Psych Practice Questions

A client with panic disorder experiences an acute attack while the nurse is completing an admission assessment. List the following interventions according to their level of priority. A. remain with the client B. Encourage physical activity C. Encourage low, deep breathing D. Reduce external stimuli E. Teach coping measures

A, D, C, B, E

Alfred was newly diagnosed with anxiety disorder. The physician prescribed buspirone. The nurse is aware that the teaching instructions for newly prescribed buspirone should include which of the following? A. A warning about the drugs delayed therapeutic effect, which is from 14-30 days. B. A warning about the incidence of neuroleptic malignant syndrome (NMS) C. A reminder of the need to schedule blood work in 1 week to check blood levels of the drug D. A warning that immediate sedation can occur with a restraint drop in pulse

A. A warning about the drugs delayed therapeutic effect, which is from 14-30 days

A client with obsessive-compulsive disorder is hospitalized on an inpatient unit. Which nursing response is most therapeutic? A. Accepting the client's OCD B. Challenging the client's OCD C. Preventing the client's OCD D. Rejecting the client's OCD

A. Accepting the client's OCD

Which neurotransmitter has been implicated in the development of Alzheimer's disease? A. Acetylcholine B. Dopamine C. Epinephrine D. Serotonin

A. Acetylcholine

A client taking the MOAI antidepressant isocarboxazid (Marplan) is instructed by the nurse to avoid which foods and beverages? A. Aged cheese and red wine B. Milk and green, leaf vegetables C. Carbonated beverages and tomato products D. Lean red meats and fruit juices

A. Aged cheese and red wine

A male client is being treated for alcoholism. After a family meeting, the client's spouse asks the nurse about ways to help the family deal with the effects of alcoholism. Nurse Lily should suggest that the family join which organization? A. Al-Anon B. Make Today Count C. Emotions Anonymous D. Alcoholics Anonymous

A. Al-Anon

Kevin is remanded by the courts for psychiatric treatment. His police record, which dates to his early teenage years, includes delinquency, running away, auto theft, and vandalism. He dropped out of school at age 16 and has been living on his own since then. His history suggests maladaptive coping, which is associated with: A. Antisocial personality disorder B. Borderline personality disorder C. Obsessive-Compulsive personality disorder D. Narcissistic personality disorder

A. Antisocial personality disorder

A client with catatonic schizophrenia is mute, can't perform activities of daily living, and stares out the window for hours. What is the nurse's first priority? A. Assist the client with feeding. B. Assist the client with showering C. Reassure the client about safety D. Encourage socialization with peers

A. Assist the client with feeding

The nurse would expect a client with early Alzheimer's disease to have problem with: A. Balancing a checkbook B. Self-care measures C. Relating to family members D. Remembering his own name

A. Balancing a checkbook

The nurse collecting family assessment data asks, "Who is in your family and where do you live?" Which of the following is the nurse attempting to identify? A. Boundaries B. Ethnicity C. Relationships D. Triangles

A. Boundaries

Nurse Lynette notices that a female client with OCD washers her hands for long periods each day. How should the nurse respond to this compulsive behavior? A. By designating time during which the client can focus on the behavior B. By urgings the client to reduce the frequency of the behavior as rapidly as possible C. By calling attention to or attempting to prevent the behavior D. By discouraging the client from verbalizing anxieties

A. By designating times during which the client can focus on the behavior

Group members have worked very hard, and the nurse reminds them that termination is approaching. Termination is considered successful if group members: A. Decide to continue B. Elevate group progress C. Focus on positive experience D. Stop attending prior to termination

A. Decide to continue

A 45 year old woman with a history of depression tells a nurse in her doctor's office that she has difficulty with sexual arousal and is fearful that her husband will have an affair. Which of the following factors would the nurse identify as least significant in contributing to the client's sexual difficulty? A. Education and work history B. Medication used C. Physical health status D. Quality of spousal relationship

A. Education and work

Nurse Bella is aware that assessment finding is most consistent with early alcohol withdrawal? A. Heart rate of 120 to 140 bpm B. Heart rate 50 to 60 bpm C. Blood pressure of 100/70 D. Blood pressure 140/80

A. Heart rate of 120 t0 140 bpm

Tim is admitted with a diagnosis of delusions of grandeur. The nurse is aware that this diagnosis reflects a belief that one is: A. Highly important or famous B. Being persecuted C. Connected to events unrelated to oneself D. Responsible for the evil in the world

A. Highly important or famous

A Schizophrenic client states, "I hear the voice of King Tut." Which response by the nurse would be the most therapeutic? A. I don't hear the voice, but i know you hear what sounds like a voice. B. You shouldn't focus on that voice C. Don't worry about the voices as it doesn't belong to anyone real D. Kind Tut has been dead for years

A. I don't hear the voice, but i know you hear what sounds like a voice.

Which of the following groups of characteristics would the nurse expect to see in the client with schizophrenia? A. Loose association, grandiose delusions, and auditory hallucinations B. Periods of hyperactivity and irritability alternating with depression C. Delusions of jealousy and persecution, paranoia, and mistrust D. Sadness, apathy, feelings of worthlessness, anorexia, and weight loss

A. Loose association, grandiose delusions, and auditory hallucinations

What is Nurse John likely to note in a male client being admitted for alcohol withdrawal? A. Perceptual disorders B. Impending coma C. Recent alcohol intake D. Depression with mutism

A. Perceptual disorders

Nurse Helen is assigned to care for a client with anorexia nervosa. Initially, which nursing intervention is most appropriate for this client? A. Providing a one-on-one supervision during meals and for one hour afterward B. Letting the client eat with other clients to create a normal mealtime atmosphere C. Trying to persuade the client to eat and thus restore nutritional balance D. Giving the client as much time to eat as desired

A. Providing a one-on-one supervision during meals and for one hour afterward

The nurse is planning care for a client admitted to the psychiatric unit with a diagnosis of paranoid schizophrenia. Which nursing diagnosis should receive the highest priority? A. Risk for violence toward self or others B. Imbalanced nutrition: Less than body requirements C. Ineffective family coping D. Impaired verbal communication

