Mental Health Davis Edge Exam 1

Which steps should the nurse follow while making an ethical decision? Arrange the steps in order of their priority.

answer: 1. gather objective and subjective information about the situation 2. identify the conflict between two or more alternative actions 3. explore the benefits and consequences of each alternative 4. implement the decision made and communicate the same to others 5. evaluate the outcomes of the decision

Which statement made by the client indicates that his or her coping strategy in a time of grief is maladaptive? 1. "I will never be able to be happy again." 2. "I manage my hostile feelings by listening to music." 3. "I try to find the reasons of failure whenever I experience it." 4. "I do breathing exercises to rejuvenate myself after heavy work."

answer: 1 A client claiming that he or she will never be happy again is an exaggeration or overreaction. When grief is prolonged or distorted and exaggerated, coping is considered to be maladaptive.

The nurse is caring for a critically ill client who is often complains about treatment and is uncooperative. During an unfavorable event, the nurse becomes very defensive in his or her approach to the client. Which outcome may be expected due to the nurse's approach to the client? 1. Increased likelihood of a lawsuit from the client against the nurse 2. Improved interpersonal communication between the nurse and the client 3. Increased chances of avoiding nursing malpractice 4. Improved chances of fulfilling the emotional needs of the client

answer: 1 A critically ill client who is often complains and uncooperative about treatment is a suit-prone client. The defensive approach of the nurse to the client may provoke the client to file a lawsuit against the nurse.

While caring for a client in a psychiatric ward, the nurse observes that the client is not turning away from a dangerous object when it comes into view and not turning toward a sound that is heard. Which brain structure alterations may the nurse find in the electroencephalogram (EEG) findings of this client? 1. Mesencephalon 2. Hypothalamus 3. Pituitary gland 4. Thalamus

answer: 1 Abnormalities in the mesencephalon may result in disturbances in visual, auditory, and righting reflexes. Visual reflexes help in automatically turning away from a dangerous object when it comes into view. Auditory reflexes help in automatically turning toward a sound that is heard.

Which characteristic does the healthy or self-actualized individual exhibit, according to Maslow? 1. creativeness 2. enculturation 3. a degree of conformance 4. desire for companionship

answer: 1 According to Maslow, a healthy or self-actualized individual possesses creativeness.

A police officer brought a client who is dangerous to himself and others to a community hospital. The health-care professionals made an emergency commitment for the client. When is the client scheduled for a court hearing? 1. Within 3 days 2. Within 7 days 3. Within 1 hour 4. Within 24 hours

answer: 1 According to law, the court decides when to discharge a client from the hospital who is under emergency commitment. Therefore, the client should be scheduled for a court hearing within 72 hours of the admission.

How is subjective data about a client obtained for use within the subjective, objective, assessment, plan, implementation, and evaluation (SOAPIE) format? 1. From verbal reports of the client, family, or other sources 2. From interpretation of the subjective and objective data by the nurse 3. From direct observation or examination by the nurse 4. From the nursing actions that were actually carried out

answer: 1 According to the SOAPIE format, information gathered from the verbal reports of the client, family, or other source is part of subjective data.

A client with depression is prescribed fluoxetine. The caregiver of the client asks the nurse, "I read on the Internet about the antidepressant and antipanic effects of alprazolam. Why didn't the primary health-care provider prescribe that instead?" How would the nurse respond to the caregiver's query? 1. "Alprazolam is less desirable due to its addictive properties." 2. "Alprazolam would not be prescribed to clients with post-traumatic stress disorder." 3. "Alprazolam has been reported to increase the symptoms of nightmares and flashbacks." 4. "Alprazolam is not approved by the Food and Drug Administration."

answer: 1 Alprazolam is a benzodiazepine drug that causes addiction. Withdrawal from alprazolam leads to severe adverse effects. Therefore, the nurse would tell the caregiver about the addictive effects of alprazolam.

In a psychiatric unit, the nurse observes a health-care professional helping a client analyze his or her own creative work in an effort to recognize the underlying conflict. Which health-care professional would be working in this role? 1. art therapist 2. music therapist 3. recreational therapist 4. occupational therapist

answer: 1 An art therapist is a member of the interdisciplinary team who helps the client in analyzing his or her own creative work in an effort to recognize and resolve underlying conflict. Therefore, the health-care professional in this case is an art therapist.

The nurse is teaching a parent of a child about antidepressants. Which is most important to include in the teaching? 1. Monitoring their child for statements or thoughts of suicidal ideation 2. Sucking on hard candy to eliminate dry mouth and nausea 3. Drinking plenty of water to reduce risk of constipation 4. Taking medication at night to decrease risk of daytime sedation

answer: 1 Antidepressants carry a black-box warning for an increased risk of suicidal ideation in children and adolescents. It is important to notify the parents of this warning.

What would be the medication of choice prescribed by the primary health-care provider for a client who works as a cab driver and has symptoms of depression and anxiety? 1. Buspirone 2. Alprazolam 3. Hydroxyzine 4. Meprobamate

answer: 1 Buspirone does not depress the central nervous system and is among the first-line medications for anxiety.

Who would be the best person to select the type of coping mechanisms for dealing with a crisis? 1. The client 2. The nurse 3. The caretaker of the client 4. The primary health-care provider

answer: 1 Coping mechanisms are highly individual. Therefore, the best person to select the type of coping mechanism is the client.

The primary health-care provider is assessing a client with anxiety. Which medication would the nurse expect the client to be prescribed? 1. Diazepam 2. Bupropion 3. Fluoxetine 4. Chlorpromazine

answer: 1 Diazepam is an antianxiety medication used to relieve the symptoms of anxiety. Therefore, the nurse is most likely to find that the client has been prescribed diazepam.

Which medication is the first-line treatment of choice for clients with post-traumatic stress disorder (PTSD)? 1. fluoxetine 2. propranolol 3. alprazolam 4. carbamazepine

answer: 1 Fluoxetine is a selective serotonin reuptake inhibitor (SSRI). SSRIs are considered the first-line treatment of choice for PTSD due to their efficacy, tolerability, and safety ratings.

What is the function of follicle-stimulating hormone? 1. Initiates the maturation of ovarian follicle 2. Secretes estrogen 3. Responsible for ovulation 4. Secretes progesterone

answer: 1 Follicle stimulating hormone initiates the maturation of ovarian follicle into ova.

Which nursing intervention provides information that can be used to build on in order to help a client cope with a traumatic experience? 1. Identifying the client's strengths 2. Listening for comments that indicate the client feels responsible for the traumatic event 3. Recommending participation in debriefing sessions 4. Evaluating current factors associated with trauma

answer: 1 Identifying the client's strengths will help provide information to build on when developing coping strategies for dealing with the trauma.

Which precaution would the nurse follow while caring for an Navajo Indian client? 1. Limit touch with this client 2. Refrain from taking financial gifts from the client 3. Refrain from collecting background data of the client 4. Refrain from giving excuses about the client's inappropriate behavior to others

answer: 1 In the Navajo Indian culture, touch is not considered acceptable. The nurse should particularly be careful while taking care of the Navajo Indian client.

The nurse finds that a client with a psychotic disorder is involved in decision making regarding psychotherapeutic treatments. The client's caregiver reports that the client has also developed a sense of optimism and hope for a rewarding future. Which stage of recovery does the nurse expect the client is in, according to the Psychological Recovery Model? 1. growth 2. awareness 3. preparation 4. moratorium

answer: 1 In the growth stage, the client is empowered by personal input and decision making regarding his or her treatment. He or she feels a sense of optimism and hope for a rewarding future.

A client who was assaulted explains the situation in detail to the nurse without any emotion. Which defense mechanism does the nurse suspect in this client? 1. isolation 2. compensation 3. displacement 4. denial

answer: 1 Isolation is separating a thought or memory from the feeling, tone, or emotion associated with it.

The nurse is caring for a client with schizophrenia who is receiving risperidone. Which symptom, if developed by the client, would warrant immediate notification of the health-care provider? 1. Jerking of the head 2. Dry mouth 3. Fatigue 4. Nausea

answer: 1 Jerking of the head is an extrapyramidal effect, which can last long after discontinuing the medication. This is a priority concern and requires immediate notification of the HCP.

The nurse is caring for a client dealing with fear and anxiety. Which nursing intervention is beneficial to reduce the sense of confusion in the client? 1. Maintaining a silent environment around the client 2. Noting the degree of disorganization 3. Determining the presence of physical symptoms 4. Identifying if the incident has reactivated preexisting situations

answer: 1 Maintaining a silent environment around the client reduces the sense of confusion.

The registered nurse is teaching the nursing process in psychiatric mental health nursing to a group of student nurses. Which statement made by the registered nurse needs correction? 1. "Nursing diagnosis is prioritized based only on client and family requests." 2. "The nurse's interpretation of subjective and objective data is recorded under the assessment category of the SOAPIE format." 3. "Focus charting follows a data, action, and response (DAR) format." 4. "Health information and data is one of the core capabilities of electronic documentation."

answer: 1 Nursing diagnosis is prioritized according to the life-threatening potential, with input from the client and family. Therefore, this statement is not correct.

According to Aguilera, which factor affects the way a client perceives and responds to a precipitating stressor? 1. Availability of coping strategies 2. Loss of a valuable possession 3. Exposure to harmful situations 4. Challenges faced during the crisis

answer: 1 One of the factors identified by Aguilera as affecting an individual's response to a stressor is the availability of coping strategies.

Which statement made by a new nurse regarding the disadvantages of paper records requires correction? 1. "Paper records are nonportable and are often illegible." 2. "Paper records cannot be accessed by multiple providers from remote sites." 3. "Paper records are disorganized and hard to store." 4. "Paper records are often incomplete, and the information can be duplicated."

answer: 1 Paper records may be illegible, but they can be transported from one place to another.

According to the Wellness Recovery Action Plan (WRAP) Model, which information is included in the third part of the crisis planning step? 1. The names of the supporters who speak on the client's behalf 2. The name of health-care providers and their phone numbers 3. The client's preferred treatments 4. The client's preferences in treatment facilities

answer: 1 Part 3 of crisis planning provides the names of the supporters previously identified by the client to speak on his or her behalf.

A client with mild anxiety tells the nurse, "I am disabled and unable to participate in sports. However, I am a great scholar." Which ego defense mechanism does the nurse suspect in this client? 1. compensation 2. isolation 3. identification 4. intellectualization

answer: 1 Physical disability is the perceived weakness of the client. This weakness of the client is compensated by becoming a great scholar. This indicates that the client is utilizing the compensation type of ego defense mechanism.

During an education session, the psychiatric nurse states that recovery encompasses an individual's whole life, including mind, body, spirit, and community. Which guiding principle of recovery does the nurse address through this statement? 1. Recovery is holistic. 2. Recovery is person-driven. 3. Recovery is based on respect. 4. Recovery occurs via many pathways.

answer: 1 Recovery encompasses an individual's whole life, including mind, body, spirit, and community. The nurse addresses the guiding principle "recovery is holistic" through this statement.

Which core capability of electronic documentation helps access various types of test reports of the client at the same time without any delay? 1. result management 2. health information and data 3. patient support 4. administrative processes

answer: 1 Result management helps the primary health-care provider access computerized results of all types of reports, such as laboratory test results and radiology reports, more easily and simultaneously.

Which combination of therapy and medication would be most effective in a client with post-traumatic stress disorder (PTSD)? 1. sertraline and group therapy 2. clonidine and family therapy 3. valproic acid and cognitive therapy 4. fluoxetine and prolonged exposure therapy

answer: 1 Sertraline, a selective serotonin reuptake inhibitor (SSRI), is the first-line treatment of choice in clients with PTSD. Group therapy enables clients with PTSD to share their experiences and talk about their problems. This is strongly recommended for clients with PTSD. Thus, this combination of medication and therapy is recommended for clients with PTSD.

