Psych Nursing Exam 3

The nurse knows that when focusing on relapse prevention, what is most important for the client? 1. Identify high-risk situations. 2. Acknowledge connection to a greater power. 3. View the disorder as only one facet of who the client is. 4. Recognize that most relapse occurs after five years of being chemically clean.

1. Identify high-risk situations

A client with a diagnosis of borderline personality disorder has had several hospitalizations for suicide attempts and self-mutilation. A priority nursing intervention for this client would include which of the following? 1. Safety maintenance 2. Social interaction 3. Anxiety reduction 4. Concrete communication

1. Safety maintenance

A community health-planning group is meeting to discuss increasing violence among children in the community. Which setting would be expected to have the lowest occurrence of violence? 1. Schools 2. Streets 3. Residential centers 4. Homes

1. Schools

A client in an alcohol rehabilitation program tells the nurse, "I've been such a loser all my life! I feel so ashamed for what I have put my family through! Now I am in rehab and I am not sure I can stay sober." What nursing diagnosis would be most appropriate? 1. Self-Esteem Disturbance 2. High Risk for Violence 3. Powerlessness 4. Alteration in Health Maintenance

1. Self-Esteem Disturbance

A nurse is meeting with a family in which the wife abuses alcohol. During the family assessment meeting, the nurse observes that the husband tends to help the wife during the assessment. The husband says, "I help her a lot. This is so difficult for her." What type of support group might be helpful for the husband? 1. Alcoholics Anonymous 2. Caretakers group 3. Adult Children of Alcoholics 4. Codependents group

4. Codependents group

A nurse is working with a client who has a diagnosis of obsessive-compulsive personality disorder. It is important for the nurse and client to discuss: 1. The effect of anger on perfectionism. 2. The need to feel superior. 3. The link between anxiety and perfectionism. 4. The need for medication.

3. The link between anxiety and perfectionism

Impulse control is part of the care plan for a client with borderline personality disorder. Which of the following is particularly important to include? 1. A no-harm contract 2. Identification of behavior patterns 3. Identification of support sources 4. Management of emotions

1. A no harm contract

The nurse instructs the client about addiction. The nurse determines that the client understands the instructions given when the client says: 1. "Addiction is a biopsychosocial problem." 2. "Addiction is an emotional attachment." 3. "Addiction is a behavioral habit." 4. "Addiction is a moral disease."

1. Addiction is a biopsychosocial problem

A client with borderline personality disorder gives written notice of intention to leave the hospital after a voluntary admission. The client tells the nurse, "I will rescind my notice if you expand my smoking privileges." The nurse should respond in a way that: 1. Convinces the client to rescind the notice. 2. Provides exceptions to the unit rules. 3. Refers the client to the physician. 4. Consistently reinforces the unit rules.

4. Consistently reinforces the unit rules

Since chemical dependency is a family disease, it is important to help non-abusing family members change over-responsible behaviors such as: 1. Expressing their feelings directly. 2. Rejecting the client until the client is chemically clean. 3. Distancing themselves from the client's problem. 4. Covering up for problems the client has.

4. Covering up for problems the client has

The nurse is assessing a child diagnosed with conduct disorder. Which would be the most appropriate question to ask the parents? 1. "Does your child have a history of cruelty to other people and animals?" 2. "Does your child unconsciously direct feelings and desires from other relationships toward others?" 3. "Does your child seem to be reassured by your presence?" 4. "Does your child readily seek out caregivers in times of stress?"

1. Does your child have a history of cruelty to other people and animals?

A nurse generalist and advanced practice nurse both work on the staff of an inpatient unit. The advanced practice nurse has a comprehensive role as a primary caregiver in child psychiatry. Which of the following will be performed by the advanced practice nurse but not by the nurse generalist? 1. Explaining the treatment plan to a family 2. Performing admission assessments 3. Participating in discharge planning 4. Providing one-to-one counseling

4. Providing one-to-one counseling

The nurse is working with a client who has been diagnosed with a somatoform disorder. The nurse knows it is important to include which of the following interventions in the client's plan of care? Standard Text: Select all that apply. 1. Encourage verbalization of feelings. 2. Encourage the client to write in a journal 3. Establish a weekly routine 4. Establish a trusting relationship. 5. Encourage the discussion of physical symptoms

1. Encourage verbalization of feelings 2. Encourage client to write in a journal 4. Establish a trusting relationship

A client diagnosed with bipolar disorder is hyperverbal during the initial assessment. In an effort to help the client understand what is required in treatment, the nurse has a calm demeanor, decreases stimuli, and talks to the client one-on-one. The nurse is responding to the client's: 1. Cognitive style. 2. Negative behavior. 3. Positive behavior style. 4. Mania.

1. Formulate practical and measurable objectives

The nurse knows that being a competent provider of cognitive behavioral interventions involves understanding and being aware of cultural considerations. Characteristics that nurses must be aware of during assessment include: 1. Gender, sexual orientation, and age. 2. Illness prevention, disability, and gender. 3. Group expression, self-awareness, and religion. 4. Family matters, self-awareness, and age.

1. Gender, sexual orientation, and age

Which of the following statements made by an abusive family member in a counseling session indicates that the individual has learned positive coping skills? 1. "I feel more prepared to care for my father now that I know where to go for assistance." 2. "I am so sorry I lost control; it will never happen again." 3. "From now on I will make sure that my father's needs are met." 4. "Now that I realize I treated my father unfairly, I will change my ways."

1. I feel more prepared to care for my father now that I know where to go for assistance

There are many roles involved in caring for clients in the specialized area of child psychiatry. Which of the following diverse clinical functions includes the role of the nurse generalist working in child psychiatry? Select all that apply. 1. Administer medication 2. Utilize knowledge and skills related to the mental health needs of clients 3. Prescribe psychotropic medications 4. Utilize knowledge related to the physical health needs of clients 5. Order diagnostic tests necessary to monitor effects of psychotropic medications

1. Administer medication 2. Utilize knowledge and skills related to the mental health needs of clients 4. Utilize knowledge related to the physical health needs of clients

A client was brought to the hospital at two a.m. She had been drinking and she fell, fracturing her femur. If the client is going to experience withdrawal symptoms, the nurse should be alert for them to peak around which time? 1. 24-48 hours after drinking stops 2. 72-92 hours after drinking stops 3. 54-72 hours after drinking stops 4. 6-12 hours after drinking stops

1. 24-48 hours after drinking stops

Who among the following females is at greatest risk of becoming a victim of sexual abuse? 1. A female who carpools with a male coworker 2. The partner of a man with a strong sex drive 3. An attractive 14-year-old female who dresses in a manner that makes her appear older 4. A 45-year-old widow who goes to a local club to meet new people

1. A female who carpools with a male coworker

The charge nurse is assigned a "float" nurse to help on the children's unit. The nurse normally works with adults and says she feels "out of place" working with the children. In making the assignments, which of the following activities would the charge nurse NOT assign to the "float" nurse? Select all that apply. 1. Administering daily medications 2. Administering PRN medications 3. Obtaining vital signs 4. Making rounds with the psychiatrist 5. Monitoring the children under "close observation"

1. Administering daily medications 2. Administering PRN medications 4. Making rounds with the psychiatrist 5. Monitoring the children under close observation

The nurse is caring for a client with somatization disorder. When providing a report to the staff on the next shift, it is important for the nurse to relate the: 1. Amount of time the client talked about physical complaints. 2. Trigger for the client's worries. 3. Use of abdominal breathing at the first sign of anxiety. 4. The client's source of the original anxiety.

