Psych Midterm Questions

In order for a nurse to effectively use Peplau's theory of interpersonal relations, the nurse must first: A. Have a baccalaureate degree B. Care about the client with problems C. Demonstrate knowledge about therapeutic communication D. Deal effectively with personal feelings.

D. Deal effectively with personal feelings.

A nurse is assessing a client diagnosed with schizophrenia spectrum disorder. The nurse asks the client, "Do you receive special messages from certain sources, such as the television or radio?" The nurse is assessing which potential symptom of this disorder? A. Thought insertion B. Paranoia C. Magical thinking D. Delusions of reference

D. Delusions of reference

A client diagnosed with factitious disorder tells the nurse an incredible story about how he overcame a tremendous disability. Based on the client's history, the nurse knows that the story is not all true. The client is exhibiting which of the following? a) Malingering b) Pseudologia fantastica c) Hypochondriasis d) Alexithymia

b) Pseudologia fantastica

Which of the following is an inaccurate statement regarding body dysmorphic disorder (BDD)? a) The preoccupation with the defect causes significant distress. b) Surgical correction of the problem corrects the preoccupation. c) The patient feels self-conscious and may avoid public situations. d) It is a debilitating disorder and may impair the person's quality of life.

b) Surgical correction of the problem corrects the preoccupation.

Three predominant client populations have been identified as benefiting most from psychiatric home health care. Which of the following is not included among this group? a. Elderly individuals b. Individuals living in poverty c. Individuals with severe and persistent mental illness d. Individuals in acute crisis situations

b. Individuals living in poverty

A client newly diagnosed with bipolar disorder: manic phase tells the nurse, "Now that I'm only sleeping 4 hours a night, I can get so much more work accomplished." Which ego defense mechanism is this client using? a. Denial b. Intellectualization c. Rationalization d. Suppression

b. Intellectualization

Henry is a member of an Alcoholics Anonymous group. He learned about the effects of alcohol on the body when a nurse from the chemical dependency unit spoke to the group. This is an example of which curative factor? a. Catharsis. b. Altruism. c. Imparting of information. d. Universality.

c. Imparting of information

Which of the following is a disorder characterized by a preoccupation with an imagined or exaggerated defect in physical appearance, such as thinking one's nose if too large? a) Hypochondriasis b) Somatization disorder c) Conversion disorder d) Body dysmorphic disorder

d) Body dysmorphic disorder

Which of the following assessment questions is most likely to allow the nurse to differentiate between anxiety disorder due to a general medical condition and psychological factors affecting a medical condition? a) Questioning the client about the clinician who first diagnosed the medical problem b) Asking the client to provide a detailed explanation of his or her medical problem to determine if the presentation is typical of the problem c) Reviewing the client's previous medication administration record and the client's current list of medications d) Establishing whether the client's anxiety preceded the medical problem or whether the medical problem appeared first

d) Establishing whether the client's anxiety preceded the medical problem or whether the medical problem appeared first

A client who has been having difficulty functioning in his daily life comes to the nurse and states, "I'm really afraid. I've had these funny feelings in my stomach. I'm scared that I might have cancer." The client has been seen by numerous health care professionals and no evidence of cancer has been demonstrated. The nurse suspects which of the following? a) Conversion disorder b) Functional neurologic symptom disorder c) Factitious disorder d) Illness anxiety disorder

d) Illness anxiety disorder

Factors that differentiate dissociative amnesia from dissociative fugue include what? a) In dissociative amnesia, the person leaves abruptly. b) In dissociative fugue, the person forgets the past three days' events. c) In dissociative amnesia, the person can recall events clearly unless they are more than 3 weeks old. d) In dissociative fugue, the person suddenly and unexpectedly leaves home or work and is unable to recall the past.

d) In dissociative fugue, the person suddenly and unexpectedly leaves home or work and is unable to recall the past.

Which of the following occurs when a person inflicts illness or injury on someone else to gain the attention of medical personnel? a) Munchausen b) Malingering c) Body dysmorphic disorder d) Munchausen by proxy

d) Munchausen by proxy

The most severe form of factitious disorder includes which of the following? a) Malingering b) Alexithymia c) Hypochondriasis d) Munchausen's syndrome

d) Munchausen's syndrome

Receiving a back rub because he or she is sick is an example of a a) La belle indifference b) Malingering c) Primary gain d) Secondary gain

d) Secondary gain

A client with complex somatic symptom disorder is complaining of significant pain in the joints. When providing care to this client, which of the following would be most important for the nurse to keep in mind? a) Complementary therapies are usually of little benefit. b) Opioid analgesics are the primary mode of therapy. c) Outcomes need to reflect the biologic aspects of the pain. d) The client's experience of pain is real.

d) The client's experience of pain is real.

Which of the following may be influential in the predisposition to PTSD? a. Unsatisfactory parent-child relationship b. Excess of the neurotransmitters serotonin c. Distorted negative cognitions d. Severity of a stressor and availability of support systems

d. Severity of a stressor and availability of support systems

Psychotropic medications that block the reuptake of serotonin may result in which of the following side effects? a. Dry mouth b. Constipation c. Blurred vision d. Sexual dysfunction

d. Sexual dysfunction

In planning care for clients with a somatic symptom disorder, an appropriate long-term outcome for treatment would be that the client will ... a) Develop alternative coping mechanisms b) Assume responsibility for self-care activities c) Resume home maintenance activities d) Learn new diversional recreation patterns

a) Develop alternative coping mechanisms

Which of the following parts of the brain is concerned with hearing, short-term memory, and sense of smell? a. Temporal lobe b. Parietal lobe c. Cerebellum d. Hypothalamus

a. Temporal lobe

A client begins attendance at AA meetings. Which of the statements by the client reflects the purpose of AA? A. "they claim they will help me stay sober" B. " I'll dry out in AA, then I can have a social drink now and then" C. " AA is only for people who have reached the bottom" D. " if I loose my job AA will help me find another"

A. "they claim they will help me stay sober"

A client diagnosed with chronic alcohol addiction is being discharged from an inpatient treatment facility after detoxification. Which client outcome, related to Alcoholics Anonymous (AA), would be most appropriate for a nurse to discuss with the client during discharge teaching? A. After discharge, the client will immediately attend 90 AA meetings in 90 days. B. After discharge, the client will rely on an AA sponsor to help control alcohol cravings. C. After discharge, the client will incorporate family in AA attendance. D. After discharge, the client will seek appropriate deterrent medications through AA.

A. After discharge, the client will immediately attend 90 AA meetings in 90 days.

Guidelines relating to "duty to warn" states that a therapist should consider taking action to warn a third party when his or her client (select all that apply): A. Threatens violence toward another individual. B. Identifies a specific intended victim. C. Has command hallucinations. D. Reveals paranoid delusions about another individual.

A., B.

Which of the following rationales by a nurse explain to parents why is it difficult to diagnose a child or adolescent exhibiting symptoms of bipolar disorder? (Select all that apply.) a. Bipolar symptoms mimic attention deficit-hyperactivity disorder symptoms. b. Children are naturally active, energetic, and spontaneous. c. Neurotransmitter levels vary considerably in accordance with age. d. The diagnosis of bipolar disorder cannot be assigned prior to the age of 18. e. Genetic predisposition is not a reliable diagnostic determinant.

A., B.

Annie has a hair pulling disorder. She is receiving treatment at the mental health clinic with habit-reversal therapy. Which of the following elements would be included in this therapy? Select all that apply: A. Awareness training B. Competing response training C. Social support D. Hypnotherapy E. Aversive therapy

A., B., C.

Sally was sexually abused as a child. She is a client on the milieu unit with a diagnosis of Borderline Personality Disorder. She has refused to talk to anyone. Which of the following therapies might the IDT team choose for Sally? Select all that apply. a. Music therapy b. Art therapy c. Psychodrama d. Electroconvulsant therapy

A., B., C.

Which of the following are basic assumptions of milieu therapy? Select all that apply. a. The client owns his or her own environment b. Each client owns his or her behavior c. Peer pressure is a useful and powerful tool d. Inappropriate behaviors are punished immediately

A., B., C.

Joan's husband, who was deployed to Afghanistan a year ago, is returning home this week. Which of the following postdevelopment situations may be likely to occur during the first few months of his return? Select all the 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.

On the milieu unit, duties of the staff psychiatric nurse include which of the following? Select all that apply. a. Medication administration b. Client teaching c. Medical diagnosis d. Reality orientation e. Relationship development f. Group therapy

A., B., D., E.

A client who was started on an antidepressant complains of a dry mouth. The nurse's most appropriate response is to: A. Call the MD, immediately B. Offer sugarless gum, candy, or sips of water C. Assess BP D. Interpret the behavior as, attention- seeking

B. Offer sugarless gum, candy, or sips of water

A nurse is caring for a client who is experiencing a flat affect, paranoid delusions, anhedonia, anergia, neologisms, and echolalia. Which statement correctly differentiates the client's positive and negative symptoms of schizophrenia? A. Paranoia, anhedonia, and anergia are positive symptoms of schizophrenia. B. Paranoia, neologisms, and echolalia are positive symptoms of schizophrenia. C. Paranoia, anergia, and echolalia are negative symptoms of schizophrenia. D. Paranoia, flat affect, and anhedonia are negative symptoms of schizophrenia.

B. Paranoia, neologisms, and echolalia are positive symptoms of schizophrenia.

A client hates her mother because of  childhood neglect. The nurse determines which client statement represents the use of the defense mechanism of reaction formation? A. "I don't like to talk about my relationship with my mother." B. "My mother hates me." C. "I have a very wonderful mother whom I love very much." D. "My mom always loved my sister more than she loved me."

C. "I have a very wonderful mother whom I love very much."

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. I'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. "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."

The nurse is interviewing a newly admitted psychiatric client. Which nursing statement is an example of offering a "general lead"? A. "Do you know why you are here?" B. "Are you feeling depressed or anxious?" C. "Yes, I see. Go on." D. "Can you chronologically order the events that led to your admission?"

C. "Yes, I see. Go on."

Nurse Jones decides to tell the client of his terminal status because she believes it is her duty to do so. Which of the following at the clip the reasons considered in this decision? A. Natural law theories B. Ethical egoism C. Kantianism D. Utilitarianism

C. Kantianism

Which client statement indicates a knowledge deficit related to a substance use disorder? A. "Although it's legal, alcohol is one of the most widely abused drugs in our society." B. "Tolerance to heroin develops quickly." C. "Flashbacks from LSD use may reoccur spontaneously." D. "Marijuana is like smoking cigarettes. Everyone does it. It's essentially harmless."

D. "Marijuana is like smoking cigarettes. Everyone does it. It's essentially harmless."

Intervention with Andrew would include: a. encouraging expression of feelings b. antianxiety medications c. participation in a support group d. a and c e. all the above

E. All the above

The nurse is prioritizing nursing diagnoses in the plan of care for a patient experiencing manic episodes. Number the diagnoses in order the appropriate priority a. Disturbed sleep pattern evidenced by sleeping only 4 to 5 hours per night b. Risk for injury related to manic hyperactivity c. Impaired social interaction evidenced by manipulation of others d. Imbalanced nutrition: Less than body requirements evidenced by a loss of weight and poor skin turgor

a = 3 b = 1 c = 4 d = 2

During a group discussion, members freely interact with each other. Which member statement is an example of Yalom's curative group factor of imparting information? a. "I found a Web site explaining the different types of brain tumors and their treatment." b. "My mother was also diagnosed with cancer of the brain." c. "My brother also had a brain tumor and now is completely cured." d. "I understand your fear and will be by your side during this time."

a. "I found a Web site explaining the different types of brain tumors and their treatment."

Sandra is the nurse leader of a supportive/therapeutic group for individuals with anxiety disorders. Violet, who is beautiful but lacks self-confidence, states to the group, "Maybe if I became a blond my boyfriend would love me more." Larry responds, "Listen, dummy, you need more than blond hair to keep the guy around. A bit more in the brains department would help!" What type of member role is Larry assuming in this group? a. Aggressor. b. Monopolizer. c. Blocker. d. Seducer.

a. Aggressor

The nurse is using the nursing process to care for a suicidal client. Which of the following nursing actions is a part of the diagnosis step of the nursing process? a. Identifies nursing diagnosis: Risk for suicide. b. Notes client's family reports recent suicide attempt. c. Prioritizes the necessity for maintaining a safe environment for the client. d. Obtains a short-term contract from the client to seek out staff if feeling suicidal.

a. Identifies nursing diagnosis: Risk for suicide.

A school nurse notices bruises and scars on the child's body. The nurse suspects 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. As a health-care worker, report the suspicion to the Department of Health and Human Services

Which of the following parts of the brain is associated with voluntary body movement, thinking and judgment, and expression of feeling? a. Frontal lobe b. Parietal lobe c. Temporal lobe d. Occipital lobe

a. Frontal lobe

One of the goals of therapeutic community is for clients to become more independent and accept self-responsibility. Which of the following approaches by the staff best encourages fulfillment of this goal? a. Including client input and decisions into the treatment plan b. Insisting that each client take a turn as "president" of the community meeting c. Making decisions for the client regarding plans for treatment d. Requiring that the client be bathed, dressed, and attend breakfast on time each morning

a. Including client input and decisions into the treatment plan

When planning care for a client, which medication classification should a nurse recognize as effective in the treatment of Tourette's syndrome? a. Neuroleptic medications b. Anti-manic medications c. Tricyclic antidepressant medications d. Monoamine oxidase inhibitor medications

a. Neuroleptic medications

A polysubstance abuser makes the statement, "The green and whites do me good after speed." How might the nurse interpret the statement? a. The client abuses amphetamines and anxiolytics. b. The client abuses alcohol and cocaine. c. The client is psychotic. d. The client abuses narcotics and marijuana.

a. The client abuses amphetamines and anxiolytics.

A client's wife of 34 years dies unexpectantly. The client cries often and becomes social isolated. The client's therapist encourages open discussion of feelings, proper nutrition, and exercise. What is the best rationale for the therapist's recommendations? a. The client is susceptible to illness because of effects of stress on the immune system b. The therapist is using an interpersonal approach c. The client has an alteration in neurotransmitters d. It is routine practice to remind clients about nutrition, exercise, and rest

a. The client is susceptible to illness because of effects of stress on the immune system

The category of adjustment disorder with disturbance of conduct identifies the individual who: a. violates the rights of others to feel better b. expresses symptoms that reveal a high level of anxiety c. exhibits severe social isolation and withdrawal d. is experiencing a complicated grieving process

a. violates the rights of others to feel better

The nurse is caring for a client in the neighborhood clinic. The client tells the nurse that ever since he was an adolescent, he has avoided social situations because he has "one ear that is obviously bigger than the other ear." The nurse observes that one of the client's ears does not appear to be larger than the other ear. The nurse suspects that the client may be experiencing which of the following? a) Complex somatic symptom disorder b) Body dysmorphic disorder c) Factitious disorder d) Functional neurologic symptoms

b) Body dysmorphic disorder

The nurse is providing care to a client with somatic symptom disorder (SSD). Which of the following would the nurse expect to be included in the client's plan of care? a) Mood stabilizers to manage the symptoms b) Cognitive behavior therapy c) Multiple provider evaluations d) Electroconvulsive therapy

b) Cognitive behavior therapy

A client who has been taking fluvoxamine (Luvox) without significant improvement asks a nurse, "I heard about something called a monoamine oxidase inhibitor (MAOI). Can't my doctor add that to my medications?" Which is an appropriate nursing response? a. "This combination of drugs can lead to delirium tremens." b. "A combination of an MAOI and Luvox can lead to a life-threatening hypertensive crisis." c. "That's a good idea. There have been good results with the combination of these two drugs." d. "The only disadvantage would be the exorbitant cost of the MAOI."

b. "A combination of an MAOI and Luvox can lead to a life-threatening hypertensive crisis."

A family member is seeking advice about an older parent who seems to worry unnecessarily about everything. The family member states, "Should I seek psychiatric help for my mother?" Which is an appropriate nursing response? a. "Anxiety is a complex phenomenon and is effectively treated only with psychotropic medications." b. "Anxiety is considered abnormal when it is out of proportion to the stimulus causing it and when it impairs functioning." c. "From what you have told me, you should get her to a psychiatrist as soon as possible." d. "My mother also worries unnecessarily. I think it is part of the aging process."

b. "Anxiety is considered abnormal when it is out of proportion to the stimulus causing it and when it impairs functioning."

A nursing instructor is teaching about case management. What student statement indicates that learning has occurred? a. "Case management is a method used to achieve independent client care." b. "Case management provides coordination of services required to meet client needs." c. "Case management exists mainly to facilitate client admission to needed inpatient services." d. "Case management is a method to facilitate physician reimbursement."

b. "Case management provides coordination of services required to meet client needs."

What tool should a nurse use to differentiate occasional spontaneous behaviors of children from behaviors associated with bipolar disorder? a. "Risky Activity" tool b. "FIND" tool c. "Consensus Committee" tool d. "Monotherapy" tool

b. "FIND" tool

Which is the priority focus of recovery models? a. Empowerment of the health-care team to bring their expertise to decision-making b. Empowerment of the client to make decisions related to individual health care c. Empowerment of the family system to provide supportive care d. Empowerment of the physician to provide appropriate treatments

b. Empowerment of the client to make decisions related to individual health care

Which is the basic premise of a recovery model used to treat clients diagnosed with bipolar disorder? a. Medication adherence b. Empowerment of the consumer c. Total absence of symptoms d. Improved psychosocial relationships

b. Empowerment of the consumer

In establishing trust with Ellen, a client with the dx of DID, the nurse must: a. Try to relate to Ellen as though she did not have multiple personalities. b. Establish a relationship with each of the personalities separately. c. Ignore behaviors that Ellen attributes to Beth. d. Explain to Ellen that he or she will work with her only if she maintains the status of the primary personality.

b. Establish a relationship with each of the personalities separately.

Jana, age 5, is sent to school nurses 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. Jana is experiencing physical abuse and neglect.

Sandra is the nurse leader of a supportive/therapeutic group for individuals with anxiety disorders. In this group, Nancy talks incessantly. When someone else tries to make a comment, she refuses to allow him or her to speak. What type of member role is Nancy assuming in this group? a. Aggressor. b. Monopolizer. c. Blocker. d. Seducer.

b. Monopolizer

Which characteristic does the nurse expect to observe in a client who is being treated for a paraphilic disorder? a. High motivation for change due to significant distress associated with the condition b. Only treated if mandated by authorities c. Symptoms are recurrent over a period of at least 3 months. d. Concern about how the consequences of behaviors affect others

b. Only treated if mandated by authorities

A client with recurrent headaches has been told by the physician that the cause is likely the result of somatization. The client reports this conversation to the nurse and says, "That just can't be true! My head hurts so bad sometimes that it makes me sick to my stomach." The nurse's best response is a) To say nothing and sit quietly with the client. b) To give the client some privacy and time to calm down c) "The pain in your head is very real." d) "Well, that's not what your doctor thinks."

c) "The pain in your head is very real."

