MSII Quiz 12 — Psychiatric Disorders

Laboratory work is prescribed for a client who has been experiencing delusions. When the laboratory technician approaches the client to obtain a specimen of the client's blood, the client begins to shout, "You're all vampires. Let me out of here!" The nurse present at the time should respond by stating which?

"Are you fearful and think that others may want to hurt you?"

A nurse is evaluating the outcomes for a client who has depression following the death of his wife 3 months ago. Which of the following client statements indicates a need for further intervention?

"I just don't feel like eating because I never liked to eat alone."

A nurse is caring for a newly admitted female client who has depression and refuses to get out of bed, dress, or participate in group therapy. Which of the following is an appropriate nursing response?

"I will assist you in getting out of bed and getting dressed."

A client is admitted to the inpatient unit and is being considered for electroconvulsive therapy (ECT). The client appears calm, but the family is hypervigilant and anxious. The client's mother begins to cry and states, "My child's brain will be destroyed. How can the doctor do this?" The nurse makes which therapeutic response?

"It sounds as though you have some concerns about the ECT procedure. Why don't we sit down together and discuss any concerns you may have?"

A charge nurse overhears another nurse talking with a client who has schizophrenia. Suddenly the client yells, "I am the devil! I am God! Open the gate for me!" Which of the following replies by the nurse requires intervention?

"There is no gate for me to open."

A nurse is in a mental health facility is sitting with a client who has schizophrenia. The client whispers to the nurse, "I'm being kept in this prison against my will. Please try to get me out." Which of the following responses should the nurse make?

"You feel that you don't belong here."

The nurse in the mental health unit reviews the therapeutic and nontherapeutic communication techniques with a nursing student. Which are therapeutic communication techniques? Select all that apply.

1.Restating 2.Listening 4.Maintaining neutral responses 6.Providing acknowledgment and feedback

A nurse in an acute care mental health facility is caring for a hospitalized client who has agoraphobia. The nurse observes the client making progress when he is able to participate in which of the following activities?

A picnic in a local park

A nurse assesses that a 42-year-old patient lives with her parents and is dependent on them for decisions about her life. Which mental health characteristic is this patient lacking? a. Reality orientation b. Autonomous behavior c. Spontaneity d. Ethical decision making

ANS: B Autonomy is a mark of mental health.

What is the goal of nursing care for the patient with a chronic illness? a.Find the cause of the illness. b.Tell the patient that he or she will learn to live with the illness. c.Help the patient manage the illness. d.Give the patient websites that have information about the illness.

ANS: C The goal of caring for patients with a chronic illness is to help them manage the illness and to develop coping skills.

When a patient is given a diagnosis of cancer, his first statement is, "What did I ever do to deserve God punishing me?" What does this exemplify? a. Maladaptive coping b. Behavioral emotionalism c. Spiritual distress d. Spiritual maladaptation

ANS: C This is a response to spiritual distress. The patient is questioning the meaning of illness and suffering

How does fear differ from anxiety? a.Fear is a useless emotion. b.Fear is an ineffective coping strategy. c.Fear is an irrational feeling. d.Fear is a response to a specific threat.

ANS: D Fear is a response to a specific threat (e.g., a rattlesnake in the garden); anxiety is a response to a nonspecific threat (e.g., first day on a new job).

A patient with low back pain confesses that he drinks heavily each night to help him sleep and control pain. What does this behavior exemplify? a. Alternate pain control methods b. Coping with a chronic condition c. Using a social coping mechanism d. Using a maladaptive coping method

ANS: D This behavior is an example of maladaptive coping. Drinking is not an appropriate means of coping with chronic pain.

A client was admitted to a medical unit with acute blindness. Many tests are performed, and there seems to be no organic reason why this client cannot see. The nurse later learns that the client became blind after witnessing a hit-and-run car crash in which a family of three was killed. The nurse suspects that the client may be experiencing which?

Conversion disorder

A nurse is caring for a client who has obsessive compulsive disorder (OCD) and is constantly picking up after others and cleaning in the day room. The nurse should recognize the client's actions as which of the following?

Decreasing anxiety to a tolerable level

A client is admitted to a psychiatric unit for treatment of a psychotic disorder. The client is at the locked exit door and is shouting, "Let me out! There's nothing wrong with me! I don't belong here!" The nurse identifies this behavior as which?

Denial

A nurse is caring for a client who has obsessive-compulsive disorder. Which of the following actions should the nurse take first?

Determine the client's anxiety level

A nurse is caring for a client who has schizophrenia and begins to talk about fantasy subjects. Which of the following is an appropriate intervention by the nurse?

Encourage the client to focus on reality-based issues

A manic client announces to everyone in the dayroom that a stripper is coming to perform that evening. When the psychiatric nurse's aide firmly states that the client's behavior is not appropriate, the manic client becomes verbally abusive and threatens physical violence to the nurse's aide. Based on the analysis of this situation, the nurse determines that the appropriate action would be to:

Escort the manic client to his or her room.

