Vsim Andrew Davis Mental Health
The nurse is assessing a client who is aggressive. Which safety measures must the nurse ensure are in place prior to continuing the assessment? (select all that apply) A. restrain the client B. give the client plenty of space C. sit in an open area D. request the presence of additional staff E. encourage the client to talk about this situation
BCD
A nurse is assessing a Haitian client. The caregiver of the client tells the nurse that the client is having an episode of Bouffée delirante. What symptoms would the nurse expect to find in this client? (select all that apply) A. insomnia B. confusion C. hallucinations D. abdominal pain E. extreme aggression
BCE
A nurse is performing an admission assessment of a client who has bulimia nervosa with purging behavior. Which of the following is an expected finding? (select all that apply) A. amenorrhea B. hypokalemia C. mottling of the skin D. slightly elevated body weight E. presence of lanugo on the face
BD
A nurse is assessing a client who has alcohol use disorder and is experiencing withdrawal. Which of the following findings should the nurse expect? (select all that apply) A. bradycardia B. fine tremors of both hands C. hypotension D. vomiting E. restlessness
BDE
A nurse is providing teaching to the family of a client who has a substance use disorder. Which of the following statements by a family member indicate an understanding of the teaching? (select all that apply) A. "We need to understand that she is responsible for her disorder" B. "eliminating any codependent behavior will promote her recovery" C. "she should participate in an Al-Anon group to help her recover" D. "the primary goal of her treatment is abstinence from substance use" E. "she needs to discuss her feelings about substance use to help her recover"
BDE
Which clinical manifestations confirm that a patient is experiencing Stage I (mild) of alcohol withdrawal syndrome? (select all that apply) A. hypotension B. course hand tremors C. disorientation D. diaphoresis E. anxiety
BDE
A client has a diagnosis of borderline personality disorder and lives at home with the client's parents. The client has been in the psychiatric unit for 2 weeks and is scheduled to be discharged tomorrow. Which would be most therapeutic when the client's parents come in to discuss discharge plans? A. Attempt to discuss placing the client into an assisted living environment B. Ask the parents how they have coped with the client's behaviors over the years C. Ask the parents to keep a written schedule of activities for each day for the client D. Encourage the parents to discuss the possibility of the client going into a day-care program when the client goes home
C
A client has been admitted to the detoxification unit after binge drinking. Even though the client is not currently intoxicated, the client is combative and exhibits altered thought processes. Which nursing diagnosis would be the priority? A. risk for injury related to effects of alcohol abuse B. risk for self-mutilation related to alcohol withdrawal and altered thought processes C. risk for other-directed violence related to alcohol withdrawal D. risk for delayed development related to chronic effects of alcohol intoxication
C
A client has lost emotional and physical control. The client is shouting, screaming, hitting others and throwing objects. Which phase of the aggression cycle is this client experiencing? A. triggering B. escalation C. crisis D. recovery
C
A client is attending anger management class and wants to know how the class will help. What is the nurse's best response? A. "you will learn how to control your violent behavior" B. "we need to explore what makes you want to hit people when you are angry" C. "it will help you to learn how to control the arousal of anger" D. "you will be able to stop feeling angry when incidents happen out of your control"
C
A cuban American client has been prescribed an antipsychotic medication. Which response is most important for the nurse to make to this client? A. "remember to take this medication at the times we've discussed" B. "will your mother be available to help administer this medication for you?" C. "call the doctor immediately if you experience any of the side effects we talked about" D. "do you have any questions about why you are taking this medication?"
C
A nurse is caring for a client who has alcohol use disorder. The client is no longer experiencing withdrawal manifestations. Which of the following medications should the nurse anticipate administering to assist the client with maintaining abstinence from alcohol? A. chlordiazepoxide B. bupropion C. disulfiram D. carbamazepine
C
A nurse is caring for a client who has bulimia nervosa and has stopped purging behavior. The client tells the nurse that she is afraid she is going to gain weight. Which of the following responses should the nurse make? A. "many clients are concerned about their weight. However, the dietitian will ensure that you don't get too many calories in your diet" B. "instead of worrying about your weight, try to focus on other problems at this time" C. "I understand you have concerns about your weight, but first, let's talk about your recent accomplishments" D. "you are not overweight, and the staff will ensure that you do not gain weight while you are in the hospital. We know that is important to you"
C
A nurse is considering using restraint and seclusion for a client who is acting out. Which is the primary guideline for the use of restraint and seclusion? A. use should be limited to times when a client has demonstrated violence and has inflicted harm to self or others B. use should be limited to times when medications have been unsuccessful in de-escalating a situation C. use should be limited to emergencies in which the risk of a client physically harming self, staff, or others is imminent D. use should be limited to emergency situations in which the client is demonstrating a potential to be violent
C
A nurse is planning a staff education program on substance use in older adults. Which of the following is appropriate for the nurse to include in the presentation? A. older adults require higher doses of a substance to achieve a desired effect B. older adults commonly use rationalization to cope with a substance use disorder C. older adults are at an increased risk for substance use following retirement D. older adults develop substance use to mask manifestations of dementia
