book questions + quiz questions
A 27-year-old woman has been married and divorced four times. She is admitted to the psychiatric unit with a diagnosis of borderline personality disorder. Which of the following behavior patterns best describes someone with borderline personality disorder? Emotional instability Belligerent and argumentative Suspiciousness of others Social isolation
Emotional instability
9. Jessica is a nurse who was floated to the psychiatric unit to cover for a staff nurse who called out sick. She encounters a patient who is diagnosed with BPD, and the patient states, "Thank goodness they sent you to the unit. No one else here has taken the time to listen to my concerns." This may be an example of which symptom common in BPD? a. Impulsivity b. Self-harming behaviors c. Dissociation d. Splitting
d Splitting
A nursing instructor is teaching about case management. What student statement indicates that learning has occurred? "Case management provides coordination of services required to meet client needs." "Case management exists mainly to facilitate client admission to needed inpatient services." "Case management is a method used to achieve independent client care." "Case management is a method to facilitate physician reimbursement."
"Case management provides coordination of services required to meet client needs."
A college student was sexually assaulted when out on a date. After several weeks of crisis intervention therapy, which client statement should indicate to a nurse that the student is handling the situation in a healthy manner? "If I don't put myself in a dating situation, I won't be at risk." "Next time I will think twice about wearing a sexy dress." "I know that it was not my fault." "My boyfriend has trouble controlling his sexual urges."
"I know that it was not my fault."
A female client on the mental health unit has been diagnosed as having borderline personality disorder. One morning she tells the day nurse that the evening nurse said she could do her laundry while the other clients went to group therapy. What is the best response? "It's o.k. this time, but she doesn't make the rules for this shift." "Let's talk to the other nurse together before you start this." "I doubt she would have said that." "Tell me what her exact words were."
"Let's talk to the other nurse together before you start this."
A nursing instructor is teaching about reminiscence therapy. What student statement indicates that learning has occurred? "Reminiscence therapy encourages members to share both positive and negative significant life memories to promote resolution." "Reminiscence therapy is a group in which participants create collages representing significant aspects of their lives." "Reminiscence therapy encourages members to share positive memories of significant life transitions." "Reminiscence therapy is a social group where members chat about past events and future plans."
"Reminiscence therapy encourages members to share both positive and negative significant life memories to promote resolution."
Which of the following medications is used to treat Tourette's disorder? a. Methylphenidate (Ritalin) b. Haloperidol (Haldol) c. Imipramine (Tofranil) d. Phenytoin (Dilantin)
b. Haloperidol (Haldol)
A 12-year-old girl suddenly refuses to change for gym, participate in physical activities, has difficulty walking and sitting, and will not eat her food at lunchtime. What should the school nurse consider when assessing this child's symptoms? A. Sexual abuse B. Emotional neglect C. Physical neglect D. Emotional abus
A Sexual abuse of a child may be considered a possibility when the child has difficulty walking or sitting; suddenly refuses to change for gym or to participate in physical activities; reports nightmares or bedwetting; experiences a sudden change in appetite; demonstrates bizarre, sophisticated, or unusual sexual knowledge; becomes pregnant or contracts a venereal disease; runs away; or reports sexual abuse by a parent or another adult caregiver. After assessing the data, the school nurse should further investigate this child's unexplained symptoms, and if warranted, report findings to authorities.
After an examination and treatment for rape, the nurse prepares to discharge a client from the emergency department (E D). Which discharge teaching should the nurse provide? A. Information on available community resources B. The names and phone numbers of local attorneys who defend rape victims C. When to return to the E D for follow-up care D. The phone number of the battered women's shelter or safe house
A The client must be made aware of the variety of resources available to her. These may include crisis hotlines, community groups for women who have been abused, and counseling services. Knowledge of available community resources decreases the victim's sense of powerlessness
A child diagnosed with oppositional defiant disorder (ODD) begins yelling at staff members when asked to leave group therapy because of inappropriate language. Which nursing intervention would be appropriate? Accompany the child to a quiet area to decrease external stimuli. Allow the child to stay in group therapy to monitor the situation further. Institute seclusion following agency protocol. Administer prn medication to decrease acting-out behaviors.
Accompany the child to a quiet area to decrease external stimuli.
A 14-year-old female client has just been admitted to the psychiatric unit for anorexia nervosa. She is emaciated and refusing to eat. What is the primary nursing diagnosis for this client? Anxiety (severe) Dysfunctional grieving Altered nutrition: less than body requirements Alteration in family process
Altered nutrition: less than body requirements
Which of the following would be an appropriate medication for a child with ADHD? Atomoxetine (Strattera) Carbamazapine (Tegretol) Halolperidal (Haldol) Chlordiazepoxide (Librium)
Atomoxetine (Strattera)
Sharon has a history of of bulimia. Which of the following symptoms would be congruent with her diagnosis? Binging, purging, severe weight loss, hyperkalemia. Binging, laxative abuse, amenorrhea, severe weight loss. Binging, purging, obesity, hyperkalemia. Binging, purging, normal weight, hypokalemia.
