Psych Exam 4

A nurse is caring for a client who has end - stage lung cancer . Which of the following statements should the nurse identify as an indication that the client is experiencing the bargaining stage of the Kubler- Ross Stages of grief? A. " I would give anything to live to see my grandchild born" B." Can you make sure there hasn't been a mistake with my test results ?" C. " I feel so sad that I will be leaving my partner all alone " D. " What have I done to deserve this death sentence "

A. " I would give anything to live to see my grandchild born "

A nurse is providing teaching to the parents of a school age child who has attention deficit/ hyperactivity disorder ( ADHD) . Which of the following should the nurse include in the teaching? A. " Ignore your child's attention seeking behaviors that are not dangerous B. " Administer ADHD medications within 30 min of bedtime" C. " Continue with an activity as planned, even if your child is frustrated "

A. " Ignore your child's attention seeking behaviors that are not dangerous

A home health nurse is talking with the partner of a client who has dementia. Which of the following statements by the partner indicated that the client is displaying signs of apraxia ? A. " Yesterday, my partner put on a jacket upside down" B. " My partner has trouble reading the newspaper" C. " My partner often repeats words" D. " Last week, my partner did not recognize the sound of the alarm clock "

A. " Yesterday, my partner put on a jacket upside down"

A nurse is assessing a newly admitted client who has generalized anxiety disorder and states " I drink alcohol to forget the pain " . the client exhibits a maladaptive response to which of the following defense mechanisms ? A. Compensation b. Conversion C. Projection D. Suppression

A. Compensation

A nurse is organizing a therapeutic support group for individuals who have bulimia nervosa . Which of the following tasks should the nurse plant to include during the orientation phase of group development ? A. determine the rules the group will follow B. Address disagreements among the group members C. Help clients work through the grief response D. Transition from the role of leader to facilitator

A. Determine the rules that the group will follow

A nurse is organizing a therapeutic support group for individuals who have bulimia nervosa. Which of the following tasks should the nurse plan to include during the orientation phase of group development ? A. Determine the rules the group will follow B.Address disagreements among group members C. Help clients work through grief response

A. Determine the rules the group will follow

A nurse is teaching a client with Alzheimers disease about donepezil. Which of the following statements should the nurse include in the teaching ?

A. Donepezil can improve cognitive functioning during the earlier stages of the disease.

A nurse is preparing an in service session about Alzheimer's disease for a group of newly licensed nurses . Which of the following findings should the nurse include as an early manifestation in the progression of the disease ? A. Forgetting material that was just read B. Losing the ability to feel emotions C. Experiencing changes in physical abilities D. Difficulty controlling the bladder

A. Forgetting material that was just read

A nurse is giving discharge teaching to a parent of a adolescent that has been hospitalized for bulimia nervosa for the past few weeks. Which statement identifies that the parent understands the teaching ? A. I should allow my child to make independent decisions B. I should gibe my child laxative routinely C. I should make sure my child takes their meds daily D. I should discourage my child from exercising

A. I should allow my child to make independent decisions

A nurse working in a retirement community is assessing an older adult client . Which of the following manifestations should the nurse identify as an expected age related change ? A. Making occasional errors when balancing a checkbook B. Confusion with time or place C. Poor Judgement D. Changes in mood

A. Making occasional errors when balancing a checkbook

A nursing is caring for a child who has Tourette's disorder . Which of the following behaviors should the nurse expect? A. Multiple motor and vocal tics B. Areas of baldness on the scalp C. Insatiable hunger D. Exaggerated startle response

A. Multiple motor and vocal tics

A nurse is caring for a client with anorexia nervosa who has light skin. Which of the following finding should the nurse expect ? A. Presence of lanugo B. Flushed skin tone C. Hyperactive bowel sounds D. Clubbing of the fingernails

A. Presence of lanugo

A nurse is providing postoperative care to an older adult client who develops delirium. Which of the following actions should the nurse take ? A. Request a prescription for anti anxiety medication B. Provide the client with a stimulating activity prior to bedtime C. Dim the lights D. Encourage them to make decisions

