nur 162 final - textbook questions

Which of the following groups is most commonly used for drug management of the child with ADHD? a. CNS depressants (diazepam [Valium]) b. CNS stimulants (methylphenidate [Ritalin]) c. Anticonvulsants (phenytoin [Dilantin]) d. Major tranquilizers (haloperidol [Haldol])

B

Which of the following is the leading cause of traumatic brain injury (TBI) in active-duty military personnel in combat? a. Military vehicle accidents b. Blasts from explosive devices c. Falls D. Blows to the head from falling debris

B

Which of the following medications is used to treat Tourette's disorder? a. Methylphenidate (Ritalin) b. Haloperidol (Haldol) c. Imipramine (Tofranil) d. Phenytoin (Dilantin)

B

Which of the following represents a nursing intervention at the secondary level of prevention? a. Teaching a class about menopause to middle aged women b. Providing support in the emergency room to a rape victim c. Leading a support group for women in transition d. Making monthly visits to the home of a client with schizophrenia to ensure medication compliance

B

Why is it important for the nurse to check the temperature of the water before an elderly individual gets into the shower? a. The client may catch cold if the water temperature is too low. b. The client may burn himself because of a higher pain threshold. c. Elderly clients have difficulty discriminating between hot and cold. d. The water must be exactly 98.6 degrees.

B

The child with ADHD has a nursing diagnosis of impaired social interaction. Which of the following nursing interventions are appropriate for this child? Select all that apply. a. Socially isolate the child when interactions with others are inappropriate. b. Set limits with consequences on inappropriate behaviors. c. Provide rewards for appropriate behaviors. d. Provide group situations for the child.

B, C, D

Sheila, a nurse, served as a captain in the military and returned from active duty three months ago. She reports experiencing nightmares and headaches since her return but denies being engaged in active combat during her tour of duty. Which of the following should the nurse include the psychosocial assessment? Select all that apply. a. Folstein's mini-mental status exam b. History of sexual trauma c. History of military promotions d. Risks for substance use disorders

B, D

Kim, a client diagnosed with *BPD, manipulates the staff in an effort to fulfill her own desires*. All of the following may be examples of manipulative behaviors in the borderline client except: A. Refusal to stay in room alone, stating, "It's so lonely." B. Asking Nurse Jones for cigarettes after 30 minutes, knowing the assigned nurse has explained she must wait 1 hour. C. Stating to Nurse Jones, "I really like having you for my nurse. You're the best one around here." D. Cutting arms with razor blade after discussing dismissal plans with physician.

A

Leon, a veteran of the war in Iraq, has been diagnosed with PTSD. He is a client of the VA outpatient clinic. He tells the nurse that he experiences panic attacks. Which of the following medications may be prescribed for Leon to treat his panic attack? a. Alprazolam b. Lithium c. Carbamazepine d. Haldol

A

Lorraine has been diagnosed with Somatic Symptom Disorder. Which of the following symptoms profiles would you expect when assessing Lorraine? a. Multiple somatic symptoms in several body systems b. Fear of having a serious disease c. Loss or alteration in sensorimotor functioning d. Belief that her body is deformed or defective in some way

A

Mr. B, age 79, is admitted to the psychiatric unit for depression. He has lost weight and has become socially isolated. His wife died 5 years ago and his son tells the nurse, "He did very well when Mom died. He didn't even cry." Which would be the priority nursing diagnosis for Mr. B? a. Complicated grieving b. Imbalanced nutrition: less than body requirements c. Social isolation d. Risk for injury

A

A battered woman presents to the emergency department with multiple cuts and abrasions. Her right eye is swollen shut. She says that her husband did this to her. Which of the following is the priority nursing intervention? a. Tending to the immediate care of her wounds. b. Providing her with information about a safe place to stay. c. Administering the prn tranquilizer ordered by the physician. d. Explaining how she may go about bringing charges against her husband.

A

A school nurse notices bruises and scars on Jana's body. The nurse suspects that the child is being physically abused. How should the nurse proceed with this information? a. As a health care worker, report the suspicion to the Department of Health and Human Services. b. Check Jana again in a week and see if there are any new bruises. c. Meet with Jana's parents and ask them how Jana got the bruises. d. Initiate paperwork to have Jana placed in foster care.