C
A nurse is planning care for a client who is experiencing benzodiazepine withdrawal. Which of the following interventions should the nurse identify as the priority? A. orient the client frequently to time, place and person B. offer fluids and nourishing diet as tolerated C. implement seizure precautions D. encourage participation in group therapy sessions
C
A nurse is providing teaching for a client who is withdrawing from alcohol and has a new prescription for propranolol. Which of the following information should the nurse to include in the teaching? A. increases the risk for seizure activity B. provides a form of aversion therapy C. decreases cravings D. results in mild hypertension
C
A nurse is teaching a client who has tobacco use disorder about the use of nicotine gum. Which of the following information should the nurse include in the teaching? A. chew the gum for no more than 10 min B. rinse out the mouth immediately before chewing the gum C. avoid eating 15 min prior to chewing the gum D. use of the gum is limited to 90 days
C
A nurse manager is discussing the care of a client who has a personality disorder with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching? A. "I can promote my client's sense of control by establishing a schedule" B. "I should encourage clients who have a schizoid personality disorder to increase socialization" C. "I should practice limit-setting to help prevent client manipulation" D. "I should implement assertiveness training with clients who have antisocial personality disorder"
C
A patient with a history of chronic alcohol abuse has begun to demonstrate signs and symptoms of delirium tremens (DTs). The nurse demonstrates an understanding of the seriousness of the patient's risk for injury when implementing which intervention? A. orienting for time, place and person as needed B. assessing for auditory and visual hallucinations frequently C. observing seizure precautions D. restricting patient to the room
C
An aggressive client is holding a weapon and threatening to harm other clients in the unit. How should the nurse handle this situation? A. try to subdue the client B. reach out for the client's knife C. shield oneself with a pillow D. instruct the client to put the knife down
C
Clients with borderline personality disorder (BPD) are usually admitted to the inpatient setting because they exhibit what? A. Aggression B. Splitting C. Self-harm D. Impulsivity
C
Mr. Davis has been prescribed an oral benzodiazepine to assist in managing his withdrawal symptoms should his CIWA-Ar score rise to 8 or above. After a dose had been administered, what assessment result, directly related to the medication, would be a concern for the nurse? A. patient reports ringing in his ears B. patient reports a headache rated as 3/5 C. respiratory rate of 11 breaths/minute D. blood pressure of 154/90 mm Hg
C
The most serious consequence of behaviors seen in borderline personality disorder includes what? A. Identity diffusion B. Impulsivity C. Self-injury D. Dissociation
C
The nurse caring for the client taking clozapine should advocate for monitoring using which diagnostic test? A. cardiac enzymes B. blood urea nitrogen and creatinine C. white blood cell count D. liver function tests
C
The nurse in charge of an inpatient psychiatric unit is irritated with a client who has borderline personality disorder. Which step should the nurse take? A. Confront the client firmly about how the client's behavior makes the nurse feel. B. Direct the client to another staff member when the client tries to interact. C. Discuss the feelings with a colleague to promote coping. D. Arrange for the client to be transferred to another unit.
C
The nurse is assessing a victim who is brought into the hospital after being found badly beaten and raped by an unknown person. Which healthcare professional should the nurse contact to collect evidence of the assault? A. healthcare provider on call B. client's primary care provider C. sexual assault nurse examiner D. charge nurse of the emergency room
C
The nurse is caring for a client with dementia who has become increasingly agitated. What is the best action for the nurse to perform? A. request a routine anti-anxiety medication for the client B. discuss with the family the need to place the client in restraints C. place the client on a regular toileting schedule D. have a staff member stay with the client
C
The school health nurse is asked to see a child who has been coming to school with no lunch for the past week. The child tells the nurse, "I don't get a lunch this week, I have been wetting the bed." The nurse identifies the this child is experiencing which type of abuse? A. physical B. sexual C. neglect D. psychological
C
What term is used to describe the tendency to view things and situations as being either all good or all bad? A. identity diffusion B. disassociation C. splitting D. manipulation
C
What term refers to the collection of symptoms that are associated with untreated alcohol withdrawal? A. korsakoff syndrome B. cardiac myopathy C. delirium tremens D. wernicke's encephalopathy
C
Which occurs when thinking, feeling, or behaviors occur outside a person's awareness? A. Affective instability B. Impulsivity C. Dissociation D. Dichotomous thinking
C
Which staff behaviors are most likely to trigger clients who are predisposed to aggressive or violent behavior? A. asking personal questions when they are inappropriate B. providing the client with a list of possible goals for behavior change C. engaging in disputes over medication, supplies, or rules on the unit D. talking excessively with the client in front of other clients
C
Which statement, made by a nurse who experienced sexual abuse as a child, demonstrates being best prepared to work with sexual abuse and trauma survivors? A. "I've put the incident behind me and seldom think of it" B. "working with survivors of sexual trauma is very fulfilling work" C. "I've been supported by health care professionals and now I want to support other survivors" D. "survivors of sexual assault deserve the best care I can give them"
C