A. Request a prescription for anti anxiety medication

A nurse is caring for an adolescent male client who has anorexia nervosa. The client asks " Have I done any permanent damage to my body ?" Which of the following responses should the nurse provide ? A. What concert do you have about your physical health B. Lets wait to discuss that until after you're feeling much better C. unconsciously you are admitting you're worried about your physical appearance D. Im glad to hear that you're concerned about the physical effect of your illness

A. What concern do you have about your physical health

A nurse is performing a mental assessment on an older adult with dementia. Which of the following questions should the nurse ask to assess the clients remote memory? A. What year did you graduate high school B. What is your favorite childhood memory C. What day is it today ? D. What did you have for supper yesterday ?

A. What year did you graduate high school

A nurse is evaluation the plan of care for a client with antisocial personality disorder , which of the following actions indicate that the client is making progress ( SATA). A. helping another client who has depression fill out a menu B. Nominated themselves for chair of the client government meeting C. Requesting a weekend home pass D. Serving as the judge for a unit talent show E. Informing the nurse that the staff provides excellent client care

A. helping another client who has depression fill out a menu C. Requesting a weekend home pass

A nurse is counseling a client who following a recent death in that family. Which of the following situations should the nurse identify as a risk factor for maladaptive grieving ? A. the death was a result of violence B. The client expresses anger over the loss C. The clients first experience with the loss of a family member D. The client demonstrates reorganization of the behavior

A. the death was a result of violence

A nurse is providing teaching to the guardian of a school aged child who has ADHD and a new prescription for clonidine. Which of the following statements but the guardian indicates and understanding of the teaching ? A. " I will not allow my child to eat anything within 2 hours of taking the medication" B. " I can expect my child to be drowsy while taking this medication C. " I will give this at noon everyday "

B. " I can expect my child to be drowsy while taking this medication

A nurse is caring for a client who has dementia. The client states to the nurse , " Everyone wants to kill me ". Which of the following responses should the nurse make ? A. " Tell me how everyone wants to hurt you" B. " You must feel very frightened to think someone wants to hurt you C. " No one here wants to kill you " D. " Who in particular do you think wants to kill you "

B. " You must feel very frightened to think someone wants to hurt you

A nurse is assessing a client who has binge eating disorder. Which of the following findings should the nurse expect? A. Amenorrhea B. Abdominal Pain C. Restricted Caloric Intake D. Frequent use of laxatives

B. Abdominal Pain

A nurse is caring for a client who has antisocial personality disorder, Which of the following actions should the nurse take? A. Encourage the client to attend assertive behavior sessions B. Ensure staff members set limits on clients behaviors C. Tell the client to increase socialization on the unit D. Frequently implement measures to increase the clients self- esteem

B. Ensure staff members set limits on clients behaviors

A nurse is providing teaching to a client who has ADHD and a new prescription for a transdermal methylphenidate patch. Which of the following statements by the client indicates an understanding of the teaching? A. I will rotate placing the patch on different parts of my upper body B. I can take showers with the patch in place C. If the patch bothers my skin , I will switch to the oral form of the medication D. I will apply a patch each night at bedtime

B. I can take showers with the patch in place

A nurse is caring for a client who has dementia. Which of the following findings should the nurse expect ? A. Altered LOC B. Impaired judgement C. Rapid personality change D. Disturbances in perception

B. Impaired Judgement

A nurse is providing teaching to the guardian of a female adolescent who has bulimia nervosa. Which of the following statements by the guardian indicates an understanding of the teaching ? A. My daughter is at risk for developing hight blood pressure B. It is important for my daughter to have regular dental check ups C. I should weigh my daughter daily for several weeks D. Bleeding during my daughters period will increase

B. It is important for my daughter to have regular dental check ups

A nurse is caring for a client who has dementia. Which of the following actions should the following actions should the nurse take ? A. Assign the client several tasks at the same time B. Maintain a low stimulation environment C. Advise family to visit frequently as a group D. encourage the clients to make choices regarding care

