Mental Health Week 3-4 Exam

Which is the minimum amount of sleep a nurse on shift work should get in a 24-hour period? A) 4 to 5 B) 5 to 6 C) 6 to 7 D) 7 to 8

D

Which is an example of malingering? A) Mr. Harris injures his foot to avoid military service. B) Mrs. Adams has been making her child vomit and lose weight to pretend he has cancer. C) Mr. Singleton has difficulty walking and uses a wheelchair, but without neurological deficits, which began 2 months after the death of his wife of 32 years. D) Ms. Munini frequently calls or comes to the clinic in a panic, believing she is ill. Her suffering is genuine, but she never has concrete signs of any illness.

A

Which of the following involves episodes of upper airway collapse and obstruction? A) Obstructive Sleep Apnea Hypopnea Syndrome (OSAHA) B) CPAP C) RSBD D) NREM

A

Which of the following should be established first in working with a child with PTSD? A) Provide safety and stabilization B) Reduce symptoms C) Develop a value system D) Provide support for catching up on developmental and social skills

A

You ask Margo how long it usually takes her to fall asleep at night. You are asking her about her: A) sleep latency. B) sleep efficiency. C) sleep continuity. D) sleep architecture.

A

A nurse assesses a patient diagnosed with dissociative identity disorder. Which finding would likely be part of the patient's history? A) Travel to a foreign country B) Physical or sexual abuse C) Thyroid dysfunction D) Eating disorder

B

Let's return to Addie, who fainted during gym class. She is grossly underweight, wears baggy clothes, and her skin is dry. To further assess for anorexia nervosa, the school nurse should ask: A) "Do you often wear heavy clothing in warm weather?" B) "When was your last menstrual period?" C)"Do you use any drugs or alcohol?" D) "Do you ever lose lapses of time?"

B

Before going home from the hospital, Max and his family begin intervention therapy. Which is probably the least useful strategy at this time? A. Establish trust and safety in the therapeutic relationship. B. Use art to help Max express his feelings. C. Bring Max's father into 1:1 play therapy sessions. D. Teach Max and his parents about grief.

C

Which is the most likely indication that Margo might really have insomnia? A) The difficulty occurs at least once a week. B) The difficulty occurs at least 2 nights a week. C) The difficulty occurs at least 3 nights a week. D) The difficulty occurs at least once a month.

C

Which of the following may be a precipitating factor for Margo's insomnia? A) She never goes to bed at the same time. B) She has a history of depression and anxiety. C) She just got a divorce and moved to a new city. D) She drinks quite a bit of alcohol in the evenings.

C

Addie condition worsens and she collapses at home. She is admitted to your unit with anorexia. You have completed your physical and biopsychosocial assessment of her. Which common personality trait is likely to present a particular challenge? A) Lack of hygiene and cleanliness B) Lack of interest in self and others C) Irresistible desire to purge D) Perfectionism

D

As part of Margo's stimulus control intervention, she should not: A) skip the prescribed daily nap. B) get out of bed if she can't sleep. C) limit bedtime to when she is actually sleepy. D) read in bed to help her relax and get sleepy.

D

During assessment, Mr. Brazzali says that when these "episodes of blindness" come over him it is often immediately after "an epileptic fit." Testing, however, shows no signs of recent seizure. The ED physician records that Mr. Brazzali has neurological symptoms but in the absence of a neurological diagnosis. He also makes note of this patient's lack of distress about what should be an alarming condition. Which diagnosis best describes Mr. Brazzali's condition? A) Psychological factors affecting medical condition B) SSD C) Illness anxiety disorder D) Conversion disorder

D

Earlier we learned that Addie's skin was slightly yellow and her skin showed signs of dehydration. What is yellow skin in anorexia nervosa linked to? A) Lanugo B) Amenorrhea C) Use of street drugs D) Hypercarotenemia

D

Mr. Anderson is found to be eating laundry powdered detergent on more than one occasion. This is most likely a sign of which feeding problem? A) Binge eating B) Rumination C) Bulimia D) Pica

D

Which is an example of illness anxiety disorder? A) Mr. Harris injures his foot to avoid military service. B) Mrs. Adams has been making her child vomit and lose weight to pretend he has cancer. C) Mr. Singleton has difficulty walking and uses a wheelchair, but without neurological deficits, which began two months after the death of his wife of 32 years. D) Ms. Munini frequently calls or comes to the clinic in a panic, believing she is ill. Her suffering is genuine, but she never has concrete signs of any illness.

D

Which statement made by the patient demonstrates an understanding of the treatment of choice for patients managing the effects of traumatic events? a. "I attend my therapy sessions regularly." b. "Those intrusive memories are hidden for a reason and should stay hidden." c. "Keeping busy is the key to getting mentally healthy." d. "I've agreed to move in with my parents so I'll get the support I need."

a. "I attend my therapy sessions regularly."