While discussing the CNS, the nursing instructor tells the students that the major inhibitory neurotransmitter in the CNS is what? A. acetylcholine B. dopamine C. GABA D. serotonin
C
A client with schizophrenia has been brought to the hospital in an agitated state. In order for the nurse to perform the initial assessment, which approaches should the nurse use to manage the situation? (select all that apply) A. inform the client medication is required B. restrain the client C. monitor facial expressions D. monitor emotional responses E. ensure availability of assistance
CDE
A nurse is assisting in the discharge planning for a client following alcohol detoxification. The nurse should anticipate prescriptions for which of the following medications to promote long-term abstinence for alcohol? (select all that apply) A. lorazepam B. diazepam C. disulfiram D. naltrexone E. acamprostate
CDE
Which long-term patterns are consistent with a diagnosis of borderline personality disorder? (select all that apply) A. auditory hallucinations B. paranoid tendencies C. impulsive behaviors D. unstable personal relationships E. unrealistic self-image
CDE
A nurse is assisting with a court-ordered evaluation of a client who has antisocial personality disorder. Which of the following findings should the nurse expect? (select all that apply) A. demonstrates extreme anxiety when placed in a social situation B. has difficulty making even simple decisions C. attempts to convince other clients to give him their belongings D. becomes agitated if his personal area is not neat and orderly E. blames others for his past and current problems
CE
A client has been prescribed clozapine for treatment of schizophrenia. Which would the nurse include in the education plan for this client and family? A. "you may experience hypertension while taking this medication" B. "one of the side effects of this medication is breast engorgement" C. "people taking this medication often experience dermatitis" D. "you may experience noticeable weight gain while taking this medication"
D
A client with a history of angry outbursts that have caused interpersonal and work problems has been in counseling for several months. The nurse judges the plan of care to be effective when which outcome is met? A. the client has gained insight into situations that trigger anger B. the client has increased self-esteem C. the client reports increased feelings of self-control D. the client uses adaptive coping to manage anger impulses
D
A nurse caring for a client with borderline personality disorder (BPD) consistently informs the client of the length of the relationship and routinely prepares the client for termination and the end of hospitalization. Which is the nurse trying to prevent? A. Poor social skills B. Depression C. Mania D. Maladaptive expression of emotions
D
A nurse in an acute mental health facility is caring for a client who is experiencing withdrawal from opioid use and has a new prescription for clonidine. Which of the following actions should the nurse identify as the priority? A. administer the clonidine on the prescribed schedule B. provide ice chips at the client's bedside C. educate the client on the effects of clonidine D. obtain baseline vital signs
D
A nurse is working with a client who has lost unit privileges due to inappropriate behavior. Which statement by the nurse demonstrates appropriate offering of choices? A. "would you like to have your family come visit you in your room today?" B. "which activity would you like to participate in today?" C. "can you select an outfit to wear to group therapy?" D. "would you rather go to the cafeteria or have dinner in the dayroom?"
D
A nurse must assess a client's thought process and content to identify risk for aggression. The assessment of the client's thought process and content would allow the nurse to identify what? A. mood and affect B. hunger and thirst C. orientation D. perceptions and delusions
D
A nurse must assess for characteristics that are predictive of violent behavior. Research suggests violent behavior is influenced by possession of which attribute? A. mindfulness B. assertive behavior C. therapeutic relationship D. low self-esteem
D
A client attends an outpatient mental health clinic accompanied by the client's spouse for an assessment. The client's spouse reports the client is easily irritated if the home is not maintained in a specific order and when the client is unable to complete a "to do" list on time. The client has a serious and formal demeanor. Which personality disorder best describes this client? A. Obsessive-compulsive personality disorder B. Avoidant personality disorder C. Narcissistic personality disorder D. Paranoid personality disorder
A
A client visits the clinic and tells the nurse that no matter how difficult the client's child acts, the client simply cannot express any anger. The nurse should plan to assess the client for symptoms of which mental health condition? A. depression B. panic disorder C. manic behaviors D. meneire's disease
A
A client with a blood alcohol level of 0.20 mg% is at high risk for injury related to the impairment of which function? A. motor B. respiratory C. consciousness D. orientation
A
A client with aggressive behavior shows no psychotic symptoms. Which medication should the nurse expect to be ordered for this client? A. lorazepam B. valproate C. haloperidol D. carbamazepine
A
A client with borderline personality disorder (BPD) tells the nurse, "You are good but the nurse on the afternoon shift is bad. The doctor is bad, too, but the therapist is good." The nurse interprets this statement as reflecting what? A. Splitting B. Identity diffusion C. Dissociation D. Cognitive schema
A
A client with borderline personality disorder has been admitted to the inpatient unit because the client has been engaging in wrist cutting. The client's sibling is visiting, and the sibling asks the nurse to explain why the client sometimes does this. Which response by the nurse would be most appropriate? A. "Sometimes the self-injurious behavior is undertaken to relieve stress." B. "Self-injurious behavior often calms and sedates people with this diagnosis." C. "Sometimes they do it to avoid the onslaught of delusional thinking." D. "The self-mutilation often slows the mood swings your sibling experiences."
