Mental Health Exam 3

Induced

Withdrawal is a substance use?/induced? disorder

Expressive

A ______________ victim response is when the victim is expressing their emotions through their behaviors

Compounded

A ________________ rape victim response is when the victim is depressed, suicidal, abusing substances, and can have psychotic behavior

Amotivation syndrome

A chronic psychiatric disorder associated with chronic cannabis use characterized by signs that are linked to cognitive and emotional states such as detachment, blunted emotion and drives, executive functions like memory and attention, disinterest, passivity, apathy, and a general lack of motivation

3

A client arrives for her mental health appointment wearing a cocktail dress and theatrical makeup. She announces loudly, dramatically, and in a flirtatious manner that she needs to be seen immediately because she is experiencing overwhelming psychological distress. The nurse should recognize behaviors suggestive of which axis II diagnosis? 1. Borderline personality disorder 2. Narcissistic personality disorder 3. Histrionic personality disorder 4. Antisocial personality disorder

Aversion therapy

Form of therapy used for patients with kleptomania where when the patient is feeling the urge, they hold their breath until it is slightly painful

Hostage response

Term for when the person being abused will do whatever they can in the situation so that they remain safe

Physical dependence

Term for when tolerance develops and the amount of substance required to achieve the desired effect increases

Lacunae

Term that can be used for patients with antisocial personality disorder to describe a lack of moral compass

Malingering

Term used to describe over exaggerating physical symptoms for personal gain

Tension phase Violent phase Honeymoon phase

The 3 phases in the cycle of violence

Covert therapy

Form of therapy used for patients with kleptomania where when the patient is feeling the urge, they imagine the negative consequences of the action

Doesn't (would be a HIPAA violation)

If a nurse suspects abuse and the patient is not a vulnerable population, the nurse does?/doesn't? legally have to report it

Visual Tactile

Illusions and hallucinations associated with alcohol detoxification are most often ____________ or ____________

Unspecified

____________ personality disorder is a diagnosis that can be given if the patient does not meet the criteria for a specific personality disorder, but tries to sabotage others

Schizotypal

____________ personality disorder is characterized by a pervasive pattern of social and interpersonal deficits, along with acute discomfort with others, and schizotypal cognitions

Instrumental

____________ violence is driven by the desire for power and control

Histrionic

_____________ personality disorder is characterized by pervasive patterns of excessive emotionality and attention seeking, and may come across and manipulative, shallow, and fake

Should

A patient with schizotypal personality disorder should?/shouldn't? have the same few nurses throughout treatment

Silent

A _____________ rape victim response is when the victim is depressed and does not tell anyone about what happened

Controlled

A ______________ victim response is when the victim is calm and subdued and talks in a matter-of-fact way

2

A female client with an eight-year history of a diagnosis of somatization disorder is to be discharged from the first psychiatric hospitalization. Which client statement indicates that nursing care has been effective for the client? "I need to make sure that all of my medications are sent home with me." 2. "I see now that when I get stressed, my 'body' speaks for me." 3. "My family is so good to me when I am sick like this." 4. "There are so many illnesses that you nurses simply do not know about."

3

A five-year-old child has been removed from the home because of sexual abuse by the stepfather. When teaching the child's mother about possible consequences the child might experience, which of the following should the nurse include? 1. Since the child was removed from the home at an early age, no long-term consequences are expected. 2. Because the abuser was someone well known by the child, the situation will be less traumatic for the child. 3. The child is at current risk for developing depression and will remain so in the future. 4. Once an adult, the child should be counseled not to have children, as the child will become an abuser.

Aren't

Hallucinogens are?/aren't? physically addictive

Derealization

An alteration in the perception of the external environment

Use

Addiction is a substance use?/induced? disorder

Men

Addiction rates in the US are higher in men?/women?

Antisocial

Patients with _________ personality disorder seem to "lack a conscious"

Obsessive-compulsive

Patients with ____________ personality disorder see the world as good and bad, with no in between

Naltrexone (ReVia)

Drug that can be prescribed to patients with borderline personality disorder to reduce the urges to self mutilate

Disulfiram (Antabuse)

Drug used for alcohol withdrawal that will make the patient sick if they drink alcohol while taking it

24

Effects of methamphetamines can be felt for up to _____ hours per dose

Intellectualization

Ego defense mechanism commonly seen in patients with obsessive-compulsive personality disorder where the person avoids expressing emotions by focusing on reason and logic

B

Histrionic personality disorder is in cluster ____

Women

Histrionic personality disorder is more common in men?/women?

Norepinephrine Dopamine

Increased levels of ______ and _________ have been associated with abuse

3

Insight therapy should not be started for a patient who has gambling disorder until they have been free of gambling for _____ months

Men

Intermittent explosive disorder is more common in men?/women?

Induced

Intoxication is a substance use?/induced? disorder

Synthetic opoiate

Methadone is a _____________

Isn't

Recreational/social use is?/isn't? considered substance disorder

Arrhythmia Seizure

S/sx (2) of amphetamine overdose

Confusion Short term memory loss Confabulation

S/sx (3) of Korsakoff's psychosis

Odor Sedation Slurred speech

S/sx (3) of alcohol intoxication

N/V Bradypnea Cyanosis

S/sx (3) of alcohol poisoning

Headache Fatigue Drowsiness

S/sx (3) of caffeine withdrawal

Irritability Decreased appetite Depression

S/sx (3) of cannabis withdrawal

N/V Diarrhea Headache

Side effects (3) of Naltrexone (ReVia)

Methadone LAAM (levo-alpha-acetylmethadol)

Synthetic opiates (2) that can be used to manage opioid withdrawal and relapse

Type (of abuse) Role (of the offender) Intensity (of abuse) Autonomic response (of the child) Duration (of abuse)

TRIAD acronym for child abuse and neglect

2

The axis II diagnosis of a client is schizoid personality disorder. Which approach should the nurse plan to use when interacting with this client? 1. Helpful and nurturing 2. Matter-of-fact and calm 3. Light and playful 4. Warm and friendly

2

The client is diagnosed with borderline personality disorder and engages in dichotomous thinking. When considering possible etiologies for this type of thinking, the nurse should give particular attention to a client history of which of the following? 1. Gender stereotyping 2. Family enmeshment 3. Perfectionistic standards 4. Physiological underarousal

4

The client who has dissociative identity disorder (DID) is now 20 minutes late for cognitive therapy group. The client says, "I was never told to go to that group." What is the nurse's best response? 1. "You can't get out of group that easily." 2. "People with dissociative identity disorder forget quite a bit." 3. "Have you thought about just why you might be resisting treatment?" 4. "It is possible that you were not aware of group time."

4

The client who is diagnosed with body dysmorphic disorder says to the nurse, "I can't get rid of the idea that my ears are weird-looking." Which of the following is the most appropriate outcome criterion for this client? 1. Consider plastic surgery to reshape the ears. 2. List three benefits of having unusual ears. 3. Understand how body image is affected by maturation. 4. Explore possible explanations for dissatisfaction with body image.

Thiamine

Wernicke's encephalopathy and Korsakoff's psychosis are both caused by ____________ deficiencies associated with alcoholism

Is

Wernicke's encephalopathy is?/isn't? reversible

Intervention

When a group of individuals come together to address the individual's substance problems and confront the person's denial

4

A 15-year-old female student visits the school nurse's office asking about date rape and pregnancy. She confides to the nurse that her boyfriend forced her to have sex against her will. The most appropriate initial intervention of the nurse would be to do which of the following? 1. Administer a pregnancy test. 2. Teach safe sex practices. 3. Teach methods of birth control. 4. Identify the student's immediate concerns and feelings.