Binging, purging, normal weight, hypokalemia.
Which statement describes a theory of aging from a biological perspective? A. Personality traits change gradually but systematically throughout the life span. B. Staying active leads to satisfactory aging. C. Life span and longevity are predetermined by heredity. D. Old values take on new meanings in keeping with changing circumstances.
C According to genetic theory, aging is an involuntarily inherited process that operates over time to alter cellular or tissue structures. This biological theory suggests that life span and longevity are predetermined.
From a biological theory perspective, which of the following predisposes individuals to be abusive? A. Unmet needs for security resulting in an underdeveloped ego and a weak superego B. Imitation of individuals who have a predisposition toward aggressive behavior C. Various levels of norepinephrine, dopamine, and serotonin D. The influence of culture and social structure
C Various components of the neurological system in both humans and animals have been implicated in both the facilitation and the inhibition of aggressive impulses. One biological theory suggests that norepinephrine, dopamine, and serotonin may play a role in aggressive behavio
A child has been recently diagnosed with mild intellectual developmental disorder (IDD). What information about this diagnosis should the nurse include when teaching the child's mother? Children with mild IDD need constant supervision. Children with mild IDD develop academic skills up to a sixth-grade level. Children with mild IDD appear different from their peers. Children with mild IDD have significant sensory-motor impairment.
Children with mild IDD develop academic skills up to a sixth-grade level.
A young mother in a severely abusive relationship is admitted to the psychiatric unit after an attempted suicide. The client tells the nurse, "I'm sure things will be better between us once I go home." Which is the most appropriate nursing response? A. "Research shows that men who batter get worse rather than improve." B. "Aren't you concerned about your children?" C. "You really should not return home to that violent situation." D. "Let's develop a safety plan in case he becomes violent in the future.
D It is critical to stress to the client the importance of safety. The client must be made aware of the variety of resources that are available to her. Most major cities in the United States now have safe houses or shelters where women can go to be assured of protection for them and their children. Helping the client develop a safety strategy will increase her sense of control and decrease her sense of powerlessness
An elderly client, newly admitted to a nursing home, refuses to participate in activities of daily living (A D L's). Which nursing intervention would best help the client to be as independent as possible in meeting self-care needs? A. Assign a variety of caregivers so that one person does not do everything for the client. B. Establish a specified amount of time for A D L completion. C. Set client expectations at the beginning of each day. D. Structure the A D L's to mirror previous home routines.
D Structuring the activities of daily living to mirror previous home routines can help foster independence in activities of daily living. Maintaining familiar routines will ease the transition to residential care and increase client compliance in meeting self-care needs.
Which of the following diagnostic criteria describe the characteristics of borderline personality disorder? (Select all that apply) Arrogant, haughty behaviors or attitudes. Frantic efforts to avoid real or imagined abandonment. Recurrent suicidal and self-mutilating behaviors. Unrealistic preoccupation with fears of being left to take care of self. Chronic feelings of emptiness.
Frantic efforts to avoid real or imagined abandonment. Recurrent suicidal and self-mutilating behaviors.. Chronic feelings of emptiness.
When admitting a child diagnosed with conduct disorder, which symptom would the nurse expect to assess? Repeated complaints of physical symptoms such as headaches and stomachaches. Excessive distress about separation from home and family. History of cruelty toward people and animals Confabulation when confronted with wrongdoing.
History of cruelty toward people and animals
Looking at a slightly bleeding paper cut, the client screams, "Somebody help me quick! I'm bleeding. Call 911!" A nurse should identify this behavior as characteristic of which personality disorder? Schizoid personality disorder Obsessive-compulsive personality disorder Histrionic personality disorder Paranoid personality disorder
Histrionic personality disorder
An instructor is teaching nursing students about the differences between partial and inpatient hospitalization. In what way does partial hospitalization differ from traditional inpatient hospitalization? Partial hospitalization does not provide supervision 24 hours a day. Partial hospitalization does not offer a comprehensive treatment plan. Partial hospitalization does not provide medication administration and monitoring. Partial hospitalization does not use an interdisciplinary team.
Partial hospitalization does not provide supervision 24 hours a day.
When attempting to provide health-care related services to the homeless, what should be a realistic concern for a nurse? Most individuals that are homeless relocate frequently. Most individuals that are homeless reject help. Most individuals that are homeless are suspicious of anyone who offers help. Most individuals that are homeless are proud and will refuse charity.
