psych practice psychobiological disorder

a 21 year old woman who was raped 6 months ago reports hallucinations lack of sleep irritability inability to concentrate and repeated recall of the incident. The primary healthcare provider suggests cognitive therapy to the client. Which outcome of this therapeutic intervention is expected? A. breaking negative thought patterns B. enabling the client to express herself C. obtaining insight through discussion and role play D. relief of anxiety through retraining of the behavioral response

A. breaking negative thought patterns

a client receiving medication to treat hallucinations delusions and disordered thinking develops agranulocytosis. which medication is most likely to be associated with this finding? A. clozapine B. olanzapine C. haloperidol D. risperidone

A. clozapine

which nursing intervention will encourage a socially withdrawn client to talk? A. focus on nonthreatening subjects B. try to get the client to discuss feelings C. ask simple yes or no questions of the client D. sit quietly while looking through magazines with the client

A. focus on nonthreatening subjects

a client with dementia has been cared for by the spouse for 5 years. during the last month the client has become agitated and aggressive and is incontinent of urine and feces. which intervention is the priority while this client is in an inpatient behavioral health facility? A. manage the behavior B. prevent further deterioration C. focus on the needs of the spouse D. establish an elimination retraining program

A. manage the behavior

which evaluation of anxious client behavior indicates the client has successfully achieved the long term goal of mobilizing effective coping responses? A. performance of relaxation exercise B. involvement in some type of quiet activity C. avoidance of situations that precipitate anxiety D. careful examination of what precipitated the anxiety

A. performance of relaxation exercise

which action should the nurse implement when a client with the diagnosis of bipolar disorder manic episode is admitted to the mental health unit? A. placing the client in a private room to provide a quiet atmosphere B. scheduling multiple activities with other clients to keep the client socially engaged C. assigning the client to a room near the day room to provide access to activities D. ensuring there are colorful drapes in the clients room to provide a cheerful environment

A. placing the client in a private room to provide a quiet atmosphere

which is the primary concern of the nurse when caring for a client withdrawing from cocaine? A. possibility of self injury B. potential for seizure C. danger of dehydration D. probability of injuring others

A. possibility of self injury

an older depressed person at an independent living facility constantly complains about their health problems to anyone who will listen. one day the client says i'm not going to any more activities all these crabby old people do is talk about their problems. which defense mechanism does the nurse conclude that the client is using? A. projection B. introjection C. somatization D. rationalization

A. projection

an older client with vascular dementia has difficulty following simple directions for selecting clothes to be worn for the day. which symptom will the nurse identify? A. receptive aphasia B. difficulties with judgement C. decreasing attention span D. clouding of consciousness

A. receptive aphasia

which intervention should be implemented when interacting with an adolescent client with the diagnosis of anorexia nervosa? A. set limits B. maintain control C. demonstrate empathy D. focus on a healthy diet

A. set limits

which initial nursing intervention is appropriate when a delusional client refuses to eat because they believe that the food is poisoned? A. state that the food is not poisoned B. taste the food in the clients presence C. show the client that other people are eating without being harmed D. tell the client that tube feedings will be started if they don't start eating

A. state that the food is not poisoned

which nursing intervention should be implemented first when a client presents with severe anxiety evidenced by crying hand wringing and pacing? A. stay physically close to the client B. gently ask what is bothering the client C. tell the client to try and relax by sitting quietly D. get the client involved in a non threatening activity

A. stay physically close to the client

the nurse prepares a plan of care for a client who continues to express fear of dying and reports symptoms of chest pain palpitations and shortness of breath despite a complete cardiac workup that revealed no problems. which outcome indicates that the nursing plan of care has been effective? A. the client is able to make independent decisions about life events B. the client is able to express feelings that reflect a positive body image C. the client is able to create a plan for responding to the presence of a phobic situation D. the client is able to manage anxiety without resorting to the use of ritualistic behaviors

A. the client is able to make independent decisions about life events

which question is best for assessing orientation to a place for a client diagnosed with dementia? A. where are you B. who brought you here C. do you know where you are D. do you know what day you arrived