A. Risk for violence toward self or others

A client is admitted to a psychiatric facility with a diagnosis of chronic schizophrenia. The history indicates that the client has been taking neuroleptic medication for many years. Assessment reveals unusual movement of the tongue, neck, and arms. Which condition should the nurse suspect? A. Tardive dyskinesia B. Dystonia C. Neuroleptic malignant syndrome D. Akathisia

A. Tardive dyskinesia

Rudolf is admitted for an overdose for amphetamines. When assessing the client, the nurse should expect to see: A. Tension and irritability B. Slow pulse C. Hypotension D. Constipation

A. Tension and irritability

Tina who is a manic, but not yet on medication, comes to the drug treatment center. The nurse would not let this client join the group session because: A. The client is disruptive B. The client is harmful to self C. The client is harmful to others D. The client needs to be on medication first

A. The client is disruptive

A nurse is working with a client who has schizophrenia, paranoid type. Which of the following outcomes related to the client's delusional perceptions would the nurse establish? A. The client will demonstrate realistic interpretation of daily events in the unit B. The client will perform daily hygiene and grooming without assistance C. The client will take prescribed medications without difficulty D. The client will participate in unit activities

A. The client will demonstrate realistic interpretation of daily events in the unit

A nurse is evaluating therapy with the family of a client with anorexia nervosa. Which of the following would indicate that the therapy was successful? A. The parents reinforce increased decision making by the client B. The parents clearly verbalized their expectation for the client C. The client verbalizes that family meals are now enjoyable D. The client tells her parents about feelings of low-self-esteem.

A. The parents reinforce increased decision making by the client

A schizophrenic client with delusions tells the nurse, "There is a man wearing a red coat who's out to get me." The client exhibits increasing anxiety when focusing on the delusions. Which of the following would be the best response? A. This subject seems to be troubling you. Let's walk to the activity room. B. There is no reason to be afraid of that man. This hospital is very secure. C. Describe the man who's out to get you. What does he look like? D. There is no need to be concerned with a man who isn't even real.

A. This subject seems to be troubling you. Let's walk to the activity room.

During the initial interview, a client with schizophrenia suddenly turns to the empty chair besides him and whispers, "Now just leave. I told you to stay home. There isn't enough work here for both of us!" What is the nurse's best initial response? A. When people are under stress, they may see things or hear things that others don't. Is that what just happened? B. I'm having a difficult time hearing you. Please look at me when you talk. C. There is no one else in the room. What are you doing? D. Who are you talking to? Are you hallucinating?

A. When people are under stress, they may see things or hear things that others don't. Is that what just happened?

The nurse must administer a medication to reverse or prevent Parkinson-type symptoms in a client receiving an antipsychotic. The medication the client will likely receive is: A. Benzotropine (Cogentin) B. diphenhydramine (Benadryl) C. propranolol (Inderal) D. haloperidol (Haldol)

A. benzotripine (Cogentin)

A man is brought to the hospital by his wife, who states for the past week her husband has refused all meals and accused her of trying to poison him. During the initial interview, the client's speech, only partly comprehensive, reveals his thoughts are controlled by delusions that he is possessed by the devil. The physician diagnoses paranoid schizophrenia. Schizophrenia is best described as a disorder characterized by: A. disturbed relationship related to inability to communicate or think clearly. B. severe mood swings and periods of low to high activity C. multiple personalities, one of which is more destructive than the others D. auditory and tactile hallucinations

A. disturbed relationship related to inability to communicate or think clearly.

The nurse knows that the physician has ordered the liquid form of the drug chlorpromazine (Thorazine) rather than the tablet form because the liquid: A. has a more predictable onset of action B. produces fewer anticholinergic effects C. produces fewer drug interactions D. has a longer duration of action

A. has a more predictable onset of action

A client with paranoid-type schizophrenia becomes angry and tells the nurse to leave him alone. The nurse should: A. tell him she'll leave for now, but will return soon B. ask him if it's okay if she sits quietly with him C. ask him why he wants to be left alone D. tell him that she won't let anything happen to him

A. tell him she'll leave for now, but will return soon

A client seeks care because she feels depressed and has gained weight. To treat her atypical depression, the physician prescribes tranylcypromine sulfate (Parnate), 10 mg by mouth twice per day. When this drug is used to treat atypical depression, what is its onset of action? A. 1 to 2 days B. 5 to 8 days C. 6 to 8 days D. 10 to 14 days

B. 5 to 8 days

A client receiving haloperidol (Haldol) complains of a stiff jaw and difficulty swallowing. The nurse's first action is to: A. Reassure the client and administer as needed lorazepam (Ativan) IM B. Administer as needed dose of benzotropine (Cogentin) IM as needed C. Administer as needed dose of benzotropine (Cogentin) PO as ordered C. Administer as needed dose of haloperidol (Haldol) PO

B. Administer as needed dose of benzotropine (Cogentin) IM as needed

The nurse correctly teaches a client taking the benzodiazepine oxazepam (Serax) to avoid excessive intake of: A. Cheese B. Coffee C. Sugar D. Shellfish

B. Coffee

The nurse understands that electroconvulsive therapy is primarily used in psychiatric care for the treatment of: A. Anxiety disorders B. Depression C. Mania D. Schizophrenia

B. Depression

According to the family systems theory, which of the following best describes the process of differentiation? A. Cooperative action among members of the family B. Development of autonomy within the family C. Incongruent messages wherein the recipient is a victim D. Maintenance of the system continuity or equilibrium

B. Development of autonomy within the family

A client take the MOAI phenelzine (Nardil) tells the client that he routinely takes all the medications listed below. Which medication would cause the nurse to express concern therefore initiate further teaching? A. Acetominophen (Tylenol) B. Diphenhydramine (Benadryl) C. Furosemide (Lasix) D Isosorbide denigrate (Isordil)

B. Diphenhydramine (Benadryl)

A person with antisocial personality disorder has toughness relating to others because of never having learned to: A. Count on others B. Empathize with others C. Be dependent on others D. Communicate with others socially

B. Empathize with others

The nurse formulates a nursing diagnosis of impaired social interaction related to disorganized thinking for a client with schizotypical personality disorder. Based on this nursing diagnosis, which nursing intervention takes highest priority? A. Helping the client to participate in social interactions B. Establishing a one-on-one relationship with the client C. Exploring the effects of the client's behavior on social interactions D. Developing a schedule for the clients participation in social interactions