1. Amount of time the client talked about physical complaints

A psychiatric nurse is providing an educational session to the emergency room staff to raise awareness on the topic of elder abuse. Which client is most at risk for elder abuse? 1. An 82-year-old woman with middle-stage dementia 2. A 73-year-old woman living in a poor neighborhood 3. A 70-year-old man with the recent diagnosis of heart disease 4. An 89-year-old man living with a mentally ill family member

1. An 82-year-old woman with middle stage dementia

Which of the following behaviors observed by the nurse will be important to disclose to the teacher of a child with a stereotypic movement disorder? 1. An episode of self-mutilation 2. Depression that results from feelings of inadequacy 3. Tendency to be hypoactive 4. Flexibility and ability to contribute to learning

1. An episode of self mutilation

The nurse admits a client who initially presents as intelligent, articulate, and superficially charming. The client claims his admission to the mental health unit is a big mistake. He states that there was a mix-up in the emergency room and he was incorrectly identified. A probable diagnosis is: 1. Antisocial personality disorder. 2. Avoidant personality disorder. 3. Dependent personality disorder. 4. Obsessive-compulsive personality disorder.

1. Antisocial PD

The student nurse is comparing the essential characteristics of each cluster of personality disorders. The student correctly identifies the essential characteristics of cluster C disorders as: 1. Anxiety. 2. Pervasive distrust. 3. Impulsivity. 4. Openness.

1. Anxiety

A client comes to the clinic complaining of headaches. Further assessment reveals three one-inch bald spots at different locations on the client's scalp. The client states the headache and the bald spots resulted from an "accident." The client's partner, who has accompanied the client into the exam room, often finishes the client's sentences. The nurse should: 1. Ask the partner to remain in the waiting room while the client is examined. 2. Alert hospital security about the potential for violence. 3. Encourage the partner to remain with the client to provide information about the client's health. 4. Contact the local authorities.

1. Ask the partner to remain in the waiting room while the client is examined

For a substance-abusing client, the most appropriate nursing goal is to: 1. Assume responsibility for the choice to use substances. 2. Allow family to determine the plan of intervention. 3. Use acceptable amounts of legal substances. 4. Learn to avoid feelings of low self-esteem.

1. Assume responsibility for the choice to use substances

An abused client in the inpatient unit recovering from injuries asks to attend Mass at the hospital chapel. The nurse understands that it is important for the client to: 1. Attend to spiritual needs in order to deal with what has happened. 2. Get back to a normal routine as soon as possible. 3. Find a distraction from the injuries. 4. Show an interest in what is going on in the world.

1. Attend to spiritual needs in order to deal with what has happened

What is the most therapeutic approach of a nurse toward a victim of violence? 1. Being supportive, nurturing, and empathetic 2. Educating the client on how to avoid future incidents 3. Distracting the client to minimize feelings of despair and guilt 4. Maintaining objectivity and offering short, to-the-point responses

1. Being supportive, nurturing, and empathetic

A client diagnosed with bipolar disorder is hyperverbal during the initial assessment. In an effort to help the client understand what is required in treatment, the nurse has a calm demeanor, decreases stimuli, and talks to the client one-on-one. The nurse is responding to the client's: 1. Cognitive style. 2. Negative behavior. 3. Positive behavior style. 4. Mania.

1. Cognitive style

The school nurse recommends that the parents of a student seek help because the student is constantly in trouble and recently has set several small fires on school grounds. The nurse is concerned because the child is manifesting signs of: 1. Conduct disorder. 2. Depression 3. Oppositional defiant disorder. 4. Attention deficit hyperactivity disorder.

1. Conduct disorder

The nursing student knows that the therapist's goal in behavior therapy is to: 1. Decrease classical conditioning. 2. Increase self-confidence. 3. Deny religiosity in mental health clients. 4. Increase social reasoning.

1. Decrease classical conditioning

A client presents with an inability to make decisions and function independently. The nurse knows these symptoms are indicative of which of the following disorders? 1. Dependent personality disorder 2. Paranoid personality disorder 3. Schizotypal personality disorder 4. Schizoid personality disorder

1. Dependent PD

What would the nurse expect to find when assessing a client with obsessive-compulsive personality disorder? 1. Difficulty completing projects 2. A sense of spontaneity 3. Open expression of feelings 4. Ability to tolerate mistakes

1. Difficulty completing projects

The new stepfather of a child diagnosed with a conduct disorder wants to know the reason for including him in family therapy sessions. The nurse explains that the goal of family therapy is to: 1. Increase the probability that the child's mental health will improve. 2. Help the child relive past events and related feelings. 3. Provide an opportunity for the parents to interact with their child in a safe environment. 4. Speak for the child so the parents can become more aware of the child's potential.

1. Increase the probability that the child's mental health will improve

In caring for victims of violence it is important for nurses to be aware of their personal feelings and attitudes about the situation because: 1. Intense negative feelings interfere with assessment and judgment. 2. It allows the nurse to express sympathy for the client. 3. Intense protective feelings result in appropriate interventions for the victim's care. 4. Self-awareness protects the nurse's own mental health.

1. Intense negative feelings interfere with assessment and judgement

A client with a diagnosis of antisocial personality disorder comes to the nurses' station at 11:00 p.m. requesting to use the phone. The client insists on consulting a lawyer immediately to discuss filing for a divorce. The unit rules prohibit phone calls after 10:00 p.m. Which of the following responses is therapeutic for this client? 1. "It is after 10:00 p.m. You can call tomorrow." 2. "You know better than to break the rules. I'm surprised at you." 3. "You really don't want to file for a divorce, do you?" 4. "You may go ahead and use the phone. I know this is hard for you."

1. It is after 10 pm. You can call tomorrow

A student nurse is working with a client on the inpatient unit who exhibits manipulative behavior. What action should the student incorporate into interactions with this client? 1. Limit setting 2. No-harm contract 3. Confront negative self-concepts 4. Matter-of-fact approach

1. Limit setting

As a nurse advocate for the reduction of family elder abuse, a nurse: 1. Locates community resources for families. 2. Educates the public about legal consequences of violent acts. 3. Helps abused victims make it to the hospital for treatment. 4. Encourages abusers to come forward to talk about their issues.

1. Locates community resources for families

The nurse knows that performing an assessment on a client with dissociative disorder can be challenging. The nurse knows it is important to include which of the following in the assessment? Select all that apply. 1. Memory 2. Identity 3. Consciousness 4. Client's spouse 5. Awareness of time

1. Memory 2. Identity 3. Consciousness 5. Awareness of time

A nursing student receiving D's on quizzes decides to begin studying with a group of students known to make A's. The nursing instructor knows that the student is exhibiting what type of behavior? 1. Modeling 2. Attributing 3. Self-efficacy 4. Assuming

1. Modeling

During a group session, the nursing student notes one of the clients imitating another client's manner of speaking and communicating. The client being imitated has actively participated in all groups and is going home tomorrow. The nursing student suspects the client doing the imitating is: 1. Modeling behavior. 2. Being a comedian. 3. Expecting an award. 4. Jealous of the other client.

1. Modeling behavior

The nurse is working with a client who exhibits a grandiose sense of self-importance. This characteristic is associated with which of the following personality disorders? 1. Narcissistic personality disorder 2. Avoidant personality disorder 3. Histrionic personality disorder 4. Dependent personality disorder

1. Narcissistic PD

A nurse is studying personality disorders. What statement would indicate that the nurse can differentiate between personality traits and personality disorders? 1. "Personality traits are persistent behavior traits that do not significantly interfere with an individual's life." 2. "Personality traits are lifelong maladaptive patterns." 3. "Personality traits are rigid, stereotyped behavioral patterns." 4. "Personality traits are enduring and deviate from societal norms."