A nurse is caring for a client who has avoidant personality disorder. Which of the following statements is expected from a client who has this type of personality disorder? a. "I'm scared that you're going to leave me." b. "I'll go to group therapy if you'll let me smoke." c. "I need to feel that everyone admires me." d. "I sometimes feel better if I cut myself."

a. "I'm scared that you're going to leave me."

A nurse is discussing the use of methadone with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching? (SATA) a. "Methadone is a replacement for physical dependence to opioids." b. "Methadone reduces the unpleasant effects associated with abstinence syndrome." c. "Methadone can be used during opioid withdrawal and to maintain abstinence." d. "Methadone increases the risk for acetaldehyde syndrome." e. "Methadone must be prescribed and dispensed by an approved treatment center."

a. "Methadone is a replacement for physical dependence to opioids." b. "Methadone reduces the unpleasant effects associated with abstinence syndrome." c. "Methadone can be used during opioid withdrawal and to maintain abstinence." e. "Methadone must be prescribed and dispensed by an approved treatment center."

1. Which statement made by a family member tends to support a diagnosis of delirium rather than dementia? a. "She was fine last night but this morning she was confused." b. "Dad doesn't seem to recognize us anymore." c. "She's convinced that snakes come into her room at night." d. "He can't remember when to take his pills or whether he's bathed."

a. "She was fine last night but this morning she was confused."

A nurse is providing teaching to a client who has alcohol use disorder and a new prescription for carbamazepine. Which of the following information should the nurse include in the teaching? a. "This medication will help prevent seizures during alcohol withdrawal." b. "Taking this medication will decrease your cravings for alcohol." c. "This medication maintains your blood pressure at a normal level during alcohol withdrawal." d. "Taking this medication will improve your ability to maintain abstinence from alcohol."

a. "This medication will help prevent seizures during alcohol withdrawal."

When considering an eating disorder, what is a physical criterion for hospital admission? a. A daytime heart rate of less than 50 beats per minute b. An oral temperature of 100°F or more c. 90% of ideal body weight d. Systolic blood pressure greater than 130 mm Hg

a. A daytime heart rate of less than 50 beats per minute

A young child is found wandering alone at a mall. A male store employee approaches and asks where her parents are. She responds, "I don't know. Maybe you will take me home with you?" This sort of response in children may be due to: a. A lack of bonding as an infant b. A healthy confidence in the child c. Adequate parental bonding d. Normal parenting

a. A lack of bonding as an infant

Ellen describes Veronica's problem further. "She has trouble remembering things, like where she put the electric bill. I helped her find it, and I thought that was that." "But then, the next week I picked her up for a lunch date, and she looked really nice, no problem with that; she was already to go, but her house was freezing!!!" I said, "Mom, did you pay your electric bill?" She just stared at me. Ellen continues: "But then, the next week I picked her up for a lunch date, and she looked really nice, no problem with that; she was already to go, but her house was freezing!!! I said, "Mom, did you pay your electric bill?" She just blinked at me. "I don't know," she said. "'Well, okay," I said. "Let's see. Where's your checkbook?" "'I don't know,' she said. 'Just stop asking questions!' I thought she was going to cry!" Veronica tries to refer to the electric bill, but ends up saying, "you know, the invitation. The invitation." What is this a sign of? a. Aphasia b. Apraxia c. Agnosia d. Perseveration

a. Aphasia

Connor is a 28-year-old student, referred by his university for a psychiatric evaluation. He reports that he has no friends at the university and people call him a loner. Recently, Connor has been giving lectures to pigeons at the university fountains. Connor is diagnosed as schizotypal, which differs from schizophrenia in that persons diagnosed as schizotypal: a. Can be made aware of their delusions b. Are far more delusional than schizophrenics c. Have a greater need for socialization d. Do not usually respond to antipsychotic medications

a. Can be made aware of their delusions

Melanie is a 38-year-old female admitted to the hospital to rule out a neurological disorder. The testing was negative, yet she is reluctant to be discharged. Today she has added lower back pain and a stabbing sensation in her abdomen. The nurse suspects a factitious disorder in which Melanie may: a. Consciously be trying to maintain her role of a sick patient b. Not recognize her unmet needs to be cared for c. Protect her child from illness d. Recognize physical symptoms as a coping mechanism

a. Consciously be trying to maintain her role of a sick patient

Acute onset of disordered thinking is most associated with: a. Delirium b. Alzheimer's disease c. Frontotemporal dementia d. Dementia with Lewy bodies

a. Delirium

A charge nurse is preparing a staff education session on personality disorders. Which of the following personality characteristics associated with all of the personality disorders should the charge nurse include in the teaching? (SATA) a. Difficulty in getting along with other members of a group b. Belief in the ability to become invisible during times of stress c. Display of defense mechanisms when routines are changed d. Claiming to be more important that other persons e. Difficulty understanding why it is inappropriate to have a personal relationship with staff

a. Difficulty in getting along with other members of a group c. Display of defense mechanisms when routines are changed e. Difficulty understanding why it is inappropriate to have a personal relationship with staff