Which of the following scenarios best exemplifies the learning theory of the development of somatoform disorders? a) A person's family of origin models ineffective coping and conflict-based interactions. b) An individual's neuroendocrine system is overstimulated and the person becomes accustomed to this condition. c) A person unconsciously realizes that a particular physiological response produces a reward. d) An individual consciously develops fictitious complaints in order to distract himself or herself from stressors.

c) A person unconsciously realizes that a particular physiological response produces a reward.

Which question would be most effective when evaluating the outcome of crisis intervention? a. "Has education helped you with positive behavioral changes?" b. "Has crisis therapy precipitated maladaptive coping strategies?" c. "Have you grown from the experience?" d. "Why did you use maladaptive coping mechanisms to deal with this crisis?"

c. "Have you grown from the experience?"

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 importance 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. "I understand that you are concerned about your weight, and we will talk about the importance 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."

After receiving three ECT treatments, a client says to the nurse, "I feel so much better, but I'm having trouble remembering some things that happened last week." The nurse's best response would be a. "Don't worry about that. Nothing important happened." b. "Memory loss is just something you have to put up with in order to feel better." c. "Memory loss is a side effect of the ECT, but it is only temporary. Your memory should return within a few weeks." d. "Forget about last week, Mr. C. You need to look forward from here."

c. "Memory loss is a side effect of the ECT, but it is only temporary. Your memory should return within a few weeks."

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. Conducting a behavioral and needs assessment on John

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. feelings of guilt associated with the exploitation of others.

The nurse is caring for a client with schizophrenia. Orders from the physician include 100 mg of chlorpromazine IM STAT and then 50 mg PO bid; 2 mg benztropine PO bid prn. Why is the chlorpromazine ordered? a. to reduce extrapyramidal symptoms b. to prevent neuroleptic malignant syndrome c. to decrease psychotic symptoms d. to induce sleep

c. to decrease psychotic symptoms

Which of the following characteristics differentiates conversion disorder from malingering disorder? a) Conversion disorder has no pathophysiological cause, while malingering disorder has a neurological or endocrine basis. b) Conversion disorder produces reward, while malingering disorder normally results in punishment or difficulty. c) Conversion disorder is normally permanent, while malingering disorder is transient in response to stress. d) Conversion disorder is an unconscious process, while malingering disorder is a deliberate fabrication of symptoms.

d) Conversion disorder is an unconscious process, while malingering disorder is a deliberate fabrication of symptoms.

Factitious disorder by proxy is commonly inflicted by which family member upon a child? a) Sibling b) Father c) Grandparent d) Mother

d) Mother

A client on an inpatient unit angrily says to a nurse, "Peter is not cleaning up after himself in the community bathroom. You need to address this problem." Which is the appropriate nursing response? a. "I'll talk to Peter and present your concerns." b. "Why are you overreacting to this issue?" c. "You should bring this to the attention of your treatment team." d. "I can see that you are angry. Let's discuss ways to approach Peter with your concerns."

d. "I can see that you are angry. Let's discuss ways to approach Peter with your concerns."

A client diagnosed with bipolar I disorder is exhibiting severe manic behaviors. A physician prescribes lithium carbonate (Eskalith) and olanzapine (Zyprexa). The client's spouse questions the Zyprexa order. Which is the appropriate nursing response? a. "Zyprexa in combination with Eskalith cures manic symptoms." b. "Zyprexa prevents extrapyramidal side effects." c. "Zyprexa increases the effectiveness of the immune system." d. "Zyprexa calms hyperactivity until the Eskalith takes effect."

d. "Zyprexa calms hyperactivity until the Eskalith takes effect."

A 16-year-old client diagnosed with schizophrenia spectrum disorder experiences command hallucinations to harm others. The client's parents ask a nurse, "Where do the voices come from?" Which is the appropriate nursing response? A. "Your child has a chemical imbalance of the brain, which leads to altered thoughts." B. "Your child's hallucinations are caused by medication interactions." C. "Your child has too little serotonin in the brain, causing delusions and hallucinations." D. "Your child's abnormal hormonal changes have precipitated auditory hallucinations."

A. "Your child has a chemical imbalance of the brain, which leads to altered thoughts."

A client taking pheneizine (nardil), an MAOI, complains of a headache and nausea. The nurse's most appropriate response is to: A. Take the BP and contact the MD B. Asses for further flu-like symptoms C. Administer and prn anti-parkinsonian agent D. Give a prn aspirin

A. Take the BP and contact the MD

From which of the following symptoms might the nurse identify a chronic cocaine user? a. Clear, constricted pupils b. Red, irritated nostrils c. Muscle aches d. Conjunctival redness

b. Red, irritated nostrils

An elderly patient is being prepared for his first ECT. He asks the nurse, "how is this treatment going to help me?" The nurse's best response is: A. Although is is not exactly known how it works, research indicates it improves brain functioning for people with depression. B. It works by calming the brain cells C. It satisfies the need to be punished by individuals who feel a lot of guilt D. I do not know, but it works.

A. Although is is not exactly known how it works, research indicates it improves brain functioning for people with depression.

A client diagnosed with major depressive episode and substance use disorder has an altered sleep pattern and demands that a psychiatrist prescribe a sedative. Which rationale explains why a nurse should encourage the client to first try nonpharmacological interventions? A. Sedative-hypnotics are potentially addictive and will lose their effectiveness due to tolerance. B. Sedative-hypnotics are expensive and have numerous side effects. C. Sedative-hypnotics interfere with necessary REM (rapid eye movement) sleep. D. Sedative-hypnotics are not as effective to promote sleep as antidepressant medications.

A. Sedative-hypnotics are potentially addictive and will lose their effectiveness due to tolerance.

Lorraine has been diagnosed with Somatic Symptom Disorder. Which of the following symptom 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. Multiple somatic symptoms in several body systems.

Which therapeutic communication technique is being used in this nurse-client interaction? Client: "My father spanked me often." Nurse: "Your father was a harsh disciplinarian." A. Restatement B. Offering general leads C. Focusing D. Accepting

A. Restatement

Which contribution to modern psychiatric mental health nursing was made by Freud? A. The theory of personality structure and levels of awareness. B. The concept of " self-actualized personality" C. The thesis that culture and society exert significant influence on personality. D. Provision of a developmental model that includes the entire life span.

A. The theory of personality structure and levels of awareness.

Select the correct term for this definition: using increasing amounts of a substance over time to achieve the same effect and markedly diminished effects with continued use. A. Tolerance B Dependence C. Withdrawal D. Addiction

A. Tolerance

Which of the following instructions regarding lithium therapy should be included in a nurse's discharge teaching? (Select all that apply.) a. Avoid excessive use of beverages containing caffeine. b. Maintain a consistent sodium intake. c. Consume at least 2,500 to 3,000 mL of fluid per day. d. Restrict sodium content. e. Restrict fluids to 1,500 mL per day.

A., B., C.

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.

Mike, a veteran of combat in Afghanistan, has a diagnosis of mild TBI. The psychiatric home health nurse from the VA medical center is assigned to make home visits to Mike and his wife, Nancy, who is his caregiver. Which of the following would 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 placement for Mike.

A., C., D.

Which of the following are positive symptoms of schizophrenia? Select all that apply. A. auditory hallucinations B. Lack of motivation C. Use of clang associations D. Delusion of persecution E. flat effect

A., C., D.

Which of the following factors influence the development of a crisis? Select all that apply. a. The individual's perception of the event b. The time of year in which the event occurred c. The individual's age at the time of the event d. The presence of adequate coping mechanisms e. The individual's gender

A., D.

In order to return a client to a pre-crisis level of functioning, which client information should the nurse initially assess? a. Incompetency b. Psychotic episodes c. Personal strengths d. Family support

c. Personal strengths

Which statement about persons with personality disorders is accurate? A. They are at a low risk for suicide B. They tend to view their problems as caused by the behavior of others. C. Their symptoms are less disabling therefore care is less complicated D. They should readily be admitted to a psychiatric in-patient setting.

B. They tend to view their problems as caused by the behavior of others.

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. "If you continue to refuse to take food orally, you will be fed through a nasogastric tube."

A client diagnosed with post-traumatic stress disorder is admitted to an inpatient psychiatric unit for evaluation and medication stabilization. Which therapeutic communication technique used by the nurse is an example of a broad opening? A. "What occurred prior to the rape, and when did you go to the emergency department?" B. "What would you like to talk about?" C. "I notice you seem uncomfortable discussing this." D. "How can we help you feel safe during your stay here?"

B. "What would you like to talk about?"

A nurse is reviewing the stat laboratory data of a client in the emergency department. At what minimum blood alcohol level should a nurse expect intoxication to occur? A. 50 mg/dL B. 100 mg/dL C. 250 mg/dL D. 300 mg/dL

B. 100 mg/dL

A client's behavior is characterized by repeated attempts at manipulation of others. Which of the following is a priority STG? The client will: A. Spend more time alone B. Acknowledge own behavior C. Explore childhood experiences D. Sustain lasting relationships.

B. Acknowledge own behavior

Which nursing behavior will enhance the establishment of a trusting relationship with a client diagnosed with schizophrenia spectrum disorder? A. Establishing personal contact with family members. B. Being reliable, honest, and consistent during interactions. C. Sharing limited personal information. D. Sitting close to the client to establish rapport.

B. Being reliable, honest, and consistent during interactions.

Which of the following is the leading cause of 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. Blasts from explosive devices

A client with a history of heavy alcohol use is brought to an emergency department (ED) by family members who state that the client has had nothing to drink in the last 48 hours. When the nurse reports to the ED physician, which client symptom should be the nurse's first priority? A. Hearing and visual impairment B. Blood pressure of 180/100 mm Hg C. Mood rating of 2/10 on numeric scale D. Dehydration

B. Blood pressure of 180/100 mm Hg

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 an stress. c. She thinks psychiatrists are only for "crazy" people. d. She thinks her doctor has made an error in diagnosis.

B. She does not understand the correlation of symptoms an stress.

A patient with a diagnosis of schizophrenia presents in the ED verbalizing a series of jumbled words and phrases that makes no sense to the listener. The nurse realizes this is an example of what unusual speech pattern? A. Echolalia B. Word Salad C. Neologisms D. Clang Associations

B. Word Salad

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. imbalanced nutrition: less than body requirements

From a physiological point of view, the most common cause of obesity is probably: a. lack of nutritional education b. more calories consumed than expended c. impaired endocrine functioning d. low basal metabolic rate

B. more calories consumed than expended

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. repression of anxiety

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.

Which of the following is a true statement about mental health recovery? Select all that apply. a. Mental health recovery applies only to severe and persistent mental illnesses. b. Mental health recovery serves to provide empowerment to the consumer c. Mental health recovery is based on the medical model d. Mental health recovery is a collaborative process

B., D.

A client's wife has been making excuses for her alcoholic husband's work absences. In family therapy, she states, "His problems at work are my fault." Which is the appropriate nursing response? A. "Why do you assume responsibility for his behaviors?" B. "Codependency is a typical behavior of spouses of alcoholics." C. "Your husband needs to deal with the consequences of his drinking." D. "Do you understand what the term 'enabler' means?"

C. "Your husband needs to deal with the consequences of his drinking."

The nurse is caring for a patient who has been taking haloperidol (haldol) for 3 days. The patient suddenly cries out, and the nurse observes the patents eyes appearing to roll back in their sockets, as well as his neck twisted uncomfortable to one side. Which one of the following will the nurse anticipate administering, when contacting the provider? A. haldol 5 mg po X1 B Thorazine 25 mg po X1 C. Benadryl 25 mg IM X1 D. Cogentin 2 mg po X1

C. Benadryl 25 mg IM X1

A paranoid client diagnosed with schizophrenia spectrum disorder states, "My psychiatrist is out to get me. I'm sad that the voice is telling me to stop him." What symptom is the client exhibiting, and what is the nurse's legal responsibility related to this symptom? A. Magical thinking; administer an antipsychotic medication B. Persecutory delusions; orient the client to reality C. Command hallucinations; warn the psychiatrist D. Altered thought processes; call an emergency treatment team meeting

C. Command hallucinations; warn the psychiatrist

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. Fluoxetine (Prozac)

Which therapeutic communication technique is being used in this nurse-client interaction? Client: "When I am anxious, the only thing that calms me down is alcohol." Nurse: "Other than drinking, what alternatives have you explored to decrease anxiety?" A. Reflecting B. Making observations C. Formulating a plan of action D. Giving recognition

C. Formulating a plan of action

A 57 yr. old woman volunteers at a homeless shelter; assists grandmothers raising grandchildren; and reads to clients in a nursing home. According to Erickson theories of personality development, this woman's behaviors are appropriate for which development crisis ? A. Intimacy vs. Isolation B. Trust vs. Mistrust C. Generativity vs. self-absorption D. Industry vs Inferiority

C. Generativity vs. self-absorption

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. bradycardia, hypotension, hypothermia

Which nursing statement focuses on the personality factors that are implicated in the predisposition to the abuse of substances? A. "Hereditary factors are involved in the development of substance abuse disorders." B. "Alcohol produces morphine-like substances in the brain that are responsible for alcohol abuse." C. "A punitive superego is at the root of substance abuse." D. "A tendency toward addictive behaviors increases as low self-esteem, passivity, and an inability to relax or defer gratification increase."

D. "A tendency toward addictive behaviors increases as low self-esteem, passivity, and an inability to relax or defer gratification increase."

Which client statement demonstrates positive progress toward recovery from a substance use disorder? A. "I have completed detox and therefore am in control of my drug use." B. "I will faithfully attend Narcotic Anonymous (NA) when I can't control my cravings." C. "As a church deacon, my focus will now be on spiritual renewal." D. "Taking those pills got out of control. It cost me my job, marriage, and children."

D. "Taking those pills got out of control. It cost me my job, marriage, and children."

Which therapeutic communication technique is being used in this nurse-client interaction? Client: "When I get angry, I get into a fistfight with my wife or I take it out on the kids." Nurse: "I notice that you are smiling as you talk about this physical violence." A. Encouraging comparison B. Exploring C. Formulating a plan of action D. Making observations

D. Making observations

Which of the following may be influential in the predisposition to PTSD? A. unsatisfactory parent-child relationship B. excess of the neurotransmitter seretonin C. Distorted, negative cognitions D. Severity of the stressor and availability of support systems

D. Severity of the stressor and availability of support systems

Which of the following interventions would be best for a patient experiencing a panic attack? A. offer a divisional activity, like playing cards B. Place the patient in restraints, to prevent them from shaking C. Attempt to teach new relaxation technique D. Stay with the patient

D. Stay with the patient

A nurse is interviewing a client in an outpatient addiction clinic. To promote success in the recovery process, which outcome should the nurse expect the client to initially accomplish? A. The client will identify one person to turn to for support. B. The client will give up all old drinking buddies. C. The client will be able to verbalize the effects of alcohol on the body. D. The client will correlate life problems with alcohol use.

D. The client will correlate life problems with alcohol use.

A nurse states to a client, "Things will look better tomorrow after a good night's sleep." This is an example of which communication technique? A. The therapeutic technique of "giving advice" B. The therapeutic technique of "defending" C. The nontherapeutic technique of "presenting reality" D. The nontherapeutic technique of "giving false reassurance"

D. The nontherapeutic technique of "giving false reassurance"

Nursing care for a client with somatic symptom disorder would focus on helping the client to: A. eliminate the stress in his or her life B. discontinue his or her numerous physical complaints C. take his or her medication only as prescribed D. learn more adaptive coping strategies

D. learn more adaptive coping strategies

Which of the following mental health disorders is characterized by a fear of developing a serious illness based on a misinterpretation of body sensation? a) Hypochondriasis b) Alexithymia c) Body dysmorphic disorder d) Conversion disorder

a) Hypochondriasis

A client's family member asks the nurse, "What is a conversion disorder?" Which of the following is the best response by the nurse? a) It involves unexplained, usually sudden, deficits in sensory or motor function. b) It is a preoccupation with the fear that one has a serious disease. c) It is characterized by multiple physical symptoms. d) It is a preoccupation with an imagined or exaggerated defect in physical appearance.

a) It involves unexplained, usually sudden, deficits in sensory or motor function.

A nurse is assessing a client who is suspected of having somatic symptom disorder (SSD). Which of the following would the nurse expect to report as the most common complaint? a) Pain b) Dizziness c) Cough d) Nausea

a) Pain

The primary gain for a client with conversion disorder is which of the following? a) Relief from emotional conflict b) Identification of anxious feelings c) Emotional detachment d) Emotional support from family

a) Relief from emotional conflict

The nurse documents that the client is displaying symptomology of a dissociative disorder because when asked to provide a history of his life, he a) Replies, "I don't remember much about my life." b) Provides plausible but false information c) Claims to have forgotten details of certain time periods d) Provides events in extreme detail

a) Replies, "I don't remember much about my life."

A client has been diagnosed with conversion disorder. Which medication classification has been shown to be effective in some cases of somatoform disorders? a) SSRIs b) Antimanics c) Antipsychotics d) Antibiotics

a) SSRIs

A client, who is taking transdermal selegiline (Emsam) for depressive symptoms, states, "My physician told me there was no need to worry about dietary restrictions." Which would be the most appropriate nursing response? a. "Because your dose of Emsam is 6 mg in 24 hours, dietary restrictions are not recommended." b. "You must have misunderstood. An MAOI like Emsam always has dietary restrictions." c. "Only oral MAOIs require dietary restrictions." d. "All transdermal MAOIs do not require dietary modifications."

a. "Because your dose of Emsam is 6 mg in 24 hours, dietary restrictions are not recommended."

Which nursing statement to a client about social anxiety disorder versus schizoid personality disorder is most accurate? a. "Clients diagnosed with social anxiety disorder avoid interactions only in social settings, whereas clients diagnosed with schizoid personality disorder avoid interactions in all areas of life." b. "Clients diagnosed with schizoid personality disorder avoid interactions only in social settings, whereas clients diagnosed with social anxiety disorder tend to avoid interactions in all areas of life." c. "Clients diagnosed with schizoid personality disorder are distressed y the symptoms experienced in social settings, whereas clients diagnosed with social anxiety disorder are not." d. "Clients diagnosed with social anxiety disorder an manage anxiety without medications, whereas clients diagnosed with schizoid personality disorder can only manage anxiety with medications."

a. "Clients diagnosed with social anxiety disorder avoid interactions only in social settings, whereas clients diagnosed with schizoid personality disorder avoid interactions in all areas of life."

An individual with a history of antisocial personality disorder was arrested for driving under the influence of alcohol and causing a serious car accident. Which comment on this behavior would be expected? a. "It's not my fault." b. "I'm too ashamed to talk about it." c. "I just don't remember doing it." d. "I'm really sorry about all the people I've hurt."

a. "It's not my fault."