B. Maintain a low stimulation environment

A nurse is caring for a client with acute delirium . Which of the following should the nurse expect ? A. Progressive deterioration of cognitive function B. Rapid fluctuation in LOC C. Loss of language ability D. Absence of contributing factors to pin point delirium

B. Rapid fluctuation in LOC

A nurse is caring for a client who is showing evidence of addiction to a pain medication prescribed for rheumatoid arthritis . When questioned about the usage of the medication , the client states " it is not an illegal drug " Which of the following defense mechanisms is the client using ? A. Displacement B. Rationalization C. Projection D. Sublimation

B. Rationalization

A nurse is interviewing a client who has anorexia nervosa. Which of the following findings should the nurse expect? A. Poor personal hygiene habits B. Strenuous exercise regimen C. Grandiose behaviors D. Intense fear of death

B. Strenuous Exercise regimen

A nurse in a health clinic is providing teaching to a client about binge eating disorder . Which of the following client statements indicated an understanding of the teaching ? A. The problem is caused by a slow metabolism B. The abdominal pain I often have is due to the amount of food that I eat C. Most of my weight gain is water weight D. At least I do not need to worry about being physically ill

B. The abdominal pain I often have is due to the amount of food that I eat

A nurse is interacting with a patient who has a psychotic disorder. The patient suddenly turns her head as if she is listening to something and says, " The boss says she is going to hit me with a stick!" . Which of the following responses should the nurse make ? A. " The boss can't hurt you with a stick" B. " Why are you talking to yourself " C. " I don't see anyone, but it does sound like you are frightened " D. " There isn't anyone here besides us, you need to talk to me "

C. " I don't see anyone, but it does sound like you are frightened "

A nurse is providing teaching to the partner of a school aged child who has ADHD and a new prescription for methylphenidate IR. Which of the following pieces of information should the nurse provide ? A. " have your child take the medication once daily " B. " This medication might make your child gain weight " C. " Your child's growth might slow while using this medication " D. " Avoid giving your child food when taking this medication "

C. " Your child's growth might slow while using this medication "

A nurse is assessing an older adult client who move in three months ago following the death of his partner. The client reports awakening early in the morning and feeling sad. What type of grief is the client experiencing ? A. Anticipatory grief B. Delayed grief C. Acute Grief D. Disenfranchised grief

C. Acute Grief

A nurse is caring for a client who is recently diagnosed with breast cancer that has metastasized to the spine . The client refuses to discuss treatment options. The nurse should identify that the client is experiencing which of the following stages of the Kubler - Ross' grief theory? A. Anger B. Bargaining C. Denial D. Depressio n

C. Denial

A nurse is assessing a client whose partner died 4 months ago. Which of the following statements indicated that the client is at risk for complicated grief? A. I wish I had been more generous to my wife when she died B. I told my wife to go to the doctor but she wouldn't listen C. I feel so empty without my wife that its hard to get up every morning

C. I feel so empty without my wife that its hard to get up every morning

A nurse is assessing a client who has oppositional defiant disorder . Which of the following findings should the nurse expect ? A. Displaying flat affect B. Unmotivated by rewards C. Ignoring unit rules D. Fearing a loss of privileges

C. Ignoring unit rules

A nurses is developing a plan of care for a client who has anorexia nervosa. Which of the following nursing actions is contraindicated for this client ? A. Explaining that tube feeding will be necessary if the client refuses oral intake B. Weigh the client each day prior to any oral intake C. Permitting the client to spend some quiet time alone after each meal D. Refrain from commenting about he clients eating during meal times

C. Permitting the client to spend some quiet time alone after each meal

A nurse is caring for a client with ADHD who has recently started taking lithium . For which of the following findings should the nurse monitor when evaluating the effectiveness of the medication ? A. Increased attention span B. Decreased Anxiety C. Reduced Agression D. Weight Loss

C. Reduced Agression

A nurse is assessing a client who has ADHD and reports abruptly stopping his amphetamine treatment. Which of the following assessments indicated that the client is physically dependent on amphetamines ? A. The client exhibits paranoia B. The client reports having insomnia C. The client reports eating excessively D. The client has an increased heart rate