Dopamine Norepinephrine

Zyban (bupropion) functions by increasing levels of _________ and ___________

Selective

_________ amnesia is when a person cannot recall all the events or persons during a certain time period

2

Adolescent alcoholic clients often relapse into drinking because they feel pressured by their peers. Which skill training should the nurse plan for these clients in order to assist them in relapse prevention? 1. Critical-thinking skills 2. Drinking-refusal skills 3. Problem-solving skills 4. Communication skills

Continuous

__________ amnesia is when a person cannot recall events associated with a trauma up to the present

3

A client asks the nurse to provide information about the detoxification process and withdrawal from a benzodiazepine. The nurse should inform the client that the process will involve which of the following? 1. Rapid reduction in amount and frequency of the drug normally used 2. Abrupt discontinuation of the drug commonly used 3. Gradual downward reduction in dosage of the drug commonly used 4. Planned, progressive addition of an antipsychotic drug

3

A client comes to the emergency department with a broken wrist and severe bruises inflicted by a beating by the intimate partner. The client states an intention to remain in the relationship at this time. What is the most appropriate response by the nurse? 1. "You need to leave the relationship." 2. "I will call a lawyer for you if you wish." 3. "Let's develop a safety plan for repeated violence." 4. "Here is a list of services that can help you."

1 5

A client detoxifying from alcohol requires medications to treat the withdrawal. The nurse observes coarse hand tremors and diaphoresis. How should the nurse first react to this observation? Select all that apply. 1. Assess level of consciousness. 2. Explain the concepts of withdrawal to the client. 3. Administer ordered thiamine and folic acid. 4. Determine the most recent blood alcohol level. 5. Assess vital signs.

1

A client diagnosed with a personality disorder is cold, aloof, and avoids others on the unit. The nurse recognizes that this behavior is symptomatic of which personality disorder? 1. Schizoid personality disorder 2. Dependent personality disorder 3. Borderline personality disorder 4. Antisocial personality disorder

4

A client diagnosed with a somatization disorder has been attending group therapy on a regular basis. Which client statement suggests to the nurse that the therapy has been effective? 1. "I think I'd better get some pain pills. My back hurts from sitting in group." 2. "The other people in the group have mental problems!" 3. "I haven't said much, but I get a lot out of listening." 4. "I feel better physically just from getting a chance to talk.'

4

A client diagnosed with antisocial personality disorder tells Nurse A, "You're a much better nurse than Nurse B said you were." The client then tells Nurse B, "Nurse A is upset with you for some reason." To Nurse C, the client states, "I think you're great, but Nurse A said she saw you make three mistakes this morning." The nurse should conclude that these behaviors are intended to have which effect? 1. Gain acceptance 2. Gain attention 3. Create guilt in the staff 4. Manipulate the staff

2

A client has been diagnosed with borderline personality disorder. The client is impulsive, shows labile affect, displays frequent angry outbursts, and has difficulty tolerating angry feelings without self-injury. The nurse selects which of the following as the priority nursing diagnosis for this client? 1. Anxiety 2. Risk for Self-Mutilation 3. Risk for Violence toward others 4. Ineffective Coping

4

A client is admitted to a medical unit for treatment of chest pain. A family member reports a client history of chemical abuse. The client is ambivalent about the recommendation for treatment made by an addiction consulting team. What would be an appropriate nursing diagnosis for the client? 1. Dysfunctional Family Processes: Alcoholism 2. Ineffective Therapeutic Regimen Management 3. Risk for Injury 4. Decisional Conflict

2 4 5

A client is admitted to the unit with a diagnosis of a personality disorder (PD). The client is withdrawn and refuses to go to group. In addition the client acts very fearful when approached by staff. The nurse considers that this behavior is consistent with which type of PD? Select all that apply. 1. Antisocial PD 2. Avoidant PD 3. Histrionic PD 4. Dependent PD 5. Obsessive compulsive PD

2

A client is brought to the emergency room after a brutal physical assault. Although oriented and coherent, the client cannot remember the assault or events surrounding it. The priority intervention by the nurse is to provide which of the following? 1. Frequent reality orientation 2. Physical comfort and safety 3. Thoughtful questioning for the police report 4. Referral to a community support group

2 4

A client is diagnosed with depersonalization disorder. Which of the following is the nurse most likely to find in the assessment? Select all that apply. 1. Two or more personalities 2. Feelings like "being in a dream" 3. Indifference to the symptoms 4. Feeling like a robot 5. Amnesia about the event

3

A client recently released from prison for embezzlement has a history of becoming defensive and angry when criticized and blaming others for personal problems. The client has expressed no remorse or emotion about the actions that resulted in the prison term, but instead says that the embezzlement was justifiable because the employer "did not treat me fairly." The nurse concludes these behaviors are consistent with which of the following mental health problems? 1. Narcissistic personality disorder 2. Histrionic personality disorder 3. Antisocial personality disorder 4. Borderline personality disorder

1

A client reports episodic depersonalization experiences to the nurse. Which of the following is an appropriate goal of care? 1. The client will describe three stress management techniques by day two. 2. The client will report no suicidal thoughts by week one. 3. The client will create a chart of all personalities by week one. 4. The client will state five personal strengths by day two.

3

A client says to the nurse, "I know you think this is in my head, but my pelvic pain is real. I have a serious malignancy and am going to die." The nurse is aware that the physician just informed the client that despite very extensive diagnostic testing, no abnormalities have been found. What is the nurse's best response? 1. "I guess it could be true. Sometimes doctors miss a diagnosis." 2. "I realize that you do have pain and hurt a lot." 3. "It must be hard for you to accept the testing results." 5. "How about resting now and asking your doctor more about it later?"

3

A client says, "I have a very small drink every morning to calm my nerves and stop my hands from trembling." The nurse concludes that this client is describing which of the following? 1. An anxiety disorder 2. Tolerance 3. Withdrawal 4. Alcohol abuse

4

A client treated for a diagnosis of hypochondriasis has an upsetting phone conversation with her husband and subsequently requests an analgesic. The client states, "My head is killing me, and I know there is a tumor in there somewhere, or it wouldn't hurt like this." Which of the following is the nurse's best response? 1. "You have no brain tumor. It is just your anger toward your husband." 2. "I'll get your vital signs and then call your doctor if they are abnormal." 3. "You must try not to rely on the pain pills so much since they are addictive." 4. "I'll get your medication and then let's talk about what just happened."

3

A client treated for a diagnosis of hypochondriasis would demonstrate understanding of the disorder by which statement to the nurse? 1. "I realize that tests and lab results cannot pick up on the seriousness of my illness." 2. "Once my family members realize how severely ill I am, they will be more understanding." 3. "I know that I don't have a serious illness, even though I still worry about the symptoms." 4. "I realize that exposure to toxins can cause significant organ damage."

3

A client who is recovering from alcoholism presents in the psychiatric unit and tells the admitting nurse she is very depressed and has a hard time staying sober. The nurse concludes that the most likely treatment sequence for this client will be which of the following? 1. Depression before the sobriety issue 2. Sobriety issue before the depression 3. Sobriety issue and depression at the same time 4. Depression after the sobriety issue has been resolved

4

A client with a long history of relapsing from cocaine dependence states that in spite of having a desire to be sober, thoughts of reusing cocaine continue to occur. The nurse decides to educate the client about the role the Brain Reward System (BRS) plays in addiction. The nurse considers that the teaching has been effective if the client makes which statement about the BRS? 1. "Reinforces the value of having positive role models." 2. "Offers a means of mediating job stress and pressure." 3. "Reduces physiologic and psychological cravings." 4. "Facilitates cravings and triggers for reusing."

