical or repetitive language. e. The person diagnosed with CD often violates the rights of others.
b. The person diagnosed with ODD tests limits and disobeys authority figures. e. The person diagnosed with CD often violates the rights of others.
A nurse works with an adolescent who was placed in a residential program after multiple episodes of violence at school. Why is establishing rapport with this adolescent is a priority? (Select all that apply.) a. it is a vital component of implementing a behavior modification program. b. a therapeutic alliance is the first step in a nurse's therapeutic use of self. c. the adolescent has demonstrated resistance to other authority figures. d. acceptance and trust convey feelings of security for the adolescent. e. adolescents usually relate better to authority figures than peers.
b. a therapeutic alliance is the first step in a nurse's therapeutic use of self. d. acceptance and trust convey feelings of security for the adolescent.
A student nurse visiting a senior center says, "It's depressing to see these old people. They are weak and frail. I doubt any of them can engage in a discussion." The student is expressing what bias? a. reality. b. ageism. c. empathy. d. vulnerability.
b. ageism.
An adolescent acts out in disruptive ways. When this adolescent threatens to throw a heavy pool ball at another adolescent, which comment by the nurse would set appropriate limits? a. "Attention everyone: we are all going to the craft room." b. "You will be taken to seclusion if you throw that ball." c. "Do not throw the ball. Put it back on the pool table." d. "Please do not lose control of your emotions."
c. "Do not throw the ball. Put it back on the pool table."
An adolescent was recently diagnosed with oppositional defiant disorder (ODD). The parents say to the nurse, "Isn't there some medication that will help with this problem?" What is the nurse's best response? a. "There are no medications to treat this problem. This diagnosis is behavioral in nature." b. "It's a common misconception that there is a medication available to treat every health problem." c. "Medication is usually not prescribed for this problem. Let's discuss some behavioral strategies you can use." d. "There are many medications that will help your child manage aggression and destructiveness. The health care provider will discuss them with you."
c. "Medication is usually not prescribed for this problem. Let's discuss some behavioral strategies you can use."
An adult consulted a nurse practitioner because of an inability to achieve orgasm for 2 years, despite having been sexually active. This adult was frustrated and expressed concerns about the relationship with the sexual partner. Which documentation best indicates the treatment was successful? a. "No complaints related to sexual function; to return next week." b. "Client reports achieving orgasm last week; seems very happy." c. "Reports satisfaction with sexual encounters; feels partner is supportive." d. "Reports achieving orgasm occasionally; relationship with partner is adequate.
c. "Reports satisfaction with sexual encounters; feels partner is supportive."
The parent of a child diagnosed with Tourette's disorder says to the nurse, "I think my child is faking the tics because they come and go." Which response by the nurse is accurate? a. "Perhaps your child was misdiagnosed." b. "Your observation indicates the medication is effective." c. "Tics often change frequency or severity. That doesn't mean they aren't real." d. "This finding is unexpected. How have you been administering your child's medication?"
c. "Tics often change frequency or severity. That doesn't mean they aren't real."
A nurse talks with a woman who recently learned that her husband died while jogging. What is the appropriate statement for the nurse to provide in response? a. "At least your husband did not suffer." b. "It's better to go quickly as your husband did." c. "Your husband's loss must be very painful for you." d. "You will begin to feel better after you get over the shock."
c. "Your husband's loss must be very painful for you."
A nurse works with a child who is sad and irritable because the child's parents are divorcing. Why is establishing a therapeutic alliance with this child a priority? a. Therapeutic relationships provide an outlet for tension. b. Focusing on the strengths increases a person's self-esteem. c. Acceptance and trust convey feelings of security to the child. d. The child should express feelings rather than internalize them.
c. Acceptance and trust convey feelings of security to the child.