1. Personality traits are persistent behavior traits that do not significantly interfere with an individual's life

The nurse is presenting an in-service on dissociative disorder. The nurse knows that which of the following is most often used to explain the occurrence of dissociative disorder in psychiatric clients? 1. Psychosocial theories 2. Biological theories 3. Genetic theories 4. Physical theories

1. Psychosocial theories

The nurse is caring for a client who is experiencing alcohol withdrawal. Which of the following diagnoses receives priority for a client in alcohol withdrawal? 1. Risk for Injury 2. Ineffective Coping 3. Disturbed Sensory Perception 4. Disturbed Thought Processes

1. Risk for injury

A client who is being physically and sexually abused states, "God doesn't want to bother with me. Am I an evil person? Why do these things always happen to me? What's wrong with God?" These statements indicate that the client is most likely experiencing. Select all that apply. 1. Spiritual distress 2. Anger 3. Altered thought process 4. Fear 5. Hopelessness

1. Spiritual distress 2. Anger 4. Fear 5. Hopelessness

The nurse is assessing a depressed child who was referred by the elementary school nurse. What is the best approach to use when assessing the child's socialization? 1. "Tell me about the friends you enjoy being with." 2. "So you spend a lot of time with your friends?" 3. "You seem like a person who would have a lot of friends." 4. "How many friends do you have at school?"

1. Tell me about the friends you enjoy being with.

A client brought to the emergency room after a motor vehicle accident tells the nurse that she attended a party and drank four drinks over the last hour. Her blood alcohol level is 0.15g/dl. She states she is "buzzed." What conclusions can the nurse draw? 1. The client is intoxicated. 2. The client's blood alcohol level is dangerously high. 3. The client has a problem with alcohol dependence. 4. There is insufficient data to draw a conclusion.

1. The client is intoxicated

The nurse finds that the client with a pain disorder has been in a physically and verbally abusive relationship. The client feels guilty and fears a loss of love. According to psychoanalytic concepts, this is believed to be a(n): 1. Unconscious conflict from childhood that was reawakened in adulthood by a similar situation. 2. Environmental factor. 3. Stress related to relationships. 4. Brain abnormality.

1. Unconscious conflict from childhood that was reawakened in adulthood by a similar situation

Self-awareness is an important aspect of nursing practice in any specialty. Which of the following questions would the nurse ask to build self-awareness when working with child psychiatric clients? Standard Text: Select all that apply. 1. "What don't I like about this child?" 2. "How can I use this opportunity to learn more about myself?" 3. "What am I learning about myself as I work with this child?" 4. "How do I avoid working with the parents?"

1. What don't I like about this child? 2. How can I use this opportunity to learn more about myself? 3. What am I learning about myself as I work with this child?

The nurse is taking the history of a psychiatric client suspected of abusing alcohol. Which assessment question is best to ask? 1. When was your last drink? 2. Do you drink regularly? 3. Are you experiencing blackouts? 4. Who are your drinking partners?

1. When was your last drink?

A mother is concerned because her 6-year-old son stutters. She wants to know if she did anything during her pregnancy to cause this. Which of the following would be the best response? The nurse should: 1. Assess for impaired thermoregulation during the postnatal period. 2. Assess for a family history of the disorder. 3. Verbalize the implied by asking, "Are you saying you feel responsible for his problem?" 4. Ask if the mother had preeclampsia during labor.

2. Assess for a family history of the disorder

The nurse is learning how to reduce the stigma associated with substance abuse. Which of the following statements by the nurse would reflect that learning has taken place? 1. "We're admitting a coked-out, manic client." 2. "A 34-year-old is being admitted for suicidal threats as a result of cocaine use." 3. "They've added another druggie to my caseload." 4. "We're admitting a cocaine addict who threatened to kill herself."

2. A 34 year old is being admitted for suicidal threats as a result of cocaine use

A growing role of the child psychiatric-mental health nurse is: 1. Scrutinizing the public. 2. Promoting infant mental health. 3. Monitoring adult inpatient psychiatric clients. 4. Preventing mental health problems.

2. Promoting infant mental health

A client is newly diagnosed with dissociative identity disorder. To support this client, who is struggling to accept the diagnosis, the nurse would: 1. Flood the client with stressful stimuli. 2. Actively listen to each identity state and provide support. 3. Assess for secondary gain to confront the client. 4. Discourage the use of psychometric tests.

2. Actively listen to each identity state and provide support

The nurse educator is discussing the family systems explanation for substance abuse with the nursing students. Which of the following is included in the family systems explanation of substance abuse? 1. Addiction can be managed through pharmacologic intervention. 2. Addiction shifts the family focus. 3. Addiction is a disease. 4. Addiction is due to genetic causes.

2. Addiction shifts family focus

A client presents to the community clinic describing abdominal pain, refuses to complete informational forms, and dismisses the nurse's assessment attempts while demanding to be seen immediately by a doctor. Which approach would be best for the nurse to use when assessing for somatoform disorders? 1. Realize client judgment is intact. 2. Avoid personalizing the behavior by recognizing that somatization is part of the illness. 3. Have sympathy for the psychopathology of the disorder. 4. Expect the client to respond appropriately to the nurse's need to complete the assessment

2. Avoid personalizing the behavior by recognizing that somatization is part of the illness

The nursing student working on a group project brings healthy snacks to the meeting so he and his fellow classmates will not gain unwanted pounds as they did on a previous massive assignment. The student has employed: 1. Unobserved behaviors tracked in subjective measurable terms. 2. Behavior modification. 3. Process illumination. 4. Interactional group therapy.

2. Behavior modification

A nursing student attempting to use a behavioral modification contract found in the textbook is having trouble getting the client to follow through with everything in the contract. The nursing instructor knows to tell the student that behavioral contracts must be: 1. Affected by the functionality of the client. 2. Reflective of the client's mental illness. 3. Tailored for the individual. 4. Reflective of the characteristics within the client's family.

2. Behavioral contract

When speaking with a client who has a mental illness, the nurse uses medical terminology and is condescending. This type of behavior negates the basic rules of negotiating a behavioral contract and: 1. Encourages the client to ask questions. 2. Causes the client to feel uncomfortable with the contract. 3. Appropriately introduces the client to important terminology. 4. Helps the client understand behavioral contracts on his/her terms.

2. Causes the client to feel uncomfortable with the contract

The nurse cares for several clients with somatoform disorders, regularly reassessing their status. The nurse is aware that it is: 1. Easy to be kind, nonjudgmental, and understanding. 2. Challenging because of the psychobiologic factors involved. 3. Best to include objective information only. 4. Best to include subjective information only.

2. Challenging because of the psychobiology factors involved

When planning a new children's mental health clinic, the nurse understands the importance of including a play area. Play and toys are used to assess children with suspected mental disorders because: 1. Children do not usually relate to adults. 2. Children express themselves through play. 3. Only toys that are developmentally appropriate and specific to the child's biological age are used. 4. Play enables the nurse to assess cognitive ability.

2. Children express themselves through play

How can the nurse differentiate the client with obsessive-compulsive personality disorder from a client with perfectionist personality traits? 1. Clients with obsessive-compulsive personality disorder will exhibit order in all areas of their lives. 2. Clients with obsessive-compulsive personality disorder will exhibit fear, anxiety, and an excessive need for order. 3. Clients with obsessive-compulsive personality disorder will exhibit the need for perfection in everyone but themselves. 4. Clients with obsessive-compulsive personality disorder will exhibit order in their work lives but are able to relax when away from work.