Nurses caring for patients who have neurocognitive disorders are exposed to stress on many levels. Specialized skills training and continuing education are helpful to diffuse nursing stress, as well as: Select all that apply. a. Expressing emotions by journaling b. Describing stressful events on Facebook c. Engage in exercise and relaxation activities d. Having realistic patient expectations e. Happy hour after work to blow off steam

a. Expressing emotions by journaling c. Engage in exercise and relaxation activities d. Having realistic patient expectations

What is the rationale for providing a patient diagnosed with dementia easily accessible finger foods through the day? a. Increases input throughout the day. b. The person may be anorexic c. Assists with monitoring food intake d. Helps prevent constipation

a. Increases input throughout the day.

What side effects should the nurse monitor for when caring for a patient prescribed donepezil (Aricept)? (SATA) a. Insomnia b. Constipation c. Bradycardia d. Signs of dizziness e. Reports of headache

a. Insomnia c. Bradycardia d. Signs of dizziness e. Reports of headache

A home health nurse is making a visit to a client who has Alzheimer's disease to assess the home for safety. Which of the following suggestions should the nurse make to decrease the client's risk for injury? a. Install extra locks at the top of exit door b. Place rugs over electrical cords c. Put cleaning supplies on the top of a shelf. d. Place the client's mattress on the floor e. Install light fixtures above stairs

a. Install extra locks at the top of exit door d. Place the client's mattress on the floor e. Install light fixtures above stairs

1. A patient with a history of alcohol use disorder has been prescribed disulfiram (Antabuse). Which physical effects support the suspicion that the patient has relapsed? (SATA) a. Intense nausea b. Diaphoresis c. Acute paranoia d. Confusion e. Dyspnea

a. Intense nausea b. Diaphoresis d. Confusion e. Dyspnea

A pregnant woman is in a relationship with a male who routinely abuses her. Her unborn child may engage in high-risk behavior as a teen as a result of: a. Maternal stress b. Parental nurturing c. Appropriate stress responses in the brain d. Memories of the abuse

a. Maternal stress

Perfectionism is a trat likely to be evident in a person with which personality disorder? a. Obsessive-compulsive b. Narcissistic c. Antisocial d. Avoidant

a. Obsessive-compulsive

Which personality disorders are generally associated with behaviors described as "odd or eccentric"? Select all that apply. a. Paranoid b. Schizoid c. Histrionic d. Obsessive-compulsive e. Avoidant

a. Paranoid b. Schizoid

When considering the need for monitoring, which intervention should the nurse implement for a patient with anorexia nervosa? Select all that apply. a. Provide scheduled portion-controlled meals and snacks. b. Congratulate patients for weight gain and behaviors that promote weight gain. c. Limit time spent in bathroom during periods when not under direct supervision. d. Promote exercise as a method to increase appetite. e. Observe patient during and after meals/snacks to ensure that adequate intake is achieved and maintained.

a. Provide scheduled portion-controlled meals and snacks. c. Limit time spent in bathroom during periods when not under direct supervision. e. Observe patient during and after meals/snacks to ensure that adequate intake is achieved and maintained.

Which assessment data confirm the suspicion that a patient is experiencing opioid withdrawal? (SATA) a. Pupils are dilated b. Pulse rate is 62 beats/min c. Slow movements d. Extreme anxiety e. Sleepy

a. Pupils are dilated d. Extreme anxiety

Which behaviors are examples of a primitive defense mechanism often relied upon by those diagnosed with a personality disorder? Select all that apply. a. Regularly attempts to split the staff b. Attempts to undo feelings of anger by offering to do favors c. Regresses to rocking and humming to sooth themselves when fearful d. Lashes out verbally when confronted with criticism e. Destroys another person's belongings when angry

a. Regularly attempts to split the staff b. Attempts to undo feelings of anger by offering to do favors c. Regresses to rocking and humming to sooth themselves when fearful

What is the current accepted professional view of the effect of culture on the development of a personality disorder? a. There aren't sufficient studies to confirm the role that ethnicity and race have on the prevalence of personality disorders. b. The North American and Australian cultures produce higher incidences of personality disorders among their populations. c. Neither culture nor ethnic background is generally considered in the development of personality disorders. d. Personality disorders have been found to be primarily the products of genetic factors, not cultural factors.

a. There aren't sufficient studies to confirm the role that ethnicity and race have on the prevalence of personality disorders.