Most individuals that are homeless relocate frequently.
A male client diagnosed with a personality disorder boasts to the nurse that he has to fight off female attention and is the highest paid in his company. These statements are reflective of what personality disorder? Obsessive-compulsive personality disorder Avoidant personality disorder Schizotypal personality disorder Narcissistic personality disorder
Narcissistic personality disorder
When questioned about bruises, a woman states, "It was an accident. My husband just had a bad day at work. He's being so gentle now and even brought me flowers. He's going to get a new job, so it won't happen again." This client is in which phase of the cycle of battering? Phase I: Tension-building Phase III: The honeymoon phase Phase IV: The resolution and reorganization phase Phase II: The acute battering incident phase
Phase III: The honeymoon phase
A nursing instructor is developing a lesson plan to teach about domestic violence. Which information should be included? Erratic relationships and vulnerability are central to the dynamic of domestic violence. Emotional injury and learned helplessness are central to the dynamic of domestic violence. Poor communication and social isolation are central to the dynamic of domestic violence. Power and control are central to the dynamic of domestic violence
Power and control are central to the dynamic of domestic violence
A school nurse provides education on drug abuse to a high school class. This nursing action is an example of which level of prevention? Primary intervention Tertiary prevention Primary prevention Secondary prevention
Primary prevention
John has a history of paranoid schizophrenia and non compliance with medications, which of the following might be the best choice of neuroleptic for John? Haldol Navane Lithium Carbonate Prolixin decanoate
Prolixin decanoate
A 25 year old woman has been admitted to your unit with Borderline Personality Disorder. She self mutilates and is bulimic. What are the nurse's priorities when planning care for the client? Provide safety and close observation Close observation and medicate Set firm limits and medicate Provide safety and set firm limits
Provide safety and close observation
A client is brought to he emerge department after being violently raped. Which nursing action is appropriate? Probe for further, detailed description of the rape event. Meet the client's self-care needs by assisting with showering and perineal care. Remain nonjudgmental while actively listening to the client's description of the violent rape event. Discourage the client from discussing the rape, because this may lead to further emotional trauma.
Remain nonjudgmental while actively listening to the client's description of the violent rape event.
A 19-year-old is bulimic. She has just finished eating her evening meal and says she feels like vomiting. What would be the best action for the nurse to take? Tell her that whether or not she vomits is her choice Send her to her room to rest for awhile Remain with her for about 60 minutes Get an order for an anti-nausea medication
Remain with her for about 60 minutes
What would be the best nursing strategy to use when a client is attempting to split staff on the 3 shifts against one another? Assign one staff member to her each shift. Rotate staff assigned to her each shift. Have each shift develop a plan. Schedule a meeting with the client to discuss the problem.
Rotate staff assigned to her each shift.
A client diagnosed with schizophrenia is hospitalized due to an exacerbation of psychosis related to nonadherence with antipsychotic medications. Which level of care does the client's hospitalization reflect? Secondary prevention level of care Case management level of care Tertiary prevention level of care Primary prevention level of care
Secondary prevention level of care
A client with Antisocial Personality Disorder is verbally threatening to the staff. Select the best, initial nursing intervention for this behavior. Set firm limits on client's behavior. Medicate the client Ignore the client's threats Call a Code
Set firm limits on client's behavior.
Which nursing diagnosis should a nurse identify as appropriate when working with a client diagnosed with schizoid personality disorder? Altered thought processes R/T increased stress Risk for suicide R/T loneliness Risk for violence: directed toward others R/T paranoid thinking Social isolation R/T inability to relate to others
Social isolation R/T inability to relate to others
In planning care for a woman who presents as a survivor of domestic abuse, a nurse should be aware of which of the following data? (select all that apply) Substance abuse is a common factor in abusive relationships. Economic factors rarely play a role in the decision to stay. Until children reach school age, they are usually not affected by abuse between their parents. It often takes several attempts before a woman leaves an abusive situation. Women in abusive relationships usually feel isolated and unsupported.
Substance abuse is a common factor in abusive relationships. It often takes several attempts before a woman leaves an abusive situation. Women in abusive relationships usually feel isolated and unsupported.
The priority nursing intervention for an abuse victim in the emergency department is: Tending to the immediate care of the wounds Providing the victim with information about a safe place to stay Administering the prn tranquilizer ordered by the physician Explaining how they may go about bringing charges against their abuser
Tending to the immediate care of the wounds
The nurse teaches deinstitutionalized chronic schizophrenics to manage meals, shop, manage finances and health care. This is an example of Tertiary prevention Secondary prevention Primary intervention Primary prevention
Tertiary prevention
When a home health nurse administers an outpatient's injection of haloperidol decanoate (Haldol decanoate), which level of care is the nurse providing? Primary prevention level of care Secondary prevention of care Tertiary prevention level of care Case management level of care
Tertiary prevention level of care
Which assessment data should a school nurse recognize as a sign of physical neglect? The child has multiple bruises on various body parts. The child is very insecure and has poor self-esteem. The child has sophisticated knowledge of sexual behaviors. The child is often absent from school and seems apathetic and tired.