A nurse is caring for a client who has bipolar disorder and states that his latest computer project is "revolutionizing the industry." Which of the following behaviors is the client exhibiting?

Grandiosity

A nurse is collecting data from a client who has PTSD following a sexual assault. Which of the following is an expected finding?

Increasing feeling of anger

The nurse is assigned to care for a client admitted to the hospital after sustaining an injury from a house fire. The client attempted to save a neighbor involved in the fire, but despite the client's efforts, the neighbor died. Which action should the nurse take to enable the client to work through the meaning of the crisis?

Inquiring about the client's feelings that may affect coping

A nurse is reinforcing teaching with a group of adolescents regarding identifying behavioral indicators of depression. Which of the following manifestations should the nurse include? Select all that apply.

Irritability, decreased energy and isolation from peers

The nurse is assigned to care for a client experiencing disturbed thought processes. The nurse is told that the client believes that the food is being poisoned. Which communication technique should the nurse plan to use to encourage the client to eat?

Open-ended questions and silence

A nurse is assigned to a client who is psychotic. The client is pacing, agitated, and using aggressive gestures and rapid speech. The nurse determines that which of the following is the immediate priority of care?

Provide safety for both the client and other clients on the unit.

A nurse is caring for a client who witnessed her brother's homicide and has PTSD. Which of the following findings should the nurse expect?

The client is easily startled by loud voices

A nurse is reviewing the medical record of a client who is to received electroconvulsive therapy (ECT) for the treatment of depression. Which of the following should the nurse ensure is in the medical record?

The client's signed informed consent form

A client has reported that crying spells have been a major problem over the past several weeks, and that the doctor said that depression is probably the reason. The nurse observes that the client is sitting slumped in the chair and the clothes that the client is wearing do not fit well. The nurse interprets that further data collection should focus on:

Weight loss

A patient says, I just dont think I can keep going on. I just want it all to end. The nurse assesses that this patient has suicidal ideation. What is the nurses best response? a. Do you have any thoughts of harming yourself? b. Have you felt like this before? c. You are just depressed. When you feel better, you wont think that way. d. We will keep you safe here.

a. Do you have any thoughts of harming yourself? The best response to a patient who may have suicidal ideation is to ask a simple direct question to determine the patients true intent. Having done that, this should be reported at once. All suicidal threats, even mild ones, should be reported and taken seriously.

A nurse is caring for a client who has depression and is discussing ADLs with his family. The nurse identifies that after discharge, the client is able to perform which of the following if independent with ADLs? a. Driving b. Hygiene c. House cleaning d. Grocery shopping

b. Hygiene

A coworker is noted to be very organized. However, you see that he is always making lists and citing the rules of the organization. He wants all his projects to be perfect and gets very upset when things happen that make him miss his deadlines. The coworker is exhibiting signs of which personality disorder? a. Avoidant b. Obsessive-compulsive c. Histrionic d. Dependent

b. Obsessive-compulsive Patients who have a preoccupation with perfectionism, orderliness, and control have an obsessive-compulsive personality disorder. These patients may be anxious and attempt to maintain the perfectionism. The patient data in this question demonstrate the elements of obsessive-compulsive disorder.

A group of nursing students are taking their first major examination. What should the nursing instructor expect the students might experience? a. Posttraumatic stress disorder b. Panic disorder c. Mild anxiety d. Moderate anxiety

c. Mild anxiety The students are usually experiencing mild anxiety, which can be beneficial as a motivator.

A patient who has a history of episodes of road rage thinks that she is a very good driver and does not understand why she keeps being told she is a poor driver. She is losing her license now, and she tells the nurse that she is feeling very unhappy and abandoned. She feels like she might hurt herself. The nurse realizes that the patient is exhibiting which personality disorder? a. Narcissistic b. Paranoid c. Schizoid d. Borderline

d. Borderline Difficulty controlling anger and an unstable sense of self are elements of a borderline personality disorder.

A patient is brought in from the emergency department after telling the physician that he is a relative of the president of the United States. He says that he should not be detained because he has important business to attend to that involves national security. He is dressed in a bright coat with plaid pants and gets very angry when you try to question him. What is this patient is experiencing? a. Panic attack b. Hyperactive episode c. Extrapyramidal effect d. Manic episode

d. Manic episode Inappropriate dress, self-aggrandizement, hyperactivity, and frustration are elements of a manic episode.

Which is not considered as a probable cause of mood disorders? a. Loss of significant others b. Learned helplessness c. Neurotransmitter dysregulation d. Traumatic event in childhood

d. Traumatic event in childhood A traumatic event in childhood could, most likely, cause PTSD. All other options are causes of mood disorders.