A
A nurse is assessing a client in a community clinic who reports feeling anxious lately because she is considering leaving her marriage. The client describes a long history of partner abuse associated with this relationship. How should the nurse respond to this client? A. "you have the right to be safe and respected" B. "relationship counseling can be very helpful" C. "I wonder if your perceptions of the relationship are accurate" D. "I am here to help you through every step of this process"
A
A nurse is attending a review class on the neurologic basis of psychiatric disorders. The class also includes a review of the anatomy and physiology of the neurological system. The nurse demonstrates understanding of the information by identifying which structures as components of the brain stem? (select all that apply) A. midbrain B. pons C. medulla D. cerebellum E. occipital lobes
A
A nurse is aware that the likelihood of a client will be in adherence with psychotropic medications is affected by what? A. receiving education and information about the medication B. a history of taking these types of medications C. the number of other medications the client is taking D. the support the client has at home for taking medications
A
A nurse is beginning the process of providing therapy to a client with anger management problems. When implementing this therapy, which should occur first to promote optimal effectiveness? A. development of a therapeutic relationship B. avoidance of stimuli that provoke the anger C. client self-monitoring for anger cues D. identification of measures to disrupt the anger response
A
A nurse is caring for a client who has avoidant personality disorder. Which of the following statements is expected from a client who has this type of personality disorder? A. "I'm scared that you're going to leave me" B. "I'll go to group therapy if you'll let me smoke" C. "I need to feel that everyone admires me" D. "I sometimes feel better if I cut myself"
A
A nurse is caring for an adolescent client who has anorexia nervosa with recent rapid weight loss and a current weight of 90 lb. Which of the following statements indicates the client is experiencing the cognitive distortion of catastrophizing? A. "life isn't worth living if I gain weight" B. "don't pretend like you don't know how fat I am" C. "if I could be skinny, I know I'd be popular" D. "when I look in the mirror, I see myself as obese"
A
A nurse is describing histrionic personality disorder to a group of new nurses. Which term would the nurse most likely use? A. Attention seeking B. Psychopath C. Sociopath D. Lacking empathy
A
A nurse on an acute care unit is planning care for a client who has anorexia nervosa with binge-eating and purging behavior. Which of the following nursing actions should the nurse include in the client's plan of care? A. allow the client to select preferred meal times B. establish consequences for purging behavior C. provide the client with a high-fat diet at the start of treatment D. implement one-to-one observation during meal times
D
A nurse is leading an anger management group in the inpatient program. A client says, "I'm feeling really tense, and I'm fidgety today." What is the nurse's most appropriate response to the client's comment? A. explore what is underlying the client's physical and emotional state B. encourage the client to engage in a relaxation exercise prior to joining the group for the rest of the session C. ask the client if the client feels triggered by another client in the group D. ask another client in the group to respond to the client's comment
A
A nurse is providing teaching to a client who has alcohol use disorder and a new prescription for carbamazepine. Which of the following information should the nurse include in the teaching? A. "this medication will help prevent seizures during alcohol withdrawal" B. "taking this medication will decrease your cravings for alcohol" C. "this medication maintains your blood pressure at a normal level during alcohol withdrawal" D. "taking this medication will improve your ability to maintain abstinence from alcohol"
A
A nurse is reviewing the medical record of a female client diagnosed with borderline personality disorder (BPD). Which would the nurse identify as one of the strongest risk factors for this disorder? A. Abuse as a child B. Parental alcohol abuse C. Poverty D. History of depression
A
A nurse is teaching a female client who has tobacco use disorder about nicotine replacement therapy. Which of the following statements by the client indicates understanding of the teaching? A. "I should avoid eating right before I chew a piece of nicotine gum" B. "I will need to stop using the nicotine gum after 1 year" C. "I know that nicotine gum is a safe alternative to smoking if I become pregnant" D. "I must chew the nicotine gum quickly for about 15 minutes"
A
A nursing instructor is reviewing the various biologic theories related to the etiology of depression. Which would the instructor most likely include as being involved when describing psychoneuroimmunology? A. cytokines B. neurotransmitters C. hypothalamic axes D. genetics
A
A personality disorder is defined as a collection of traits that do what? A. cause behavioral dysfunction and inner distress B. are malleable and poorly defined C. lead to aggression and violence D. lead to withdrawn and antisocial behavior
A
After reviewing information about different personality disorders, a group of nursing students demonstrates understanding when they identify which as associated with schizoid personality disorder? A. Introverted B. Overly friendly C. Highly social D. Exuberant
A
Aggression control can be measured by the nurse's observation of a client's ability to do what? A. show an increased tolerance for frustration B. use increased doses of medication to reach a desired effect C. display increasing motor activity D. withhold his or her thoughts and feelings
A
Based on psychological theories, which is believed to be critical to understanding personality disorders? A. Difficult temperament B. Chaotic families C. Abuse D. Functional attachments
A
During which phase of the aggression cycle does the client regain physical and emotional control? A. recovery B. triggering C. postcrisis D. escalation
