Psych: Quiz Reviews

An acutely depressed client is receiving cognitive-behavioral therapy. The nurse is developing a plan of care for the client and includes interventions that focus on this type of therapy. Which of the following interventions would the nurse include? Select all that apply. a. Assisting the client to rehearse new cognitive and behavioral responses b. Assisting the client with the administration of antidepressant medications c. Assisting the client to develop alternative thinking patterns d. Assisting the client's family to participate in group therapy on a regular basis e. Assisting the client to participate in the treatment process f. Assisting the client to identify and test negative cognition

A. C. E. F.

The nurse is talking with a male client who is actively hallucinating. The client is fearful that the voices he hears will direct him to kill himself or will hurt him directly. Which of the following nursing statements would be therapeutic at this time? a. "I don't hear them, but it must be frightening to hear voices that others can't hear." b. "I can hear the voices too, but they are telling you to go to bed now." c. "I know whose voices you are hearing and told them not to hurt you." d. "I know you believe they are going to cause you harm, but it's not true."

a. "I don't hear them, but it must be frightening to hear voices that others can't hear."

The nurse is preparing a client for discharge who was hospitalized following a suicide attempt. The nurse evaluates that the client could benefit from further development of coping strategies if the client was overheard making which of the following statements prior to discharge? a. "I know that I won't become depressed again after the treatment I received here." b. "I know now that I can't be all things to all people all the time." c. "It's been good to learn better ways to deal with the stresses in my life." d. "It is important for me to take my medications just as prescribed."

a. "I know that I won't become depressed again after the treatment I received here."

A voluntarily hospitalized patient tells the nurse, "Get me the forms for discharge against medical advice so I can leave now." What is the nurse's best initial response? a. "I will get them for you, but let's talk about your decision to leave treatment." b. "Since you signed your consent for treatment, you may leave if you desire." c. "I'll get the forms for you right now and bring them to your room." d. "I can't give you those forms without your health care provider's knowledge."

a. "I will get them for you, but let's talk about your decision to leave treatment."

The nurse has been caring for a client with a diagnosis of depression. The client says to the nurse, "I wish you would just be my friend." The appropriate response by the nurse is: a. "Our relationship is a therapeutic and helping one." b. "You have plenty of friends. You don't need me to be your friend, too." c. "I am your friend." d. "I can't be your friend. I'm the nurse, and you're the client."

a. "Our relationship is a therapeutic and helping one."

A client with a potential for violence is exhibiting aggressive gestures, making belligerent comments to the other clients, and is continuously pacing in the hallway. Which of the following comments by the nurse would be therapeutic at this time? a. "What is causing you to become agitated?" b. "Why are you intent on upsetting the other clients?" c. "Please stop so I don't have to put you in seclusion." d. "You are going to be restrained if you do not change your behavior."

a. "What is causing you to become agitated?"

Two students fail their introductory nursing course. One student plans to seek tutoring and retake the course next fall. The second student attempts suicide. Which of the following factors would have been influential in the development of the second student's crisis? a. A lack of adequate coping mechanisms b. The individual's family birth order c. The time of year in which the event occurred d. The presence of support systems

a. A lack of adequate coping mechanisms

A client who attempted suicide by hanging is brought to the emergency department by emergency medical services. The immediate nursing action is which of the following? a. Assess the client's respiratory status and for the presence of neck injuries. b. Call the mental health crisis team and notify them that a client who attempted suicide is being admitted to the hospital. c. Take the client's vital signs. d. Perform a focused assessment, paying particular attention to the client's neurological status.

a. Assess the client's respiratory status and for the presence of neck injuries.

A nurse with a history of narcotic dependence is found unconscious in the hospital locker room after overdosing. The nurse is transferred to the inpatient chemical dependence unit for care. Which attitudes or behaviors by nursing staff may be enabling? a. Conveying understanding that pressures associated with nursing practice underlie substance abuse. b. Pointing out that work problems are the result, but not the cause, of substance dependence. c. Conveying empathy when the nurse discusses fears of disciplinary action by the state board of nursing. d. Providing health teaching about stress management.

a. Conveying understanding that pressures associated with nursing practice underlie substance abuse

When a patient with a personality disorder uses manipulation to get his or her needs met, the staff decides to apply limit-setting interventions. What is the correct rationale for this action? a. External controls are necessary while internal controls are developed. b. It respects the patient's wishes so assertiveness will develop. c. It provides an outlet for feelings of anger and frustration. d. Anxiety is reduced when staff members assume responsibility for the patient's behavior.

a. External controls are necessary while internal controls are developed.