A nurse is providing teaching to the family of a client who has a substance use disorder. Which of the following statements by a family member indicates an understanding of the teaching?(SATA) a. "We need to understand that our sibling is responsible for their disorder." b. "Eliminating codependent behavior will promote recovery." c. "Our sibling should participate in an Al-Anon group to assist with recovery." d. "The primary goal of treatment is abstinence from substance use." e. "Our sibling needs to discuss personal feelings about substance use to help with recovery."

b. "Eliminating codependent behavior will promote recovery." d. "The primary goal of treatment is abstinence from substance use." e. "Our sibling needs to discuss personal feelings about substance use to help with recovery."

Lester and Eileen have always enjoyed gambling. Lately, Eileen has discovered that their savings account is down by $50,000. Eileen insists that Lester undergo therapy for his gambling behavior. The nurse recognizes that Lester is making progress when he states: a. "I understand that I am a bad person for depleting our savings." b. "Gambling activates the reward pathways in my brain." c. "Gambling is the only thing that makes me feel alive." d. "We have always enjoyed gaming. I do not know why Eileen is so upset."

b. "Gambling activates the reward pathways in my brain."

Which statement made by the psychiatric nurse demonstrates an accurate understanding of the factors that affect an individual's personality? a. "Therapy will help her identify that her problems are personality related." b. "I'll need to learn more about this patient's cultural beliefs." c. "It's encouraging to know that personality disorders respond well to treatment." d. "A person's personality is fluid and adjusts to current social situations."

b. "I'll need to learn more about this patient's cultural beliefs."

Which patient statement acknowledges the characteristic behavior associated with a diagnosis of pica? a. "Nothing could make me drink milk." b. "I'm ashamed of it, but I eat my hair." c. "I haven't eaten a green vegetable since I was 3 years old." d. "I regurgitate and re-chew my food after almost every meal."

b. "I'm ashamed of it, but I eat my hair."

A nurse is evaluating a client's understanding of a new prescription for clonidine for the treatment of opioid use disorder. Which of the following statements by the client indicates an understanding of the teaching? a. "Taking this medication will help reduce my craving for heroin." b. "While taking this medication, I should keep a pack of sugarless gum." c. "I can expect some diarrhea from taking this medicine." d. "Each dose of this medication should be placed under my tongue to dissolve."

b. "While taking this medication, I should keep a pack of sugarless gum."

A nurse is caring for a client who has early stage Alzheimer's disease and a new prescription for donepezil. The nurse should include which of the following statements when teaching the client about the medication? a. "You should avoid taking over-the-counter acetaminophen while on donepezil." b. "You should take this medication before going to bed at the end of the day." c. "You will be screened for underlying kidney disease prior to starting donepezil." d. "You should stop taking donepezil if you experience nausea or diarrhea."

b. "You should take this medication before going to bed at the end of the day."

Conversion disorder is described as an absence of a neurological diagnosis that manifests in neurological symptoms. Channeling of emotions, conflicts, and stressors into physical symptoms is thought to be the cause in conversion disorder. Which statement is true? a. People with conversion disorder are extremely upset about often dramatic symptoms. b. Abnormal patterns of cerebral activation have been found in individuals with conversion disorder. c. An organic cause is usually found in most cases of conversion disorder. d. Symptoms can be turned off and on depending on the patient's choice.

b. Abnormal patterns of cerebral activation have been found in individuals with conversion disorder.

Josie, a 27-year-old patient, complains that most of the staff do not like her. She says she can tell that you are a caring person. Josie is unsure of what she wants to do with her life and her "mixed-up feelings" about relationships. When you tell her that you will be on vacation next week, she becomes very angry. Two hours later, she is found using a curling iron to burn her underarms and explains that it "makes the numbness stop." Given this presentation, which personality disorder would you suspect? a. Obsessive-compulsive b. Borderline c. Antisocial d. Schizotypal

b. Borderline

Use of splitting is most associated with which personality disorder? a. Antisocial b. Borderline c. Dependent d. Schizotypal

b. Borderline

The care plan of a patient diagnosed with a somatic disorder includes the nursing diagnosis ineffective coping. Which patient behavior demonstrates a successful outcome for that nursing diagnosis? a. Showers and dresses in clean clothes daily b. Calls a friend to talk when feeling lonely c. Spends more time talking about pain in her abdomen d. Maintains focus and concentration

b. Calls a friend to talk when feeling lonely

A person has recently abused morphine. The person's pupils would most likely be a. Dilated b. Constricted c. Asymmetrical d. Unresponsive to light

b. Constricted

Maxwell is a 30-year-old male who arrives at the emergency department stating, "I feel like I am having a stroke." During the intake assessment, the nurse discovers that Maxwell has been working for 36 hours straight without eating and has consumed eight double espresso drinks and 12 caffeinated sodas. The nurse suspects: a. Fluid overload b. Dehydration and caffeine overdose c. Benzodiazepine overdose d. Sleep deprivation syndrome

b. Dehydration and caffeine overdose

The nursing diagnosis ineffective denial is especially useful when working with substance use disorders and gambling. Which statements describe this diagnosis? (SATA) a. Reports inability to cope b. Does not perceive danger of substance use or gambling c. Minimizes symptoms d. Refuses healthcare attention e. Unable to admit impact of disease on life pattern

b. Does not perceive danger of substance use or gambling c. Minimizes symptoms d. Refuses healthcare attention e. Unable to admit impact of disease on life pattern

