Psych Nursing Quiz 7

Which statement by a family member of a person diagnosed with schizophrenia demonstrates effective learning about the disease? 1. "The disease was probably caused by problems with several genes. These genes cause changes in how certain brain chemicals work." 2. "The disease could be cured if our politicians and laws allowed for more stem cell research. Adult stem cells hold so much promise." 3. "The disease probably resulted from the mother's smoking during pregnancy. Nicotine is actually a neurotransmitter." 4. "If our family had more money, we could afford the promising psychoneuroimmunological treatments available to other people with schizophrenia."

1. "The disease was probably caused by problems with several genes. These genes cause changes in how certain brain chemicals work." Rationale The statement describing that several genes change how certain brain chemicals work demonstrates an accurate understanding of what is known about the causes of schizophrenia. Rationalizing the use of stem cell research does not demonstrate knowledge about the current understanding of the disease. A causative relationship between maternal smoking and schizophrenia in offspring has not yet been established. Suggesting that money could buy more promising alternative treatments may be true, but it does not indicate an understanding of the disease itself.

A client diagnosed with schizophrenia states "I will take my medicine so I will be cured." What is the most appropriate response from the nurse? 1. "Your disease is not curable, but we can continue to treat it." 2. "The disease is short lived and will resolve on its own." 3. "Your disease is curable with medication." 4. "We are not sure if we can cure it with medication."

1. "Your disease is not curable, but we can continue to treat it." Rationale "Your disease is not curable, but we can continue to treat it," is the most appropriate response. Schizophrenia is unlikely to resolve on its own and is not curable with medication.

How is obsession defined? 1. A recurrent, persistent thought or impulse 2. An intense irrational fear of an object or situation 3. A recurrent behavior performed in the same manner 4. Thinking of an action and immediately taking the action

1. A recurrent, persistent thought or impulse Rationale Obsessions are thoughts, impulses, or images that persist and recur so that they cannot be dismissed from the mind. An intense irrational Year of an object or situation is a phobia. A recurrent behavior is a compulsion. Immediately taking an action is unrelated to obsession.

What alternative to inpatient treatment is most appropriate for an individual with schizophrenia who has been stabilized and discharged home? 1. Day treatment 2. Partial hospitalization 3. Adult day care 4. Halfway house

1. Day treatment Rationale Day treatment is the most appropriate alternative for an individual with schizophrenia who has been stabilized and discharged home. Partial hospitalization or a half day house are not necessary if the client is stable and can live at home. Adult day care is for extreme mental illness.

The client says to the nurse, "I'm not me anymore. I'm just playing a part in this hospital movie." What is this client experiencing? 1. Depersonalization 2. False perception 3. Boundary issues 4. Derealization

1. Depersonalization Rationale Depersonalization is a nonspecific feeling that a person has lost his or her identity. Derealization is a false perception by a person that the environment has changed. Boundary issues can be defined in many different ways; clients with schizophrenia often lack a sense of where their bodies end in relation to where others bodies begin.

A client is experiencing a panic attack. Which nursing intervention will be most therapeutic? 1. Encourage the client to take slow, deep breaths. 2. Verbalize mild disapproval of the anxious behavior. 3. Offer an explanation about why the symptoms are occurring. 4. Ask the client what he or she means when he or she says "I am dying."

1. Encourage the client to take slow, deep breaths. Rationale Slow diaphragmatic breathing can induce relaxation and reduce symptoms of anxiety. Often the nurse has to tell the client to "breathe with me" and keep the client focused on the task. The slower breathing also reduces the threat of hypercapnia with its attendant symptoms. Verbalizing disapproval, offering an explanation about the symptoms, and asking the client what he or she means will not be helpful to the client during a panic attack and may exacerbate it.

What is a client diagnosed with schizophrenia who is expressing suicidality displaying? 1. Mood symptom 2. Inability to reason 3. Cognitive symptom 4. Anhedonia

1. Mood symptom Rationale The schizophrenic client expressing suicidality is displaying a mood symptom. Inability to reason is a cognitive symptom, and anhedonia is a negative symptom.