While teaching about obsessive-compulsive disorder (OCD), the registered nurse says to the student nurses, "Active avoidance explains the behavioral patterns of a client with OCD." The nurse's statement is most consistent with what theory? 1. learning theory 2. cognitive theory 3. psychoanalytic theory 4. psychodynamic theory

answer: 1 Some clients may indulge in behaviors that provide comfort from the anxiety associated with a traumatic event. This is known as active avoidance, and this explains the behavioral patterns of the clients with OCD according to the learning theory.

During data collection, the nurse finds that the client has financial problems and work-related stress. The client develops a plan for preventing these issues from worsening. Which step of the Wellness Recovery Action Plan (WRAP) Model is the client following in this situation? 1. step 3 2. step 4 3. step 5 4. step 6

answer: 1 Step 3 of the Wellness Recovery Action Plan includes identifying triggers that interfere with the client's wellness and developing a plan to prevent them from worsening. Financial problems and work stress are the triggers that interfere with the wellness of an individual.

After losing a friend in a motorcycle accident, the client tells the nurse, "I should have died in the accident instead of my friend. I was driving the bike too fast." What does the client's statement indicate? 1. Survivor's guilt 2. Spiritual distress 3. Suicidal ideation 4. Withdrawn behavior

answer: 1 Survivor's guilt is a perception of being in the wrong for having survived a traumatic incident. The statement of the client is an indication of survivor's guilt.

While assessing a client with psychotic disorder, the nurse finds that the client is irritable and has increased anxiety levels. On interaction with the client's partner, the nurse finds that the client has decreased libido. What could be the reason for such behavioral symptoms in the client? 1. Hypersecretion of prolactin 2. Undersecretion of gonadotropic hormones 3. Hypersecretion of thyroid stimulating hormone 4. Undersecretion of adrenocorticotropic hormone

answer: 1 The behavioral symptoms associated with hypersecretion of prolactin include irritability, anxiety, and decreased libido.

A psychiatric client claims to be the messenger of God, drapes himself in a blanket, "performs miracles" on other clients, and refuses to respond unless addressed as Jesus Christ. Which type of ego defense mechanism does the nurse suspect in this client? 1. introjection 2. projection 3. regression 4. repression

answer: 1 The client believes and values Jesus Christ. So, the client behaves as Jesus and does the same activities associated with Jesus Christ. Therefore, the client is showing the introjection defense mechanism.

The parent of a client who is HIV positive tells the nurse, "My son is not interested in seeing his friends or going out. Honestly, I am still not convinced that he is HIV positive." Which diagnosis made by the nurse will help to create an effective care plan for the parent and client? 1. The client is depressed and the parent is in denial. 2. The client is showing acceptance and the parent is in denial. 3. The client is showing acceptance and the parent is bargaining. 4. The client is depressed and the parent is showing acceptance.

answer: 1 The client is not involved in any daily activities and is choosing to remain alone, which indicates that the client is depressed. The parent of the client is unable to accept that the client is ill, which indicates that the parent is experiencing denial.

A client with schizophrenia who is experiencing auditory hallucinations, paranoid delusions, social withdrawal, and developmental regression is admitted to the psychiatric unit. Which symptom of the client requires priority of treatment? 1. auditory hallucinations 2. paranoid delusions 3. social withdrawal 4. developmental regression

answer: 1 The client may hear voices that command him or her to harm self or others. Therefore, auditory hallucinations require priority of treatment.

Which statement supports the nurse's suspicion that the client has obsessive-compulsive disorder? 1. "I wash my hands every 15 minutes." 2. "I have 12 puppies and love caring for them." 3. "My nose has a deformity even after rhinoplasty." 4. "I bite my nails and scratch myself in extreme tension."

answer: 1 The client with obsessive-compulsive disorder will show repetitive behaviors, including excessive hand washing.

The nurse observes that the client with schizophrenia has an inability to trust others. Which problem would the client's treatment team determine the client exhibits? 1. Paranoid delusions 2. Social withdrawal 3. Auditory hallucinations 4. Developmental regression

answer: 1 The client with schizophrenia, who lacks ability to trust others, will have paranoid delusions.

The mother of a 10-year-old client tells the nurse, "My child frequently eats pieces of chalk." Which member of the interdisciplinary treatment team is recommended to this client? 1. dietitian 2. psychiatric nurse 3. psychiatric aide 4. psychiatric clinical nurse specialist

answer: 1 The condition of the child is called pica. In this condition, clients eat or crave nonnutritious materials such as clay or chalk. The dietitian can explain the effects of eating chalk to the client and then prepare a diet plan.

The estimated length of a hospital stay for a client experiencing alcohol withdrawal symptoms is 7 days. What is the expected dose of chlordiazepoxide administered to the client on the first day of admission in the hospital? 1. 200 mg in divided doses 2. 160 mg in divided doses 3. 120 mg in divided doses 4. 80 mg in divided doses

answer: 1 The estimated dose of chlordiazepoxide administered to the client on the first day of hospital admission is 200 mg in divided doses.

A client with a psychiatric illness complains to the nurse of insomnia and pain sensation in the legs. Which neurotransmitter function does the nurse expect to be associated with these symptoms? 1. Histamine 2. Dopamine 3. Somatostatin 4. Norepinephrine

answer: 1 The functions regulated by the neurotransmitter histamine are wakefulness and pain sensation. Therefore, the nurse expects release of histamine is associated with these symptoms.

While caring for a client diagnosed with ineffective community coping, the nurse develops a plan jointly with members of the community. Which would be the reason for such an intervention? 1. To deal with deficits 2. To meet collective needs 3. To promote understanding 4. To promote a sense of working together

answer: 1 The nurse develops a plan jointly with the members of the community to deal with deficits in support of identified goals.

The nurse tells a client who is psychotic, "If you don't keep quiet, I am going to give you your medication with a needle." The nurse can be charged with which legal action? 1. Assault 2. Battery 3. False imprisonment 4. Breach of confidentiality

answer: 1 The nurse in this scenario may be charged with assaulting the client. The act of assault is inducing fear in the client when touching him or her against his or her wishes. Therefore, the nurse can be charged with assault in this situation.

The parents of a 10-year-old child are informed that the child is in the terminal stage of acute lymphocytic leukemia. Which characteristics of the parents indicate that they are in the acceptance stage of grief? 1. Being sad but determined to spend meaningful last days with their child, letting her know their love 2. Insisting that no one is telling the truth 3. Delaying consent for treatment and procedures 4. Asking no questions about treatment or prognosis

answer: 1 The parents being sad is natural but the fact that they are focusing on using the time left to love their child indicates that they are in the acceptance stage of grief.

What daily dose range of lorazepam would the nurse expect a primary health-care provider to prescribe to an adult client with panic disorder? 1. 2 to 6 mg 2. 4 to 40 mg 3. 15 to 60 mg 4. 30 to 120 mg

answer: 1 The primary health-care provider would prescribe 2 to 6 mg of lorazepam to an adult client with panic disorder.

Which describes the role of the psychiatric nurse in a therapeutic community? 1. Performing ongoing assessment of the client's condition 2. Interpreting psychological tests 3. Conducting in-depth psychosocial history 4. Working with the client to assist in activities of daily living

answer: 1 The psychiatric nurse will perform ongoing physical and mental assessment of the client's condition and manage the therapeutic milieu on a 24-hour basis.

Which sentence explains the psychosocial theory of adjustment disorder? 1. Adjustment disorder is a maladaptive response to stress. 2. Neurocognitive disorders impair the client's ability to adapt to stress. 3. Chronic disorders cause an increase in vulnerability to adjustment disorder. 4. Alterations in the interaction between the client and environment may result in maladaptive response to stress.

answer: 1 The psychosocial theory suggests that adjustment disorder is a maladaptive response to stress.

The nurse is caring for a client who is experiencing recurrent unpredictable episodes of anxiety that manifest as sweating, trembling, chest pain, and dizziness. During interactions with this client, the nurse maintains a calm, nonthreatening, and matter-of-fact approach. What is the rationale behind this nursing intervention? 1. To develop a sense of security in the client 2. To explore the reasons of anxiety in the client 3. To interrupt the progression of anxiety in the client 4. To demonstrate various ways to interrupt anxiety to the client

answer: 1 The symptoms of the client indicate panic anxiety. While caring for a client with panic anxiety, the nurse should maintain a calm and nonthreatening approach. This intervention helps minimize the stimuli around the client and helps develop a sense of security.

Why would the therapist assign responsibilities to the client during a therapeutic community setting? 1. To enhance self-esteem in the client 2. To facilitate interpersonal communication by the client 3.To reinforce the democratic posture of the group 4. To facilitate discharge of the client from treatment

answer: 1 The therapist assigns responsibilities to the client to enhance the client's self-esteem.

Which therapeutic communication technique is often used with clients experiencing delusional thinking? 1. voicing doubt 2. exploring 3. verbalizing the implied 4. belittling feelings expressed

answer: 1 Voicing doubt allows the client to express an uncertainty about the reality of the client's perception. This technique is often used with clients experiencing delusional thinking.

While caring for a client with anxiety, the nurse says, "I wouldn't worry so much if I were you." What is the impact of this statement by the nurse? 1. It devalues the client's feelings. 2. It encourages a like response from the client. 3. It prevents the client from exploring areas of difficulty. 4. It increases the understanding for both the client and nurse.

answer: 1 When the nurse says, "I would not worry so much if I were you," it will devalue the client's feelings.

The nurse is caring for a client who is complaining about her treatment in an aggressive tone of voice. Which statement made by the nurse would encourage the client to continue what she is saying? 1. "Yes, I understand. Please continue." 2. "I will sit in the room with you now." 3. "Tell me what you are thinking." 4. "Yes, I understand what you said."

answer: 1 When the nurse tells the client, "Yes, I understand. Please continue," it indicates that the nurse is encouraging the client to continue with what she is saying.

The nursing instructor is teaching a group of nursing students about the program of the therapeutic community. Which statements made by the nursing students require correction? Select all that apply. 1. "Only two or three members of the interdisciplinary treatment (IDT) should sign the treatment plan." 2. "The clinical psychologist should perform the initial assessment to establish the priority of care." 3. "All team members of the therapeutic community should meet regularly to update the plan as needed." 4. "The nurse should assume the responsibility for the management of the therapeutic milieu." 5. "The information from the initial nursing assessment should be used to create the IDT plan."

answer: 1, 2 Everyone involved in the IDT should sign the treatment plan for ethical and legal purposes within the scope of their practice. This statement by the student nurse is invalid and requires correction. The psychiatrist, the nurse, or the admitting agent will perform the initial assessments in order to establish the priority of care. The clinical psychologist will not perform the initial assessment.

A client is diagnosed with trichotillomania. Which other comorbid conditions should be evaluated in the client? Select all that apply. 1. mood disorders 2. anxiety disorders 3. schizoid disorders 4. endocrine disorders 5. personality disorders

answer: 1, 2 Mood disorder is a psychiatric disorder associated with trichotillomania. Anxiety disorders may be associated with hair-pulling disorder.

After assessing a client with a psychiatric illness, the nurse suspects that the client is in the moratorium stage of recovery. Which findings support the nurse's suspicion? Select all that apply. 1. The client appears confused. 2. The client feels out of control. 3. The client exhibits confidence in managing the illness. 4. The client tries new activities to reestablish a sense of self. 5. The client strives for personal comprehension of the illness.

answer: 1, 2 The moratorium stage is identified by dark despair and confusion. In this stage, the client appears confused due to a lack of hope. Therefore, this finding supports the nurse's suspicion. The client in the moratorium stage feels out of control and powerless to change. Therefore, this finding supports the nurse's suspicion.