A. where are you

a depressed client tells a nurse i want to die. which therapeutic response by the nurse is most appropriate? A. you would rather not live B. you're not alone in feeling this way C. when was the last time you felt this way D. do you believe there is life after death

A. you would rather not live

a daycare environment is recommended for a client with incapacitating behaviors resulting from OCD. the clients partner asks the nurse why this approach is necessary. which response by the nurse accurately answers the question A. this environment limits time to carry out the rituals B. a neutral atmosphere facilitates the working through of conflicts C. a location that requires no decision making will resolve feelings of anxiety D. the daycare setting allows staff to exert control over unacceptable behaviors

B. a neutral atmosphere facilitates the working through of conflicts

which nursing approach should be implemented first when caring for a client who presents as self accusatory and guilt ridden? A. contradict the clients persecutory delusions B. accept the clients statements as the clients beliefs C. medicate the client when these thoughts are expressed D. redirect the client whenever a negative topic is mentioned.

B. accept the clients statements as the clients beliefs

which action is most important for the nurse to implement when caring for a client participating in an alcohol detoxification program? A. supporting the clients need for nurture B. addressing the clients holistic needs C. discussing with the client the negative effects of alcohol D. promoting the clients compliance with the program through gentle prodding

B. addressing the clients holistic needs

which term should be documented when a client diagnosed with schizophrenia is experiencing opposing emotions simultaneously? A. double bind B. ambivalence C. loose association D. inappropriate affect

B. ambivalence

a suicidal teenage client has low self esteem and expresses feelings of worthlessness. which nursing intervention may hinder the clients development of positive self worth? A. reinforcing the clients strengths B. discouraging expressions of negative emotions C. interacting with the client in a nonjudgmental manner D. providing feedback for all successes and reassurance after failure

B. discouraging expressions of negative emotions

an older adult accompanied by family members is admitted to a long term care facility with symptoms of dementia. which initial statement by the nurse most helpful to this client during the admission process? A. your a little disoriented now but don't worry you'll be alright in a few days B. don't be afraid i'm your nurse and everyone here in the hospital is here to help you C. i'm the nurse on duty today your in the hospital your family can stay with you for a while D. let me introduce you to the staff here first. in a little while i'll get you acquainted with our unit routine

B. don't be afraid i'm your nurse and everyone here in the hospital is here to help you

a client in the outpatient clinic is denying that he is addicted to alcohol. he tells the nurse that he is not an alcoholic and that it is his nagging wife who causes him to drink. which response by the nurse is the most therapeutic? A. i don't think that your wife is the problem B. everyone is responsible for their own actions C. perhaps you should have marriage couseling D. why do you think your wife is the cause of your drinking

B. everyone is responsible for their own actions

which intervention should the nurse implement first when caring for a client diagnosed with conversion disorder? A. focus on the clients concerns regarding the symptoms B. explore ways to verbalize feelings C. explain how stress caused the physical problems D. talk about the physical problems

B. explore ways to verbalize feelings

a client with a mental illness reports weakness and fatigue. during the assessment the primary health care provider notes hoarseness esophagitis dental erosion and palate lacerations. which medication will the nurse expect to be prescribed to treat these symptoms? A. clozapine B. fluoxetine C. olanzapine D. risperidone

B. fluoxetine

a disturbed client unprovoked attempts to attack another client. which initial short term intervention is appropriate for this client? A. placing the client in restraints or secluding the client B. having the client sit with a staff member whom they trust C. keeping the client actively participating in activities and in contact with reality D. getting the client to apologize for the attack to the other client and to show remorse

B. having the client sit with a staff member whom they trust

which action should the nurse implement when caring for a client whose behavior is characterized by pathologic suspicion? A. protect the client from enviromental stress B. help the client feel accepted by the staff on the unit C. help the client realize that the suspicions are unrealistic D. ask the client to explain the reasons for the feelings