Personality disorders often co-occur with mood and eating disorders. A young woman is undergoing treatment at an eating disorders clinic and her nurse suspects the patient may also have a Cluster B personality disorder due to the young woman's: a. Desire to avoid eating b. Dramatic response to frustration c. Excessive exercise routine d. Morose personality traits

b. Dramatic response to frustration

A nurse is performing an admission assessment for a client who has delirium related to an acute UTI. Which of the following findings should the nurse expect? (SATA) a. History of gradual memory loss b. Family report of personality changes c. Hallucinations d. Unaltered level of consciousness e. Restlessness

b. Family report of personality changes c. Hallucinations e. Restlessness

A nurse is assessing a client who has alcohol use disorder and is experiencing withdrawal. Which of the following findings should the nurse expect? (SATA) a. Bradycardia b. Fine tremors of both hands c. Hypotension d. Vomiting e. Restlessness

b. Fine tremors of both hands d. Vomiting e. Restlessness

A patient diagnosed with opioid use disorder has expressed a desire to enter into a rehabilitation program. What initial nursing intervention during the early days after admission will help ensure the patient's success? a. Restrict visitors to family members only. b. Manage the patient's withdrawal symptoms well. c. Provide the patient a low stimulus environment. d. Advocate for at least 3 months of treatment.

b. Manage the patient's withdrawal symptoms well.

When considering the pathophysiology responsible for both delirium and dementia, which intervention is appropriate for delirium specifically? a. Assist with needs related to nutrition, elimination, hydration, and personal hygiene. b. Monitor neurological status on an ongoing basis. c. Place identification bracelet on patient. d. Give one simple direction at a time in a respectful tone of voice.

b. Monitor neurological status on an ongoing basis.

A nurse is caring for a client who has borderline personality disorder. The client says, "The nurse on the evening shift is always nice! You are the meanest nurse ever!" The nurse should recognize this client's statement as an example of which of the following defense mechanisms? a. Regression b. Splitting c. Undoing d. Identification

b. Splitting

Lucas is a nurse on a medical floor caring for Kelly, a 48-year-old patient with newly diagnosed type 2 diabetes. He realizes that depression is a complicating factor in the patient's adjustment to her new diagnosis. What problem has the most potential to arise? a. Development of agoraphobia b. Treatment nonadherence c. Frequent hypoglycemic reactions d. Sleeping rather than checking blood sugar

b. Treatment nonadherence

The care plan of a male patient diagnosed with a dissociative disorder includes the nursing diagnosis ineffective coping. Which behavior demonstrated by the patient supports this nursing diagnosis? a. Has no memory of the physical abuse he endured. b. Using both alcohol and marijuana. c. Often reports being unaware of surroundings. d. Reports feelings of "not really being here."

b. Using both alcohol and marijuana.

Which statement made by the primary caregiver of a patient diagnosed with dementia demonstrates accurate understanding of providing the patient with a safe environment? a. "The local police know that he has wandered off before." b. "I keep the noise level low in the house." c. "We've installed locks on all the outside doors." d. "Our telephone number is always attached to the inside of his shirt pocket."

c. "We've installed locks on all the outside doors."

A nurse manager is discussing the care of a client who has a personality disorder with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching? a. "I can promote my client's sense of control by establishing a schedule." b. "I should encourage clients who have a schizoid personality disorder to increase socialization." c. "I should practice limit-setting to help prevent client manipulation." d. "I should implement assertiveness training with clients who have antisocial personality disorder."

c. "I should practice limit-setting to help prevent client manipulation."

Maggie, a child in protective custody, is found to have an imaginary friend, Holly. Her foster family shares this information with the nurse. The nurse teaches the family members about children who have suffered trauma and knows her teaching was effective when the foster mother states: a. "I understand that imaginary friends are abnormal." b. "I understand that imaginary friends are a maladaptive behavior." c. "I understand that imaginary friends are a coping mechanism." d. "I understand that we should tell the child that imaginary friends are unacceptable."

c. "I understand that imaginary friends are a coping mechanism.