2. Clients with obsessive-compulsive PD will exhibit fear, anxiety, and an excessive need for order

The nurse providing case management to a child with a mental illness will collect data from the child's parents, teachers, and other health care providers in order to: 1. Complete a mental status exam. 2. Complete a comprehensive evaluation. 3. Collaborate with individuals that are significant to the child. 4. Complete a personality profile

2. Complete a comprehensive evaluation

A client diagnosed with schizoaffective disorder has threatened suicide. While developing the care plan, the nurse puts in the nurse's notes, "The client, though disheveled, is articulate and has a clear plan for suicide, but has made no current attempts." The nursing note helps the nurse develop the behavioral contract by: 1. Orienting the client to the nursing process. 2. Considering interactions during the assessment process. 3. Observing essential information. 4. Cooperating with the family.

2. Considering interactions during the assessment process

A client with a poorly regulated corticotropin-releasing factor (CRF) will most likely have difficulties: 1. Relating to others. 2. Coping with stress. 3. Balancing life issues. 4. Interpreting the environment.

2. Coping with stress

The nurse administering a lithium carbonate (Lithobid) to a child with mental retardation monitors the child for which of the following therapeutic effects? 1. Weight loss 2. Decreased agitation 3. Weight gain 4. Elevated mood

2. Decreased agitation

When working with a client who has exhibited a pattern of violent outbursts followed by remorse, a nurse's plan of care should focus on: 1. Decreasing the client's stressors. 2. Developing effective anger management techniques. 3. Offering the client family counseling. 4. Identifying the client's strengths.

2. Developing effective anger management techniques

Clients with antisocial personality disorder display a lack of empathy and will put their own needs above the needs of others. Interventions for clients with antisocial personality disorder will be targeted toward which of the following behaviors? 1. Displaying a great deal of responsibility toward others 2. Displaying a disregard for the rights of others 3. Displaying a great deal of self-control 4. Displaying a great deal of anxiety

2. Displaying a disregard for the rights of others

The nurse is teaching an alcoholic patient about the importance of proper nutrition. Which of the following nutritional recommendations is appropriate for clients with alcohol dependence? 1. Restrict fluid intake to decrease renal load 2. Provide a multivitamin supplementation, including thiamine and folate 3. Encourage a high-protein, low-carbohydrate diet to promote lean body mass 4. Increase sodium-rich foods to increase iodine levels

2. Provide a multivitamin supplementation, including thiamine and folate

The parents of a premature infant are visiting their baby in the neonatal intensive care unit for the first time. The nurse observes the couple standing beside the incubator. Which of the following interventions will help facilitate the infant's immediate mental health needs? 1. Notify the infant's physician to come and talk with the parents 2. Facilitate stroking and touching their infant 3. Continue to observe their interactions to rule out a problem with bonding 4. Have them meet with other parents of premature infants

2. Facilitate stroking and touching their infant

A nurse is taking the history of a client and suspects that the client has been sexually abused. Which question will prompt a response that will aid the nurse in making an accurate assessment? 1. "Do you like to dress in provocative outfits?" 2. "Has anyone touched you in a way that made you feel uneasy or uncomfortable?" 3. "Do you have any bruises anywhere on your body?" 4. "How is your relationship with your parents and older siblings?"

2. Has anyone touched you in a way that made you feel uneasy or uncomfortable?

Which statement by a nurse would indicate a nonjudgmental attitude toward violence and abuse? 1. "Parents should not allow their children to party in the middle of the night; this is when most date rapes happen." 2. "I admitted an 18-year-old for a suicide attempt following a date rape." 3. "Most people who have sex when drunk tend to perceive it as rape." 4. "Most adolescents call it rape when they don't enjoy a sexual experience."

2. I admitted an 18-year old for a suicide attempt following a date rape

A 30-year-old man is accused of sexual assault and is arrested by law enforcement. During the interview with the forensic nurse, the client uses flattery and compliments the nurse's interview skills. He asks the nurse for her phone number so his lawyer can contact her as an expert witness for his case. How should the nurse respond? 1. Tell the client that she is listed in the phone book. 2. In a way that establishes the boundaries of the nurse-client relationship. 3. Tell the client that the nurse is working for the prosecution. 4. In a way that nurtures the client's feelings.

2. In a way that establishes the boundaries of the nurse-client relationship

The nurse knows that obtaining a smoking cessation contract from a client will: 1. Help clients adapt through change. 2. Increase positive reinforcement through adaptation. 3. Facilitate change through contracts. 4. Formulate well-thought-out plans.

2. Increase positive reinforcement through adaptation

The nurse is meeting for the first time with a child who was brought to the clinic with a mental health concern. When planning care for a child with a mental health problem, the nurse must understand both the child's mental health problems and the child's: 1. Previous hospitalizations. 2. Life experiences. 3. Physiological health problems. 4. Artistic ability.

2. Life experiences

The nurse is assessing a client with nicotine addiction. The nurse knows the client plans to compete in a marathon several months away and asks the client to imagine snapping a cigarette in half and winning the marathon whenever the urge to smoke occurs. The nurse knows that shaping one's thoughts so that they have control over a particular situation, thereby creating a successful behavior change, is called: 1. Communication. 2. Mastery imagery. 3. Image restructuring. 4. Positive imagery.

2. Mastery imagery

An appropriate ongoing, long-term treatment goal for a victim who experienced sexual abuse eight months ago is to: 1. Establish rapport and build a trusting nurse-client relationship. 2. Move from victim to survivor status. 3. Become aware of legal rights. 4. Involve significant others in the treatment plan.

2. Move from victim to survivor status

Which of the following combinations of clinical presentations constitutes the most compelling indication that a client may have been abused? 1. Poor eye contact, depressed mood, unwillingness to give history data 2. Multiple bruises and scars, low self-esteem 3. Acting-out behaviors, disobedience, trouble with the law 4. Sores around the mouth, brittle hair

2. Multiple bruises and scars, low self-esteem

The nurse would teach the adolescent with a conversion disorder what the person "gets" from having the disorder. This explanation would include a discussion of: 1. Preoccupation with the belief that the person has a serious disease without physical evidence. 2. Primary and secondary gains. 3. An overreaction by caregivers to the client's somatic complaints. 4. A pain cure.

2. Primary and secondary gains

The nurse observes an 8-year-old child regressing to behavior that is characteristic of a toddler when faced with new situations. The child has been in several foster care families over the past three years. Which of the following interventions is appropriate for this child? 1. Providing for unmet needs 2. Providing consistency and continuity of caregivers 3. Ignoring the regressive behavior 4. Ignoring the negative behavior and reinforcing the positive behavior

2. Providing consistency and continuity of caregivers

The client states, "I was reared in a chaotic, alcoholic family situation." The nurse knows that the most useful theory for explaining the client's somatoform disorder would come from: 1. Humanistic theory. 2. Psychosocial theory. 3. Biologic theory. 4. Genetic theory.

2. Psychosocial theory

The nurse is caring for a 15-month-old who is admitted to the hospital for the fifth time in six months with severe diarrhea. The patient's mother has been diagnosed with Munchausen by proxy syndrome (MBPS) as she has been giving her child large doses of laxatives to make the child sick. The nurse is having difficulty dealing with the situation. Which of the following is the best way for the nurse to proceed? 1. Confront the mother about making her child sick. 2. Seek clinical supervision to cope with situation. 3. Refuse to take care of the child and family. 4. Have as little contact with the mother as possible.

2. Seek clinical supervision to cope with the situation

The nurse knows that when the mental health client has learned how to successfully adapt in new or different circumstances, the client has developed a sense of: 1. Pride. 2. Self-efficacy. 3. Self. 4. Self-esteem.

