review questions pt 2

A client with depression and substance abuse has an interrupted sleep pattern and demands a sedative. Which teaching would the nurse provide about sedative-hypnotics? 1. "Sedative-hypnotics are potentially addictive and gradually lose their effectiveness as one builds up tolerance to them." 2. "Sedative-hypnotics work best in combination with other techniques." 3. "Sedative-hypnotics are not permitted for use in clients with substance abuse disorders." 4. "Sedative-hypnotics are not as effective as the antidepressant medications for treating sleep disturbances."

1

A client with schizophrenia has recently begun a new medication, clozapine (Clozaril). Which potentially fatal side effect will the nurse teach the client about? 1. Agranulocytosis 2. Akathisia 3. Pseudoparkinsonism 4. Akinesia

1

A client diagnosed with alcohol use disorder experiences a first relapse. During an Alcoholics Anonymous (AA) meeting, another group member states, "I relapsed three times, but now have been sober for 15 years." Which of Yalom's therapeutic factors does this illustrate? 1. Imparting of information 2. Instillation of hope 3. Catharsis 4. Universality

2

Which of the following characteristics should be included in a therapeutic nurse-client relationship? (Select all that apply.) 1. Meeting the psychological needs of the nurse and the client 2. Ensuring therapeutic termination 3. Promoting client insight into problematic behavior 4. Collaborating to set appropriate goals 5. Meeting both the physical and psychological needs of the client

2,3,4,5

_______________________ is a diffuse apprehension that is vague in nature and is associated with feelings of uncertainty and helplessness.

Anxiety

_______________________ is a subjective state of emotional, physical, and social responses to the loss of a valued entity.

Grief

______ refers to a nurse's behavioral and emotional response to a client. These responses may be related to unresolved feelings toward significant others from the nurse's past.

countertransference

____________________ is the study of the biological foundations of cognitive, emotional, and behavioral processes.

psychobiology

The term _______ implies special feelings on the part of both the client and the nurse, based on acceptance, warmth, friendliness, common interest, a sense of trust, and a nonjudgmental attitude.

rapport

The junction between two neurons is called a ____________________.

synapse

The nurse would associate the fight-or-flight response with which neurotransmitter? 1. Acetylcholine 2. Dopamine 3. Serotonin 4. Norepinephrine

4

A client is taking a monoamine oxidase inhibitor (MAOI). When teaching the client about diet, which foods will the nurse caution the client to avoid? 1. Pepperoni pizza and red wine 2. Bagels with cream cheese and tea 3. Apple pie and coffee 4. Potato chips and diet cola

1

A health-care provider prescribes computerized electroencephalography mapping for a client with suspected schizophrenia. Which statement made by the client accurately describes the procedure? 1. "Electrodes will be placed on my scalp and measure and mark waves of activity in my brain." 2. "X-rays will be taken to detect any lesions I might have in my brain." 3. "This test will use magnetic imaging and show if I have any swelling in my brain." 4. "After receiving an injection of a radioactive substance, an image will measure brain functioning and produce an image."

1

A nurse would expect that an increase in dopamine activity might play a significant role in the development of which mental illness? 1. Schizophrenia spectrum disorder 2. Major depressive disorder 3. Tourette syndrome 4. Parkinson's disease

1

A psychiatric nurse intern states, "This client's use of defense mechanisms should be eliminated." Which is a correct evaluation of this nurse's statement? 1. Defense mechanisms can be appropriate responses to stress and need not be eliminated. 2. Defense mechanisms are a maladaptive attempt of the ego to manage anxiety and should always be eliminated. 3. Defense mechanisms, used by individuals with weak ego integrity, should be discouraged and not completely eliminated. 4. Defense mechanisms cause disintegration of the ego and should be fostered and encouraged.

