MH lipp questions

an adolescent client has struggled academically throughout high school and realizes during her last semester in school that she is not going to graduate with her class, which will delay her admission to college. in the past she has intermittently used drugs and alcohol to deal with her anxiety, but now her involvement with substances escalates to daily use. in what order of priority from first to last should the nurse, who has become aware of the problem, take the actions? 1. refer her to the school authorities to address her academic issues so she can graduate next semester 2. refer her to a program at the local community college to improve the client's readiness for college and decrease her anxiety 3. refer her to an outpatient program that treats clients with chemical dependency issues 4. refer her to a psychiatric clinic so she can get an appropriate diagnosis and medication for her anxiety

4. refer her to a psychiatric clinic so she can get an appropriate diagnosis and medication for her anxiety 3. refer her to an outpatient program that treats clients with chemical dependency issues 1. refer her to the school authorities to address her academic issues so she can graduate next semester 2. refer her to a program at the local community college to improve the client's readiness for college and decrease her anxiety

a hospitalized adolescent diagnosed with anorexia nervosa refuses to comply with her daily before breakfast weigh in. she states that she just drank a glass of water, which she feels will unfairly increase her weight. what is the nurse's best response to the client? 1. you're in here to gain weight so that will work in your favor 2. don't drink or eat for 2 hours and then I'll weigh you 3. you must weigh in every day at this time. please step on the scale 4. if you don't get on the scale I'll be forced to call your HCP

3. you must weigh in every day at this time. please step on the scale

a preschool aged child with a history of being abused has blood drawn. the child lies very still and makes no sound during the procedure. which comment by the nurse would be most appropriate? 1. it's ok to cry when something hurts 2. that really didn't hurt, did it? 3. we must seem mean to hurt you that way 4. you were very good not to cry with the needle

1. it's ok to cry when something hurts

a preadolescent child is suspected of being sexually abused because he demonstrates the self destructive behaviors of self mutilation and attempted suicide. which common behavior should the nurse also expect to assess? 1. inability to play 2. truancy and running away 3. head banging 4. overcontrol of anger

2. truancy and running away

One of the myths about sexual abuse of young children is that it usually involves physically violent acts. Which of the following behaviors is more likely to be used by the abusers? 1. Tying the child down. 2. Bribery with money. 3. Coercion as a result of the trusting relationship. 4. Asking for the child's consent for sex.

3. Coercion as a result of the trusting relationship.

when obtaining a nursing history from parents who are suspected of abusing their child, which characteristic about the parents should the nurse particularly assess? 1. attentiveness to the child's needs 2. self blame for the injury to the child 3. ability to relate the child's developmental achievements 4. difficulty with controlling aggression

4. difficulty with controlling aggression

a client who has been sexually abused is admitted to the ED. which is the most important initial statement by the nurse? 1. did you know the person who did this to you? 2. I'll get the emergency rape kit 3. I'll stay with you while you're here 4. don't worry, trained responders are coming

3. I'll stay with you while you're here

a nurse is assessing a client who is being abused. the nurse should assess for which characteristics? select all that apply 1. assertiveness 2. self blame 3. alcohol abuse 4. suicidal thoughts 5. guilt

2. self blame 3. alcohol abuse 4. suicidal thoughts 5. guilt

After a client reveals a history of childhood sexual abuse, the nurse should ask which of the following questions first? 1. "What other forms of abuse did you experience?" 2. "How long did the abuse go on?" 3. "Was there a time when you did not remember the abuse?" 4. "Does your abuser still have contact with young children?"

4. "Does your abuser still have contact with young children?"

a client with suspected abuse describes her husband as a good man who works hard and provides well for the family. she does not work outside the home and states that she is proud to be a wife and mother, just like her own mother. the nurse interprets the family pattern described by the client as best illustrating which characteristic of abusive families? 1. tight, impermeable boundaries 2. unbalanced power ratio 3. role stereotyping 4. dysfunctional feeling tone

3. role stereotyping

when collaborating with the HCP to develop a plan of care for a child diagnosed with ADHD the treatment plan will likely include which treatments? 1. antianxiety meds such as busiprone, and homeschooling 2. antidepressant medications such as imipramine and family therapy 3. anticonvulsant meds such as carbamazepine and monthly blood levels 4. psychostimulant meds such as methylphenidate and behavior modification