A client is taking a monoamine oxidase inhibitor (MAOI). The nurse assesses the client closely because: a. Headache, hypertension, and nausea and vomiting may indicate toxicity. b. Hypotension may indicate toxicity c. Hypotensive crisis may be precipitated by foods rich in tyramine and tryptophan. d. These medications increase the amount of MAOI in the liver.

a. Headache, hypertension, and nausea and vomiting may indicate toxicity.

Which of the following factors is most likely associated with more positive prognosis for autistic disorder? a. Language development/verbal IQ b. Family socioeconomic status c. Sibling order d. Physical development/performance IQ e. Presence of a seizure disorder

a. Language development/verbal IQ

A patient with catatonic schizophrenia exhibits little spontaneous movement and demonstrates waxy flexibility. Which patient's needs are of priority importance? a. Physiologic b. Safety and security c. Psychosocial d. Self-actualization

a. Physiologic

Which changes in brain biochemical function is most associated with suicidal behavior? a. Serotonin deficiency b. Gamma-aminobutyric acid deficiency c. Acetylcholine excess d. Dopamine excess

a. Serotonin deficiency

Which rationale best explains why a nurse should be aware of personal feelings while working with a family experiencing family violence? a. Strong negative feelings interfere with assessment and judgment. b. Self-awareness protects one's own mental health. c. Positive feelings promote the development of sympathy for patients. d. Strong positive feelings lead to underinvolvement with the victim.

a. Strong negative feelings interfere with assessment and judgment.

The nurse is assisting in developing a plan of care for a client with a psychotic disorder who is experiencing altered thought processes that include the belief that the food is being poisoned. The nurse develops strategies that will encourage the client to discuss feelings and plans to: a. Use open-ended questions and silence. b. Focus on the fact that the client's beliefs are untrue. c. Focus on the components of adequate nutrition. d. Instruct the client about the need for adequate nutrition.

a. Use open-ended questions and silence.

An older adult patient in the intensive care unit has visual and auditory illusions. Which intervention will be most helpful? a. Use the patient's glasses and hearing aids. b. Keep the room brightly lit at all times. c. Place large clocks and calendars on the wall. d. Place personally meaningful objects in view

a. Use the patient's glasses and hearing aids.

The assumption most useful to a nurse planning crisis intervention for any patient is that the patient: a. is experiencing a state of disequilibrium. b. has a high potential for self-injury. c. poses a threat of violence to others. d. is experiencing a type of mental illness.

a. is experiencing a state of disequilibrium.

A patient with schizophrenia anxiously says, "I can see the left side of my body merging with the wall, then my face appears and disappears in the mirror." While listening, the nurse should: a. maintain a normal social interaction distance from the patient. b. sit close to the patient. c. place a hand on the patient's arm and exert light pressure. d. place an arm protectively around the patient's shoulders.

a. maintain a normal social interaction distance from the patient.

A client admitted to the inpatient unit is being considered for electroconvulsive therapy (ECT). The client is calm, but the client's daughter is hypervigilant and anxious. The daughter says to the nurse, "My mother's brain will be shocked with electricity. How can the doctor even think about doing this to her?" Which of the following responses by the nurse would be therapeutic? a. "I think you need to speak directly to the psychiatrist." b. "It sounds as though you are very concerned about the procedure. Let's discuss the procedure." c. "Maybe you'll feel better if you see the ECT room and speak to the staff." d. "Your mother has decided to have this treatment. You should support her."

b. "It sounds as though you are very concerned about the procedure. Let's discuss the procedure."

An emergency department nurse assesses a child with a fractured ulna. The nurse also observes yellow and purple bruises across the child's back and shoulders. Which comment by the parents should prompt the nurse to consider making a report to Child Protective Services? a. "We do not believe in immunization of our children." b. "This child is always creating problems for the family." c. "Our child would rather play alone than with other children." d. "We home-school our children in order to include religious education."

b. "This child is always creating problems for the family."

