mental health

A client asks the nurse what kind of therapy will help. Based on current knowledge, what form of therapy is most appropriate for a client diagnosed with a conversion disorder?

"Cognitive-behavioral therapy (CBT) has been shown to consistently provide the best outcome for these types of disorders."

Which statement by a patient who was educated about the importance of acquiring adequate sleep indicates a need for further teaching?

"I will be sure to try to get 8 hours of sleep every night, and 9 or 10 hours of sleep if I can."

One criterion for the diagnosis of primary insomnia is met when the client makes which statement?

"I've actually missed work because I'm too tired to go."

What stress-reduction technique should a nurse teach an individual experiencing severe performance anxiety?

deep breathing.

A 23 years old is admitted with reports of abdominal pain, dizziness, and headache. When told that all the results of a physical workup have been negative, the client shares, "Now I am having back pain." Which notation in the client's medical record may alert the nurse to the possibility of malingering?

A court date this week for drunk driving

A client tells the nurse, "I just don't sleep more than 5 hours at night." The nurse assesses the client best for individual sleep requirements by asking which question?

"Do you usually feel rested and alert when you get up?"

A client reports symptomatology that supports the diagnosis of sleep paralysis. The nurse effectively assesses the client by asking which question?

"Have you ever fallen asleep while driving?"

The nurse appropriately assesses an obese, hypertensive, Type 2 diabetic client when asking which question?

"How much sleep do you usually get each night?"

Ali is a 17-year-old patient diagnosed with bulimia coming to the outpatient mental health clinic for counseling. Which of the following statements by Ali indicates that an appropriate outcome for treatment has been met?

"I am a hard worker and I am very compassionate toward others."

Which statement by a patient who has been taught cognitive reframing indicates that the teaching was successful?

"I can be successful if I do all the things required to learn the job."

What statement by a client would indicate that goals for treatment for a somatization disorder are being achieved?

"I don't think about my symptoms all the time as I used to be."

Which statement made by a client would support the diagnosis of Illness anxiety disorder?

"I know I have cancer, but the doctors just cannot find it."

Which statement, made by a client diagnosed with dissociative identity disorder, demonstrates effective understanding in response to the question, "What exactly are the 'alters'? your provider told you about?" illustrates that the education provided has been effective?

"So, alters are separate personalities with their own characteristics that take over during stress."

A patient admitted with anxiety asks, "What exactly are stressors?" What is the nurse's best response to the patient's question?

"Stressors are events that happen that threaten your current functioning and require you to adapt."

A client diagnosed with a chronic sleep disorders begins to cry and states, "I can't keep going like this! I work in a bank and if I can't function correctly I'll lose my job. I just don't think I'll get better." Which statement provides a therapeutic response to the client's concerns?

"There is much hope for improvement through treatment. Let's talk about some strategies for your problems at work."

Ever since participating in a village raid where explosives were used, a military veteran has been unable to walk. After all diagnostic testing were negative for any physical abnormalities, the client was diagnosed with conversion disorder. What is the nurse's best response when asked by the client, "Why can't I walk?"

"Your emotional distress is being expressed as a physical symptom."

What is the usual time period that medications to treat insomnia are usually prescribed?

2 weeks

Which client is most likely to initially demonstrate behaviors suggesting a somatic disorder?

23-year-old female

Which child is at greatest risk for developing attachment problems as a result of a neurobiological development?

A 4-year-old female

Which client behavior illustrates eustress?

A bride is planning for her wedding.

What symptom can the nurse expect a client diagnosed with depersonalization disorder to manifest?

A feeling of detachment from one's body or mental processes

What is the most effective nursing intervention regarding the accurate assessment of sleep disorders?

A sleep diary

A client newly diagnosed with hypersomnolence asks about what medication will be prescribed to manage this disorder. The nurse will base his/her response based on what knowledge?

A stimulant will most likely be prescribed.

A 16-year-old patient being treated for anorexia, has been prescribed medication to reduce compulsive behaviors regarding food now that ideal weight has been reached. Which class of medication is prescribed for this specific issue associated with eating disorders?

Antidepressants

What therapeutic intervention should be prescribed for a client diagnosed with a somatoform disorder?

Conveying an interest in the client rather than in the symptoms

Which assessment monitors the effect of stress attributed to the stimulation of the hypothalamus-pituitary-adrenal cortex?

Blood glucose levels

A child who was physically and sexually abused is at great risk for demonstrating which characteristic?

Bullying, abusive behavior

Studies have shown a correlation between mental disorders and which medical condition?

Cardiovascular disease

What would be an appropriate expected outcome of the treatment plan for a client diagnosed with a conversion disorder that interferes with the ability to walk effective?

Client will be able to state two new effective coping skills within 2 weeks.

Which statement about somatoform disorders is true?

Clients lack awareness of the relations among symptoms, anxiety, and conflicts.

It is most important for the nurse to employ which holistic strategy when managing clients diagnosed with a somatization disorder?

