psych final exam study guide

A client says, "I get in trouble sometimes because I make quick decisions and act on them." What is the nurse's most therapeutic response?

"Let's consider the advantages of being able to stop and think before acting."

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.)

independently perform own personal hygiene. obtain employment in a local sheltered workshop. correctly use public buses to travel in the community

What is the nurse's priority focused assessment for side effects in a child taking methylphenidate for attention deficit hyperactivity disorder (ADHD)?

Sleep disturbances and weight loss

A client report, "Last night I had several mixed drinks at a party. When I got home, I had difficulty falling sleep. I made two cups of herbal tea with lavender. This morning, I feel very groggy and have a headache." What explanation should the nurse provide the client?

lavender may increase sedation from other central nervous system depressants.

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?

loneliness and increase self-esteem.

A client in a detoxification unit asks, "What good it will do to go to Alcoholics Anonymous and talk to other people with the same problem?" What is the nurse's best response when explaining the opportunities AA provides?

people with common problems can share their experiences with alcoholism and recovery.

. A client with multi-infarct dementia lashes out and kicks at people who walk past in the hall of a skilled nursing facility. Intervention by the nurse should begin with what intervention?

saying to the client, "This is a safe place."

The nurse caring for an individual demonstrating symptoms of schizotypal personality disorder would expect assessment findings to include what characteristics?

socially anxious, rambling stories, peculiar ideas.

A nurse set limits while interacting with a client demonstrating behaviors associated with borderline personality disorder. The client tells the nurse, "You used to care about me. I thought you were wonderful. Now I can see I was wrong. You're evil." This outburst can be documented using what term?

splitting.

Which history information from a client's record would indicate marginal coping skills and the need for careful assessment of the risk for violence?

substance abuse.

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?

play and talk about a play activity

A nurse assesses a 3-year-old diagnosed with an autism spectrum disorder. Which finding is most associated with the child's disorder?

cries when separated from a parent.

Which agency provides coordination in the event of a terrorist attack?

National Incident Management System (NIMS)

For which client would it be most important for the nurse to urge immediate discontinuation of kava?

A client with a comorbid diagnosis of cirrhosis.

Which central nervous system structures are most associated with anger and aggression? (Select all that apply.)

Amygdala, Temporal lobe, Prefrontal cortex

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?

"Do not throw the ball. Put it back on the pool table."

The parent of an adolescent diagnosed with mental illness asks the nurse, "Why do you want to do a family assessment? My teenager is the client, not the rest of us." What is the nurse's best response?

"Every family member's perception of events is different and adds to the total picture."

A nurse in the emergency department assesses an unresponsive victim of rape. The victim's friend reports, "That guy gave her salty water before he raped her." Which question is most important for the nurse to ask of the victim's friend?

"Has the victim consumed any alcohol?"

Which remark by a group participant would the nurse expect during the working stage of group therapy?

"I don't think I agree with your action. It might help you, but it seems like it would upset your family."

. An immigrant from China needs a colonic resection but is anxious and reluctant about surgery. This client usually follows traditional Chinese health practices. Which comment by the nurse would most likely reduce the client's anxiety and reluctance?

"If you would like, we could investigate using acupuncture to help control pain."

A community health nurse visits a family with four children. The father behaves angrily, finds fault with the oldest child, and asks twice, "Why are you such a stupid kid?" The wife says, "I have difficulty disciplining the children. It's so frustrating." Which comments by the nurse will facilitate an interview with these parents? (Select all that apply.)

"Tell me how you discipline your children." "How do you stop your baby from crying?" "Caring for four small children must be difficult."

A nurse interviews a homeless parent with two teenage children. To best assess the family's use of resources, the nurse should ask which question?

"What community agencies have you found helpful in the past?"

A client is seen in the clinic for superficial cuts on both wrists. Initially the client paces and sobs but after a few minutes, the client is calmer. The nurse attempts to determine the client's perception of the precipitating event by asking which question?