A depressed client states, "I have a chemical imbalance in my brain. I have no control over my behavior. Medications are my only hope to feel normal again." Which nursing response is appropriate? a. "Medications only address biological factors. Environmental and interpersonal factors must also be considered." b. "Because biological factors are the sole cause of depression, medications will improve your mood." c. "Environmental factors have been shown to exert themost influence in the development of depression." d. "Researchers have been unable to demonstrate a link between nature (biology and genetics) and nurture (environment)."

a. "Medications only address biological factors. Environmental and interpersonal factors must also be considered."

A newly admitted client asks, "Why do we need a unit schedule? I'm not going to these groups. I'm here to get some rest." Which is the most appropriate nursing response? a. "The purpose of group therapy is to learn and practice new coping skills." b. "Group therapy is mandatory. All clients must attend." c. "Group therapy is optional. You can go if you find the topic helpful and interesting." d. "Group therapy is an economical way of providing therapy to many clients concurrently."

a. "The purpose of group therapy is to learn and practice new coping skills."

A client at the mental health clinic tells the case manager, "I can't think about living another day, but don't tell anyone about the way I feel. I know you are obligated to protect my confidentiality." Which case manager response is most appropriate? a. "The treatment team is composed of many specialists who are working to improve your ability to function. Sharing this information with the team is critical to your care." b. "Let's discuss steps that will resolve negative lifestyle choices that may have increased your suicidal risk." c. "You seem to be preoccupied with self. You should concentrate on hope for the future." d. "This information is secure with me because of client confidentiality."

a. "The treatment team is composed of many specialists who are working to improve your ability to function. Sharing this information with the team is critical to your care."

Dan begins attendance at AA meetings. Which of the statements by Dan reflects the purpose of this organization? a. "They claim they will help me stay sober." b. "I'll dry out in AA, then I can have a social drink now and then." c. "AA is only for people who have reached the bottom." d. "If I lose my job, AA will help me find another."

a. "They claim they will help me stay sober."

A nursing instructor presents a case study in which a three-year-old child is in constant motion and is unable to sit still during story time. She asks a student to evaluate this child's behavior. Which student response indicates an appropriate evaluation of the situation? a. "This child's behavior must be evaluated according to developmental norms." b. "This child has symptoms of attention deficit-hyperactivity disorder." c. "This child has symptoms of the early stages of autistic disorder." d. "This child's behavior indicates possible symptoms of oppositional defiant disorder."

a. "This child's behavior must be evaluated according to developmental norms."

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 medicine." 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 medicine, the doctor can order a different kind for you."

a. "You may feel dizzy when you stand up, so go slowly when you get up from sitting or lying down."

The physician orders lithium carbonate 600 mg tid for a newly diagnosed client with BP 1 disorder. There is a narrow margin between the therapeutic and toxic levels of lithium. Therapeutic range for acute mania is: a. 1.0 to 1.5 mEq/L b. 10 to 15 mEq/L c. 0.5 to 1.0 mEq/L d. 5 to 10 mEq/L

a. 1.0 to 1.5 mEq/L

Approximately two million American children have experienced the deployment of a parent to Iraq or Afghanistan. How many of these children either lost a parent or have a parent who was wounded in these conflicts? a. 48,000 b. 26,000 c. 11,000 d. 8,000

a. 48,000

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. Absence of parental bonding

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 attacks? a. Alprazolam b. Lithium c. Carbamazepine d. Haldol

a. Alprazolam

During the initial interview with a client in crisis, which intervention should the mental health nurse initially implement? a. Assess the potential for self-harm. b. Assess the adequacy of the client's support system. c. Assess the level of pre-crisis functioning. d. Assess for substance use disorder

a. Assess the potential for self-harm.

A client tells the nurse, "You're so much nicer than that mean nurse on nightshift." This statement would be associated with which personality disorder? a. Borderline personality disorder b. Narcissistic personality disorder c. Schizotypal personality disorder d. Avoidant personality disorder

a. Borderline personality disorder

A nurse assesses an adolescent client diagnosed with conduct disorder who, at the age of 8, was sentenced to juvenile detention. How should the nurse interpret this assessment data? a. Childhood-onset conduct disorder is more severe than the adolescent-onset type, and these individuals are more likely to develop antisocial personality disorder in adulthood. b. Childhood-onset conduct disorder is caused by a difficult temperament, and the child is likely to outgrow these behaviors by adulthood. c. Childhood-onset conduct disorder is diagnosed only when behaviors emerge before the age of 5, and, therefore, improvement is likely. d. Childhood-onset conduct disorder has no treatment or cure, and children diagnosed with this disorder are likely to develop progressive oppositional defiant disorder.

a. Childhood-onset conduct disorder is more severe than the adolescent-onset type, and these individuals are more likely to develop antisocial personality disorder in adulthood.

Which symptoms should a nurse recognize that differentiate a client diagnosed with obsessive-compulsive disorder (OCD) from a client diagnosed with obsessive-compulsive personality disorder? a. Clients diagnosed with OCD experience both obsessions and compulsions, and clients diagnosed with obsessive-compulsive personality disorder do not. b. Clients diagnosed with obsessive-compulsive personality disorder experience both obsessions and compulsions, and clients diagnosed with OCD do not. c. Clients diagnosed with OCD experience only obsessions, and clients diagnosed with obsessive-compulsive personality disorder experience only compulsions. d. Clients diagnosed with obsessive-compulsive personality disorder experience only obsessions, and clients diagnosed with OCD experience only compulsions.

a. Clients diagnosed with OCD experience both obsessions and compulsions, and clients diagnosed with obsessive-compulsive personality disorder do not.

A nurse is attempting to differentiate between the symptoms of anorexia nervosa and the symptoms of bulimia. Which statement delineates the difference between these two disorders? a. Clients diagnosed with anorexia nervosa experience extreme nutritional deficits, whereas clients diagnosed with bulimia nervosa do not. b. Clients diagnosed with bulimia nervosa experience amenorrhea, whereas clients diagnosed with anorexia nervosa do not. c. Clients diagnosed with bulimia nervosa experience hypotension, edema, and lanugo, whereas clients diagnosed with anorexia nervosa do not. d. Clients diagnosed with anorexia nervosa have eroded tooth enamel, whereas clients diagnosed with bulimia nervosa do not.

a. Clients diagnosed with anorexia nervosa experience extreme nutritional deficits, whereas clients diagnosed with bulimia nervosa do not.

La belle indifference is a seeming lack of concern or distress. The la belle indifference occurs in which of the following somatoform disorders? a. Conversion disorder b. Body dysmorphic disorder c. Hypochondriasis d. Somatization disorder

a. Conversion disorder

A client is admitted to an emergency department experiencing memory deficits and decreased motor function. What alteration in brain chemistry should a nurse correlate with the production of these symptoms? a. Decreased levels of acetylcholine b. Decreased levels of dopamine c. Abnormal levels of serotonin d. Increased levels of norepinephrine

a. Decreased levels of acetylcholine

During a community meeting, a nurse encourages clients to present unit problems and discuss possible solutions. Which type of leadership style is the nurse demonstrating? a. Democratic b. Autocratic c. Laissez-faire d. Bureaucrati

a. Democratic

By which biological mechanism does EMDR achieve its therapeutic effect? a. EMDR achieves its therapeutic effect, but the exact biological mechanism is unknown. b. EMDR achieves its therapeutic effect by causing a decrease in imagery vividness. c. EMDR achieves its therapeutic effect by causing an increase in memory access. d. EMDR achieves its therapeutic effect by decreasing trauma associated anxiety.

a. EMDR achieves its therapeutic effect, but the exact biological mechanism is unknown.

To promote self-reliance, how should a psychiatric nurse best conduct medication administration? a. Encourage clients to request their medications at the appropriate times. b. Refuse to administer medications unless clients request them at the appropriate times. c. Allow the clients to determine appropriate medication times. d. Take medications to the clients' bedside at the appropriate times.

a. Encourage clients to request their medications at the appropriate times.

A client diagnosed with antisocial personality disorder is admitted to the inpatient unit after setting the police chief's house on fire. The client is scheduled for further psychological testing this morning. Which nursing intervention takes priority? a. Instruct the client about psychological testing. b. Explore alternatives to pyromania. c. Limit the client's social interactions. d. Encourage the client to follow the unit rules.

a. Instruct the client about psychological testing.

The ultimate goal of therapy for a client with DID is: 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. Integration of the personalities into one

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. Lack of guilt for wrongdoing

A client diagnosed with a substance use disorder is experiencing delirium related to alcohol withdrawal syndrome. Which nursing intervention should be prioritized? a. Maintain seizure precautions. b. Restrict fluid intake. c. Increase sensory stimuli. d. Apply ankle and wrist restraints.

a. Maintain seizure precautions.

Although historically lithium has been the drug of choice for mania, several other drugs have been used with good results. Which of the following are used in the treatment of bipolar disorder? (Select all that apply) a. Olanzepine (Zyprexa) b. Paroxetine (Paxil) c. Carbamazepine (Tegretol) d. Gabapentin (Neurontin) e. Tranylcypromine (Parnate)

a. Olanzepine (Zyprexa) c. Carbamazepine (Tegretol) d. Gabapentin (Neurontin)

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. Overly self-centered and exploitative of others

Which factors differentiate the diagnosis of PTSD from the diagnosis of adjustment disorder (AD)? a. PTSD results from exposure to an extreme traumatic event, whereas AD results from exposure to "normal" daily events. b. AD results from exposure to an extreme traumatic event, whereas PTSD results from exposure to "normal" daily events. c. Depressive symptoms occur in PTSD and not in AD. d. Depressive symptoms occur in AD and not in PTSD.

a. PTSD results from exposure to an extreme traumatic event, whereas AD results from exposure to "normal" daily events.

John, a veteran of the war in Iraq, is diagnosed with PTSD. Which of the following therapy regimens would most appropriately be ordered for John? a. Paroxetine and group therapy b. Diazepam and implosion therapy c. Alprazolam and behavior therapy d. Carbamazepine and cognitive therapy

a. Paroxetine and group therapy

A nurse is assessing a pathological gambler. What would differentiate this client's behaviors from the behaviors of a non-pathological gambler? a. Pathological gamblers have abnormal levels of neurotransmitters, whereas non-pathological gamblers do not. b. Pathological gambling occurs more commonly among women, whereas non-pathological gambling occurs more commonly among men. c. Pathological gambling generally runs an acute course, whereas non-pathological gambling runs a chronic course. d. Pathological gambling is not related to stress relief, whereas non-pathological gambling is related to stress relief

a. Pathological gamblers have abnormal levels of neurotransmitters, whereas non-pathological gamblers do not.

A school nurse provides education on drug abuse to a high school class. This nursing action is an example of which level of preventive care? a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Primary intervention

a. Primary prevention

The nurse is using the nursing process to care for a suicidal client. Which of the following nursing actions is a part of the planning step of the nursing process? a. Prioritizes the necessity for maintaining a safe environment for the client. b. Determines if nursing interventions have been appropriate to achieve desired results. c. Obtains a short-term contract from the client to seek out staff if feeling suicidal. d. Establishes goal of care: Client will not harm self during hospitalization.

a. Prioritizes the necessity for maintaining a safe environment for the client.

A client is diagnosed with bipolar disorder: manic episode. Which nursing intervention would be implemented to achieve the outcome of "Client will gain 2 lb by the end of the week?" a. Provide client with high-calorie finger foods throughout the day. b. Accompany client to cafeteria to encourage adequate dietary consumption. c. Initiate total parenteral nutrition to meet dietary needs. d. Teach the importance of a varied diet to meet nutritional needs.

a. Provide client with high-calorie finger foods throughout the day.

The client says to the nurse, "I've been offered a promotion, but I don't know if I can handle it." The nurse replies, "You're afraid you may fail in the new position." This is an example of which therapeutic technique? a. Restating b. Making observations c. Focusing d. Verbalizing the implied

a. Restating

In the initial stages of caring for a client experiencing an acute manic episode, what should the nurse consider to be the priority nursing diagnosis? a. Risk for injury related to excessive hyperactivity b. Disturbed sleep pattern related to manic hyperactivity c. Imbalanced nutrition, less than body requirements, related to inadequate intake d. Situational low self-esteem related to embarrassment secondary to high-risk behaviors

a. Risk for injury related to excessive hyperactivity

Which of the following nursing diagnoses would be considered the priority in planning care for the child with autism spectrum disorder? 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. Risk for self-mutilation evidenced by banging head against wall

A client diagnosed with bipolar disorder: depressive episode intentionally overdoses on sertraline (Zoloft). Family members report that the client has experienced anorexia, insomnia, and recent job loss. Which nursing diagnosis should a nurse prioritize? a. Risk for suicide R/T hopelessness b. Anxiety: severe R/T hyperactivity c. Imbalanced nutrition: less than body requirements R/T refusal to eat d. Dysfunctional grieving R/T loss of employment

a. Risk for suicide R/T hopelessness

Which of the following represents a nursing intervention at the tertiary level of prevention? a. Serving as a 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. Serving as a case manager for a mentally ill homeless client.

Mr. White is admitted to the hospital after an extended period of binge alcohol drinking. His wife reports that he has been a heavy drinker for a number of years. Lab reports reveal he has a blood alcohol level of 250 mg/dL. He is placed on the chemical addictions unit for detoxification. When would the first signs of alcohol withdrawal symptoms be expected to occur? a. Several hours after the last drink. b. 2 to 3 days after the last drink. c. 4 to 5 days after the last drink. d. 6 to 7 days after the last drink.

a. Several hours after the last drink.

A nurse who is helping a client in the preparation stage of the Psychological Recovery Model might include which of the following interventions? a. Teach about effects of the illness and how to recognize, monitor, and manage symptoms. b. Help the client identify "triggers" that cause distress or discomfort. c. Help the client establish a daily maintenance list. d. Listen actively while the client composes his or her personal story

a. Teach about effects of the illness and how to recognize, monitor, and manage symptoms.

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. Teaching a class in parent effectiveness training

A child diagnosed with severe autistic spectrum disorder has the nursing diagnosis disturbed personal identity. Which outcome would best address this client diagnosis? a. The client will name own body parts as separate from others by day five. b. The client will establish a means of communicating personal needs by discharge. c. The client will initiate social interactions with caregivers by day four. d. The client will not harm self or others by discharge.

a. The client will name own body parts as separate from others by day five.

During an inpatient educational group, a client shouts out, "This information is worthless. Nothing you have said can help me." These statements indicate to a nurse leader that the client is assuming which group role? a. The group role of aggressor b. The group role of initiator c. The group role of gatekeeper d. The group role of blocker

a. The group role of aggressor

Which cerebral structure should a nursing instructor describe to students as the "emotional brain"? a. The limbic system b. The cortex c. The left temporal lobe d. The cerebellum

a. The limbic system

After an adolescent diagnosed with attention deficit-hyperactivity disorder (ADHD) begins methylphenidate (Ritalin) therapy, a nurse notes that the adolescent loses 10 pounds in a 2-month period. What is the best explanation for this weight loss? a. The pharmacological action of Ritalin causes a decrease in appetite. b. Hyperactivity seen in ADHD causes increased caloric expenditure. c. Side effects of Ritalin cause nausea, and, therefore, caloric intake is decreased. d. Increased ability to concentrate allows the client to focus on activities rather than food.

a. The pharmacological action of Ritalin causes a decrease in appetite.

A 10-week, prenuptial counseling group composed of five couples is terminating. At the last group meeting, a nurse notices that the two most faithful and participative couples are absent. When considering concepts of group development, what might explain this behavior? a. They are experiencing problems with termination, leading to feelings of abandonment b. They did not think any new material would be covered at the last session c. They were angry with the leader for not extending the length of the group d. They were bored with the material covered in the group.

a. They are experiencing problems with termination, leading to feelings of abandonment

A nurse reviews the laboratory data of a client suspected of having the diagnosis of major depressive episode. Which lab value would potentially rule out this diagnosis? a. Thyroid-stimulating hormone (TSH) level of 25 U/mL b. Potassium (K+) level of 4.2 mEq/L c. Sodium (Na+) level of 140 mEq/L d. Calcium (Ca2+) level of 9.5 mg/dL

a. Thyroid-stimulating hormone (TSH) level of 25 U/mL

The physician has ordered lithium carbonate (Eskalith) for a client diagnosed with bipolar disorder. What is the most likely rationale for prescribing this drug? a. To decrease hyperactivity b. To control anger c. To elevate the mood d. To diminish anxiety

a. To decrease hyperactivity

The binging episode is thought to involve: a. a release of tension, followed by feelings of depression b. feelings of fear, followed by feelings of relief c. unmet dependency needs and a way to gain attention d. feelings of euphoria, excitement, and self-gratification

a. a release of tension, followed by feelings of depression

Clint, a client on the psych unit, has been diagnosed with Schizophrenia. He begins to tell the nurse about how the CIA is looking for him and will kill him if they find him. Clints belief is an example of a: a. delusion of persecution b. delusion of reference c. delusion of control or influence d. delusion of grandeur

a. delusion of persecution

Dan, who has been admitted to the alcohol rehabilitation unit after being fired for drinking on the job, states to the nurse, "I don't have a problem with alcohol. I can handle my booze better than anyone I know. My boss is a jerk! I haven't missed any more days than my coworkers." The defense mechanism that Dan is using is: a. denial. b. projection. c. displacement. d. rationalization.

a. denial.

The physician orders sertraline (Zoloft) for a client who is hospitalized with adjustment disorder with depressed mood. This medication is intended to: a. increase energy and elevate mood b. stimulate the central nervous system c. prevent psychotic symptoms d. produce a calming effect

a. increase energy and elevate mood

Psychoanalytically, the theory of obesity relates to the individual's unconscious equation of food with: a. nurturance and caring b. power and control c. autonomy and emotional growth d. strength and endurance

a. nurturance and caring

Kim, a client diagnosed with Borderline Personality Disorder, manipulates 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 one 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. refusal to stay in room alone, stating, "It's so lonely."

A battered women presents to the ED with multiple cuts and abrasions. Her right eye is swollen shut. She says her husband did this to her. The priority is: a. tending to the immediate care for her wounds b. providing her with info about a safe place to stay c. admin the prn tranquilizer ordered by the physician d. explain how she can bring charges against her hustband

a. tending to the immediate care for her wounds

The nurse is preparing a patient for an electroconvulsive therapy (ECT) treatment. About 30 minutes prior to the treatment the nurse administers atropine sulfate 0.4 mg IM. Rationale for this order is: a. to decrease secretions and increase heart rate b. to relax muscles c. to produce a calming effect d. to induce anesthesia

a. to decrease secretions and increase heart rate

When describing the term alexithymia as a personality trait associated with somatic symptom disorder, which of the following would the nurse include in the explanation? a) Physical symptoms identified by the client b) Difficulty identifying and expressing emotion c) Neuroactivity in brain areas d) An issue involving cognition

b) Difficulty identifying and expressing emotion

A mother brings her teenaged son, who is complaining of having a severe headache, to the clinic. The teenager is groaning with pain. During assessment, the client asks the nurse for a note to excuse his absence from school. After further assessment, the nurse suspects that the client is malingering. What leads the nurse to come to this conclusion? Choose the best answer. a) The client reported having signs related to raised intracranial pressure, such as nausea. b) The client's symptoms disappeared after getting the medical note. c) The client's symptoms may have been a result of stress caused by studying all night for an exam. d) The client was not found to have any underlying cause of headache on assessment.

b) The client's symptoms disappeared after getting the medical note.