A
How should the nurse respond when asked why alcohol withdrawal and detoxification should be managed in a hospital setting? A. "alcohol withdrawal can be life-threatening and thus requires care provided by trained staff" B. "most often, neither families nor friends are willing and capable of managing the patient during the withdrawal" C. "the cost of the treatment is covered by insurance only if delivered in a hospital setting" D. "patients prefer to be isolated from family and friends when experiencing the severe symptoms of withdrawal"
A
In clients who do not completely recover from being victimized by rape, which mental illness is most likely to develop? A. post traumatic distress syndrome B. anxiety disorders C. borderline personality disorder D. delirium
A
In which phase of the aggression cycle can techniques of seclusion or restraint be used to deal with the aggression quickly? A. crisis B. recovery C. triggering D. escalation
A
The nurse finds that a client with a history of aggressive behavior is restless, is pacing up and down in the hallway and has clenched fists. The client also talks in a loud voice. Which intervention would be most appropriate at this point? A. immediately approach the client to engage in communication B. ask colleagues to contact hospital security for support C. offer the client an antianxiolytic mediation D. prepare to seclude the client
A
The nurse is counseling a client couple who are trying to reconcile and hold their marriage together. During therapy the wife states, "he makes me so mad when he spends all his weekend time with his friends instead of us. He makes me want to hurt him back." Using concepts from assertiveness training and effective communication techniques, the nurse implements which intervention after hearing the wife's remarks? A. teach the client to make "I" statements B. ask the wife to provide details about what she means by "all his time" C. ask the husband to discuss why he spends so much time with his friends D. encourage the wife to express exactly what she wants her husband to do on weekends
A
The nurse is orienting a new staff member in an inpatient mental health unit when a client begins to act in a violent manner. The nurse should explain to the new staff member that some clients use violence and aggression to .. A. have their needs met B. relive their childhood experiences C. practice assertiveness skills D. be placed in their rooms by themselves
A
The nurse should consider which as a possible indicator of child neglect? A. malnourishment unrelated to illness B. helplessness C. angry outbursts D. hesitance to talk openly
A
The nurse states "I know this must be frightening for you" to a client who is angry and has a potential for violence. Which communication technique is the nurse utilizing with this statement? A. validation B. acceptance C. reflection D. confrontation
A
The prescription of clozapine requires weekly blood samples for which time frame? A. 6 months B. 2 months C. 4 months D. 8 months
A
When clients diagnosed with borderline personality disorder (BPD) see nurses as either all good or all bad, the client is using which primitive defense? A. Splitting B. Defending C. Invalidating Projective D. identification
A
When determining a client's potential for aggression and violence prior to engaging in a detailed psychosocial assessment, which would be most important for the nurse to do? A. obtain a thorough client history B. ask the client about the client's living situation C. observe the client for nonverbal indicators D. review the client's use of medications
A
When providing care to a client who consistently attempts to manipulate the staff, the nurse can best maintain the therapeutic milieu by doing what? A. Instructing the staff to enforce all unit rules consistently B. Encouraging questions and discussing the client's concerns C. Promoting social ostracism of the client's exhibiting manipulation D. Scheduling staff one-on-one time with the client
A
Which assessment finding confirms that a patient is experiencing moderate alcohol withdrawal? A. nausea and vomiting B. profuse sweating C. restless sleep D. total wakefulness
A
Which class of medication is regularly prescribed to provide a gradual withdrawal from alcohol? A. tranquilizer B. stimulant C. anticonvulsant D. antidepressant
A
Which describes a strong emotional response to a real or perceived provocation? A. anger B. physical aggression C. catharsis D. hostility
A
Which diagnosis is associated with a pervasive disregard for and violation of the rights of others? A. Antisocial personality B. Borderline personality C. Passive-aggressive personality D. Schizoid personality
A
Which drug has been effective in treating aggressive clients diagnosed with bipolar disorders? A. lithium B. carbamazepine C. valproic acid D. clozapine
A
Which factor is most likely to decrease the severity of Mr. Davis's alcohol withdrawal signs and symptoms? A. never experiencing alcohol withdrawal signs and symptoms before B. having the emotional support of his strong religious faith and beliefs C. having been consuming vodka for only 5 years D. being only 56 years of age
A
Which is a pattern of repeated unwanted contact, attention and harassment that often increases in frequency? A. stalking B. rape C. incest D. physical abuse
A
Which personality disorder is characterized by an alteration between hostile self-assertion, such as stubbornness, and excessive dependence? A. Passive-aggressive B. Dependent C. Narcissistic D. Histrionic
A
Which personality disorder would be placed in Cluster B? A. borderline B. avoidant C. paranoid D. schizoid
A
Which statement regarding the diagnosis of a personality disorder is accurate? A. personality disorders are diagnosed in early adulthood, when personality formation is complete B. the diagnosis of personality disorders is extremely difficult because the individual doesn't acknowledge the illness C. diagnosis involves identifying significant impairment in forming self-confidence and appropriate self-esteem D. diagnosis of a personality disorder depends on the existence of an early childhood trauma
A
Which term describes a situation that occurs when very small amounts of alcohol intoxicates the person after continued heavy drinking? A. tolerance break B. blackout C. tolerance D. intoxication
