Psych Exam 3 Lippincott

A nurse is caring for an adolescent female who reports amenorrhea, weight loss, and depression. Which additional assessment finding suggests that the client has an eating disorder? hyperkalemia increased blood pressure oily skin excessive and ritualized exercise

excessive and ritualized exercise

A client is to be discharged from an alcohol rehabilitation program. What should the nurse emphasize in the discharge plan as a priority? supportive friends a list of goals returning to work follow-up care

follow-up care

The nurse evaluates the progress of a client being treated for somatoform disorder. Which statement indicates to the nurse that the client is progressing toward recovery from a somatoform disorder? "I understand my pain will feel worse when I am worried about my divorce." "My stomach pain will go away once I get properly diagnosed." "My headache feels better when I time my medication dose." "I need to find a health care provider who understands what my pain is like."

"I understand my pain will feel worse when I am worried about my divorce."

The stigma related to having a mental illness, especially a chronic illness, persists despite improvements in the management of illnesses and an increase in public education. Which view most perpetuates the stigma? Mental illness is hereditary. Mental illnesses have biochemical bases. Clients cannot prevent mental illness if they want to do so. Clients can recover from mental illness if they have willpower.

Clients can recover from mental illness if they have willpower.

A client is admitted to the psychiatric inpatient unit after being found walking on a highway at night talking to themself. The client is unkempt and appears thin and dirty. What would be the best way to assess the client's nutritional status and changes significant to mental health status? Compare current weight with past weight in chart. Discuss recent dietary intake. Arrange for a medical consult. Observe at mealtimes.

Compare current weight with past weight in chart.

The campus health nurse is caring for a client after she was sexually assaulted. Which of the following intervention would be most beneficial for this client? Advise the client to take martial arts lessons. Agree when the client states, "I should just move on." Explore the client's strengths and resources with her. Assess for negative coping behaviors.

Explore the client's strengths and resources with her.

During the admission interview, a client reports frequent nightmares and memories of a rape that occurred 3 years earlier. The client feels depressed and asks the nurse, "Do you think I will ever get better? I don't know what is wrong with me." The nurse's most supportive response would be: "It sounds like you have some unresolved pain about the trauma. Take time while you're here to talk and allow yourself to heal." "I'm not sure what is wrong, but the medication will help you soon enough." "It's important for you to talk with your physician about an issue such as this." "Don't feel bad; the treatment will help you."

"It sounds like you have some unresolved pain about the trauma. Take time while you're here to talk and allow yourself to heal."

A client with a diagnosis of antisocial personality disorder has a potential for violence and aggressive behavior. Which short-term client outcome is most appropriate for the nurse to include in the plan of care? Use humor when expressing anger. Discuss feelings of anger with the staff. Ask the nurse for medication when upset. Use indirect behaviors to express anger.

Discuss feelings of anger with the staff.

The client diagnosed with borderline personality disorder who is to be discharged soon threatens to "do something" to themself if discharged. What action should the nurse take first? Request that the client's discharge be canceled. Ignore the client's statement because it is a sign of manipulation. Ask a family member to stay with the client at home temporarily. Discuss the meaning of the client's statement with them.

Discuss the meaning of the client's statement with them.

A client with a diagnosis of anorexia nervosa is admitted to the psychiatric unit. The client is 5′ 8″ (1.7 m) tall, weighs only 103 lb (46.7 kg), and talks incessantly about how fat the client is. Which measure should the nurse take first when caring for this client? Teach the client about nutrition, calories, and a balanced diet. Establish a trusting relationship with the client. Discuss cultural stereotypes regarding thinness and attractiveness. Explore the reasons why the client doesn't eat.

Establish a trusting relationship with the client.

A nurse works with a client diagnosed with bulimia. What is the most appropriate long-term client goal for this client? Eat meals at home without bingeing or purging. Be able to eat out without bingeing or purging. Manage stresses in life without bingeing or purging. Be able to attend college without bingeing or purging.

Manage stresses in life without bingeing or purging.

The nurse is planning care for a client after being admitted in the emergency room for domestic violence. What would be the best action for the nurse? Teach client problem-solving techniques and structured activities. Use an insight-oriented analytic approach in the education. Send medication home to sedate the client. Use nondirective communication techniques, such as free association.

Teach client problem-solving techniques and structured activities.

A client reports severe pain in the back and joints. Upon reviewing the client's history, the nurse notes a diagnosis of depression and frequent hospitalizations for somatic illnesses. What should the nurse encourage this client to do? Tell the physician about the pain so that its cause can be determined. Remember all the client's previous "health problems" that weren't real. Try to get more rest and use relaxation techniques. Ignore the pain and focus on happy things.

Tell the physician about the pain so that its cause can be determined.

A client's cultural beliefs view emotional or mental illnesses as behavior that is out of control and that brings shame upon the family. Which response to psychological distress would be mostlikely to occur by the client given this cultural view? The client has to have order and symmetry. The client withdraws and has a lack of appetite. The client states symptoms of headache and vague gastrointestinal issues. The client develops a fear of crowds.

The client states symptoms of headache and vague gastrointestinal issues.

A client experienced the loss of home and beloved family dog in flood waters 4 months ago. The client states that since the loss, the client finds it hard to "feel anything." The client says they can't concentrate on simple tasks, thinks about the flood incessantly, and fears losing control. The client reports becoming extremely anxious whenever the flood is mentioned and must leave the room if people talk about it. The admitting nurse suspects the client has post-traumatic stress disorder (PTSD). Which nursing goal would be most appropriate for this client? The client will avoid disturbing thoughts or feelings associated with the trauma. The client will acclimate to the psychiatric unit. The client will be able to sleep 8 hours per night. The client will demonstrate progress in dealing with the grief of losing their home and dog.