The child is often absent from school and seems apathetic and tired.
Family dynamics are thought to be a major influence in the development of anorexia nervosa. Which statement regarding a client's home environment should a nurse associate with the development of anorexia nervosa? The home environment places an overemphasis on food. The home environment is overprotective and demands perfection. The home environment maintains loose personal boundaries. The home environment condones corporal punishment.
The home environment is overprotective and demands perfection.
After an adolescent diagnosed with attention deficit-hyperactivity disorder (ADHD) begins methylphenidate (Ritalin) therapy, a nurse notes that the adolescent loses 10 pounds in a 2-month period. What is the best explanation for this weight loss? Hyperactivity seen in ADHD causes increased caloric expenditure. Side effects of methylphenidate (Ritalin) cause nausea, and, therefore, caloric intake is decreased. Increased ability to concentrate allows the client to focus on activities rather than food. The pharmacological action of methylphenidate (Ritalin) causes a decrease in appetite.
The pharmacological action of methylphenidate (Ritalin) causes a decrease in appetite.
A nurse is caring for a client diagnosed with antisocial personality disorder. Which factors should the nurse consider when planning this client's care? (Select all that apply) This client has personality traits that are deeply ingrained and difficult to modify. This client needs medication to treat the underlying physiological pathology. This client uses manipulation, making the implementation of treatment problematic. This client has poor impulse control that hinders compliance with a plan of care. This client is likely to have secondary diagnoses of substance abuse and depression.
This client has personality traits that are deeply ingrained and difficult to modify. This client uses manipulation, making the implementation of treatment problematic. This client has poor impulse control that hinders compliance with a plan of care. This client is likely to have secondary diagnoses of substance abuse and depression.
A homeless client comes to the emergency department reporting cough, night sweats, weight loss, and blood-tinged sputum. Which disease, which has recently become more prevalent among the homeless community, should a nurse suspect? Mononucleosis Tuberculosis Meningitis Encephalopathy
Tuberculosis
5. Jack is a new patient on the psychiatric unit with a diagnosis of antisocial personality disorder. Which of the following characteristics would you expect to assess in Jack? a. Lack of guilt for wrongdoing b. Insight into his own behavior c. Ability to learn from past experiences d. Compliance with authority
a Lack of guilt for wrongdoing
8. Which of the following behavioral patterns is characteristic of individuals with narcissistic personality disorder? a. Overly self-centered and exploitative of others b. Suspicious and mistrustful of others c. Rule conscious and disapproving of change d. Anxious and socially isolated
a Overly self-centered and exploitative of others
2. Kim, a patient diagnosed with BPD, manipulates the staff in an effort to fulfill her own desires. All of the following may be examples of manipulative behaviors in the borderline client except: a. Refusal to stay in room alone, stating, "It's so lonely." b. Asking the nurse for cigarettes after 30 minutes, knowing that the assigned nurse has explained she must wait 1 hour. c. Stating to the nurse, "I really like having you for my nurse. You're the best one around here." d. Cutting arms with razor blade after discussing discharge plans with physician.
a Refusal to stay in room alone, stating, "It's so lonely."
The physician orders trazadone (Desyrel) for Mrs. W, a 78-year-old widow with depression, 150 mg to take at bedtime. Which of the following statements about this medication would be appropriate for the home health nurse to make in teaching Mrs. W about trazadone? a. "You may feel dizzy when you stand up, so go slowly when you get up from sitting or lying down." b. "You must be sure and not eat any chocolate while you are taking this medicine." c. "We will need to draw a sample of blood to send to the lab every month while you are on this medication." d. "If you don't feel better right away with this medicine, the doctor can order a different kind for you."
a. "You may feel dizzy when you stand up, so go slowly when you get up from sitting or lying down."
Which of the following is least likely to predispose a child to Tourette's disorder? a. Absence of parental bonding b. Family history of the disorder c. Abnormalities of brain neurotransmitters d. Structural abnormalities of the brain
a. Absence of parental bonding
A school nurse notices bruises and scars on Jana's body. The nurse suspects that the child is being physically abused. How should the nurse proceed with this information? a. As a healthcare worker, report the suspicion to child protective services. b. Check Jana again in a week and see if there are any new bruises. c. Meet with Jana's parents and ask them how Jana got the bruises. d. Initiate paperwork to have Jana placed in foster care.
a. As a healthcare worker, report the suspicion to child protective services.