A
Which term is used to describe an activity used to release anger? A. catharsis B. hostility C. anger D. physical aggression
A
Which term is used to describe an emotion expressed through verbal abuse and violation of rules or norms? A. hostility B. anger C. catharsis D. physical aggression
A
While assessing for intimate partner violence, the nurse learns that a client has not seen immediate family members for several years because the visits would upset the client's spouse. On which potential issue should the nurse focus with this client? A. social isolation B. revictimization C. economic dependency D. emotional dependency
A
Gambling, binge eating, and engaging in unsafe sex are examples of what? A. Identity diffusion B. Dissociation C. Affective instability D. Impulsivity
D
Impulsivity is a characteristic of borderline personality disorder (BPD). Which aspect of this behavior is most likely to cause problems for the patient? A. anxiety B. egocentricity C. extreme confidence D. disregard for consequences
D
A charge nurse is planning a staff education session to discuss medications used during the care of a client experiencing alcohol withdrawal. Which of the following medications should the charge nurse include in the discussion? (select all that apply) A. lorazepam B. diazepam C. disulfiram D. naltrexone E. acamprosate
AB
What are some types of behavior that the nurse would recognize as qualifying as psychological abuse? (select all that apply) A. criticizing B. ridiculing C. threatening a victim's dog D. asking for time alone when frustrated E. using assertive language
ABC
Which nursing interventions are directly associated with the primary goals of the management of a patient, like Mr. Davis, who is currently experiencing alcohol withdrawal? (select all that apply) A. implement seizure precautions B. assess and record heart rate every 4 hours C. keep SpO2 probe at bedside D. provide information regarding AA support groups E. identifying triggers for alcohol consumption
ABC
What characteristic behavior demonstrated by Mr. Davis is associated with stage III withdrawal symptoms? (select all that apply) A. experiencing tactile disturbances B. admitting to visual hallucinations C. disoriented by more than 2 calendar days D. near continuous pacing E. hypothermia
ABCD
Which nursing interventions would best assess Mr. Davis's safety issues if his CIWA-Ar score were to rise to 8 or above? (select all that apply) A. minimize all sources of noise in his room B. dim the lighting in his room C. suction equipment is kept at the bedside D. institute falls precautions E. provide him with high protein, low fat meals
ABCD
In the Diagnostic and Statistical Manual of Mental Disorders (5th ed.), borderline personality disorder is categorized as a Cluster B disorder. The nurse understands that which of the following is the primary behavioral characteristic of this cluster of disorders? A. anxious B. odd C. eccentric D. dramatic
D
A nurse is discussing the use of methadone with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching? (select all that apply) A. "methadone is a replacement for physical dependence to opioids" B. "methadone reduces the unpleasant effects associated with abstinence syndrome" C. "methadone can be used during opioid withdrawal and to maintain abstinence" D. "methadone increases the risk for acetaldehyde syndrome" E. "methadone must be prescribed and dispensed by an approved treatment center"
ABCE
A charge nurse is preparing a staff education session on personality disorders. Which of the following personality characteristics associated with all of the personality disorders should the charge nurse include in the teaching? (select all that apply) A. difficulty in getting along with other members of a group B. belief in the ability to become invisible during times of stress C. display of defense mechanisms when routines are changed D. claiming to be more important than other persons E. difficulty understanding why it is inappropriate to have a personal relationship with staff
ACE
A nurse is preparing to obtain a nursing history from a client who has a new diagnosis of anorexia nervosa. Which of the following questions should the nurse include in the assessment? (select all that apply) A. "what is your relationship like with your family?" B. "why do you want to lose weight?" C. "would you describe your current eating habits?" D. "at what weight do you believe you will look better?" E. "can you discuss your feelings about your appearance?"
ACE
Mr. Davis reported having consumed his last drink around 4 pm, and he was admitted to the facility's detoxification unit shortly thereafter. What clinical manifestations of alcohol withdrawal should the nurse expect him to demonstrate by 10 pm that night? A. he is likely currently experiencing the peak of his signs and symptoms B. his signs and symptoms will likely taper off in severity over the next 12 hours C. the majority of his withdrawal will consist of signs and symptoms similar to the current ones D. the signs and symptoms are likely to increase in type and severity
D
Symptoms of alcohol withdrawal begin within what time period after the cessation or marked reduction of alcohol intake by the chronic alcohol drinker? A. 120 minutes B. 1 week C. 3 days D. 12 hours
D
The nurse is performing a history and physical examination on a client with chronic alcoholism. The client has a history of gastritis, esophagitis, elevated liver enzymes, cardiomyopathy, and pancreatitis. Which of these conditions are attributable to the client's history of alcohol abuse? A. pancreatitis and elevated liver enzymes B. gastritis and elevated liver enzymes C. pancreatitis, esophagitis, gastritis, and elevated liver enzymes D. all the conditions are attributable to the alcohol abuse
D
The nurse is working with a client who yells at the nurse "I am angry about how you keep treating me without respect!" What is the nurse's best response? A. "I am not going to talk to you while you are angry" B. "do you need to take your medication to help calm down?" C. "if you don't calm down, I will need you to go to your room" D. "why do you think I am not being respectful to you?"