1

During a community meeting, a nurse encourages clients to present unit problems and discuss possible solutions. Which type of leadership style is the nurse demonstrating? 1. Democratic 2. Autocratic 3. Laissez-faire 4. Bureaucratic

1

During a group discussion, members freely interact with each other. Which member statement is an example of Yalom's therapeutic factor of imparting information? 1. "I found a Web site explaining the different types of brain tumors and their treatment." 2. "My brother also had a brain tumor and now is completely cured." 3. "I understand your fear and will be by your side during this time." 4. "My mother was also diagnosed with cancer of the brain."

1

During an inpatient educational group, a client shouts out, "This information is worthless. Nothing you have said can help me." These statements indicate to a nurse leader that the client is assuming which group role? 1. The group role of aggressor 2. The group role of initiator 3. The group role of gatekeeper 4. The group role of blocker

1

In the treatment of anxiety disorders, benzodiazepines (such as Ativan and Xanax) are indicated for ______ use and have a ______ abuse potential. 1. short-term; high 2. long-term; high 3. short-term; low 4. long-term; low

1

Logan, age 8 years, takes methylphenidate (Ritalin) for attention deficit/hyperactivity disorder. His mother reports to the nurse that Logan has a very poor appetite, and she struggles to help him gain weight. Which teaching will the nurse provide? 1. Administer Logan's medication immediately after meals. 2. Give Logan's medication at bedtime. 3. Skip a dose of the medication when Logan does not eat anything. 4. Assure Logan's mother that Logan will eat when he is hungry.

1

To which client would the nurse most likely administer a benzodiazepine? 1. One with alcohol withdrawals 2. One taking cough medicine 3. One with schizophrenia 4. One taking opioid pain agents

1

Which client action would a nurse expect during the working phase of the nurse-client relationship? 1. The client gains insight and incorporates alternative behaviors. 2. The client establishes rapport with the nurse and mutually develops treatment goals. 3. The client explores feelings related to reentering the community. 4. The client explores personal strengths and weaknesses that impact behavioral choices.

1

Which client would the nurse instruct to obtain routine blood-level monitoring? 1. A client taking lithium 2. A client taking buspirone 3. A client taking chlorpromazine 4. A client taking paroxetine

1

Which is the most essential task for a nurse to accomplish prior to forming a therapeutic relationship with a client? 1. Clarify personal attitudes, values, and beliefs. 2. Obtain thorough assessment data. 3. Determine the client's length of stay. 4. Establish personal goals for the interaction.

1

Which mental illness would a nurse identify as being associated with an increase in prolactin level? 1. Depression 2. Psychosis 3. Anorexia nervosa 4. Alzheimer's disease

1

Which therapeutic communication technique is being used in the following nurse-client interaction?Client: "My father spanked me often."Nurse: "Your father was a harsh disciplinarian." 1. Restating 2. Offering general leads 3. Focusing 4. Accepting

1

Which type of touch is described as functional-professional? 1. A nurse performing an assessment 2. Shaking the hand of an acquaintance 3. A child laying their head on the mother's lap 4. Hugging a good friend and former coworker good-bye

1

The nurse is reviewing the DSM-5 definition of a mental health disorder and notes the definition includes a disturbance in which areas? (Select all that apply.) 1. Cognition 2. Physical 3. Emotional regulation 4. Behavior 5. Developmental

1, 3, 4, 5

The nurse is caring for a client who has been found to have decreased levels of thyroid-stimulating hormone (TSH). Which symptoms would like the client likely exhibit? (Select all that apply.) 1. Depression 2. Fatigue 3. Increased libido 4. Mania 5. Hyperexcitability

1,2

The nurse is preparing to assess a client before the physician prescribes a regimen of psychopharmacological therapy. Which components will the nurse assess? (Select all that apply.) 1. Medical history 2. Physical examination findings 3. Ethnocultural characteristics 4. Current medication 5. Marital status