4. psychostimulant meds such as methylphenidate and behavior modification

after months of counseling, a client abused by her husband tells the nurse that she has decided to stop treatment. there has been no abuse during this time and she feels better able to cope with the needs of her husband and children. how should the nurse begin the discussion of this decision with the client? 1. tell the client that this is a bed decision that she will regret in the future. 2. find out more about the client's rationale for her decision to stop treatment 3. warn the client that abuse commonly stops when one partner is in treatment only to begin again later 4. remind the client of her duty to protect her children by continuing treatment

2. find out more about the client's rationale for her decision to stop treatment

a young child who has been sexually abused has difficulty putting feelings into words. which approach should the nurse employ with the child? 1. engaging in play therapy 2. role playing 3. giving the child's drawings to the abuser 4. reporting the abuse to a prosecutor

1. engaging in play therapy

a school age child is referred to the mental health clinic by the school nurse because he is fearful, anxious, and socially isolated. after meeting with the client, the nurse talks with his mother who says "it's that school nurse again. she's done nothing but try to make trouble for our family since my son started school. and now you're in on it." what is nurse's most appropriate response? 1. the school nurse is concerned about your son and is only doing her job. 2. you don't need to feel singled out. we see a number of children who go to your son's school. 3. you sound pretty angry with the school nurse. tell me what happened 4. let me tell you why your son was referred, and then you can tell me about your concerns

3. you sound pretty angry with the school nurse. tell me what happened

the nurse discovers that an adolescent client with anorexia nervosa is taking diet pills rather than complying with the diet. what should the nurse do first? 1. explain to the client how diet pills can jeopardize health 2. listen to the client discuss fears of losing control of eating while being treated 3. talk with the client about how weight loss worry the HCPs 4. inquire about worries of the client's family concerning the client's health

2. listen to the client discuss fears of losing control of eating while being treated

a client diagnosed with bulimia tells the nurse she only eats excessively when upset with her best friend and she vomits to avoid gaining a lot of weight. what should the nurse do next? 1. schedule daily family therapy sessions 2. enroll the client in a coping skills group 3. work with the client to limit her purging 4. obtain a PRN prescription for lorazepam to reduce binge eating urges

2. enroll the client in a coping skills group

an adolescent client is admitted to a psychiatric day treatment program due to severe lower back pain since her mothers death 3 years ago. medical examinations have not discovered a physical cause for her pain. she cares for her 4 younger siblings after school and on weekends because of her fathers long work hours. which predischarge statement indicates that treatment for her condition has been successful? 1. I understand why my father spends so much time away from home 2. my back pain is worse on weekends with more responsibility and homework 3. I do not want to talk about my family. it is my back that is hurting 4. I just need more rest and relaxation and then my back will feel fine

2. my back pain is worse on weekends with more responsibility and homework

the parents of an adolescent child newly diagnosed with anorexia nervosa are meeting with the nurse during the admission process. which remarks should the nurse interpret as typical for parents of a client with anorexia nervosa? 1. we've given her everything and look how she betrays us 2. she's had behavior problems for the past year at home and at school 3. she's been a model child. we've never had any problems with her 4. we have five children, all normal kids with some problems sometimes

3. she's been a model child. we've never had any problems with her

a client newly diagnosed with bulimia is attending the nurse led group at the mental health center. she tells the group that she came only because her husband said he would divorce her if she did not get help. which response by the nurse is appropriate? 1. you sound angry with your husband. is that correct? 2. you'll find that you like coming to group. these people are a lot of fun 3. tell me more about why you're here and how you feel about that 4. tell me something specific about what has caused you to be bulimic?

3. tell me more about why you're here and how you feel about that

which observation by the nurse should suggest that a 15 month old toddler has been abused? 1. the child appears happy when personnel work with him 2. the child plays alongside others contentedly 3. the child is underdeveloped for his age 4. the child sucks his thumb

3. the child is underdeveloped for his age

adolescents and adults who were sexually abused as children commonly mutilate themselves . how does the nurse interpret this behavior? 1. the need to make themselves less sexually attractive 2. an alternative to binging and purging 3. use of physical pain to avoid dealing with emotional pain 4. an alternative to getting high on drugs

3. use of physical pain to avoid dealing with emotional pain

When planning interventions for parents who are abusive, the nurse should incorporate knowledge of which factor as a common parental indicator? 1. Lower socioeconomic group. 2. Unemployment. 3. Low self-esteem. 4. Loss of emotional family attachments.