2

A client with dissociative identity disorder (DID) is admitted after an overdose of alcohol and benzodiazepines, claiming that another alter "did it." The nurse formulates which of the following as the priority nursing diagnosis? 1. Post trauma Response 2. Risk for Self-Directed Violence 3. Disturbed Personal Identity 4. Anxiety

3

A client with dissociative identity disorder (DID) suddenly begins to speak with a child's vocabulary and voice. The nurse should interpret this as which of the following? 1. An attempt to gain attention 2. A state of depersonalization 3. Changing to a child alter 4. Malingering

3

A client with dissociative identity disorder (DID) suddenly has a change in voice quality and sentence structure. What is the most therapeutic response by the nurse? 1. "You must be feeling very needy." 2. "I wonder why you're not acting your age." 3. "Can you tell me what is happening?" 4. "This behavior keeps you from working on your problems."

4

A female alcohol-dependent client who has cardiomyopathy tells the nurse that she is certain that her family and friends are against her. The client goes on to say, "They stay on my back about my drinking and say I could die from it." What would be the best response by the nurse? 1. "Anyone saying this to you must have a problem with his or her own drinking." 2. "Although their intentions are good, they have no right to judge another person's drinking." 3. "Do you think they may be jealous that you can drink more than they can?" 4. "Perhaps they have noticed that your drinking creates consequences for you."

3

A five-year-old girl is brought to the clinic for symptoms of a urinary tract infection (UTI). The nurse's assessment reveals bruises in the child's genital and rectal areas. The mother reports that she had left the little girl with her boyfriend the night before. The nurse's first priority with this client is to take which action? 1. Obtain a urine sample to confirm a UTI. 2. Teach the mother about symptoms of UTI. 3. Report suspected sexual abuse to protective services. 4. Assess the child for other health problems.

1

A hospitalized client diagnosed with a somatization disorder asks for as needed (prn) medication for complaints of abdominal pain. What is the nurse's best response? 1. Matter-of-factly assess the pain and administer prn medication. 2. Inform the client of negative gastroscopy findings. 3. Teach the client to take slow, deep breaths. 4. Delay fulfilling request for medication to see if the pain subsides first.

1

A male client comes to day treatment surrounded by an intense odor of alcohol. The client staggers when walking but insists that he has not consumed any alcohol. The nurse concludes that this behavior constitutes which of the following? 1. Denial 2. Rationalization 3. Transference 4. Countertransference

2

A mother brings in an eight-month-old infant who is having difficulty breathing. The nurse assesses bleeding in the baby's retinas. The mother states that the child was being cared for by the father while the mother was out of the house. What is the most appropriate initial response of the nurse? 1. Question the mother about the events prior to the respiratory distress. 2. Identify this situation as a medical emergency. 3. Inform the mother that the period of greatest danger has passed. 4. Report the situation to the children's protective services agency.

1 3

A newly licensed nurse asks an experienced nurse about theories related to violent behaviors towards others. The experienced nurse should respond by making which statements? Select all that apply. 1. "The underpinnings of social learning theory lay in the idea that violent behavior is related to the perpetrator's need for control and power." 2. "There is no etiological basis for violent behavior towards others." 3. "Poor impulse control may be one reason for violent behavior." 4. "Feminist theory states that it is due to the physiology of the male gender." 5. "The male response theory states that women provoke men, and that women are responsible for the abuse."

3

A nurse is teaching a class on domestic violence to high school students. Which statement by a student would indicate to the nurse that further teaching is needed? 1. "Violence often begins in a dating relationship." 2. "The abuser will often apologize and promise to stop." 3. "If you are educated and have money, abuse does not happen." 4. "Abusers are often excessively jealous and possessive."

1

A nurse is teaching a group of clients about addiction. One client says he can stop drinking whenever he wants. The nurse concludes that this client does not yet understand that addiction is a disease in which individuals primarily lose ability to do which of the following? 1. Control addictive and impulsive behaviors. 2. Recognize that addictive behavior is harmful to themselves and others. 3. Act sober even if they are not. 4. Think logically about their addictive behaviors.

3

A nurse is teaching a group of community health col leagues about the use of naltrexone (Re Via) in treating alcoholism. The nurse interprets that the teaching was effective if the colleagues state that naltrexone (ReVia) is used to do which of the following? 1. Prevent withdrawal symptoms. 2. Reduce number of blackouts. 3. Reduce craving for alcohol. 4. Manage heightened anxiety.

1 2 4 5

A nurse working on an inpatient psychiatric unit is orienting a new graduate nurse. The new graduate nurse asks what symptoms a person with a somatization disorder might manifest. The nurse replies by stating which of the following? Select all that apply. 1. Pain during intercourse 2. Menstrual irregularity 3. Shortness of breath 4. Nausea and vomiting 5. Urinary retention

1

A nursing assistant (NA) asks for advice about talking with a client recently diagnosed with dissociative identity disorder (DID). When the NA asks, "Should I talk about her childhood abuse?" What is the best response? 1. "If she brings up the abuse, listen to her and be supportive." 2. "You will need to really push her to get it all out." 3. "Ask her to discuss this only with her therapist." 4. "Remind her that sometimes adults exaggerate their childhood experiences."

1

A pediatric client has severe injuries to the abdomen. The nurse should suspect child abuse if the parents do which of the following? 1. Delay seeking treatment for the child's injuries. 2. Give a very detailed description of the events prior to the injuries. 3. Exhibit an anxious and concerned attitude. 4. Encourage the child to explain the injuries.

1

A pregnant female comes to the emergency depart ment with bruises on her arms and abdomen after a fight with her boyfriend. What is most important for the nurse to address when teaching this client? 1. Risks of pregnancy complications caused by abuse 2. Assertiveness training to deal with the boyfriend 3. Childbirth classes to prepare for the birth 4. Instructions on the use of resources available to her

Somatic symptom disorder

A syndrome of multiple somatic symptoms that cannot be explained medically and are associated with psychological distress and long-term seeking of assistance from healthcare professionals

4

A windstorm severely damaged a client's farm. The client recalls very little about the storm and repeatedly says, "I can't believe the farm is destroyed." When the nurse is providing care, which of the following client goals should take priority? 1. Report decreased depression by day two. 2. Express anger about his loss by day two. 3. Apply for job retraining by day two. 4. Attend a support group for disaster survivors by day two.

Sexual violence

Any type of sexual act in which an individual is threatened or coerced or forced against his or her will

Schizoid

__________ personality disorder is characterized by detachment, social withdrawal, indifference to others feelings, and restricted emotional range in interpersonal settings

Generalized

___________ amnesia is when a person has a complete loss of memory, including identity

Antisocial

___________ personality disorder is characterized by chronic antisocial behavior that violates others rights or generally accepted social norms

Localized

____________ amnesia is when a person cannot recall events associated with a trauma or events a few hours or days afterwards, then recalls it

Paranoid

____________ personality disorder exhibits pervasive distrust, suspicious, and may be seen as "evil"

Obsessive-compulsive

____________ personality disorder is characterized by a desire for perfection and order at the expense of openness, flexibility, and efficiency

Borderline

____________ personality disorder is characterized by a pattern of instability in interpersonal relationships, mood, behavior, and self image, with alternate extremes of anger and depression

Expressive

____________ violence is when the abuser's emotions are triggered and are disproportionate to the situation, causing them to lash out in anger

Dependent

_____________ personality is characterized by the extreme need to be taken care of, which leads to submissive, clinging behavior, and fear of separation or rejection

Avoidant

______________ personality disorder is characterized by feelings of inadequacy, extreme social anxiety, social withdrawal, and hypersensitivity to others' opinions

2

The nurse is conducting a home visit. The nurse observes a five-year-old child wearing a diaper while sucking his thumb, rocking, and banging his head. The child made adequate verbal responses to the nurse's verbal greeting. What would the nurse suspect this behavior to represent? 1. Mental retardation 2. Possible emotional abuse or neglect 3. An indication of autism 4. Pervasive developmental delay