1,2,3,4

Which individuals are communicating a message? (Select all that apply.) 1. A mother spanking her son for playing with matches 2. A teenage boy isolating himself and playing loud music 3. A biker sporting an eagle tattoo on his biceps 4. A teenage girl writing, "No one understands me" 5. A father checking for new email on a regular basis

1,2,3,4

Which of the following information would a nurse include when explaining causes of anorexia nervosa to a client? (Select all that apply.) 1. There is a possible correlation between abnormal secretion of growth hormone and anorexia nervosa. 2. There is a possible correlation between antidiuretic hormone levels and anorexia nervosa. 3. There is a possible correlation between low levels of gonadotropin and anorexia nervosa. 4. There is a possible correlation between increased levels of prolactin and anorexia nervosa. 5. There is a possible correlation between high levels of oxytocin and anorexia nervosa.

1,3

A client diagnosed with posttraumatic stress disorder related to a rape is admitted to an inpatient psychiatric unit for evaluation and medication stabilization. Which therapeutic communication technique might a nurse use that is an example of "broad openings"? 1. "What occurred prior to the rape, and when did you go to the emergency department?" 2. "What would you like to talk about?" 3. "I notice you seem uncomfortable discussing this." 4. "How can we help you feel safe during your stay here?"

2

A client has been given a diagnosis of human immunodeficiency virus (HIV). Which statement made by the client does the nurse recognize as the bargaining stage of grief? 1. "I hate my partner for giving me this disease I will die from!" 2. "If I don't do intravenous (IV) drugs anymore, God won't let me die." 3. "I am going to support groups and learn more about the disease."4. "Can you please re-draw the test results, I think they may be wrong?"

2

A client was recently admitted to the inpatient unit after a suicide attempt and has not responded to SSRIs or tricyclic antidepressants. The client asks the nurse, "Why can't monoamine oxidase inhibitors (MAOIs) be added to what I am on now?" Which response should the nurse make? 1. "Electroconvulsive therapy is your best option at this point." 2. "Combined use can lead to a life-threatening condition called hypertensive crisis." 3. "There is no reason why an MAOI couldn't be added to your therapy." 4. "They can't be used together because their mechanisms of action are very different."

2

A client was recently admitted to the inpatient unit after a suicide attempt and is prescribed a selective serotonin reuptake inhibitor (SSRI). Which sign or symptom would the nurse include in the teaching session about serotonin syndrome? 1. Constipation 2. Myoclonus 3. Hypothermia 4. Impotence

2

A mother rescues two of her four children from a house fire. The other two children die in the house fire. In an emergency department, she cries, "I should have gone back in to get them. I should have died, not them." What is the nurse's best response? 1. "The smoke was too thick. You couldn't have gone back in." 2. "You're experiencing feelings of guilt, because you weren't able to save your children." 3. "Focus on the fact that you could have lost all four of your children." 4. "It's best if you try not to think about what happened. Try to move on."

2

A nurse maintains an uncrossed arm and leg posture when communicating with a client. This nonverbal behavior is reflective of which letter of the SOLER acronym for active listening? 1. S 2. O 3. L 4. E

2

According to Maslow's hierarchy of needs, which situation on an inpatient psychiatric unit would require priority intervention by a nurse? 1. A client rudely complaining about limited visiting hours 2. A client exhibiting aggressive behavior toward another client 3. A client stating that no one cares 4. A client verbalizing feelings of failure

2

As part of discharge teaching, which guideline regarding lithium therapy will the nurse plan to include? 1. Avoid foods high in tyramine. 2. Maintain a consistent sodium intake. 3. Consume at least 3,000 to 3,500 mL of fluid per day. 4. Watch for signs of tardive dyskinesia.

2

At which point would the nurse determine that a client is at risk for developing a mental illness? 1. When thoughts, feelings, and behaviors are not reflective of the DSM-5 criteria. 2. When maladaptive responses to stress are coupled with interference in daily functioning. 3. When a client communicates significant distress. 4. When a client uses defense mechanisms as ego protection.