A

According to the literature, which of the following is most important for individuals to maintain a healthy, adaptive old age? a. To remain socially interactive b. To disengage slowly in preparation of the last stage of life c. To move in with family d. To maintain total independence and accept no help from anyone

A

Carol is a nurse who was floated to the psychiatric unit to cover for a staff nurse who called out sick. She encounters a patient who is diagnosed with BPD, and the patient states "Thank goodness they sent you to the unit. No one else here has taken the time to listen to my concerns." This may be an example of which symptom common in BPD? a. Impulsivity b. Self-harming behaviors c. Dissociation d. Splitting

A

Clara, an 80-year-old woman, says to the nurse, "I'm all alone now. My husband is gone. My best friend is gone. My daughter is busy with her work and family. I might as well just go, too." Which is the best response by the nurse? a. "Are you thinking that you want to die, Clara?" b. "You have lots to live for, Clara." c. "Cheer up, Clara. You have so much to be thankful for." d. "Tell me about your family, Clara."

A

In group exercise, Mr. B, a 79 year old man with major depressive disorder, becomes tired and short of breath very quickly. This is most likely due to: a. Age-related changes in the cardiovascular system b. A sedentary lifestyle c. The effects of pathological depression d. Medication the physician has prescribed for depression

A

Jack is a new client on the psychiatric unit with a diagnosis of antisocial personality disorder. Which of the following characteristics would you expect to assess in Jack? a. Lack of guilt for wrongdoing b. Insight into his own behavior c. Ability to learn from past experiences d. Compliance with authority

A

The Maudsley approach to treatment of adolescents with anorexia nervosa advances which of the following fundamental concepts? a. Family should be actively involved in each phase of treatment b. Parents should be prohibited from involvement in helping their child eat more because there are often control issues c. Adolescents need to work on developing health self identities before they can begin to gain weight d. Individual psychotherapy is the most effective treatment for adolescents with anorexia nervosa

A

The physician orders trazadone (Desyrel) for Mrs. W, a 78 year old widow with depression, 150 mg to take at bedtime. Which of the following statements about this medication would be appropriate for the home health nurse to make in teaching Mrs. W about trazadone? a. "You may feel dizzy when you stand up, so go slowly when you get up from sitting or lying down." b. "You must be sure and not eat any chocolate while you are taking this medication." c. "We will need to draw a sample of blood to send to the lab every month while you are on this medication." d. "If you don't feel better right away with this medication, the doctor can order a different kind for you."

A

What is the ultimate goal of therapy for a client with DID? a. Integration of the personalities into one b. For the client to have the ability to switch from one personality to another voluntarily c. For the client to select which personality he or she wants to be the dominant self d. For the client to recognize that the various personalities exist

A

When Frank's wife of 34 years dies, he is very stoic, handles all the funeral arrangements, doesn't cry or appear sad, and comforts all of the other family members in their grief. Two years later, when Frank's best friend dies, Frank has sleep disturbances, difficulty concentrating, loss of weight, and difficulty performing on his job. This is an example of which of the following maladaptive responses to loss? a. Delayed grieving b. Distorted grieving c. Prolonged grieving d. Exaggerated grieving

A

Which of the following behavioral patterns is characteristic of individuals with narcissistic personality disorder? a. Overly self centered and exploitative of others b. Suspicious and mistrustful of others c. Rule conscious and disapproving of change d. Anxious and socially isolated

A

Which of the following is a correct statement when attempting to distinguish normal grief from clinical depression? a. In clinical depression, anhedonia is prevalent. b. In normal grieving, the person has generalized feelings of guilt. c. The person who is clinically depressed relates feelings of depression to a specific loss. d. In normal grieving, there is a persistent state of dysphoria.

A

Which of the following is least likely to predispose a child to Tourette's disorder? a. Absence of parental bonding b. Family history of the disorder c. Abnormalities of brain neurotransmitters d. Structural abnormalities of the brain

A

Which of the following is thought to facilitate the grief process? a. The ability to grieve an anticipation of the loss b. The ability to grieve alone without interference from others c. Having recently grieved for another loss d. Taking personal responsibility for the loss

A

Which of the following medications may be prescribed for early ejaculation? a. Paroxetine b. Tadalafil c. Diazepam d. Imipramine

A

Which of the following nursing diagnoses would be considered the priority in planning care for the child with a severe ASD? a. Risk for self mutilation evidenced by banging head against wall. b. Impaired social interaction evidenced by unresponsiveness to people. c. Impaired verbal communication evidenced by absence of verbal expression. d. Disturbed personal identity evidenced by inability to differentiate self from others.