An acutely violent patient with schizophrenia receives several doses of haloperidol (Haldol). Two hours later the nurse notices the patient's head rotated to one side in a stiffly fixed position; the lower jaw is thrust forward, and the patient is drooling. Which intervention by the nurse is indicated? Select one: a. Reassure the patient that the symptoms will subside. Practice relaxation exercises with the patient. b. Administer diphenhydramine (Benadryl) 50 mg IM from the PRN medication administration record. c. Administer atropine sulfate 2 mg subcut from the PRN medication administration record. d. Give trihexyphenidyl (Artane) 5 mg orally at the next regularly scheduled medication administration time.

b. Administer diphenhydramine (Benadryl) 50 mg IM from the PRN medication administration record.

A patient diagnosed with disorganized schizophrenia says, "It's beat. Time to eat. No room for that cat." What type of verbalization is evident? a. Thought broadcasting b. Associative looseness c. Idea of reference d. Neologism

b. Associative looseness

A patient admitted yesterday for injuries sustained while intoxicated believes the window blinds are snakes trying to get into the room. The patient is anxious, agitated, and diaphoretic. Which medication can the nurse anticipate the health care provider will prescribe? a. Monoamine oxidase inhibitor, such as phenelzine (Nardil) b. Benzodiazepine, such as lorazepam (Ativan) c. Narcotic analgesics, such as morphine d. Phenothiazine, such as thioridazine (Mellaril)

b. Benzodiazepine, such as lorazepam (Ativan)

The nurse is told that the result of a serum carbamazepine (Tegretol) level for a client who is receiving the medication for the control his mood swings is 10mcg/mL. Based on this laboratory result, the nurse anticipates that the physician will prescribe: a. A decrease of the dosage of the medication b. Continuation of the presently prescribed dosage c. Discontinuation of the medication d. An increase of the dosage of the medication

b. Continuation of the presently prescribed dosage

The nurse is describing medication side effects to a client who is taking a benzodiazepine. The nurse tells the client to take the medication only as prescribed because of the most serious risk of: Select one: a. Headache b. Dependence c. Skin rashes d. Gastrointestinal side effects

b. Dependence

The nurse is working with a client who shows signs of benzodiazepine withdrawal. The nurse suspects that the client has suddenly discontinued taking which of the following prescribed medications? Select one: a. Fluoxetine (Prozac) b. Diazepam (Valium) c. Sertraline (Zoloft) d. Haloperidol (Haldol)

b. Diazepam (Valium)

An 11-year-old child is absent from school to care for siblings while the parents work. The family cannot afford a babysitter. When asked about the parents, the child reluctantly says, "My parents don't like me. They call me stupid and say I never do anything right." Which type of abuse is likely? a. Economic b. Emotional c. Sexual d. Physical

b. Emotional

A client who has sustained severe injuries in a motorcycle accident was diagnosed with intensive care unit (ICU) psychosis. The nurse would be most likely to conclude that the client's status is improving if the client: a. Keeps his eyes fixed on the nurses while they are working in the room but has stable vital signs b. Increases the number of hours slept at one time and is increasingly alert c. Appears to be delirious but has stopped trying to pull out the nasogastric tube d. Tells his wife, "I feel better, but the doctors want to give me a lethal injection."

b. Increases the number of hours slept at one time and is increasingly alert

The nurse is assigned to a client who is psychotic, pacing, agitated, and using aggressive gestures and rapid speech. The nurse determines that the priority of care at this time is which of the following? a. Assisting in caring for the client in a controlled environment, such as a quiet room b. Providing safety for the client and other clients on the unit c. Providing the other clients on the unit with a sense of comfort and safety by isolating the client d. Offering the client a less stimulated area in which to calm down and gain control

b. Providing safety for the client and other clients on the unit

A patient begins therapy with a phenothiazine medication. What teaching should a nurse provide related to the drug's strong dopaminergic effects? a. Chew sugarless gum. b. Report muscle stiffness. c. Arise slowly from bed. d. Increase dietary fiber.

b. Report muscle stiffness.

A nurse in the emergency department is preparing to care for a female client who has just been sexually assaulted. Which of the following client behaviors would demonstrate denial? a. The client is blaming her sister for the incident. b. The client is calm and quiet. c. The client is justifying unacceptable self-behaviors. d. The client is verbalizing generalizations about the incident.

b. The client is calm and quiet.