Considering all dimensions of the patient, including biological, psychological, and sociocultural

The nurse feels uncomfortable talking with a young male client about his sexual problem. Which action should the nurse take?

Continue the interview using an appropriate professional tone and matter-of-fact approach.

Which mental health disorder is an example of a somatoform disorder?

Conversion disorder

Which statement concerning syndromes seen in other cultures but not seen in our own, such as amok should be considered true?

Culture-bound syndromes that are not dissociative disorders

A woman suddenly finds she cannot see but seems unconcerned about her symptom and tells her husband, "Don't worry, dear. Things will all work out." Her attitude is an example of what process?

La belle indifference

Which coping mechanism is used excessively by clients diagnosed with bulimia nervosa to cope with their obsession with their body image?

Denial

Which item of data should be routinely gathered during assessment of a client with a somatoform disorder?

Dependence on medication

The symptoms of an adjustment disorder can include which characteristics? (Select all that apply.)

Depression Guilt Anger Social withdrawal

A client diagnosed with bulimia nervosa uses enemas and laxatives to purge to maintain weight. What is the likely physiological outcome of this practice?

Disruption of the fluid and electrolyte balance

What information should the nurse give to the family of a client who has had a dissociative episode?

Dissociation is a method for coping with severe stress.

Which of the following statements about dissociative disorders is true?

Dissociative symptoms are not under the person's conscious control.

According to current theory, which statement regarding eating disorders is accurate?

Eating disorders are possibly influenced by sociocultural factors.

A primary health provider describes a client as "malingering." The nurse knows this means that the client is demonstrating which behavior

Falsely claiming to have symptoms.

Which subjective symptom should the nurse expect to note during assessment of a client diagnosed with anorexia nervosa?

Fear of gaining weight

The first stage of the general adaptation syndrome (GAS) can be characterized by which response?

Fight or flight

A depressed client is likely to report a sleep disorder that includes which characteristics?

Frequent awakenings during the night

A client hospitalized with anorexia nervosa has a weight that is 65% of normal. For this client, what is a realistic short-term goal for the first week of hospitalization regarding the physical impact of his/her weight?

Gain a maximum of 3 lb.

When providing possible interventions to promote the safety of a client reporting symptoms of somnambulism, the nurse should include which intervention?

Gating the stairways

Which approach to reducing client stress is most effective for children experiencing postoperative pain?

Guided Imagery

The nurse can determine that inpatient treatment for a client diagnosed with an eating disorder would be warranted when which assessment data is observed?

Has systolic blood pressure less than 90 mm Hg.

A 38-year-old patient referred for sleep studies reports frequent daytime lethargy, unintended lapses into sleep, and never feeling rested on awakening in the morning. These symptoms support which sleep-related diagnosis?

Hypersomnolence

Which behavior best supports the diagnosis of posttraumatic stress disorder (PTSD) in a 4-year-old child?

Hypervigilance

A client reveals that she induces vomiting as often as a dozen times a day. The nurse would expect assessment findings to support which electrolyte imbalance?

Hypokalemia

Which disorder is characterized by the client's misinterpretation of physical sensations or feelings?

Illness anxiety disorder

A client, who is 16 years old, 5 foot, 3 inches tall, and weighs 80 pounds, eats one tiny meal daily and engages in a rigorous exercise program. Which nursing diagnosis addresses this assessment data?

Imbalanced nutrition: less than body requirements

A client diagnosed with post-traumatic stress disorder (PTSD) shows little symptom improvement after being prescribed a selective serotonin reuptake inhibitor (SSRI). The nurse expects that which medication will be prescribed next?

Imipramine

Which nursing diagnosis should be investigated for clients with somatoform disorders?

Ineffective coping

Effective care of a client suspected of experiencing bulimia nervosa calls for the nurse to perform which assessment?

Inspection of the oral cavity.

What would a client experience during a progressive relaxation session?

Instruction in sequential tensing and relaxing of various muscle groups until the entire body is relaxed

When educating a client diagnosed with bulimia nervosa about the medication fluoxetine, the nurse should include what information about this medication?

It will be prescribed at a higher than typical dose.

Empathic listening is therapeutic because it focuses on what form of action?

Lessening feelings of isolation

What tool should the nurse use in assessing the amount of stress a client has experienced in the past year?

Life-Changing Event Questionnaire

The client experiencing bulimia differs from the client diagnosed with anorexia nervosa by exhibiting which characteristic?

Maintaining a normal weight

A client reports insomnia and shares that a friend has recommended a nonprescription hormone product that can be purchased at the local health food store. The nurse suspects that the medication contains which component?

Melatonin

Stress can be attributed to stimulation of the hypothalamus-pituitary-adrenal cortex. Which assessment finding would confirm the long-term effects of such stress? (Select all that apply.)

Obesity Insulin resistance

The relaxation response calls upon the initiation of what process?

Parasympathetic activation

An older adult client is reporting symptomatology that suggests rapid eye movement (REM) sleep behavior disorder (RSBD). Which comorbid condition should the nurse assess for?