Shortly after the parents announced that they were divorcing, a 15-year-old became truant from school and assaulted a friend. The adolescent told the school nurse, "I'd rather stay in my room and listen to music. It's easier than thinking about what is happening in my family." Which nursing diagnosis is most applicable? a. Chronic low self-esteem related to role within the family b. Decisional conflict related to compliance with school requirements c. Defensive coping related to adjustment to changes in family relationships d. Disturbed personal identity related to self-perceptions of changing family dynamics
c. Defensive coping related to adjustment to changes in family relationships
An adolescent was arrested for prostitution and assault on a parent. The adolescent says, "I hate my parents. They focus all attention on my brother, who's perfect in their eyes." Which nursing diagnosis is most applicable? a. Disturbed personal identity related to acting out as evidenced by prostitution b. Hopelessness related to achievement of role identity as evidenced by feeling unloved by parents c. Defensive coping related to inappropriate methods of seeking parental attention as evidenced by acting out d. Impaired parenting related to inequitable feelings toward children as evidenced by showing preference for one child over another
c. Defensive coping related to inappropriate methods of seeking parental attention as evidenced by acting out
A child diagnosed with attention deficit hyperactivity disorder (ADHD) shows hyperactivity, aggression, and impaired play. The health care provider prescribed amphetamine salts. The nurse should monitor for which desired behavior? a. Increased expressiveness in communication with others b. Abilities to identify anxiety and implement self-control strategies c. Improved abilities to participate in cooperative play with other children d. Tolerates social interactions for short periods without disruption or frustration
c. Improved abilities to participate in cooperative play with other children
Assessment data for a 7-year-old reveals an inability to take turns, blurting out answers to questions before a question is complete, and frequently interrupting others' conversations. How should the nurse document these behaviors? a. Disobedience b. Hyperactivity c. Impulsivity d. Anxiety
c. Impulsivity
A client who was widowed 18 months ago says, "I can remember good times we had without getting upset. Sometimes I even think about the disappointments. I am still trying to become accustomed to sleeping in the bed all alone." How should the work of mourning be described? a. It is beginning. b. It has not begun. c. It is at or near completion. d. It is progressing abnormally.
c. It is at or near completion.
A nurse will prepare teaching materials for the parents of a child newly diagnosed with attention deficit hyperactivity disorder (ADHD). Information will focus on which medication likely to be prescribed? a. Paroxetine b. Imipramine c. Methylphenidate d. Carbamazepine
c. Methylphenidate
An adolescent diagnosed with a conduct disorder (CD) stole and wrecked a neighbor's motorcycle. Afterward, the adolescent was confronted about the behavior but expressed no remorse. Which variation in the central nervous system best explains the adolescent's reaction? a. Serotonin dysregulation and increased testosterone activity impair one's capacity for remorse. b. Increased neuron destruction in the hippocampus results in decreased abilities to conform to social rules. c. Reduced gray matter in the cortex and dysfunction of the amygdala results in decreased feelings of empathy. d. Disturbances in the occipital lobe reduce sensations that help an individual clearly visualize the consequences of behavior.
c. Reduced gray matter in the cortex and dysfunction of the amygdala results in decreased feelings of empathy.
Which characteristic fits the usual profile of an individual diagnosed with pedophilic disorder? a. Homosexual b. Ritualistic behaviors c. Seeks access to children d. Self-confident professional
c. Seeks access to children
What is the nurse's priority focused assessment for side effects in a child taking methylphenidate for attention deficit hyperactivity disorder (ADHD)? a. Dystonia, akinesia, and extrapyramidal symptoms b. Bradycardia and hypotensive episodes c. Sleep disturbances and weight loss d. Neuroleptic malignant syndrome
c. Sleep disturbances and weight loss
A desired outcome for a 12-year-old diagnosed with attention deficit hyperactivity disorder (ADHD) is to improve relationships with other children. Which treatment modality should the nurse suggest for the plan of care? a. Reality therapy b. Simple restitution c. Social skills group d. Insight-oriented group therapy
c. Social skills group
An 11-year-old diagnosed with oppositional defiant disorder (ODD) becomes angry over the rules at a residential treatment program and begins cursing at the nurse. Select the best method for the nurse to defuse the situation. a. Ignore the child's behavior. b. Send the child to time-out for 2 hours. c. Take the child to the gym and engage in an activity. d. Role-play a more appropriate behavior with the child.
c. Take the child to the gym and engage in an activity.
A client's medical record documents sexual masochism. This client derives sexual pleasure from what source? a. from inanimate objects. b. by inflicting pain on a partner. c. being sexually humiliated by a partner. d. touching a nonconsenting person.
c. being sexually humiliated by a partner.
Which behavior indicates that the treatment plan for a child diagnosed with an autism spectrum disorder was effective? a. plays with one toy for 30 minutes. b. repeats words spoken by a parent. c. holds the parent's hand while walking. d. spins around and claps hands while walking.
c. holds the parent's hand while walking.
A nurse prepares the plan of care for a 15-year-old diagnosed with moderate intellectual developmental disorder. What are the highest outcomes that are realistic for this patient? Within 5 years, the patient will (Select all that apply.) a. graduate from high school. b. live independently in an apartment. c. independently perform own personal hygiene. d. obtain employment in a local sheltered workshop. e. correctly use public buses to travel in the community.
c. independently perform own personal hygiene. d. obtain employment in a local sheltered workshop. e. correctly use public buses to travel in the community.
A kindergartener is disruptive in class. This child is unable to sit for expected lengths of time, inattentive to the teacher, screams while the teacher is talking, and is aggressive toward other children. The nurse plans interventions designed to achieve what? a. integration of self-concept. b. inpatient treatment for the child. c. loneliness and increase self-esteem. d. language and communication skills.
c. loneliness and increase self-esteem.