With conventional (typical) antipsychotics, the higher the potency, Select one: a. The lower the risk for EPS b. The higher the risk of EPS c. The lower the risk for dystonia d. the higher the risk for sedation

b. The higher the risk of EPS

Which referral is most appropriate for a woman who is severely beaten by her husband, who has no relatives or friends in the community, is afraid to return home, and has limited financial resources? a. Law enforcement b. Women's shelter c. Support group d. Vocational counseling

b. Women's shelter

When assessing a patient who has ingested flunitrazepam (Rohypnol) also known as roofies, the nurse would expect: a. hallucinations b. anterograde amnesia c. hypothermia d. acrophobia

b. anterograde amnesia

Psychotherapy involves all below except Select one: a. neural plasticity b. appropriate medications c. a therapeutic relationship

b. appropriate medications

A patient has a history of physical violence against family members when frustrated and then experiences periods or remorse after each outburst. Which finding indicates success in the plan of care? The patient: a. agrees to seek counseling. b. expresses frustration verbally instead of physically c. explains the rationale for behaviors to the victim. d. identifies three personal strengths.

b. expresses frustration verbally instead of physically

Which personality characteristic is a nurse most likely to assess in a patient with anorexia nervosa? a. high spirits and optimism b. rigidity, perfectionism c. carefree flexibility d. open displays of emotion

b. rigidity, perfectionism

A nurse uses the SAD PERSONS scale to interview a patient. This tool provides data relevant to: Select one: a. level of anxiety. b. suicide potential. c. mood disturbance. d. current stress level.

b. suicide potential.

A victim of spousal violence comes to the crisis center seeking help. The nurse uses crisis intervention strategies that focus on: Select one: a. providing legal assistance b. supporting emotional security and reestablishing equilibrium c. promoting growth of the individual d. offering a long-term resolution of issues precipitating the crisis e. offering a long-term resolution of issues precipitating the crisis

b. supporting emotional security and reestablishing equilibrium

A client hates her mother because of childhood neglect.The nurse determines which client statement represents the use of the use of the defense mechanism of reaction formation? a. "My mother hates me." b. "My mom always loved my sister more than she loved me." c. "I have a very wonderful mother whom I love very much." d. "I don't like to talk about my relationship with my mother."

c. "I have a very wonderful mother whom I love very much."

A nurse has provided home care instructions to a patient taking lithium carbonate (Eskalith). Which patient statement indicates that the patient understands the prescribed regimen? Select one: a. "I am careful to avoid eating foods high in potassium." b. "I keep my medication next to the milk in the refrigerator so that I can remember to take it every day." c. "I make sure that my diet contains salt." d. "It is not difficult to restrict my water intake."

c. "I make sure that my diet contains salt."

Cognitive therapy was provided for a patient who frequently said, "I'm stupid." Which statement by the patient indicates the therapy was effective? Select one: a. "I always fail when I try new things." b. "I'm disappointed in my lack of ability." c. "Sometimes I do stupid things." d. "Things always go wrong for me."

c. "Sometimes I do stupid things."

The nurse is developing a care plan that will include goals that will help the client achieve an optimal level of functioning and appropriate resource utilization. When the nurse enters the client's room, the client asks the nurse, "Could you ask the physician to let me have a pass for the weekend?" The nursing response that assists the client in achieving these goals is: a. "When your doctor comes in, I will ask for a pass for the weekend." b. "I will call the doctor and find out if you can have a pass so that you can make your arrangements." c. "When the physician arrives on the unit, I will let him or her know that you have a question." d. "You can't have a pass for the weekend. You are not ready, and I'm sure that your doctor will say no."

c. "When the physician arrives on the unit, I will let him or her know that you have a question."