Systematized

_______________ amnesia is when a person is unable to recall certain events related to a specific category of information or a specific person or event

Narcissistic

_______________ personality disorder is characterized by self-centeredness, self-absorption, and an inability to empathize with the effects of one's behaviors on others

High High

Diet for patient undergoing alcohol detoxification: High?/Low? protein High?/Low? calories

Dialectical behavior

_______________ therapy was created specifically for patients with borderline personality disorder to control impulses and acting out and to reduce sensitivity to criticism and rejection

Alcohol withdrawal

Acamprosate calcium (Campral) is used for _____________

2

After orienting the client to the addiction treatment unit, the nurse suggests that the client invite his 13-year-old son to the family sessions. The client questions why the son needs to participate, because he has not seen his father drunk. What is the best response by the nurse? 1. "Your son probably knows that you are an alcoholic." 2. "Your son has probably seen changes in you when you were drinking." 3. "It's good that you have concern for your underage son." 4. "Thirteen-year-olds are old enough to start learning about the effects of alcohol."

Dilated

Alcohol intoxication will cause constricted?/dilated? pupils

Dissociative

Amnesia is a type of ___________ disorder

Increased

Amphetamine abuse will cause increased?/decreased? BP

Increased

Amphetamine abuse will cause increased?/decreased? HR

1

An 18-month-old client is scheduled for a minor sur gical procedure. The client has numerous large bruises of different stages over the back and but tocks. The mother states that the child must have fallen down while playing alone outside but cannot provide specific information about these incidents. How should the nurse evaluate this situation? 1. Possible child abuse 2. Immature parenting 3. Normal findings in an 18-month-old 4. Indications of tissue fragility

3

An adult survivor of child abuse states, "Why couldn't I make him stop the abuse? If I were a stronger person, I might have been able to make him stop. Maybe it was my fault he abused me." Based on this data, which would be the most appropriate nursing diagnosis? 1. Ineffective Family Coping 2. Social Isolation 3. Chronic Low Self-Esteem 4. Anxiety

Personality

An enduring pattern of thoughts, feelings, and behaviors

1

An individual, with a history of antisocial personality disorder, was arrested for driving under the influence of alcohol and causing a serious car accident. Which comment on this behavior would be expected? 1. "It's not my fault." 2. "I'm too ashamed to talk about it." 3. "I just don't remember doing it." 4. "I'm really sorry about all the people I've hurt."

1

An older adult has been admitted to the hospital for dehydration. The client is poorly dressed, has body odor, appears unkempt, and has numerous unexplained bruises. In addition, he states that he has not been receiving his medications from his caregiver. What is the nurse's priority initial action? 1. Determine if the client is experiencing abuse or neglect. 2. Contact the appropriate elderly protective services agency. 3. Explore methods of rehydration attempted at home. 4. Inquire about medications the client is taking.

2

An older client diagnosed with chronic low back pain secondary to pain disorder receives cooking and cleaning help from her extended family. The mental health nurse anticipates that this client benefits from which of the following in this situation? 1. Primary gain 2. Secondary gain 3. Attention 4. Malingering

Decrease

Anabolic-androgen steroid use leads to a increase?/decrease? in HDLs

Increase

Anabolic-androgen steroid use leads to a increase?/decrease? in LDLs

Benzodiazepines

Antianxiety drugs that can be given to treat dissociative disorders

SSRI SNRI TCA

Antidepressants (3) that can be given to treat dissociative disorders

B

Antisocial personality disorder is in cluster ____

Men

Antisocial personality disorder is more common in men?/women?

Cannot

As a nurse, you can?/cannot? say that you think a patient is being abused unless the patient says that they are being abused

2 3 5

As part of assessment activities to determine if the client is alcohol dependent, the nurse needs to conduct a CAGE assessment with the client. Which question asked by the nurse would be consistent with the structure of CAGE? Select all that apply. 1. "Have you ever counted the number of drinks consumed?" 2. "Have you ever felt that you needed to cut down on your drinking?" 3. "Have you ever been annoyed by comments made about your drinking?" 4. "Have you ever found yourself gulping drinks before going out?" 5. "Have you ever had a morning'eye-opener' to calm your nerves?"

1 3

As part of the clinical experience, a student nurse is required to attend an Alcoholics Anonymous (AA) meeting and write a report about what was learned. What information would the student include in the report about the twelve-step program? Select all that apply. 1. People learn to change negative attitudes and behaviors into positive ones. 2. Once an individual learns how to be sober, he or she can graduate from attending meetings. 3. Once an individual has achieved sobriety, he or she continues to be at risk for relapse into drinking. 4. Acceptance of being an alcoholic will prevent urges to drink, since it represents giving up one's denial. 5. A Higher Power will protect individuals if they feel like using

C

Avoidant personality disorder is in cluster ___

Women

Avoidant personality disorder is more common in men?/women?

1 2

For a client diagnosed with a somatoform disorder, the nurse plans to write which nursing diagnoses in the client's plan of care? Select all that apply. 1. Ineffective Role Performance 2. Impaired Coping 3. Risk for Violence, Self-Directed 4. Impaired Oxygenation 5. Health-Seeking Behaviors

B

Borderline personality disorder is in cluster ____

Decrease

In cluster B personality disorders, symptoms may increase?/decrease? with age

Increase

In cluster C personality disorders, symptoms may increase?/decrease? with age

Cutting down use Annoyed Guilty Eye opener

CAGE acronym for screening for alcoholism

Ativan

CIWA (clinical institute withdrawal assessment) is used to calculate a score to determine whether a patient in alcohol detoxification needs to be administered _________

Increased

Caffeine intoxication will cause increased?/decreased? HR

Increased

Cannabis intoxication will cause increased?/decreased? HR

Mental illness

Chantix is contraindicated for patients with ______________

Women

Cluster B personality disorders are more common in men?/women?

B

Cluster ___ is the most common cluster of personality disorders

Drug abuse

Complication that is common in patients with somatic symptom disorder

Factitious disorder

Conscious, intentional feigning of physical and/or psychological symptoms in order to receive emotional care and support

DID (dissociative identity disorder) Borderline personality disorder

Splitting is often a coping mechanism seen in patients with ____________ or ______________

1 2 3

Which nursing interventions would be appropriate for the nurse to implement when caring for the client diagnosed obsessive-compulsive personality disorder? Select all that apply. 1. Assertiveness training 2. Decision-making skills 3. Anxiety management 4. A 12-step program 5. Distraction techniques

Displacement

Defense mechanism used by abusers where they transfer their feelings and emotions from one target to another

Doing and undoing

Defense mechanism used by abusers where they try to undo what they have done and make things right

C

Dependent personality disorder is in cluster ___

Women

Dependent personality disorder is more common in men?/women?