B. Establishing a one-on-one relationship with the client

The parents of a young man with schizophrenia express feelings of responsibility and guilt for their son's problems. How can the nurse best educate the family? A. Acknowledge the parent's responsibility B. Explain the biological nature of schizophrenia C. Refer the family to a support group D. Teach the parents various ways they much change

B. Explain the biological nature of schizophrenia

A client whose husband just left her has a recurrence of anorexia nervosa. Nurse Vic caring for her realizes that this exacerbation of anorexia nervosa results from the client: A. Manipulate her husband B. Gain control of one part of her life C. Commit suicide D. Live up to the mother's expectations

B. Gain control of one part of her life

Nurse Cristina is caring for a client who experiences false sensory perceptions with no basic reality. These perceptions are known as: A. Delusions B. Hallucinations C. Loose association D. Nelogisms

B. Hallucinations

The nurse provides a referral to Alcoholics Anonymous to a client who described a 20-year history of alcohol abuse. The primary function of this group is to: A. Encourage the use of a 12-step program B. Help maintain sobriety C. Provide fellowship among members D. Teach positive coping mechanisms

B. Help maintain sobriety

The nurse understands that if a client continues to be dependent on heroin throughout her pregnancy, her baby will be at high risk for: A. Mental retardation B. Heroin dependency C. Addiction in adulthood D. Psychological disturbances

B. Heroin dependency

A client is admitted to the inpatient unit of the mental health center with a diagnosis of paranoid schizophrenia. He's shouting that the government of France is trying to assassinate him. Which of the following responses is most appropriate? A. I think you're wrong. France is a friendly country and an ally of the United States. Their government wouldn't try to kill you B. I find it hard to believe that a foreign government or anyone else is trying to hurt you. You must feel frightened by this. C. You're wrong. Nobody is trying to kill you. D. A foreign government is trying to kill you? Please tell me more about it.

B. I find it hard to believe that a foreign government or anyone else is trying to hurt you. You must feel frightened by this.

Two nurses are co-leading group therapy for seven clients in a psychiatric unit. The leaders observe that the group members are anxious and look to the leaders for answers. Which phase of development is this group in? A. Conflict resolution phase B. Initiation phase C. Working phase D. Termination phase

B. Initiation phase

Nicolas is experiencing hallucinations tells the nurse, "The voices are telling me I'm not good." The client asks if the nurse hears the voices. The most appropriate response by the nurse would be to: A. It is the voice of your conscience, which only you can control B. No, I do not hear your voices, but I believe you can hear them. C. The voices are coming from within you and only you can hear them. D. Oh, the voices are a symptom of your illness; don't pay any attention to them

B. No, I do not hear your voices, but I believe you can hear them.

Nurse Amy is aware that which client is at highest risk for suicide? A. One who appears depressed frequently thinks of dying and gives away all personal possessions B. One who plans a violent death and has the means readily available C. One who tells others that he or she might do something if life doesn't get better soon D. One who talks about wanting to die

B. One who plans a violent death and has the means readily available

A client is admitted with a diagnosis of schizotypical personality disorder. Which signs would this client exhibit during social situations? A. Aggressive behaviors B. Paranoid thoughts C. Emotional affect D. Independence needs

B. Paranoid thoughts

Richard is admitted with a diagnosis of schizotypal personality disorder. Which signs would the client exhibit during social situations? A. Aggressive behavior B. Paranoid thoughts C. Emotional affect D. Independence needs

B. Paranoid thoughts

An 11 year old child diagnosed with conduct disorder is admitted to the psychiatric unit for treatment. Which of the following behaviors would the nurse assess? A. Restlessness B. Physical aggressiveness, low stress tolerance, disregard for the rights of others C. Deterioration in social functioning, excessive anxiety and worry, bizarre behavior D. Sadness, poor appetite and sleepiness, loss of interest in activities

B. Physical aggressiveness, low stress tolerance, disregard for the rights of others

A 65 year old client is in the first stage of Alzheimer's disease. Nurse Patricia should plan to focus this client's care on: A. Offering nourishing finger foods to help maintain the client's nutritional status. B. Providing emotional support and individual counseling C. Monitoring the client to prevent minor illnesses from turning into major problems D. Suggesting new activities for the client and family to do together.

B. Providing emotional support and individual counseling

Richard with agoraphobia has been symptom-free for 4 months. Classic signs and symptoms of phobias include: A. Insomnia and an inability to concentrate B. Severe anxiety and fear C. Depression and weight loss D. Withdrawal and failure to distinguish reality from fantasy

B. Severe anxiety and fear

A client has a history of chronic undifferentiated schizophrenia. Because she has a history of noncompliance with antipsychotic therapy, she'll receive fluphenazine decanoate (Prolixin Deconoate) injections every 4 weeks. Before discharge, what should the nurse include in her teaching plan? A. asking the physician for droperidol (Inapsine) to control any extrapyramidal symptoms that occur B. Sitting up for a few minutes before standing to minimize orthostatic hypotenison C. Notifying the physician if her thoughts don't normalize in a week D. Expecting symptoms of tardive dyskinesia to occur and to be transient

B. Sitting up for a few minutes before standing to minimize orthostatic hypotenison

Miranda, a psychiatric client, is to be discharged with orders for haloperidol (Haldol) therapy. When developing a teaching plan for discharge, the nurse should include cautioning the client against: A. Driving at night B. Staying in the sun C. Ingesting wines and cheeses D. Taking medications containing aspirin

B. Staying in the sun

Which of the following behaviors by a client with dependent personality disorder shows the client has made progress toward the goal of increasing problem-solving skills? A. The client is courteous B. The client asks questions C. The client stops acting out D. The client controls emotions

B. The client asks questions

Which goal is a priority for a client with a DSM-IV-TR diagnosis of delirium and the nursing diagnosis: Acute confusion related to recent surgery secondary to traumatic hip fracture? A. The client will complete ADLs B. The client will maintain safety C. The client will remain oriented D. he client will understand communication