Which structures are parts of the hindbrain? Select all that apply. 1. Pons 2. Medulla 3. Cerebellum 4. Diencephalon 5. Mesencephalon

answer: 1, 2, 3

Which symptoms may occur in a client suffering from alcohol withdrawal? Select all that apply. 1. Nausea and vomiting 2. Insomnia 3. Seizures 4. Bradycardia 5. Hypotension

answer: 1, 2, 3

Which information would the nurse find under the section of general information in the mental history form? Select all that apply. 1. Client's sex 2. Client's name 3. Client's height or weight 4. Client's occupational history 5. Client's educational background

answer: 1, 2, 3 The nurse finds the client's sex under the section of general information in the mental history form. The nurse finds the name of the client under the section of general information in the mental history form. The nurse finds the height or weight of the client under the section of general information in the mental history form.

Which actions of the nurse convey an attitude of respect toward the client? Select all that apply. 1. Being honest while interacting with the client 2. Calling the client by name 3. Spending time with the client 4. Understanding the situation from the client's point of view 5. Promoting an atmosphere of privacy during therapeutic interaction

answer: 1, 2, 3, 5 Being honest while interacting with the client even when the truth may be difficult to discuss conveys respect. Calling the client by name conveys respect toward the client. Spending time with the client conveys respect toward the client. Promoting an atmosphere of privacy during therapeutic interactions with the client conveys respect toward the client.

While caring for a client with psychiatric illness, the nurse finds that the client frequently pulls out hair from the scalp and eyebrows. Which other behaviors does the nurse expect in the client accompanying this behavior? Select all that apply. 1. biting 2. scratching 3. skin picking 4. head banging 5. mirror checking

answer: 1, 2, 4 A client with trichotillomania may perform self-mutilating behaviors such as biting. A client with trichotillomania may perform self-mutilating behaviors such as scratching. A client with trichotillomania may perform self-mutilating behaviors such as head banging.

Which physical characteristics may be noticed in a client with severe anxiety? Select all that apply. 1. Palpitations 2. Headaches 3. Diaphoresis 4. Insomnia 5. Inability to verbalize

answer: 1, 2, 4 Palpitations are a common symptom of patients with severe anxiety not commonly seen in patients with mild or moderate anxiety. Headaches are a physical symptom that is commonly seen in the client with severe anxiety. Insomnia is a common physical symptom of patients with severe anxiety.

Which features are expected in a client who has experienced a traumatic event? Select all that apply. 1. Feeling of impending doom 2. Exaggerated sense of responsibility 3. Reduced participation in community functions 4. Concerned expressions about belief systems 5. Expressing having no control over anything in life verbally

answer: 1, 2, 5 A client who has experienced a traumatic event is anxious and fearful. Therefore, a feeling of impending doom could be evidenced in the client. A client who has experienced a traumatic event may feel responsible for it. A traumatic experience is usually out of the client's control. Therefore, the client may express lack of control over anything in life.

The registered nurse is teaching about the ethical principle of advocacy that has to be followed while caring for a client on the psychiatric unit. Which actions taken by the student nurse indicate teaching has been effective? Select all that apply. 1. Educating the client's family about legal rights 2. Encouraging the client to fulfill his or her own needs without assistance 3. Being honest with the client's family about the client's condition 4. Avoiding harming the client 5. Speaking about the client's condition on his or her behalf to secure necessary health care services

answer: 1, 2, 5 Explaining about legal rights to the client's family indicates effective implementation of the ethical principle of advocacy. The nurse implements the advocacy principle by encouraging the client to fulfill his or her needs without any assistance. The nurse acts as advocate by speaking on behalf of clients with mental illness to secure essential mental health services.

The registered nurse is teaching a group of student nurses about the various diagnostic procedures that are used to detect altered brain functioning. Which statements made by the student nurse indicate effective learning? Select all that apply. 1. "Computerized electroencephalography (EEG) mapping is largely used in the research field." 2. "Electroencephalography is useful in the detection of aneurysm." 3. "No radiation or contrast medium is used in magnetic resonance imaging (MRI)." 4. "The longer-acting radioactive substance is injected to the client during positron emission tomography (PET) scanning." 5. "The nuclei of oxygen atoms play an important role in MRI."

answer: 1, 3 Computerized EEG mapping is useful in the measurement of the electrical activity of the brain and is widely used in research. In MRI, a radiation or contrast medium is not used. A magnetic field is used for diagnosis of various brain alterations.

Which signs and symptoms indicate that the client has disturbed thought processes? Select all that apply. 1. suspiciousness 2. social withdrawal 3. delusional thinking 4. unkempt appearance 5. expression of fear of failure

answer: 1, 3 The client with disturbed thought processes is suspicious about others. Delusions are the false ideas believed by the client. Delusional thinking indicates disturbed thought processes in the client.

Which characteristics would the nurse expect to find in a patient with neurosis? Select all that apply. 1. They feel helpless to change their situation. 2. They experience loss of contact with reality. 3. They are aware that they are experiencing distress. 4. They are aware that their behaviors are maladaptive. 5. They are aware of any possible psychological causes of the distress.

answer: 1, 3, 4 Neuroses are psychiatric disturbances, characterized by excessive anxiety that is expressed directly or altered through defense mechanisms. Clients with neuroses feel helpless to change their situations. Clients with neuroses are aware that they are experiencing distress. Clients with neuroses are aware that their behaviors are maladaptive.

Which symptoms are commonly observed in a client with psychosis? Select all that apply. 1. delusions 2. obsessions 3. hallucinations 4. hypochondrias 5. disorganized speech

answer: 1, 3, 5 Delusions are a common characteristic seen in a client with psychosis. Hallucination is the most common symptom in the client with psychosis. The client with psychosis shows disorganized speech or behavior.

While caring for a client in a psychiatric ward, the nurse suspects the client may be suffering from hyperthyroidism. Which symptoms in the client support the nurse's suspicion? Select all that apply. 1. Recent weight loss 2. Depression 3. Insomnia 4. Social withdrawal 5. Irritability

answer: 1, 3, 5 Hyperirritability is noticed in clients with hyperthyroidism.

Based on a 2015 Food and Drug Administration (FDA) law, which is required to be placed on a label for psychotropic medications to protect women of childbearing age? Select all that apply. 1. Pregnancy-associated risks 2. Dietary interactions 3. Risks of cancer 4. Lactation considerations 5. Reproductive potential

answer: 1, 4, 5

What characteristic symptoms does a client who has social phobia exhibit? Select all that apply. 1. The client has a fear of using public restrooms. 2. The client is afraid of snakes. 3. The client does not cook food because of the fear of fire. 4. The client is afraid to present a speech in an auditorium. 5. The client gets embarrassed during stage performances.

answer: 1, 4, 5 A client with social phobia has a fear of using public restrooms. Using public restrooms may cause the client to have intense sweating and tachycardia. The client with social phobia has a fear of speaking in public areas. The client who has social phobia gets embarrassed during stage performances due to fear.

A client with schizophrenia is found to have low self-esteem. Which interventions would the nurse implement while caring for the client? Select all that apply. 1. Spending time with the client 2. Observing signs of hallucinations 3. Assigning the same staff as much as possible 4. Attending the group activities along with the client at initial stages 5. Teaching effective communication techniques to the client

answer: 1, 4, 5 The client with low self-esteem has a fear of failure. The nurse should spend time with the client and develop trust. The nurse should attend the group activities along with the client at initial stages since the client expresses a fear of failure. The nurse should teach effective communication techniques to the client to reduce the fear of failure.

A client with claustrophobia is undergoing therapy in which the therapist instructs the client to imagine anxiety-provoking situations and then a healthy response to that anxiety. Which response by the client indicates that the therapy is effective? 1. "I prefer to stay in open spaces rather than closed spaces." 2. "I'm not having any discomfort while watching a movie in a theater." 3. "I always ensure that somebody accompanies me while walking in a subway." 4. "I'm not feeling dizzy while walking up a flight of stairs."

answer: 2 A client who has overcome the fear of closed spaces may not feel any discomfort in theaters or any such closed spaces. Therefore, this indicates that the therapy provided to the client is effective.

After interacting with the mother of an adolescent client, the nurse finds that the client masturbates frequently, watches pornographic films, and makes calls to phone sex operators often. Which complication should the nurse expect in the client? 1. Hoarding disorder 2. Paraphilic disorder 3. Body dysmorphic disorder 4. Stereotypic movement disorder

answer: 2 A client with paraphilic disorder has sexual urges or fantasies. Because the client masturbates frequently, watches pornographic films, and talks to phone sex operators often, the nurse should expect paraphilic disorder in this case.

Which member of the psychiatric care unit is responsible for evaluating the psychological tests of the clients and assisting in diagnostic processes? 1. Psychiatrist 2. Clinical psychologist 3. Mental health technician 4. Psychiatric clinical nurse specialist

answer: 2 A clinical psychologist is a member of the psychiatric care unit with a doctoral degree in clinical psychology. He or she is responsible for administering, interpreting, and evaluating psychological tests.

What is the function of afferent neurons? 1. Serving as integrators in the pathways in the brain 2. Carrying impulses from receptors in the periphery to the central nervous system 3. Carrying impulses from the central nervous system to muscles and glands 4. Carrying only one of the sensory or motor impulses at a time

answer: 2 Afferent neurons, or sensory neurons, carry impulses from receptors in the external and internal periphery to the central nervous system.

Which diagnostic procedure is used to detect the presence of lesions and abscesses in various regions of the brain? 1. Electroencephalography (EEG) 2. Computed tomography scan (CT) 3. Single photon emission computed tomography (SPECT) 4. Positron emission tomography (PET)

answer: 2 CT scans measure the accuracy of brain structures and can help to detect presence of lesions and abscesses in various regions of the brain.

The nurse is caring for a client with risk-prone health behavior. Which statement from the client indicates the effectiveness of the therapy? 1. "I no longer have bad dreams." 2. "I want to discuss the modification of my lifestyle." 3. "I want to explain how the accident occurred." 4. "I think I have to accept the fact and move on."

answer: 2 In risk-prone health behavior, the client shows inability to modify lifestyle or behaviors, which would improve health status. The nursing care is effective when the client is able to discuss the modifications or changes in lifestyle.

A client is trying to comprehend her illness. Which stage of the Psychological Recovery Model is the client undergoing? 1. moratorium 2. awareness 3. preparation 4. rebuilding

answer: 2 In the awareness stage, the client strives for personal comprehension of her illness and tries to understand unexplainable negative events caused by the illness by finding a reason for them.

Which is a goal of including aspects of the community that affect the client in the treatment program? 1. To develop social skills in the client 2. To incorporate skills the client needs in life 3. To develop new coping strategies in the client 4. To facilitate interpersonal interaction with the client

answer: 2 Including aspects of the community will incorporate real-life skills the client will need in life.

Which neurotransmitter is an example of a monoamine? 1. acetylcholine 2. norepinephrine 3. endorphins 4. glycine

answer: 2 Norepinephrine is an example of a monoamine. Other examples include dopamine, serotonin, and histamine.

Which information documented by the client is categorized under Part 1 of the daily maintenance list? 1. "I write in my journal for at least 30 minutes." 2. "I feel bright and optimistic when experiencing wellness." 3. "I spend at least 30 minutes daily enjoying a fun activity." 4. "I send birthday wishes to my friend every year without fail."

answer: 2 Part 1 of the daily maintenance list includes the description of feelings experienced by the client during the process of recovery. Therefore, feeling bright and optimistic is categorized under Part 1 of the daily maintenance list.

The nurse is assessing the respiratory rate, musculoskeletal status, and side effects of medications used by the client in a psychiatric unit. Which section of the mental history form includes these assessments? 1. Reality orientation 2. Pertinent physical assessments 3. Drug history and assessment 4. Psychosomatic manifestations

answer: 2 Pertinent physical assessment is the section under which respiratory rate, musculoskeletal status, and side effects of the medications used by the client are included and assessed.