When group therapy is prescribed as a treatment modality, the nurse would suggest placement of a 9-year-old in a group that uses what strategy? a. guided imagery. b. talk focused on a specific issue. c. play and talk about a play activity. d. group discussion about selected topics.
c. play and talk about a play activity.
A widow repeatedly tells details of finding her elderly husband not breathing, performing cardiopulmonary resuscitation, and seeing him pronounced dead. Family members are concerned and ask, "What can we do?" What response should the nurse provide when counsel the family? a. they should express their feelings to the widow and ask her not to retell the story. b. the retelling should be limited to once daily to avoid unnecessary stimulation. c. repeating the story and her feelings is a helpful and necessary part of grieving. d. retelling of memories is expected as part of the aging process.
c. repeating the story and her feelings is a helpful and necessary part of grieving.
When a 5-year-old is disruptive, the nurse says, "You must take a time-out." The expectation is that the child will do what? a. go to a quiet room until called for the next activity. b. slowly count to 20 before returning to the group activity. c. sit on the edge of the activity until able to regain self-control. d. sit quietly on the lap of a staff member until able to apologize for the behavior.
c. sit on the edge of the activity until able to regain self-control.
A bystander was killed during a robbery 2 weeks ago. His widow, who is diagnosed with schizoaffective disorder, cries spontaneously when talking about his death. What is the nurse's most therapeutic response? a. "Are you hearing voices at night?" b. "I am worried about how much you are crying. Your grief over your husband's death has gone on too long." c. "This loss is harder to accept because of your mental illness. I will refer you to a partial hospitalization program." d. "The unexpected death of your husband must be very painful. I am glad you are able to talk to me about your feelings."
d. "The unexpected death of your husband must be very painful. I am glad you are able to talk to me about your feelings."
Which child demonstrates behaviors indicative of a neurodevelopmental disorder? a. A 4-year-old who stuttered for 3 weeks after the birth of a sibling b. A 9-month-old who does not eat vegetables and likes to be rocked c. A 3-month-old who cries after feeding until burped and sucks a thumb d. A 3-year-old who is mute, passive toward adults, and twirls while walking
d. A 3-year-old who is mute, passive toward adults, and twirls while walking
A widower tells friends, "I am taking my neighbor out for dinner. It's time for me to be more sociable again." Considering the stages of grief described by Kübler-Ross, which stage is evident? a. Anger b. Denial c. Depression d. Acceptance
d. Acceptance
Which statement about paraphilic disorders is accurate? a. Paraphilic behavior is controllable by willpower, but most persons with these disorders fail to do so. b. Persons with paraphilic disorders rarely experience shame and are not distressed by their acts. c. Persons with paraphilic disorders prey primarily on female children between the ages of 12 and 15 years. d. Acts of paraphilia are common because persons with the disorders commit the acts repeatedly, but paraphilic disorders are uncommon.
d. Acts of paraphilia are common because persons with the disorders commit the acts repeatedly, but paraphilic disorders are uncommon.
An adult says to the nurse, "The cancer in my neck spread in only 2 months. I've been cursed my whole life. Maybe if I had been more generous with others ..." Considering the stages of grief described by Kübler-Ross, which stage is evident? a. Anger b. Denial c. Depression d. Bargaining
d. Bargaining
Which nursing action should occur first regarding a client who has a problem of sexual dysfunction or sexual disorder? a. Developing an understanding of human sexual response. b. Assessing the client's sexual functioning and needs. c. Acquiring knowledge of the client's sexual roles. d. Clarifying own personal values about sexuality.
d. Clarifying own personal values about sexuality.