A nurse is working with a client demonstrating behaviors often associated with the acute phase of schizophrenia. Which assessment findings increase the risk of aggressive and violent client behaviors? Select all that apply. 1. Paranoia 2. Flat affect 3. Poor hygiene 4. Delusional thinking 5. Command hallucinations

1. Paranoia 4. Delusional thinking 5. Command hallucinations Rationale A small percentage of clients with schizophrenia, especially during the acute phase, may exhibit a risk for physical violence, typically in response to paranoia, delusions, hallucinations (especially command hallucinations), and impaired judgment or impulse control. A flat affect and poor hygiene are negative symptoms not typically associated with aggression or violence.

What is the most likely potential problem for a client diagnosed with severe obsessive- compulsive disorder? 1. Sleep disturbance 2. Excessive socialization 3. Command hallucinations 4. Altered state of consciousness

1. Sleep disturbance Rationale Clients who must engage in compulsive rituals for anxiety relief rarely are afforded relief for any prolonged period. The high anxiety level and need to perform the ritual may interfere with sleep. Excessive socialization, command hallucinations, and altered states of consciousness are not typically associated with obsessive- compulsive disorder.

Selective inattention is first noted when an individual experiences which level of anxiety? 1. Mild 2. Moderate 3. Severe 4. Panic

2. Moderate Rationale Selective inattention is noted in moderate anxiety. The individual's perceptual field is reduced and the he or she is not able to see the entire picture of events. Selective inattention is not a feature of mild, severe, or panic level anxiety.

A client states to the nurse, "My heart is no longer working, I am dead." What type of delusion is this client experiencing? 1. Somatic 2. Bizarre 3. Erotomania 4. Ideas of reference

1. Somatic Rationale This client is experiencing a somatic delusion. A somatic delusion is the false belief that the body is changing in an unusual way. Bizarre delusions are clearly implausible and incomprehensible beliefs that do not derive from ordinary experiences, such as a client complaining that an alien is taking over his or her brain. Erotomania is the false belief that someone, usually a stranger, high-class, or famous person, is in love with the client. The client displaying ideas of reference is misconstruing trivial events and remarks giving them personal significance.

Which drug must be administered along with chlorpromazine to reduce the risk of extrapyramidal side effects? 1. Trihexiphenidyl 2. Montelukast 3. Lamivudine 4. Valacyclovir

1. Trihexiphenidyl Rationale Chlorpromazine is a first-generation antipsychotic drug. It can cause extrapyramidal side effects, like akathisia, tremor, impaired gait, and so on, due to the blockage of dopamine receptors. These side effects can be treated by administering antiparkinson drugs like trihexiphenidyl. Trihexiphenidyl is an antimuscarinic class of drug. Montelukast is a leukotriene receptor antagonist used to treat asthma. Lamivudine is a nucleoside reverse transcriptase used to treat HIV/AIDS. Valacyclovir is an antiviral drug used to treat viral infections.

What is the most important question to ask during assessment of a client diagnosed with an anxiety disorder? 1. "How often do you hear voices?" 2. "Have you ever considered suicide?" 3. "How long has your memory been poor?" 4. "Do your thoughts always seem jumbled ?"

2. "Have you ever considered suicide?" Rationale The presence of anxiety may cause an individual to consider suicide as a means of finding comfort and peace. Suicide assessment is important for any client with an anxiety disorder. Hearing voices, poor memory and jumbled thoughts may be related to anxiety but are not as important to the client's safety as risk for suicide.

During an assessment, a client reports Year that "people are trying to poison me." Which statement by the nurse indicates a need for instructions regarding the management of this type of client statement? 1. "Have other members of your family ever experienced this kind of thing?" 2. "Tell me more about how someone keeps trying to poison your food." 3. "How has this affected your ability to keep a job or care for yourself?" 4. "Let's discuss the stressors you have in your life right now."

2. "Tell me more about how someone keeps trying to poison your food." Rationale It is nontherapeutic to reinforce the delusion by encouraging the individual to focus on the details, as suggested by asking the client how his or her food is being poisoned. The statements "Have other members of your family ever experienced this kind of thing?", "How has this affected your ability to keep a job or care for yourself?", and "Let's discuss the stressors you have in your life right now" do not reinforce the delusion. Rather, they help gain knowledge about the history of the disorder in the family, the extent of the dysfunction the Year is causing, and the triggers that may have resulted in this behavior.

Which statement is true regarding the comorbidity of anxiety disorders? 1. Anxiety disorders generally exist alone. 2. A second anxiety disorder may co-occur with the first. 3. Anxiety disorders virtually never coexist with mood disorders. 4. Substance abuse disorders rarely coexist with anxiety disorders.