2

During a group session, which client statement demonstrates that the group has progressed to the middle, or working, phase of group development? 1. "It's hard for me to tell my story when I'm not sure about the reactions of others." 2. "I think Joe's Antabuse suggestion is a good one and might work for me." 3. "My situation is very complex, and I need professional, not peer, advice." 4. "I am really upset that you expect me to solve my own problems."

2

Six months after her husband and children were killed in a car accident, a client is diagnosed with ulcerative colitis. The nurse would recognize that this situation validates which study perspective? 1. Neuroendocrinology 2. Psychoneuroimmunology 3. Diagnostic technology 4. Neurophysiology

2

The client with schizophrenia has recently begun a new medication, clozapine (Clozaril). Which signs and symptoms of a potentially fatal side effect will the nurse teach the client about? 1. Blurring vision, dry mouth, and constipation 2. Sore throat, fever, and malaise 3. Tremor, shuffling gait, and rigidity 4. Fine tremor, tinnitus, and nausea

2

The nurse has just met a new client and is beginning to get to know to the client. Which would be the priority nursing action during this phase of the nurse-client relationship? 1. Acknowledge the client's actions and generate alternative behaviors. 2. Establish rapport and develop treatment goals. 3. Attempt to find alternative placement for the client. 4. Explore how thoughts and feelings about this client may adversely impact nursing care.

2

The nurse is building a therapeutic relationship with a client. During their interaction, the nurse feels the individual is not always honest or open during their interactions. Which characteristic would a nurse identify as missing? 1. Respect 2. Genuineness 3. Sympathy 4. Rapport

2

The physician prescribes an additional medication for a client taking an antipsychotic agent. The medication is to be administered "prn for EPS." When will the nurse plan to administer this medication? 1. When the client's white blood cell count falls below 3,000/mm3 2. When the client exhibits tremors and a shuffling gait 3. When the client reports having a dry mouth 4. When the client experiences a seizure

2

When used in combination with anxiolytic medication, alcohol leads to ______ effects, and caffeine leads to ______ effects. 1. increased; increased 2. increased; decreased 3. decreased; decreased 4. decreased; increased

2

Which information should the nurse include in a staff education program about the history of psychopharmacology? 1. Some antipsychotic medications can cure mental illnesses. 2. Psychotropic medications are used as adjunctive therapy. 3. Antidepressants were the first type of mental health drugs. 4. Mood stabilizers help eliminate bipolar mental disorders.

2

Which information should the nurse share with the client about tricyclic antidepressant medications? 1. Strong or aged cheese should not be eaten while taking them. 2. Their full therapeutic potential may not be reached until 4 weeks. 3. They may cause hypomania or recent memory impairment. 4. They should not be given with antianxiety agents.

2

Which neurotransmitters would a nurse expect to be elevated in a client with a diagnosis of catatonic schizophrenia? 1. Serotonin 2. Dopamine 3. Gamma-aminobutyric acid (GABA) 4. Histamine

2

Which nursing statement regarding the concept of psychosis is most accurate? 1. Individuals experiencing psychoses are aware that their behaviors are maladaptive. 2. Individuals experiencing psychoses experience little distress. 3. Individuals experiencing psychoses are aware of experiencing psychological problems. 4. Individuals experiencing psychoses are based in reality.

2

Which situation would a nurse identify as an example of an autocratic leadership style? 1. The president of Sigma Theta Tau assigns members to committees to research problems. 2. Without faculty input, the dean mandates that all course content be delivered via the Internet. 3. During a community meeting, a nurse listens as clients generate solutions. 4. The student nurses' association advertises for candidates for president.