A

Which of the following represents a nursing intervention at the primary level of prevention? a. Teaching a class in parent effectiveness training b. Leading a group of adolescents in drug rehabilitation c. Referring a married couple for sex therapy d. Leading a support group for battered women

A

Which of the following represents a nursing intervention at the tertiary level of prevention? a. Serving as case manager for a mentally ill homeless client b. Leading a support group for newly retired men c. Teaching prepared childbirth classes d. Caring for a depressed widow in the hospital

A

Jane is hospitalized on the psychiatric unit. She has a history and current diagnosis of bulimia nervosa. Which of the following symptoms would be congruent with Jane's diagnosis? a. Binging, purging, obesity, hyperkalemia b. Binging, purging, normal weight, hypokalemia c. Binging, laxative abuse, amenorrhea, severe weight loss d. Binging, purging, severe weight loss, hyperkalemia

B

A client comes to the mental health clinic with a complaint of lack of sexual desire. In the initial interview, what assessments would the nurse make? (Select all that apply) a. Mood b. Level of energy c. Medications being taken d. Previous level of sexual activity

A, B, C, D

Joanne presents in the emergency department with complaints of suicidal ideation. The following data is collected by the nurse. Which of these assessment findings suggests that bulimia nervosa might be a health problem? Select all that apply. A. Joanne's parotid glands appear enlarged. B. Joanne's teeth have a "moth eaten" pattern of tooth decay. C. Joanne reports that she takes laxatives daily. D. Joanne's weight is within the expected range.

A, B, C, D

Pam's husband of 1 year left 2 weeks ago for a year-long deployment in Afghanistan. Pam makes an appointment with the psychiatric nurse practitioner at the Community Mental Health Clinic. She tells the nurse that she can't sleep, has no appetite, is chronically fatigued, thinks about her husband constantly and fears for his life. Which of the following might the nurse suggest/prescribe for Pam? Select all that apply. a. A prescription for sertraline, 50 mg/day b. Participation in a support group c. Resume involvement in usual activities d. Perform regular relaxation exercises

A, B, C, D

Which of the following issues have been identified as contributing to the rise in the population of those who are homeless? Select all that apply. a. Poverty b. Lack of affordable health care c. Substance abuse d. Severe and persistent mental illness e. Growth in the number of family members living together

A, B, C, D

Joan's husband, who was deployed to Afghanistan a year ago, is returning home this week. Which of the following postdeployment situations may be likely to occur during the fist few months of his return? Select all that apply. a. A honeymoon period of physical reconnection b. Resistance from the spouse regarding possible loss of autonomy c. Rejection by the children for perceived abandonment d. A period of adjustment to reconnect emotionally

A, B, D

A client with erectile disorder has a new prescription for sildenafil. The nurse who is providing education about this medication tells the client that which of the following are common side effects of this medication? Select all that apply. a. Headache b. Facial flushing c. Constipation d. Nasal congestion e. Indigestion

A, B, D, E

Mike, a veteran of combat in Afghanistan, has a diagnosis of mild TBI. The psychiatric home health nurse form the VA medical center is assigned to make home visits to Mike and his wife, Nancy, who is his caregiver. Which of the following be an appropriate nursing intervention by the home health nurse? Select all that apply. a. Assess for use of substances by Mike or Nancy b. Encourage Nancy to do everything for Mike to prevent further deterioration in his condition c. Assess Nancy's level of stress and potential for burnout d. Encourage Nancy to allow Mike to be as independent as possible e. Suggest that Nancy ask the physician for a nursing home replacement for Mike

A, C, D

Which of the following ego defense mechanisms describes the underlying psychodynamics of somatic symptom disorder? a. Denial of depression b. Repression of anxiety c. Suppression of grief d. Displacement of anger

B

"Splitting" by the client with BPD denotes which of the following? a. Evidence of precocious development b. A primitive defense mechanism in which the client sees objects as all good or all bad c. A brief psychotic episode in which the client loses contact with reality d. Two distinct personalities within the borderline client

B

A major difference between normal and maladaptive grieving has been identified by which of the following? a. There are no feelings of depression in normal grieving. b. There is no loss of self-esteem in normal grieving. c. Normal grieving lasts no longer than 1 year. d. In normal grief, the person does not show anger toward the loss.

B

A young woman who has just undergone a sexual assault is brought into the emergency department by a friend. Which of the following is the priority nursing intervention? a. Help her to bathe and clean herself up. b. Provide physical and emotional support during evidence collection. c. Provide her with a written list of community resources for survivor of rape. d. Discuss the importance of a follow-up visit to evaluate for sexually transmitted diseases.