"What was happening when you started feeling this way?"

Which comment by the nurse would best support relationship building with a survivor of intimate partner abuse?

"You are feeling violated because you thought you could trust your partner."

A rape victim tells the nurse, "I should not have been out on the street alone." Select the nurse's most therapeutic response.

"You feel as though this would not have happened if you had not been alone."

A cognitively impaired client has been a widow for 30 years. This client frantically tries to leave the facility, saying, "I have to go home to cook dinner before my husband arrives from work." To intervene with validation therapy, what should the nurse say?

"You want to go home to prepare your husband's dinner?"

A client who is visiting the crisis clinic for the first time asks, "How long will I be coming here?" The nurse's reply should consider that the usual duration of crisis intervention is what time frame?

4 to 6 weeks.

Which scenario is an example of a situational crisis?

A riot at a rock concert

An adult comes to the crisis clinic after termination from a job of 15 years. The client says, "I don't know what to do. How can I get another job? Who will pay the bills? How will I feed my family?" Which nursing diagnosis applies?

Powerlessness

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?

Acceptance and trust convey feelings of security to the child

A nurse plans care for an individual diagnosed with antisocial personality disorder. Which characteristic behaviors will the nurse expect? (Select all that apply.)

Callous attitude, aggression

An emergency department nurse prepares to assist with examination of a sexual assault client. What equipment will be needed to collect and document forensic evidence? (Select all that apply.)

Camera Body map DNA swabs

A nurse assesses a client for inclusion in group therapy. This client has a childhood history of neglect and ridicule by parents. The client says to the nurse, "My boss always expects more of me than the others but talking to him would only make it worse." Which type of group would best address the client's needs?

Cognitive-behavioral

Which aspects of assessment have priority when a nurse interviews a rape victim in an acute setting? (Select all that apply.)

Coping mechanisms, the patient is using Signs and symptoms of emotional and physical trauma Adequacy and availability of the patient's support system

A young female member in a therapy group says to an older female member, "You are just like my mother, always trying to control me with your observations and suggestions." Which therapeutic factor of a group is evident by this behavior?

Corrective recapitulation of the primary family group

A young adult has recently had multiple absences from work. After each absence, this adult returned to work wearing dark glasses and long-sleeved shirts. During an interview with the occupational health nurse, this adult says, "My partner beat me, but it was because I did not do the laundry." What is the nurse's next action?

Document injuries with a body map.

A client diagnosed with borderline personality disorder (BPD) self-inflicted wrist lacerations after gaining new privileges on the unit. In this case, the self-mutilation may have been due to which trigger?

Fear of abandonment is associated with progress toward autonomy and independence.

A nurse plans health education for a client who will be receiving warfarin for several weeks after knee-replacement surgery. Which substance should the nurse caution the client to avoid? Fish oil

Fish oil

Which complementary and alternative medicine (CAM) method is associated with using allergy injections of small amounts of an allergen in solution?

Homeopathy

. A client who recently emigrated from India is hospitalized. The client and family use ayurvedic medicine. The nurse wants to adjust this client's care so that it is more comfortable and familiar. What changes from usual Western practice should be considered? (Select all that apply.)

In preparation for discharge include a significant focus on preventive practices, Spend time exploring the client's life overall, focusing on broader issues than health, Provide relevant health-related information and then encourage the client to determine which course of action to pursue.

A family expresses helplessness related to dealing with a mentally ill member's odd behaviors, mood swings, and argumentativeness. Which nursing intervention will be of greatest benefit for this family?

Instruction regarding the benefit of role-playing difficult situations.

A group is in the working phase. One member states, "That is the stupidest thing I've ever heard. Everyone whines and tells everyone else what to do. This group is a waste of my time." Which initial action by the group leader would be most therapeutic?

Meet privately with the member outside of group to discuss the anger.

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?