3. Low self-esteem.

a client tells the nurse that she has been raped but has not reported it to the police. after determining whether the client was injured, whether is is still possible to collect evidence, and whether the client wants to file a report, the nurse's next priority is to offer which intervention to the client? 1. legal assistance 2. crisis intervention 3. a rape support group 4. medication for disturbed sleep

2. crisis intervention

while interviewing a preschool age girl who has been sexually abused about the event, which approach would be most effective? 1. describe what happened during the abusive act 2. draw a picture and explain what it all means 3. play out the event using anatomically correct dolls 4. name the perpetrator

3. play out the event using anatomically correct dolls

the mother of an adolescent client who is diagnosed with oppositional defiant disorder tells the nurse that she has read extensively on the disorder and does not believe that the diagnosis is correct for her daughter. which response by the nurse is appropriate? 1. it sounds like you are very interested in your daughter. lets focus on what is best for her 2. tell me what you have found in your reading that is leading you to that conclusion. 3. your HCP has had many years of education and experience so you can believe he is right 4. that doesnt matter now because we just need to help he get better

2. tell me what you have found in your reading that is leading you to that conclusion.

a married female client has been referred to the mental health center because she is depressed. the nurse notices bruises on her upper arms and asks about them. after denying any problems the client starts to cry and says "he did not really mean to hurt me, but I hate for the kids to see this. I am so worried about them." what is the most crucial information for the nurse to determine? 1. the type and extent of abuse occurring in the family 2. the potential of immediate danger to the client and her children 3. the resources available to the client 4. whether the client wants to be separated from her husband

2. the potential of immediate danger to the client and her children

the nurse is with the parents of an adolescent client who recently attempted suicide. the nurse cautions the parents to be especially alert for which changes in their child? 1. expression of a desire to date 2. decision to try out for an extracurricular activity 3. giving away valued personal items 4. desire to spend more time with friends

3. giving away valued personal items

a nurse who works with a client diagnosed with bulimia. what is the most appropriate long term client goal for this client? 1. eat meals at home without binging or purging 2. be able to eat out without binging or purging 3. manage stresses in life without binging or purging 4. be able to attend college without binging or purging

3. manage stresses in life without binging or purging

in the process of dealing with intense feelings about being raped, victims commonly verbalize that they weren't afraid they would be killed during the rape and wish that they had been. the nurse should decide that further counseling is needed if the client makes which statement? 1. I didn't fight him but I guess I did the right thing because I am alive 2. suicide would be an easy escape from all this pain but I couldn't do it to myself 3. I wish they gave the death penalty to all rapists and other sexual predators 4. I get so angry at times that I have to have a couple drinks before I sleep

4. I get so angry at times that I have to have a couple drinks before I sleep

when caring for a client who was a victim of a crime, the nurse is aware that recovery from any crime can be long and difficult process depending on the meaning it has for the client. what should the nurse establish as a victim's ultimate goal in reconstructing his or her life? 1. getting through the shock and confusion 2. carrying out home and work routines 3. resolving grief over any losses 4. regaining a sense of security and safety

4. regaining a sense of security and safety

a young adult female client is brought to the ED by her roommate to seek treatment for gastrointestinal problems. the client reveals that she attends college and works at a coffee shop in the evening. a diet history indicates that the client has unhealthy eating habits, commonly eating large amounts of carbohydrates and junk food with few fruits and vegetables. "her stomach is upset a lot." the roommate says. she further reports that the client is in the bathroom all the time. which referral is most important for the nurse to make for the client? 1. a mental health clinic 2. a weight loss program 3. an overeating support group 4. the clients HCP

1. a mental health clinic

an adolescent client who has been taking an antidepressant for 6 weeks has returned to the clinic for a medication check. when the nurse talks with the client and her parent, the mother reports that she has to remind the client to take her antidepressant every day. the client says "yeah I'm pretty bad about remembering to take my meds, but I never miss a dose because mom always bugs me about taking it." which response would be effective for the nurse to make to the client? 1. it is a good thing your mom takes care of you by reminding you to take your meds 2. it seems there are some difficulties being responsible for your medications that we need to address 3. you'll never be able to handle your medication administration at college next year if you are so dependent on her 4. I'm surprised your mother allows you to be so irresponsible