Which of the following is a significant obstacle in providing psychiatric care for clients who have somatoform disorders? a) Clients are often embarrassed about the number and extent of their physical complaints. b) They are often unrecognized because clients receive treatment in different primary care offices, and care is often fragmented. c) Clients with these disorders find it difficult to go to a clinic setting. d) There are no known successful treatments for these disorders.

b) They are often unrecognized because clients receive treatment in different primary care offices, and care is often fragmented.

Sharon, a women 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 him." The best response is, 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. "It is not your fault. You did the right thing by coming here."

Dan, who has been admitted to the alcohol rehabilitation unit after being fired for drinking on the job, states to the nurse, "I don't have a problem with alcohol. I can handle my booze better than anyone I know. My boss is a jerk! I haven't missed any more days than my coworkers." The nurse's best response is: a. "Maybe your boss is mistaken, Dan." b. "You are here because your drinking was interfering with your work, Dan." c. "Get real, Dan! You're a boozer and you know it!" d. "Why do you think your boss sent you here, Dan?"

b. "You are here because your drinking was interfering with your work, Dan."

A child has been diagnosed with autistic spectrum disorder. The distraught mother cries out, "I'm such a terrible mother. What did I do to cause this?" Which nursing response is most appropriate? a. "Researchers really don't know what causes autistic spectrum disorder, but the relationship between autistic disorder and fetal alcohol syndrome is being explored." b. "Poor parenting doesn't cause autistic spectrum disorder. Research has shown that abnormalities in brain structure or function are to blame. This is beyond your control." c. "Research has shown that the mother appears to play a greater role in the development of autistic spectrum disorder than the father." d. "Lack of early infant bonding with the mother has shown to be a cause of autistic spectrum disorder. Did you breastfeed or bottle-feed?"

b. "Poor parenting doesn't cause autistic spectrum disorder. Research has shown that abnormalities in brain structure or function are to blame. This is beyond your control."

A nursing instructor is teaching about the guiding principles of the recovery model, as described by the Substance Abuse and Mental Health Services Administration (SAMHSA). Which student statement indicates that further teaching is needed? a. "Recovery occurs via many pathways." b. "Recovery emerges from strong religious affiliations." c. "Recovery is supported by peers and allies." d. "Recovery is culturally based and influenced."

b. "Recovery emerges from strong religious affiliations."

A nursing instructor is teaching about recovery as it applies to mental illness. Which student statement indicates that further teaching is needed? a. "The goal of recovery is improved health and wellness." b. "The goal of recovery is expedient, comprehensive behavioral change." c. "The goal of recovery is the ability to live a self-directed life." d. "The goal of recovery is the ability to reach full potential"

b. "The goal of recovery is expedient, comprehensive behavioral change."

A nursing instructor is explaining the etiology of trauma-related disorders from a learning theory perspective. Which student statement indicates that learning has occurred? a. "How clients perceive events and view the world affect their response to trauma." b. "The psychic numbing in PTSD is a result of negative reinforcement." c. "The individual becomes addicted to the trauma owing to an endogenous opioid response." d. "Believing that the world is meaningful and controllable can protect an individual from PTSD."

b. "The psychic numbing in PTSD is a result of negative reinforcement."

A nursing student is learning about schizotypal personality disorder. Which statement by the student indicates that learning has occurred? a. "These individuals have peculiarities of ideation." b. "These individuals display irresponsible and guiltless behavior." c. "These individuals are overly disciplined and perfectionistic." d. "These individuals have an unrealistic sense of entitlement."

b. "These individuals display irresponsible and guiltless behavior."

A client receiving EMDR therapy says, "After only two sessions of my therapy, I am feeling great. Now I can stop and get on with my life." Which of the following nursing responses is most appropriate? a. "I am thrilled that you have responded so rapidly to EMDR." b. "To achieve lasting results, all eight phases of EMDR must be completed." c. "If I were you, I would complete the EMDR and comply with doctor's orders." d. "How do you feel about continuing the therapy?"

b. "To achieve lasting results, all eight phases of EMDR must be completed."

Nina, who is depressed following the breakup of a very stormy marriage, says to the nurse, "I feel so bad. I thought i would feel better once I left. But I feel worse!" Which is the best response by the nurse? a. "Cheer up Nina, you have a lot to be happy about." b. "You are grieving for the marriage you did not have. It's natural for you to feel badly." c. "Try not to dwell on how you feel. If you don't think about it, you'll feel better." d. "You did the right thing, Nina. Knowing that should make you feel better."

b. "You are grieving for the marriage you did not have. It's natural for you to feel badly."

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

b. CNS stimulants (e.g., methylphenidate [Ritalin])

Kate is an 18-year-old freshmen at the state university. She was extremely flattered when Don, a senior star football plater, 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 flight him, but his physical strength overpowered her. He dumped her in the dorm parking lot and left. The dorm supervisor rusked Kate to the ED. 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. "You are not to blame for his behavior. You obviously made some right decisions, because you survived the attack."

John tells the nurse, "I think lights out at 10 o'clock on a weekend is stupid. We should be able to watch TV until midnight!" Which of the following is the most appropriate response from the nurse on the milieu unit? a. "John, you were told the rules when you were admitted." b. "You may bring it up before the others at the community meeting, John." c. "Some people want to go to bed early, John." d. "You are not the only person on this unit, John. You must think of the others."

b. "You may bring it up before the others at the community meeting, John."

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

b. A lifelong pattern of social withdrawal

A physician orders methylphenidate (Ritalin) for a child diagnosed with ADHD. Which information about this medication should the nurse provide to the parents? a. If one dose of Ritalin is missed, double the next dose. b. Administer Ritalin to the child after breakfast. c. Administer Ritalin to the child just prior to bedtime. d. A side effect of Ritalin is decreased ability to learn.

b. Administer Ritalin to the child after breakfast.

A client diagnosed with bipolar disorder is distraught over insomnia experienced over the last 3 nights and a 12-pound weight loss over the past 2 weeks. Which should be this client's priority nursing diagnosis? a. Knowledge deficit R/T bipolar disorder AEB concern about symptoms b. Altered nutrition: less than body requirements R/T hyperactivity AEB weight loss c. Risk for suicide R/T powerlessness AEB insomnia and anorexia d. Altered sleep patterns R/T mania AEB insomnia for the past 3 nights

b. Altered nutrition: less than body requirements R/T hyperactivity AEB weight loss

A client has an IQ of 47. Which nursing diagnosis best addresses a client problem associated with this degree of IDD? a. Risk for injury R/T self-mutilation b. Altered social interaction R/T non-adherence to social convention c. Altered verbal communication R/T delusional thinking d. Social isolation R/T severely decreased gross motor skills

b. Altered social interaction R/T non-adherence to social convention

A client has been assigned a nursing diagnosis of complicated grieving related to the death of multiple family members in a motor vehicle accident. Which intervention should the nurse initially employ? a. Encourage the journaling of feelings. b. Assess for the stage of grief in which the client is fixed. c. Provide community resources to address the client's concerns. d. Encourage attending a grief therapy group.

b. Assess for the stage of grief in which the client is fixed.

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. Binging, purging, normal weight, hypokalemia

A child has been recently diagnosed with mild IDD. What information about this diagnosis should the nurse include when teaching the child's mother? a. Children with mild IDD need constant supervision. b. Children with mild IDD develop academic skills up to a sixth-grade level. c. Children with mild IDD appear different from their peers. d. Children with mild IDD have significant sensory-motor impairment.

b. Children with mild IDD develop academic skills up to a sixth-grade level.

Which of the following medications is the physician most likely to order for a client experiencing alcohol withdrawal syndrome? a. Haloperidol (Haldol) b. Chlordiazepoxide (Librium) c. Methadone (Dolophine) d. Phenytoin (Dilantin)

b. Chlordiazepoxide (Librium)

Nina recently left her husband of 10 years. She was very dependent on her husband and is having difficulties adjusting to an independent lifestyle. She has been hospitalized with a diagnosis of Adjustment Disorder with depressed mood. The priority nursing diagnosis for Nina would be: a. Risk-prone health behavior r/t loss of dependency b. Complicated grieving r/t breakup of marriage c. Ineffective coping r/t problems with dependency d. Social isolation r/t depressed mood

b. Complicated grieving r/t breakup of marriage

Which of the following activities would be a responsibility of the psychiatric clinical nurse specialist? a. Manages the therapeutic milieu on a 24-hour basis b. Conducts group therapies and provides consultation and education to staff nurses c. Directs a group of clients in acting out a situation that is otherwise too painful for a client to discuss openly d. Locates a halfway house and arranges living conditions for client being discharged from the hospital

b. Conducts group therapies and provides consultation and education to staff nurses

The nurse is using the nursing process to care for a suicidal client. Which of the following nursing actions is a part of the evaluation step of the nursing process? a. Prioritizes the necessity for maintaining a safe environment for the client. b. Determines if nursing interventions have been appropriate to achieve desired results. c. Obtains a short-term contract from the client to seek out staff if feeling suicidal. d. Establishes goal of care: Client will not harm self during hospitalization.

b. Determines if nursing interventions have been appropriate to achieve desired results.

A client has been diagnosed with major depressive episode. After treatment with fluoxetine (Prozac), the client exhibits pressured speech and flight of ideas. Based on this symptom change, which physician action would the nurse anticipate? a. Increase the dosage of fluoxetine. b. Discontinue the fluoxetine and rethink the client's diagnosis. c. Order benztropine (Cogentin) to address extrapyramidal symptoms. d. Order olanzapine (Zyprexa) to address altered thoughts.

b. Discontinue the fluoxetine and rethink the client's diagnosis.

When assessing a client diagnosed with narcissistic personality disorder, the nurse expects to identify which characteristic behavior? a. Odd beliefs and magical thinking b. Grandiose sense of self-importance c. Pattern of intense and chaotic relationships d. Extremely shy and fears rejection

b. Grandiose sense of self-importance

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. Haloperidol (Haldol)

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. Mrs. W. is physically too weak to travel without risk of injury.

The nurse is using the nursing process to care for a suicidal client. Which of the following nursing actions is a part of the assessment step of the nursing process? a. Identifies nursing diagnosis: Risk for suicide. b. Notes client's family reports recent suicide attempt. c. Prioritizes the necessity for maintaining a safe environment for the client. d. Obtains a short-term contract from the client to seek out staff if feeling suicidal.

b. Notes client's family reports recent suicide attempt.

A nurse recently admitted a client to an inpatient unit after a suicide attempt. A health-care provider orders amitriptyline (Elavil) for the client. Which intervention, related to this medication, should be initiated to maintain this client's safety upon discharge? a. Provide a 6-month supply of Elavil to ensure long-term compliance. b. Provide a 1-week supply of Elavil, with refills contingent on follow-up appointments. c. Provide pill dispenser as a memory aid. d. Provide education regarding the avoidance of foods containing tyramine.

b. Provide a 1-week supply of Elavil, with refills contingent on follow-up appointments.

A preschool child is admitted to a psychiatric unit with the diagnosis autistic spectrum disorder. To help the child feel more secure on the unit, which intervention should a nurse include in this client's plan of care? a. Encourage and reward peer contact. b. Provide consistent caregivers. c. Provide a variety of safe daily activities. d. Maintain close physical contact throughout the day.

b. Provide consistent caregivers.

Which nursing intervention related to self-care would be most appropriate for a teenager diagnosed with moderate IDD? a. Meeting all of the client's self-care needs to avoid injury to the client b. Providing simple directions and praising client's independent self-care efforts c. Avoid interfering with the client's self-care efforts in order to promote autonomy d. Encouraging family to meet the client's self-care needs to promote bonding

b. Providing simple directions and praising client's independent self-care efforts

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. Providing support in the emergency room to a rape victim

Which behavioral approach should a nurse use when caring for children diagnosed with disruptive behavior disorders? a. Involving parents in designing and implementing the treatment process b. Reinforcing positive actions to encourage repetition of desirable behaviors c. Providing opportunities to learn appropriate peer interactions d. Administering psychotropic medications to improve quality of life

b. Reinforcing positive actions to encourage repetition of desirable behaviors

The nurse says to a client, "You are being readmitted to the hospital. Why did you stop taking your medication?" What communication technique does this represent? a. Disapproving b. Requesting an explanation c. Disagreeing d. Probing

b. Requesting an explanation

In the community meeting, which of the following actions is most important for reinforcing the democratic posture of the therapy setting? a. Allowing each person a specific and equal amount of time to talk b. Reviewing group rules and behavioral limits that apply to all clients c. Reading the minutes from yesterday's meeting d. Waiting until all clients are present before initiating the meeting

b. Reviewing group rules and behavioral limits that apply to all clients

Margaret, a 68-year-old widow, is brought to the emergency department by her sister-in-law. Margaret has a history of bipolar disorder and has been maintained on medication for many years. Her sister-in-law reports that Margaret quit taking her medication a few months ago, thinking she didn't need it anymore. She is agitated, pacing, demanding, and speaking very loudly. Her sister-in-law reports that Margaret eats little, is losing weight, and almost never sleeps: "I'm afraid she's going to just collapse!" Margaret is admitted to the psychiatric unit. The priority nursing diagnosis for Margaret is: a. Imbalance nutrition: less than body requirement related to not eating b. Risk for injury related to hyperactivity c. Disturbed sleep pattern related to agitation d. Ineffective coping related to denial of depression

b. Risk for injury related to hyperactivity

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 he has been admitted to the psychiatric unit. In developing his 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. Risk for suicide

A client diagnosed with schizophrenia is hospitalized owing to an exacerbation of psychosis related to non-adherence with antipsychotic medications. Which level of care does the client's hospitalization reflect? a. Primary prevention level of care b. Secondary prevention level of care c. Tertiary prevention level of care d. Case management level of care

b. Secondary prevention level of care

A nursing student questions an instructor regarding the order for fluvoxamine (Luvox) 300 mg daily for a client diagnosed with obsessive-compulsive disorder (OCD). Which instructor response is most accurate? a. High doses of tricyclic medications will be required for effective treatment of OCD. b. Selective serotonin reuptake inhibitor (SSRI) doses, in excess of what is effective for treating depression, may be required for OCD. c. The dose of Luvox is low because of the side effect of daytime drowsiness. d. The dose of this selective serotonin reuptake inhibitor (SSRI) is outside the therapeutic range and needs to be questioned.

b. Selective serotonin reuptake inhibitor (SSRI) doses, in excess of what is effective for treating depression, may be required for OCD.

In an effort to help the child with mild to moderate intellectual disability 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. Set limits on behavior that is socially inappropriate.

A client diagnosed with schizophrenia functions well and is bright, spontaneous, and interactive during hospitalization but then decompensates after discharge. What does the milieu provide that may be missing in the home environment? a. Peer pressure b. Structured programming c. Visitor restrictions d. Mandated activities

b. Structured programming

John, a veteran of the war in Iraq, is diagnosed with PTSD. He says to the nurse, "I can't figure out why God took my buddy instead of me." From this statement, the nurse assesses which of the following in John? a. Repressed anger b. Survivor's guilt c. Intrusive thoughts d. Spiritual distress

b. Survivor's guilt

Which finding should a nurse expect when assessing a child diagnosed with separation anxiety disorder? a. The child has a history of antisocial behaviors. b. The child's mother is diagnosed with an anxiety disorder. c. The child previously had an extroverted temperament. d. The child's mother and father have an inconsistent parenting style.

b. The child's mother is diagnosed with an anxiety disorder.

A suicidal client with a history of manic behavior is admitted to the emergency department. The client's diagnosis is documented as bipolar I disorder: depressive state. What is the rationale for this diagnosis versus a diagnosis of major depressive episode? a. The physician does not believe the client is suffering from major depression. b. The client has experienced a manic episode in the past. c. The client does not exhibit psychotic symptoms. d. There is no history of major depression in the client's family.

b. The client has experienced a manic episode in the past.

A client diagnosed with obsessive-compulsive disorder is admitted to a psychiatric unit. The client has an elaborate routine for toileting activities. Which would be an appropriate initial client outcome during the first week of hospitalization? a. The client will participate in three unit activities by day three. b. The client will wake early enough to complete rituals prior to breakfast. c. The client will refrain from ritualistic behaviors during daylight hours. d. The client will substitute a productive activity for rituals by day one.

b. The client will wake early enough to complete rituals prior to breakfast.

A nurse is educating a client about his lithium therapy. She is explaining signs and symptoms of lithium toxicity. For which of the following would she instruct the client to be on the alert? a. Fever, sore throat, malaise b. Tinnitus, severe diarrhea, ataxia c. Occipital head ache, palpitations, chest pain d. Skin rash, marked rise in blood pressure, bradycardia

b. Tinnitus, severe diarrhea, ataxia

A client has been extremely nervous ever since a person died as a result of the client's drunk driving. When assessing for the diagnosis of adjustment disorder (AD), within what time frame should the nurse expect the client to exhibit symptoms? a. To meet the DSM-5 criteria for adjustment disorder, the client should exhibit symptoms within one year of the accident. b. To meet the DSM-5 criteria for adjustment disorder, the client should exhibit symptoms within three months of the accident. c. To meet the DSM-5 criteria for adjustment disorder, the client should exhibit symptoms within six months of the accident. d. To meet the DSM-5 criteria for adjustment disorder, the client should exhibit symptoms within nine months of the accident.

b. To meet the DSM-5 criteria for adjustment disorder, the client should exhibit symptoms within three months of the accident.