You are caring for Yolanda, a 67-year-old patient who has been receiving hemodialysis for 3 months. Yolanda reports that she feels angry whenever it is time for her dialysis treatment. You attribute this to: a. Organic changes in Yolanda's brain b. A flaw in Yolanda's personality c. A normal response to grief and loss d. Denial of the reality of a poor prognosis

c. A normal response to grief and loss

1. Nancy is a nurse. After talking with her mother, she became concerned enough to drive over and check on her. Her mother's appearance is disheveled, words are nonsensical, smells strongly of urine, and there is a stain on her dressing gown. Nancy recognizes that her mother's condition is likely temporary due to: a. Early onset dementia b. A mild cognitive disorder c. A urinary tract infection d. Skipping breakfast

c. A urinary tract infection

During a routine health screening, a grieving widow whose husband died 15 months ago reports emptiness, a loss of self, difficulty thinking of the future, and anger at her dead husband. The nurse suggests bereavement counseling. The widow is most likely suffering from: a. Major depression b. Normal grieving c. Adjustment disorder d. Posttraumatic stress disorder

c. Adjustment disorder

Veronica's AD has progresses. One morning, she attempts to brush her teeth with a spoon. Which problem is evident? a. Aphasia b. Apraxia c. Agnosia d. Perseveration

c. Agnosia

A nurse is assisting with a court-ordered evaluation of a client who has antisocial personality disorder. Which of the following findings should the nurse expect? (SATA) a. Demonstrates extreme anxiety when placed in social situation b. Often engages in magical thinking c. Attempts to convince other clients to relinquish their belongings d. Becomes agitated if personal area is not neat and orderly e. Blames others for personal past and current problems

c. Attempts to convince other clients to relinquish their belongings e. Blames others for personal past and current problems

A nurse is teaching a client who has tobacco use disorder about the use of nicotine gum. Which of the following information should the nurse include in the teaching? a. Chew the gum for no more than 10 min. b. Rinse out the mouth immediately before chewing the gum c. Avoid eating 15 min prior to chewing the gum d. Use of the gum is limited to 90 days

c. Avoid eating 15 min prior to chewing the gum

Shortly before treatment, after crying and begging him to get help, Ahmed's girlfriend stayed home from a planned night out with her friends to pour all the alcohol in his apartment down the drain. What type of behavior is evident? a. Enabling b. Tolerance c. Codependence d. Use of defense mechanisms

c. Codependence

Diane, a 63-year-old mother of three, was brought to the community psychiatric clinic. Diane and her son had a bitter fight over finances. Ever since Diane has been complaining of "a severe pain in my neck." She has seen several doctors who cannot find a physical basis for the pain. The nurse knows that: a. Showing concern for Diane's pain will increase her obsessional thinking. b. Diane's symptoms are manipulative and under conscious control. c. Diane believes there is a physical cause for the pain and will resist a psychological explanation. d. Diane is trying to make her son feel bad about the argument.

c. Diane believes there is a physical cause for the pain and will resist a psychological explanation.

A nurse is caring for a client who has alcohol use disorder. The client is no longer experiencing withdrawal manifestations. Which of the following medications should the nurse anticipate administering to assist the client with maintaining abstinence from alcohol? a. Chlordiazepoxide b. Bupropion c. Disulfiram d. Carbamazepine

c. Disulfiram

1. A nurse is assisting in the discharge planning for a client following alcohol detox. The nurse should expect prescriptions for which of the following medications to promote long-term abstinence from alcohol? (SATA) a. Lorazepam b. Diazepam c. Disulfiram d. Naltrexone e. Acamprosate

c. Disulfiram d. Naltrexone e. Acamprosate

Which statement accurately describes the effects of emotional trauma on the individual physically? a. Emotional trauma is a distinct category and unrelated to physical problems b. The physical manifestations of emotional trauma are usually temporary c. Emotional trauma is often manifested as physical symptoms d. Patients are more aware of the physical problems caused by trauma

c. Emotional trauma is often manifested as physical symptoms

Which goal should be addressed initially when providing care for 10-year-old Harper who is diagnosed with posttraumatic stress disorder (PTSD)? a. Harper will be able to identify feelings through the use of play therapy. b. Harper and her parents will have access to protective resources available through social services. c. Harper will demonstrate the effective use of relaxation techniques to restore a sense of control over disturbing thoughts. d. Harper and her parents will demonstrate an understanding of the personal human response to traumatic events.

c. Harper will demonstrate the effective use of relaxation techniques to restore a sense of control over disturbing thoughts.