B. help the client feel accepted by the staff on the unit

which initial reply by the nurse is most therapeutic when a client undergoing alcohol detoxification asks about attending AA meetings after discharge? A. you'll find that you need their support B. how do you feel about going to those meetings C. they'll help you to learn how to cope with your problem D. don't you think its better to wait until you're sure that you're ready

B. how do you feel about going to those meetings

a nurse caring for a client who is hyperactive and manic and who is exhibiting flight of ideas and not eating. which reason best explains why the client is not eating? A. feels undeserving of the food B. is too busy to take the time to eat C. wishes to avoid others in the dining room D. believes that there is no need for food at this time

B. is too busy to take the time to eat

which approach by the nurse will minimize psychological stress in an anxious client who has been admitted to the psychiatric unit? A. explain in detail the therapies being used B. learn what is of particular importance to the client C. advise the client that the nurse is in charge of the clients situation D. avoid the discussion of any topics that may be emotionally charged

B. learn what is of particular importance to the client

a 9 year old boy who is hyperactive and acting out is started on a behavior modification program in which tokens are given for acceptable behavior. when he begins to lose a game he is playing with other children he begins to kick the other children under the table and call them names. which behavior modification technique is most appropriate for the nurse to implement? A. ignore the childs behavior B. place the child in a short time out C. take the childs daily allotment of tokens away D. engage the child in a conversation about good sportsmanship

B. place the child in a short time out

a client exhibiting initial signs of dementia of the Alzheimer type is prescribed three medications to be taken at different times during the day. which instruction will the nurse give to the clients spouse? A. hang a list of medications with the times at which the spouse should take them B. prefill a weekly drug box with the medications for the spouse to self administer C. remind the spouse in the morning which medications must be taken during the day D. provide the spouse with the medication at the appropriate times they should be taken

B. prefill a weekly drug box with the medications for the spouse to self administer

the nurse is caring for an infant brought to the emergency department by the mother who reports that the infant stopped breathing and she had to perform mouth to mouth resuscitation for the fourth time. which action by the nurse would be priority? A. ask the mother about other hospitalizations B. report the suspicion to the local child welfare agency C. determine whether the mother is the primary caregiver D. ensure the mother has been certified in basic life support

B. report the suspicion to the local child welfare agency

a healthcare provider prescribes drug therapy to a client who presented with chills parethesia sweating choking heart palpitations and fear of dying. which medication teaching will be beneficial to the client? A. increase salt intake during hot weather B. rise slowly from a sitting to a standing position C. stop medications immediately if drowsiness occurs D. take medications with food if the medication causes indigestion

B. rise slowly from a sitting to a standing position

a male client with the diagnosis of pedophilia is admitted to the psychiatric hospital because of repeated episodes of exhibitionism. the client is in the recreation room and exposes himself and begins to masturbate. which action by the nurse is the most appropriate? A. turning away from the client and ignoring the behavior B. telling the client that the behavior is unacceptable and to stop C. removing the client from the recreation room and escorting him to his own room D. recognizing that the behavior is part of his illness and obtaining a prescription for a libido lowering medication

B. telling the client that the behavior is unacceptable and to stop

which outcome indicates that nursing interventions are effective for a client who is undergoing treatment for generalized anxiety disorder? A. the client is able to express negative feelings B. the client recognizes the signs of escalating anxiety C. the client manages anxiety without using ritualistic behavior D. the client increases social interaction and recognizes their own feelings about an interaction that has just taken place

B. the client recognizes the signs of escalating anxiety

a client experiences auditory hallucinations and agrees to discuss alternative coping strategies with the nurse. The nurse attempts to focus on alternative strategies and the client responds by leaving the interaction. Which response by the nurse is most therapeutic? A. come back you agreed that you would discuss other ways to cope B. you seem very uncomfortable every time i bring up a new way to cope C. did you agree to talk about other ways to cope because you thought that was what i wanted D. you walk out each time i start to discuss the hallucinations does that mean you've changed your mind