A client diagnosed with bipolar I disorder: manic episode refuses to take lithium carbonate (Lithobid) because of excessive weight gain. In order to increase adherence, which medication should a nurse anticipate that a physician may prescribe? a. Sertraline (Zoloft) b. Valproic acid (Depakote) c. Trazodone (Desyrel) d. Paroxetine (Paxil)

b. Valproic acid (Depakote)

Which of the following activities would be most appropriate for the child with ADHD? a. Monopoly b. Volleyball c. Pool d. Checkers

b. Volleyball

Splitting by the client with borderline personality disorder denotes: 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 primitive defense mechanism in which the client sees objects as all good or all bad

The nurse is interviewing a client on the psychiatric unit. The client tilts his head to the side, stops talking in mid sentence, and listens intently. The nurse recognizes these behaviors as a symptom of the clients illness. The most appropriate nursing intervention for this symptom would be: a. as the client to describe his physical symptoms b. ask the client to describe what he is hearing c. administer a dose of benztropine d. call the physician for additional orders

b. ask the client to describe what he is hearing

A nurse evaluates a client's patient-controlled analgesia (PCA) pump and notices 100 attempts within a 30-minute period. Which is the best rationale for assessing this client for substance addiction? a. narcotic pain medication is contraindicated for all clients with active substance abuse disorders b. clients who are addicted to alcohol or benzodiazepines may develop cross-tolerance to analgesics and require increased doses to achieve affective pain control c. there is no need to assess the client for substance addiction. There is an obvious PCA malfunction, because these clients have a higher pain tolerance d. The client is experiencing alcohol withdrawal symptoms and needs accurate assessment.

b. clients who are addicted to alcohol or benzodiazepines may develop cross-tolerance to analgesics and require increased doses to achieve affective pain control

The primary goal in working with an actively psychotic, suspicious client would be to: a. promote interaction with others b. decrease his anxiety and increase trust c. improve his relationship with his parents d. encourage participation in therapy activities b

b. decrease his anxiety and increase trust

Margaret, a 68-year-old widow with bipolar mania, is admitted to the psychiatric unit after being brought to the ED by her sister in law. Margaret yells, "My sister in law is just jealous of me! She's trying to make it look like I'm insane!" This behavior is an example of a: a. delusion of grandeur b. delusion of persecution c. delusion of reference d. delusion of control or influence

b. delusion of persecution

Milieu therapy is a good choice for clients with antisocial personality disorder because it: a. provides a system of punishment and reward 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 interactions between clients and therapists d. provides a very structured setting in which the clients have very little input into the planning of their care

b. emulates a social community in which the client may learn to live harmoniously with others

Tony, age 21, has been diagnosed with schizophrenia. He has been socially isolated and hearing voices telling him to kill his parents. He has been admitted to the psychiatric unit from the emergency department. The initial nursing intervention for Tony is to: a. give him an injection of Thorazine b. ensure a safe environment for him and others. c. place him in restraints d. order him a nutritious diet

b. ensure a safe environment for him and others.

A young woman who has just undergone sexual assault is brought to the ED by a friend. The priority nursing intervention would be: 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 survivors of rape d. discuss the importance of a follow-up visit to evaluate for sexually transmitted diseases

b. provide physical and emotional support during evidence collection

The ultimate goal of therapy for a client with DID is most likely achieved through: a. crisis intervention and directed association b. psychotherapy and hypnosis c. psychoanalysis and free association d. insight psychotherapy and dextroamphetamines

b. psychotherapy and hypnosis

Which of the following disorders involves the emergence of varying personalities in a person that is associated with stress and conflict? a) Dissociative amnesia b) Depersonalization disorder c) Dissociative identity disorder d) Dissociative fugue

c) Dissociative identity disorder

Which of the following is a central feature of somatoform disorders? a) The client willfully controls the physical symptoms. b) The client's symptoms are under the conscious control of the client. c) The client reports physical symptoms without a demonstrable organic basis to fully account for them. d) Denial and repression are the chief defense mechanisms used.

c) The client reports physical symptoms without a demonstrable organic basis to fully account for them.

A client began taking lithium carbonate (Lithobid) for the treatment of bipolar disorder approximately 1 month ago. The client asks if it is normal to have gained 12 pounds in this time frame. Which is the appropriate nursing response? a. "That's strange. Weight loss is the typical pattern." b. "What have you been eating? Weight gain is not usually associated with lithium." c. "Weight gain is a common, but troubling, side effect." d. "Weight gain only occurs during the first month of treatment with this drug."

c. "Weight gain is a common, but troubling, side effect."

A mother questions the decreased effectiveness of methylphenidate (Ritalin), prescribed for her child's ADHD. Which nursing response best addresses the mother's concern? a. "The physician will probably switch from Ritalin to a central nervous system stimulant." b. "The physician may prescribe an antihistamine with the Ritalin to improve effectiveness." c. "Your child has probably developed a tolerance to Ritalin and may need a higher dosage." d. "Your child has developed sensitivity to Ritalin and may be exhibiting an allergy."

c. "Your child has probably developed a tolerance to Ritalin and may need a higher dosage."

A newly admitted homeless client diagnosed with schizophrenia states, "I have been living in a cardboard box for two weeks. Why did the government let me down?" Which is an appropriate nursing response? a. "Your discharge from the state hospital was done prematurely. Had you remained in the state hospital longer, you would not be homeless." b. "Your premature discharge from the state hospital was not intended for patients diagnosed with chronic schizophrenia." c. "Your discharge from the state hospital was based on firm principles; however, the resources were not available to make the transition a success." d. "Your discharge from the state hospital was based on presumed family support, and this was not forthcoming."

c. "Your discharge from the state hospital was based on firm principles; however, the resources were not available to make the transition a success."

A nurse is planning care for a client diagnosed with bipolar disorder: manic episode. In which order should the nurse prioritize the client outcomes in the exhibit? Client Outcomes: 1. Maintains nutritional status 2. Interacts appropriately with peers 3. Remains free from injury 4. Sleeps 6 to 8 hours a night a. 2, 1, 3, 4 b. 4, 1, 2, 3 c. 3, 1, 4, 2 d. 1, 4, 2, 3

c. 3, 1, 4, 2

A nurse who is helping a client with mental illness recovery using the WRAP Model says to the client, "First you must create a wellness toolbox." She explains to the client that a wellness toolbox is which of the following? a. A list of words that describe how the individual feels when he or she is feeling well b. A list of things the client needs to do every day to maintain wellness c. A list of strategies the client has used in the past that help relieve disturbing symptoms d. A list of the client's favorite health-care providers and phone numbers

c. A list of strategies the client has used in the past that help relieve disturbing symptoms

Which of the following activities would be a responsibility of the clinical psychologist member of the IDT? a. Locates halfway house and arranges living conditions for client being discharged from the hospital b. Manages the therapeutic milieu on a 24-hour basis c. Administers and evaluates psychological tests that assist in diagnosis d. Conducts psychotherapy and administers electroconvulsive therapy treatments

c. Administers and evaluates psychological tests that assist in diagnosis

The child with autism spectrum disorder has difficulty with trust. With this in mind, which of the follow- ing 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. Assign same staff person as often as possible to promote feelings of security and trust.

In prioritizing care within the therapeutic environment, which of the following nursing interventions would receive the highest priority? a. Ensuring that the physical facilities are conductive to achievement of the goals of therapy b. Scheduling a community meeting for 8:30 each morning c. Attending to the nutritional and comfort needs of all clients d. Establishing contacts with community resources

c. Attending to the nutritional and comfort needs of all clients

When planning group therapy, a nurse should identify which configuration as most optimal for a therapeutic group? a. Open-ended membership; circle of chairs; group size of 5 to 10 members b. Open-ended membership; chairs around a table; group size of 10 to 15 members c. Closed membership; circle of chairs; group size of 5 to 10 members d. Closed membership; chairs around a table; group size of 10 to 15 members

c. Closed membership; circle of chairs; group size of 5 to 10 members

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. Donepezil

A client is admitted to a psychiatric unit with the diagnosis of catatonic schizophrenia. Which of the client's neurotransmitters should a nurse expect to be elevated? a. Serotonin b. Histamine c. Dopamine d. Gamma-aminobutyric acid (GABA)

c. Dopamine

A nursing instructor is teaching about bipolar disorders. Which statement differentiates the DSM-5 diagnostic criteria of a manic episode from a hypomanic episode? a. During a manic episode, clients may experience an inflated self-esteem or grandiosity, and these symptoms are absent in hypomania. b. During a manic episode, clients may experience a decreased need for sleep, and this symptom is absent in hypomania. c. During a manic episode, clients may experience psychosis, and this symptom is absent in hypomania. d. During a manic episode, clients may experience flight of ideas and racing thoughts, and these symptoms are absent in hypomania.

c. During a manic episode, clients may experience psychosis, and this symptom is absent in hypomania.

A client diagnosed with borderline personality disorder presents to the mental health clinic and demands to see a counselor immediately. Which is the appropriate nursing action? a. Instruct the client to leave the clinic. b. Confront demanding behaviors. c. Explain the rules and set limits. d. Help the client problem solve.

c. Explain the rules and set limits.

The nurse determines which is most essential when planning care for a client who is experiencing a crisis? a. Focusing on emotional deficits b. Encouraging lengthy explanations of the situation c. Exploring previous coping strategies d. Focusing on developmental issues that may have affected the client's ability to cope

c. Exploring previous coping strategies

What is the expected feeling and/or behavior experienced by military families during the "sustainment" cycle of deployment, as described by Pincus and associates? a. Feelings alternate between denial and anticipation of loss. b. Feelings alternate between excitement and apprehension associated with homecoming. c. Feelings focus on the establishment of new support systems and new family routines. d. Feelings focus on the struggle to take charge of the details of the new family structure.

c. Feelings focus on the establishment of new support systems and new family routines.

A client diagnosed with post traumatic stress disorder (PTSD) is receiving paliperidone (Invega). Which symptoms should a nurse identify that would warrant the need for this medication? a. Flat affect and anhedonia b. Persistent anorexia and 10 lb weight loss in 3 weeks c. Flashbacks of killing the enemy d. Distant and guarded in relationships

c. Flashbacks of killing the enemy

A preschool child diagnosed with autistic spectrum disorder has been engaging in constant head-banging behavior. Which nursing intervention is appropriate? a. Place client in restraints until the aggression subsides. b. Sedate the client with neuroleptic medications. c. Hold client's head steady and apply a helmet. d. Distract the client with a variety of games and puzzles.

c. Hold client's head steady and apply a helmet.

A client diagnosed with schizoaffective disorder is admitted for social skills training. Which information should be included in the nurse's teaching? a. The side effects of medications b. Deep breathing techniques to decrease stress c. How to make eye contact when communicating d. How to be a leader

c. How to make eye contact when communicating

A client diagnosed with panic disorder states "When an attack happens, I feel like I am going to die." Which is the most appropriate nursing response? a. Death from a panic attack happens so infrequently that there is no need to worry. b. Most people who experience panic attacks have feelings of impending doom c. I know its frightening, but try to remind yourself that this will only last a short time d. Tell me why you think you are going to die every time you have a panic attack.

c. I know its frightening, but try to remind yourself that this will only last a short time

A client with a history of suicide attempts has been taking fluoxetine (Prozac) for one month. The client suddenly presents with a bright affect, rates mood at 9 out of 10, and is much more communicative. Which action should be the nurse's priority at this time? a. Give the client off-unit privileges as positive reinforcement. b. Encourage the client to share mood improvement in group. c. Increase the level of this client's suicide precautions. d. Request that the psychiatrist reevaluate the current medication protocol.

c. Increase the level of this client's suicide precautions.

John, who was hospitalized with alcohol intoxication and violent behavior, is sitting in the dayroom watching TV with the other clients when the nurse approaches with his 5:00 p.m. dose of haloperidol. John says, "I feel in control now. I don't need any drugs." The nurse's best response is based on which of the following statements? a. John must have the medication, or he will become violent. b. John knows that if he will not take the medication orally, he will be restrained and given an intramuscular injection. c. John has the right to refuse the medication provided there is no immediate danger to self or others. d. John must take the medication at this time in order to maintain adequate blood levels.

c. John has the right to refuse the medication provided there is no immediate danger to self or others.

Nursing diagnoses are prioritized according to: a. Degree of potential for resolution. b. Legal implications associated with nursing intervention. c. Life-threatening potential. d. Client and family requests.

c. Life-threatening potential.

In assessing a client diagnosed with borderline personality disorder, which characteristic would the nurse expect to observe? a. Predictability b. Controlled anger c. Little tolerance for being alone d. Stable and satisfactory relationships

c. Little tolerance for being alone

has become demanding and hyperactive. Which is the most appropriate nursing intervention to address these client behaviors? a. Help lessen the client's feelings of guilt and rejection. b. Warn the client that restraints may be necessary if behavior does not improve. c. Maintain supportive, structured environment, setting firm limits in a nonthreatening manner. d. Introduce the client to peers in order to increase interpersonal contacts.

c. Maintain supportive, structured environment, setting firm limits in a nonthreatening manner.

Research has shown that an adolescent (13 to18 years) would typically exhibit which behavior as a reaction to parental military deployment? a. May exhibit regressive behaviors and assume blame for parent's departure. b. May become sullen, tearful, throw temper tantrums, or develop sleep problems. c. May participate in high-risk behaviors, sexual acting out, and drug or alcohol abuse. d. May respond to schedule disruptions with irritability and/or apathy and weight loss.

c. May participate in high-risk behaviors, sexual acting out, and drug or alcohol abuse.

A client diagnosed with a personality disorder tells the nurse, "With my expertise, I could become this hospital's CEO tomorrow." This statement would be associated with which personality disorder? a. Antisocial personality disorder b. Obsessive-compulsive personality disorder c. Narcissistic personality disorder d. Avoidant personality disorder

c. Narcissistic personality disorder

Nina has been hospitalized with adjustment disorder with depressed mood following the breakup of her marriage. Which of the following is true regarding the diagnosis of adjustment disorder? a. Nina will require long-term psychotherapy to achieve relief. b. Nina likely inherited a genetic tendency for the disorder. c. Nina's symptoms will likely remit once she has accepted the change in her life. d. Nina probably would not have experienced an adjustment disorder if she had a higher level of intelligence.

c. Nina's symptoms will likely remit once she has accepted the change in her life.

The nurse is using the nursing process to care for a suicidal client. Which of the following nursing actions is a part of the implementation step of the nursing process? a. Prioritizes the necessity for maintaining a safe environment for the client. b. Determines if nursing interventions have been appropriate to achieve desired results. c. Obtains a short-term contract from the client to seek out staff if feeling suicidal. d. Establishes goal of care: Client will not harm self during hospitalization.

c. Obtains a short-term contract from the client to seek out staff if feeling suicidal.

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 changes? 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 fights anymore

c. On his own initiative, Jack sent a note of apology to a man he had injured in a recent fight

An angry client on an inpatient unit approaches a nurse stating, "Someone took my lunch! People need to respect others, and you need to do something about this now!" The nurse's response should be guided by which basic assumption of milieu therapy? a. Conflict should be avoided at all costs on inpatient psychiatric units. b. Conflict should be resolved by the nursing staff. c. On inpatient units, every interaction is an opportunity for therapeutic intervention. d. Conflict resolution should only be addressed during group therapy.

c. On inpatient units, every interaction is an opportunity for therapeutic intervention.

Which statement is correct concerning personality disorders? a. Personality disorders generally emerge during adolescence. b. Individuals diagnosed with personality disorders have insight into their disorder. c. Personality disorders occur when personality traits become inflexible, maladaptive, and cause dysfunctional patterns of behavior. d. Individuals diagnosed with personality disorders demonstrate adaptive ability to perceive and relate to themselves and the environment.

c. Personality disorders occur when personality traits become inflexible, maladaptive, and cause dysfunctional patterns of behavior.

Sharon, a women 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 that I was going to take the kids and leave. He got furious and began beating me with his fists. " What part of the cycle is this? a. Phase I. Sharon was trying to stay out of his way to keep everything calm b. Phase I. A minor battering incident for which Sharon assumes the blame c. Phase II. The acute battering incident that Sharon provoked with her threat to leave d. Phase 3. The honeymoon phase where the husband believes that he has "taught her a lesson and she won't act up again."

c. Phase II. The acute battering incident that Sharon provoked with her threat to leave

A nurse discovers a client's suicide note that details the time, place, and means to commit suicide. What should be the priority nursing action, and why? a. Administer lorazepam (Ativan) prn, because the client is angry about plan exposure. b. Establish room restrictions, because the client's threat is an attempt to manipulate the staff. c. Place client on one-to-one suicide precautions, because specific plans likely lead to attempts. d. Call an emergency treatment team meeting, because the client's threat must be addressed.

c. Place client on one-to-one suicide precautions, because specific plans likely lead to attempts.

A crisis is an internal disturbance. Which is characteristic of a crisis? a. Crises are chronic in nature. b. Crises are universal in nature. c. Precipitating events are specific and identifiable. d. A crisis will eventually lead to psychological growth.

c. Precipitating events are specific and identifiable.

Six months after her husband and children were killed in a car accident, a client is diagnosed with ulcerative colitis. The nurse should recognize that this situation validates which study perspective? a. Neuroendocrinology b. Neurophysiology c. Psychoimmunology d. Diagnostic technology

c. Psychoimmunology

A client diagnosed with bipolar mania enters the milieu area dressed in a provocative and physically revealing outfit. Which of the following is the most appropriate intervention by the nurse? a. Tell the client she cannot wear this outfit while she is in the hospital b. Do nothing and allow her to learn from the responses of her peers c. Quietly walk with her back to her room and help her change into something more appropriate d. Explain to her that, if she wears this outfit, she must remain in her room

c. Quietly walk with her back to her room and help her change into something more appropriate

Which should be the priority nursing intervention when caring for a child diagnosed with conduct disorder? a. Modify environment to decrease stimulation and provide opportunities for quiet reflection. b. Convey unconditional acceptance and positive regard. c. Recognize escalating aggressive behavior and intervene before violence occurs. d. Provide immediate positive feedback for appropriate behaviors.

c. Recognize escalating aggressive behavior and intervene before violence occurs.

An instructor is teaching nursing students about neurotransmitters. Which best explains the process of how neurotransmitters released into the synaptic cleft may return to the presynaptic neuron? a. Retransmission b. Regeneration c. Reuptake d. Recycling

c. Reuptake

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. Based on a needs assessment, which of the following problems would Ann address during her first visit? a. Complicated grieving b. Social isolation c. Risk for injury d. Sleep pattern disturbance

c. Risk for injury

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

c. Tolerance

Dan has been admitted to the alcohol rehabilitation unit after being fired for drinking on the job. Dan's drinking buddies come for a visit, and when they leave, the nurse smells alcohol on Dan's breath. Which of the following would be the best intervention with Dan at this time? a. Search his room for evidence. b. Ask, "Have you been drinking alcohol, Dan?" c. Send a urine specimen from Dan to the lab for drug screening. d. Tell Dan, "These guys cannot come to the unit to visit you again."

c. Send a urine specimen from Dan to the lab for drug screening.

A client diagnosed with avoidant personality disorder states, "I've never been close to my daughter. I'm sure she will never have time for me." Which nursing diagnosis applies to this client? a. Relocation stress syndrome b. Risk for violence: other directed c. Social withdrawal d. Fear

c. Social withdrawal

A nursing instructor is teaching about the Community Health Centers Act of 1963. What was a deterring factor to the proper implementation of this act? a. Many perspective clients did not meet criteria for mental illness diagnostic-related groups. b. Zoning laws discouraged the development of community mental health centers. c. States could not match federal funds to establish community mental health centers. d. There was not a sufficient employment pool to staff community mental health centers.

c. States could not match federal funds to establish community mental health centers.

A nursing instructor is teaching about suicide among active duty military. Which fact should the instructor include in the lesson plan? a. On average, two suicides a day occur in the U.S. military. b. From 2005 to 2009, relationship distress factored in more than 25% of Army suicides. c. Statistically, in 2012, suicide rates of service members surpassed the number killed in combat. d. Military suicides are associated with a narcissistic personality disorder diagnosis.

c. Statistically, in 2012, suicide rates of service members surpassed the number killed in combat.