A nurse is planning care for a client who is experiencing benzodiazepine withdrawal. Which of the following interventions should the nurse identify as the priority? a. Orient the client frequently to time, place, and person b. Offer fluids and nourishing diet as tolerated c. Implement seizure precautions d. Encourage participation in group therapy sessions

c. Implement seizure precautions

Garret's wife of 8 years is divorcing him because the marriage never developed a warm or loving atmosphere. Garrett states in therapy, "I have always been a loner," and was never concerned about what others think. The nurse practitioner suggests that Garrett try a trial of bupropion (Wellbutrin) to: a. Improve his flat emotions b. Assist in getting a good night's sleep c. Increase the pleasure of living d. Prepare Garrett for group therapy

c. Increase the pleasure of living

1. Donald, a 49-year-ole male, is admitted for inpatient alcohol detoxification. He is cachexic, has multiple scabs on his arms and legs, and has lower extremity edema. An appropriate nursing diagnosis for Donald along with an expected outcome is: a. Risk for injury/Remains free from injury b. Ineffective denial/Accepts responsibility for behavior c. Nutrition: Less than body requirements/Maintains nutrient intake for metabolic needs d. Risk for suicide/Expresses feelings, plans for the future

c. Nutrition: Less than body requirements/Maintains nutrient intake for metabolic needs

As nurse is planning a staff education program on substance use in older adults. Which of the following information should the nurse to include in the presentation? a. Older adults require higher doses of a substance to achieve a desired effect b. Older adults commonly use rationalization to cope with a substance use disorder c. Older adults are at an increased risk for substance use following retirement d. Older adults develop substance use to mask manifestations of dementia.

c. Older adults are at an increased risk for substance use following retirement

A nurse is making a home visit to a client who is in the late stage of Alzheimer's disease. The client's partner, who is the primary caregiver, wished to discuss concerns about the client's nutrition and the stress of providing care. Which of the following actions should the nurse take? a. Verify that a current power of attorney document is on file b. Instruct the client's partner to offer finger foods to increase oral intake c. Provide information on resources for respite care d. Schedule the client for placement of an enteral feeding tube

c. Provide information on resources for respite care

Which behavior indicates that a patient diagnosed with borderline personality disorder is improving? a. The patient cries when her roommate refuses to go to the dining room with her. b. The patient yells at the group facilitator when he points out that she is monopolizing the group. c. The patient informs a staff member that she is having thoughts of harming herself. d. The patient tells the evening staff that the day staff excused her from group to smoke when she got upset.

c. The patient informs a staff member that she is having thoughts of harming herself.

Opioid use disorder is characterized by: a. Lack of withdrawal symptoms b. Intoxication symptoms of pupillary dilation, agitation, and insomnia c. Tolerance d. Requiring smaller amounts of the drug to achieve a high over time

c. Tolerance

A nurse in a long-term care facility is caring for a client who has major neurocognitive disorder and attempts to wander out of the building. The client states, "I have to get home." Which of the following statements should the nurse make? a. "You have forgotten that this is your home." b. "You cannot go outside without a staff member." c. "Why would you want to leave? Aren't you happy with your care?" d. "I am your nurse. Let's walk together to your room."

d. "I am your nurse. Let's walk together to your room."

When assessing a patient diagnosed with a borderline personality disorder, which statement by the patient warrants immediate attention? a. "My mother died ten years ago." b. "I haven't needed medication in weeks." c. "My dad never loved me." d. "I'd really like to hurt her for hurting me."

d. "I'd really like to hurt her for hurting me."

1. Darnell is an 84-year-old widower who has lived alone since his wife died 6 years ago. A neighbor called Darnell's son to tell him that Darnell was trying to start his car from the passenger's side. He became angry and aggressive when the car would not start. After a medical assessment, Darnell was diagnosed with a major neurocognitive disorder. The nurse realized additional family teaching is necessary when Darnell's son states: a. "My father's diagnosis is interfering with his daily functioning." b. "This neurocognitive disorder will probably progress." c. "Advancing age is a risk factor in my father's diagnosis." d. "With person-centered care, my father will be able to remain in his home."

d. "With person-centered care, my father will be able to remain in his home."

An incest survivor undergoing treatment at the mental health clinic is relieved when she learns that her anxiety and depression are: a. Going to be eradicated with treatment b. Normal and will soon pass c. Abnormal but will pass d. A normal reaction to posttraumatic events

d. A normal reaction to posttraumatic events

Which patient is at greatest risk for developing a stress- induced myocardial infarction? a. A patient who lost a child in an accidental shooting 24 hours ago b. A woman who has begun experiencing early signs of menopause c. A patient who has spent years trying to sustain a successful business d. A patient who was diagnosed with chronic depression 10 years ago

d. A patient who was diagnosed with chronic depression 10 years ago

The school nurse has been alerted to the fact that an 8-year-old boy routinely playacts as a police officer "locking up" other children on the playground to the point where the children get scared. The nurse recognizes that this behavior is most likely an indication of: a. The need to dominate others b. Inventing traumatic events c. A need to develop close relationships d. A potential symptom of traumatization

d. A potential symptom of traumatization

You are caring for Aaron, a 38-year-old patient diagnosed with somatic symptom disorder. When interacting with you, Aaron continues to focus on his severe headaches. In planning care for Aaron, which of the following interventions would be appropriate? a. Call for a family meeting with Aaron in attendance to confront Aaron regarding his diagnosis. b. Educate Aaron on alternative therapies to deal with pain. c. Improve reality testing by telling Aaron that you do not believe that the headaches are real. d. After a limited discussion of physical concerns, shift focus to feelings and effective coping skills.

d. After a limited discussion of physical concerns, shift focus to feelings and effective coping skills.