Intermittent explosive disorder

Disorder characterized by episodes of losing control "spells or attacks" may result in serious injury to self or other, or destruction of property

Kleptomania

Disorder characterized by recurrent failure to resist impulses to steal objects not needed for personal use or for their monetary value

Pyromania

Disorder characterized by the deliberate and purposeful fire setting on more than one occasion

DID (dissociative identity disorder)

Dissociative disorder characterized by a person having two or more distinct identities or personality states

24 hours

Disulfiram (Antabuse) can be administered _________ after the patient's last drink

Benzodiazepine

Drug given to treat delirium tremens during alcohol detoxification

Methadone

Drug that can be prescribed long term as a replacement for heroin

Naltrexone (ReVia)

Drug used to decrease cravings and oppose the effects of opioids

Chantix Zyban (buproprion)

Drugs (2) given for nicotine smoking cessation

Antipsychotics Anxiolytics

Drugs (2) given to treat intoxication of stimulants (amphetamines, cocaine, club drugs, bath salts)

Propranolol (Inderal) Buspirone (Buspar)

Drugs (2) that can be given to treat the anxiety component in a patient with intermittent explosive disorder

Diazepam Benzodiazepines

Drugs (2) used to treat seizures for patients who overdosed on PCP

Naloxone (Narcan) Naltrexone (ReVia) Nalmefene (Revex)

Drugs (3) used to treat opioid intoxication

Aren't

Electronic cigarettes and vaping are?/aren't? approved for smoking cessation

Agression Depression

Emotional changes (2) in patients who use anabolic-androgen steroids

Isn't

Experimental use is?/isn't? considered substance disorder

Increases

Experimenting with a substance at an early age increases?/decreases? the likelihood of developing dependence

Amnesia

Gaps in memory usually relate to traumatic or extremely stressful events

90

Hair tests can detect TCH, opiates, PCP, meth, ecstasy, and cocaine for up to _____ days

Deliriums tremens

Hallucinations associated with alcohol detoxification that last several hours, including delirium and generalized motor seizures

1

Having requested it as part of a comprehensive treatment program, the client is to receive disulfiram (Antabuse). Which statement should the nurse include when teaching the client about this drug? 1. "Inhaling fumes from paints and wood stains may cause a disulfiram reaction." 2. "Eating inadequately cooked seafood may lead to disulfiram resistance." 3. "Taking disulfiram will reduce your physical craving for alcohol." 4. "If you consume alcohol while taking disulfiram, rapid intoxication will occur."

Does

If a nurse suspects abuse and the patient is a vulnerable population, the nurse does?/doesn't? legally have to report it

Unaware

In patients with DID (dissociative identity disorder), the primary personality is often aware?/unaware? of the alternate personalities

Remorse

In patients with intermittent explosive disorder, episodes are usually followed by __________

Aura

In patients with intermittent explosive disorder, episodes are usually preceded by a __________

Initial assessment

In patients with substance use, resistance and ambivalence are highest during the time of ______________

Decrease

In personality disorder cluster A, symptoms may increase?/decrease? with age

Synthetic opioid

LAAM (levo-alpha-acetylmethadol) is a ____________

Korsakoff's psychosis

Late complication of persistent Wernicke encephalopathy and results in memory deficits, confusion, and behavioral changes associated with alcohol

Body wasting in AIDS patients

Legal use for anabolic-androgen steroids

Stunted growth Short stature

Long term health risks (2) in adolescents using anabolic-androgen steroids

Shrinking of testicles Infertility Baldness Development of breasts

Long term health risks (4) in men using anabolic-androgen steroids

Facial hair Male patterned baldness Changes in menstruation Deepened voice

Long term health risks (4) in women using anabolic-androgen steroids

3

Which of the following does the nurse expect to assess when taking the history of a client with a diagnosis of pain disorder? 1. Good responses to past pharmacological treatment 2. Indifference to the discomfort of pain 3. Pain does not respond well to medication 4. Insight into relationship between stress and pain

Conversion disorder

Loss of or change in voluntary motor or sensory function that suggests neurological or other medical condition but cannot be explained by these

Control and cope with symptoms

Main goal of treatment for anxiety illness disorder

Cope with symptoms

Main goal of treatment for conversion disorder

Manage symptoms (not eliminate)

Main goal of treatment for somatic symptom disorder

Abuse

Maltreatment of one person by another

Lithium

Medication that can be used to lessen the aggressive behavior in patients with intermittent explosive disorder

Caffeine

Most abused legal substance in the US

Neglect

Most common form of elder abuse

Risk for violence (other-directed)

Most important nursing diagnosis for antisocial personality disorder

Risk for violence (self/other-directed)

Most important nursing diagnosis for patients who have experienced a dissociative fugue

Risk for violence (other directed)

Most important nursing diagnosis for patients with paranoid personality disorder

Alcohol withdrawal

Naltrexone (ReVia) is used for ___________

Alcohol withdrawal

Naltrexone (Vivtrol) is used for ___________

B

Narcissistic personality disorder is in cluster ____

Buprenorphine (Buprenex)

Narcotic analgesic used to treat opioid dependence

Dopamine Norepinephrine

Nicotine increases levels of _________ and __________

Increases

Nicotine increases?/decreases? levels of dopamine and norepinephrine

Increased

Nicotine poisoning will cause increased?/decreased? BP

Increased

Nicotine poisoning will cause increased?/decreased? HR

Increased

Nicotine poisoning will cause increased?/decreased? RR

Decreased

Nicotine withdrawal will cause increased?/decreased? HR

Encourage

Nurses should encourage?/discourage? patients with paranoid personality disorder to interact with other patients

Shouldn't

Nurses should?/shouldn't? try to talk down patients on PCP

Rape trauma syndrome

Nursing diagnosis that can be given to victims of rape

C

Obsessive-compulsive personality disorder is in cluster ____

Men

Obsessive-compulsive personality disorder is more common in men?/women?

Constricted

Opioid intoxication will cause constricted?/dilated? pupils

Aren't

Opioid withdrawal symptoms are?/aren't? life threatening

6 12 5 7

Opioid withdrawal symptoms can occur ____-____ hours after the last use and can last for up to ____-____ days

A

Paranoid personality disorder is in cluster ____

Dependent

Patient with __________ personality disorder may tolerate abusive relationships

Cannot

Patients can?/cannot? be given a benzodiazepine when intoxicated with alcohol

Cannot

Patients can?/cannot? smoke while wearing a nicotine patch

Self harm

Patients on LSD are at a major risk for __________

Other directed violence

Patients on PSP are at a major risk for ___________

Pneumonia

Patients taking naltrexone (Vivitrol) should monitor for s/sx of __________

Oral

Patients who are predisposed to substance abuse are often stuck in Freud's ________ phase

Rigidity

Patients who have overdosed on PCP can experience muscle flaccidity?/rigidity?

Borderline

Patients with __________ personality disorder have a higher rate of self-harm and substance abuse

Narcissistic

Patients with __________ personality disorder have an inflated sense of themselves and an intense need for admiration

Dependent

Patients with __________ personality disorder have difficulty making decisions and need reassurance and support when making decisions

Histrionic

Patients with __________ personality disorder often dress provocatively and behave seductively

Avoidant

Patients with ___________ personality disorder desire social relationships but avoid them for fear of rejection and embarrassment

Decreased

Patients with alcohol intoxication will have increased?/decreased? blood pressure

Decreased

Patients with alcohol poisoning will have increased?/decreased? respiratory rate

Low

Patients with borderline personality disorder typically have a high?/low? self-esteem

B

Patients with cluster ____ personality disorders tend to act in dramatic, emotional, and erratic fasions

B

Patients with cluster ____ personality disorders tend to have difficulty with impulse control

Psychotic

Patients with histrionic disorder may become _________ if overly stressed

Suicide

Patients with histrionic personality disorder are at an increased risk for ____________

Low

Patients with histrionic personality disorder often have high?/low? self-esteem

Low

Patients with narcissistic personality disorder tend to have high?/low? self-esteem

Task

Patients with schizoid personality disorder should be placed in ______ focused groups

Shouldn't

Patients with schizoid personality should?/shouldn't? initially be started in group therapy

Low

Patients with schizotypal personality disorder typically have a high?/low? self-esteem

XXY

People with __________ chromosomes have been found to be at an increased risk for becoming abusers

C

People with cluster ____ personality disorders are often viewed as anxious and fearful

A

People with cluster ____ personality disorders are often viewed as odd or eccentric and have difficult relating to others