B. you seem very uncomfortable every time i bring up a new way to cope

One morning a client tells the nurse, "My legs are turning to rubber because I have an incurable disease called schizophrenia." which behavior will the nurse document when describing this behavior? A. hallucinations B. paranoid thinking C. depersonalization D. autistic verbalization

C. depersonalization

which initial nursing intervention is a priority for a client admitted to a behavioral health unit with the diagnosis of schizoid personality disorder? A. help the client enter into group recreational activities B. convince the client that the hospital staff is trying to help C. help the clients learn to trust the staff through selected experiences D. arrange the clients contact with others so it is limited while the client is in the hospital

C. help the clients learn to trust the staff through selected experiences

a nurse moves into the working phase of a therapeutic relationship with a depressed client who has a history of suicide attempts. which question should the nurse ask the client when exploring alternative coping strategies? A. how have you managed your problems in the past B. what do you feel you have learned from this suicide attempt C. how will you manage the next time your problems start piling up D. were there other things going on in your life that made you want to die

C. how will you manage the next time your problems start piling up

which intervention is most effective to implement to best limit confusion in an older client diagnosed with dementia who sleeps very little and becomes increasingly disoriented? A. shut the clients door during the night B. apply a vest restraint when the client is in the bed C. leave a dim light on in the clients room at night D. administer the clients PRN sedative medication

C. leave a dim light on in the clients room at night

which intervention should be a priority when caring for a client with generalized anxiety disorder? A. encourage the client to verbalize feelings of anxiety B. have the client list the behaviors used to reduce anxiety C. remove as many stimuli from the clients environment as possible D. administer PRN medications prescribed by the health care provider

C. remove as many stimuli from the clients environment as possible

which nursing action is best when initally establishing a therapeutic relationship with a client diagnosed with schizotypal personality disorder? A. set limits on manipulative behavior B. encourage participation in group therapy C. respect the clients needs for social isolation D. recognize that seductive behavior is expected

C. respect the clients needs for social isolation

which initial intervention will be used when it is determined that a staff nurse has a drug problem? A. refer the nurse for counseling with the staff psychiatrist B. dismiss the nurse from the job immediately C. send the nurse to employee assistance program D. force the nurse to promise to abstain from drug use in the future

C. send the nurse to employee assistance program

which response by the nurse is best when a client states i used to believe i was a princess now i know that's not true? A. you really believed that B. many people have this delusion C. that's a sign that you're getting better D. what caused you to think that you were a princess

C. that's a sign that you're getting better

An obviously upset client comes to the mental health clinic and, after pushing ahead of the other clients, states, "I had an argument with my daughter, and now I'm tense, and worried, and angry." What level of anxiety does the nurse determine that the client is experiencing? A. Mild B. Panic C. Severe D. Moderate

D. Moderate

which key intervention would be included for clients with psychophysical problems? A. maximize secondary gains once the acute phase of the illness is resolved B. assist the client and family in narrowing their social networks for consistency C. discourage the client to talk about feelings that brought on the physical symptoms D. acknowledge the client as a responsible adult while indirectly addressing dependency needs

D. acknowledge the client as a responsible adult while indirectly addressing dependency needs

a young client demonstrating hyperactive manic behavior greets new hospital staff by saying welcome to the funny farm im jojo the head yoyo. which meaning can the nurse assign to the clients statement? A. attempt to fill the life of the party role B. attention seeking C. inability to distinguish fantasy from reality D. anxiety over the arrival of new staff members

D. anxiety over the arrival of new staff members

which action of neuroleptic drugs prescribed for schizophrenic clients promotes mental health? A. inhibiting enzymes at the postsynaptic receptor site B. decreasing serotonin at the postsynaptic receptor site C. increasing dopamine intake at the postsynaptic receptor site D. blocking access to dopamine receptors at the postsynaptic receptor site

D. blocking access to dopamine receptors at the postsynaptic receptor site

which conclusion should the nurse document about a client who states i've been thinking about suicide lately? A. intentions to frighten the nurse B. attention seeking from the staff C. feelings of safety and sharing of feelings D. fearfulness of impulses and seeking protection