2. Self-efficacy

Clients with mental disorders who form inferences from rational beliefs are: 1. Better supported by family members. 2. Significantly more functional than clients who hold irrational beliefs. 3. Able to control impulses. 4. On their way to feeling "normal."

2. Significantly more functional than clients who held irrational beliefs

The night nurse at the mental health clinic is designing a behavioral contract for a client diagnosed with panic attacks. During the assessment phase, the client is negative and exhibits low self-esteem. However, the nurse knows that in order to develop an effective contract, the focus must be on: 1. Specific social weaknesses. 2. The client's abilities and strengths. 3. The client's family. 4. The goals of discharge.

2. The client's abilities and strengths

The parents of a child with a spectrum disorder are asking the nurse about what kind of social expectations are realistic for their child. Which of the following is the overall outcome for a child diagnosed with a spectrum disorder? 1. To acknowledge the effects of one's own behavior on others 2. To function more effectively in social and emotional interactions 3. To stay on task 4. To acknowledge personal strengths

2. To function more effectively in social and emotional interactions

The nurse works with both the child and parents to help the child develop interpersonal skills. Which of the following general outcomes facilitates engaging the parents in the process? 1. Increasing knowledge of the child's psychopathology 2. Understanding the child's unique temperament and needs 3. Responding to separation anxiety 4. Administering PRN medications effectively

2. Understanding the child's unique temperament and needs

A client, age 8, has just been prescribed pemoline (Cylert). The child's parents ask about the long-term effects of this medication. The nurse conducting patient teaching for the parents about this medication will include which of the following statements? 1. "Photosensitivity is a problem with long-term use." 2. "This is one of the drugs found to be safe for long-term use." 3. "At the present time, there is limited information about this." 4. "There seems to be a better outcome when the higher dose is given at bedtime."

3

The nurse understands that the underlying issue of most abusers is: 1. An uncontrollably urge to love. 2. The inability to control intense anxiety. 3. A desire to enslave and control. 4. A desire to play out fantasies.

3. A desire to enslave and control

A victim of sexual abuse expresses the belief to the nurse that the abuse is a punishment for not having lived a spiritually pure life prior to the event. The nurse: 1. Indicates to the victim that this is an incorrect view. 2. Makes it clear to the client that the rape was not a punishment for the client's own behavior. 3. Acknowledges the client's spiritual frustration and invites the client to express these feelings. 4. Explains that rape can happen even to the most religious people.

3. Acknowledges the client's spiritual frustration and invites the client to express these feelings

The nurse is planning care for an individual diagnosed with borderline personality disorder. The nurse realizes that interventions will have to be focused on which of the following behaviors? 1. Desiring order and perfection 2. Not being able to make decisions 3. Acting out when feeling abandoned or disrespected 4. Withdrawing and becoming isolative

3. Acting out when feeling abandoned or disrespected

The nurse is caring for a client with a history of admissions to several hospitals over the last several years. Each hospitalization was for a different disorder in which there was no physical evidence. The medical record indicates the client is a pathological liar. Which of the following disorders does the client suffer from? 1. A somatoform disorder 2. Factitious disorder by proxy 3. Adult factitious disorder 4. Dissociative identity disorder

3. Adult factitious disorder

A nurse manager in a women's clinic is meeting with the staff to discuss assessment of substance abuse among pregnant clients. What would the group typically assess as the most frequently abused substance by pregnant women? 1. Caffeine 2. Tobacco 3. Alcohol 4. Cocaine

3. Alcohol

A client, age 8, has just been prescribed pemoline (Cylert). The child's parents ask about the long-term effects of this medication. The nurse conducting patient teaching for the parents about this medication will include which of the following statements? 1. "Photosensitivity is a problem with long-term use." 2. "This is one of the drugs found to be safe for long-term use." 3. "At the present time, there is limited information about this." 4. "There seems to be a better outcome when the higher dose is given at bedtime."

3. At the present time, there is limited information about this.

Involving families with the client's treatment is an important aspect of family nursing. It is important to involve them as much as appropriate for the formulation and implementation of: 1. Family identity. 2. Hope, support, and happiness. 3. Behavioral contracts. 4. Positive client behavior.

3. Behavioral contracts

The nurse finds that the client with a somatoform disorder has physical symptoms, but there is no evidence of physiologic disease. The client may have decreased amounts of serotonin and endorphins, causing the client to experience an increased sensitivity to pain. This explanation of the client's symptoms is based in: 1. Communication theory. 2. Humanistic theory. 3. Biologic theory. 4. Genetic theory.

3. Biologic theory

The nurse student taking care of a client with schizophrenia has difficulty keeping up with the client's music therapy and individual therapy times. The nurse knows, however, that the case manager is helpful in maintaining the routines and schedules of: 1. Self-study. 2. All clients on the unit. 3. Cognitive behavioral interventions.. 4. Clients in music therapy.

3. Cognitive behavioral interventions

A nurse interviews a client with a diagnosis of both a psychiatric disorder and a substance use disorder. Dual diagnosis will: 1. Demand that the substance use disorder be prioritized. 2. Demand that the psychiatric disorder be prioritized. 3. Complicate the clinical picture as both diagnoses have to be addressed. 4. Have little or no impact on the plan of care.

3. Complicate the clinical picture as both diagnoses have to be addressed

A community nurse who is preparing education on opioid usage in the community should focus the education on: 1. Teaching seizure precautions. 2. Effects of opioids on long-term vision problems. 3. Dangers of overdose. 4. Recognition of signs of withdrawal.

3. Dangers of overdose

The nurse is working with a client who exhibits a pervasive, excessive, and unrealistic need to receive care. This client's behavior is a characteristic of which of the following personality disorders? 1. Histrionic personality disorder 2. Narcissistic personality disorder 3. Dependent personality disorder 4. Avoidant personality disorder

3. Dependent PD

A client who presents in the psychiatric unit tells the admitting nurse that she is very depressed and is having a hard time staying clean and sober. Which of the following is true regarding mental illness in a client with identified substance abuse? 1. Depression or other mental illnesses should be treated only after the client has been sober for one month. 2. Depression or other mental illness is an expected outcome of substance abuse recovery. 3. Depression or other untreated mental illness can contribute to relapse. 4. Depression or other mental illnesses are symptoms of the substance abuse.

3. Depression or other untreated mental illness can contribute to relapse

A client admitted with borderline personality disorder complains during group therapy that she, "always falls for the bad guy." She has been in and out of rehabilitation and abuse crisis centers. The nursing student knows this client would benefit from: 1. Intrapsychic cognitive therapy. 2. Family conflict therapy. 3. Dialectical behavioral therapy. 4. Self-reflective therapy.

3. Dialectical behavioral therapy

When working with clients with somatoform disorders, the nurse knows the priority intervention is to: 1. Encourage clients to participate in group therapy to receive feedback about the effect of their behavior on others. 2. Tone down clients' characteristic extravagance. 3. Establish a trusting relationship. 4. Express respectful skepticism regarding clients' oversimplifications and overdramatizations

3. Establish a trusting relationship

The nurse is working with a client who is being admitted to the psychiatric-mental health unit. The client was missing for two weeks and returned home not knowing any time had passed. Which of the following dissociative disorders has this client experienced? 1. Amnesia 2. Depersonalization disorder 3. Fugue 4. Dissociative identity disorder (DID)

3. Fugue

A client is certain she has cancer and peritonitis despite her doctor's reassurance she does not. She most likely is experiencing: 1. Malingering. 2. Conversion disorder. 3. Hypochondriasis. 4. Factitious disorder.