John, a veteran of the war in Iraq, is diagnosed with PTSD. He experiences a nightmare during his first night in the hospital. He explains to the nurse that he was dreaming about gunfire all around and people being killed. The nurse's most appropriate initial intervention is to: a. administer alprazolam as ordered prn for anxiety. b. call the physician and report the incident. c. Stay with John and reassure him of his safety. d. Have John listen to a tape of relaxation exercises

c. Stay with John and reassure him of his safety.

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. Stay with Leon and reassure him of his safety.

Which part of the nervous system should a nurse identify as playing a major role during stressful situations? a. Peripheral nervous system b. Somatic nervous system c. Sympathetic nervous system d. Parasympathetic nervous system

c. Sympathetic nervous system

A nurse is implementing care within the parameters of tertiary prevention. Which nursing action is an example of this type of care? a. Teaching an adolescent about pregnancy prevention b. Teaching a client the reportable side effects of a newly prescribed neuroleptic medication c. Teaching a client to cook meals, make a grocery list, and establish a budget d. Teaching a client about his or her new diagnosis of bipolar disorder

c. Teaching a client to cook meals, make a grocery list, and establish a budget

When a home health nurse administers an outpatient's injection of haloperidol decanoate (Haldol decanoate), which level of care is the nurse providing? a. Primary prevention level of care b. Secondary prevention level of care c. Tertiary prevention level of care d. Case management level of care

c. Tertiary prevention level of care

A child with bipolar disorder also has attention-deficit/hyperactivity disorder (ADHD). How would these comorbid conditions most likely be treated? a. No medication would be given for either condition b. Medication would be given for both conditions simultaneously c. The bipolar condition would be stabilized first before medication for the ADHD would be given d. The ADHD would be treated before consideration of the bipolar disorder

c. The bipolar condition would be stabilized first before medication for the ADHD would be given

In planning care for a child diagnosed with autistic spectrum disorder, which would be a realistic client outcome? a. The client will communicate all needs verbally by discharge. b. The client will participate with peers in a team sport by day four. c. The client will establish trust with at least one caregiver by day five. d. The client will perform most self-care tasks independently.

c. The client will establish trust with at least one caregiver by day five.

A client is to undergo psychological testing. Which member of the interdisciplinary team should a nurse consult for this purpose? a. The psychiatrist b. The psychiatric social worker c. The clinical psychologist d. The clinical nurse specialist

c. The clinical psychologist

A nurse is assisting an individual with mental illness recovery using the Tidal Model. Which of the following is a component of this model? a. The wellness toolbox b. The daily maintenance list c. The individual's personal story d. Triggers

c. The individual's personal story

A woman who has been recently widowed is unable to cope with the tasks of daily living because a recent hurricane completely destroyed her home. She is unable to identify any available family support. The nurse identifies that the client is experiencing which type of crisis? a. Dispositional crisis b. Life transitions crisis c. Traumatic stress crisis d. Maturational/developmental crisis

c. Traumatic stress crisis

Mr. J. has been diagnosed with Paranoid Schizophrenia. He refuses to eat, and told the nurse he knew he knew he was "being poisoned." According to Erikson's theory, in what developmental stage would you place Mr. J.? a. Intimacy vs. isolation b. Generativity vs. self-absorption c. Trust vs. mistrust d. Autonomy vs. shame and doubt

c. Trust vs. mistrust

When it has been assessed that a client is in control and no longer requires restraining, how does the nurse proceed? a. The nurse removes the restraints. b. The nurse calls for assistance to remove the restraints. c. With assistance, the nurse removes one restraint. d. The nurse tells the client he will have to wait until the doctor comes in.

c. With assistance, the nurse removes one restraint.

The nurse is interviewing a client on the psychiatric unit. The client tilts his head to the side, stops talking in midsentence, and listens intently. The nurse recognized from these signs that the client is likely experiencing: a. somatic delusions b. catatonic stupor c. auditory hallucinations d. pseudoparkinsoisn

c. auditory hallucinations

When a client suddenly becomes aggressive and violent on the unit which of the following approaches would be best for the nurse to use first? a. provide large motor activities to relieve the clients pent-up tension b. administer a dose of pen chlorpromazine to keep the client calm c. call for sufficient help to control the situation d.convey to the client that his behavior is unacceptable and will not be permitted

c. call for sufficient help to control the situation

Symptoms of alcohol withdrawal include: a. euphoria, hyperactivity, and insomnia. b. depression, suicidal ideation, and hypersomnia. c. diaphoresis, nausea and vomiting, and tremors. d. unsteady gait, nystagmus, and profound disorientation.

c. diaphoresis, nausea and vomiting, and tremors.

Margaret, age 68, is diagnosed with Bipolar Disorder, manic episode. She is extremely hyperactive and has lost weight. One way to promote adequate nutritional intake for Margaret is to: a. sit with her during meals to ensure that she eats everything on her tray b. have her sister-in-law bring all her food from home because she knows her likes and dislikes c. provide high-calorie, nutritious finger foods and snacks that she can eat "on the run" d. tell her that she will be on room restriction until she starts gaining weight

c. provide high-calorie, nutritious finger foods and snacks that she can eat "on the run"

A highly agitated client paces the unit and states, "I could buy and sell this place." The client's mood fluctuates from fits of laughter to outbursts of anger. Which is the most accurate documentation of this client's behavior? a. "Rates mood 8/10. Exhibiting looseness of association. Euphoric." b. "Mood euthymic. Exhibiting magical thinking. Restless." c. "Mood labile. Exhibiting delusions of reference. Hyperactive." d. "Agitated and pacing. Exhibiting grandiosity. Mood labile."

d. "Agitated and pacing. Exhibiting grandiosity. Mood labile."

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. "Have you been thinking about harming yourself in any way?"

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 the staff and peers and has been made aware of the alternatives open to her. Nevertheless, she's decided to return to her home and marriage. The best response by the nurse to the woman's decision is: 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've made the right decision. Call this number if you need help"

d. "I hope you've made the right decision. Call this number if you need help"

Clint, a client on a phych unit, has been diagnosed with Schizophrenia. He begins to tell the nurse about how the CIA is looking for him and will kill him if they find him. The most appropriate response is: a. "That's ridiculous, Clint. No one is going to hurt you." b. "The CIA isn't interested in people like you, Clint." c. "Why do you think the CIA wants to kill you?" d. "I know you believe that, Clint, but its really hard for me to believe."

d. "I know you believe that, Clint, but its really hard for me to believe."

Client teaching is an important nursing function in milieu therapy. Which of the following statements by the client indicates the need for knowledg and a readiness to learn? a. "Get away from me with that medicine! I'm not sick!" b. "I don't need psychiatric treatment. It's my migraine headaches that I need help with." c. "I've taken Valium every day of my life for the last 20 years. I'll stop when I'm good and ready!" d. "The doctor says I have bipolar disorder. What does that really mean?"

d. "The doctor says I have bipolar disorder. What does that really mean?"

A nursing instructor is teaching about the developmental characteristics of clients diagnosed with moderate intellectual developmental disorder (IDD). Which student statement indicates that further instruction is needed? a. "These clients can work in a sheltered workshop setting." b. "These clients can perform some personal care activities." c. "These clients may have difficulties relating to peers." d. "These clients can successfully complete elementary school."

d. "These clients can successfully complete elementary school."

A client living in a beachfront community is seeking help with an extreme fear of bridges, which is interfering with daily functioning. A psychiatric nurse practitioner decides to try systematic desensitization. Which explanation of this treatment should the nurse provide? a. "Using your imagination, we will attempt to achieve a state of relaxation." b. "In one intense session, you will be exposed to a maximum level of anxiety that you will learn to tolerate." c. "Because anxiety and relaxation are mutually exclusive states, we can attempt to substitute a relaxation response for the anxiety response." d. "Through a series of increasingly anxiety-provoking steps, we will gradually increase your tolerance to anxiety."

d. "Through a series of increasingly anxiety-provoking steps, we will gradually increase your tolerance to anxiety."

A nursing instructor is discussing various challenges in the treatment of clients diagnosed with bipolar disorder. Which student statement demonstrates an understanding of the most critical challenge in the care of these clients? a. "Treatment is compromised when clients can't sleep." b. "Treatment is compromised when irritability interferes with social interactions." c. "Treatment is compromised when clients have no insight into their problems." d. "Treatment is compromised when clients choose not to take their medications."

d. "Treatment is compromised when clients choose not to take their medications."

An adolescent recently lost his father in a plane crash. He has begun to question his belief in God. He cries out, "No God would have let my father die like that! I'm so angry I could scream!" Which is the nurse's best response? a. "You shouldn't say things like that." b. "Are you having any thoughts of wanting to harm yourself in any way?" c. "I believe that God has your father in a safe place right now." d. "You're feeling so angry. I'm here for you. I'm listening."

d. "You're feeling so angry. I'm here for you. I'm listening."

Which situation presents an example of the basic concept of a recovery model? a. The client's family is encouraged to make decisions in order to facilitate discharge. b. A social worker, discovering the client's income, changes the client's discharge placement. c. A psychiatrist prescribes an antipsychotic drug based on observed symptoms. d. A client diagnosed with schizophrenia schedules follow-up appointments and group therapy.

d. A client diagnosed with schizophrenia schedules follow-up appointments and group therapy.

A client diagnosed with a history of anorexia nervosa comes to an outpatient clinic after being medically cleared. The client states, "My parents watch me like a hawk and never let me out of their sight." Which nursing diagnosis would take priority at this time? a. Altered nutrition less than body requirements b. Altered social interaction c. Impaired verbal communication d. Altered family processes

d. Altered family processes

After studying the DSM-5 criteria for oppositional defiant disorder (ODD), which listed symptom would a student nurse recognize? a. Arguing and annoying older sibling over the past year b. Angry and resentful behavior over a three-month period c. Initiating physical fights for more than 18 months d. Arguing with authority figures for more than six months

d. Arguing with authority figures for more than six months

The most common comorbid condition in children with bipolar disorder is: a. Schizophrenia b. Substance disorders c. Oppositional defiant disorder d. Attention-deficit/hyperactivity disorder

d. Attention-deficit/hyperactivity disorder

How does a democratic form of self-government in the milieu contribute to client therapy? a. By interacting with professional staff members to learn about therapeutic interventions b. By setting punishments for clients who violate the community rules c. By dealing with inappropriate behaviors as they occur d. By setting expectations wherein all clients are treated on an equal basis

d. By setting expectations wherein all clients are treated on an equal basis

Which of the following psychosocial therapies has been shown to be helpful in clients with TBI? a. Eye movement desensitization b. Psychoanalysis c. Reality therapy d. Cognitive-behavioral therapy

d. Cognitive-behavioral therapy

When intervening with a married couple experiencing relationship discord, which nursing action reflects an intervention at the secondary level of prevention? a. Teaching assertiveness skills in order to meet assessed needs b. Supplying the couple with guidelines related to marital seminar leadership c. Teaching the couple about various methods of birth control d. Counseling the couple related to open and honest communication skills

d. Counseling the couple related to open and honest communication skills

Walter is angry with his psychiatrist and says to the nurse, "He doesn't know what he is doing. That medication isn't helping a thing!" The nurse responds, "He has been a doctor for many years and has helped many people." This is an example of what nontherapeutic technique? a. Rejecting b. Disapproving c. Probing d. Defending

d. Defending

Which clinical presentation is associated with the most commonly diagnosed adjustment disorder (AD)? a. Anxiety, feelings of hopelessness, and worry b. Truancy, vandalism, and fighting c. Nervousness, worry, and jitteriness d. Depressed mood, tearfulness, and hopelessness

d. Depressed mood, tearfulness, and hopelessness

A client is newly diagnosed with obsessive-compulsive disorder and spends 45 minutes folding clothes and rearranging them in drawers. Which nursing intervention would best address this client's problem? a. Report the behavior to the psychiatrist to obtain an order for medication dosage increase. b. Distract the client with other activities whenever the ritual behaviors begin. c. Lock the room to discourage ritualistic behavior. d. Discuss the anxiety-provoking triggers that precipitate the ritualistic behaviors.

d. Discuss the anxiety-provoking triggers that precipitate the ritualistic behaviors.

Lucille has a diagnosis of Somatic Symptom Disorder, Predominantly Pain. Which of the following medications would the psychiatric nurse practitioner most likely prescribe for Lucille? a. Chlorpromazine (Thorazine) b. Diazepam (Valium) c. Carbamazepine (Tegretol) d. Duloxetine (Cymbalta)

d. Duloxetine (Cymbalta)

A nurse is planning care for a 13 -year-old who is experiencing depression. Which medication is approved by the Food and Drug Administration (FDA) for the treatment of depression in adolescents? a. Paroxetine (Paxil) b. Sertraline (Zoloft) c. Citalopram (Celexa) d. Escitalopram (Lexipro)

d. Escitalopram (Lexipro)

The nurse is using the nursing process to care for a suicidal client. Which of the following nursing actions is a part of the outcome identification step of the nursing process? a. Prioritizes the necessity for maintaining a safe environment for the client. b. Determines if nursing interventions have been appropriate to achieve desired results. c. Obtains a short-term contract from the client to seek out staff if feeling suicidal. d. Establishes goal of care: Client will not harm self during hospitalization.

d. Establishes goal of care: Client will not harm self during hospitalization.

A client diagnosed with borderline personality disorder is admitted to a psychiatric unit. Which behavior patterns would the nurse expect to observe? a. Socially isolates b. Exhibits entitled behaviors c. Has bizarre speech patterns d. Generates conflict among the staff

d. Generates conflict among the staff

S.T. is a 15-year-old girl who has just been admitted to the adolescent psychiatric unit with a diagnosis of anorexia nervosa. She is 55 tall and weighs 82 lb. She was elected to the cheerleading squad for the fall but states that she is not as good as the others on the squad. The treatment team has identified the following problems: refusal to eat, occasional purging, refusing to interact with staff and peers, and fear of failure. Which of the following nursing diagnoses would be the priority diagnosis for S.T.? a. Social Isolation. b. Disturbed Body Image. c. Low Self-Esteem. d. Imbalanced Nutrition: Less than body requirements.

d. Imbalanced Nutrition: Less than body requirements.

A client is diagnosed with bipolar disorder. Which medication is the drug of choice to treat this diagnosis? a. Risperidone (Risperdal) b. Clozapine (Clozaril) c. Lorazepam (Ativan) d. Lithium carbonate (Eskalith)

d. Lithium carbonate (Eskalith)

When attempting to provide health-care services to the homeless, what should be a realistic concern for a nurse? a. Most individuals that are homeless reject help. b. Most individuals that are homeless are suspicious of anyone who offers help. c. Most individuals that are homeless are proud and will often refuse charity. d. Most individuals that are homeless relocate frequently.

d. Most individuals that are homeless relocate frequently.

An individual who is addicted to heroin is likely to experience which of the following symptoms of withdrawal? a. Increased heart rate and blood pressure b. Tremors, insomnia, and seizures c. Incoordination and unsteady gait d. Nausea and vomiting, diarrhea, and diaphoresis

d. Nausea and vomiting, diarrhea, and diaphoresis

Carol is a new nursing graduate being oriented on a medical/surgical unit by the head nurse, Mrs. Carey. When Carol describes a new technique she has learned for positioning immobile clients, Mrs. Carey states, "What are you trying to do... tell me how to do my job? We have always done it this way on this unit, and we will continue to do it this way until I say differently!" This is an example of which type of personality characteristic? a. Antisocial b. Paranoid c. Passive-aggressive d. Obsessive-compulsive

d. Obsessive-compulsive

A nursing instructor is teaching about the symptoms of agoraphobia. Which student statement indicates that learning has occurred? a. Onset of symptoms most commonly occurs in the 40s and 50s and persists until death. b. Onset of symptoms most commonly occurs after the age of 60 and persists for at least 6 years. c. Onset of symptoms most commonly occurs in early adolescence and persists until midlife. d. Onset of symptoms most commonly occurs in the 20s and 30s and persists for many years.

d. Onset of symptoms most commonly occurs in the 20s and 30s and persists for many years.

A cab driver, stuck in traffic, becomes lightheaded, tremulous, diaphoretic, tachycardic and dyspneic. A workup in an emergency department reveals no pathology. Which medical diagnosis should a nurse suspect, and what nursing diagnosis should be the nurse's first priority? a. Generalized anxiety disorder and a nursing diagnosis of fear b. Altered sensory perception and a nursing diagnosis of panic disorder c. Pain disorder and a nursing diagnosis of altered role performance d. Panic disorder and a nursing diagnosis of anxiety

d. Panic disorder and a nursing diagnosis of anxiety

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. Parents who are alcohol dependent

An instructor is teaching nursing students about the difference between partial and inpatient hospitalization. In what way does partial hospitalization differ from traditional inpatient hospitalization? a. Partial hospitalization does not provide medication administration and monitoring. b. Partial hospitalization does not use an interdisciplinary team. c. Partial hospitalization does not offer a comprehensive treatment plan. d. Partial hospitalization does not provide supervision 24 hours a day.

d. Partial hospitalization does not provide supervision 24 hours a day.

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. Prolixin decanoate

According to Margaret Mahler, predisposition to borderline personality disorder occurs when developmental tasks go unfulfilled in which on 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 their mother c. Differentiation stage, 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. Rapprochement phase, during which the mother withdraws emotional support in response to the child's increasing independence.

Ellen has a history of childhood physical and sexual abuse. She was dx with Dissociative Identity Disorder (DID) 6 years ago. She has been admitted to the psychiatric unit following a suicide attempt. The primary nursing dx 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. Risk for suicide related to unresolved grief.

Carol, age 16, has recently been diagnosed with Diabetes Mellitus. She must watch her diet and take an oral hypoglycemic medication daily. She has become very depressed, and her mother reports that Carol refuses to change her diet and often skips her medication. Carol has been hospitalized for stabilization of her blood sugar. The psychiatric nurse practitioner has been called in as a consult. Which of the following nursing diagnoses by the psychiatric nurse would be a priority for Carol at this time? a. Anxiety r/t hospitalization, evidenced by noncompliance b. Low self-esteem r/t feeling different from her peers, evidenced by social isolation c. Risk for suicide r/t new diagnosis of Diabetes Mellitus d. Risk-prone health behavior r/t denial of seriousness of her illness, evidenced by refusal to follow diet and take medication

d. Risk-prone health behavior r/t denial of seriousness of her illness, evidenced by refusal to follow diet and take medication

Sandra is the nurse leader of a supportive/therapeutic group for individuals with anxiety disorders. On the first day the group meets, Valerie speaks first and begins by sharing the intimate details of her incestuous relationship with her father. What type of member role is Nancy assuming in this group? a. Aggressor. b. Monopolizer. c. Blocker. d. Seducer.

d. Seducer

An older client has recently been prescribed sertraline (Zoloft). The client's spouse is taking paroxetine (Paxil). A nurse assesses that the client is experiencing restlessness, tachycardia, diaphoresis, and tremors. Which complication should a nurse suspect, and why? a. Neuroleptic malignant syndrome; caused by ingestion of two different seratonin reuptake inhibitors (SSRIs) b. Neuroleptic malignant syndrome; caused by ingestion of an SSRI and a monoamine oxidase inhibitor (MAOI) c. Serotonin syndrome; possibly caused by ingestion of an SSRI and an MAOI d. Serotonin syndrome; possibly caused by ingestion of two different SSRIs

d. Serotonin syndrome; possibly caused by ingestion of two different SSRIs

A suicidal client diagnosed with borderline personality disorder exhibits both fear and anger during the intake interview. Which nursing intervention would be appropriate for this client? a. Confine the client to a single room to promote calmness. b. Medicate client with antipsychotic medication to decrease fear and anger. c. Within 7 days, client will verbalize strategies to interrupt escalation of fear and anger. d. Start supportive counseling to identify sources of anger.

d. Start supportive counseling to identify sources of anger.