Gambling disorder

Persistent and recurrent maladaptive gambling behavior

Depersonalization

Persistent or recurrent feelings of being detached from or an observer outside one's mental processes or body

Paranoid PD Schizoid PD Schizotypal PD

Personality disorders (3) in cluster A

Avoidant PD Dependent PD Obsessive-compulsive PD

Personality disorders (3) in cluster C

Borderline PD Antisocial PD Histrionic PD Narcissistic PD

Personality disorders (4) in cluster B

Chronic phase (Phase 4)

Phase of alcohol use disorder that is characterized by emotional and physical disintegration, and the person is usually intoxicated more often than sober

Pre alcoholic phase (phase 1)

Phase of alcohol use disorder that is characterized by the use of alcohol to relieve everyday stress and tensions of life

Early alcoholic phase (phase 2)

Phase of alcohol use disorder that is characterized with blackouts and alcohol is required by the person

Crucial phase (phase 3)

Phase of alcohol use disorder where the person has lost control and physiological dependence is clearly evident

Honeymoon phase

Phase of the cycle of violence where the abuser is apologetic and repeatedly asks for forgiveness

Violent phase

Phase of the cycle of violence where the acute battering incident occurs, usually lasting around 24 hours

Tension phase

Phase of the cycle of violence where the person being abused feels like they are "walking on egg shells", and there is typically no or little violence at this phase

14

Pregnancy and STIs in children younger than _____ years old indicates sexual abuse

Anxiety illness disorder (hypochondria)

Preoccupation with fears of having, or the idea that one has, a serious disease despite medical evaluation and reassurance

Secondary

Primary?/Secondary? gain is the receipt of positive reinforcement for somatizing by added attention, sympathy, and nurturing

Primary

Primary?/Secondary? gain is the receipt of positive reinforcement for somatizing by being able to avoid difficult situations because of the physical complaint

Cycling

Term for when abusers use a drug orally or injected, typically in cycles of weeks or months, rather than continuously

Stacking

Term for when abusers use several different types of steroids in combination to maximize their effectiveness while minimizing negative effects

LaBelle indifference

Term for when patients do not seem to care about the symptoms they are experiencing; a paradoxical absence of psychological distress despite having a serious medical illness or symptoms related to a health condition

Circumstantial

Term for when someone uses a substance to cope with life's problems and is a potential for addiction

Hallucinations Seizures Pulmonary edema

S/sx (3) of cocaine overdose

Increased vitals Diaphoresis GI upset

S/sx (3) of opioid withdrawal

Ocular muscle paralysis Diplopia Ataxia Stupor

S/sx (4) of Wernicke's encephalopathy

Tremors N/V Diaphoresis Illusions

S/sx (4) of alcohol detoxification

Restlessness Diuresis GI upset Muscle twitching

S/sx (4) of caffeine intoxication

Relaxation Slowed reflexes Apathy Decreased coordination

S/sx (4) of cannabis intoxication

Panic attacks Seizures Hyperthermia Rhabdomyolysis

S/sx (4) of club drug (ecstasy) overdose

Empathetic Enhanced senses Elevated vitals Dehydration

S/sx (4) of club drugs (ecstasy) intoxication

Impaired judgement Nausea Hot flashes Seizures

S/sx (4) of dextromethorphan intoxication

Nystagmus Decreased reflexes Illusions Drowsiness

S/sx (4) of inhalant intoxication

HTN Tachycardia Twitching Confusion

S/sx (4) of nicotine poisoning

Irritability Restlessness Weight gain Headaches

S/sx (4) of nicotine withdrawal

Agitation HTN Tachycardia Impaired judgement Picking at skin

S/sx (5) of amphetamine intoxication

Agitation Paranoia Hallucinations Tachycardia HTN

S/sx (5) of bath salt intoxication

Sleep disturbance Tremors Diaphoresis Nausea Illusions

S/sx (5) of inhalant withdrawal

Respiratory depression Nausea Constriction of pupils Drowsiness Constipation

S/sx (5) of opioid intoxication

Enhanced senses Impaired judgement Depersonalization Derealization Illusions Tachycardia

S/sx (6) of hallucinogen intoxication

Agitation

S/sx of cocaine intoxication

A

Schizoid personality disorder is in cluster ____

Men

Schizoid personality disorder is more common in men?/women?

A

Schizotypal personality disorder is in cluster ___

Barbiturates Benzodiazepines Alcohol

Substances (3) that have withdrawals that can be potentially fatal

Dissociative fugue

Subtype of dissociative amnesia where the person has a sudden unexpected travel away from home or work with the inability to recall some or all of the past

Splitting

Term for a psychological mechanism that allows the person to tolerate difficult and overwhelming emotions by seeing someone as either good or bad

Medicated interview

Term for a treatment for dissociative disorders where a short term acting barbiturate is given IV to help the person recover lost memories

Statutory

Term for sexual interactions between someone of the age of consent with someone under the age of consent

Intoxication

Term for the development of a reversible syndrome of symptoms following excessive use of a substance

Withdrawal

Term for the development of symptoms that occurs upon abrupt reduction or discontinuation of a substance that has been used regularly over a prolonged period of time

Learning theory

Term for the idea that people learn to engage in addictive behavior according to well-established learning principles

Psychological dependence

Term for the overwhelming desire to repeat the use of a particular drug to produce pleasure or avoid discomfort

Codependency

Term for the tendency for the victim in an abusive relationship to develop dysfunctional patterns or habits in the process of trying to cope with a family member or partner who is abusive or neglectful or has an addiction

Enabling

Term for when a victim of abuse seeks to avoid confrontation and conflict by absorbing the abuse without challenging it or setting boundaries

2

The client diagnosed with a personality disorder says, "There is no need for me to be treated. I've always acted this way. It's normal for me." What term should the nurse use when describing this statement in documentation? 1. Narcissistic 2. Egosyntonic 3. Schizotypal 4. Avoidant

2

The client diagnosed with antisocial personality disorder persists in asking for the address and other personal information about the nurse. The client states, "I just want to get to know you better. You're the only one I can really talk to." What is the most effective response by the nurse? 1. "You're getting too involved with me. Maybe another nurse would be more appropriate for you." 2. "Let's talk about my purpose in working with you and your feelings about it." 3. "Why are you focusing on me all the time?" 4. "Are you trying to avoid talking about yourself and your problems?"

4

The client diagnosed with borderline personality tells the nurse, "You are so much smarter than the other nurses. You're an ideal nurse." The nurse should interpret this behavior as an example of which of the following? 1. Secondary gain 2. Acting out 3. Passive aggression 4. Dichotomous thinking

4

The client diagnosed with narcissistic personality disorder arrives late to group therapy. Without apologizing, the client interrupts another client and says, "Well, I'm here. The group can start now." The nurse interprets this behavior as which of the following? 1. Splitting 2. Hypersensitivity 3. Suspiciousness 4. Entitlement

1

The client has chronic pain to the back and is diagnosed with pain disorder. Which statement by the client indicates to the nurse that the plan of care has been successful? 1. "I realize that my pain can be influenced by stress." 2. "I should avoid most physical activity." 3. "Relaxation techniques only help when I am anxious about my pain." 4. "I should keep myself pain free by increasing my pain medication as I need it."

2

The client has dissociative identity disorder (DID). When the client is changing from one alter to another, which of the following would the nurse expect to observe? 1. Orthostatic hypotension 2. Blinking or rolling of the eyes 3. Dystonic reactions 4. Pallor

2

The client is experiencing dissociative amnesia. The nurse has taught the client about therapeutic methods for memory retrieval. The nurse determines that the teaching has been effective when the client makes which statement? 1. "Even if it does uncover hidden memories, I don't want to have electroconvulsive therapy." 2. "I'm a little uneasy about being hypnotized, but it does help release memories." 3. "If I use relaxation techniques properly, my memories will come back quickly." 4. "Anxiety causes this memory problem, and antianxiety agents will greatly reduce it."