B

Ann is a psychiatric home health nurse. She has just received an order to begin regular visits to Mrs. W, a 78-year-old widow who lives alone. Mrs. W's primary care physician has diagnosed her as depressed. Which of the following criteria would qualify Mrs. W for home health visits? a. Mrs. W never learned to drive and has to depend on others for her transportation. b. Mrs. W is physically too weak to travel without risk of injury. c. Mrs. W refuses to seek assistance as suggested by her physician because "I don't have a psychiatric problem." d. Mrs. W says she would prefer to have home visits than go to the physician's office.

B

Anne, age 24, and her husband are seeking treatment at a sex therapy clinic. They have been married for 3 weeks and have never had sexual intercourse together. Pain and vaginal tightness prevent penile entry. Sexual history reveals Anne was raped when she was 15 years old. The physician would most likely assign which of the following diagnoses to Anne? a. Female orgasmic disorder b. Genito-pelvic pain/penetration disorder c. Female sexual interest/arousal disorder d. Sexual aversion disorder

B

In an effort to help the child with mild to moderate intellectual developmental disorder develop satisfying relationships with others, which of the following nursing interventions is most appropriate? a. Interpret the child's behavior for others b. Set limits on behavior that is socially inappropriate c. Allow the child to behave spontaneously, for he or she has no concept of right or wrong d. This child is not capable of forming social relationships

B

In establishing trust with Ellen, a client with the diagnosis of DID, the nurse must do which of the following? a. Try to relate to Ellen as though she did not have multiple personalities. b. Listen nonjudgementally and respond empathically when Ellen transitions to different personality states. c. Ignore behaviors that Ellen attributes to other subpersonalities d. Explain to Ellen that he or she will work with her only if she maintains the status of the primary personality

B

Jana, age 5, is sent to the school nurse's office with an upset stomach. She has vomited and soiled her blouse. When the nurse removes her blouse, she notices that Jana has numerous bruises on her arms and torso, in various stages of healing. She also notices some small scars. Jana's abdomen protrudes on her small, thin frame. From the objective physical assessment, the nurse suspects that: a. Jana is experiencing physical and sexual abuse. b. Jana is experiencing physical abuse and neglect. c. Jana is experiencing emotional neglect. d. Jana is experiencing sexual and emotional abuse.

B

Which of the following behavioral patterns is characteristic of individuals with schizotypal personality disorder? a. Belittling themselves and their ability b. A lifelong pattern of social withdrawal c. Suspiciousness and mistrust of others d. Overreacting inappropriately to minor stimuli

B

John has sought help for his concern that he is binge eating, and he feels it has "gotten out of control." He asks the nurse what can be done to help him. Which of the following is the most accurate response? a. "There is nothing that can be done." b. "There are some medications and psychological treatments that have demonstrated effectiveness in reducing binge eating behaviors." c. "The primary problem is obesity. I can help you set up a calorie-restricted diet." d. "There are medications that can help with weight loss, but there are no medications effective for reducing binge eating."

B

Kate is an 18-year-old freshman at the state university. She was extremely flattered when Don, a senior star football player, invited her to a party. On the way home, he parked the car in a secluded area by the lake. He became angry when she refused his sexual advances. He began to beat her and finally raped her. She tried to fight him, but his physical strength overpowered her. He dumped her in the dorm parking lot and left. The dorm supervisor rushed Kate to the emergency department. Kate says to the nurse, "It's all my fault. I shouldn't have allowed him to stop at the lake." The nurse's best response is, a. "Yes, you're right. You put yourself in a very vulnerable position when you allowed him to stop at the lake." b. "You are not to blame for his behavior. You obviously made some right decisions, because you survived the attack." c. "There's no sense looking back now. Just look forward, and make sure you don't put yourself in the same situation again." d. "You'll just have to see that he is arrested so he won't do this to anyone else."