2. A second anxiety disorder may co-occur with the first. Rationale In many instances, when one anxiety disorder is present, a second one co-occurs. Health care providers and researchers have clearly shown that anxiety disorders frequently co-occur with other psychiatric problems. Major depression often co-occurs and produces a greater impairment with poorer response to treatment. Substance abuse also frequently co-occurs and has a negative impact on treatment.

A client is fearful of riding in elevators and always takes the stairs. Which brain structure is involved in this fear and behavior? 1. Thalamus 2. Amygdala 3. Hypothalamus 4. Pituitary gland

2. Amygdala Rationale The amygdala plays a role in anxiety disorders. It alerts the brain to the presence of danger and brings about Year or anxiety to preserve the system. Memories with emotional significance are stored in the amygdala and are implicated in phobic responses. The thalamus relays sensory information to other brain centers. The hypothalamus is involved in regulation of the autonomic nervous system. The pituitary gland secretes regulatory hormones.

A client diagnosed with schizophrenia says to the nurse, "I do not need any treatment because there is nothing wrong with me, I am perfectly fine." The nurse recognizes that the client is experiencing what symptom? 1. Delusions 2. Anosognosia 3. Hallucinations 4. Disorganized thinking

2. Anosognosia Rationale Clients diagnosed with schizophrenia often don't believe that they are ill, which leads to complications in treatment. Anosognosia is the inability for a person to recognize that he or she has an illness because of the illness itself Delusions and hallucinations are elements of a psychotic state in which the client has the inability to recognize reality and experiences alterations in perception. Disorganized thinking is a neurocognitive aspect of schizophrenia.

A client smiles broadly at the nurse and says, "Look at my clean teeth. I brushed them with scouring powder because the label said, 'It brightens and whitens everything."' Which term should the nurse include when documenting this encounter? 1. Circumstantiality 2. Concrete thinking 3. Poverty of speech 4. Associative looseness

2. Concrete thinking Rationale The nurse should document that the client is experiencing concrete thinking because the person is demonstrating an overemphasis on the specific details of the cleaner's claims. The client has an impairment in the ability to use abstract concepts that would allow him or her to understand the claim applies to only certain surfaces appropriate to the scouring powder product. Circumstantiality is a delay in getting to the point of communication because of unneeded details, so this client is not demonstrating circumstantiality. A client who demonstrates associative looseness has an impaired ability to make connections between threads of thought, resulting in haphazard and confused communication. The client does not use monosyllabic words or stop mi -sentence, so poverty of speech is not evident.

Panic attacks in Latin American individuals often involve which symptom? 1. Blushing 2. Fear of dying 3. Offensive verbalizations 4. Repetitive involuntary actions

2. Fear of dying Rationale Fear of dying is often involved in panic attacks in Latin Americans. Blushing may be related to social phobias in Japanese and Korean cultures. Offensive verbalizations are typically not seen in panic attacks. Repetitive involuntary actions are typically not seen in panic attacks.

Friends invite an adult diagnosed with type 2 diabetes to go on a mountain hike the following week. The client replies, "I can't go because I don't have any hiking shoes." In actuality, this adult Years difficulty with blood glucose management during strenuous activity. Which defense mechanism is evident in the adult's response? 1. Displacement 2. Rationalization 3. Passive aggression 4. Reaction formation

2. Rationalization Rationale The correct answer, rationalization, refers to justifying an action to satisfy the teller and the listener, which the client does by using hiking shoes as an excuse to mask the real reason for not going. Displacement is the transfer of emotions about a particular person, object, or situation to one that is nonthreatening. Passive aggression is the indirect and unassertive expression of aggression toward others. Reaction formation involves keeping unacceptable feelings or behaviors out of one's awareness by developing the opposite behavior or emotion.

In a clinical interview conducted at a community health care center, the nurses observe that a client diagnosed with schizophrenia is very sensitive and feels guilty about his or her previous actions. What is the appropriate nursing diagnosis for this client? 1. Impaired verbal communication 2. Risk for self-directed violence 3. Positive symptoms of schizophrenia 4. History of abuse as a child

2. Risk for self-directed violence Rationale Self-blaming, guilt, and extreme sensitivity are associated with self-directed violence in clients with schizophrenia. These symptoms do not suggest impaired verbal communication, which is characterized by dissociative ideas. These symptoms are negative symptoms; positive symptoms of schizophrenia include hallucinations and associative looseness. Schizophrenia is not associated with a history of child abuse.