B. The client will maintain safety

Kellan, a high school student is referred to the school nurse for suspected substance abuse. Following the nurse's assessment and interventions, what would be the most desirable outcome? A. The student discusses conflict over drug use B. The student accepts a referral to a substance abuse counselor C. The student agrees to inform his parents of the problem D. The student reports increased comfort with making choice

B. The student accepts a referral to a substance abuse counselor

A male client has approached the nurse asking for advice on how to deal with his alcohol addiction. Nurse Sally should tell the client that the only effective treatment for alcoholism is: A. Psychotherapy B. Total abstinence C. Alcoholics Anonymous (AA) D. Aversion therapy

B. Total abstinence

Benzotropine (Cogentin) is used to treat the extrapyramidal effects induced by antipsychotics. This drug exerts its effects by: A. decreasing the anxiety causing muscle rigidity B. blocking the cholinergic activity on the CNS C. increasing the acetylcholine in the CNS D. increasing norepinephrine in the CNS

B. blocking the cholinergic activity on the CNS

Which of the following medications would the nurse expect the physician to order to reverse a dystonic reaction? A. prochlorperazine (Compazine) B. diphenhydramine (Benadryl) C. haloperidol (Haldol) D. midazolam (Versed)

B. diphenhydramine (Benadryl)

A client with paranoid schizophrenia has been experiencing auditory hallucinations for many years. One approach that has proven effective for hallucinating patients is to: A. take an as needed dose of psychotic medication whenever they hear voices. B. practice saying "Go away" or "stop" when they hear the voices C. Sing loudly to drown out the voices and provide distractions D. go to their room until the voices go away

B. practice saying "Go away" or "stop" when they hear the voices

During the assessment stage, a client with schizophrenia leaves his arm in the air after the nurse has taken his blood pressure. His action shows evidence of: A. somatic delusions B. waxy flexibility C. neologisms D. nihilistic delusions

B. waxy flexibility

The doctor has prescribed haloperidol (Haldol) 2.5 mg IM for an agitated client. The medication is labeled haloperidol 10mg/2mL. The nurse prepares the correct dose by drawing up how many mL in the syringe? A. 0.3 B. 0.4 C. 0.5 D. 0.6

C. 0.5

The nurse is caring for a client with schizophrenia who experiences auditory hallucinations. The client appears to be listening to someone who isn't visible. He gestures, shouts angrily, and stops shouting in mid-sentence. Which nursing intervention is the most appropriate? A. Approach the client and touch him to get his attention. B. Encourage the client to go to his room where he'll experience fewer distractions. C. Acknowledge that the client is hearing voices but make it clear that the nurse doesn't hear these voices. D. Ask the client to describe what the voices are saying.

C. Acknowledge that the client is hearing voices but make it clear that the nurse doesn't hear these voices.

What parental behavior toward a child during an admission procedure should cause Nurse Erin to suspect child abuse? A. Flat affect B. Expressing guilt C. Acting overly solicitous toward the child D. Ignoring the child

C. Acting over solicitous toward the child

Dervid, an adolescent boy, was admitted for substance abuse and hallucinations. The client's mother asks Nurse Armando to talk with his husband when he arrives at the hospital. The mother says that she is afraid of what the father might say to the boy. The most appropriate nursing intervention would be to: A. Inform the mother that she and the father can work through this problem themselves. B. Refer the mother to the hospital social worker C. Agree to talk with the mother and father together. D. Suggest that the father and son work things out.

C. Agree to talk to the mother and father together.

A client who has been hospitalized with disorganized type schizophrenia for 8 years can't complete ADLs without staff direction or assistance. The nurse formulates a nursing diagnosis or self-care deficient: Dressing/grooming related to inability to function without assistance. What is an appropriate goal for the client? A. Client will be able to complete the ADLs independently within 1 month B. Client will be able to complete ADLs with only verbal encouragement within 1 month C. Client will be able to complete ADLs with assistance in organizing grooming items and clothing within 1 month D. Client will be able to complete ADLs with complete assistance within 1 month

C. Client will be able to complete ADLs with assistance in organizing grooming items and clothing within 1 month

The nurse is aware that the side effect of electroconvulsive therapy that a client may experience: A. Loss of appetite B. Postural hypotension C. Confusion for a time after therapy D. Complete loss of memory for a time

C. Confusion for a time after the therapy

Important teaching for women in their childbearing years who are receiving antipsychotic medications includes which of the following? A. Occurrence of increased libido due to medication adverse effects B. Increased incidence of dysmenorrhea while taking the drug C. Continuing previous use of contraception during periods of amenorrhea D. Instruction that amenorrhea is irreversible

C. Continuing previous use of contraception during periods of amenorrhea

Most antipsychotic medications exert which of the following effects on the CNS? A. Stimulate the CNS by blocking post synaptic dopamine, norepinephrine and serotonin receptors. B. Sedates the CNS by stimulating serotonin at the synaptic cleft. C. Depress the CNS by blocking the post synaptic transmission of dopamine, serotonin and norepinephrine D. Depress the CNS by stimulating the release of acetylcholine

C. Depress the CNS by blocking the post synaptic transmission of dopamine, serotonin and norepinephrine

Nurse Penny is aware that the following medical conditions is commonly found in clients with bulimia nervosa? A. Allergies B. Cancer C. Diabetes mellitus D. Hepatitis A

C. Diabetes mellitus

The nurse is teaching a group of clients about the mood-stabilizing medications lithium carbonate. Which medications should she instruct the clients to avoid because of the increased risk of lithium toxicity? A. Antacids B. Antibiotics C. Diuretics D. Hypoglycemic agents

C. Diuretics

The nurse is assessing a client who has just been admitted to the emergency department. What sign would suggest an overdose of an anti anxiety agent? A. Combativeness, sweating, and confusion B. Agitation, hyperactivity, and grandiose ideation C. Emotional lability, euphoria, and impaired memory D. Suspiciousness, dilated pupils, and increased blood pressure

C. Emotional lability, euphoria, and impaired memory

A 16 year old girl has returned home following hospitalization for treatment of anorexia nervosa. The parents tell the family nurse performing a home visit that their child has always done everything to please them and they cannot understand her current stubbornness about eating. The nurse analyzes the family situation and determines it is characteristic of which relationship style? A. Differentiation B. Disengagement C. Enmeshment D. Scapegoating