In the 2 months after his wife's death, Aaron, aged 90 and in good health, has begun to pay less attention to his hygiene and seems less alert to his surroundings. He complains of difficulty concentrating and sleeping and reports that he lacks energy. His family sometimes has to remind and encourage him to shower, take his medications, and eat, all of which he then does. Which response is most appropriate? a. Reorient Mr. Smith by pointing out the day and date each time you have occasion to interact with him. b. Meet with family and support them to accept, anticipate, and prepare for the progression of his stage 2 dementia. c. Avoid touch and proximity; these are likely to be uncomfortable for Mr. Smith and may provoke aggression when he is disoriented. d. Arrange for an appointment with a therapist for evaluation and treatment of suspected depression.

d. Arrange for an appointment with a therapist for evaluation and treatment of suspected depression.

What action should you take when a female staff member is demonstrating behaviors associated with a substance use disorder? a. Accompany the staff member when she is giving patient care b. Offer to attend rehabilitation counseling with her c. Refer her to a peer assistance program d. Confront her about your concerns and/or report your concerns to a supervisor immediately.

d. Confront her about your concerns and/or report your concerns to a supervisor immediately.

What precipitating emotional factor has been associated with an increased incidence of cancers? Select all that apply. a. Anxiety b. Job-related stress c. Acute grief d. Feelings of hopelessness and despair from depression e. Prolonged, intense stress

d. Feelings of hopelessness and despair from depression e. Prolonged, intense stress

Living comfortable and materialistic lives in Western societies seems to have altered the original hierarchy proposed by Maslow in that: a. Once lower level needs are satisfied, no further growth feels necessary b. Self-actualization is easier to achieve with financial stability c. Esteem is more highly valued than safety d. Focusing on materialism reduces interests in love, belonging, and family

d. Focusing on materialism reduces interests in love, belonging, and family

A nurse is assigned the care of four patients who are detoxifying from alcohol. The patient with which symptom would be the nurse's highest priority? a. Fine motor tremors b. Diaphoresis c. Diarrhea d. Hallucinations and delusions

d. Hallucinations and delusions

A woman brings her mother to your clinic, concerned that her 85-year-old mother may have dementia. "I'm Ellen," she says when you enter. "This is my mother Veronica. She's not much of a talker these days, so I've come with her to help her express a few things we're both a bit worried about." "Right now," Ellen says, "we're pretty sure she has either delirium or dementia, maybe. What's the difference between those two?" Ellen continues: "Well, it's mostly a problem with memory that started maybe two years ago? One and a half, maybe?" You ask, "Did something abrupt set this off?" "No," Ellen says. "Mom? Do you think some event may have triggered all this?" Veronica shakes her head. "Does she have abrupt moments of lucidity?" you ask. "Not really," Ellen shakes her head. "She's pretty much the same all the time." Which is an indication that Veronica does not have delirium? a. She seems confused. b. She gets anxious and agitated. c. She seems disorganized in her thoughts. d. Her problems with memory have been developing gradually.

d. Her problems with memory have been developing gradually.

Larry is from a small town and began displaying aggressive and manipulative traits while still a teenager. Now at 40 years old, Larry is serving a life sentence for the murders of his wife and her brother. John, the prison psychiatric nurse practitioner, recognizes that Larry's treatment will most likely: a. Transform Larry to a model prisoner b. Not improve Larry's coping skills c. Reaffirm Larry's high-risk behaviors d. Manifest as small incremental changes

d. Manifest as small incremental changes

Antisocial, obsessive-compulsive, and schizotypal personality disorders occur most frequently in a. Adolescents b. Children c. Women d. Men

d. Men

Terry is a young male in a chemical dependency program. Recently he has become increasingly distracted and disengaged. The nurse concludes that Terry is: a. Bored b. Depressed c. Bipolar d. Not ready to change

d. Not ready to change

Ophelia, a 69-year-old retired nurse, attends a reunion of her former coworkers. Ophelia is concerned because she usually knows everyone, and she cannot recognize faces today. A RN colleague recognizes Ophelia's distress and "introduces" Ophelia to those attending. The NP recognizes that Ophelia seems to have a deficit in: a. Lower-level cognitive domain b. Delirium threshold c. Executive function d. Social cognition

d. Social cognition