A client is scheduled for eye movement desensitization and reprocessing (EMDR) psychotherapy. Which action of the client would the therapist monitor to evaluate the effectiveness of phase 4 of EMDR? 1. Ranking disturbing emotions on the zero to 10 Subjective Units of Disturbance (SUD) scale 2. Reduction in stress level related to negative beliefs 3. Identifying the areas of the body where residual tension is experienced 4. Identifying a specific scene or picture from the target event

answer: 2 Phase IV of EMDR is desensitization. If the client's stress level associated with negative beliefs is reduced to zero or one, it indicates the effectiveness of the therapy.

The nurse is reviewing orders for a client who has been prescribed a medication that is used to treat anxiety. The medication is also used to treat hypertension. Which medication has the client been prescribed? 1. Topiramate 2. Propranolol 3. Hydroxyzine 4. Disulfiram

answer: 2 Propranolol is a beta blocker used to treat hypertension and also prescribed to treat anxiety.

A client with a psychotic disorder shows symptoms of agitation and psychotic behavior. What is the priority nursing intervention to reduce agitation in the client? 1. Administer tranquilizers to the client 2. Speak with the client in a simplified fashion 3. Restrict the client's freedom of movement by using mechanical restraints 4. Restrain the client by confining him or her to a room from which he or she is unable to leave

answer: 2 Speaking with the client in a simplified fashion should be the priority intervention by the nurse to reduce agitation in the client. It reflects that the nurse respects the client's right to the least-restrictive treatment.

The client says, "All men are messy and untidy." What type of belief does the client have? 1. faith 2. stereotype 3. rational belief 4. irrational belief

answer: 2 Stereotypes are socially shared beliefs that categorize all individuals with a common factor like age, sex, or race into one group. Therefore, the client's statement represents a stereotype.

A client complains of frequent nervousness, worry, and jitteriness leading to impairment in social and occupational functioning. Which condition does the nurse suspect in the client? 1. Adjustment disorder unspecified 2. Adjustment disorder with anxiety 3. Adjustment disorder with depressed mood 4. Adjustment disorder with disturbance of conduct

answer: 2 Symptoms of nervousness, worry, and jitteriness in the client indicate that the client has anxiety adjustment disorder.

The nurse observes that a client who is diagnosed with anxiety disorder has tremors in her hand. Which area of the client's brain may be affected? 1. Brainstem 2. Basal ganglia 3. Hypothalamus 4. Locus ceruleus

answer: 2 The area of the brain that is affected and mediates tremors of the hands in a client with anxiety disorder is known as the basal ganglia.

According to the Psychological Recovery Model, which client is undergoing stage 2 of the recovery process? 1. The client who begins to actively take control of his or her life 2. The client who develops an awareness of the need to take control of his or her life 3. The client who has the ability to be independent and take care of basic needs 4. The client who feels out of control and powerless to change his or her life

answer: 2 The client who develops an awareness of the need to take control of his or her life is undergoing stage 2 of recovery. Awareness is the second stage of recovery.

To find relief from anxiety, a client tells the nurse, "Sorry, I did not take my medication today; my mother did not remind me to take it." Which defense mechanism does the nurse suspect from the client's statement? 1. denial 2. projection 3. introjection 4. rationalization

answer: 2 The client who uses projection passes the blame of undesirable feelings to another person.

A client with severe and persistent bipolar disorder is scheduled for emergency neurosurgery. Which action would the nurse take in this situation? 1. Explain the entire treatment procedure to the client. 2. Secure informed consent from the client's family member. 3. Give ample time for the client to decide about the treatment. 4. Instruct the client to sign the consent form

answer: 2 The client with severe and persistent bipolar disorder may not be able to make decisions on his or her own in an emergency situation. Therefore, the nurse should secure informed consent from the client's family member.

Which commitment is included under the Tidal Model that focuses on the individual's personal story? 1. Recovery occurs via many pathways. 2. Recovery occurs by valuing the voice of the client. 3. Recovery is supported by addressing trauma. 4. Recovery is supported through relationships and social networks.

answer: 2 The model that focuses on the individual's personal story is the Tidal Model. "Value the voice" is one of the commitments of the Tidal Model.

During the process recording, a client says, "I know I will have a hard time, but I also know that I have support." What are the nurse's thoughts and feelings concerning the interaction after the client's reply? 1. feeling sorry 2. feeling confident 3. feeling comfortable 4. feeling uncomfortable

answer: 2 The nurse feels confident after listening to the positive reply of the client. This positive reply indicates that the session was successful and may help the client succeed.

While caring for an elderly client with a mental disorder, the nurse finds that the family feels the client is a burden for them and does not provide proper home care. What is the best nursing intervention in this situation? 1. The nurse does not get involved in the issue. 2. The nurse advocates on behalf of the client. 3. The nurse suggests the client contact a long-term care facility. 4. The nurse arranges for the client to be transferred to a permanent room in the hospital.

answer: 2 The nurse should ensure his or her client's safety by advocating on behalf of the client.

The registered nurse is implementing the care plan for a newly admitted client in a psychiatric unit. Which standard of psychiatric mental health clinical nursing practice is the nurse implementing? 1. standard 1: assessment 2. standard 5: implementation 3. standard 3: outcomes identification 4. standard 4: planning

answer: 2 The nurse who implements the care plan for a client is performing the implementation standard. The implementation standard is the fifth step of the nursing practice.

Which stage of anxiety is associated with incoherent speech and ineffective communication? 1. mild 2. panic 3. severe 4. moderate

answer: 2 The panic stage of anxiety is characterized by a severe state of psychological stress. The client will have incoherent speech and ineffective communication during this stage of anxiety.

A client who separated from his or her spouse tells the nurse, "I don't know why I am living. There is nothing to live for." Which statement made by the nurse serves as the best nontherapeutic communication technique? 1. "Tell me why you separated." 2. "You appear to be upset. Can you tell me how you're feeling?" 3. "Everybody gets down sometimes. I also feel this sometimes." 4. "It must have been very difficult for you when you separated from your spouse."

answer: 2 This statement made by the nurse is the best nontherapeutic communication technique because it conveys understanding and empathy to the client.

Which statement made by the student nurse indicates further teaching is needed regarding genetic testing? 1. "My client had genetic testing to determine if their child may have Down syndrome." 2. "I suggested my client have their child tested to see if they are a carrier for bipolar disorder." 3. "My client's father had Huntington's disease, so they are undergoing genetic testing to determine if they are a carrier." 4. "The son of my client has cystic fibrosis so they are having their daughter tested to see if she is a carrier."

answer: 2 This statement requires further teaching. Although bipolar has familial tendencies, there is no genetic test for bipolar disorder.

Which statement made by the student nurse indicates the need for further teaching regarding monoamine oxidase inhibitors (MAOI)? 1. "MAOIs were the first medication used to treat depression." 2. "There are few drug interactions with MAOIs, making them very safe." 3. "MAOIs were first used to treat tuberculosis." 4. "Clients should avoid eating aged cheese while taking MAOIs."

answer: 2 This statement requires further teaching. MAOIs were found to have several serious interactions with other drugs.

Which theory of ethical decision making states that ethical decisions that are "right" are determined by the decision's tendency to bring happiness to the client? 1. Kantianism 2. Utilitarianism 3. Ethical egoism 4. Christian ethics

answer: 2 Utilitarianism states that whether an ethical decision is right is determined by its tendency to bring happiness to the client.

Which would be the primary intervention of the nurse for a client who is diagnosed with risk-prone health behavior? 1. Encourage the client to discuss the change or loss and to express the anger associated with it 2. Encourage the client to discuss his or her lifestyle prior to the changes in health status 3. Encourage the client to express the fears associated with the change 4. Provide assistance with activities of daily living, but also encourage independence within a limit

answer: 2 When the nurse is caring for a client with risk-prone health behavior, the primary intervention of the nurse is to encourage the client to discuss lifestyle prior to the changes in his or her health status.

Which action may place a nurse at risk of being charged with slander? 1. Discussing the client's condition with another nurse 2. Spreading false information about a client by word of mouth 3. Providing information to others about the client's condition without his or her consent 4. Writing malicious and false information about the client during assessment

answer: 2 When the nurse orally defames a client's image by spreading malicious or false information, then he or she might have committed slander.

A client is prescribed temazepam 15 mg. Only 7.5 mg tablets are available. How many tablets will the nurse administer? Enter the numeral only.

answer: 2 tablets

Which actions in nursing practice can result in the nurse being accused of false imprisonment? Select all that apply. 1. Keeping an aggressive client alone in a room 2. Taking the clothes of a depressed client against his or her wishes 3. Restraining the extremities of a voluntary competent client demanding release 4. Locking the client in a room for the nurse's convenience 5. Administering tranquilizers to the client who attempts to harm others

answer: 2, 3, 4 The nurse should not lock the client alone in a room for the nurse's convenience. This intervention can lead to false imprisonment accusations.

Which statements made by the client indicate effectiveness of sedative-hypnotic therapy? Select all that apply. 1. "I am able to fall asleep within 2 hours of taking my medication and stay asleep for 5 hours." 2. "I have not experienced any periods of confusion while taking the medication." 3. "I feel more energized during the day since I've been taking this medication." 4. "I fell asleep in class this morning, so I may need to cut back on my medication." 5. "I was able to participate in my intramural football game this afternoon."

answer: 2, 3, 5

Which biological responses occur at the sustained response stage of stress during the "fight or flight" response? Select all that apply. 1. decreased fluid retention 2. decreased immune response 3. decreased retention of sodium 4. decreased inflammatory response 5. decreased basal metabolic rate (BMR)

answer: 2, 4 Glucocorticoids are released by the adrenal cortex during stress. These glucocorticoids decrease immune responses. Inflammatory response decreases during stress due to the release of glucocorticoids from the adrenal cortex.

Which are the guiding principles that support recovery, according to the Substance Abuse and Mental Health Services Administration (SAMHSA)? Select all that apply. 1. Recovery is atomistic. 2. Recovery is client-driven. 3. Recovery occurs via a single pathway. 4.Recovery is culturally-based and influenced. 5. Recovery is supported by addressing trauma.

answer: 2, 4, 5 Self-determination and self-direction are the foundations for recovery as individuals define their own life goals and design their unique paths toward those goals. Therefore, recovery is client-driven. Culture and cultural background are keys in determining an individual's journey and unique pathway to recovery. Therefore, recovery is culturally based and influenced. The experience of trauma is the precursor for mental illness and other related issues. Therefore, recovery is supported by addressing trauma.

Which factors determine the duration of stressors? Select all that apply. 1. Age of the client 2. Type of stressor 3. Religious beliefs of the client 4. Client's perception of stressor 5. Response to stressor by the client

answer: 2, 4, 5 The type of stressor is an important factor in duration of the crisis. A severe crisis may require a lot of time to solve, and a less severe crisis may require a shorter period of time. Perception of the client plays an important role in the duration of the stressor. A client who perceives his or her stressor to be huge and irresolvable may require a lot of time. Whenever a client faces a stressor, it is important that the response is adequate and correct to solve it. Therefore, response to the stressor by the client is a factor in determining the duration of stressor.

What does the nurse suspect in the client who is depressed, shows aggressive tendencies toward others, and destroys items without permission? 1. Adjustment disorder unspecified 2. Adjustment disorder with disturbance of conduct 3. Adjustment disorder with mixed disturbance of emotions and conduct 4. Adjustment disorder with anxiety

answer: 3 A client with adjustment disorder with mixed disturbance of emotions and conduct is depressed and shows disturbances in conduct such as violating the rights of others.