The Maudsley approach to treatment of adolescents with anorexia nervosa advances which of the following fundamental concepts? a. Family should be actively involved in each phase of treatment. b. Parents should be prohibited from involvement in helping their child eat more because there are often control issues. c. Adolescents need to work on developing healthy self-identities before they can begin to gain weight. d. Individual psychotherapy is the most effective treatment for adolescents with anorexia nervosa.
a. Family should be actively involved in each phase of treatment.
. Mandy presents in the emergency department with complaints of suicidal ideation. The following data is collected by the nurse. Which of these assessment findings suggests that bulimia nervosa might be a health problem? (Select all that apply.) a. Mandy's parotid glands appear enlarged. b. Mandy's teeth have a "moth eaten" pattern of tooth decay. c. Mandy reports that she takes laxatives daily. d. Mandy's weight is within the expected range.
a. Mandy's parotid glands appear enlarged. b. Mandy's teeth have a "moth eaten" pattern of tooth decay. c. Mandy reports that she takes laxatives daily. d. Mandy's weight is within the expected range.
10. Which of the following issues have been identified as contributing to the rise in the population of those who are homeless? (Select all that apply.) a. Poverty b. Lack of affordable healthcare c. Substance abuse d. Severe and persistent mental illness e. Growth in the number of family members living together
a. Poverty b. Lack of affordable healthcare c. Substance abuse d. Severe and persistent mental illness
Which of the following nursing diagnoses would be considered the priority in planning care for the child with a severe ASD? a. Risk for self-mutilation evidenced by banging head against wall b. Impaired social interaction evidenced by unresponsiveness to people c. Impaired verbal communication evidenced by absence of verbal expression d. Disturbed personal identity evidenced by inability to differentiate self from others
a. Risk for self-mutilation evidenced by banging head against wall
. Which of the following represents a nursing intervention at the tertiary level of prevention? a. Serving as case manager for a mentally ill homeless client b. Leading a support group for newly retired men c. Teaching prepared childbirth classes d. Caring for a depressed widow in the hospital
a. Serving as case manager for a mentally ill homeless client
Which of the following represents a nursing intervention at the primary level of prevention? a. Teaching a class in parental effectiveness training b. Leading a group of adolescents in drug rehabilitation c. Referring a married couple for sex therapy d. Leading a support group for battered women
a. Teaching a class in parental effectiveness training
A battered woman presents to the emergency department with multiple cuts and abrasions. Her right eye is swollen shut. She says that her husband did this to her. Which of the following is the priority nursing intervention? a. Tending to the immediate care of her wounds b. Providing her with information about a safe place to stay c. Administering the prn tranquilizer ordered by the physician d. Explaining how she may go about bringing charges against her husband
a. Tending to the immediate care of her wounds
All of the following are examples of elder abuse except: restraining yelling lack of eyeglasses, hearing aides, false teeth annual physician visits
annual physician visits
John has sought help for his concern that he is binge eating, and he feels it has "gotten out of control." He asks the nurse what can be done to help him. Which of the following is the most accurate response? a. "There is nothing that can be done." b. "There are some medications and psychological treatments that have demonstrated effectiveness in reducing binge eating behaviors." c. "The primary problem is obesity. I can help you set up a calorie-restricted diet." d. "There are medications that can help with weight loss, but there are no medications effective for reducing binge eating."
b "There are some medications and psychological treatments that have demonstrated effectiveness in reducing binge eating behaviors."
10. Which of the following behavioral patterns is characteristic of individuals with schizotypal personality disorder? a. Belittling themselves and their abilities b. A lifelong pattern of social withdrawal c. Suspiciousness and mistrust of others d. Overreacting inappropriately to minor stimuli
b A lifelong pattern of social withdrawal
3. "Splitting" by the client with BPD denotes which of the following? a. Evidence of precocious development b. A primitive defense mechanism in which the client sees objects as all good or all bad c. A brief psychotic episode in which the client loses contact with reality d. Two distinct personalities within the borderline client
b A primitive defense mechanism in which the client sees objects as all good or all bad
6. Milieu therapy is a good choice for patients with antisocial personality disorder because it: a. Provides a system of punishment and rewards for behavior modification. b. Emulates a social community in which the patient may learn to live harmoniously with others. c. Provides mostly one-to-one interaction between the patient and therapist. d. Provides a structured setting in which the patients have very little input into the planning of their care.
b Emulates a social community in which the patient may learn to live harmoniously with others.