Which intervention should the nurse include in the plan of care for all hospitalized clients experiencing psychotic episodes associated with schizophrenia? 1. Identifying theme of hallucinations 2. Suicide precautions per institution policies 3. Boundary setting to manage aggressiveness 4. Assessing for the presence of feelings of guilt

2. Suicide precautions per institution policies Rationale When the nurse works with patients with schizophrenia, four specific groups of symptoms may be evident. No one symptom is found in all cases but depression is almost always present. Suicide precautions are necessary to keep the client safe.

A client attempted suicide 3 days ago. When the nurse asks about the related events, the client says, "I don't want to think about that now, but maybe we could talk about it later." Which defense mechanism has the client used? 1. Repression 2. Suppression 3. Rationalization 4. Intellectualization

2. Suppression Rationale Defenses against anxiety can be adaptive or maladaptive. Suppression is a conscious, deliberate effort to avoid painful and anxiety-producing memories. Repression is an unconscious exclusion of unpleasant or unwanted experiences, emotions, or ideas from conscious awareness. In this scenario, the client is aware of the memory. Rationalization consists of justifying illogical or unreasonable ideas, actions, or feelings by developing acceptable explanations. Intellectualization is a process in which events are analyzed based on facts and without passion, rather than including feeling and emotion.

A client demonstrating delusional behavior is escalating as a result of increasing anxiety regarding his or her personal safety. Which action demonstrates that the client has an understanding of actions to de-escalate this anxiety? 1. The client retreats to his or her room accompanied by staff 2. The client asks that he or she be allowed to seclude themselves 3. The client engages in a group therapy session led by nursing staff 4. The client expresses the understanding that his or her safety is the primary nursing goal

2. The client asks that he or she be allowed to seclude themselves Rationale If anxiety escalates and the patient is losing control, least restrictive interventions (e.g., one-to-one therapy, last resort seclusion) are most appropriate. Self-seclusion is an example that the client understands how to manage his or her anxiety effectively. None of the other options demonstrate the necessary principles associated with anxiety de-escalation.

A nurse is working on a project to find the epidemiology of panic disorder in the Latin American community. Which signs should the nurse expect to observe in a client from this community experiencing a panic attack? Select all that apply. 1. The client fears offensive body odor. 2. The client has sensations of choking. 3. The client feels numbness or tingling. 4. The client has sensations of smothering. 5. The client attributes the attack to magic or witchcraft.

2. The client has sensations of choking. 3. The client feels numbness or tingling. 4. The client has sensations of smothering. Rationale The Latin American community experiences sensations of choking, numbness or tingling, and smothering, as well as Year of dying. In Japanese and Korean culture, people have a Year of offensive body odor. Other cultures may attribute the panic attack related to magic or witchcraft.

A nurse begins a therapeutic relationship with a client diagnosed with schizophrenia. The client has severe paranoia. Which comment by the nurse is most appropriate? 1. "Let's begin by talking about the goals you have for yourself." 2. "I understand that you have problems with Year and suspiciousness of others." 3. "As you get to know me better, I hope you will feel comfortable talking to me." 4. "I am part of your treatment team. Our goal is to help stabilize your symptoms."

3. "As you get to know me better, I hope you will feel comfortable talking to me." Rationale The nurse's statement that he or she hopes the client will become comfortable talking with him or her as the client is most appropriate. It addresses the client in a nonthreatening way. Asking someone with severe paranoia to make goals for him or herself could stimulate an increase in paranoid thinking. Directly addressing the client's problem with fear and suspicion will likely only increase the client's Year and suspicion, so this is not the most appropriate comment. Indicating that the nurse is personally a part of the treatment plan acts contrary to the best practice of avoiding placing the client-caregiver relationship at the center of the conversation, so this is not the most appropriate statement either.

The nurse performing an assessment of geriatric clients in a community health care center, suspects that one of the clients is demonstrating behaviors associated with schizophrenia. Which statement made by the client during the assessment supports the nurse's suspicion? 1. "Every morning I enjoy the humming of birds; it relaxes me." 2. "Every day my friends wait for me in front of my gate for our morning walk." 3. "Every day birds sing songs for me and spread flowers on the path where I walk." 4. "Everyone feels as if I am a burden to them; I would like to put an end to their problem."