C. Enmeshment

A psychotic client reports to the evening nursing that the day nurse put something suspicious in his water with his medication. The nurse replies, "You're worried about your medication?" The nurses communication is: A. An example of presenting reality B. Reinforcing the client's delusions C. focusing on emotional content D. a non-therapeutic technique called mind reading

C. Focusing on emotional content

A client is receiving haloperidol (Haldol) to reduce psychotic symptoms. As he watches television with other clients, the nurse notes that he has trouble sitting still. He seems restless, constantly moving his hands and feet and changing position. When the nurse asks what is wrong, he says he feels jittery. How should the nurse manage this situation? A. Ask the client to sit still or leave the room because he is distracting other clients B. Ask the client if he is nervous or anxious about something C. Give an as needed dose of prescribed anticholinergic medication to control akathisia. D. Administer an as needed dose of haloperidol to decrease agitation.

C. Give an as needed dose of prescribed anticholinergic medication to control akathisia.

Macoy and Helen seek emergency crisis intervention because he slapped her repeatedly the night before. The husband indicated that his childhood was marred by an abusive relationship with his father. When intervening with this couple, nurse Gerry knows they are at risk for repeated violence because the husband: A. Has only moderate impulse control B. Denies feelings of jealousy or possessiveness C. Has learned violence as an acceptable behavior D. Feels secure in his relationship with his wife

C. Has learned violence as an acceptable behavior

Which is the best indicator of success in the long-term management of the client? A. His symptoms are replaced by indifference to his feelings B. He participates in diversionary activities C. He learns to verbalize his feelings and concerns D. He states that his behavior is irrational

C. He learns to verbalize his feelings and concerns

Which nursing intervention is most important for a client with anorexia nervosa during initial hospitalization on a behavioral therapy unit? A. Emphasize the importance of good nutrition to establish normal weight B. Ignore the client's mealtime behavior and focus on instead on issues of dependence and independence C. Help establish a plan using privileges and restrictions based on compliance with refeeding D. Teach the client information about the long-term physical consequences of anorexia

C. Help establish a plan using privileges and restrictions based on compliance with refeeding

Nurse Mickey is caring for a client diagnosed with bulimia. The most appropriate initial goal for the client diagnosed with bulimia is to: A. Avoid shopping for large amounts of food. B. Control eating impulses C. Identify anxiety-causing situations D. Eat only three meals per day

C. Identify anxiety-causing situations

A male client who reportedly consumes one quart of vodka daily is admitted for alcohol detoxification. To try to prevent alcohol withdrawal symptoms, Dr. Smith is most likely to prescribe which drug? A. Clozapine (Clozaril) B. Thiothixene (Navane) C. Lorazepam (Ativan) D. Lithium carbonate (Eskalith)

C. Lorazepam (Ativan)

Nurse Amy is providing care for a male client undergoing opiate withdrawal. Opiate withdrawal causes severe physical discomfort and can be life-threatening. To minimize these effects, opiate users are commonly detoxified with: A. Barbiturates B. Amphetamines C. Methadone D. Benzodiazepines

C. Methadone

A female client is admitted to the psychiatric clinic for treatment of anorexia nervosa. To promote the client's physical health, nurse Tair should plan to: A. Severely restrict the client's physical activities B. Weigh the client daily, after the evening meal C. Monitor vital signs, serum electrolyte levels, and acid-base balance D. Instruct the client to keep an accurate record of food and fluid intake

C. Monitor vital signs, serum electrolyte levels, and acid-base balance

The nurse enters the room of a client with a cognitive impairment disorder and asks what day of the week it is: what the date, month and year are; and where the client is. The nurse is attempting to assess: A. Confabulation B. Delirium C. Orientation D. Perseveration

C. Orientation

A female client begins to experience alcoholic hallucinations. Nurse Joy is aware that the best nursing intervention at this time? A. Keeping the client restrained in bed B. Checking the client's blood pressure every 15 mins and offering juices C. Providing a quiet environment and administering medication as needed and prescribed D. Restraining the client and measuring blood pressure every 30 mins

C. Providing a quiet environment and administering medication as needed and prescribed

Which method would a nurse use to determine a client's potential risk for suicide? A. Wait for the client to bring up the subject of suicide B. Observe the client's behavior for cues of suicide ideation C. Question the client directly about suicidal thoughts D. Question the client about future plans

C. Question the client directly about suicidal thoughts

A client who abuses alcohol and cocaine tells a nurse that he only uses substances because of his stressful marriage and difficult job. Which defense mechanism is the client using? A. Displacement B. Projection C. Rationalization D. Sublimation

C. Rationalization

Which nursing intervention is most appropriate for a client with Alzheimer's disease who has frequent episodes of emotional lability? A. Attempt humor to alter the client's mood B. Explore reasons for the client's altered mood C. Reduce environmental stimuli to redirect the client's attention D. Use logic to point out reality aspects

C. Reduce environmental stimuli to redirect the client's attention

An elderly client with Alzheimer's disease becomes agitated and combative when a nurse approached to help with morning care. The most appropriate nursing intervention in this situation would be to: A. Tell the client's firmly that it is time to get dressed B. Obtain assistance to restrain the client for safety C. Remain calm and talk quietly to the client D. Call the doctor and request an order for sedation

C. Remain calm and talk quietly to the client

Then nurse is administering a psychotropic drug to an elderly client who has history of benign prostatic hypertrophy. It is most important for the nurse to teach this client to: A. Add fiber to his diet B. Exercise on a regular basis C. Report incomplete bladder emptying D. Take the prescribed dose at bedtime

C. Report incomplete bladder emptying

A client with delusional thinking shows lack of interest in eating at meal times. Sh estates that she is unworthy of eating and that her children will die if she eats. Which nursing action would be most appropriate for this client? A. Telling the client that she may become sick and die unless she eats B. Paying special attention to the clients rituals and emotions associated with meals C. Restricting the client's access to food except at specified meal and snack times D. Encouraging the client to express her feelings at meal times