3. Hypochondriasis

The nurse is learning how to handle feelings of frustration and helplessness when caring for clients with cluster B personality disorders. Which of the following statements by the nurse would reflect that learning has taken place? 1. "I can just ignore my feelings and focus on the client's needs." 2. "As long as my words are therapeutic, the client cannot tell what I am really thinking." 3. "I need to maintain professional distance by using empathy." 4. "I can talk about my feelings with my friends."

3. I need to maintain professional distance by using empathy

A 10-year-old is brought to the clinic for assessment. During the interview, the nurse learns that the child has been the victim of domestic violence. Which of the following messages would the nurse expect to hear in the assessment of the child due to the child's experience of abuse? Select all that apply. 1. It is appropriate to love the people you hit. 2. Violence does not resolve conflict. 3. If you are small and weak, you deserve to be hit. 4. Violence is appropriate if the end result is good. 5. People who love you don't hit you.

3. If you are small and weak, you deserve to be hit 4. Violence is appropriate if the end result is good

A client with a diagnosis of paranoid personality disorder appears hypervigilant and sits alone in an isolated area of the unit. The client does not acknowledge other clients and often uses sarcasm when addressing staff. The nurse invites the client to attend a milieu group, but the client ignores the nurse's efforts. An appropriate nursing diagnosis for this client is which of the following? 1. Activity Intolerance 2. Fear 3. Impaired Social Interaction 4. Powerlessness

3. Impaired social interaction

The nurse knows that nursing diagnoses for cognitive behavioral assessment include: 1. Pseudohostility and Ineffective Coping. 2. Knowledge Deficit and Effective Coping. 3. Interrupted Family Processes and Hopelessness. 4. Hopelessness and Functional Family Processes.

3. Interrupted family processes and hopelessness

A new nurse feels that it is hopeless to provide sexual and physical abuse victims with community resources when most of them choose to go back and live with their abusers. What would be an appropriate response by the counselor? 1. "Some of these clients don't know any better." 2. "We are mandated by law to give clients information on resources prior to discharge." 3. "It is important to empower clients and help them see that they can make positive changes." 4. "Sometimes things do improve at home."

3. It is important to empower clients and help them see that they can make positive changes

A nursing student expresses a belief that it is hopeless to keep providing substance abuse treatment when the rate of relapse is so high. The staff nurse should respond with which of the following statements? 1. "Sometimes a client doesn't show much effort." 2. "You are right. I don't know why we bother." 3. "It is important to maintain hope that a client can make positive change." 4. "We are legally obligated to provide care."

3. It is important to maintain hope that a client can make positive change

A client is being seen in the clinic for right-hand paresthesia that the client does not seem to be overly concerned about. The condition developed abruptly after being caught cheating on an exam by the teacher. The paresthesia also ended abruptly as well. Which symptom most clearly relates to la belle indifférence? 1. Being caught cheating on the exam 2. Right-hand paresthesia 3. Lack of concern over the paresthesia 4. Paresthesia beginning and ending abruptly

3. Lack of concern over the paresthesia

In working with a preschool-age child, which intervention would be considered as part of an effective plan for time-outs? 1. Identify in advance, situations that lead to anger 2. Explanations are not important to the child who is out of control 3. Length of time depends upon how long it takes the child to calm down 4. Incorporate a token economy

3. Length of time depends upon how long it takes the child to calm down

The nurse is working with a client who suffers from addiction. What treatment approach would be most appropriate for this client who has had multiple substance abuse treatments and has relapsed? 1. 12-step self-help program 2. Long-term outpatient therapy 3. Lifestyle change 4. One week detoxification program

3. Lifestyle Change

An 18-year-old client who joined the military shortly after graduating from high school is admitted to the mental health unit for depression and suicidal ideation. He tells the nurse the military is not what he expected and he wants to go home. The nurse observes a variance in affect between his interaction with peers and staff. The nurse suspects: 1. Conversion disorder. 2. Factitious disorder. 3. Malingering. 4. Body dysmorphic disorder.

3. Malingering

The nurse knows that attributions are perceived causes that: 1. Isolate family members from one another. 2. Promote rigidity and chaos. 3. May or may not be objectively accurate. 4. Support a loss of autonomy.

3. May or may not be objectively accurate

A mother told the nurse she was "appalled" that the nurse would dare to ask if she took any drugs during her pregnancy. The nurse explains that the information is important in understanding the child's health because embryonic exposure to toxins during pregnancy is the major risk factor for: 1. Depression in preschoolers. 2. Lactose intolerance. 3. Mental retardation. 4. Mental illness.

3. Mental retardation

The nurse is admitting a client to the unit for acute alcohol intoxication. In planning the client's care, which of the following is the priority intervention for this client? 1. Check for seizure precaution equipment 2. Darken the room 3. Monitor vital signs frequently 4. Restrain the client when restless

3. Monitor VS frequently

A preceptor nurse is discussing the substance abuse program with a new graduate nurse. The new graduate nurse asks the preceptor what is the most important initial outcome for clients in substance abuse programs. Which of the following is the best answer from the preceptor? 1. Make a moral inventory of self 2. Make amends for people they have hurt 3. Overcome denial 4. Learn problem-solving

3. Overcome denial

In describing personality disorders to a group of consumers, which statement by the nurse is accurate? 1. "People with personality disorders are unable to experience painful feelings." 2. "These disorders usually develop during the toddler stage." 3. "People with personality disorders view their problems as separate from themselves." 4. "Behavior is sporadic with no particular pattern."

3. People with personality disorders view their problems as separate from themselves

The nursing instructor notes a nursing student is very imaginative. When teaching students about designing and adjusting behavioral contracts, the nursing instructor knows that this particular student will have an advantage in developing contracts because: 1. Monitoring nonverbal communication is a secondary goal. 2. Effective communication skill is the key negotiating tool. 3. Reprioritization of goals is the most important issue. 4. Creativity is an essential component.

4. Creativity is an essential component

A nurse caring for a child is concerned about remaining therapeutic when working with a child with anger management issues. Which of the following must the nurse avoid in order to remain therapeutic? 1. Examining personal feelings about the child 2. Reflecting back on a situation 3. Projecting his/her feelings onto the child 4. Sharing his/her concerns with peers and colleagues

3. Projecting his/her feelings onto the child

The client states that she has been ill and in pain since childhood. Her many symptoms are not caused intentionally, nor are they feigned. She has seen many doctors. Consistent with this client's disorder, the nurse believes the pain the client experiences is: 1. Fake. 2. Exaggerated. 3. Real. 4. For attention.

3. Real

In assessing a client who has suffered domestic violence, the nurse observes that the client is regressing back to childhood, is having difficulty trusting the nurse, is expressing rage and grief, and is talking about how unfair God has been and wondering why God has been "so insensitive." Based on these observations, what would be the most appropriate plan of action for the nurse? 1. Suggest that the client join a survivor support group. 2. Encourage the client to attend religious activities at the local church. 3. Refer the client to a religious counselor. 4. Explain to the client that God has his own reasons that most of us do not understand.

3. Refer the client to a religious counselor

The nurse knows that a client who has panic attacks when she sees waterfalls because she had been physically assaulted in a park with a waterfall, would benefit from the feature of cognitive and behavioral treatment of: 1. Suggesting alternative behavior. 2. Seeking social support. 3. Reframing. 4. Expressing affection.