3. "Every day birds sing songs for me and spread flowers on the path where I walk." Rationale Clients with schizophrenia may have delusions of grandiosity or self-importance and state false events related to them, like birds singing songs for them and spreading flowers on their path. The statement that every morning the client enjoys the humming of birds indicates that the client has no impaired perception and is able to connect with reality. The statement that every morning the client has friends waiting at the gate is typical of reality. The statement that everyone feels the client is a burden indicates that the client feels worthless and has suicidal intentions; however, this does not necessarily indicate schizophrenic symptoms.

Buspirone is prescribed for a client diagnosed with anxiety. Which instruction should the nurse provide to this client? 1. "Take this medication on an empty stomach." 2. "Take this medication only when you feel anxious." 3. "It will take 3 or more weeks for you to feel the full benefit." 4. "Avoid consuming aged cheese products while you are taking this medication."

3. "It will take 3 or more weeks for you to feel the full benefit." Rationale Buspirone is an alternative antianxiety medication that does not cause dependence, but 3 or more weeks are required for it to reach full effects. It should be taken with food. The drug may be used for long-term treatment and should be taken regularly. Aged cheese products should be avoided when taking MAOls (monoamine oxidase inhibitors).

Which statement made by a client describes a nonbizarre delusion? 1. "The trees are silver and gold." 2. "Elephants and tigers are chasing me." 3. "Someone is following me." 4. "I can fly."

3. "Someone is following me." Rationale Nonbizarre delusions are situations that occur in real life. "Someone is following me" describes a nonbizarre delusion. Silver and gold trees, being chased by elephants and tigers, and the ability to fly are not likely real-life situations.

Which situation is most likely to produce fear when encountered by any mentally healthy adult? 1. A large spider crawls along the kitchen wall. 2. An elevator stops between floors because of a power outage. 3. A gunman begins firing an assault weapon in a crowded mall. 4. A storm accompanied by heavy thunder and lightning lasts for over an hour.

3. A gunman begins firing an assault weapon in a crowded mall. Rationale Fear is a reaction to a specific danger, such as that presented by a gunman attacking at a mall. While all of the other situations may produce some level of anxiety or may produce Year in an adult who is not mentally healthy, a gunman in a crowded mall presents a scenario of imminent, specific danger. Spiders, stopped elevators, and thunderstorms may scare those who have specific phobias of these situations.

A client diagnosed with schizophrenia is most likely to experience which type of hallucination? 1. Visual 2. Tactile 3. Auditory 4. Olfactory

3. Auditory Rationale Clients diagnosed with schizophrenia may experience hallucinations arising out of any of the senses; however, 60 percent of people with schizophrenia experience auditory hallucinations at some time during their lives. Visual hallucinations are more commonly associated with substance abuse and withdrawal. Tactile and olfactory hallucinations are rare.

Which statement is true regarding obsessive-compulsive disorder (OCD)? 1. Behaviors suggestive of OCD usually begin in infancy. 2. Hospitalization is often necessary for persons diagnosed with OCD. 3. Clients diagnosed with OCD should be assessed regularly for risk for suicide. 4. Compulsions are repetitive thoughts, whereas obsessions are ritualistic behaviors.

3. Clients diagnosed with OCD should be assessed regularly for risk for suicide. Rationale People suffering from OCD may become desperate and attempt suicide. Risk for suicide should be assessed regularly in these clients. Obsessive-compulsive disorder can begin in childhood, with symptoms present as early as age 3, but symptoms would not be expected in infancy. People with obsessive-compulsive disorders rarely need hospitalization unless they are suicidal or have compulsions that cause injury. Compulsions are ritualistic behaviors an individual feels driven to perform in an attempt to reduce anxiety. Obsessions are thoughts, impulses, or images that persist, recur, and cannot be dismissed from the mind.

A client has recently been prescribed an antipsychotropic medication. Which assessment data should the nurse identify as a risk factor for the development of autonomic dysfunction? 1. Male 2. 23 years of age 3. Comorbid diagnosis of depression 4. Concomitant use of dantrolene

3. Comorbid diagnosis of depression Rationale Risk factors for the development of autonomic dysfunction include older age, female gender (3:2), and presence of a mood disorder. Dantrolene is a medication used as a muscle relaxant and is not considered a risk factor of autonomic dysfunction.