C. Restricting the client's access to food except at specific meal and snack times

A client tells a nurse, "Everyone would be better off if I wasn't alive." Which nursing diagnosis would be made based on this statement? A. Disturbed thought processes B. Ineffective coping C. Risk for self-directed violence D. Impaired social interaction

C. Risk for self-directed violence

Nurse Marco is developing a plan of care for a client with anorexia nervosa. Which action should the nurse include in the plan? A. Restrict visits with the family and friends until the client begins to eat B. Provide privacy during meals. C. Set up a strict eating plan for the client D. Encourage the client to exercise, which will reduce her anxiety

C. Set up a strict eating plan for the client

In preparing a female client for electroconvulsive therapy (ECT), Nurse Michelle knows that succinylcholine (Anectine) will be administered for which therapeutic affect? A. Short-acting anesthesia B. Decreased oral and respiratory secretions C. Skeletal muscle paralysis D. Analgesia

C. Skeletal muscle paralysis

Dervid, an adolescent, has a history of truancy from school, running away from home, and "borrowing" other people's things without their permission. The adolescent denies stealing, rationalizing instead that as long as no one was using the items, it was all right to borrow them. It is important for the nurse to understand that psychodynamically, this behavior may be largely attributed to a developmental defect related to the: A. Id B. Ego C. Superego D. Oedipal complex

C. Superego

A clinical instructor is correcting a nursing student's worksheet. Which instructor statement is the best example of effective feedback? A. Why did you use the client's name on your clinical worksheet? B. You were very careless to refer to your client by name on your clinical worksheet. C. Surely you didn't do it deliberately, but you breached confidentiality by using the client's name. D. It is disappointing that after being told, you're still using client names on your worksheet.

C. Surely you didn't do it deliberately, but you breached confidentiality by using the client's name.

Prior to administering chlorpromazine (Thorazine) to an agitated client, the nurse should: A. Assess skin color and sclera B. Assess the radial pulse C. Take the client's blood pressure D. Ask the client to void

C. Take the client's blood pressure

Which client outcome is most appropriately achieved in a community approach setting in psychiatric nursing? A. The client performs activities of daily living and learns about crafts B. The client is able to prevent aggressive behavior and monitors his use of medications C. The client demonstrates self-reliance and social adaptation D. The client experiences anxiety relief and learns about his symptoms

C. The client demonstrates self-reliance and social adaptations

A client with bipolar disorder exhibits manic behavior. The nursing diagnosis is: Disturbed thought processes related to difficulty concentrating, secondary to flight of ideas. Which of the following outcome criteria would indicate improvement in the client? A. The client verbalizes feelings directly during treatment B. The client verbalizes positive "self" statement C. The client speaks in coherent sentences D. The client reports feeling calmer

C. The client speaks in coherent sentences

Which factors are most essential for the nurse to assess when providing crisis intervention for a client? A. The client's communication and coping skills B. The client's anxiety level and ability to express feelings C. The client's perception of the triggering event and availability of situational supports D. The client's use of reality testing and level depression

C. The client's perception of the triggering event and availability of situational supports

The school guidance counselor refers a family with an 8 year old child to the mental health clinic because of the child's frequent fighting in school and truancy. Which of the following data would be a priority to the nurse doing the initial family assessment? A. The child's performance in school B. Family education and work history C. The family's perception of the current problem D. The teacher's attempt to solve the problem

C. The family's perception of the current problem

A client has been receiving chlorpromazine (Thorazine), an antipsychotic, to treat his psychosis. Which findings should alert the nurse that the client is experiencing pseudoparkinsonism? A. Restlessness, difficulty swallowing, and pacing B. Involuntary rolling of the eyes C. Tremors, shuffling gait, and masklike face D. Extremity and neck spasms, facial grimacing, and jerky movements

C. Tremors, shuffling gait and masklike face

Meryl, age 19, is highly dependent on her parents and fears leaving home to go away to college. Shortly before the semester starts, she complains that her legs are paralyzed and rushed to the emergency department. When the physical exam rules out cause of paralysis, the physician admits her to the psychiatric unit where she is diagnosed with conversion disorder. Meryl asks the nurse, "Why has this happened to me?" What is the nurse's best response? A. You've developed paralysis so you can stay with your parents. You must deal with this conflict if you want to walk again B. It must be awful not to be able to move your legs. You may feel better if you realize the problem is psychological, not physical. C. Your problem is real but there is no physical basis for it. We'll work on what is going on in your life to find out why its happened. D. It isn't uncommon for someone with your personality to develop a conversion disorder during times of stress.

C. Your problem is real but there is no physical basis for it. We'll work on what is going on in your life to find out why it's happened.

The definition of nihilistic delusions is: A. a false belief about what the functioning of the body B. belief that the body is deformed or defective in a specific way C. false ideas about the self, others, or the world D. the inability to carry out motor activities

C. false ideas about the self, others, or the world

Nurse Krina knows that the following drugs have been known to be effective in treating OCD? A. benzotropine (Cogentin) and diphenhydramine (Benadryl) B. chlordiazepoxide (Librium) and diazepam (Valium) C. fluvoxamine (Luvox) and clomipramine (Anafranil) D. divalproex (Depakote) and lithium (Lithobid)

C. fluvoxamine (Luvox) and clomipramine (Anafranil)

The nurse is preparing for the discharge of a client who has been hospitalized for paranoid schizophrenia. The client's husband expresses concern over whether his wife will continue to take her daily prescribed medication. The nurse should inform him that: A. his concern is valid but his wife is an adult and has the right to make her own decisions B. he can easily mix the medication in his wife's food if she stops taking it C. his wife can be given a long-acting medication that is administered every 1 to 4 weeks D. his wife knows she must take her medication as prescribed to avoid further hospitalizations

C. his wife can be given a long-acting medication that is administered every 1 to 4 weeks

A client with chronic schizophrenia who takes neuroleptic medication is admitted to the psychiatric unit. Nursing assessment reveals rigidity, fever, hypertension, and diaphoresis. These findings suggest which life-threatening reaction: A. tardive dyskinesia B. dystonia C. neuroleptic malignant syndrome D. akathisia

C. neuroleptic malignant syndrome

A client with schizophrenia tells the nurse, "My intestines are rotted from the worms chewing on them." This statement indicates a: A. delusion of persecution B. delusion of grandeur C. somatic delusion D. jealous delusion

C. somatic delusion

The nurse observes a client pacing in the hall. Which statement by the nurse may help the client recognize his anxiety? A. "I guess you're worried about something, aren't you?" B. "Can I get some medication to help calm you down?" C. "Have you been pacing for a long time?" D. "I notice that you're pacing. How are you feeling?"