3. Reframing

The nurse is working with a client who has a history of impulsive and self-harming behavior. The nurse will need to address which of the following in the plan of care? 1. Boundary setting 2. Confidentiality 3. Safety 4. Appropriate self-disclosure

3. Safety

The nurse is caring for a client with schizoid personality disorder. Which nursing diagnosis is most appropriate for this client with a cluster A personality disorder? 1. Fear related to feelings of abandonment 2. High Risk for Violence, Self-Directed, related to poor impulse control 3. Social Isolation related to inadequate social skills, craving of solitude 4. Ineffective Individual Coping related to high dependency needs

3. Social isolation related to inadequate social skills, craving of solitude

A short-term goal that can be identified for a client completing his fourth alcohol detoxification program in one year is that the client will: 1. Develop a treatment relationship with another client. 2. Identify constructive outlets for stress. 3. State that he sees the need for ongoing treatment. 4. Use denial and rationalization in a healthier way

3. State that he sees the need for ongoing treatment

A nursing student attempting to use a behavioral modification contract found in the textbook is having trouble getting the client to follow through with everything in the contract. The nursing instructor knows to tell the student that behavioral contracts must be: 1. Affected by the functionality of the client. 2. Reflective of the client's mental illness. 3. Tailored for the individual. 4. Reflective of the characteristics within the client's family.

3. Tailored for the individual

A nurse is describing the multicausal perspective of mental health and illness to the parents of a child recently diagnosed with a spectrum disorder. Which statement would the nurse utilize when describing this approach? 1. Exposure to drugs and alcohol has been associated with psychiatric disorders. 2. The feedback mechanism appears dysfunctional, creating neurotoxic effects on brain development and function. 3. The child's genetically determined attributes and life experiences interact to influence mental health outcomes. 4. Early psychological trauma may create deficits or abnormalities in brain structure.

3. The child's genetically determined attributes and life experiences interact to influence mental health outcomes

A client admitted for a heroin overdose receives naloxone (Narcan), which relieves his altered breathing pattern. Two hours later, he complains of muscle aches and abdominal cramps. He also displays a runny nose and is shivering. What assessment can be made? 1. The client should be placed on seizure precautions. 2. The client is experiencing relapse. 3. The client is experiencing symptoms of narcotic withdrawal. 4. The client is experiencing a side effect to the naloxone.

3. The client is experiencing symptoms of narcotic withdrawal

The nurse is working with a client who has been diagnosed with a personality disorder. Which situation best describes the client's external response to stress? 1. The client attends group therapy. 2. The client uses meditation when upset. 3. The client tries to change the environment instead of changing him- or herself. 4. The client engages in self-awareness exercises.

3. The client tries to change the environment instead of changing themselves

A client with borderline personality disorder approaches the nurse voicing concerns about being ignored by the nursing staff and feeling unimportant. The client blames the nursing staff for not paying attention to the client. The nurse's best therapeutic response to this client would include which of the following statements? 1. "Tell me more about your feeling of being ignored." 2. "That's all in your imagination." 3. "You need to share your feelings with the nurses you feel are ignoring you." 4. "I will bring it up at the next meeting."

3. You need to share your feelings with the nurses you feel are ignoring you

A 24-year-old client with body dysmorphic disorder (BDD) tells the nurse that he plans to have a surgical procedure that will affect his appearance. The nurse understands that this plan is an effort to: 1. Suppress intrusive thoughts. 2. Deal with multiple physical complaints. 3. Treat associated depression. 4. Cure the imagined defect.

4. Cure the imagined defect

An older client comes to the health center with vague complaints of abdominal discomfort. Assessment findings include several old and fresh bruises in the abdominal area, and signs of malnutrition. What is the most appropriate question for the nurse to ask? 1. "Are you dieting?" 2. "Did you have any falls lately?" 3. "Do you have an alcohol problem?" 4. "Did anyone hurt you?"

4. Did anyone hurt you?

When doing the morning medication count for the past two weeks, the nurse noticed several drugs that had been "wasted" or "re-ordered." Which of the following is the most appropriate intervention when suspecting drug diversion? 1. Set up a "sting" operation 2. Obtain definitive evidence 3. Stay out of the situation 4. Document findings

4. Document findings

A nurse skillful in the writing process knows that this talent may benefit the client because a well-written behavioral contract: 1. Teaches the client about past mistakes to lead to a successful outcome. 2. Provides everything needed for a cure. 3. Teaches the client to embrace the future helps overcome past misdeeds. 4. Can promote successful outcomes.

4. Can promote successful outcomes

A mother questions why it is important to list when her child sat up, began crawling, started walking, and was potty trained as she is bringing the toddler in because the child screams at night. The nurse explains to the mother that: 1. It is not normal for a young child to scream at night. 2. Children who scream at night have more difficulty with problem solving. 3. Children with mental disorders have difficulty with elimination at night. 4. A developmental history is part of assessing well-being of a child.

4. A developmental history is part of assessing well=being of a child

A client consistently fails to accept the consequences of his or her own behavior. The nurse identifies this behavior as characteristic of: 1. Immaturity. 2. A lack of structure. 3. A need for medication. 4. A personality disorder.

4. A personality disorder

The nurse and a client talk about healthy ways to meet needs. The client states, "When I am looking really good, it is not asking too much for people to acknowledge me." The nurse recognizes that this experience is indicative of: 1. Affective instability. 2. Splitting. 3. Feelings of emptiness. 4. A sense of entitlement.

4. A sense of entitlement

A client being discharged from the mental health clinic is fearful about not being able to keep up with therapy and treatments after leaving the clinic. The nurse knows that to ensure client success after discharge, the client's behavioral contract should: 1. Support the client's family and friends. 2. Ensure client success. 3. Build and maintain treatments to help the community. 4. Address issues the client will face in community living.

4. Address issues the client will face in community living

Ten hours after admission to the ICU following an auto accident, a client begins to exhibit mild tachycardia, irritability, and tremors. Three hours later the client has a grand mal seizure. The staff suspect that the client has: 1. Wernicke's encephalopathy. 2. Korsakoff's syndrome. 3. Undetected internal bleeding. 4. Alcohol withdrawal syndrome.

4. Alcohol withdrawal syndrome

Domestic violence is often associated with: 1. High school dropouts. 2. The poor and undereducated. 3. Blue-collar workers. 4. All levels of society.

4. All levels of society

A teen is brought to the emergency room by a parent. The assessment reveals that the client has been acting strangely for the past three hours and is hypervigilant, grandiose, and irritable. Vital signs indicate hypertension, tachycardia, and some arrhythmias. The teen may have ingested: 1. Alcohol. 2. Crack. 3. Cocaine. 4. Amphetamines.

4. Amphetamines

Which of the following interventions would the nurse implement to address the client with feelings of abandonment? 1. Assist client to suppress feelings of abandonment. 2. Encourage client to never get involved in a relationship again. 3. Assist client to express deep rage at the ending of the relationship. 4. Assist client to verbalize feelings of abandonment in an appropriate manner

4. Assist client to verbalize feelings of abandonment in an appropriate manner

A client with a history of physical and sexual abuse by her husband is admitted to the hospital for treatment of vaginal lacerations. While hospitalized, the client expresses concerns to the nurse about her safety when she returns home. The first priority for the nurse is to: 1. Offer to contact outpatient services if the client promises that she will not return home after her discharge. 2. Encourage the client to take charge of her situation. 3. Make it clear to the client that her husband needs to see a therapist. 4. Assist the client to devise a safety or escape plan.

4. Assist the client to devise a safety or escape plan

A client diagnosed with depression states, "Even in high school I was a failure. It's a wonder I was associated with successful friends." The nurse knows this client is making: 1. A hard situation worse. 2. Attributions about his life. 3. Excuses about his present behavior. 4. Assumptions about his friends

4. Assumptions about his friends

A client complains of feeling angry whenever he sees families relating well with one another. During a family group session, the nursing student observes a family member belittling every statement made by the client. The nursing student knows that the client's thinking is often: 1. What leads the client to negative behaviors. 2. Erratic and problematic. 3. Conscious and deliberate. 4. Automatic, without active or conscious effort.