A teenager changes study habits to earn better grades after initially failing a test. What is the most likely cause of this behavioral change? 1. Altruism 2. Idealization 3. Normal anxiety 4. Acting-out behavior

3. Normal anxiety Rationale Normal anxiety is a healthy life force needed to carry out the tasks of living and striving toward goals. It prompts constructive actions. Altruism involves addressing stressors by meeting the needs of others. Idealization involves attributing exaggerated positive qualities to others. Acting-out behavior is a destructive coping style of lashing out at others.

What disorder is best described by an uninterrupted period of illness during which there is a major depressive, manic, or mixed episode, concurrent with symptoms that meet the criteria for schizophrenia? 1. Delusional disorder 2. Schizophreniform disorder 3. Schizoaffective disorder 4. Substance-induced psychotic disorder

3. Schizoaffective disorder Rationale Schizoaffective disorder is best described by an uninterrupted period of illness during which there is a major depressive, manic, or mixed episode, concurrent with symptoms that meet the criteria for schizophrenia. Delusional disorder involves nonbizarre delusions for at least one month. Schizophreniform disorder has the essential features that are exactly the same as those of schizophrenia. Substance-induced psychotic disorder is caused by the ingestion of or withdrawal from a substance.

A student nurse observes that a client compulsively looks at his or her reflection in the mirror. Based on the client's behavior, what is the most likely diagnosis the student nurse will expect the health care provider to make? 1. The client has panic disorder. 2. The client has hoarding disorder. 3. The client has body dysmorphic disorder. 4. The client has obsessive-compulsive disorder.

3. The client has body dysmorphic disorder. Rationale Body dysmorphic disorder is characterized by a preoccupation with an imagined defective body part. Client with body dysmorphic disorder often pay excessive attention to body parts that they imagine to be defective. As a result, they may compulsively look at themselves in mirrors. Clients with panic disorder may have an unusual Year of future events. In hoarding disorder, the client accumulates and collects materials for future use. Obsessive-compulsive disorder is marked by performing repeated activities or rituals.

What population is most at risk for schizophrenia spectrum disorders? 1. Middle age adults 2. Older adults 3. Young adults 4. Toddlers

3. Young adults Rationale The schizophrenia spectrum disorders are devastating brain diseases that target young people in their teens or early twenties at the beginning of their productive lives. Middle age and older adults are less at risk. It is rarely evidenced in childhood.

Which scenario presents the most accurate example of altruism? 1. After recovering from a gunshot wound, a police officer attends a local support group. 2. After recovering from open-heart surgery, an individual plays tennis three times a week. 3. An individual with a longstanding fear of animals volunteers at a community animal shelter. 4. An individual who received a liver transplant volunteers at a local organ procurement agency.

4. An individual who received a liver transplant volunteers at a local organ procurement agency. Rationale Altruism is a healthy defense mechanism in which emotional conflicts and stressors are addressed by meeting the needs of others. With altruism, the person receives gratification either vicariously or from the response of others. Volunteering at a local organ procurement agency after receiving an organ transplant meets the needs of others. Attending a support group, playing tennis, and volunteering at an animal shelter to address one's own fears are all examples of meeting the individual's needs, but they are not necessarily altruistic.

Which therapeutic modality helps a client view a disturbing occurrence in a more positive light? 1. Exposure 2. Desensitization 3. Response prevention 4. Cognitive restructuring

4. Cognitive restructuring Rationale The purpose of cognitive restructuring is to change the individual's negative view of an event or a situation to a view that remains consistent with the facts but that is more positive. Exposure and response prevention are useful in obsessive-compulsive disorder. Desensitization is useful in panic disorder.

What is the major distinction between fear and anxiety? 1. Fear is a universal experience; anxiety is neurotic. 2. Fear enables constructive action; anxiety is dysfunctional. 3. Fear is a psychological experience; anxiety is a physiological experience. 4. Fear is a response to a specific danger; anxiety is a response to an unknown source.

4. Fear is a response to a specific danger; anxiety is a response to an unknown source. Rationale Fear is a response to a specific danger; anxiety is a response to an unknown source. Fear and anxiety are both experienced to some degree in healthy individuals and may contribute to constructive action. Both Year and anxiety have psychological and physiological components.

Which symptom is commonly associated with panic attacks? 1. Fever 2. Apathy 3. Obsessions 4. Fear of impending doom

4. Fear of impending doom Rationale Panic attacks are associated with an extreme fear of impending doom. Fever, apathy, and obsessions are not typically associated with panic attacks.