C. The client reports eating excessively

A nurse is providing a teaching to the client who has conversion disorder. Which of the statements by the partner shows an understanding of the teaching ? A. My partner is pretending to be ill to get attention B. My partners is purposefully making our child sick C. The stress of losing our child caused my partner to go blind D. My partner is worried that he has cancer, even though his tests are normal

C. The stress of losing our child caused my partner to go blind

A nurse is assessing a client whose sister recently died in a motor vehicle crash. The nurse should identify that which of the following factors indicates an increase of complicated grief reaction? A. The loss of a sibling B. The perception that the death was unavoidable C. The sudden occurrence of the death D. The presence of a social support network

C. The sudden occurrence of the death

A nurse at. a college campus health clinic is caring for a client who reports manifestations of bulimia nervosa . The client tells the nurse, " I know my eating binges and vomiting are not normal, but I can't control them ." Which of the following responses should the nurse provide ? A. " why do you think you are experiencing these behaviors of binges and vomiting". B. " Are other students in your dorm also experiencing this behavior " C." You are feeling helpless about changing this behavior ? " D. " You know you must stop because you are endangering your health "

C." You are feeling helpless about changing this behavior ? "

A nurse is caring for a client who has Alzheimer's disease and a new prescription for donepezil. Which of the following actions should the nurse take ? A. Monitor the clients liver function B. Increase dosing every 72 hours C. Offer a PRN NSAID while taking this mediation D. Administer at bedtime

D. Administer at bedtime

A nurse is assessing a client who has conduct disorder. Which of the following findings should the nurse expect ? A. Fearful of authority figures B. Flat Affect C. Preoccupation with enforcing rules D. Aggressive behavior towards others

D. Aggressive behavior towards others

A nurse is caring for a client who has anorexia nervosa. The client states " IF I gain weight, Ill never get a boyfriend " . Which of the following cognitive distortions is the client displaying ? A. Overgeneralization B. Personalization C. emotional reasoning D. Catastrophizing

D. Catastrophizing

A nurse is performing an admission for a client who has restricting type anorexia nervosa. The nurse should expect which of the following ? A. recurrent binging B. compensatory vomiting C. loss of appetite D. Decreased caloric intake

D. Decreased caloric intake

A nurse is providing teaching to a family of a client who has dementia . Which of the following statements should the nurse include ? A. Dementia is often associated with a reaction to a new medication B. Dementia is usually reversible with prompt treatment C. Dementia develops rapidly over a matter of hours or days D. Dementia is commonly associated with Alzheimers disease

D. Dementia is commonly associated with Alzheimers disease

A nurse is caring for a client who was admitted for the treatment of anorexia nervosa. Which of the following actions should the nurse take ? A. Discuss food nutritional value B. Weigh the client 3 mornings per week C. Allow the client to exercise 1 hr a day D. Monitor the client for 1 hour following meals and snacks

D. Monitor the client for 1 hour following meals and snacks

A nurse caring for a client with dementia who paces during meals . Which of the following actions should the nurse take ? A. Restrain the client during meals B. Provide large meals at bedtime C. Administer an antipsychotic medication D. Provider Finger foods to the client

D. Provider Finger foods to the client

A nurse is caring for a client who has delirium. Which of the following items should the nurse use to promote optimal cognitive function for this client ? A. Identification bracelet B. Menu of the cafeteria C. map of the facility D. Wall calendar

D. Wall Calendar

A nurse in a long-term care facility is caring for a client who has dementia and becomes increasingly agitated in the afternoon. Which of the following actions should the nurse take first ? A. Place the client in a private room B. Apply soft wrist restraints on the client C. Administer haloperidol to the client D. offer diversionary activities to the client

D. offer diversionary activities for the client

A nurse is in a provider's office and is asking a client who is crying and states , " It's my child's first day of school " . The nurse should recognize that the client is experiencing which of the following types of loss ?

Maturational Loss