Which core capability of the electronic documentation system improves workflow by eliminating ambiguities caused by illegible handwriting? 1. results management 2. health information and data 3. order entry / order management 4. electronic communication and connectivity

answer: 3 A computer-based order entry system improves workflow processes by eliminating lost orders and ambiguities caused by illegible handwriting.

In which stage of recovery does the client rediscover lost aspects of self, identify new aspects, and incorporate both into a new self-identity, according to the Psychological Recovery Model? 1. stage 1 2. stage 2 3. stage 3 4. stage 4

answer: 3 According to the Psychological Recovery Model, Stage 3 of recovery is the preparation stage. In this stage, the client rediscovers lost aspects of self, identifies new aspects, and incorporates both into a new self-identity

Which therapy of adjustment disorder includes role-playing and coaching to alter maladaptive response patterns? 1. Psychotherapy 2. Cognitive therapy 3. Behavior therapy 4. Prolonged exposure therapy

answer: 3 Adjustment disorder is treated with behavior therapy. In this therapy, the situations that promote ineffective responses are identified, and carefully designed reinforcement schedules, along with role-playing and coaching, are used to alter maladaptive response patterns.

A research nurse, while participating in clinical trials, finds that a 67-year-old client has Alzheimer's disease. Which chromosome does the nurse suspect is altered in the client based on this finding of late-onset Alzheimer's disease? 1. chromosome 1 2. chromosome 14 3. chromosome 19 4. chromosome 21

answer: 3 Alterations in chromosome 19 may result in late-onset Alzheimer's disease.

The nurse is reviewing orders for a client who is prescribed sertraline for depression and an atypical antipsychotic medication as adjunct therapy. Which medication can the nurse expect to administer? 1. Lithium 2. Alprazolam 3. Aripiprazole 4. Methylphenidate

answer: 3 Aripiprazole and quetiapine are prescribed as adjunctive therapy to antidepressants.

Which statement made by the student nurse indicates effective learning regarding the cerebrum of the brain? 1. "The corpus callosum consists of a band of 100 million neurons." 2. "White matter axons of the cerebrum are the actual thinking structures of the brain." 3. "Basal ganglion in the cerebrum are responsible for making gestures while speaking." 4. "The deep grooves between the folds of the cerebral cortex are called gyri."

answer: 3 Basal ganglia in the cerebrum are responsible for certain subconscious aspects of voluntary movement like gesturing while speaking, swinging the arms when walking, etc.

The nurse is reviewing a medication history for a client who takes alprazolam. Which herbal remedy listed by the client would be of most concern to the nurse? 1. green tea 2. ginseng 3. chamomile 4. milk thistle

answer: 3 Chamomile is used to treat anxiety, which used in conjunction with alprazolam can cause over-sedation of the client. The client should be instructed to discontinue use of this herbal remedy.

A client in a psychiatric unit tells the nurse, "I think I don't want to continue with the treatment. Maybe I should just self-medicate." What is the best response the nurse can give in this situation using a nontherapeutic communication technique? 1. "I find it hard to believe that you could do that." 2. "No one here would lie to you." 3. "I will try to answer your questions and clarify issues regarding the treatment." 4. "You have a very capable physician who only has your best interests in mind."

answer: 3 Clarifying the issues related to the treatment is the best response that a nurse can give in this situation because it helps provide assurance to the client about the treatment.

The nurse is caring for a client with panic anxiety who is receiving psychotherapeutic treatment. The nurse gives the client positive feedback when the client demonstrates improved ways of managing anxiety. Which outcome does the nurse expect in the client through this intervention? 1. The client's mood will be lifted. 2. The client will be able to find his or her own solutions to concerns. 3. The client's ability to deal with fearful situations will be enhanced. 4. The likelihood of eruptions that lead to abusive behavior will be reduced.

answer: 3 Clients with panic anxiety demonstrate better ways to manage anxiety during psychotherapeutic treatment. Providing positive feedback to the client regarding management of anxiety is meant to enhance the client's ability to deal with fearful situations.

Which role is most appropriate for the nurse regarding a client's coping mechanisms? 1. Selecting the type of coping mechanism 2. Educating the client about different types of coping mechanisms 3. Assisting the client in choosing alternative coping mechanisms 4. Helping the client implement a coping mechanism through unconditional acceptance

answer: 3 Coping mechanisms are highly individual. The most appropriate role for the nurse is to assist and help the client choose a type of coping mechanism.

Which statement made by the client indicates dissociative symptoms associated with acute stress disorder (ASD)? 1. "I am restless and irritated." 2. "I am haunted by nightmares." 3. "I can't remember what happened during my accident." 4. "I have recurrent distressing memories of my accident."

answer: 3 Dissociative symptoms of ASD include an altered sense of reality and inability to remember the important aspects of the traumatic event.

The nurse is assessing a client's condition by asking some questions. Which facial expression indicates that the client is surprised? 1. flared nostrils 2. compressed lips 3. raised eyebrows 4. narrowed eyelids

answer: 3 Facial expressions reveal an individual's emotional status. When the client is surprised, his or her eyebrows will be raised.

The nurse would question which order for a 13-year-old client? 1. Methylphenidate 2. Sertraline 3. Flurazepam 4. Lithium

answer: 3 Flurazepam is a sedative hypnotic, and it is contraindicated in clients younger than 15.

A client who has fear of darkness is exposed to a room with darkness for a long time during therapy. Which therapy is the client undergoing? 1. Psychotherapy 2. Cognitive therapy 3. Implosion therapy 4. Behavior therapy

answer: 3 In implosion therapy (flooding), the client imagines or participates in real-life situations that frighten him or her.

According to Roberts' seven-stage crisis intervention model, which is the primary intervention during stage IV? 1. Identifying major problems 2. Implementing an action plan 3. Dealing with feelings and emotions 4. Generating and exploring alternatives

answer: 3 In stage IV of Roberts' seven-stage crisis intervention model, the client is encouraged to explain the story of his or her crisis. Therefore, stage IV is dealing with feelings and emotions.

A client tells the nurse, "I recognize that my illness has not paralyzed me." What does the nurse interpret from the client's statement? 1. The client is in the rebuilding stage of recovery. 2. The client is in the preparation stage of recovery. 3. The client is in the awareness stage of recovery. 4. The client is in the moratorium stage of recovery.

answer: 3 In the awareness stage, the client realizes that he or she is independent of the illness and is capable of taking action by himself or herself.

While caring for a client with mental illness, the nurse finds that the client identifies his or her own strengths and weaknesses, gathers knowledge and information about the illness being faced, and seeks out available treatment facilities in the psychiatric unit. Which stage of the Psychological Recovery Model does the nurse anticipate in this client? 1. moratorium 2. awareness 3. preparation 4. rebuilding

answer: 3 In the preparation stage, the client manifests hope to foster self-care using external resources and finds pathways to achieve goals. The various pathways include identifying strengths and weaknesses, gathering knowledge and information of the illness faced, and seeking out available treatment facilities in the psychiatric unit.

What information is required to prepare an interdisciplinary treatment (IDT) plan for a client with a psychotic disorder in a therapeutic milieu? 1. Information about the medical diagnosis 2. Information about cultural and spiritual needs 3. Information from the initial nursing assessment 4. Information from community and family resources

answer: 3 Information from the initial nursing assessment is required for the creation of an IDT plan because it establishes the priority of care.

Which statement of the client indicates the symptom of marked alterations in arousal and reactivity associated with the traumatic event? 1. "I can never trust anybody." 2. "I feel detached from the world." 3. "I feel irritable and annoyed most of the time." 4. "I avoid any activity that reminds me of the trauma."

answer: 3 Irritable behavior and angry outbursts are symptoms of marked alterations in arousal and reactivity associated with the traumatic event.

The nursing instructor is teaching a group of student nurses about clients' rights that were established by the American Hospital Association (AHA). Which statement made by a student nurse demonstrates effective learning? 1. "The guidelines about clients' rights are legal documents." 2. "The health-care facility can make changes to the clients' rights if required." 3. "The nurses and health-care facility are responsible for upholding the clients' rights." 4. "The guidelines drafted by the AHA are different from those drafted by the National League for Nursing (NLN)."

answer: 3 It is the moral responsibility of health-care professionals to uphold the rights of a client.

Which intervention does the therapist adopt to facilitate interpersonal communication? 1. Setting norms and rules for the client 2. Assigning responsibilities to the client 3. Maintaining a structured schedule of social activities 4. Including the family and the community of the client in therapy

answer: 3 Maintaining a structured schedule of social activities helps the client participate in group therapies. Group activities facilitate interpersonal communication.

Which medication does the nurse expect the primary health-care provider to prescribe for safe and effective treatment of trichotillomania? 1. Buspirone 2. Fluoxetine 3. Olanzapine 4. Clomipramine

answer: 3 Olanzapine is a psychopharmacological agent that is a safe and effective medication for the treatment of trichotillomania.

Which statement made by the student nurse indicates the need for correction regarding Skinner's assumptions about how a therapeutic community is based? 1. "Every client owns his or her environment." 2. "Clients should be encouraged to improve their health." 3. "Peer pressure hinders the client's development." 4. "An opportunity for therapeutic intervention may be found in every interaction."

answer: 3 Peer pressure is an influence on the client to bring out a change in attitude, behavior, and thoughts. Therefore, this statement made by the student nurse indicates the need for correction.

The nurse patted a client's back while providing care. The client felt offended by the nurse's gesture. Which boundary is in jeopardy in this situation? 1. social boundary 2. material boundary 3. personal boundary 4. professional boundary

answer: 3 Personal boundaries are limits set by a client that may include how the client allows others to invade his or her physical space. Therefore because the client was offended by the nurse patting his or her back, the personal boundary is in jeopardy.

The nurse is caring for a client who is being treated with a tricyclic antidepressant. For which symptom should the nurse monitor the client? 1. Weight loss 2. Bradycardia 3. Postural hypotension 4. Diarrhea

answer: 3 Postural hypotension is a commonly seen in clients being treated with tricyclic antidepressants.

The nurse is providing emergency care to a client who is a victim of a fire accident. While assessing vital signs, the nurse finds the respiratory rate of 32 breaths/min and a heart rate of 120 beats per minute. Which stage of anxiety does the nurse suspect in the client? 1. mild 2. panic 3. severe 4. moderate

answer: 3 Since the client is a victim of a fire accident, the central nervous system is overstimulated, resulting in severe anxiety. Tachycardia and hyperventilation are symptoms of severe anxiety.

While caring for a client with a mental illness, the nurse protects the client's rights and eliminates discrimination while working with the client toward recovery. Which guiding principle of recovery is the nurse following? 1. Recovery model supported by addressing past trauma 2. Recovery model supported through relationships and social networks 3. Recovery model based on respect 4. Recovery model that is culture-based and -influenced

answer: 3 Societal acceptance and appreciation of the client, which includes protecting the client's rights and eliminating discrimination, play a crucial role in achieving recovery. It clearly explains that one can recover based on the respect provided to him or her.

Which client may exhibit decreased levels of gonadotropins? 1. A client with Alzheimer's disease 2. A client with obsessive-compulsive disorder 3. A client with anorexia nervosa 4. A client with panic disorder

answer: 3 The client with anorexia nervosa exhibits decreased levels of gonadotropins and growth hormone and increased levels of cortisol.

The nurse is in the first phase of relationship development with a client who is an alcoholic. What should be the goal of the nurse during this phase? 1. establishing trust 2. promoting client change 3. exploring self-perceptions 4. ensuring therapeutic closure

answer: 3 The first phase is the preinteraction phase, where the nurse prepares for the first encounter with the client. Everyone brings attitudes and feelings from their own experiences to the clinical setting. Therefore, it is necessary to be aware of self-perceptions so as to not let them affect providing care to clients.