2

Which would a nursing instructor describe to students as the "emotional brain"? 1. The cerebellum 2. The limbic system 3. The cortex 4. The left temporal lobe

2

Which describes a defense mechanism an individual may use to relieve anxiety in a stressful situation? (Select all that apply.) 1. Homework 2. Smoking 3. Itching 4. Nail biting 5. Sleeping

2, 4, 5

Which are biological implications of both bipolar disorder and panic disorder? (Select all that apply.) 1. Increased levels of dopamine 2. Increased levels of thyroid hormones 3. Decreased cortisol levels 4. Decreased GABA activity 5. Increased levels of norepinephrine

2,5

Place in order the Kübler Ross stages of grief from 1-5. (Enter the number of each step in the proper sequence, using comma and space format, such as: 1, 2, 3, 4.) 1. Bargaining 2. Denial 3. Acceptance 4. Depression 5. Anger

25143

A client began taking lithium for the treatment of bipolar disorder approximately 1 month ago and asks why he has gained 12 lbs. (5.4 kg.) since then. Which response by the nurse is appropriate? 1. "I'm surprised you have gained; weight loss is the typical pattern when taking lithium." 2. "Your weight gain is more likely related to food intake than medication." 3. "Weight gain is a common but troubling side effect. Let's talk about some strategies for safely improving your nutrition and exercise habits." 4. "There's not much you can do about the weight gain. It's better than being emotionally unstable, though."

3

A client diagnosed with schizophrenia is experiencing frequent hallucinations. What altered component of the nervous system would a nurse recognize as being responsible for this behavior? 1. Increase in serotonin 2. Decrease in histamine 3. Increase in dopamine 4. Decrease in acetylcholine

3

A client exhibiting dependent behaviors says, "Do you think I should move out of my parents' house and get a job?" Which nursing response is most appropriate? 1. "It would be best to do that in order to increase independence." 2. "Why would you want to leave a secure home?" 3. "Let's discuss and explore all of your options." 4. "I'm afraid you would feel very guilty leaving your parents."

3

A client who is being treated for chronic kidney disease complains to the health-care provider that he does not like the food available to him while hospitalized. The health-care provider insists that the client strictly adhere to the diet plan. What action can be expected is the client uses the defense mechanism of displacement? 1. The client assertively confronts the health-care provider. 2. The client insists on being discharged and goes for a long, brisk walk. 3. The client snaps at the nurse and criticizes the nursing care provided. 4. The client hides his anger by explaining the logical reasoning for the diet to his spouse.

3

A fourth-grade boy teases and makes jokes about a cute girl in his class. A nurse would recognize this behavior as indicative of which defense mechanism? 1. Displacement 2. Projection 3. Reaction formation 4. Sublimation

3

A nurse would identify which part of the nervous system as playing a major role during a stressful situation? 1. Peripheral nervous system 2. Somatic nervous system 3. Sympathetic nervous system 4. Parasympathetic nervous system

3

According to Maslow's hierarchy of needs, which client action would demonstrate the highest achievement in terms of mental health? 1. Maintaining a long-term, faithful, intimate relationship 2. Achieving a sense of self-confidence 3. Possessing a feeling of self-fulfillment and realizing full potential 4. Developing a sense of purpose and the ability to direct activities

3

An aging client with chronic schizophrenia takes a beta-adrenergic blocking agent (propranolol) for hypertension and an antipsychotic. Given the combined side effects of these drugs, what teaching should the nurse provide? 1. "Make sure you concentrate on taking slow, deep, cleansing breaths." 2. "Watch your diet and try to engage in some regular physical activity." 3. "Rise slowly when you change position from lying to sitting or sitting to standing." 4. "Wear sunscreen and try to avoid midday sun exposure."

3

An instructor is correcting a nursing student's clinical worksheet. Which instructor statement is the best example of effective feedback? 1. "Why did you use the client's name on your clinical worksheet?" 2. "You were very careless to refer to your client by name on your clinical worksheet." 3. "Surely you didn't do this deliberately, but you breached confidentiality by using names." 4. "It is disappointing that after being told you're still using client names on your worksheet."