D
The nurses on a mental health unit are reviewing aspects of the unit environment in a staff meeting. Which factor would be predictive of a client becoming aggressive or violent? A. flexible unit rules B. reduced use of restraints C. scheduled unit activities D. strict hierarchy of authority
D
Which behavior is most associated with a borderline personality disorder (BPD) and the tendency to self-harm? A. chain smoking B. intentional risk taking C. sexual promiscuity D. cutting body parts
D
Which is the best definition of personality? A. the individual characteristics that change as one grows and experiences life situations B. the way an individual reacts to situations and circumstances, over which he or she has little or no control C. behaviors and beliefs that are present and acted on from an individual's birth D. a complex, engrained pattern of behaviors and characteristics that are largely outside of the individual's consciousness
D
Which statement made by a client raises the greatest concern that the client may be experiencing relationship violence? A. "he was so much nicer when we started dating" B. "his father physically abused his mother for years" C. "he doesn't like it when I go out with my girlfriends" D. "I don't know what else I can do to keep him from getting angry at me"
D
Which would be the priority nursing diagnosis for a client diagnosed with borderline personality disorder (BPD)? A. Disturbed thought process B. Ineffective coping C. Personal identity disturbance D. Risk for self-mutilation
D
A client drinks 24 oz of vodka every day, having gradually increased to this level over the past 2 to 3 years. The client continues to maintain a job and functions well in activities of daily living, relationships, and other aspects of social life. Which term should the nurse use to describe this drinking behavior? A. abuse B. tolerance C. withdrawal D. intoxication
B
A client in the emergency department has self-inflicted wounds on both arms. Assessment reveals that the client was diagnosed with borderline personality disorder 6 months ago, for which the client has been receiving outpatient treatment. The client tells the nurse that the client recently found out the client's therapist is moving and will no longer be able to work with the client. What is the priority nursing diagnosis for this client? A. Anxiety B. Self-mutilation C. Loneliness D. Stress
B
A client is admitted to the emergency department for intoxication with alcohol. The client has an unsteady gait, myopathy, and neuropathy and cannot remember past or recent events. When treated with thiamine, the client's symptoms greatly improve. Which condition was the client likely experiencing? A. scurvy B. wernicke-korsakoff syndrome C. alcohol dependence with memory impairment D. alcoholic dementia
B
A client tells the nurse that the client has strong urges to damage property as a result of feelings of hostility and anger. Which is an appropriate nursing action? A. place the client in a separate room B. take the client to the gym for exercise C. inform the client that restraints may be applied D. speak to the client in a firm voice
B
A client with Parkinson's disease is hospitalized on a medical unit. The nurse would be correct in identifying which neurotransmitter decreased in this disease? A. acetylcholine B. dopamine C. neurontin D. serotonin
B
A client's roommate yells at the client and the client acts as if nothing has occurred and ignores the roommate. The nurse identifies that the client may have which style of anger expression related to this incident? A. constructive anger discussion B. anger suppression C. catharsis of anger D. expressive anger
B
A new nurse asks the nurse manager about the best intervention to use when trying to de-escalate a potentially violent client. Which response would be most appropriate? A. "I've always had good results with medications" B. "what works best is what fits the client and the situation" C. "make sure that another colleague knows where you are at all times" D. "you need to confront the client to show you are in charge"
B
A nurse is assessing a child with a diagnosis of autism spectrum disorder. The child has severe uncontrollable temper outburst and repeatedly bangs the head on the wall or door. When considering medication for treatment, the nurse knows which will be the most effective? A. pemoline B. haloperidol C. methylphenidate D. imipramine
B
A nurse is caring for a client who has borderline personality disorder. The client says, "the nurse on the evening shift is always nice! you are the meanest nurse ever!" The nurse should recognize the client's statement as an example of which of the following defense mechanisms? A. regression B. splitting C. undoing D. identification
B
A nurse is evaluating a client's understanding of a new prescription for clonidine for the treatment of opioid use disorder. Which of the following statements by the client indicates an understanding of the teaching? A. "taking this medication will help reduce by craving for heroin" B. "while taking this medication, I should keep a pack of sugarless gum" C. "I can expect some diarrhea from taking this medicine" D. "each dose of this medication should be placed under my tongue to dissolve"
B
A nurse is giving a talk about child abuse to a local community group. When discussing risk factors for child abusers, which would the nurse identify as the most likely profile of the perpetrator of fatal child abuse? A. middle-aged woman with a college degree B. unemployed young woman who dropped out of high school C. middle-aged, wealthy businessman D. young college graduate who recently gave birth to her first child
B
A nurse is preparing a presentation for a group of staff nurses on personality disorders. When describing antisocial personality disorders (ASPD), the nurse would explain that for a person to be diagnosed with the disorder, the person must be at least which age? A. 15 years B. 18 years C. 21 years D. 25 years
B
A nurse is providing teaching to a client who has a new prescription for clonidine to assist with maintenance of abstinence from opioids. The nurse should instruct the client to monitor for which of the following adverse effects? A. diarrhea B. dry mouth C. insomnia D. hypertension
B
A nursing instructor is teaching about the importance of bonding and how an easy temperament can serve as a protective factor against psychopathology. Which statement made by a student demonstrates a need for further instruction? A. "Temperament is malleable." B. "Temperament is not changeable." C. "Temperament seen in infancy is often seen later in life." D. "Temperamental differences among children can be observed very early in life."