B

Leon, a veteran of the war in Iraq, has been diagnosed with PTSD. He has been hospitalized after swallowing a handful of his anti-panic medication. His physical condition has been stabilized in the emergency department, and has been admitted to the psychiatric unit. In developing the initial plan of care, which is the priority nursing diagnosis that the nurse selects for Leon? a. Post-trauma syndrome b. Risk for suicide c. Complicated grieving d. Disturbed thought processes

B

Lorraine, a client diagnosed with Somatic Symptom Disorder, states, "My doctor thinks I should see a psychiatrist. I can't imagine why he would make such a suggestion?" What is the basis for Lorraine's statement? a. She thinks her doctor wants to get rid of her as a client. b. She does not understand the correlation of symptoms and stress. c. She thinks psychiatrists are only for "crazy" people. d. She thinks her doctor has made an error in diagnosis

B

Milieu therapy is a good choice for clients with antisocial personality disorder because it: a. Provides a system of punishment and rewards for behavior modification b. Emulates a social community in which the client may learn to live harmoniously with others c. Provides mostly one to one interaction between the client and therapist d. Provides structured setting in which the clients have very little input into the planning of their care

B

Nancy, age 14, has just been admitted to the psychiatric unit for anorexia nervosa. She is emaciated and refusing to eat. What is the primary nursing diagnosis for Nancy? a. Complicated grieving b. Imbalanced nutrition, less than body requirements c. Interrupted family processes d. Anxiety (severe)

B

Nurse Jones is caring for a client who has been hospitalized with anorexia nervosa and is severely malnourished. The client continues to refuse to eat. What is the most appropriate response by the nurse? a. "You know that if you don't eat, you will die." b. "If you continue to refuse to take food orally, you will be fed through a nasogastric tube." c. "You might as well leave if you are not going to follow your therapy regimen." d. "You don't have to eat if you don't want to. It is your choice."

B

Sharon, a woman with multiple cuts and abrasions, arrives at the ED with her three small children. She tells the nurse her husband inflicted these wounds on her. She says, "I didn't want to come. I'm really okay. He only does this when he has too much to drink. I just shouldn't have yelled at him." Which of the following is the best response by the nurse? a. "How often does he drink too much?" b. "It is not your fault. You did the right thing by coming here." c. "How many times has he done this to you?" d. "He is not a good husband. You have to leave him before he kills you."

B

The ultimate goal of therapy for a client with DID is most likely achieved through which of the following interventions? a. Crisis intervention and directed association b. Psychotherapy and hypnosis c. Psychoanalysis and free association d. Insight psychotherapy and dextroamphetamines

B

Tim, age 18, babysits for his 11-year-old neighbor, Jeff. Six months ago, Tim began fondling Jeff's genitals. They now engage in mutual masturbation each time they are together. This is an example of which paraphilic disorder? a. Fetishistic disorder b. Pedophilic disorder c. Exhibitionistic disorder d. Voyeuristic disorder

B

Tom watches his neighbor through her window each night as she undresses for bed. Later, he fantasizes about having sex with her. This is an example of which paraphilic disorder? a. Exhibitionistic disorder b. Voyeuristic disorder c. Frotteuristic disorder d. Pedophilic disorder

B

Which of the following activities would be most appropriate for the child with attention deficit/hyperactivity disorder (ADHD)? a. Monopoly b. Volleyball c. Pool d. Checkers

B

A hospitalized client with bulimia nervosa has stopped vomiting in the hospital and tells the nurse she is afraid she is going to gain weight. Which is the most appropriate response by the nurse? a. "Don't worry. The dietitian will ensure you don't get too many calories in your diet." b. "Don't worry about your weight. We are going to work on other problems while you are in the hospital." c. "I understand that you are concerned about your weight, and we will talk about the important of good nutrition; but for now, I want you to tell me about your recent invitation to join the National Honor Society. That's quite an accomplishment." d. "You are not fat, and the staff will ensure that you do not gain weight while you are in the hospital, because we know that is important to you."

C

Nancy, who is dying of cancer, says to the nurse, "I just want to see my new grandbaby. If only God will let me live until she is born. Then I'll be ready to go." This is an example of which of Kübler-Ross's stages of grief? a. Denial b. Anger c. Bargaining d. Acceptance

C

An elderly client says to the nurse, "I don't want to go to that crafts class. I'm too old to learn anything." Based on knowledge of the aging process, which of the following is a true statement? a. Memory functioning in the elderly most likely reflects loss of long term memories of remote events. b. Intellectual functioning declines with advancing age. c. Leraning ability remain intact, but time required for learning increases with age. d. Cognitive functioning is rarely affected in aging individuals.