D. "I notice that you're pacing. How are you feeling?"

The outcome that is unrelated to a crisis state is: A. Learning more constructive coping skills B. Decompensation to a lower level of functioning C. Adaptation and a return to a prior level of functioning D. A higher level of anxiety continuing for more than 3 months

D. A higher level of anxiety continuing for more than 3 months

Upon evaluation of the patient's record, the nurse sees the admission was voluntary. Based on this data, the nurse expects which patient behavior? A. Fearfulness regarding treatment measures B. Anger and aggressiveness directed toward others C. An understanding of the pathology and symptoms of the diagnosis D. A willingness to participate in the planning of the care and treatment plan

D. A willingness to participate in the planning of the care and treatment plan

A dying male client gradually moves toward resolution of feelings regarding impending death. Basing care on the theory of Kugler-Ross, Nurse Trish plans to use nonverbal interventions when assessment reveals the client is in the: A. Anger stage B. Denial stage C. Bargaining stage D. Acceptance stage

D. Acceptance stage

A dopamine receptor agonist such as bromocriptine (Parlodel) relieves muscle rigidity activity caused by antipsychotic medication by: A. Blocking dopamine receptors in the CNS B. Blocking acetylcholine in the CNS C. Activating norepinephrine in the CNS D. Activating dopamine receptors in the CNS

D. Activating dopamine receptors in the CNS

The nurse is caring for a client diagnosed with antisocial personality disorder. The client has history of fighting, cruelty to animals, and stealing. Which of the following traits would the nurse most likely to uncover during assessment? A. History of gainful employment B. Frequent expression of guilt regarding antisocial behavior C. Demonstrated ability to maintain close, stable relationships D. Allow tolerance for frustration

D. Allow tolerance for frustration

While looking out the window, a client with schizophrenia remarks, "That school across the street has creatures in it that are waiting for me." Which of the following terms best describes what the creatures represent? A. Anxiety attack B. Projection C. Hallucination D. Delusion

D. Delusion

Ramon is admitted for detoxification after a cocaine overdose. The client tells the nurse that he frequently uses cocaine but that he can control his use if he chooses. Which coping mechanism is he using? A. Withdrawal B. Logical thinking C. Repression D. Denial

D. Denial

The emergency department nurse is assigned to provide care for a victim of a sexual assault. When following legal and agency guidelines, which intervention is most important? A. Determine the assailant's identity B. Preserve the client's privacy C. Identify the extent of injury D. Ensure an unbroken chain of evidence

D. Ensure an unbroken chain of evidence

After seeking help at an outpatient mental health clinic, Ruby who was raped while walking her dog is diagnosed with PTSD. Three months later, Ruby returns to the clinic, complaining of fear, loss of control, and helpless feelings. Which nursing intervention is appropriate for Ruby? A. Recommending a high-protein, low-fat diet. B. Giving sleep medication, as prescribed, to restore a normal sleep-wake cycle C. Allowing the client time to heal D. Exploring the meaning of the traumatic event with the client

D. Exploring the meaning of the traumatic event with the client.

A 75-year-old client has dementia of the Alzheimer's type and confabulates. The nurse understands that this client: A. Denies confusion by being jovial B. Pretends to be someone else C. Rationalizes various behaviors D. Fills memory gaps with fantasy

D. Fills memory gaps with fantasy

Mr. Marquez reports of losing his job, not being able to sleep at night and feeling upset with his wife. Nurse John responds to the client, "You may want to talk about your employment situation at group today." The nurse is using which therapeutic technique? A. Observations B. Restating C. Exploring D. Focusing

D. Focusing

The nurse asks a client to roll up his sleeves so she can take his blood pressure. The client replies, "If you want I can go naked for you." The most therapeutic response by the nurse is: A. You're attractive, but I'm not interested. B. You wouldn't be the first person I've seen naked. C. I will report you to the guard if you don't control yourself. D. I only need access to your arm. Putting up your sleeve is fine.

D. I only need access to your arm. Putting up your sleeve is fine.

Nurse Gina is aware that the dietary implications for a client in manic phase of bipolar disorder are: A. Serve the client a bowl of soup, buttered French bread, and apple slices. B. Increase calories, decrease fat, and decreased protein C. Give the client cut-up steak, carrots, and an apple D. Increase calories, carbohydrates, and protein

D. Increased calories, carbohydrates, and protein

Nurse Jen is caring for a male client with manic depression. The plan of care for a client with manic state would include: A. Offering high-calorie meals and strongly encouraging the client to finish all food. B. Insisting that the client remain active through the day so that he'll sleep at night. C. Allowing the client to exhibit hyperactive, demanding, manipulative behavior without seeing limits. D. Listening attentively with a neutral attitude and avoiding power struggles.

D. Listening attentively with a neutral attitude and avoiding power struggles.

A client who's taking antipsychotic medication develops a very high temperature, severe muscle rigidity, tachycardia, and rapid deterioration in mental status. The nurse suspects what complication of antipsychotic medication therapy? A. agranulocytosis B. Extrapyramidal effects C. Anticholinergic effects D. Neuroleptic malignant syndrome (NMS)

D. Neuroleptic malignant syndrome (NMS)

When providing family therapy, the nurse analyzes the functioning of healthy family systems. Which situations would not increase stress on a healthy family system? A. An adolescent going away to college B. The birth of a child C. The death of a grandparent D. Parental disagreement

D. Parental disagreement

The nurse explains to a mental health care technician that a client's obsessive-compulsive behaviors are related to unconscious conflict between id impulses and the superego (or conscience). On which of the following theories does the nurse base this statement? A. Behavioral theory B. Cognitive theory C. Interpersonal theory D. Psychoanalytic theory