4. Automatic, without active or conscious effort

What is the most therapeutic approach when caring for a client who has been the victim of domestic violence? 1. Acknowledge the client's inability to change the situation. 2. Do not ask direct questions about abuse as this will intimidate the client. 3. Invite the abuser to the assessment session. 4. Avoid pressuring the client to leave the abuser.

4. Avoid pressuring the client to leave the abuser

A college student tells the nurse that he sometimes cannot recall conversations or events during times when he was drinking heavily. The nurse teaches the client that this experience is indicative of which of the following symptoms? 1. Addiction 2. Confabulation 3. Delusion 4. Blackout

4. Blackouts

The nursing staff is discussing boundary setting. Which of the following statements about boundary setting is inaccurate? 1. "Boundaries are established by providing consistent expectations." 2. "Boundaries define the therapeutic relationship." 3. "Boundaries provide guidelines for self-control." 4. "Boundaries are established to make the nursing staff's job easier."

4. Boundaries are established to make the nursing staff's job easier

When discussing indicators of emotionally disturbed children or children with disruptive behavior disorders with a group of student nurses, the psychiatric nurse states that one of the best indicators of emotionally disturbed children is that they have difficulty: 1. Seeking out peers. 2. Digesting a balanced diet. 3. Interpreting internal stimuli or external cues. 4. Following rules and norms of behavior.

4. Following rules and norms of behavior

When working with sibling abuse victim, the nurse should recognize that: 1. Most adults were victims of sibling abuse. 2. 40% of all child homicides are caused by sibling abuse. 3. Parents recognize and condone physical confrontation. 4. Hitting increases the probability of violence.

4. Hitting increases the probability of violence

Nurses are instrumental in helping clients during cognitive therapy. The nurse helps clients: 1. Correct the id and the superego in relation to self-awareness. 2. Examine connections of the mind, body, and spirit. 3. Determine the best course of treatment. 4. Identify unrealistic and negative thoughts.

4. Identify unrealistic and negative thoughts

A client who abuses alcohol has been placed on naltrexone (Trexan). What information should be included in the client education about the effects of this medication? 1. The client may discontinue its use in alcohol abuse treatment. 2. If alcohol is ingested, the client may experience a lethal reaction. 3. The client needs to avoid use of over-the-counter products that contain alcohol. 4. If alcohol is ingested, the client will feel less "high."

4. If alcohol is ingested, the client will feel less "high"

The client with a diagnosis of borderline personality disorder shows the nurse multiple superficial cuts to the arms that were made during the night. The client states, "I told the night staff that I was feeling alone." The nurse recognizes that the self-mutilation may be a result of: 1. Manipulation. 2. Anxiety. 3. Splitting. 4. Impulsive behavior.

4. Impulsive behavior

The nurse is caring for a client who has been diagnosed with dissociative disorder. The nurse knows that an appropriate intervention to promote effective role performance is to: 1. Encourage the client to have no contact with friends and family. 2. Ignore the client's other personalities. 3. Help the client alienate family members who do not believe the client is sick. 4. Include family members is therapy.

4. Include family members in therapy

The nurse therapist skilled in rational emotive therapy (RET) helps clients identify: 1. Cognitive causes for rational beliefs. 2. Health-damaging beliefs and practices. 3. Rational thoughts and healthy emotions. 4. Irrational thoughts and develop more rational life philosophies.

4. Irrational thoughts and develop more rational life philosophies

The nurse and a client talk about Alcoholics Anonymous (AA). The client asks, "What's AA all about?" Which reply by the nurse best describes AA? 1. "It's a group that learns about drinking from a group leader." 2. "It's a form of group therapy led by a psychiatrist." 3. "It's a group that advocates strong punishment for drunk drivers." 4. "It's a self-help group where the norm is sobriety."

4. It's a self-help group where the norm is sobriety

A client's family member states, "I don't understand the reason for the methadone treatment. Why replace heroin with methadone?" What is the best explanation for this family? 1. Methadone is safe even in large doses. 2. Methadone replaces a more potent drug. 3. Methadone is a deterrent to the use of drugs. 4. Methadone blocks the craving for and the action of opiates.

4. Methadone blocks the craving for and the action of opiates

When caring for children in the mental health setting, nurses may become aware of unresolved issues about their own family. If left unaddressed, care for the child may be affected because: 1. This experience should not affect nurses. 2. There is an increased potential for regression. 3. This opportunity will help the nurses heal. 4. Nurses' feelings may become activated.

4. Nurses' feelings may become activated

A client with a long history of experiencing domestic violence tells the nurse, "There is no way out for me, this situation will never change." What nursing diagnosis would be most appropriate? 1. High Risk for Violence 2. Self-Esteem Disturbance 3. Alteration in Health Maintenance 4. Powerlessness

4. Powerlessness

To intervene effectively with clients with somatoform disorders, it is essential that the nurse: 1. Help the client express a decreased degree of comfort regarding physical symptoms. 2. Encourage the client's expression of feelings symbolically through physical symptoms. 3. Address client anxiety at a later time. 4. Recognize and understand the client's self-perception as demonstrating an inability to cope.

4. Recognize and understand the client's self-perception as demonstrating an inability to cope

A 7-year-old child recently experienced the death of the family's pet dog, which was the child's constant companion. The child is at risk for: 1. A conduct disorder. 2. Elimination disorder. 3. Angoraphobia. 4. Separation anxiety disorder.

4. Separation anxiety disorder

During the assessment, the family nurse therapist inquires about weaknesses regarding learning the client may have. The client becomes defensive and states, "You sure are nosy!" Smiling, the nurse states, "I don't mean to seem nosy, but I must ask these questions to develop a plan that will work for you." The nurse's therapeutic response is an attempt to ascertain: Select all that apply. 1. How the client interacts with family members. 2. Anecdotes from family and friends. 3. The psychiatrist's progress notes. 4. Specific factors that have interfered with the success of a goal.

4. Specific factors that have interfered with the success of a goal

The nurse is preparing to assess a client with a diagnosis of paranoid personality disorder. What client characteristics will the nurse expect to observe? 1. Grandiosity 2. Superficial charm 3. Affective instability 4. Suspicions and rigidity

4. Suspicions and rigidity

Nurses working with abused clients most commonly feel: 1. Sadness for the victim, tolerance toward the abuser. 2. Sympathy for the victim, indifference toward the abuser. 3. Anger toward the victim, dislike for the abuser. 4. Sympathy for the victim, anger toward the abuser.

4. Sympathy for the victim, anger toward the abuser

Who is at greatest risk for becoming the victim of intrafamily violence? 1. The child who has a stepfather 2. The male child 3. The child born out of an unplanned pregnancy 4. The child living in a home in which a parent is being abused

4. The child living in a home in which a parent is being abused

During an education session, a community member asks what causes domestic violence. The best response is: 1. The statistics indicate that it is caused by poverty. 2. It is caused by the demanding workload of either parent. 3. The police commissioner can provide complete and accurate data on the causes. 4. There is no single cause of this type of violence

4. There is no single cause of this type of violence

The school nurse is observing a young child who has episodes of rage toward peers during recess and at lunchtime. The advantage of conducting an assessment in this environment is: 1. This will assist in identifying the bullies who trigger the explosive episodes. 2. This provides an opportunity to collect data in the event that other children are injured and legal documentation is needed. 3. To provide data for the parents who are in denial about the problem. 4. This provides a picture of problems and strengths in a realistic context.

4. This provides a picture of problems and strengths in a realistic context