Which hormone plays an important role in maintaining the basic metabolic rate? 1. vasopressin 2. growth hormone 3. thyrotropic hormone 4. adrenocorticotropic hormone

answer: 3 The hypothalamus stimulates the pituitary gland, which releases thyrotropic hormone. This hormone stimulates the thyroid gland. The thyroid gland plays an important role in maintaining the basic metabolic rate.

A client who underwent facial surgery refuses to see his peers and cannot look at the scar on his face. The client confines himself to a room and speaks only to his mother. Which is the major goal of treatment for this client? 1. To demonstrate the ability to decide lifestyle changes 2. To demonstrate progress in dealing with the stages of grief 3. To enhance coping with stressors that cannot be reduced or removed 4. To integrate the traumatic experience into his or her persona

answer: 3 The maladaptive reactions of the client indicate that the client has adjustment disorder with depressed mood. The major goal of treatment in this client is to enhance coping with stressors that cannot be reduced or removed.

What is the priority nursing intervention for a newly admitted client in a psychiatric unit? 1. Scheduling follow-up visits for the client 2. Notifying the psychiatrist before assessing the client. 3. Providing notice of privacy policies to the client and the client's representative 4. Explaining the entire treatment procedure to the client's representative

answer: 3 The notice of privacy policies ensures protected health information (PHI). The priority nursing intervention is to provide notice of privacy policies to the client and the client's representative.

The nurse is counseling a group of clients on a one-to-one basis to obtain information regarding their current health situation. Which type of distance should the nurse maintain while communicating with the clients? 1. public 2. social 3. personal 4. intimate

answer: 3 The nurse can have a close conversation with the client in a personal distance while maintaining a distance of 18 to 40 inches.

The nurse is caring for a client with situational low self-esteem. Which statement made by the nurse helps the client recognize his or her life experiences? 1. "Explain what happened when you felt that way." 2. "I understand that you are telling me this happened." 3. "How did you respond when this happened in the past?" 4. "What might you do to handle this more appropriately?"

answer: 3 The nurse encourages the client to compare the similarities and differences of experiences and ideas, which helps the client recognize that life experiences may recur.

The nurse is reviewing the laboratory results for a client who has been taking lithium for the past year. The nurse notes the lithium levels are 1.6 mEq/L. Which action should the nurse take? 1. Administer half of the scheduled dose 2. Document the result and administer the dose 3. Hold the dose and notify the health-care provider 4. Administer an additional dose of the lithium

answer: 3 This is a correct action for the nurse to take; the nurse should hold the dose and notify the health-care provider. Normal maintenance lithium levels are 0.6 to 1.2 mEq/L. A level of 1.6mEq/L is too high.

Which statement made by the client indicates a need for knowledge and demonstrates a readiness to learn? 1. "Please take these medicines away. I do not need them." 2. "I don't require any mental treatment. I just have migraines." 3. "The doctor diagnosed me with schizophrenia. What does it mean?" 4. "I have always taken these drugs. I will discontinue them when I am ready."

answer: 3 This statement made by the client indicates that the client is curious to know about his or her medical condition. Therefore, this statement made by the client indicates the need for knowledge and readiness to learn.

The nurse is caring for a client who unconsciously transfers his or her feelings for a person in the client's past toward the nurse because the nurse's appearance reminds the client of that person. Which outcome in the client would indicate the effectiveness of the nursing care? 1. The client will formulate a plan with the nurse. 2. The client will develop problem-solving skills. 3. The client will assume responsibility for his or her own behavior. 4. The client will discuss and compare the exhibited behaviors with the nurse.

answer: 3 When the client assumes responsibility for his or her own behavior, it indicates that the client no longer shows the transference behavior and that the nursing care is effective.

Which conditions indicate psychiatric emergencies in a client? Select all that apply. 1. Value conflicts 2. Sexual identity 3. Drug overdoses 4. Acute psychoses 5. Alcohol intoxication

answer: 3, 4, 5 Psychiatric emergencies are crisis situations in which general functioning has been severely impaired and the individual rendered incompetent or unable to assume personal responsibility. Drug overdoses indicate a psychiatric emergency. Psychiatric emergencies are crisis situations in which general functioning has been severely impaired and the individual rendered incompetent or unable to assume personal responsibility. Acute psychoses indicate a psychiatric emergency. Psychiatric emergencies are crisis situations in which general functioning has been severely impaired and the individual rendered incompetent or unable to assume personal responsibility. Alcohol intoxication indicates a psychiatric emergency.

The nurse is providing education to a client who will be discharged with a prescription for methylphenidate. Which information should the nurse include in the teaching? Select all that apply. 1. Take the medication before meals 2. Administer the last dose at least 1 hour before bedtime 3. Keep stimuli low and environment quiet 4. Do not stop taking medication abruptly 5. Avoid consumption of large amounts of caffeine

answer: 3, 4, 5 The nurse should instruct the client to keep stimuli low and the environment quiet to discourage overstimulation. The medication should not be discontinued abruptly; doing so can cause nausea, vomiting, abdominal cramping, headache, fatigue, suicidal ideation, and psychotic behavior. The client should be instructed to avoid large amounts of caffeine to avoid overstimulation.

Which structures of the brain play an important role in the regulation of respiration, blood pressure and temperature? Select all that apply. 1. temporal lobes 2. parietal lobes 3. hypothalamus 4. thalamus 5. pons

answer: 3, 5 The hypothalamus regulates anterior and posterior lobes of the pituitary gland and also regulates blood pressure and temperature in the body. The primary function of pons is regulation of respiration and skeletal muscle tone.

The nurse is caring for a client with anxiety disorder who is taking antianxiety medication therapy. The nurse instructs the client to rise slowly from a lying or sitting position. Which side effect is the nurse trying to reduce in the client by using this intervention? 1. lethargy 2. nausea 3. drowsiness 4. orthostatic hypotension

answer: 4 A client with orthostatic hypotension should be instructed to rise slowly from a sitting or lying position.

The nurse is reviewing laboratory values for a client receiving clozapine. Which absolute neutrophil count (ANC) value would be of most concern to the nurse? 1. 4000 µL 2. 1500 µL 3. 800 µL 4. 300 µL

answer: 4 A normal range for an ANC is 1500 to 8000. This level is low. For dosing of clozapine, if the level falls below 1500 µL, blood counts are monitored more frequently. If the ANC levels are at least 1500µL, blood counts are monitored biweekly for 6 months, then monthly. An ANC less than 500 µL is indicative of neutropenia, which can be fatal. This ANC level is most concerning.

What educational credentials are required to become a psychiatric clinical nurse specialist? 1. Registered nurse with a hospital diploma 2. Medical degree with residency in psychiatry 3. Doctorate in clinical psychology with 2 to 3 years of internship 4. Registered nurse with a minimum of a master's degree in psychiatric nursing

answer: 4 A psychiatric clinical nurse specialist should be a registered nurse with a minimum of a master's degree in psychiatric nursing.

Which fear supports the nurse's suspicion that the client has algophobia? 1. The client has fear of people. 2. The client has fear of needles. 3. The client has a persistent fear of lightning. 4. The client has a persistent fear of pain.

answer: 4 Algophobia is the condition in which the client has a persistent fear of pain. Therefore, this client fear supports the nurse's suspicion.

The nurse is caring for a child who has a terminal illness. The nurse informs the child's parents about the impending death of the child. Which type of grief does the nurse initially find in the parents? 1. denial 2. bargaining 3. acceptance 4. anticipatory grief

answer: 4 Anticipatory grief is the initial stage of grief where the parents of the child experience knowing the child's condition and show increased concern for the child.

The nurse is caring for a client who has been receiving treatment for anxiety for 6 months. Which medication can the nurse expect to administer to the client? 1. Clonazepam 2. Buspirone 3. Alprazolam 4. Sertraline

answer: 4 Antidepressants should be administered for long-term treatment of anxiety. Sertraline is an antidepressant.

Which atypical third-generation antipsychotic is prescribed because of minimal risk of extrapyramidal effects? 1. haloperidol 2. clozapine 3. pimozide 4. aripiprazole

answer: 4 Aripiprazole is a third-generation atypical antipsychotic prescribed because it has minimal risk of extrapyramidal effects.

During a follow-up visit, the legal representative of a client with mental illness has withdrawn consent for treatment after it was given. What should the nurse expect the primary health-care provider to do in this situation? 1. Launch a court case against the client's representative 2. Discuss this with the client's insurance agents 3. Continue the treatment upon rejecting the representative's wish 4. Stop the treatment and inform the client's representative of risks associated with the interrupted treatment

answer: 4 Clients and their legal representatives have the right to stop treatment by withdrawing consent. If the client has a mental illness, generally the closest representative of the client can withdraw the consent given by him or her. Therefore, the primary health-care provider should respect the client's representative's wish, terminate the treatment in the safest way possible, and explain the risks associated with the interrupted treatment to the client's representative.

What is the aim of crisis intervention? 1. Personality change 2. Reconstruction of the situation 3. Detailed problem-solving methods 4. Quick relief of crises using all the possible resources

answer: 4 Crisis interventions aim at quick relief of crises using all the possible resources.

A client is receiving atomoxetine to treat attention-deficit-hyperactivity disorder. Which symptom should be reported to the health-care provider immediately? 1. constipation 2. dilated pupils 3. nausea 4. dark urine

answer: 4 Dark urine is a sign of liver damage in a client taking atomoxetine and should be reported immediately.

Which statement made by a student nurse needs correction regarding the goals of a therapeutic community? 1. "The goal is to teach interpersonal interactions to the client." 2. "The goal is to teach adaptive coping techniques to the client." 3. "The goal is to develop the relationship skills of the client." 4. "The goal is to determine a comprehensive treatment plan for the client."

answer: 4 Determining a comprehensive treatment plan for the client is the goal of an interdisciplinary treatment team. Thus, this statement of the student nurse needs correction.

While caring for an angry client, the nurse makes empty conversation. What could be the rationale behind this nursing intervention? 1. To explore the client's areas of difficulty 2. To tell the client about the meaning of the experience 3. To take over the direction of the discussion from the client 4. To encourage a like response from the client

answer: 4 Empty conversation from the nurse encourages a like response from the client. It is practiced as a nontherapeutic communication technique in which stereotyped comments are made to encourage a like response from the client.

Which statement made by the student nurse indicates effective learning about fluid group work? 1. "It is a multitude of complex interactions that occur only between staff members and visitors." 2. "It is a multitude of complex interactions that occur only between clients and staff members." 3. "It is a multitude of complex interactions that occur only between clients and visitors." 4. "It is a multitude of complex interactions that occur between clients, staff members, and visitors."

answer: 4 Fluid group work is a multitude of complex interactions between the clients, staff members, and visitors. Therefore, this statement made by the student nurse indicates effective learning.

Which inhibitory neurotransmitter levels are elevated by benzodiazepines to produce a calming effect? 1. Serotonin 2. Epinephrine 3. Acetylcholine 4. Gamma amino butyric acid (GABA)

answer: 4 GABA is an inhibitory neurotransmitter that suppresses the central nervous system, resulting in a calming effect.

A client tells the nurse, "If God was really present, He would have never taken my child from me." Which action would be most appropriate for the nurse to take to provide specific assistance in the recovery process of the client? 1. Accept the client's spiritual concern 2. Listen to the client's expressions of inability to find meaning in life 3. Discuss the difference between grief and guilt 4. Identify and refer to resources such as crisis counseling

answer: 4 Identifying and referring to resources such as crisis counseling will help the client overcome the devastating loss. This will provide specific assistance in the recovery process of the client.