Emma, age 14, has just been admitted to the psychiatric unit for anorexia nervosa. She is emaciated and refuses to eat. What is the primary nursing diagnosis for Emma? a. Complicated grieving b. Imbalanced nutrition: Less than body requirements c. Interrupted family processes d. Anxiety (severe)
b Imbalanced nutrition: Less than body requirements
The nurse is caring for a patient who has been hospitalized with anorexia nervosa and is severely malnourished. The patient continues to refuse to eat. What is the most appropriate response by the nurse? a. "You know that if you don't eat, you will die." b. "If you continue to refuse to take food orally, you will be fed through a nasogastric tube." c. "You might as well leave if you are not going to follow your therapy regimen." d. "You don't have to eat if you don't want to. It is your choice."
b. "If you continue to refuse to take food orally, you will be fed through a nasogastric tube."
Sharon, a woman with multiple cuts and abrasions, arrives at the emergency department with her three small children. She tells the nurse that her husband inflicted these wounds on her. She says, "I didn't want to come. I'm really okay. He only does this when he has too much to drink. I just shouldn't have yelled at him." Which of the following is the best response by the nurse? a. "How often does he drink too much?" b. "It is not your fault. You did the right thing by coming here." c. "How many times has he done this to you?" d. "He is not a good husband. You have to leave him before he kills you."
b. "It is not your fault. You did the right thing by coming here."
Kate is an 18-year-old freshman at the state university. She was extremely flattered when Don, a senior star football player, invited her to a party. On the way home, he parked the car in a secluded area by the lake. He became angry when she refused his sexual advances. He began to beat her and finally raped her. She tried to fight him, but his physical strength overpowered her. He dumped her in the dorm parking lot and left. The dorm supervisor rushed Kate to the emergency department. Kate says to the nurse, "It's all my fault. I shouldn't have allowed him to stop at the lake." Which of the following is the nurse's best response? a. "Yes, you're right. You put yourself in a very vulnerable position when you allowed him to stop at the lake." b. "You are not to blame for his behavior. You obviously made some right decisions, because you survived the attack." c. "There's no sense looking back now. Just look forward, and make sure you don't put yourself in the same situation again." d. "You'll just have to see that he is arrested so he won't do this to anyone else."
b. "You are not to blame for his behavior. You obviously made some right decisions, because you survived the attack."
Which of the following drug classes is most commonly used for management of the child with ADHD? a. CNS depressants (e.g., diazepam [Valium]) b. CNS stimulants (e.g., methylphenidate [Ritalin]) c. Anticonvulsants (e.g., phenytoin [Dilantin]) d. Major tranquilizers (e.g., haloperidol [Haldol])
b. CNS stimulants (e.g., methylphenidate [Ritalin])
Jana, age 5, is sent to the school nurse's office with an upset stomach. She has vomited and soiled her blouse. When the nurse removes her blouse, she notices that Jana has numerous bruises on her arms and torso in various stages of healing. She also notices some small scars. Jana's abdomen protrudes on her small, thin frame. From the objective physical assessment, the nurse suspects that: a. Jana is experiencing physical and sexual abuse. b. Jana is experiencing physical abuse and neglect. c. Jana is experiencing emotional neglect. d. Jana is experiencing sexual and emotional abuse.
b. Jana is experiencing physical abuse and neglect.
Ann is a psychiatric home health nurse. She has just received an order to begin regular visits to Mrs. W, a 78-year-old widow who lives alone. Mrs. W's primary care physician has diagnosed her as depressed. Which of the following criteria would qualify Mrs. W for home health visits? a. Mrs. W never learned to drive and has to depend on others for her transportation. b. Mrs. W is physically too weak to travel without risk of injury. c. Mrs. W refuses to seek assistance as suggested by her physician because "I don't have a psychiatric problem." d. Mrs. W says she would prefer to have home visits than go to the physician's office.
b. Mrs. W is physically too weak to travel without risk of injury.
A young woman who was a recent victim of a sexual assault is brought into the emergency department by a friend. Which of the following is the priority nursing intervention? a. Help her to bathe and clean herself up. b. Provide physical and emotional support during evidence collection. c. Provide her with a written list of community resources for survivors of rape. d. Discuss the importance of a follow-up visit to evaluate for sexually transmitted diseases.
b. Provide physical and emotional support during evidence collection.
Which of the following represents a nursing intervention at the secondary level of prevention? a. Teaching a class about menopause to middle-aged women b. Providing support in the emergency department to a rape victim c. Leading a support group for women in transition d. Making monthly visits to the home of a client with schizophrenia to ensure medication compliance
b. Providing support in the emergency department to a rape victim
. In an effort to help the child with mild to moderate intellectual developmental disorder develop satisfying relationships with others, which of the following nursing interventions is most appropriate? a. Interpret the child's behavior for others. b. Set limits on behavior that is socially inappropriate. c. Allow the child to behave spontaneously, for he or she has no concept of right or wrong. d. This child is not capable of forming social relationships.
b. Set limits on behavior that is socially inappropriate.