A 12-year-old has engaged in bullying for several years. The parents say, "We can't believe anything our child says." Recently this child shot a dog with a pellet gun and set fire to a neighbor's trash bin. The child's behaviors support which diagnosis? a. Attention-deficit/hyperactivity disorder (ADHD) b. Intermittent explosive disorder. c. Oppositional defiant disorder (ODD). d. Conduct disorder (CD)
d. Conduct disorder (CD)
A 15-year-old ran away from home six times and was arrested for shoplifting. The parents told the Court, "We can't manage our teenager." The adolescent is physically abusive to the mother and defiant with the father. Which diagnosis is supported by this adolescent's behavior? a. Attention deficit hyperactivity disorder (ADHD) b. Posttraumatic stress disorder (PTSD) c. Intermittent explosive disorder d. Conduct disorder (CD)
d. Conduct disorder (CD)
The family of a child diagnosed with an impulse control disorder needs help to function more adaptively. Which aspect of the child's plan of care will be provided by an advanced practice nurse rather than a staff nurse? a. Leading an activity group b. Providing positive feedback c. Formulating nursing diagnoses d. Dialectical behavioral therapy (DBT)
d. Dialectical behavioral therapy (DBT)
A man with hypospadias tells the nurse, "Intercourse with my new bride is painful." Which term applies to the client's report? a. Delayed ejaculation b. Erectile dysfunction c. Premature ejaculation d. Genito-pelvic pain/penetration disorder
d. Genito-pelvic pain/penetration disorder
An adolescent diagnosed with an impulse control disorder says, "I want to die. I spend my time getting even with people who hurt me." When asked about a suicide plan, the adolescent replies, "I'll jump from a bridge near my home. My father threw kittens off that bridge and they died." What is the client's suicide risk? a. Absent b. Low c. Moderate d. High
d. High
While performing an assessment, the nurse says to a client, "While growing up, most of us heard some half-truths about sexual matters that continue to puzzle us as adults. Do any come to your mind now?" The purpose of this question is to achieve what? a. Identify areas of sexual dysfunction for treatment. b. Determine possible homosexual urges. c. Introduce the topic of masturbation. d. Identify sexual misinformation.
d. Identify sexual misinformation.
When a 5-year-old diagnosed with attention deficit hyperactivity disorder (ADHD) bounces out of a chair and runs over and slaps another child, what is the nurse's best action? a. Instruct the parents to take the aggressive child home. b. Direct the aggressive child to stop immediately. c. Call for emergency assistance from other staff. d. Take the aggressive child to another room.
d. Take the aggressive child to another room.
A child drowned while swimming in a local lake 2 years ago. Which behavior best indicates the child's parents are mourning in an effective way? a. They forbid their other children from going swimming. b. They keep a place set for the deceased child at the family dinner table. c. They sealed their child's room exactly as the child left it 2 years ago. d. They throw flowers on the lake at each anniversary date of the accident.
d. They throw flowers on the lake at each anniversary date of the accident.
The parent of a 6-year-old says, "My child is in constant motion and talks all the time. My child isn't interested in toys but is out of bed every morning before me." The child's behavior is most consistent with diagnostic criteria for which disorder? a. communication disorder. b. stereotypic movement disorder. c. intellectual development disorder. d. attention deficit hyperactivity disorder (ADHD).
d. attention deficit hyperactivity disorder (ADHD).
A nurse assesses a 3-year-old diagnosed with an autism spectrum disorder. Which finding is most associated with the child's disorder? a. has occasional toileting accidents. b. interrupts or intrudes on others. c. cries when separated from a parent. d. continuously rocks in place for 30 minutes.
d. continuously rocks in place for 30 minutes.
Four teenagers died in an automobile accident. Six months later, which behavior by the parents best demonstrates acceptance of the tragedy? a. isolating themselves at home. b. returning immediately to employment. c. forbidding other teens in the household to drive a car. d. creating a scholarship fund at their child's high school.
d. creating a scholarship fund at their child's high school.
A child diagnosed with attention deficit hyperactivity disorder (ADHD) had this nursing diagnosis: impaired social interaction related to excessive neuronal activity as evidenced by aggression and demanding behavior with others. Which finding indicates the plan of care was effective? a. has an improved ability to identify anxiety and use self-control strategies b. has increased expressiveness in communication with others. c. shows increased responsiveness to authority figures. d. engages in cooperative play with other children.
d. engages in cooperative play with other children.
A client tells the nurse that his sexual functioning is normal when his wife wears short, red camisole-style nightgowns. He states, "Without the red teddies, I am not interested in sex." The nurse can assess this as consistent with what sexual disorder? a. exhibitionism. b. voyeurism. c. frotteurism. d. fetishism.
d. fetishism.
After a spouse's death, an adult repeatedly says, "I should have recognized what was happening and been more helpful." What emotion is this adult experiencing? a. depression. b. sadness. c. anger. d. guilt.
d. guilt.
A hospice client tells the nurse, "Life has been good. I am proud of being self-educated. I overcame adversity and always gave my best. I intend to die as I lived." The nurse planning care for this client would recognize the priority of supporting which client need? a. providing aggressive pain and symptom management. b. helping the client reassess and explore existing conflicts. c. assisting the client to focus on the meaning in life and death. d. supporting the patient's use of own resources to meet challenges.
d. supporting the patient's use of own resources to meet challenges.
The male manager of a health club placed a hidden video camera in the women's locker room and recorded several women as they showered and dressed. What is the disorder most likely represented by this behavior? a. homosexuality. b. exhibitionism c. pedophilia. d. voyeurism.
d. voyeurism.