A client receiving long-term therapy with lithium carbonate (Lithobid) exhibits muscle tremors, confusion, vomiting, and diarrhea. The nurse anticipates that the results of the latest test of the serum lithium level will be between: a. 0 and 0.5 mEq/L b. 0.6 and 1.0 mEq/L c. 1.5 and 2.0 mEq/L d. 1.0 and 1.3 mEq/L

c. 1.5 and 2.0 mEq/L

A mental health nurse who has been meeting with a client with a diagnosis of post-traumatic stress disorder is in the termination phase of the nurse-client relationship. The nurse notes that the client has been quiet and withdrawn and interprets the client's behavior as: a. An inability of the client to terminate from the nurse b. An indication of the need for antidepressants c. A normal behavior that can occur during termination d. An indication of the need for additional therapy sessions

c. A normal behavior that can occur during termination

During a psychiatric assessment, the nurse observes a patient's facial expressions that are without emotion. The patient says, "Life feels so hopeless to me. I've been feeling sad for several months." How should the nurse document the patient's affect and mood? a. Affect depressed; mood flat. b. Affect and mood are incongruent c. Affect flat; mood depressed. d. Affect labile; mood euphoric.

c. Affect flat; mood depressed.

The nurse in the pediatric unit is admitting a 2-year-old child. The nurse plans care, knowing that the child is in which stage of Erikson's psychosocial stages of development? Select one: a. Trust versus mistrust b. Industry versus inferiority c. Autonomy versus shame and doubt d. Initiative versus guilt

c. Autonomy versus shame and doubt

What is the priority intervention for a patient with delirium who has fluctuating levels of consciousness, disturbed orientation, and perceptual alterations? a. Avoidance of physical contact b. Application of wrist and ankle restraints c. Careful observation and supervision d. High level of sensory stimulation

c. Careful observation and supervision

A client has been admitted to the inpatient psychiatric unit because the client has displayed violent behavior and is at risk for potentially harming others. Which of the following should the nurse avoid doing when caring for this client? a. Arranging for a security officer to be available in the general area b. Admitting the client to a room near the nurses' station c. Closing the door to the client's room when giving care to the client d. Facing the client while speaking and providing nursing care

c. Closing the door to the client's room when giving care to the client

Which nursing diagnosis would most likely apply to both a patient with depression and one with acute mania? a. Defensive coping b. Deficient diversional activity c. Disturbed sleep pattern d. Fluid volume excess

c. Disturbed sleep pattern

Which nursing diagnosis would likely apply to both patients with paranoid schizophrenia and patients with amphetamine-induced psychosis? a. Impaired oral mucous membrane b. Ineffective thermoregulation c. Disturbed thought processes d. Powerlessness

c. Disturbed thought processes

A client has recently been diagnosed with mild to moderate NCD due to Alzheimer's disease.Which medication would the nurse expect the physician to order for the client's cognitive impairment? Select one: a. Zaleplon (Sonata) b. Nortriptyline (Pamelor) c. Donepezil (Aricept) d. Quetiapine (Seroquel)

c. Donepezil (Aricept)

In preparing for the orientation phase of the therapeutic relationship, the nurse suggests addressing which of the following subjects? Select one: a. Promoting problem solving skills in the client b. Promoting self-esteem in the client c. Establishing the parameters of the relationship d. Facilitating behavioral change

c. Establishing the parameters of the relationship

A patient tells the nurse, "My husband is abusive most often when he drinks too much. His family was like that when he was growing up. He always apologizes and regrets hurting me." What risk factor was most predictive for the husband to become abusive? a. Poverty b. Loss of employment c. History of family violence d. Abuse of alcohol

c. History of family violence

Which nursing diagnosis is written correctly? a. Conduct disorder related to childhood sexual abuse evidenced by hostile and aggressive behaviors. b. Low self-esteem related to major depressive disorder evidenced by childhood abuse. c. Imbalanced nutrition: less than body requirements related to suspiciousness evidenced by 20 lbs. weight loss. d. Risk for social isolation related to low self-esteem evidenced by staying in room during the day.

c. Imbalanced nutrition: less than body requirements related to suspiciousness evidenced by 20 lbs. weight loss.

A mental health nurse is assigned to care for a client with a diagnosis of undifferentiated schizophrenia with acute exacerbation. The nurse uses which of the following approaches when planning care for this client? Select one: a. Repeatedly point out inconsistencies in the client's communication during initial treatment. b. Let the client act out initially, and use the quiet room and restraints as needed. c. Provide assistance with grooming and nutrition until the client's thinking has cleared. d. Allow the client to set the goals for the plan of care.

c. Provide assistance with grooming and nutrition until the client's thinking has cleared.