The child with ADHD has a nursing diagnosis of impaired social interaction. Which of the following nursing interventions are appropriate for this child? (Select all that apply.) a. Socially isolate the child when interactions with others are inappropriate. b. Set limits with consequences on inappropriate behaviors. c. Provide rewards for appropriate behaviors. d. Provide group situations for the child.
b. Set limits with consequences on inappropriate behaviors. c. Provide rewards for appropriate behaviors. d. Provide group situations for the child.
Which of the following activities would be most appropriate for the child with attention-deficit/hyperactivity disorder (ADHD)? a. Monopoly b. Volleyball c. Pool d. Checkers
b. Volleyball
. A hospitalized patient with bulimia nervosa has stopped vomiting in the hospital and tells the nurse she is afraid she is going to gain weight. Which is the most appropriate response by the nurse? a. "Don't worry. The dietitian will ensure you don't get too many calories in your diet." b. "Don't worry about your weight. We are going to work on other problems while you are in the hospital." c. "I understand that you are concerned about your weight, and we will talk about the importance of good nutrition; but for now, I want you to tell me about your recent invitation to join the National Honor Society. That's quite an accomplishment." d. "You are not fat, and the staff will ensure that you do not gain weight while you are in the hospital, because we know that is important to you."
c "I understand that you are concerned about your weight, and we will talk about the importance of good nutrition; but for now, I want you to tell me about your recent invitation to join the National Honor Society. That's quite an accomplishment."
Which of the following physical manifestations would you expect to assess in a patient suffering from anorexia nervosa? a. Tachycardia, hypertension, hyperthermia b. Bradycardia, hypertension, hyperthermia c. Bradycardia, hypotension, hypothermia d. Tachycardia, hypotension, hypothermia
c Bradycardia, hypotension, hypothermia
Which medication has been used with some success in clients with anorexia nervosa? a. Lorcaserin (Belviq) b. Diazepam (Valium) c. Fluoxetine (Prozac) d. Carbamazepine (Tegretol)
c Fluoxetine (Prozac)
7. In evaluating the progress of Jack, a patient diagnosed with antisocial personality disorder, which of the following behaviors would be considered the most significant indication of positive change? a. Jack got angry only once in group this week. b. Jack tells the nurse how much he respects her work and that she has helped him immensely. c. On his own initiative, Jack sent a note of apology to a man he had injured in a recent fight. d. Jack stated that he would not start any more fights.
c On his own initiative, Jack sent a note of apology to a man he had injured in a recent fight.
Some obese individuals take amphetamines to suppress appetite and help them lose weight. Which of the following is an adverse effect associated with use of amphetamines that makes this practice undesirable? a. Bradycardia b. Amenorrhea c. Tolerance d. Convulsions
c Tolerance
. The child with autism spectrum disorder (ASD) has difficulty with trust. With this in mind, which of the following nursing actions would be most appropriate? a. Encourage all staff to hold the child as often as possible, conveying trust through touch. b. Assign a different staff member each day so child will learn that everyone can be trusted. c. Assign same staff person as often as possible to promote feelings of security and trust. d. Avoid eye contact, because this is extremely uncomfortable for the child, and may even discourage trust.
c. Assign same staff person as often as possible to promote feelings of security and trust.
John, a homeless person, has just come to live in the shelter. The shelter nurse is assigned to his care. Which of the following is a priority intervention on the part of the nurse? a. Referring John to a social worker b. Developing a plan of care for John c. Conducting a behavioral and needs assessment on John d. Helping John apply for Social Security benefits
c. Conducting a behavioral and needs assessment on John
The nursing history and assessment of an adolescent with a conduct disorder might reveal all of the following behaviors except: a. Manipulation of others for fulfillment of own desires. b. Chronic violation of rules. c. Feelings of guilt associated with the exploitation of others. d. Inability to form close peer relationships.
c. Feelings of guilt associated with the exploitation of others.
Sharon, a woman with multiple cuts and abrasions, arrives at the emergency department with her three small children. She tells the nurse that her husband inflicted these wounds on her. In the interview, Sharon tells the nurse, "He's been getting more and more violent lately. He's been under a lot of stress at work the last few weeks, so he drinks a lot when he gets home. He always gets mean when he drinks. I was getting scared. So I just finally told him I was going to take the kids and leave. He got furious when I said that and began beating me with his fists." With knowledge about the cycle of battering, what does this situation represent? a. Phase I. Sharon was desperately trying to stay out of his way and keep everything calm. b. Phase I. A minor battering incident for which Sharon assumes all the blame. c. Phase II. The acute battering incident that was provoked by her threat to leave. d. Phase III. The honeymoon phase when the husband believes that he has "taught her a lesson and she won't act up again." Continued
c. Phase II. The acute battering incident that was provoked by her threat to leave.