After undergoing an abortion, an adolescent client asks the nurse, "Can you provide me with some information regarding birth control pills?" Which response from the nurse indicates ethical egoism? 1. "You can ask the primary health-care provider about birth control pills." 2. "I will provide you the information if it is really helpful to avoid pregnancy." 3. "It is my moral duty not to provide information about birth control pills to teenagers." 4. "I am sorry. Providing information about birth control pills to teenagers will pose a risk for my job."

answer: 4 If the nurse refuses to provide information about birth control pills to avoid risk of losing his or her job, it indicates ethical egoism. The decision made by the nurse is beneficial only to him or her, but not to the client.

Which statement made by the wife of a client indicates a class I crisis, according to Baldwin? 1. "My husband is haunted by nightmares of the accident." 2. "My husband frequently wanders down the road when he has intense anxiety." 3. "My husband had a medication overdose due to stress at the office." 4. "My husband has become physically ill due to his anxiety about growing older."

answer: 4 In crises of anticipated life transitions, the client feels a lack of control due to normal anticipated life-cycle transitions and has physical complaints. Therefore, Baldwin's class II crisis is reflected in this statement of the spouse.

The nurse is caring for a client whose cognitive functions are disordered. Which phase of crisis development would the nurse anticipate the client to be in? 1. Phase I 2. Phase II 3. Phase III 4. Phase IV

answer: 4 In phase IV, an increase in the burden of tension to the level of a breaking point occurs. Therefore, if the client's cognitive functioning is disordered, the nurse would anticipate the client to be in phase IV.

The nurse is assisting a client with psychiatric illness recovery using the Psychological Recovery Model. During which stage does the client manifest hope to foster self-care using external resources? 1. rebuilding 2. awareness 3. moratorium 4. preparation

answer: 4 In the preparation stage, the client manifests hope to foster self-care using personal and external resources.

Which structure of the brain plays a major role in the expression of emotions through connection with limbic system? 1. parietal lobe 2. frontal lobe 3. occipital lobe 4. temporal lobe

answer: 4 Option 4 in the figure depicts the temporal lobes. The primary function of the temporal lobes is hearing, short-term memory, the sense of smell, and the expression of emotions through connection with limbic system.

While preparing the client with a psychiatric illness for a diagnostic procedure, the nurse administers an IV injection of a radioactive substance to the client. Which diagnostic procedure requires this intervention? 1. Computerized electroencephalography (EEG) mapping 2. Computed tomography (CT) scan 3. Magnetic resonance imaging (MRI) 4. Positron emission tomography (PET)

answer: 4 PET scanning measures specific brain functioning such as oxygen utilization and blood flow. During this procedure, the client receives an IV injection of a radioactive substance.

A client who had witnessed an accident 5 months ago now complains of recurrent memories of the accident. Which does the nurse suspect in this client? 1. Adjustment disorder 2. Complicated grieving disorders 3. Acute stress disorder (ASD) 4. Post-traumatic stress disorder(PTSD)

answer: 4 PSTD is associated with recurrent memories. The symptoms may occur within 3 months and may be delayed for several months or even years.

The nurse is caring for a client with schizophrenia in a psychiatric unit. Which outcome in the client indicates effective treatment? 1. Demonstrate trust in one staff member within 5 days 2. Within 10 days, verbalize an understanding that the voices heard by him or her are not real 3. Complete one simple craft project within 15 days 4. Perform activities of daily living independently by the time of discharge

answer: 4 Performing activities of daily living independently by the time of discharge indicates effective treatment because the client with schizophrenia is unable to perform daily living activities independently.

A client in the milieu unit tells the nurse, "I think it's stupid to close the front gate at 10 p.m. We should be allowed to be out until midnight." How should the nurse respond to this client? 1. "You will be disturbing those who go to bed early when you come in late making noise." 2. "You must discuss this in the community meeting." 3. "You should know the rules of the community." 4. "You are not the only person in the unit. Decisions are made as a group."

answer: 4 Reminding the client that his or her behavior affects the other clients in the community is an appropriate response by the nurse in this scenario. This response will help the client understand the situation.

The nurse is caring for a client with acute stress disorder. Which statement made by the client during the follow-up visit indicates that the intrusive symptoms have subsided? 1. "I do not feel dazed." 2. "I no longer feel irritable." 3. "I feel happy and satisfied." 4. "I no longer have dreams about the accident."

answer: 4 Repeated distressing dreams are among the intrusive symptoms. As the client no longer has dreams about the accident, it suggests that the intrusive symptoms have subsided.

Which standard of psychiatric mental health clinical nursing practice includes milieu therapy? 1. Standard 2: Diagnosis 2. Standard 3: Outcomes Identification 3. Standard 4: Planning 4. Standard 5: Implementation

answer: 4 Standard 5 of psychiatric mental health clinical nursing practice includes milieu therapy. The nurse maintains a safe and therapeutic environment in collaboration with clients, families, and other primary health-care providers.

A client tells the nurse, "I feel lightheaded after exercising." The nurse finds that the client has an unsteady gait, pale skin, and bruises on the right arm. What is the subjective data in the given scenario? 1. Bruises on the right arm 2. Presence of pale skin 3. Presence of unsteady gait 4. Lightheadedness after exercising

answer: 4 Subjective data is the information gathered from the client or family. In this scenario, when the client states that he or she feels lightheadedness after exercising, it is subjective data.

The nurse is caring for a client who has taphophobia. What does the nurse expect in the client as a result of this fear? 1. fear of fire 2. fear of death 3. fear of insanity 4. fear of being buried alive

answer: 4 Taphophobia refers to the fear of being buried alive. The nurse expects the client to have this fear.

A client's Hamilton anxiety rating score is 23. What does the nurse infer from this finding? 1. The client has mild anxiety. 2. The client has severe anxiety. 3. The client condition is normal. 4. The client has moderate anxiety.

answer: 4 The assessment score of 23 indicates that the client has moderate anxiety.

A client tells the nurse, "I drink because it's the only way I can deal with my bad marriage and my worse job." What does the nurse understand from the client's statement? 1. The client is showing a sublimation type of ego defense mechanism. 2. The client is showing a repression type of ego defense mechanism. 3. The client is showing the undoing type of ego defense mechanism. 4. The client is showing the rationalization type of ego defense mechanism.

answer: 4 The client is trying to justify the unacceptable behavior, which is drinking. According to the client, the reasons for drinking are bad marriage and worse job. This justification indicates the rationalization type of defense mechanism

According to the Psychological Recovery Model, which client is undergoing Stage 4 of the recovery process? 1. A client who feels out of control and powerless to change his or her life 2. A client who develops an awareness of the need to take control of his or her life 3. A client who has the ability to be independent and take care of his or her basic needs 4. A client who begins to actively take control of his or her life

answer: 4 The client who begins to control his or her life is experiencing the rebuilding stage, according to the Psychological Recovery Model. This stage is Stage 4 of the recovery process.

While caring for a client with posttraumatic stress disorder, the art therapist uses the creative abilities of the client to encourage the expression of feelings and emotions through artwork. Which action of the client indicates the effectiveness of the treatment? 1. The client will develop new coping strategies. 2. The client will demonstrate interpersonal interaction with the therapist. 3. The client will demonstrate reality orientation with the environment. 4. The client will analyze his or her own work to recognize and resolve underlying conflict.

answer: 4 The client will analyze his or her own work to recognize and resolve underlying conflict.

A client with schizophrenia is diagnosed with a self-care deficit. Which activity should the nurse include in the treatment plan for the client? 1. Engage the client in physical activity 2. Encourage verbalization of fears 3. Provide adequate quantities of food and fluids 4. Assist the client in performing personal hygiene and grooming

answer: 4 The client with schizophrenia neglects hygiene and grooming. Therefore, the nurse assists the client in performing personal hygiene and grooming.

While discussing "recovery in life" with a group of student nurses, the registered nurse states, "Relationships and social networks provide support, friendship, love, and hope." Which major dimension is the registered nurse discussing, according to perspective of the Substance Abuse and Mental Health Services Administration (SAMHSA)? 1. health 2. home 3. purpose 4. community

answer: 4 The community dimension includes relationships and social networks that provide support, friendship, love, and hope.

The nurse is caring for a client whose distress level as measured by the Subjective Units of Disturbance (SUD) scale is reduced to zero. What does the nurse infer from this finding? 1. The client has completed the closure phase. 2. The client has completed the installation phase. 3. The client has completed the reevaluation phase. 4. The client has completed the desensitization phase.

answer: 4 The desensitization phase is completed once the score on Subjective Units of Disturbance scale is reduced to zero. Thus, the nurse expects that the client has completed the desensitization phase.

Which biological response occurs at the initial stage of stress during "fight or flight" syndrome? 1. lipogenesis 2. constriction of pupils 3. increase in intestinal motility 4. increase in lacrimal secretions

answer: 4 The hypothalamus stimulates the sympathetic nervous system, which innervates the lacrimal glands. Therefore, lacrimal secretions increase during stress.

A client recently diagnosed with hypertension is brought to a psychiatric unit for being depressed, refusing to change his diet, and deliberately skipping his medication. Which is the long-term goal for this client? 1. The client will discuss lifestyle changes with the nurse. 2. The client will formulate a plan of action for incorporating changes with the help of the nurse. 3. The client will demonstrate movement toward independence, considering the change in the health status. 4. The client will demonstrate competency to function independently to his optimal ability, considering his change in health status by the time of discharge.

answer: 4 The major or long-term goal is that the client will demonstrate competency to function independently to his optimal ability considering his change in health status.

The primary health-care provider instructs the nurse to seclude a psychotic client showing aggressive behaviors. Which action should the nurse take in this situation? 1. Take the client for shock therapy 2. Administer tranquilizers to the client 3. Restrain the client's extremities with leather straps 4. Place the client alone in a closed, minimally furnished roo

answer: 4 The nurse places the client in a minimally furnished room that offers little stimulation to the client in order to deescalate the aggressive behavior.

A client who lost his or her spouse in an accident tells the nurse, "Leave me alone. I can't talk to you." How would the nurse respond to this client using therapeutic communication techniques? 1. "Everything will be fine." 2. "Tell me what you are thinking." 3. "I think you should come in here and discuss your feelings." 4. "Do you feel that no one understands your feelings?"

answer: 4 The nurse should put into words what the client has implied or said indirectly. This statement made by the nurse is the best response to the client.

A client tells the nurse, "I can't concentrate on anything. My mind keeps wandering." How should the nurse respond to convey to the client that he or she has understood the client's statement? 1. Referring questions back to the client 2. Taking notice of a single idea of the client 3. Researching further into the client's feelings 4. Repeating the main idea of what the client has said

answer: 4 The nurse should repeat the main idea of what the client has said to make the client know that the statement is understood. Repeating the main idea will help both the client and the nurse validate the statement.

During evaluation, the registered nurse concludes that a new trainee nurse is implementing the ethical principle of justice effectively. Which action of the trainee nurse supports the registered nurse's conclusion? 1. Avoiding harm to the client intentionally or unintentionally 2. Avoiding secrecy about the client's condition 3. Ensuring that the client fulfills his or her needs without any help 4. Treating both married and unmarried clients equally

answer: 4 The nurse should treat all clients equally irrespective of sex, race, marital status, or socioeconomic status to implement justice effectively in his or her profession.

Which statement made by the student nurse needs correction regarding the Tidal Model? 1. "The nurse would assist the client in recording the story in his or her own words." 2. "The nurse would show interest when the client is telling the story." 3. "The nurse would assist the client in developing self-confidence in his or her abilities." 4. "The nurse would ensure that the client is unaware of all interventions."

answer: 4 The nurse would be transparent and ensure that the client is aware of all interventions for recovery.

While caring for a client with anger, the nurse asks, "What would you like to discuss today?" What could be the rationale behind this statement of the nurse? 1. To increase the client's feelings of self-worth 2. To convey an attitude of reception and reward 3. To offer the client encouragement to continue 4. To emphasize the importance of the client's role in the interaction

answer: 4 The nurse's question would emphasize the importance of the client's role in the interaction.