C

Ann is a psychiatric home health nurse. She has just received an order to begin regular visits to Mrs. W, a 78-year-old widow who lives alone. Mrs. W's primary care physician has diagnosed her as depressed. Which of these potential problems is a priority to evaluate during the first home visit? a. Complicated grieving b. Social isolation c. Risk for injury d. Sleep pattern disturbance

C

Anne, age 24, and her husband are seeking treatment at the sex therapy clinic. They have been married for 3 weeks and have never had sexual intercourse together. Pain and vaginal tightness precent penile entry. Sexual history reveals Anne was raped when she was 15 years old. The most appropriate nursing diagnosis for Anne would be which of the following? a. Pain related to vaginal constriction b. Ineffective sexuality patterns related to inability to have vaginal intercourse c. Sexual dysfunction related to history of sexual trauma d. Complicated grieving related to loss of self esteem because of rape

C

Fred rides a crowded subway every day. He stands beside a woman he views as very attractive. Just as the subway is about to stop, he places his hand on her breast and rubs his genitals against her buttock. As the door opens, he dashes out and away. Later he fantasizes she is in love with him. This is an example of which paraphilia? a. Voyeuristic disorder b. Sexual sadism disorder c. Frotteuristic disorder d. Exhibitionistic disorder

C

Gloria, a recent widow, states, "I'm going to have to learn to pay all the bills. Hank always did that. I don't know if I can handle all of that." This is an example of which of the tasks described by Worden? a. Task I. Accepting the reality of the loss b. Task II. Processing the pain of grief c. Task III. Adjusting to a world without the lost entity d. Task IV. Finding an enduring connection with the lost entity in the midst of embarking on a new life

C

In evaluating the progress of Jack, a client diagnosed with antisocial personality disorder, which of the following behaviors would be considered the most significant indication of positive change? a. Jack got angry only once in group this week b. Jack was able to wait a whole hour for a cigarette without verbally abusing the staff c. On his own initiative, Jack sent a note of apology to a man he had injured in a recent fight d. Jack stated that he would no longer start any more fights

C

John, a homeless person, has just come to live in the shelter. The shelter nurse is assigned to his care. Which of the following is a priority intervention on the part of the nurse? a. Referring John to a social worker b. Developing a plan of care for John c. Conducting a behavioral and needs assessment on John d. Helping John apply for social security benefits

C

Leon, a veteran of the war in Iraq, has been diagnosed with PTSD. He has been hospitalized on the psychiatric unit following an attempted suicide. In the middle of the night, he wakes up yelling and tells the nurse he was having a flashback to when his unit transport drove over an improvised explosive device (IED) and most of his fellow soldiers were killed. He is breathing heavily, perspiring, and his heart is pounding. The nurse's most appropriate initial intervention is which of the following? a. Contact the doctor on call to report the incident. b. Administer the prn. order for chlorpromazine. c. Stay with Leon and reassure him of his safety. d. Have Leon sit outside the nurses' station until he is calm.

C

Lorraine, a client diagnosed with Somatic Symptom Disorder, tells the nurse about a pain in her side. She says she has not experienced it before. Which is the most appropriate response by the nurse? a. "I don't want to hear about another physical complaint. You know they are all in your head. It's time for group therapy now." b. "Let's sit down here together and you can tell me about this new pain you are experiencing. You'll just have to miss group therapy today." c. "I will report this pain to your physician. In the meantime, group therapy starts in 5 minutes. You must leave now to be on time." d. "I will call your physician and see if he will order a new pain medication for your side. The one you have now doesn't seem to provide relief. Why don't you get some rest for now?"

C

Mike was injured during combat in Afghanistan. He has a diagnosis of TBI. Which of the following medications might the physician prescribe to improve Mike's memory and thinking capability? a. Carbamazepine b. Duloxetine c. Donepezil d. Bupropion

C

Mr. B, age 79, is admitted to the psychiatric unit for depression. He has lost weight and has become socially isolated. His wife died 5 years ago, and he lives alone. A suicide assessment is conducted. Why is Mr. B at high risk for suicide? a. All depressed people are at high risk for suicide. b. Mr. B is in the age group in which the highest percentage of suicides occur. c. Mr. B is a white man, recently bereaved, living alone. d. His son reports that Mr. B owns a gun.

C

Sharon, a woman with multiple cuts and abrasions, arrives at the ED with her three small children. She tells the nurse her husband inflicted these wounds on her. In the interview, Sharon tells the nurse, "He's been getting more and more violent lately. He's been under a lot of stress at work the last few weeks, so he drinks a lot when he gets home. He always gets mean when he drinks. I was getting scared. So I just finally told him I was going to take the kids and leave. He got furious when I said that and began beating me with his fists." With knowledge about the cycle of battering, what does this situation represent? a. Phase I. Sharon was desperately trying to stay out of his way and keep everything calm. b. Phase I. A minor battering incident for which Sharon assumes all the blame. c. Phase II. The acute battering incident that Sharon provoked with her threat to leave. d. Phase III. The honeymoon phase where the husband believes that he has "taught her a lesson and she won't act up again."