Ann is a psychiatric home health nurse. She has just received an order to begin regular visits to Mrs. W, a 78-year-old widow who lives alone. Mrs. W's primary care physician has diagnosed her as depressed. Which of these potential problems is a priority to evaluate during the first home visit? a. Complicated grieving b. Social isolation c. Risk for injury d. Sleep pattern disturbance
c. Risk for injury
Mrs. W, a 78-year-old depressed widow, says to her home health nurse, "What's the use? I don't have anything to live for anymore." Which is the best response on the part of the nurse? a. "Of course you do, Mrs. W. Why would you say such a thing?" b. "You seem so sad. I'm going to do my best to cheer you up." c. "Let's talk about why you are feeling this way." d. "Have you been thinking about harming yourself in any way?"
d. "Have you been thinking about harming yourself in any way?"
A woman who has a long history of being battered by her husband is staying at the woman's shelter. She has received emotional support from staff and peers and has been made aware of the alternatives open to her. Nevertheless, she decides to return to her home and marriage. Which of the following is the best response by the nurse to the woman's decision? a. "I just can't believe you have decided to go back to that horrible man." b. "I'm just afraid he will kill you or the children when you go back." c. "What makes you think things have changed with him?" d. "I hope you have made the right decision. Call this number if you need help."
d. "I hope you have made the right decision. Call this number if you need help."
A woman who was sexually assaulted 6 months ago by a man with whom she was acquainted has since been attending a support group for survivors of rape. From this group, she has learned that the most likely reason the man raped her was: a. Because he had been drinking, he was not in control of his actions. b. He had not had sexual relations with a girl in many months. c. He was predisposed to become a rapist by virtue of the poverty conditions under which he was reared d. He was expressing power and dominance by means of sexual aggression and violence.
d. He was expressing power and dominance by means of sexual aggression and violence.
Certain family dynamics often predispose adolescents to the development of conduct disorder. Which of the following patterns is thought to be a contributing factor? a. Parents who are overprotective b. Parents who have high expectations for their children c. Parents who consistently set limits on their children's behavior d. Parents who are alcohol dependent
d. Parents who are alcohol dependent
John, a homeless person, has a history of schizophrenia and nonadherence to his medication regimen. Which of the following medications might be the best choice for John? a. Haldol b. Navane c. Lithium carbonate d. Prolixin decanoate
d. Prolixin decanoate
4. According to Margaret Mahler, predisposition to BPD occurs when developmental tasks go unfulfilled in which of the following phases? a. Autistic phase, during which the child's needs for security and comfort go unfulfilled b. Symbiotic phase, during which the child fails to bond with the mother c. Differentiation phase, during which the child fails to recognize a separateness between self and mother d. Rapprochement phase, during which the mother withdraws emotional support in response to the child's increasing independence
d. Rapprochement phase, during which the mother withdraws emotional support in response to the child's increasing independence
Kim has a diagnosis of BPD. She often exhibits alternating clinging and distancing behaviors. Which of the following is the most appropriate nursing intervention with this type of behavior? a. Encourage Kim to establish trust in one staff person with whom all therapeutic interaction should take place. b. Secure a verbal contract from Kim that she will discontinue these behaviors. c. Withdraw attention if these behaviors continue. d. Rotate staff members who work with Kim so that she will learn to relate to more than one person.
d. Rotate staff members who work with Kim so that she will learn to relate to more than one person.
A school nurse notices bruises and scars on a child's body, but the child refuses to say how she received them. What is another way in which the nurse can get information from the child? a. Have her evaluated by the school psychologist. b. Tell her she may select a "treat" from the treat box (e.g., sucker, balloon, junk jewelry) if she answers the nurse's questions. c. Explain to her that if she answers the questions, she may stay in the nurse's office and not have to go back to class. d. Use a "family" of dolls to role-play the child's family with her.
d. Use a "family" of dolls to role-play the child's family with her.
Priority nursing care for a 16 year old Anorexic female would be: coaxing her to each as much as she can. provide her with extra snacks to stash for later when she might be hungry. rewarding her when she increases her caloric intake. sitting at the table with her for all meals and for 1 hour after meals.
sitting at the table with her for all meals and for 1 hour after meals.
A client is referred to a support group for rape victims. She has been attending regularly for 6 months. From the group, she has learned that the most likely reason she was raped is that the male who raped her: had not had sexual relations with a girl in many months. was predisposed to become a rapist by virtue of the poverty conditions under which he was reared. had too much to drink at the party and was not in control of his actions. was expressing power and dominance by means of sexual aggression and violence.
was expressing power and dominance by means of sexual aggression and violence