1 2 3 5

The client presents to an outpatient clinic with a history of conversion disorder reporting a new symptom of paralysis to the bilateral upper extremities. This is not the first time this has occurred. He states, "I can not work anymore, and I've missed work for three weeks now." The nurse would infer which of the following about this client's condition? Select all that apply. 1. It causes significant distress in occupational, social, and or academic functioning. 2. It does sometimes manifest with paralysis. 3. It can sometimes cause psychosis; a mental status exam should be performed on the client. 4. It follows neurological pathways. 5. It may manifest with an affect of la belle indifference.

1 2 3 5

The client with a diagnosis of antisocial personality disorder has reportedly physically abused his spouse. During a nurse-client interview, the client makes all of the following comments listed. The nurse concludes that which of the comments are likely to be insincere? Select all that apply. 1. "I've done a stupid thing, but I've learned my lesson." 2. "I'm feeling awful about the way I've hurt my wife." 3. "I have a quick temper, but I can usually keep it under control." 4. "I hit her because she nags at me." 5. "If I was a little too forceful, I do apologize."

4

The client's behavior is characterized by repeated attempts at manipulation of staff members and other clients. Which of the following is the most important short-term client goal for the nurse to establish? 1. Spend more time alone. 2. Sustain lasting relationships. 3. Explore childhood experiences. 4. Acknowledge own behavior.

2

The client, although oriented to person, place, and time, cannot remember being extracted from a burning automobile the day before. What term should the nurse use when documenting the client's inability to remember events surrounding the accident? 1. Suppression 2. Localized amnesia 3. Confabulation 4. Continuous amnesia

4

The emergency department client is admitted following a blow to the head sustained in a motor vehicle accident. The blood alcohol level (BAL) is 0.35% and the client is walking without stumbling and talking rationally about the accident. What alcoholic phenomenon should the nurse recognize? 1. Alcohol withdrawal syndrome 2. Intolerance 3. Psychological dependence 4. Alcohol dependency

3

The mental health nurse is reviewing a 35-year-old client's history before conducting an interview. The client's history indicates fear of criticism and rejection from others, having few friends, and withholding information about thoughts and feelings in anticipation of rejection by others. Based on the data, the nurse suspects that the client may have which personality disorder? 1. Schizotypal 2. Paranoid 3. Avoidant 4. Schizoid

3

The mother of a six-year-old client in the emergency department (ED) tells the nurse that the child vomits after every meal. The child has a normal appearance and is in no acute distress. This is the fifth time within three months that the child has been taken to the ED by the mother. The mother states, "This time I won't go away until my child is admitted for a complete and thorough gastrointestinal workup. The doctors say there's nothing wrong, but I know my child is very ill." What should the nurse suspect about what the mother is experiencing? 1. Panic level anxiety 2. Dissociative identity disorder 3. Munchausen's syndrome by proxy 4. Cluster A personality traits

1 4 5

The nurse assessing a client with dissociative identity disorder (DID) is most likely to note which of the following? Select all that apply. 1. History of headaches 2. Elated mood 3. Intact memory for recent and remote events 4. Asthma 5. Irritable bowel syndrome

3 5

The nurse assessing the client in a fugue state would look for which of the following? Select all that apply. 1. A history of childhood trauma 2. Coexisting depression 3. Exposure to a major stressor 4. Dissociative episodes 5. A recent history of being raped

3

The nurse caring for a client diagnosed with antisocial personality disorder would place highest priority on which nursing diagnosis? 1. Disturbed Personal Identity 2. Fear 3. Risk for Violence directed at others 4. Social Isolation

2

The nurse conducts an in-service session about impaired nursing practice. The nurse evaluates that the teaching was effective when one of the nurses says that the most influential risk for impaired nursing practice is which of the following? 1. Having grown up in a dysfunctional family 2. Feeling that nurses' knowledge about drugs protects them from drug dependency 3. Thinking that professionals are not at high risk for substance dependency 4. Having a tendency to involve self in codependent professional and personal relationships

2

The nurse determines that client education to manage dissociative episodes is effective if the client states to do which of the following if he starts to dissociate? 1. "Immediately take my anti-anxiety medication." 2. "Focus on what I can see and hear externally." 3. "Begin my relaxation technique." 4. "Focus on my internal feelings."

1

The nurse determines that which of the following is a priority nursing intervention for a person recently admitted to an inpatient unit with a dissociative disorder? 1. Creation of a calm, safe environment 2. Increasing sensory stimulation 3. Working through past trauma 4. Promoting social skills

3

The nurse formulates which priority nursing diagnosis for a client experiencing amnesia associated with high levels of anxiety? 1. Confusion 2. Powerlessness 3. Ineffective Coping 4. Disturbed Sensory Perception

2 3 4

The nurse instructs the client about addiction. The nurse determines that the client understands the information given when the client makes which statements? Select all that apply. 1. "Addiction is a moral problem." 2. "Addiction is a medical illness." 3. "Addiction is a behavioral habit." 4. "Addiction is an emotional attachment." 5. "Addiction is difficult to cure."

4

The nurse is caring for a client who is being treated for migraine headaches. Upon physical exam the nurse assesses old scars on the client's arms and legs. The client confides childhood memories of sexual abuse by the father. What should be the nurse's immediate response? 1. "Tell me more about your migraines." 2. "How did you get the scars?" 3. "How old were you when the abuse stopped?" 4. "Are you comfortable discussing the abuse?"

1 4 5

The nurse is caring for a female client who comes to the emergency room with bruises on the face, a cracked tooth and back pain. She voices concern about the safety of her pets and children, and her ability to enroll in her college as she plans. The nurse replies by explaining which of the following? Select all that apply. 1. She is correct that her pets may be at risk for injury or death from her spouse. 2. Her pets are safe; there is no correlation between interpersonal violence and injury to pets. 3. Her children are safe; there is no correlation between spousal violence and injury to children. 4. It is probable that her husband may try to sabotage her career goals. 5. She is correct that her children may be at risk for abuse.

4

The nurse is conducting a client teaching session about dissociative disorders. Which client statement indicates to the nurse that the client understands important concepts about the disorder? 1. "People with dissociative disorder usually have gradual loss of memory for names and phone numbers." 2. "Dissociative disorders serve as a means of avoiding adult responsibilities." 3. "Dissociative disorders are caused from past use of hallucinogens." 4. "People develop dissociative disorders to protect themselves from extreme anxiety."

1

Which of the following is the most appropriate nursing diagnosis for a client with pain disorder who is homebound and unable to work in his previous profession for the past two years? 1. Impaired Role Performance 2. Anxiety 3. High Risk for Injury 4. Disturbed Sensory Perception

4 5

The nurse is conducting an in-service program on risk factors for victims of domestic violence. The nurse would include which items of information about risk factors during the session? Select all that apply. 1. A high school dropout is at higher risk then a high school graduate. 2. Persons of lower income status are at higher risk than those of higher economic status. 3. Gay/lesbian persons are at not risk. 4. Domestic violence cuts across all socioeconomic lines. 5. Domestic violence cuts across all educational levels.

1

The nurse is counseling an extremely distressed female victim immediately after a sexual assault. What is the nurse's most important initial intervention? 1. Reassure the victim that the sexual assault was not her fault. 2. Ask the client to provide a sample of pubic hair for the evidence kit. 3. Collect a serum specimen for pregnancy testing. 4. Teach the client about the risk for sexually transmitted infections.