C

Some obese individuals take amphetamines to suppress appetite and help them lose weight. Which of the following is an adverse effect associated with use of amphetamines that makes this practice undesirable? a. Bradycardia b. Amenorrhea c. Tolerance d. Convulsions

C

Stanley, age 72, is admitted to the hospital for depression. His son reports that he has periods of confusion and forgetfulness. In her admission assessment, the nurse notices an open sore on Stanley's arm. When she questions him about it he says, "I scraped it on the fence 2 weeks ago. It's smaller than it was." How might the nurse analyze these data? a. Consider that Stanley may have been attempting self-harm b. The delay in healing may indicate that Stanley has developed skin cancer c. A diminished inflammatory response in the elderly increases healing time d. Age-related skin changes and distribution of adipose tissue delay healing in the elderly

C

The child with autism spectrum disorder (ASD) has difficulty with trust. With this in mind, which of the following nursing actions would be most appropriate? a. Encourage all staff to hold the child as often as possible, conveying trust through touch. b. Assign a different staff member each day so child will learn that everyone can be trusted. c. Assign same staff person as often as possible to promote feelings of security and trust. d. Avoid eye contact, because this is extremely uncomfortable for the child, and may even discourage trust.

C

The nursing history and assessment of an adolescent with a conduct disorder might reveal all of the following behaviors except: a. Manipulation of others for fulfillment of own desires. b. Chronic violation of rules. c. Feelings of guilt associated with the exploitation of others. d. Inability to form close peer relationships.

C

Which grief reaction can the nurse anticipate in a 10 year old child? a. Statements that the deceased person will soon return b. Regressive behaviors, such as loss of bladder control c. AB preoccupation with the loss d. Thinking that they may have done something to cause the death

C

Which medication has been used with some success in clients with anorexia nervosa? a. Lorcaserin (Belviq) b. Diazepam (Valium) c. Fluoxetine (Prozac) d. Carbamazepine (Tegretol)

C

Which of the following is not true regarding grieving by an adolescent? a. Adolescents may not show their true feelings about the death. b. Adolescents tend to have an immortal attitude. c. Adolescents do not perceive death as inevitable. d. Adolescents may exhibit acting out behaviors as part of their grief.

C

Which of the following physical manifestations would you expect to assess in a client suffering from anorexia nervosa? a. Tachycardia, hypertension, hyperthermia b. Bradycardia, hypertension, hyperthermia c. Bradycardia, hypotension, hypothermia d. Tachycardia, hypotension, hypothermia

C

John, a homeless person, has a history of schizophrenia and noncompliance with medications. Which of the following medications might be the best choice for John? a. Haldol b. Navane c. Lithium carbonate d. Prolixin decanoate

D

Kim has a diagnosis of BPD. She often exhibits alternating clinging and distancing behaviors. Which of the following is the most appropriate nursing intervention with this type of behavior? a. Encourage Kim to establish trust in one staff person with whom all therapeutic interaction should take place. b. Secure a verbal contract from Kim that she will discontinue these behaviors. c. Withdraw attention if these behaviors continue. d. Rotate staff members who work with Kim so that she will learn to relate to more than one person.

D

A school nurse notices bruises and scars on a child's body, but the child refuses to say how she received them. What is another way in which the nurse can get information from the child? a. Have her evaluated by the school psychologist. b. Tell her she may select a treat from the treat box if she answers the nurses questions. c. Explain to her that if she answers the questions, she may stay in the nurse's office and not have to go back to class. d. Use a "family" of dolls to role play the child's family with her.

D

A woman who has a long history of being battered by her husband is staying at the woman's shelter. She has received emotional support from staff and peers and has been made aware of the alternatives open to her. Nevertheless, she decides to return to her home and marriage. Which of the following is the best response by the nurse to the woman's decision? a. "I just can't believe you have decided to go back to that horrible man." b. "I'm just afraid he will kill you or the children when you go back." c. "What makes you think things have changed with him?" d. "I hope you have made the right decision. Call this number if you need help."