Parkinson's disease

Which statement is true of the eating disorder referred to as bulimia?

Patients with bulimia often appear at a normal weight.

Jacob, a college student whose friend recently committed suicide, rates his stress as low. Melissa was also friend with the person who committed suicide, but she rates her stress as high. The difference in how Jacob and Melissa rate their stress may be explained by which coping mechanism?

Perception

A slightly obese client reports falling asleep during the daytime even though she has slept all night. Her husband says she snores, and her blood pressure is noted to be in the low hypertensive range. The nurse anticipates that the client will be scheduled for which diagnostic test?

Polysomnography

A 4 years old is referred to the outpatient mental health clinic after being in a severe car accident during which the child's mother died. The father states that the child is withdrawn, not sleeping, having nightmares, and acts out the car accident over and over again when playing. The child states, "It's my fault because I'm bad." What trauma induced disorder does this data support?

Posttraumatic stress disorder (PTSD)

A 31-year-old patient who has been referred to the sexual disorders clinic by a primary care provider. The client describing his problem states, "I can have an orgasm, no problem. It just happens way too soon." This description support what form of sexual dysfunction?

Premature ejaculation

What non-habit-forming melatonin receptor agonist is often prescribed for insomnia?

Ramelteon

Dissociative identity disorder is characterized by what event?

Recurring feelings of detachment from one's body or mental processes

What are the physiologic responses associated with successful guided imagery? Select all that apply.

Reduction of obsessive thoughts Reduction of anxiety Improved sleep patterns

Providing care to a client diagnosed with a somatization disorder can be frustrating owing to the client's lack of an organic illness. In order to best manage this barrier to care the staff should implement which personal intervention?

Regularly discuss their feelings about the client during the unit's interprofessional care meetings.

An individual who is able to regain mental stability after a traumatic event is said to be demonstrating what trait?

Resilience

Which diagnosis from the list below would be given priority for a client diagnosed with bulimia nervosa?

Risk for injury: electrolyte imbalance

Biological theorists suggest that the cause of eating disorders may be related to which factor?

Serotonin imbalance

Which statement provides accurate information regarding transvestic disorder?

Sexual orientation has no bearing on transvestic disorder.

Self-help groups are useful for reducing stress because they provide the individual with the stress mediator that take what form?

Social support

When discussing somatic disorders from a cultural perspective, which statement is true?

Somatic symptoms vary widely from culture to culture.

A student nurse in the emergency department is assigned to care for a client convicted of the sexual abuse of a child. The student is repulsed by the client because of the nature of his crime and doesn't know how to care for the client under these circumstances. What action should the student nurse take?

Talk with a faculty member or an experienced nurse in the emergency department.

A client, whose friend recently committed suicide, asks the nurse about some ways to help cope with the stress regarding the event. Which option should the nurse discuss with the client?

Talking with friends and attending a loss support group

A client reports to the nurse that falling asleep can often take hours. Which intervention should the nurse implement?

Teach the client how to do progressive relaxation.

The nurse working with clients diagnosed with eating disorders can help families develop effective coping mechanisms by implementing which intervention?

Teaching the family about the disorder and the client's behaviors

A client asks the nurse to explain what basal sleep requirement is. What is the nurse's best response?

The amount of sleep needed to be fully awake and perform well in the daytime.

Parents express concern when their 5-year-old child, who is receiving treatment for cancer, keeps referring to an imaginary friend, Candy. Which response should the nurse provide to best address the parent's concerns?

The imaginary friend is a coping mechanism the child is using.

What factor exerts the greatest influence on the degree to which various life events upset a specific individual?

The individual's perception of the event

When discussing the symptoms of post-traumatic stress disorder (PTSD), the nurse should make which statement?

The symptoms can neither occur almost immediately or even take years to manifest."

Which statement about structural dissociation of the personality is true?

Trauma is the basis for this type of disorder.

Which intervention would be least useful for accurate assessment of the weight of a client diagnosed with anorexia nervosa?

Weigh fully clothed before breakfast.

After stabilization of symptoms, what is the primary focus of treatment for a client diagnosed with anorexia nervosa?

Weight restoration

The primary difference between a factitious disorder and other somatic disorders is described in which statement?

actitious disorders have a symptomatology that is actually controlled by the client.

What factors are consistently observed to increase the risk for sleep disturbances?

alcohol and caffeine

What class of medications is commonly prescribed for somatic disorders?

anxiolytics.

A client diagnosed with hypertension uses an automatic cycling blood pressure cuff with audible changing tones. The client uses relaxation techniques to lower her blood pressure and is informed of her ongoing success by the tone. This process describes this technique?

biofeedback.

A nurse teaches a client a technique for examining negative thoughts and restating them in positive ways. What term is used to identify this technique?

cognitive reframing

Meditation is successful in promoting stress reduction because it brings about which outcome?

quiets the sympathetic nervous system

A client, prescribed which class of antidepressant medication should be monitored for the development of premature ejaculation?

selective serotonin reuptake inhibitor (SSRI) antidepressants