Which statement made by the student nurse needs correction regarding the autonomic nervous system? 1. "The parasympathetic nervous system is dominant in nonstressful situations." 2. "The neuronal cell bodies of the parasympathetic nervous system originate in the sacral region of the spinal cord." 3. "The synapse in the parasympathetic division occurs very close to the visceral organ being innervated." 4. "The parasympathetic nervous system, when stimulated, decreases digestive secretions."

answer: 4 The parasympathetic nervous system, when stimulated, increases peristalsis and digestive secretions for normal digestion.

While reviewing the mental history of a client with psychiatric illness, the nurse finds that the client expresses incoherent neologisms and has slurred speech. Which would the nurse infer from these findings? 1. The client has impaired orientation. 2. The client has impaired thought processes. 3. The client has impaired interaction patterns. 4. The client has impaired communication patterns.

answer: 4 The presence of expressing incoherent neologisms and slurred speech indicates that the client has impaired communication patterns.

The nurse is caring for a client with trauma disorder. Which variable might help the nurse determine the client's response to trauma? 1. Religious and cultural influences 2. Level of anticipatory preparation 3. Duration and severity of the stressor 4. Present psychosocial development stage

answer: 4 The present psychosocial development stage is a variable for the individual's response to the trauma because it helps determine the client's behavior and response to the trauma.

Which medical conditions are empirically validated for eye movement desensitization and reprocessing (EMDR) psychotherapy? Select all that apply. 1. seizures 2. psychosis 3. adjustment disorder 4. acute stress disorder (ASD) 5. post-traumatic stress disorder (PTSD)

answer: 4, 5 ASD occurs after being the witness or victim of a natural or fabricated disaster, violent accident, or combat. EMDR is empirically validated in ASD. PTSD is accompanied by a natural or fabricated disaster, violent death, combat, or accident. EMDR is empirically validated in PTSD.

A client with a psychiatric illness makes a list of things he or she needs to do every day to maintain wellness. Which information does the client include under the daily maintenance list? Select all that apply. 1. Listening to music 2. Talking to a friend 3. Attending a support group 4.Avoiding caffeine and junk foods 5. Taking medications and vitamin supplements

answer: 4, 5 The client includes information such as avoiding caffeine and junk food in the second step of the daily maintenance list. The client includes information such as administration of medications and vitamin supplements in the second step of the daily maintenance list.

Which statement made by the student nurse indicates effective learning about restraints? Select all that apply. 1. "Restraints are straps that should be made only of leather." 2. "Restraints will help promote the psychological well-being of the client." 3. "Restraints can be used for the staff's convenience during a medical procedure." 4. "Restraints should only be used if the client's behavior poses a risk to his or her physical safety." 5. "Restraints can include a medication that causes sedation and controls the client's behavior."

answer: 4, 5 When the student nurse says that restraints are only used if the client's behavior poses a risk to his or her physical safety, it indicates effective learning. Restraints control the client's behavior during psychotic episodes and help prevent the risk of physical injury. Restraints include medications like tranquilizers that are used to control the behavior of a client with agitation. This statement by the student nurse indicates effective learning.

Arrange the steps of the nursing process in order according to the standards of practice for psychiatric mental health nursing set by the American Nurses Association (ANA).

1. assessment 2. diagnosis 3. outcomes identification 4. planning 5. implementation 6. evaluation

While caring for a client with acute stress disorder, the therapist uses recreational activities as a part of the therapy. Which outcome in the client will indicate effectiveness of the therapy? 1. The client will show interpersonal interactions. 2. The client will resolve underlying conflicts. 3. The client will learn skills that can be used in leisure time. 4. The client will show independence in performing activities of daily life.

answer 3: Recreational activities redirect the client's thinking about the trauma. When the therapist uses recreational abilities, the client will learn skills that can be used in leisure time to redirect the client's thought process.

Which statement by the client may indicate a sublimation type of defense mechanism to overcome anxiety? 1. "I used my aggressive and competitive drive to become a star kickboxer." 2. "I don't want to think about that situation now. I'll think about that tomorrow." 3. "I yelled at my spouse because I had a bad day at the office. I should buy my spouse roses." 4. "I curl up in a fetal position in the bed and sleep for long periods when I am depressed."

answer: 1 The client who uses a sublimation defense mechanism rechannels personally or socially unacceptable impulses into activities that are constructive. The client uses aggressive behavior in kickboxing to become a star.

Which interventions indicate that the nurse is implementing the Tidal Model of recovery through nursing practice? Select all that apply. 1. Giving the client the gift of time 2. Providing feedback to the client when needed 3. Assisting the client in monitoring illness symptoms 4. Assisting the client in managing illness symptoms 5. Encouraging the client to be as independent as possible.

answer: 1, 2, 5 The nurse spends quality time with the client to build a therapeutic relationship. This intervention indicates that the nurse is implementing the Tidal Model of recovery through nursing practice. The nurse provides positive feedback to the client when needed to make life changes and for the successes achieved. This intervention indicates that the nurse is implementing the Tidal Model of recovery through nursing practice. The nurse encourages the client to be as independent as possible and offers assistance only when needed. This intervention indicates that the nurse is implementing the Tidal Model of recovery through nursing practice.

Which members of the interdisciplinary treatment team can conduct individual, group, and family therapy? Select all that apply. 1. Clinical psychologist 2. Recreational therapist 3. Occupational therapist 4. Psychiatric social worker 5. Psychiatric clinical nurse specialist

answer: 1, 4, 5 The clinical psychologist has a doctoral degree in clinical psychology and can conduct individual, group, and family therapy. The psychiatric social worker has a master's degree in social work and can conduct individual, group, and family therapy. The psychiatric clinical nurse specialist has a master's degree in psychiatry. Therefore, he or she can conduct individual, group, and family therapy.

A newly admitted client reports periods of feeling "blue" and lonely. Based on the client's description, the nurse would suspect an increase in which neurotransmitter levels? Select all that apply. 1. Acetylcholine 2. Norepinephrine 3. Dopamine 4. Serotonin 5. Substance P

answer: 1, 5

In which the psychiatric disorders are familial tendencies are indicated? Select all that apply. 1. schizophrenia 2. cystic fibrosis 3. phenylketonuriaa 4. Down syndrome 5. Anorexia nervosa

answer: 1, 5

Which area of the brain may be affected when a client with anxiety disorder shows symptoms related to respiratory activation and increased heart rate? 1. thalamus 2. brainstem 3. frontal cortex 4. hypothalamus

answer: 2 A client with anxiety disorder may have symptoms related to respiratory activation and increased heart rate, which affects the brainstem.

Which therapy may help the client recognize and modify trauma-related thoughts? 1. group therapy 2. cognitive therapy 3. prolonged exposure (PE) therapy 4. eye movement desensitization and processing (EMDR) therapy

answer: 2 Cognitive therapy helps the client recognize and modify negative thoughts associated with trauma disorder.

Which law provides protection from conduct deemed injurious to the public welfare? 1. Civil law 2. Criminal law 3. Common law 4. Statutory law

answer: 2 Criminal law provides protection from conduct deemed injurious to the public welfare.

Which action would the nurse most likely take to determine the internal needs of a community? 1. Determine community strengths 2. Evaluate community activities 3. Note community reports of functioning 4. Create a plan to manage interactions within the community

answer: 2 Evaluating activities within the community and between the community and the larger society will help determine the community needs.

The nurse is caring for a client who is experiencing a great deal of anxiety because previously used problem-solving techniques have failed. In which phase of crisis development is the client most likely to be? 1. Phase I 2. Phase II 3. Phase III 4. Phase IV

answer: 2 In phase II of crisis development, anxiety increases due to failure of previously used problem-solving techniques. Therefore, the client is most likely in phase II of crisis development.

Who is responsible for evaluating the effectiveness of psychotropic medications? 1. the client 2. the nurse 3. the social worker 4. the therapist

answer: 2 The nurse is responsible for evaluating the effectiveness of psychotropic medications.

The nurse is teaching a group of student nurses about disorders in which the characteristic symptoms are manifested as physical symptoms. Which disorders does the nurse include in the teaching plan? Select all that apply. 1. panic disorder 2. factitious disorder 3. conversion disorder 4. separation anxiety disorder 5. dissociative identity disorder

answer: 2, 3 Somatic symptom disorders are the disorders in which the characteristic symptoms are physical symptoms. Factitious disorder is a somatic symptom disorder. Therefore, the nurse includes this disorder in the teaching plan. Conversion disorder is a somatic symptom disorder. Therefore, the nurse includes this disorder in the teaching plan.

Which therapy would best help in redirecting the client's destructive energy? 1. Use of art therapy 2. Use of music therapy 3. Use of recreational therapy 4. Use of occupational therapy

answer: 3 Recreational therapy encourages the client to redirect thinking with the help of recreational techniques, such as playing. Therefore, this therapy would best help in redirecting the client's destructive energy.

Which symptom would be a manifestation of hoarding disorder? 1. Sexual urges or fantasies 2. Ritualized eating behavior 3. Recurrent pulling of one's hair 4. Difficulty in parting with possessions

answer: 4 A client with hoarding disorder will have extreme difficulty in discarding or parting with their possessions even if they are cheap and of low quality.

The nurse is reviewing orders for a client with hallucinations associated with Parkinson disease psychosis. Which medication can the nurse expect to administer? 1. Clozapine 2. Risperidone 3. Haloperidol 4. Pimavanserin

answer: 4 Pimavanserin is indicated for the treatment of hallucinations and delusions associated with Parkinson disease psychosis.

A client who lost her spouse in an accident says, "God does not have mercy on me. He always takes away the people I love." Which is the best response given by the nurse in this situation? 1. "It is not as you think. God is never wrong." 2. "I think you are correct. I also feel this way sometimes." 3. "It is okay. There are many other people in your life who love you." 4. "I understand how you are feeling. Being angry is natural in this situation."

answer: 4 The nurse should respond in such a way that the client understands that being angry with God is a normal part of the grieving process. Therefore, this response is best for the client.

What information should the nurse specifically provide to the client's parents as a part of the therapeutic milieu? 1. Problem-solving skills 2. Stress management techniques 3. The essentials of good nutrition 4. Signs and symptoms of substance abuse

answer: 4 The nurse should teach the signs and symptoms of substance abuse to the client's parents or guardians so that they will be aware of abusive behavior, which in turn will have negative effects on the therapeutic program.

The nurse is caring for a client with chronic low self-esteem. Which statement made by the nurse indicates an accepting attitude? 1. "I want to listen to what you have to say." 2. "Explain to me what you are feeling now." 3. "We can sit in the dayroom and eat dinner together." 4. "I understand what you're saying."

answer: 4 This statement indicates an accepting attitude of reception to and regard for the client.

Which term is used to refer to the personal beliefs of the nurse about what is important and desirable in a given situation? 1. Rights 2. Moral behavior 3. Ethics 4. Values

answer: 4 Values refer to the personal beliefs of the nurse about what is important and desirable in a given situation.

The nurse is assessing a client who has been receiving a selective serotonin reuptake inhibitor (SSRI) for 2 months and is also receiving warfarin for deep-vein thrombosis. Which statement made by the client would be of most concern to the nurse? 1. "I took my medication in the morning, so I am sleepy today." 2. "I take the medication with food because it makes me a little nauseated." 3. "I need to talk to someone about the sexual side effects of the antidepressant." 4. "When I brush my teeth, I notice my gums bleed more than normally."

answer: 4 Warfarin and nonsteroidal anti-inflammatory drugs can cause an increase in bleeding with combined with SSRIs. Bleeding gums are a sign of increased bleeding. This is concerning and should be mentioned to the health-care provider.