Which belief by the nurse supports the highest degree of patient advocacy during a multidisciplinary patient care planning session? a. Schizophrenia and bipolar disorder are cross-cultural disorders. b. All mental illnesses are culturally determined. c. Some symptoms of mental disorders reflect a patient's cultural patterns. d. Symptoms of mental disorders are constant from culture to culture.

c. Some symptoms of mental disorders reflect a patient's cultural patterns.

The client admitted to the mental health unit with major depression 3 days ago could hardly get out of bed without coaxing and needed constant encouragement to get dressed and participate in unit activities. Today, the client appears in the dayroom dressed and well-groomed, without any guidance from the staff. The client appears to be calm and relaxed, yet more energetic than before. The nurse should take which initial action after noting this client's behavior? a. Notify the staff of these observations at the team meeting, which will begin in 3 hours. b. Continue to monitor the client's behavior from a distance. c. Speak to the client personally about the nurse's observations, and ask if the client is thinking about suicide. d. Document that the client is adapting to the unit and is feeling safe.

c. Speak to the client personally about the nurse's observations, and ask if the client is thinking about suicide.

An older adult patient takes digoxin and hydochlorothiazide daily, as well as lorazepam (Ativan) as needed for anxiety. Over 2 days, the patient developed confusion, slurred speech, an unsteady gait, and fluctuating levels of orientation. These findings are most characteristic of: a. dementia b. amnestic syndrome c. delirium d. Alzheimer's disease

c. delirium

A patient with schizophrenia has taken a conventional antipsychotic medication for a year. Hallucinations are less intrusive, but the patient continues to have apathy, poverty of thought, and social isolation. The nurse expects a change to which medication? a. chlorpromazine (Thorazine) b. haloperidol (Haldol) c. olanzapine (Zyprexa) d. diphenhydramine (Benadryl)

c. olanzapine (Zyprexa)

Goals and outcomes for an older adult patient with delirium caused by fever and dehydration will focus on: a. exerting control over responses to perceptual distortions b. demonstrating motor responses to noxious stimuli c. returning to premorbid levels of function d. identifying stressors negatively affecting self

c. returning to premorbid levels of function

A nursing student is conducting a clinical conference and is describing the characteristics associated with milieu therapy. Which of the following statements, if made by the student, indicates an understanding of the focus of this form of therapy? a. "A behavioral approach to changing behavior is the focus of milieu therapy." b. "Milieu therapy provides a behavior modification approach type of therapy." c. "Milieu therapy provides a cognitive approach to changing behavior." d. "A living, learning, or working environment is the focus of milieu therapy."

d. "A living, learning, or working environment is the focus of milieu therapy."

In the shift-change report, an off-going nurse criticizes a patient who wars heavy makeup. Which comment by the nurse who receives the report best demonstrates advocacy? a. "This is a psychiatric hospital. Craziness is what we are all about." b. "Your comments are inconsiderate and inappropriate. Keep the report objective." c. "Let's all show acceptance of this patient by wearing lots of makeup too." d. "Our patients need our help to learn behaviors that will help them get along in society."

d. "Our patients need our help to learn behaviors that will help them get along in society."

Which question has the highest priority when assessing a newly admitted patient with a history of alcohol abuse? a. "When did you decide to seek treatment?" b. "Has drinking caused you any problems?" c. "Have you ever had blackouts?" d. "When did you have your last drink?"

d. "When did you have your last drink?"

A nurse is having a conversation with a depressed client on an inpatient psychiatric unit. The client says to the nurse, "Things would be so much better for everyone if I just weren't around." Which of the following responses by the nurse would be appropriate at this time? a. "I know what you mean; everyone gets that way when they are depressed." b. "Those feelings will go away when your medication really takes effect." c. "Have you talked to anyone specifically about what is bothering you?" d. "You sound very unhappy. Are you thinking of harming yourself?"

d. "You sound very unhappy. Are you thinking of harming yourself?"