A nurse working on an inpatient psychiatric unit is assigned to conduct a 45-minute education group. What should the nurse identify as an appropriate group topic? a. Dream analysis b. Creative cooking c. Paint by number d. Stress management

d. Stress management

A client diagnosed with bipolar disorder has been taking lithium carbonate (Lithobid) for one year. The client presents in an emergency department with a temperature of 101°F (38°C), severe diarrhea, blurred vision, and tinnitus. How should the nurse interpret these symptoms? a. Symptoms indicate consumption of foods high in tyramine. b. Symptoms indicate lithium carbonate discontinuation syndrome. c. Symptoms indicate the development of lithium carbonate tolerance. d. Symptoms indicate lithium carbonate toxicity.

d. Symptoms indicate lithium carbonate toxicity.

Which developmental characteristic should a nurse identify as typical of a client diagnosed with severe intellectual developmental disorder (IDD)? a. The client can perform some self-care activities independently. b. The client has more advanced speech development. c. Other than possible coordination problems, the client's psychomotor skills are not affected. d. The client communicates wants and needs by "acting out" behaviors.

d. The client communicates wants and needs by "acting out" behaviors.

A nurse assesses a client suspected of having the diagnosis of major depressive episode. Which client symptom would rule out this diagnosis? a. The client is disheveled and malodorous. b. The client refuses to interact with others and isolates self in room. c. The client is unable to feel any pleasure. d. The client has maxed-out charge cards and exhibits promiscuous behaviors.

d. The client has maxed-out charge cards and exhibits promiscuous behaviors.

An athlete has been recently diagnosed with diabetes mellitus but denies the diagnosis. The athlete's speech is monotone when stating, "I'm ready to end my life." Which would be the priority outcome of crisis intervention for this client? a. The client will participate in unit activities. b. The client will express the desire for continued therapy by day 3. c. The client will list five personal strengths by day 2. d. The client will remain safe during hospitalization.

d. The client will remain safe during hospitalization.

Which group leader activity should a nurse identify as being most effective in the final, or termination, phase of group development? a. The group leader establishes the rules that will govern the group after discharge. b. The group leader encourages members to rely on each other for problem solving. c. The group leader presents and discusses the concept of group termination. d. The group leader helps the members to process feelings of loss.

d. The group leader helps the members to process feelings of loss.

A nurse is assisting an individual with mental illness recovery using the Psychological Recovery Model. The client says to the nurse, "I have schizophrenia. Nothing can be done. I might as well die." In which stage of the Psychological Recovery Model would the nurse assess this individual to be? a. The awareness stage b. The preparation stage c. The rebuilding stage d. The moratorium stage

d. The moratorium stage

A woman who was sexually assaulted six months ago by man with whom she was acquainted has since been attending a support group for survivors of rape. From this group, she's learned that the most likely reason the man raped or was that: 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. he was expressing power and dominance by means of sexual aggression and violence

Kim has a diagnosis of Borderline Personality Disorder. She often exhibits alternating clinging and distracting behaviors. The most appropriate nursing intervention with this type of behavior would be to a. encourage Kim to establish trust in one staff person, with whom all therapeutic interaction should take place b. secure a verbal contract with 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. rotate staff members who work with Kim so that she will learn to relate to more than one person

The nurse is caring for a client with schizophrenia. Orders from the physician include 100 mg chlorpromazine IM STAT and then 50 mg po bid; 2 mg benztropine po bid prn. Because benztropine was ordered on a prn basis, which of the following assessments by the nurse would convey a need for this medication? a. the clients level of agitation increases b. the client complains of a sore throat c. the clients skin has a yellowish cast d. the client develops tremors and a shuffling gait

d. the client develops tremors and a shuffling gait

The primary focus of family therapy for clients with schizophrenia and their families is: a. to discuss concrete problem-solving and adaptive behaviors for coping with stress b. to introduce the family to others with the same problem c. to keep the client and family in touch with the health-care system d. to promote family interaction and increase understanding of the illness

d. to promote family interaction and increase understanding of the illness

A school nurse notices bruises and scars on the child's body but the child refuses to say how she received them. Another way the nurse can get information from the child is to: a. have her evaluated by the school psychologist b. tell her she may select a "treat" from the treat box if she answers the nurse's 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. use a "family" of dolls to role-play the child's family with her

Anna, who is 72 years old, is of the age at which she may have experienced many losses coming close together. What is this called? a. Bereavement overload b. Normal mourning c. Isolation d. Cultural relativity

A. Bereavement overload

John has a history of violence and is hospitalized with substance use disorder. One evening, the nurse hears John yelling in the dayroom. The nurse observes his increased agitation, clenched fists, and loud demanding voice. He is challenging and threatening staff and the other clients. The nurses priority intervention is? A. Call for assistance. B. Draw up a syringe of prn haloperidol. C. Ask John if he would like to talk about his anger. D. Tell John that if he does not calm down, he will have to be restrained.

A. Call for assistance.

A client with OCD spends many hours each day washing her hands. The most likely reason she washes her hands so much is that it: A. Relieves her anxiety B. Reduces the probability of infection C. Gives her a feeling of control over her life D. Increases her self-concept

A. Relieves her anxiety

A client who is experiencing a panic attack has just arrived at the emergency dpt. Which is priority nursing intervention for this client? A. Stay with the client and reassure safety B. Administer a dose of diazepam C. Leave the client alone in a quiet room so that she can calm down D. Encourage the client to talk about what triggered the attack

A. Stay with the client and reassure safety

Nurse Jones decides to respect family wishes and not tell the client of his terminal status because that would bring the most happiness to the most people. With the following ethical theories is considered in this decision? A. Utilitarianism B. Kantianism C. Christian ethics D. Ethical egoism

A. Utilitarianism

Which of the following behaviors suggest a possible breach of professional boundaries? (Select all that apply.) a. The nurse repeatedly requests to be assigned to a specific client. b. The nurse shares the details of her divorce with the client. c. The nurse makes arrangements to meet the client outside of the therapeutic environment. d. The nurse shares how she dealt with a similar difficult situation.

A., B., C.

A client has just been admitted to the psychiatric unit with a diagnosis of Major Depressive Disorder. Which of the following behavioral manifestations might the nurse expect to assess? Select all that apply. a. Slumped posture b. Delusional thinking c. Feelings of despair d. Feels best early in morning and worse as the day progresses e. Anorexia

A., B., C., E.

A nurse is preparing a client who is a potential candidate for ECT and providing information about the treatments. The nurse may do which of the following? Select all that apply. a. Encourage the client to express fears about ECT b. Discuss with the client and family the possibility of short-term memory loss c. Remind the client and family that injury from the induced seizure is common d. Monitor any cardiac alterations (current or past) to avoid possible negative outcomes e. Ensure the client will be awake during the entire procedure

A., B., D.

An individual may be considered gravely disabled for which of the following reasons? Select all that apply. A. person, because of mental illness, cannot fulfill basic needs. B. A mentally ill person is in danger of physical harm based on inability to care for self. C. A mentally ill person lacks the resources to provide the necessities of life. D. A mentally ill person is unable to make use of available resources to meet daily living requirements

A., B., D.

Janet has a diagnosis of Generalized anxiety disorder. Her physician has prescribed buspirone 15 mg daily. Janet says to the nurse, "Why do I have to take this every day? My friend's doctor prescribed her Xanax and she only takes it when she feels anxious." Which of the following is most appropriate response? A. "Xanax is not effective for GAD" B. "Buspirone must be taken daily to be effective" C. "I will ask the doctor to change your dose to prn so you do not have to take it everyday D. "Your friend should be taking Xanax everyday" B

B. "Buspirone must be taken daily to be effective"

Which of the following statements by Anna might suggest that she is achieving resolution of her grief over Lucky's death? a. "I don't care anymore when I think about Lucky" b. "It's true. Lucky didn't always mind me. Sometimes he ignored my commands." c. "I remember how it happened now. I should have held tighter to his leash!" d. " I won't ever have another dog. It's just too painful to lose them."

B. "It's true. Lucky didn't always mind me. Sometimes he ignored my commands."

Anna is diagnosed with Major Depression. She is most likely fixed in which stage of the grief process? a. Denial b. Anger c. Depression d. Acceptance

B. Anger

The nurse assessed the position with electroconvulsive therapy on his client who has refuse to give consent. With which of the following legal actions might the nurse be charged because of this nursing action? A. Assault B. Battery C. False imprisonment D. Breach of confidentiality

B. Battery

Nurse Jones decides to go against family wishes and tell the client of his terminal status because that is what she would want if she were the client. Which of the following ethical theories is considering this decision? A. Kantianism B. Christian ethics C. Natural law theories D. Ethical egoism to a

B. Christian ethics

A widow of 23 years has not removed any of her husband's possessions including his slippers beside their bed. Which pathological grief response is being exhibited by this client? A. Inhibited grief response B. Prolonged grief response C. Delayed grief response D. Distorted grief response

B. Prolonged grief response

Anna, age 72, has been grieving the death of her dog, Lucky, for 3 years. She is not able to take care of her ADLs and wants only to make daily visits to Lucky's grave. Her daughter has likely put off seeking help for Anna because: a. Women are less likely to seek help for emotional problems than men b. Relatives often try to "normalize" the behavior rather than label it mental illness c. She knows that all older people are expected to be a little depresses d. She is afraid that the neighbors "will think her mother is crazy"

B. Relatives often try to "normalize" the behavior, rather than label it a mental illness.

The initial care plan for a client with OCD who washes her hands obsessively would include which of the the following nursing interventions? A. Keep the client's bathroom locked so she cannot wash her hands all the time. B. Structure the client's schedule so that she has plenty of time for washing her hands C. Place the client in isolation until she promises to stop washing her hands so much D. Explain the client's behavior to her, since she is probability unaware that it is maladapative

B. Structure the client's schedule so that she has plenty of time for washing her hands

John, 27, was brought to the ED by police officers. He smelled strongly of alcohol and was combative. His blood alcohol level was measured at 293 mg/dL. His girlfriend reports that he drinks excessively every day and is verbally and physically abusive. The nurses give John the nursing diagnosis of Risk for Other-directed Violence. What would the appropriate outcome objectives for this diagnosis? Select all that apply. A. The client will not verbalize anger or hit anyone. B. The client will verbalize anger rather than hit others. C. The client will not harm self or others. D. The client will be restrained if he becomes verbally or physically abusive.

B. The client will verbalize anger rather than hit others. C. The client will not harm self or others.

John, who has a history of verbal and physical abuse of his girlfriend, is hospitalized with substance use disorder. One evening, during a visit from John's girlfriend, she and John are overheard having a loud argument. Which behavior by John would indicate he is learning to adaptively problem solve his frustrations? a. John says to the nurse, "Give me some of that medication before I end up in restraints!" b. When John's girlfriend leaves, John goes to the exercise room and punches on the punching bag. c. John says to the nurse, "I guess I'm going to have to dump that broad!" d. John says to his girlfriend, "You'd better leave before I do something I'm sorry for."

B. When John's girlfriend leaves, John goes to the exercise room and punches on the punching bag.

In teaching a client about his antidepressant medication, fluoxetine, which of the following would the nurse include? Select all that apply. a. Don't eat chocolate while taking this medication b. Keep taking this medication, even if you don't feel it is helping. It sometimes takes a while to take effect. c. Don't take this medication with the migraine drugs "triptans." d. Go to the lab each week to have your blood drawn for therapeutic level of this drug e. This drug causes a high degree of sedation, so take it just before bedtime.

B., C.

Which of the following statements is (are) correct regarding the use of restraints? Select all that apply. A. Restraints may never be initiated without a physicians order. B. Orders for restraints must be be issued by physician every two hours for children and adolescents. C. Client in restraints must be observed and assessed every hour for issues regarding circulation, nutrition, respiration, hydration, and elimination. D. Adults in restraints must have an in-person reevaluation by physician every 8 hours.

B., D.

Which of the following tasks are associated with the orientation phase of relationship development? (Select all that apply.) a. Promoting the client's insight and perception of reality. b. Creating an environment for the establishment of trust and rapport. c. Using the problem-solving model toward goal fulfillment. d. Obtaining available information about the client from various sources. e. Formulating nursing diagnoses and setting goals.

B., E.

Which of the following is the most appropriate therapy for a client with agoraphobia? A. 10 mg Valium qid B. Group therapy with other agoraphobics C. Facing her fear in gradual step progression D. Hypnosis

C. Facing her fear in gradual step progression

A competent, voluntary client has stated he wants to leave the hospital. The nurse hides his clothes in an effort to keep him from leaving. With which of the following legal actions might the nurse be charged because of this nursing action? A. Assault B. Battery C. False imprisonment D. Breach of confidentiality

C. False imprisonment

Joanie is a new patient at the mental health clinic. She has been diagnosed with Body Dysmorphic Disorder. Which of the following meds is the psychiatric nurse most likely to prescribe for Joanie? A. Alprazolam (Xanax) B. Diazepam (Valium) C. Fluoxetine (Prozac) D. Olanazpine (Zyprexa)

C. Fluoxetine (Prozac)

Three years ago, Anna's dog, Lucky, whom she had for 16 years was hit by a car and killed. Since that time, Anna has lost weight, rarely leaves her home, and sits around talking about Lucky. Anna's behavior would be considered maladaptive because: a. It has been more than 3 years since Lucky has died. b. Her grief is too intense just over the loss of a dog c. Her grief is interfering with her functioning d. People in this culture would not comprehend such behavior over loss of a pet

C. Her grief is interfering with her functioning.

Lucky sometimes refused to obey Anna, and indeed did not come back to her when she called to him on the day he was killed. But Anna continues to insist, "He was the very best dog. He always minded me. He always did everything I told him to do." This represents the defense mechanism: a. Sublimation b. Compensation c. Reaction formation d. Undoing

C. Reaction Formation

A client with OCD, says to the nurse, "I've been here 4 days now, and I'm feeling better. I feel comfortable on this unit, and I'm not ill-at-ease with the staff or other patients anymore." In light of this change, which nursing intervention is most appropriate? A. Give attention to the ritualistic behaviors each time they occur and point out their inappropriateness B. Ignore the ritualistic behaviors, and they will be eliminated for lack of reinforcement C. Set limits on the amount of time Sandy may engage in the ritualistic behavior. D. Continue to allow Sandy all the time she wants to carry out the ritualistic behavior

C. Set limits on the amount of time Sandy may engage in the ritualistic behavior.

For what reason would Anna's illness be considered a neurosis rather than a psychosis? a. She is unaware that her behavior is maladaptive b. She exhibits inappropriate emotional tone c. She experiences no loss of contact with reality d. She tells the nurse, "There is nothing wrong with me!"

C. She experiences no loss of contact with reality.

Andrew, a New York City firefighter, and his entire unit responded to the terrorist attacks on the World Trade Center. His friend Carlo was killed when the building collapsed. Andrew was injured, but survived. Since then, Andrew has frequent nightmares and anxiety attacks. He says to the mental health worker, "I don't know why Carlo had to die and I didn't!" This statement suggests that he is experiencing: a. spiritual distress b. night terrors c. survivor's guilt d. suicidal ideation

C. Survivor's guilt

What is the desired outcome of working with an individual who has witnessed a traumatic event and is now experiencing panic anxiety? a. the individual will experience no anxiety. b. the individual will demonstrate hope for the future. c. the individual will maintain anxiety at a manageable level. d. the individual will verbalize acceptance of self as worthy.

C. The individual will maintain anxiety at a manageable level.

Attempting to calm an angry client by using "talk therapy" is an example which of the following clients rights? a. The right to privacy B. The right to refuse medication C. The right to the least restrictive treatment alternative D. The right to confidentiality

C. The right to the least restrictive treatment alternative

Joe is very restless and is pacing a lot. The nurse says to Joe, "if you don't sit down in the chair and be still, I'm going to put you in restraints!" With which of the following legal actions might the nurse be charged because of this nursing action? A. Defamation of character B. Battery C. Breach of confidentiality D. Assault

D. Assault

Ms. T. has been diagnosed with agoraphobia. Which behavior would be most characteristic of this disorder? A. Ms. T. experiences panic anxiety when she encounters snakes B. Ms. T. refused to fly in an airplane C. Ms. T. will not eat in a public place D. Ms. T. stays in her home for fear of being in a place from which she cannot escape

D. Ms. T. stays in her home for fear of being in a place from which she cannot escape

With implosion therapy, a client with phobic anxiety would be: A. Taught relaxation exercises B. Subjected to graded intensities of the fear C. Instructed to stop the therapeutic sessions as soon as anxiety is experienced D. Presented with massive exposure to a variety of stimuli associated with the phobic object

D. Presented with massive exposure to a variety of stimuli associated with the phobic object

Anna's dog, Lucky, got away from her while they were taking a walk. He ran into the street and was hit by a car. Anna cannot remember any of these circumstances of his death. What defense mechanism is this? a. Rationalization b. Suppression c. Denial d. Repression

D. Repression

Based on the information in question 1, Anna's grieving behavior would most likely be considered to be: a. Delayed b. Inhibited c. Prolonged d. Distorted

D. distorted

Nancy, a depressed client who has been unkept and untidy for weeks, today comes to group therapy wearing makeup and a clean dress and having washed and combed her hair. Which of the following responses by the nurse is most appropriate? a. "Nancy, I see you have put on a clean dress and combed your hair." b. "Nancy, you look wonderful today!" c. "Nancy, I'm sure everyone will appreciate that you have cleaned up for the group today." d. "Now that you see how important it is, I hope you will do this every day."

a. "Nancy, I see you have put on a clean dress and combed your hair."

Mrs. S. asks the nurse, "Do you think I should tell my husband about my affair with my boss?" Which is the most appropriate response by the nurse? a. "What do you think would be best for you to do?" b. "Of course you should. Marriage has to be based on truth." c. "Of course not. That would only make things worse." d. "I can't tell you what to do. You have to decide for yourself."

a. "What do you think would be best for you to do?"