3

Devastated by a divorce from an abusive husband, a wife completes grief counseling. Which statement by the wife would indicate to a nurse that the client is in the acceptance stage of grief? 1. "If only we could have tried again, things might have worked out." 2. "I am so mad that the children and I had to put up with him as long as we did." 3. "Yes, it was a difficult relationship, but I think I have learned from the experience." 4. "I have a difficult time getting out of bed most days."

3

During a therapeutic group, which nursing action demonstrates a laissez-faire leadership style? 1. The nurse requires that all group members reveal an embarrassing personal situation. 2. The nurse asks for a show of hands to determine group topic preference. 3. The nurse sits silently as the group members stray from the assigned topic. 4. The nurse shuffles through papers to determine the facility policy on length of group.

3

During an intake assessment, a nurse asks both physiological and psychosocial questions. The client angrily responds, "I'm here for my heart, not my head problems." Which is the nurse's best response?1. "It is just a routine part of our assessment. All clients are asked these same questions." 2. "Why are you concerned about these types of questions?" 3. "Psychological factors, like excessive stress, have been found to affect medical conditions." 4. "We can skip these questions, if you like. It isn't imperative that we complete this section."

3

Prayer group members at a local Baptist church are meeting with a poor, homeless family whom they are supporting. Which member statement is an example of Yalom's therapeutic factor of altruism? 1. "Social services might be able to help you find a job." 2. "The last time we helped a family, they got back on their feet and prospered." 3. "I can give you all of my baby clothes for your little one." 4. "I can appreciate your situation. I had to declare bankruptcy last year."

3

The client is diagnosed with anxiety disorder. Which medication would the nurse administer for anxiety? 1. Chlorpromazine (Thorazine) 2. Clozapine (Clozaril) 3. Diazepam (Valium) 4. Methylphenidate (Ritalin)

3

The nurse is assessing a client who has a diagnosis of schizophrenia and takes an antipsychotic agent daily. Which finding requires further nursing assessment immediately? 1. Respirations of 20 breaths/minute 2. Weight gain of 8 lbs. (3.6 kg.) in 2 months 3. Temperature of 101oF (38.3 oC) 4. Excess salivation

3

The nurse is caring for a client whose diagnosis has been linked to an abnormal secretion of growth hormone. Which illness does the client most likely have? 1. Acute mania 2. Schizophrenia 3. Anorexia nervosa 4. Alzheimer's disease

3

When planning group therapy, a nurse would identify which configuration as most optimal for a therapeutic group? 1. Open-ended membership; circle of chairs; group size of 5 to 10 members 2. Open-ended membership; chairs around a table; group size of 10 to 15 members 3. Closed membership; circle of chairs; group size of 5 to 10 members 4. Closed membership; chairs around a table; group size of 10 to 15 members

3

Which client statement reflects an understanding of circadian rhythms? 1. "When I dream about my mother's horrible train accident, I become hysterical." 2. "I get really irritable during my menstrual cycle." 3. "I'm a morning person. I get my best work done before noon." 4. "Every February, I tend to experience periods of sadness."

3

Which client statement would a nurse identify as a typical response to stress most often experienced in the working phase of the nurse-client relationship? 1. "I can't bear the thought of leaving here and failing." 2. "I might have a hard time working with you because you remind me of my mother." 3. "I really don't want to talk any more about my childhood abuse." 4. "I'm not sure that I can count on you to protect my confidentiality."

3

Which is an example of offering a "general lead" when interviewing a newly admitted psychiatric client? 1. "Do you know why you are here?" 2. "Are you feeling depressed or anxious?" 3. "Yes, I see. Go on." 4. "Can you order the specific events that led to your admission?"