Methylphenidate (Ritalin) is prescribed for a child with a diagnosis of attention deficit hyperactivity disorder (ADHD). The nurse provides instructions to the mother regarding the administration of the medication and tells the mother to administer the medication: a. In the morning after breakfast and at bedtime. b. At the noontime and evening meals. c. Before dinner and at bedtime. d. Before breakfast and before the noontime meal

d. Before breakfast and before the noontime meal

When caring for a client who is experiencing a panic attack, which of the following nursing actions should be implemented? Select one: a. Instruct the client regarding unit rules and regulations. b. Leave the client alone to maintain privacy. c. Sit with the client in the day room to provide comfort d. Communicate with simple words and brief message

d. Communicate with simple words and brief message

During morning care, a nursing assistant asks a a patient with dementia, "How was your night?" The patient replies, "It was lovely. I went out to dinner and a movie with my friend." Which term applies to the patient's response? a. Sundown syndrome b. Perseveration c. Delirium d. Confabulation

d. Confabulation

A client is admitted to the psychiatric unit with a diagnosis of bipolar affective disorder and mania. The nurse would prioritize that which of the following symptoms or behaviors requires immediate intervention? a. Outlandish behaviors and wearing odd and eccentric clothing b. Constant, incessant talking, with sexual innuendoes c. Grandiose delusions of being a czar of Russia

d. Constant physical activity and poor oral intake

For the last year, a college student continually and unrealistically worries about academic performance and love life performance. The student is irritable and suffers from severe insomnia.This behavior is associated with which diagnosis? Select one: a. Agoraphobia b. Obsessive-Compulsive Disorder (OCD) c. Social Phobia Disorder d. Generalized Anxiety Disorder (GAD)

d. Generalized Anxiety Disorder (GAD)

Which communication technique is used more in crisis intervention than traditional counseling? a. Empathic listening b. Role modeling c. Giving direction Correct d. Information giving

d. Information giving

The nurse is preparing for the arrival of a new client at a drug abusers' residential treatment center and prepares to explain to the client that the emphasis of the center is on group and social interaction, and that rules and expectations are mediated by peer pressure. The most likely focus of therapy of this residential center is: Select one: a. Aversion conditioning b. Systematic desensitization c. Cognitive-behavioral therapy d. Milieu therapy

d. Milieu therapy

Select the nursing intervention necessary after administering naloxone (Narcan) to a patient with an opiate overdose. a. Insert an indwelling urinary catheter. b. Insert a nasogastric tube and test gastric pH. c. Treat hyperpyrexia with cooling measures. d. Monitor the airway and vital signs every 15 minutes.

d. Monitor the airway and vital signs every 15 minutes.

Which intervention is appropriate to use for patients with either delirium or dementia? Select one: a. Touch the patient before speaking. b. Speak in a loud, firm voice. c. When the patient becomes aggressive, use physical restraint instead of medication. d. Reintroduce the health care worker at each contact.

d. Reintroduce the health care worker at each contact.

The client who is diagnosed with a borderline personality is admitted to the psychiatric unit. Based on a thorough understanding of personality disorders, the nurse would select which nursing diagnosis as the priority? a. Social isolation b. Chronic low self-esteem c. Ineffective coping d. Risk for self-mutilation

d. Risk for self-mutilation

A person intentionally overdoses on antidepressant drugs. Which nursing diagnosis has the highest priority? a. Social isolation b. Powerlessness c. Compromised family coping d. Risk for suicide

d. Risk for suicide

Which principle should guide the nurse in determining the extent of silence to use during patient interview sessions? a. Silence helps patients know that what they have said is understood. b. Nurse are responsible for breaking silences. c. Patients withdraw if silences are prolonged. d. Silence provides meaningful moments for reflection.

d. Silence provides meaningful moments for reflection.

The goal for a patient is to increase resiliency. Which outcome should a nurse add to the plan of care? Within 3 days, the patient will: a. meet own needs without considering the rights of others. b. describe feelings associated with loss and stress. c. allow others to assume responsibility for major areas of own life. d. identify healthy coping behaviors in response to stressful events.

d. identify healthy coping behaviors in response to stressful events.

The following patients are seen in the emergency department. Which of the following patients meets the severity of illness and intensity of care required for the admitting officer to recommend admission to the psychiatric unit? The patient who: a. experiencing dry mouth and tremor related to side effects of haloperidol (Haldol) b. who self inflicted a superficial cut on the forearm after a family argument. c. experiencing anxiety and a sad mood after a separation from a spouse of 10 years. d. who is a single parent and hears voices saying, "Smother your infant."

d. who is a single parent and hears voices saying, "Smother your infant."