B
A nursing student is aware that which accounts for more deaths, illnesses, and disabilities across the life span than any other preventable condition? A. motor vehicle accidents B. substance abuse disorders C. falls D. mood disorders
B
How can the nurse caring for Mr. Davis best provide the appropriate emotional care during his alcohol withdrawal? A. remind him frequently that the signs and symptoms will lessen in severity B. ensure that his needs are met in a nonjudgmental manner C. assure him that the withdrawal process generally lasts no more than 96 hours D. encourage his family to spend time at his bedside
B
The nurse is assessing a client of an Eastern culture who is admitted due to the need for anger management. What question should the nurse ask to determine the effect of culture on the client's expression of anger? A. "what happens when you get angry?" B. "what did you learn about anger when growing up?" C. "do you feel that you can manage your reactions with anger?" D. "do you know why you are being admitted?"
B
The nurse is caring for a client with rheumatoid arthritis. Upon entering the client's room, the nurse finds the the client is very angry and is punching pillows to express the anger. What should be the nurse's response to this behavior? (select all that apply) A. "please do not damage the hospital's property" B. "I am here so we can talk about what is making you angry" C. "I am sure your anger would be reduced by punching the pillows" D. "I appreciate that you are experiencing anger in an appropriate manner"
B
The nurse is counseling a 28-year-old client with avoidant personality disorder. Despite being employed, the client verbalizes having low quality of life due to anxiety and isolation. Which therapeutic goals does the nurse establish as priority? A. The client will be able to accept a job promotion. B. The client will experience increased self-esteem. C. The client will engage in less risk-taking behavior D. The client will form a romantic relationship.
B
The nurse working in a psychology clinic finds that suppression of anger is more common in women than in men. What is the possible explanation for such a finding? choose the best answer A. women have a greater threshold for controlling anger B. women are expected not to express so-called negative feelings like anger C. women express sadness instead of anger while facing unjust situations D. women are more aware about the health consequences related to inappropriate anger expression
B
To defuse a critical situation, the nurse can use the therapeutic communication techniques for which reason? A. shout and let the client know that this behavior is not tolerated B. try to clarify what has upset the client C. inform client that the nurse is in charge of situation D. offer medication as the solution to the outburst
B
What nursing intervention would most likely improve the therapeutic relationship between the nurse and a patient experiencing alcohol withdrawal by increasing the nurse's self-awareness? A. providing prompt, effective nursing care for the patient with a history of alcohol abuse B. monitoring one's own biases and reactions regarding alcoholism C. providing empathetic care for the patient in alcohol withdrawal D. regularly reviewing research results regarding the triggers for chronic alcoholism
B
What request of the patient being assessed for possible alcohol withdrawal should the nurse make to determine the presence of tremors? A. "please touch your thumb to your little finger" B. "pease extend your arms and spread your fingers apart" C. "please interlock the fingers of both hands" D. "please make a tight fit and hold it for 5 seconds"
B
What symptom of alcohol withdrawal syndrome would be the most urgent for the nurse to address? A. hallucinations B. grand mal seizures C. anxiety D. insomnia
B
Which personality trait is associated with aggressive behavior? A. self-centeredness B. impulsivity C. pessimism D. lying
B
Which statement accurately describes the relationship between culture and behaviors associated with personality disorders? A. culture is not a consideration when evaluating behaviors associated with personality disorders B. personality disorders result in behaviors that consistently deviate from those considered culturally acceptable C. cultural norms determine the behaviors that are associated with personality disorders D. the behaviors demonstrated by an individual diagnosed with a personality disorder conform to cultural expectations
B
While interviewing a client, a nurse asks, "what do you do when you get angry?" Which client response would indicate to the nurse that the client engages in anger suppression? A. "I've been known to fly off the handle when I'm angry" B. "people say I withdraw and pout about the problem" C. "I usually approach the person directly to talk about it" D. "I try to discuss how I'm feeling about it with a close friend"
B