D. fearfulness of impulses and seeking protection

a client who has been attending a day treatment facility for 1 month with the diagnosis of major depression is to be discharged in a week. which comment by the nurse is most appropriate? A. we have just a few sessions left. i'm really pleased by your progress B. your discharge date has been set for next week. thats wonderful news C. we have 5 sessions remaining we need to start making plans to end our sessions D. i understand that your discharge is set for next week. i'm wondering how you feel about this

D. i understand that your discharge is set for next week. i'm wondering how you feel about this

which factor will the nurse consider most important when evaluating a newly admitted depressed clients current risk for suicide? A. history of suicide attempts B. lack of interest in appearance C. how long the depression has existed D. impending anniversary of the loss of a loved one

D. impending anniversary of the loss of a loved one

a client whose depression is beginning to lift remains aloof from the other clients on the mental health unit. which nursing action will best assist this client to participate in an activity? A. finding solitary pursuits that the client can enjoy B. speaking to the client about the importance of entering into activities C. asking the health care provider to speak to the client about participating D. inviting the client to take part in a joint activity with the nurse and the client

D. inviting the client to take part in a joint activity with the nurse and the client

which medication will the nurse identify on the patients MAR that slows the rate of decline associated with alzheimer disease? A. digoxin B. lansoprazole C. levothyroxine D. naproxen sodium

D. naproxen sodium

which intervention would the nurse implement for restlessness in a client at the end stages of the dying process? A. elevate the head of the bed B. obtain an order for restraints C. change bedding as appropriate D. reduce the light in the room and play soothing music

D. reduce the light in the room and play soothing music

a client with the diagnosis of schizophrenia watches the nurse pour juice for the morning medication from an almost empty pitcher and screams that juice is no good it's poisoned. which response by the nurse is the most therapeutic? A. assure the client the juice is not poisoned B. pour the client a glass of juice from a full pitcher C. take a drink of the juice to show the client that it is safe D. remark you sound frightened is there something else i can give you to take your medication with

D. remark you sound frightened is there something else i can give you to take your medication with

an adult with the diagnosis of schizophrenia is admitted to the psychiatric hospital. the client is ungroomed appears to be hearing voices is withdrawn and has not spoken to anyone for several days. which intervention should the nurse implement during the first few hospital days? A. see that the client bathes and changes clothes daily B. wait and see whether the client approaches the staff C. conduct an admission assessment interview with the client D. seek out the client frequently to spend short periods of time together

D. seek out the client frequently to spend short periods of time together

a male client with paranoid schizophrenia wraps his legs in toilet paper believing that this will protect him form deadly germs contaminating the floor. which nursing intervention should be implemented? A. limit the clients access to toilet paper B. provide the client with antimicrobial soap C. explain to the client why this action is ineffective D. talk with the client about anxiety with a focus on health

D. talk with the client about anxiety with a focus on health

which reason explains why the nurse instructs a client diagnosed with schizophrenia to increase fluid intake when taking an antipsychotic medication? A. to prevent photosensitivity B. to prevent extrapyramidal symtoms C. to protect the client from falls and injuries D. to provide relief from autonomic reactions

D. to provide relief from autonomic reactions

a nurse on a mental health unit has developed a therapeutic relationship with a manipulative acting out client. one day as the nurse is leaving the client says please stay im afraid that the evening staff doesn't like me they're always punishing me. which response by the nurse is most therapeutic? A. i'll ask the staff not to punish you B. tell me more about what your feeling now C. don't worry i told you everything will be alright D. you know i leave at this time we will talk about this in the morning

D. you know i leave at this time we will talk about this in the morning

a hospitalized client with a mood disorder begins to be less hyperactive and states my husband and i have problems getting along sometimes we see things differently. which response is nontherapeutic? A. what do you normally do when this happens B. tell me what you mean by see things differently C. not getting along with your spouse can be upsetting D. you seem calmer today than you have been the last several days

D. you seem calmer today than you have been the last several days