D

A woman who was sexually assaulted 6 months ago by a man with whom she was acquainted has since been attending a support group for survivors of rape. From this group, she has learned that the most likely reason the man raped her was: a. Because he had been drinking, he was not in control of his actions. b. He had not had sexual relations with a girl in many months. c. He was predisposed to become a rapist by virtue of the poverty conditions under which he was reared. d. He was expressing power and dominance by means of sexual aggression and violence.

D

According to Margaret Mahler, predisposition to borderline personality disorder occurs when developmental tasks go unfulfilled in which of the following phases? a. Autistic phase, during which the child's needs for security and comfort go unfulfilled b. Symbiotic phase, during which the child fails to bond with the mother c. Differentiation phase, during which the child fails to recognize a separateness between self and mother d. Rapprochement phase, during which the mother withdraws emotional support in response to the child's increasing independence

D

Certain family dynamics often predispose adolescents to the development of conduct disorder. Which of the following patterns is thought to be a contributing factor? a. Parents who are overprotective b. Parents who have high expectations for their children c. Parents who consistently set limits on their children's behavior d. Parents who are alcohol dependent

D

Ellen has a history of childhood physical and sexual abuse. She was diagnosed with Dissociative Identity Disorder (DID) 6 years ago. She has been admitted to the psychiatric unit following a suicide attempt. The primary nursing diagnosis for Ellen would be: a. Disturbed personal identity r/t childhood abuse. b. Disturbed sensory perception r/t repressed anxiety. c. Disturbed thought process related to memory deficit. d. Risk for suicide related to unresolved grief.

D

Engel identifies which of the following as successful resolution of the grief process? a. When the bereaved person can talk about the loss without crying b. When the bereaved person no longer talks about the lost entity c. When the bereaved person puts all remembrances of the loss out of sight d. When the bereaved person can discuss both positive and negative aspects about the lost entity

D

Frank drives his car up to a strange woman, stops, and asks her for directions. As she is explaining, he reveals his erect penis to her. This is an example of which paraphilic disorder? a. Sexual sadism disorder b. Sexual masochism disorder c. Frotteuristic disorder d. Exhibitionistic disorder

D

John is 32 years old. He buys women's clothing at the thrift shop. Sometimes he dresses as a woman and goes to a singles' bar He becomes sexually excited as he fantasizes about men being attracted to him as a woman. This is an example of which paraphilic disorder? a. Sexual masochism disorder b. Voyeuristic disorder c. Exhibitionistic disorder d. Transvestic disorder

D

Lucille has a diagnosis of Illness Anxiety Disorder. Which of the following symptoms would be consistent with this diagnosis? a. Complains of a multitude of incapacitating physical symptoms b. Manifests with pseudoseizures or pseudocyesis c. Takes substances to induce vomiting in order to convince the nurse that she needs treatment d. Expresses persistent fears of having life-threatening disease. e. All of the above

D

Mr. B, age 79, is admitted to the psychiatric unit for depression. He has lost weight and has become socially isolated. His wife died 5 years ago, and his son tells the nurse, "He did very well when Mom died. He didn't even cry." Which would be the priority nursing intervention for Mr. B? a. Take blood pressure once each shift. b. Ensure that Mr. B attends group activities. c. Encourage Mr. B to eat all of the food on his food tray. d. Encourage MR. B to talk about his wife's death.

D

Mrs. W, a 78-year-old depressed widow, says to her home health nurse, "What's the use? I don't have anything to live for anymore." Which is the best response on the part of the nurse? a. "Of course you do, Mrs. W. Why would you say such a thing?" b. "You seem so sad. I'm going to do my best to cheer you up." c. "Let's talk about why you are feeling this way." d. "Have you been thinking about harming yourself in any way?"

D

Nursing care for a client with somatic symptom disorder would focus on helping her to do which of the following? a. Eliminate the stress in her life b. Discontinue her numerous physical complaints c. Take her medication only as prescribed d. Learn more adaptive coping strategies

D

What is the most appropriate way to communicate with an elderly person who is deaf in his right ear? a. Speak loudly into his left ear. b. Speak to him from a position on his left side. c. Speak face to face in a high pitched voice. d. Speak face to face in a low pitched voice.

D

Which of the following psychosocial therapies has been shown to be helpful for clients with traumatic brain injury (TBI)? a. Eye movement desensitization b. Psychoanalysis c. Reality therapy d. Cognitive behavioral therapy

D

Which of the following is most likely to initiate a grief response in an individual? a. Death of a pet dog b. Being told by her doctor that she has begun menopause c. Failing an exam d. A only e. All of the above

E