3

Which medication would the nurse most likely administer to treat the extrapyramidal side effects of antipsychotic medications? 1. Diazepam (Valium) 2. Amitriptyline (Elavil) 3. Benztropine (Cogentin) 4. Methylphenidate (Ritalin)

3

Which therapeutic communication technique is being used in the following nurse-client interaction?Client: "When I am anxious, the only thing that calms me down is alcohol."Nurse: "Other than drinking, what alternatives have you explored to decrease anxiety?" 1. Encouraging comparison 2. Making observations 3. Formulating a plan of action 4. Giving recognition

3

A client diagnosed with major depressive disorder asks, "What part of my brain controls my emotions?" Which nursing response is appropriate? 1. "The occipital lobe governs perceptions, judging them as positive or negative." 2. "The parietal lobe has been linked to depression." 3. "The medulla regulates key biological and psychological activities." 4. "The limbic system is largely responsible for one's emotional state."

4

A client is admitted to an emergency department experiencing memory deficits and decreased motor function. What alteration in brain chemistry should a nurse correlate with the production of these symptoms? 1. Abnormal levels of serotonin 2. Decreased levels of histamine 3. Increased levels of norepinephrine 4. Decreased levels of acetylcholine

4

A client's wife of 34 years dies unexpectedly. The client cries often and becomes socially isolated. The client's therapist encourages open discussion of feelings, proper nutrition, and exercise. What is the best rationale for the therapist's recommendations? 1. The therapist recognizes the role of circadian rhythms in the client's condition. 2. The client has an alteration in neurotransmitters. 3. The therapist is attempting to increase the client's acetylcholine levels. 4. The client is susceptible to illness because of effects of stress on the immune system.

4

A female client takes a maintenance dosage of lithium carbonate for bipolar disorder. She has come to the community health clinic, stating that she "has had the flu for several days." She describes her symptoms as muscle weakness, coughing, headache, fever, and gastrointestinal upset. Her temperature is 100.9°F (38.3°C). Which situation does the nurse anticipate? 1. She has consumed some foods high in tyramine while taking lithium carbonate. 2. She has stopped taking her lithium carbonate. 3. She has probably developed a tolerance to the lithium carbonate. 4. She has signs and symptoms of toxicity from the lithium carbonate.

4

A newly admitted client, diagnosed with obsessive-compulsive disorder (OCD), washes his hands continually. This behavior prevents unit activity attendance. Which nursing statement best addresses this situation? 1. "Everyone diagnosed with OCD needs to control their ritualistic behaviors." 2. "It is important for you to discontinue these ritualistic behaviors." 3. "Why are you asking for help if you won't participate in unit therapy?" 4. "Let's figure out a way for you to attend unit activities and still wash your hands."

4

A nurse is assessing a client who experiences occasional feelings of sadness because of the recent death of a beloved pet. The client's appetite, sleep patterns, and daily routine have not changed. How would the nurse interpret the client's behaviors? a. The client's behaviors demonstrate mental illness in the form of depression. b. The client's behaviors are inappropriate, which indicates the presence of mental illness. c. The client's behaviors are not congruent with cultural norms. d. The client's behaviors demonstrate no functional impairment, indicating no mental illness.

4

A nurse is caring for a client with decreased norepinephrine levels. Which mental illness is the client most likely at risk for? 1. Bipolar disorder: mania 2. Schizophrenia 3. Generalized anxiety disorder 4. Major depressive episode

4

A nurse notes that a client is extremely withdrawn, delusional, and emotionally exhausted. The nurse assesses the client's anxiety as which level? 1. Mild anxiety 2. Moderate anxiety 3. Severe anxiety 4. Panic anxiety

4

A nurse says to a client, "Things will look better tomorrow after a good night's sleep." This is an example of which communication technique? 1. The therapeutic technique of giving advice 2. The therapeutic technique of defending 3. The nontherapeutic technique of presenting reality 4. The nontherapeutic technique of giving reassurance

4

A nursing instructor is teaching students about self-help groups like Alcoholics Anonymous (AA). Which student statement indicates that learning has occurred? 1. "There is little research to support AA's effectiveness." 2. "Self-help groups used to be the treatment of choice, but their popularity is waning." 3. "These groups have no external regulation, so clients need to be cautious." 4. "Members themselves run the group, with leadership usually rotating among the members."