2. it seems there are some difficulties being responsible for your medications that we need to address

assessment of suicidal risk in children and adolescents requires the nurse to know what information? 1. children rarely commit suicide unless one of their parents has already committed suicide especially in the past year 2. the risk of suicide increases during adolescence with those who have recently suffered a loss, abuse, or family discord being most at risk 3.children do have a suicidal risk that coincides with some significant event such as a recent gun purchase in the family 4. adolescents typically do not choose suicide unless they live in certain geographical regions of the US and Canada

2. the risk of suicide increases during adolescence with those who have recently suffered a loss, abuse, or family discord being most at risk

the nurse assesses a school age client who excessively cleans and categorizes. her parents report that she has always been orderly but since her brother died of cancer 6 months ago, her cleaning and categorizing have escalated. in school, she reads instead of playing with the other children. these behaviors are now interfering with homework and leisure activities. to bolster her self esteem the nurse should encourage the child to engage in what activity? 1. serve as a library helper 2. volunteer to organize a party for the class 3. lead a group project with 4 peers 4. be captain of the kickball team

1. serve as a library helper

a nurse is working with a client with bulimia. which goals should be included in the care plan? select all that apply 1. the client will maintain normal weight 2. the client will comply with medication 3. the client will achieve a positive self concept 4. the client will acknowledge the disorder 5. the client will never have the desire to purge again

1. the client will maintain normal weight 2. the client will comply with medication 3. the client will achieve a positive self concept

a parent of a school aged child diagnosed with ADHD is talking to the nurse about her concerns about the sons physical condition. the parent states the methylphenidate extended release controls his symptoms well but is causing him to lose weight. it is difficult to get him up and ready for school in the morning unless he is given the medication as soon as he awakens. he does not eat breakfast or very much of his lunch at school; he eats dinner but only an average amount of food. he has lost 3 lbs in the last 2 weeks. which action should the nurse suggest the parent do first? 1. have the child eat a breakfast bar, banana, and a glass of milk at his bedside at the same time he takes his medication every morning 2. monitor the child's weight closely for a month since he is likely to stop losing weight when the school year ends in 2 weeks. 3. suggest a change of medication to a nonstimulant drug that will treat his ADHD without causing the appetite decrease 4. suggest that the parent supplement the child's dinner with a high protein drink or other food that will increase his caloric intake.

1. have the child eat a breakfast bar, banana, and a glass of milk at his bedside at the same time he takes his medication every morning

an adolescent is a heavy user of marijuana and alcohol. when the nurse confronts the client about his drug and alcohol use, he admits previous heavy use in order to feel more comfortable around peers and achieve social acceptance. he says he has been trying to stay clean since his parents found out and had him seek treatment. when the nurse develops a plan of care with the client, what should be the highest priority to help him maintain sobriety? 1. peer recognition that does not involve substance use 2. support and guidance from his parents 3. a strict no drug policy at his high school 4. the threat of legal charges if caught drinking or smoking marijuana

1. peer recognition that does not involve substance use

the nurse meets with the mother of a child diagnosed with attention deficit hyperactivity disorder. the mother states "I feel so guilty about that he has this disease, like I did something wrong. I feel like I need to be with him constantly in order for him to get better. but still sometimes I feel like I'm going to lose control and hurt him." the nurse should suggest which intervention to the mother? 1. arranging for respite care to watch her child and give herself a regular break 2. taking a job to allow herself to feel some success because her child will not ever improve 3. arranging a way to have coffee with friends daily as a way to begin a support group 4. considering foster care if she feels she cannot handle her child's problems

1. arranging for respite care to watch her child and give herself a regular break

the nurse is planning an eating disorder protocol for hospitalized clients experiencing bulimia and anorexia. which elements should be included in the protocol? select all that apply 1. clients must eat within view of a staff member 2. clients are not told their weight and cannot see their weight while being weighed 3. clients must rest within view of a staff member for one half hour to an hour after eating 4. clients may not go to the bathroom for one half hour to an hour after eating 5. clients cannot participate in any groups after admission until they gain 1 lb