4

The nurse is evaluating a family in which an 18-month-old son has been abused by both parents. At the initial interview with the nurse, the parents stated that they spank the toddler because he "cries and cries and never tells us what is wrong." The parents are adolescents who are still in high school. The nurse determines that what parental outcome would indicate progress? 1. Less use of spanking for discipline 2. Joint attendance at parenting classes 3. Holding high expectations for their child 4. Recognizing crying as an age-appropriate way to communicate

1 2 4

The nurse is preparing to orient a new graduate to the psychiatric unit. When teaching the new nurse about general principles related to psychopharmacology and personality disorders, the nurse includes which information about pharmacologic treatment? Select all that apply. 1. It is aimed at treating various psychiatric target symptoms in persons with personality disorders. 2. Carbamazepine (Tegretol) may be a prescribed treatment for mood stabilization in Cluster B disorders. 3. They have no role in treating any of the Cluster A, Cluster B, or Cluster C personality disorders. 4. Quetiapine (Seroquel) may be used to treat symptoms manifested in Cluster A personality disorders. 5. Benztropine (Cogentin) is useful in treating avoidant symptoms in Cluster C personality disorders.

4

The nurse is responsible for providing care to a group of clients with various personality disorders. The nurse should anticipate that a characteristic common to each client will be which of the following? 1. An ability to charm and manipulate people 2. A desire for interpersonal relationships 3. A diminished need for approval 4. A disruption in some aspect of his or her life

2 3 4 5

The nurse is working on a neurological unit. A client with three young children was beaten so severely that she is unconscious and has sustained a traumatic brain injury. Another staff nurse on the unit states, "She was stupid for staying in the relationship; she deserved it." What is the best response by the nurse? Select all that apply. 1. "Yes, she has a lot of family and friends whom she could have gone to." 2. "One reason she may have stayed is because of traumatic bonding." 3. "One reason she may have stayed is the fear of losing her children." 4. "Women may stay in violent relationships due to fear, helplessness, guilt, or shame." 5. "Maybe she has come to think violence is acceptable."

3

The nurse working in the maternal care area is reinforcing physician health teaching about the risks of substance use during pregnancy. When questioned by the client, the nurse should reply that which drugs are most likely to lead to significant physical, cognitive, and developmental problems for any infant? 1. Benzodiazepines 2. Hallucinogens 3. Alcohol 4. Cocaine

3

The nurse would anticipate that a health assessment of a client with a diagnosis of conversion disorder is likely to reveal which of the following? 1. Elevated serum calcium levels 2. Sensory loss along affected nerve tracks 3. No significant physical or laboratory findings 4. Motor loss to body parts along the nerve tracks.

1 5

The nurse would select which of the following as appropriate nursing diagnoses for a client experiencing a fugue state? Select all that apply. 1. Anxiety 2. Disturbed Self-Esteem 3. Interrupted Family Processes 4. Relocation Stress Syndrome 5. Posttrauma Syndrome

Wernicke's encephalopathy

The presence of neurological symptoms caused by biochemical lesions of the central nervous system associated with alcohol

Power Control

The reason for abuse is ________ and _________

1

The spouse of a client who is experiencing a fugue state asks the nurse if the spouse will be able to remember what happened during the time of the fugue. What is the nurse's best response? 1. "Your spouse will probably have no memory for events during the fugue." 2. "Your spouse will be able to tell you, if you can gently encourage talking." 3. "It is not possible to predict whether your spouse will remember the fugue state." 4. "Avoid mentioning it, or your spouse may start alternating old and new identities."

3

The spouse of a woman diagnosed with somatization disorder tells the nurse that he is running out of patience with her" and feels that "she has all of those health problems on purpose." What is the best response by the nurse? 1. "Have you tried asking her? I think she'd tell you the truth." 2. "Your wife is trying to gain your attention." 3. "She doesn't have the problem on purpose; however, this is probably difficult for both of you." 4. "She has some significant emotional problems that she cannot admit."

Increased

The use of bath salts will cause increased?/decreased? BP

Increased

The use of bath salts will cause increased?/decreased? HR

Psychotherapy

Treatment for paranoid personality disorder

Should

Treatment for the patient with conversion disorder should?/shouldn't? include reinforcing that the patient does not have a serious illness and will receive care by the physician

Should

Treatment for the patient with somatic symptom disorder should?/shouldn't? include reinforcing that the patient does not have a serious illness and will receive care by the physician

2

While taking the nursing history, a client with body dysmorphic disorder says, "After three surgeries, my jaw line still isn't right. Plus, it took five surgeries before my nose was finally fixed." Which of the following is the most appropriate nursing diagnosis? 1. Health-Seeking Behaviors 2. Disturbed Body Image 3. Disturbed Personal Identity 4. Risk for Self-Mutilation

Children Elderly Intellectually disabled Chronic mentally ill

Vulnerable populations (4) in SC

3

When caring for a client diagnosed with hypochondriasis, the nurse should take which of the following actions? 1. Explore the details and history of the client's early life and illnesses. 2. Encourage the client to seek second opinions about the symptoms experienced. 3. Assist the client to identify relationships between life events and physical symptoms. 4. Have the spouse encourage the client to talk more about the symptoms.

Should

When caring for a patient with avoidant personality disorder, the nurse should?/shouldn't? inform the patient of the schedule as much as possible

Shouldn't

When caring for a patient with conversion disorder, the nurse should?/shouldn't? insist the patient use the affected part

Shouldn't

When caring for a patient with dependent personality disorder, the nurse should?/shouldn't? encourage actions that promote dependency on caregivers

Should

When caring for a patient with dependent personality disorder, the nurse should?/shouldn't? encourage the patient to make decisions

Should

When caring for a patient with obsessive-compulsive personality disorder, the nurse should?/shouldn't? allow the patient to control their own treatment whenever possible

4

When completing the nursing history, what would the nurse expect the client who is diagnosed with somatization disorder to reveal? 1. Abrupt onset of physical symptoms at menopause 2. Episodes of personality dissociation 3. Ignoring physical symptoms until role performance was altered 4. Numerous physical symptoms in many organ systems

4

When the nurse is caring for a client experiencing delirium tremens, what is the most important nursing intervention? 1. Present psycho-education on the dangers of drug and alcohol use. 2. Encourage the client to develop a relapse prevention plan. 3. Administer anti-craving medications. 4. Provide withdrawal care based on unit protocol.

3

When the nurse is evaluating the progress of the client whose interpersonal relationships are based on manipulation, which statement by the client indicates that progress has been made? 1. "I plan to stop taking advantage of other people." 2. "I've promised myself that I will be kind to others." 3. "I did not try to take advantage of anyone today." 4. "I can be more kind if I make an effort to do so."

Emotional

When treating a patient with conversion disorder, focus on the physical?/emotional? symptoms

Shouldn't

When treating a patient with factitious disorder, the nurse should?/shouldn't? tell the patient that their symptoms aren't real

1

Which intervention strategy should the nurse routinely include in the nursing care plan for a client diagnosed with antisocial personality disorder? 1. Establish clear and enforceable limits. 2. Vary unit rules based on client demands. 3. Vary unit rules based on staff needs. 4. Let the client have a voice in when unit rules should apply.

1 3 4 5

Which nursing intervention approaches would the nurse take that may be effective when caring for a client diagnosed with body dysmorphic disorder (BDD) who is preoccupied with a mole on her face? Select all that apply. 1. Teach the client meditation and breathing relaxation techniques. 2. Explain to the client that her perception of the mole is absolutely a misperception, and that it is all "in her head." 3. Respect the client's preoccupation with the perceived physical defect. 4. Encourage the client to participate in a self-help group. 5. Focus on the client's positive relationships with family members.

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Withdrawal from alcohol begins shortly after drinking stops and lasts for ___-____ days