What is an expected finding in a client displaying associative looseness? 1. Speaking in rhyme 2. Made-up words 3. Mimicking movements of another 4. Illogical thinking

4. Illogical thinking Rationale The expected findings in a client displaying associative looseness include illogical thinking. Clang associations are the meaningless rhyming of words. A neologism is a made-up word that has special meaning to the client. Mimicking movements of another is known as echopraxia.

A client is running from chair to chair in the solarium. The client is wide-eyed and keeps repeating, "They are coming! They are coming!" The client neither follows staff direction nor responds to verbal efforts to calm him or her. The nurse assesses the client's anxiety at which level? 1. Mild 2. Moderate 3. Severe 4. Panic

4. Panic Rationale Panic-level anxiety results in markedly disorganized, disturbed behavior, including confusion, shouting, and hallucinating. Individuals may be unable to follow directions and may need external limits to ensure safety. Mild, moderate, and severe levels of anxiety typically do not include such extreme behavior.

Which behavior would be characteristic of an individual who is displaying passive aggression? 1. Lying 2. Stealing 3. Slapping 4. Procrastinating

4. Procrastinating Rationale A passive-aggressive person deals with emotional conflict by indirectly and unassertively expressing aggression toward others. Procrastination is an expression of resistance. Lying, stealing, and slapping are direct aggressions.

A client experiencing an inability to recognize reality is exhibiting which symptom? 1. Sensory perceptions 2. Schizophrenia 3. Hallucinations 4. Psychosis

4. Psychosis Rationale A client who is experiencing an inability to recognize reality is exhibiting psychosis. All individuals experience sensory perceptions. Schizophrenia is a diagnosis not a symptom. Hallucinations are alterations in perceptions.

The nurse caring for a client experiencing a panic attack expects the health care provider to prescribe an immediate dose of which type of medication? 1. Anticholinergic medication 2. Standard antipsychotic medication 3. Tricyclic antidepressant medication 4. Short-acting benzodiazepine medication

4. Short-acting benzodiazepine medication Rationale A short-acting benzodiazepine is the only type of medication listed that would lessen the patient's symptoms of anxiety within a few minutes. Anticholinergics do not lower anxiety. Standard antipsychotic medication will lower anxiety but has a slower onset of action and the potential for more side effects. Tricyclic antidepressants have very little antianxiety effect and have a slow onset of action.

A client remains motionless for long periods of time and at times appears to be in a coma. How can this state be described? 1. Waxy flexibility 2. Active negativism 3. Automatic obedience 4. Stupor

4. Stupor Rationale Stupor refers to a state in which the catatonic client is motionless for long periods and may even appear to be in a coma. Waxy flexibility is excessive maintenance of unusual postures for long periods of time. In active negativism, clients do the opposite of what they are told to do. Automatic obedience is the performance by a catatonic client of all simple commands in a robot-like fashion.

What is the leading cause of premature death in clients diagnosed with schizophrenia? 1. HIV 2. Obesity 3. Substance abuse 4. Suicide

4. Suicide Rationale Suicide is the leading cause of death in the population diagnosed with schizophrenia. HIV is double the rate of the general population and contributes to the morbidity and mortality of the clients diagnosed with schizophrenia. Obesity and substance use disorder are also higher in the schizophrenic population and most certainly contribute to the comorbidities and mortality.

Which side effect of antipsychotic medication therapy is generally irreversible? 1. Anticholinergic effects 2. Pseudoparkinsonism 3. Dystonic reaction 4. Tardive dyskinesia

4. Tardive dyskinesia Rationale Tardive dyskinesia is not always reversible with discontinuation of the medication and has no proven cure. The side effects in anticholinergic effects, pseudoparkinsonism, and dystonic reaction often appear early in therapy and can generally be minimized with appropriate treatment.

A client believes the thoughts of others are being put into the client's mind. What type of delusion is this client experiencing? 1. Thought withdrawal 2. Thought broadcasting 3. Thought control 4. Thought insertion

4. Thought insertion Rationale A client who believes the thoughts of others are being put into his or her mind is experiencing thought insertion. Thought withdrawal is a belief that one's thoughts have been removed by an outside agency. Thought control can be categorized under delusions of being controlled, which is a belief that one's body or mind is controlled by an outside agency. Thought broadcasting is a belief that others can hear one's thoughts.