1. clients must eat within view of a staff member 2. clients are not told their weight and cannot see their weight while being weighed 3. clients must rest within view of a staff member for one half hour to an hour after eating 4. clients may not go to the bathroom for one half hour to an hour after eating

a child is being seen at the clinic for ADHD assessment. what symptoms would the nurse expect to find? select all that apply 1. excessive climbing and running 2. excessive fidgeting 3. pouting behaviors 4. cannot wait to take turns 5. easily distracted

1. excessive climbing and running 2. excessive fidgeting 4. cannot wait to take turns 5. easily distracted

an adolescent is brought to the ED after accidentally taking an overdose of heroin. they are semiconscious unable to respond appropriately to the questions, slurs words and has constricted pupils. BP 60/50, pulse 50, respirations 8. naloxone is adminsitered to temporarily reverse the effects of the heroin. which finding would first indicate that the naloxone administration has been effective? 1. blood opiate level drops to a nontoxic level 2. client becomes talkative and physically active 3. memory and attention become normal 4. respirations improve to 12

4. respirations improve to 12

the parent of a school aged child tells the nurse that "for most of the past year my husband was unemployed and I worked a second job. twice during the year I spanked my son repeatedly when he refused to obey. it hasn't happened again. our family is back to normal." after assessing the family, the nurse decides that the child is still at risk for abuse. which observation best supports this conclusion? 1. the parents say they are taking away privileges when their son refuses to obey 2. the child has talked about family activities with the nurse. 3. the parents are less negative toward the nurse 4. the child wears long sleeved shirts and long pants even in warm weather

4. the child wears long sleeved shirts and long pants even in warm weather

a mother states to the nurse in the HCPs office that she is frustrated with her school aged son's nightly enuresis for the past 3 years. she says she has limited his evening fluids, eliminated all caffeine and soft drinks from his diet and has had him wash his own sheets, but he still wets the bed almost every night. her husband has told her that he was a bed wetter as a child. he thinks the son will get over it. the mother is worried that it could negatively affect the son's peer relationships as he gets older. which action should the nurse take? 1. reinforce that she should be patient since her husbands enuresis stopped without intervention 2. suggest asking the HCP about medication treatment to deal with the enuresis 3. discuss a behavioral treatment plan to improve the child's social skills 4. suggest the mother ask the HCP about a complete renal workup

2. suggest asking the HCP about medication treatment to deal with the enuresis

when planning the care for a client who is being abused, which measure is most important to include? 1. being compassionate and empathetic 2. teaching the client about abuse and the cycle of violence 3. explaining to the client about the client's personal and legal rights 4. helping the client develop a safety plan

4. helping the client develop a safety plan

a community health nurse working with a group of fifth grade girls is planning a primary intervention to help the girls avoid developing eating disorders during their teen years. the nurse should focus on which factor? 1. working with the school nurse to closely monitor for the girls' weight during middle school 2. limiting the girls' access to media images of very thin models and celebrities 3. telling the girls parents to monitor their daughters weight and media access 4. helping the girls accept and appreciate their bodies and feel good about themselves

4. helping the girls accept and appreciate their bodies and feel good about themselves

when teaching a group of adolescents about anorexia nervosa the nurse should describe this disorder as being characterized by which factors? 1. excessive fear of becoming obese, near normal weight, and a self critical body image 2. obsession with the weight of others, chronic dieting, and an altered body image 3. extreme concern about dieting, calorie counting and an unrealistic body image 4. intense fear of becoming obese, emaciation, and a disturbed body image

4. intense fear of becoming obese, emaciation, and a disturbed body image

In working with a rape victim, which of the following is most important? 1. Continuing to encourage the client to report the rape to the legal authorities. 2. Recommending that the client resume sexual relations with her partner as soon as possible. 3. Periodically reminding the client that she did not deserve and did not cause the rape. 4. Telling the client that the rapist will eventually be caught, put on trial, and jailed.

3. Periodically reminding the client that she did not deserve and did not cause the rape.

an adolescent client is being admitted with an eating disorder. which initial assessment finding is of greatest concern for the nurse? 1. a systolic BP of 100 2. a weight loss of 10% over 6 months 3. a potassium level of 2.5 4. a heart rate of 57 BPM

3. a potassium level of 2.5