Methylphenidate

. A team of nurse's report to the community after a category 5 hurricane devastates many homes and businesses. The nurses provide emergency supplies of insulin to persons with diabetes and help transfer clients in skilled nursing facilities to sites that have electrical power. Which aspects of disaster management have these nurses fulfilled? (Select all that apply.)

Mitigationc Response

A client diagnosed with borderline personality disorder has a history of self-mutilation and suicide attempts. The client reveals feelings of depression and anger with life. Which type of medication would the nurse expect to be prescribed?

Mood stabilizing medication

A new client acts out so aggressively that seclusion is required before the admission assessment is completed, or orders written. Immediately after safely secluding the client, which action is the nurse's priority?

Notify the health care provider to obtain a seclusion order.

A 10-year-old cares for siblings while the parents work because the family cannot afford a babysitter. This child says, "My father doesn't like me. He calls me stupid all the time." The mother says the father is easily frustrated and has trouble disciplining the children. The community health nurse should consider which resources as priorities to stabilize the home situation? (Select all that apply.)

Parental sessions to teach childrearing practices Anger management counseling for the father Continuing home visits to give support

An adult has recently been absent from work for 3-day periods on several occasions. Each time, the individual returned wearing dark glasses. Facial and body bruises were apparent. What is occupational health nurse's priority assessment?

Physical injuries

Which intervention is appropriate for an individual diagnosed with an antisocial personality disorder who frequently manipulates others?

Refer requests and questions related to care to the case manager

A client has talked constantly throughout the group therapy session, often repeating the same comments. Other members were initially attentive then became bored, inattentive, and finally sullen. Which comment by the nurse leader would be most effective?

Say to everyone, "Most of you have become quiet. I wonder if it might be related to concerns you may have about how the group is progressing today."

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?

Second-generation antipsychotic

An older woman diagnosed with Alzheimer's disease lives with family and attends day care. After observing poor hygiene, the nurse talked with the caregiver. This caregiver became defensive and said, "It takes all my energy to care for my mother. She's awake all night. I never get any sleep." Which nursing intervention has priority?

Secure additional resources for the mother's evening and night care.

. A client tells the nurse, "I get sick so much, so I started taking ginseng to boost my immune system." The client's only other medication is warfarin daily. Which potential complication should be included in the nursing assessment?

Spontaneous bleeding

A client with a history of command hallucinations approaches the nurse yelling obscenities. Which nursing actions are most likely to be effective in de-escalation for this scenario? (Select all that apply.)

Stating the expectation that the client will stay in control, Offering to provide the client with medication to help, Speaking in a firm but calm voice.

. 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?

Take the child swimming at the facility's pool.

. A client with a history of anger and impulsivity was hospitalized after an accident resulting in multiple injuries. The client loudly scolds nursing staff, "I'm in pain all the time but you don't give me medicine until YOU think it's time." Which nursing intervention would best address this problem?

Talk with the health care provider about changing the pain medication from prn to client-controlled analgesia.

A nurse determines desired outcomes for a client diagnosed with schizotypal personality disorder. What is the best outcome?

The client will demonstrate the ability to introduce self to a stranger in a social situation.

What is the desired outcome for a client who uses valerian?

The client will report undisturbed sleep throughout the night.

The nursing diagnosis Rape-trauma syndrome applies to a rape victim in the emergency department. Select the most appropriate outcome to achieve before discharging the patient.

The patient agrees to a follow-up appointment with a rape victim advocate.

. 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 therapeutic alliance is the first step in a nurse's therapeutic use of self., acceptance and trust convey feelings of security for the adolescent.

. Parents of a teenager recently diagnosed with serious mental illness express dismay. One parent says, "Our hopes for our child's future are ruined. We probably won't ever have grandchildren." The nurse will use interventions to assist with which likely reaction?

acceptance

The child prescribed an antipsychotic medication to manage violent behavior is one most likely diagnosed with what disorder?

attention deficit hyperactivity disorder (ADHD).