Nancy says to the nurse, "I worked as a secretary to put my husband through college, and as soon as he graduated, he left me. I hate him! I hate all men!" Which is an empathetic response by the nurse? a. "You are very angry now. This is a normal response to your loss." b. "I know what you mean. Men can be very insensitive." c. "I understand completely. My husband divorced me, too." d. "You are depressed now, but you will feel better in time."

a. "You are very angry now. This is a normal response to your loss."

A client with depression has just been prescribed the antidepressant phenelzine (Nardil). She says to the nurse, "The doctor says I will need to watch my diet while I'm on the medication. What foods should I avoid?" a. Blue cheese, red wine, raisin b. Black beans, garlic, pears c. Pork, shellfish, egg yolks d. Milk, peanuts, tomatoes

a. Blue cheese, red wine, raisin

Amanda's mobile home was destroyed by a tornado. Amanda received only minor injuries, but is experiencing disabling anxiety in the aftermath of the event. This type of crisis is called: a. Crisis resulting from traumatic stress. b. Maturational/developmental crisis. c. Dispositional crisis. d. Crisis of anticipated life transitions.

a. Crisis resulting from traumatic stress.

Psychotropic medications that block the acetylcholine receptor may result in which of the following side effects? a. Dry mouth b. Sexual dysfunction c. Nausea d. Priapism

a. Dry mouth

Which of the following hormones has been implicated in the etiology of mood disorder with seasonal pattern? a. Increased levels of melatonin b. Decreased levels of oxytocin c. Decreased levels of prolactin d. Increased levels of thyrotropin

a. Increased levels of melatonin

The most appropriate nursing intervention with Jenny would be to: a. Make arrangements for her to start attending Alateen meetings. b. Help her identify the positive things in her life and recognize that her situation could be a lot worse than it is. c. Teach her about the effects of alcohol on the body and that it can be hereditary. d. Refer her to a psychiatrist for private therapy to learn to deal with her home situation.

a. Make arrangements for her to start attending Alateen meetings.

The nurse has just admitted Nancy to the psychiatric unit. The psychiatrist has diagnosed Nancy with major depressive disorder. The nurse says to Nancy, "What questions do you have about being here on the unit?" Which nursing role described by Peplau is the nurse fulfilling in this instance? a. Resource person b. Counselor c. Surrogate d. Technical Expert

a. Resource person

JJ is a staff nurse on a surgical unit. He has been selected as leader of a newly established group of staff nurses organized to determine ways to decrease the number of medication errors occurring on the unit. J.J. has definite ideas about how to bring this about. He has also applied for the position of Head Nurse on the unit and believes that, if he is successful in leading the group toward achievement of its goals, he can also facilitate his chances for promotion. At each meeting he addresses the group in an effort to convince the members to adopt his ideas. Which type of group and style of leadership is described in this situation? a. Task, autocratic. b. Teaching, autocratic. c. Self-help, democratic. d. Supportive/therapeutic, laissez-faire.

a. Task, autocratic

Danny has been diagnosed with Paranoid Schizophrenia. On the unit he appears very anxious, paces back and forth, and darts his head from side to side in a continuous scanning of the area. He has refused to eat, making some barely audible comment related to "being poisoned." In planning care for Danny, which of the following would be the primary focus for nursing? a. To decrease anxiety and develop trust b. To set limits on his behavior c. To ensure that he gets to group therapy d. To attend to his hygiene needs

a. To decrease anxiety and develop trust

Anna has been a widow for 20 years. Her maladaptive grief response to the loss of her dog may be attributed to which of the following? (select all that apply) a. Unresolved grief over loss of her husband b. Loss of several relatives & friends over last few years c. Repressed feelings of guilt over the way in which Lucky died d. Inability to prepare in advance for the loss

a. Unresolved grief over loss of her husband b. Loss of several relatives & friends over last few years c. Repressed feelings of guilt over the way in which Lucky died d. Inability to prepare in advance for the loss ALL OF THESE

The goal of cognitive therapy with depressed clients is to a. identify and change dysfunctional patterns of thinking b. resolve the symptoms and initiate or restore adaptive family functioning c. alter the neurotransmitters that are creating the depressed mood d. provide feedback from peers who are having similar experiences

a. identify and change dysfunctional patterns of thinking

A client states: "I refuse to shower in this room. I must be very cautious. The FBI has placed a camera in here to monitor my every move." Which of the following is the therapeutic response? a. "That's not true." b. "I have a hard time believing that is true." c. "Surely you don't really believe that." d. "I will help you search this room so that you can see there is no camera."

b. "I have a hard time believing that is true."

The physician orders sertraline (Zoloft) 50mg bid for Margaret, a 68-year old woman with Major Depressive Disorder. After 3 days taking the medication, Margaret says tot he nurse, "I don't think this medicine is doing any good. I don't feel a bit better." What is the most appropriate response by the nurse? a. "Cheer up, Margaret. You have so much to be happy about." b. "Sometimes it takes a few weeks for the medicine to bring about an improvement in symptoms." c. "I'll report that to the physician, Margaret. Maybe he'll order something different." d. "Try not to dwell on your symptoms, Margaret. Why don't you join the others down in the dayroom."

b. "Sometimes it takes a few weeks for the medicine to bring about an improvement in symptoms."

Carol, an adolescent, just returned from group therapy and is crying. She says to the nurse, "All the other kids laughed at me! I try to fit in, but I always seem to say the wrong thing. I've never had a close friend. I guess I never will." Which is the most appropriate response by the nurse? a. "What makes you think you will never have any friends?" b. "You're feeling pretty down on yourself right now." c. "I'm sure they didn't mean to hurt your feelings." d. "Why do you feel this way about yourself?"

b. "You're feeling pretty down on yourself right now."

John is on the Alcohol Treatment Unit. He walks into the dayroom where other clients are watching a program on TV. He picks up the remote and changes the channel and says, "That's a stupid program! I want to watch something else!" In what stage of development is John fixed according to Sullivan's interpersonal theory? a. Juvenile because he is learning to form satisfactory peer relationships. b. Childhood because he has not learned to delay gratification. c. Early adolescence because he is struggling to form an identity. d. Late adolescence because he is working to develop a lasting relationship.

b. Childhood because he has not learned to delay gratification.

Marie, age 56, is the mother of five children. Her youngest child, who had been living at home and attending the local college, recently graduated and accepted a job in another state. Marie has never worked outside the home and has devoted her life to satisfying the needs of her husband and children. Since the departure of her last child from home, Marie has become more and more despondent. Her husband has become very concerned, and takes her to the local mental health center. This type of crisis is called: a. Dispositional crisis. b. Crisis of anticipated life transitions. c. Psychiatric emergency. d. Crisis resulting from traumatic stress.

b. Crisis of anticipated life transitions.

The most appropriate crisis intervention with Amanda would be to: a. Encourage her to recognize how lucky she is to be alive. b. Discuss stages of grief and feelings associated with each. c. Identify community resources that can help Amanda. d. Suggest that she find a place to live that provides a storm shelter.

b. Discuss stages of grief and feelings associated with each.

Mr. J. is a new client on the psychiatric unit. He is 35 years old. Theoretically, in which level of psychosocial development (according to Erikson) would you place Mr. J.? a. Intimacy vs. isolation b. Generativity vs. self-absorption c. Trust vs. mistrust d. Autonomy vs. shame and doubt

b. Generativity vs. self-absorption

Larry, who has antisocial personality disorder, feels no guilt about violating the rights of others. He does as he pleases without thought to possible consequences. In which of Peplau's stages of development would you place Larry? a. Learning to count on others b. Learning to delay gratification c. Identifying oneself d. Developing skills in participation

b. Learning to delay gratification

A decrease in which of the following neurotransmitters has been implicated in depression? a. GABA, acetylcholine, and aspartate b. Norepinephrine, serotonin, and dopamine c. Somatostatin, substance P, and glycine d. Glutamate, histamine, and opioid peptides

b. Norepinephrine, serotonin, and dopamine

Adam has antisocial personality disorder. He says to the nurse, "I'm not crazy. I'm just fun-loving. I believe in looking out for myself. Who cares what anyone thinks? If it feels good, do it!" Which of the following describes the psychoanalytical structure of Adam's personality? a.Weak id, strong ego, weak superego b. Strong id, weak ego, weak superego c.Weak id, weak ego, punitive superego d. Strong id, weak ego, punitive superego

b. Strong id, weak ego, weak superego

The nurse has just admitted Nancy to the psychiatric unit. The psychiatrist has diagnosed Nancy with major depressive disorder. The nurse says to Nancy, "Some changes will have to be made in your behavior. I care about what happens to you." Which nursing role described by Peplau is the nurse fulfilling in this instance? a. Counselor b. Surrogate c. Technical Expert d. Resource Person

b. Surrogate

N.J. is the nurse leader of a childbirth preparation group. Each week she shows various films and sets out various reading materials. She expects the participants to utilize their time on a topic of their choice or practice skills they have observed on the films. Two couples have dropped out of the group, stating, "This is a big waste of time." Which type of group and style of leadership is described in this situation? a. Task, democratic. b. Teaching, laissez-faire. c. Self-help, democratic. d. Supportive/therapeutic, autocratic.

b. Teaching, laissez-faire.

Which of the following parts of the brain integrates all sensory input (except smell) on the way to the cortex? a. Temporal lobe b. Thalamus c. Limbic system d. Hypothalamus

b. Thalamus

The most appropriate nursing intervention with Ginger would be to: a. Suggest she move to a college closer to home. b. Work with Ginger on unresolved dependency issues. c. Help her find someone in the college town from whom she could seek assistance rather than calling her mother regularly. d. Recommend that the college physician prescribe an antianxiety medication for Ginger.

b. Work with Ginger on unresolved dependency issues.

Nurse Mary has been providing care for Tom during his hospital stay. On Tom's day of discharge, his wife brings a bouquet of flowers and box of chocolates to his room. He presents these gifts to Nurse Mary saying, "Thank you for taking care of me." What is a correct response by the nurse? a. "I don't accept gifts from patients." b. "Thank you so much! It is so nice to be appreciated." c. "Thank you. I will share these with the rest of the staff." d. "Hospital policy forbids me to accept gifts from patients."

c. "Thank you. I will share these with the rest of the staff."

Judy has been in the hospital for 3 weeks. She has used Valium "to settle my nerves" for the past 15 years. She was admitted by her psychiatrist for safe withdrawal from the drug. She has passed the physical symptoms of withdrawal at this time, but states to the nurse, "I don't know if I will be able to make it without Valium after I go home. I'm already starting to feel nervous. I have so many personal problems." Which is the most appropriate response by the nurse? a. "Why do you think you have to have drugs to deal with your problems?" b. "Everybody has problems, but not everybody uses drugs to deal with them. You'll just have to do the best that you can." c. "We will just have to think about some things that you can do to decrease your anxiety without resorting to drugs." d. "Just hang in there. I'm sure everything is going to be okay."

c. "We will just have to think about some things that you can do to decrease your anxiety without resorting to drugs."

Which of the following is a correct assumption regarding the concept of crisis? a. Crises occur only in individuals with psychopathology. b. The stressful event that precipitates crisis is seldom identifiable. c. A crisis situation contains the potential for psychological growth or deterioration. d. Crises are chronic situations that recur many times during an individual's life.

c. A crisis situation contains the potential for psychological growth or deterioration.

The nurse has just admitted Nancy to the psychiatric unit. The psychiatrist has diagnosed Nancy with major depressive disorder. The nurse says to Nancy, "Please tell me what it was like when you were growing up." Which nursing role described by Peplau is the nurse fulfilling in this instance? a. Surrogate b. Resource person c. Counselor d. Technical Expert

c. Counselor

Jenny reported to the high school nurse that her mother drinks too much. She is drunk every afternoon when Jenny gets home from school. Jenny is afraid to invite friends over because of her mother's behavior. This type of crisis is called: a. Crisis resulting from traumatic stress. b. Maturational/developmental crisis. c. Dispositional crisis. d. Crisis reflecting psychopathology.

c. Dispositional crisis.

Psychotropic medications that are strong blockers of the D2 receptor are more likely to result in which of the following side effects? a. Sedation b. Urinary retention c. Extrapyramidal symptoms d. Hypertensive crisis

c. Extrapyramidal symptoms

Nurse Jones is the leader of a bereavement group for widows. Nancy is a new member. She listens to the group and sees that Jane has been a widow for 5 years now. Jane has adjusted well and Nancy thinks maybe she can too. This is an example of which curative factor? a. Universality. b. Imitative behavior. c. Instillation of hope. d. Imparting of information.

c. Instillation of hope

At a synapse, the determination of further impulse transmission is accomplished by means of which of the following? a. Potassium ions b. Interneurons c. Neurotransmitters d. The myelin sheath

c. Neurotransmitters

Which of the following parts of the brain deals with sensory perception and interpretation? a. Hypothalamus b. Cerebellum c. Parietal lobe d. Hippocampus

c. Parietal lobe

The nurse leader is explaining about group "curative factors" to members of the group. She tells the group that group situations are beneficial because members can see that they are not alone in their experiences. This is an example of which curative factor? a. Altruism. b. Imitative behavior. c. Universality. d. Imparting of information.

c. Universality

ECT is thought to effect a therapeutic response by: a. stimulation of the CNS b. decreasing the levels of acetylcholine and monoamine oxidase c. increasing the levels of serotonin, norepinephrine, and dopamine d. altering sodium metabolism within nerve and muscle cells

c. increasing the levels of serotonin, norepinephrine, and dopamine

Margaret, age 68, is a widow of 6 months. Since her husband died, her sister reports that Margaret has become socially withdrawn, has lost weight, and does little more each day than visit the cemetery where her husband was buried. She told her sister today that she "didn't have anything more to live for." She has been hospitalized with Major Depressive Disorder. The priority nursing diagnosis for Margaret would be: a. imbalanced nutrition; less than body requirements b. complicated grieving c. risk for suicide d. social isolation

c. risk for suicide

Dorothy was involved in an automobile accident while under the influence of alcohol. She swerved her car into a tree and narrowly missed hitting a child on a bicycle. She is in the hospital with multiple abrasions and contusions. She is talking about the accident with the nurse. Which of the following statements by the nurse is most appropriate? a. "Now that you know what can happen when you drink and drive, I'm sure you won't let it happen again." b. "You know that was a terrible thing you did. That child could have been killed." c. "I'm sure everything is going to be okay now that you understand the possible consequence of such behavior." d. "How are you feeling about what happened?"

d. "How are you feeling about what happened?"

The most appropriate nursing intervention with Marie would be to: a. Refer her to her family physician for a complete physical examination. b. Suggest she seek outside employment now that her children have left home. c. Identify convenient support systems for times when she is feeling particularly despondent. d. Begin grief work and assist her to recognize areas of self-worth separate and apart from her children.

d. Begin grief work and assist her to recognize areas of self-worth separate and apart from her children.

Paul is a member of an anger management group. He knew that people did not want to be his friend because of his violent temper. In the group, he has learned to control his temper and form satisfactory interpersonal relationships with others. This is an example of which curative factor? a. Catharsis. b. Altruism. c. Imparting of information. d. Development of socializing techniques.

d. Development of socializing techniques

Crises occur when an individual: a. Is exposed to a precipitating stressor. b. Perceives a stressor to be threatening. c. Has no support systems. d. Experiences a stressor and perceives coping strategies to be ineffective.

d. Experiences a stressor and perceives coping strategies to be ineffective.

John is a client at the mental health clinic. He is depressed, has been expressing suicidal ideations, and has been seeing the psychiatric nurse every 3 days. He has been taking 100 mg of sertraline daily for about a month, receiving small amounts of the medication from his nurse at each visit. Today he comes to the clinic in a cheerful mood, much different than he seemed just 3 days ago. How might the nurse assess this behavioral change? a. The sertraline is finally taking effect. b. He is no longer in need of antidepressant medication. c. He has completed the grief response over loss of his wife. d. He may have decided to carry out his suicide plan.

d. He may have decided to carry out his suicide plan.

Which of the following parts of the brain has control over the pituitary gland and autonomic nervous system, as well as regulation of appetite and temperature? a. Temporal lobe b. Parietal lobe c. Cerebellum d. Hypothalamus

d. Hypothalamus

Which of the following parts of the brain is associated with multiple feelings and behaviors and is sometimes referred to as the "emotional brain?" a. Frontal lobe b. Thalamus c. Hypothalamus d. Limbic System

d. Limbic System

Ginger, age 19 and an only child, left 3 months ago to attend a college of her choice 500 miles away from her parents. It is Ginger's first time away from home. She has difficulty making decisions and will not undertake anything new without first consulting her mother. They talk on the phone almost every day. Ginger has recently started having anxiety attacks. She consults the nurse practitioner in the student health center. This type of crisis is called: a. Crisis resulting from traumatic stress. b. Dispositional crisis. c. Psychiatric emergency. d. Maturational/developmental crisis.

d. Maturational/developmental crisis.

Which of the following parts of the brain is concerned with visual reception and interpretation? a. Frontal lobe b. Parietal lobe c. Temporal lobe d. Occipital lobe

d. Occipital lobe

Janet, a psychiatric client diagnosed with borderline personality disorder, has just been hospitalized for threatening suicide. According to Mahler's theory, Janet did not receive the critical "emotional refueling" required during the rapprochement phase of development. What are the consequences of this deficiency? a. She has not yet learned to delay gratification. b. She does not feel guilt about wrongdoings to others. c. She is unable to trust others. d. She has internalized rage and fears of abandonment.

d. She has internalized rage and fears of abandonment.

M.K. is a psychiatric nurse who has been selected to lead a group for women who desire to lose weight. The criterion for membership is that they must be at least 20 pounds overweight. All have tried to lose weight on their own many times in the past without success. At their first meeting, M.K. provides suggestions as the members determine what their goals will be and how they plan to go about achieving those goals. They decided how often they wanted to meet, and what they planned to do at each meeting. Which type of group and style of leadership is described in this situation? a. Task, autocratic. b. Teaching, democratic. c. Self-help, laissez-faire. d. Supportive/therapeutic, democratic

d. Supportive/therapeutic, democratic

Education for the client who is taking MAOIs should include which of the following? a. Fluid and sodium replacement when appropriate, frequent drug blood levels, signs and symptoms of toxicity. b. Lifetime of continuous use, possible tardive dyskinesia, advantages of an injection every 2 to 4 weeks. c. Short-term use, possible tolerance to beneficial effects, careful tapering of the drug at end of treatment. d. Tyramine-restricted diet, prohibitive concurrent use of over the counter medications without physician notification.

d. Tyramine-restricted diet, prohibitive concurrent use of over the counter medications without physician notification.

A depressed client is receiving an ECT treatment. In the treatment room, the anesthesiologist administers methohexital sodium (Brevital) followed by IV succinylcholine (Anectine). The purpose of these medications are to: a. decrease secretions and increase heart rate b. prevent nausea and induce a calming effect c. minimize memory loss and stabilize mood d. induce anesthesia and relax muscles

d. induce anesthesia and relax muscles