4

A single, pregnant teenager in a parenting class discloses her ambivalence toward the pregnancy and the subsequent guilt that these thoughts generate. A mother of three admits to having felt that way herself. Which of Yalom's therapeutic factors does this illustrate? 1. Imparting of information 2. Instillation of hope 3. Altruism 4. Universality

4

An elderly client has been diagnosed with major depression and is prescribed a selective serotonin reuptake inhibitor (SSRI). Which side effect would the nurse monitor for in this client? 1. Diarrhea 2. Pseudoparkinsonism 3. Hypertensive crisis 4. Hyponatremia

4

During the sixth week of a 10-week parenting skills group, a nurse observes as several members get into a heated dispute about spanking. As a group, they decide to create a pros-and-cons poster on the use of physical discipline. At this time, which is the role of the group leader? 1. The leader would referee the debate. 2. The leader would adamantly oppose physical disciplining measures. 3. The leader would redirect the group to a less controversial topic. 4. The leader would positively reinforce the behavior of collective problem solving.

4

On which task would a nurse place highest priority during the working phase of relationship development? 1. Establishing a contract for intervention 2. Examining feelings about working with a particular client 3. Establishing a plan for continuing aftercare 4. Promoting the client's insight and perception of reality

4

The client is taking selective serotonin reuptake inhibitor (SSRI). Which finding indicates the client is having a therapeutic effect from the SSRI? 1. Psychosis is reduced. 2. Neuropathy pain is relieved. 3. Panic attacks are prevented. 4. Obsessions are controlled.

4

The client with schizophrenia has recently begun a new medication, clozapine (Clozaril). Which laboratory result would reveal a potentially fatal side effect of this medication? 1. Elevated white blood cell count 2. Elevated bleeding times 3. Low platelet count 4. Low absolute neutrophil count

4

The male client is experiencing a psychotic episode. He is in good physical health but has allergies to penicillin, prochlorperazine (Compazine), and bee stings. Which antipsychotic medication would be contraindicated for the client? 1. Haloperidol, because it is used only in elderly clients 2. Clozapine, because it is a typical, first generation antipsychotic 3. Risperidone, because it exacerbates symptoms of depression 4. Thioridazine, because of cross sensitivity among phenothiazines

4

The nurse is caring for a client who lost a child in a car accident. The client states she does not want to go on living. Which nursing statement conveys empathy for the client? 1. "This situation is very sad, but time is a great healer." 2. "You are sad, but you must be strong for your other children." 3. "Once you cry it all out, things will seem so much better." 4. "It must be horrible to lose a child, and I'll stay with you until your husband arrives."

4

The nurse is caring for an older male client who states, "You remind me so much of my late wife." During subsequent encounters with the client, he expresses overwhelming feelings of affection toward the nurse and states "I don't know what I would do if you weren't my nurse. No one cares for me like you do." How should the nurse respond? 1. Promote safety and immediately terminate the relationship with the client. 2. Encourage the client to ignore these thoughts and feelings. 3. Immediately reassign the client to another staff member. 4. Help the client to clarify the meaning of the relationship.

4

When under stress, a client routinely uses alcohol to excess. When the client's husband finds her drunk, the husband yells at the client about her chronic alcohol abuse. Which action alerts the nurse to the client's use of the defense mechanism of denial? 1. The client hides liquor bottles in a closet. 2. The client yells at her son for slouching in his chair. 3. The client burns dinner on purpose. 4. The client says to the spouse, "I don't drink too much!"

4

Which group leader activity would a nurse identify as being most effective in the final, or termination, phase of group development? 1. The group leader establishes the rules that will govern the group after discharge. 2. The group leader encourages members to rely on each other for problem solving. 3. The group leader presents and discusses the concept of group termination. 4. The group leader helps the members to process feelings of loss.

4