The client will demonstrate progress in dealing with the grief of losing their home and dog.

The nurse is part of a team charged with making recommendations to create a healthy work environment. What workplace measure(s) would most likely support the health and well-being of workers? Select all that apply. workshops for workers nearing retirement counseling for workers exposed to traumatic events interventions for workers with substance use and related problems standard work hours that include scheduled rest periods education for workers regarding customary workplace practices

a,b,c

The nurse is developing a long-term care plan for an outpatient client diagnosed with dissociative identity disorder. Which intervention(s) should be included in this plan? Select all that apply. learning how to manage feelings, especially anger and rage joining several outpatient support groups that are process-oriented identifying resources to call when there is a risk of suicide or self-mutilation selecting a method for alternate personalities ("alters") to communicate with each other, such as journaling trying different medicines to find one that eliminates the dissociative process

a,c,d

A client diagnosed with borderline personality disorder has self-inflicted cuts on the arms. The nurse is assessing the client's risk for suicide. What should the nurse ask the client first? about medications the client has taken recently if the client is taking antidepressants if the client has a suicide plan why the client self-inflicted the cuts

if the client has a suicide plan

A client is admitted to an inpatient unit for treatment of recurrent anorexia nervosa. The client states that 1 month before admission the spouse took the children, moved out of the family home, and filed for divorce. The nurse recognizes that the exacerbation of anorexia nervosa most likely results from the client's effort to: manipulate the spouse. regain a sense of control. commit suicide. live up to parental expectations.

regain a sense of control.

The client with histrionic personality disorder is melodramatic and responds to others and situations in an exaggerated manner. The nurse should recommend which activity for this client? party planning music group cooking class role-playing

role-playing

A client and their partner come to the clinic stating they have been unable to have sexual intercourse. The female client states they have pain and their "vagina is too tight." The client was raped at 15 years of age. Which nursing diagnosis is mostappropriate for this client? dysfunctional grieving related to loss of self-esteem because of lack of sexual intimacy risk for trauma related to fear of vaginal penetration vaginismus related to vaginal constriction sexual dysfunction related to sexual trauma

sexual dysfunction related to sexual trauma

A client struggling with a binge eating disorder tells a nurse, "I don't know why I eat the way I do each night." What question would be most helpful for the nurse to ask this client? "What do you do when you feel stressed or upset?" "Do you worry that bad things will happen to you?" "Are there periods of time at night that you can't account for?" "Have you experienced changes in your leisure activities?"

"What do you do when you feel stressed or upset?"

An adolescent client is having difficulty coping following the drowning death of a close friend. The client reports recurring nightmares and intrusive thoughts about the friend's death. Which assessment is most important for the nurse to make? availability of social supports grades in school signs of isolation or withdrawal accessibility of drugs in school

availability of social supports

A client tells the nurse that they have been raped but has not reported it to the police. After determining whether the client was injured, whether it is still possible to collect evidence, and whether the client wants to file a report, the nurse's nextpriority is to offer which intervention to the client? legal assistance crisis intervention a rape support group medication for disturbed sleep

crisis intervention

The health care provider (HCP) refers a client diagnosed with somatization disorder to the outpatient clinic because of problems with nausea. The client's past symptoms involved back pain, chest pain, and problems with urination. The client tells the nurse that the nausea began when their spouse asked for a divorce. Which intervention is most appropriate? asking the client to describe their problem with nausea directing the client to describe their feelings about the impending divorce allowing the client to talk about the HCPs they have seen and the medications they have taken informing the client about a different medication for their nausea

directing the client to describe their feelings about the impending divorce

The client with borderline personality disorder spends much time around the nurse's station, making numerous minor requests. The nurse interprets these behaviors as indicating which factor? fears of abandonment and attention seeking enjoyment of bothering the staff boredom suggesting the need for something to do lack of desire for involvement in milieu activities

fears of abandonment and attention seeking

A female client who is hospitalized for an eating disorder weighs 15 lb (6.8 kg) less than the ideal body weight. Which goal is a priority for this client? attending all eating disorder support groups eating bigger meals at breakfast gaining 1 lb (0.5 kg) per week reporting an improved self-image

gaining 1 lb (0.5 kg) per week

A nurse is caring for a veteran, who exhibits signs and symptoms of posttraumatic stress disorder (PTSD). Signs and symptoms of posttraumatic stress disorder include: hyperalertness and sleep disturbances. memory loss of a traumatic event and somatic distress. feelings of hostility and violent behavior. sudden behavioral changes and anorexia.

hyperalertness and sleep disturbances.

A client diagnosed with paranoid personality disorder is hospitalized for physically threatening their spouse because they suspect the spouse is having an affair with a coworker. What approach should the nurse employ with this client? authoritarian parental matter-of-fact controlling

matter-of-fact

An adolescent client is being admitted with an eating disorder. Which initial assessment finding is of greatest concern for the nurse? systolic blood pressure of 86 mm Hg weight loss of 10% over 6 months potassium level of 2.5 mEq/L (2.5 mmol/L) heart rate of 57 bpm

potassium level of 2.5 mEq/L (2.5 mmol/L)

A client with a diagnosis of borderline personality disorder is admitted to the psychiatric unit. What assessment data obtained by the nurse correlates with the client's disorder? unpredictable actions and intense interpersonal relationships inability to function as a responsible parent chronic extreme pain that cannot be explained by any medical condition apathy, detachment, and lack of affectionate feelings

unpredictable actions and intense interpersonal relationships