D. Psychoanalytic theory

Tony refuses his evening dose of Haloperidol (Haldol), then becomes extremely agitated in the dayroom while other clients are watching television. He begins cursing and throwing furniture. Nurse Oliver first action is to: A. check the client's medical record for an order for an as needed IM dose of medication for agitation B. Place the client in full leather restraints C. Call the attending physician and report the behavior D. Remove all other clients from the dayroom

D. Remove all other clients from the dayroom

The nurse considers a client's response to crisis intervention successful if the client: A. Changes coping skills and behavioral patterns B. Develops insight into reasons why the crisis occurred C. Learns to relate better to others D. Returns to his previous level of functioning

D. Returns to his previous level of functioning

A client with bipolar disorder, manic type, exhibits extreme excitement, delusional thinking, and command hallucinations. Which of the following is the priority nursing diagnosis? A. Anxiety B. Impaired social interaction C. Disturbed sensory-perceptual alterations (auditory) D. Risk for other-directed violence

D. Risk for other-directed violence

Which of the following will the nurse use when communicating with a client who has a cognitive impairment? A. Complete explanations with multiple details B. Picture or gestures instead of words C. Stimulating words and phrases to capture the client's attention D. Short words and simple sentences

D. Short words and simple sentences

Aira has taken amitriptyline HCL (Elavil) for 3 days, but now complains that it "doesn't help" and refuses to take it. What should the nurse say or do? A. Withhold the drug B. Record the client's response C. Encourage the client to tell the doctor D. Suggest that it takes awhile before seeing the results

D. Suggest that it takes awhile before seeing the results.

When discharging a client after treatment for a dystonic reaction, the emergency department nurse must ensure that the client understands which of the following? A. Results of treatment are rapid and dramatic but may not last B. Although uncomfortable, this reaction isn't serious C. The client shouldn't buy drugs on the street D. The client must take benztropin (Cogentin) as prescribed to prevent a return of symptoms

D. The client must take benztropin (Cogentin) as prescribed to prevent a return of symptoms

The nurse is working with a client with a somatoform disorder. Which client outcome goal would the nurse most likely establish in this situation? A. The client will recognize signs and symptoms of physical illness B. The client will cope with physical illness C. The client will take prescribed medications D. The client will express anxiety verbally rather than though physical symptoms

D. The client will express anxiety verbally through physical symptoms

Which of the following outcome criteria is appropriate for the client with dementia? A. The client will return to adequate level of self-functioning B. The client will learn new coping mechanisms to handle anxiety C. The client will seek out resources in the community for support D. The client will follow an establishing schedule for activities of daily living

D. The client will follow an establishing schedule for activities of daily living.

Which information is most essential in the initial teaching session for the family of a young adult recently diagnosed with schizophrenia? A. Symptoms of this disease imbalance in the brain B. Genetic history is an important factor related to the development of schizophrenia C. Schizophrenia is a serious disease affecting every aspect of a person's functioning D. The distressing symptoms of this disorder can respond to the treatment with medications

D. The distressing symptoms of this disorder can respond to the treatment with medications

Which factor is least important in the decision regarding whether a victim of family violence can safely remain in the home? A. The availability of appropriate community shelters B. The non-abusing caretaker's ability to intervene on the client's behalf C. The client's possible response to relocation D. The family's socioeconomic status

D. The family's socioeconomic status

The nurse is interacting with a family consisting of a mother, father, and a hospitalized adolescent who has a diagnosis of alcohol abuse. The nurse analyzes the situation and agrees with the adolescent's view about family rules. Which intervention is most appropriate? A. The nurse should align with the adolescent, is the family scapegoat. B. The nurse should encourage the parents to adopt more realistic views C. The nurse should encourage the adolescent to comply with parental rules. D. The nurse should remain objective and encourage mutual negotiation of issues

D. The nurse should remain objective and encourage mutual negotiation of issues

Which nursing intervention is best for facilitating communication with a psychiatric client who speaks a foreign language? A. Rely on nonverbal B. Select symbolic pictures as aids C. Speak in universal phrases D. Use the services of an interpreter

D. Use the services of an interpreter

Which nursing statement is a good example of the therapeutic communication technique of focusing? A. Describe one of the best things that happened to you this week. B. I'm having a difficult time understanding what you mean. C. Your counseling session is in 30 minutes. I'll stay with you until then. D. You mentioned your relationship with your father. Let's discuss that further.

D. You mentioned your relationship with your father. Let's discuss that further.

A client with schizophrenia hears a voice telling him he is evil and must die. The nurse understands that the client is experiencing: A. a delusion B. flight of ideas C. ideas of reference D. a hallucination

D. a hallucination

Nursing care for a client with schizophrenia must be based on valid psychiatric and nursing theories. The nurse's interpersonal communication with the client and specific nursing interventions must be: A. clearly identified with boundaries and specifically defined roles B. warm and non-threatening C. centered on clearly defined limits and expression of empathy D. flexible enough for the nurse to adjust the plan of care as the situation warrants

D. flexible enough for the nurse to adjust the plan of care as the situation warrants

A client is admitted to the psychiatric unit of a local hospital with chronic undifferentiated schizophrenia. During the next several days, the client is seen laughing, yelling, and talking to herself. This behavior is characteristic of: A. delusion B. looseness of association C. illusion D. hallucinations

D. hallucinations

What medication would probably be ordered for the acutely aggressive schizophrenic client? A. chlorpromazine (Thorazine) B. haloperidol (Haldol) C. lithium carbonate (Lithonate) D. amitriptyline (Elavil)

haloperidol (Haldol)

A client tells the nurse that the television newscaster is sending a secret message to her. The nurse suspects the client is experiencing: A. a delusion B. flight of ideas C. ideas of reference D. a hallucination

C. ideas of reference

Which medications have been found to help reduce and eliminate panic attacks? A. Antidepressants B. Anticholinergics C. Antipsychotics D. Mood stabilizers

A. Antidepressants

In clients with a cognitive impairment disorder, the phenomenon of increased confusion in the early evening hours is called: A. Aphasia B. Agnosia C. Sundowning D. Confabulation

C. Sundowning