Psych- Quiz #2

After several months of taking olanzapine, the client reports that he is no longer hearing voices of any kind. Which statement would confirm that the client is developing insight into his illness? a) "My mom is proud of me for staying on my medicines." b) "I did not realize how sick I could get from a chemical brain imbalance." c) "I think I may be able to get a little part-time job soon." d) "That olanzapine is the best medicine I have ever had."

I did not realize how sick I could get from a chemical brain imbalance."

At an outpatient visit 3 months after discharge from the hospital, a client says he has stopped his olanzapine even though it controls his symptoms of schizophrenia better than other medications. "I have gained 20 lb (9.1 kg) already. I cannot stand anymore." Which response by the nurse is most appropriate? a) "I can help you with a diet and exercise plan to keep your weight down." b) "Your weight gain will level off if you stay on the medication 3 more months." c) "I do not think you look fat; why do you think so?" d) "You can be switched to another medicine."

a) "I can help you with a diet and exercise plan to keep your weight down."

The client with a diagnosis of schizophrenia walks into group naked. The nurse should: a) lead the client to his room and help him dress if he needs assistance. b) instruct the client to go to his room and to put on some clothes. c) wrap a blanket around him and tell him to be seated for the remainder of group. d) ask a male client to take off his sweater and wrap it around the client's waist.

a) lead the client to his room and help him dress if he needs assistance.

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

a) somatic delusion.

A client with a diagnosis of schizophrenia is admitted to the inpatient unit of the mental health center. He's shouting that the government of France is trying to assassinate him. Which response is most appropriate? a) "I think you're wrong. France is a friendly country. The French government wouldn't try to kill you." b) "I don't see evidence 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 don't see evidence that a foreign government or anyone else is trying to hurt you. You must feel frightened by this."

A female client with acute mania brings six suitcases and three shopping bags of personal belongings on admission to the unit. When informed that some of the suitcases and bags need to be returned home with her husband because of a lack of storage space, the client begins to use profanity against the nurse. Which response by the nurse is most therapeutic? a) "We do not want to put you in seclusion yet." b) "I will not tolerate your talking to me like that." c) "You are acting inappropriately." d) "Swearing and profanity are unacceptable here."

d) "Swearing and profanity are unacceptable here."??

Which concept is most important for a nurse to communicate to a client preparing to sign an informed consent for electroconvulsive therapy (ECT)? a) "You may experience a complete loss of memory after the treatment." b) "This therapy will provide excellent symptom relief." c) "You'll be offered a strong sedative before the procedure." d) "You may experience a time of confusion after the treatment."

d) "You may experience a time of confusion after the treatment."

A nurse is aware that antipsychotic medications may cause: a) increased coagulation time. b) increased insulin production. c) increased risk of heart failure. d) lower seizure threshold.

d) lower seizure threshold.

A client is admitted to the local psychiatric facility with bipolar disorder in the manic phase. The physician decides to start the client on lithium carbonate therapy. One week after this therapy starts, the nurse notes that the client's serum lithium level is 1 mEq/L. What should the nurse do? a) Continue to administer the medication as ordered. b) Call the physician immediately to report the laboratory result. c) Withhold the next dose and repeat the laboratory test. d) Observe the client closely for signs and symptoms of lithium toxicity.

a) Continue to administer the medication as ordered

A client is unable to get out of bed and get dressed unless a nurse prompts every step. This is an example of which behavior? a) Word salad b) Avolition c) Perseveration d) Tangential

b) Avolition

Which group of characteristics should a nurse expect to see in the client with schizophrenia? a) Delusions of jealousy and persecution, paranoia, and mistrust b) Sadness, apathy, feelings of worthlessness, anorexia, and weight loss c) Loose associations, grandiose delusions, and auditory hallucinations d) Periods of hyperactivity and irritability alternating with depression

c) Loose associations, grandiose delusions, and auditory hallucinations

A nurse notices that a depressed client who has been taking amitriptyline hydrochloride for 2 weeks has become very outgoing, cheerful, and talkative. The nurse suspects that the client: a) is responding appropriately to the antipsychotic. b) is ready to be discharged from treatment. c) may be experiencing increased energy and is at increased risk for suicide. d) is experiencing a split personality.

c) may be experiencing increased energy and is at increased risk for suicide.

Which statement should be included when teaching clients about monoamine oxidase (MAO) inhibitors? a) Don't take any prescribed or over-the-counter medications without consulting a physician and pharmacist. b) Avoid strenuous activity because of the drug's cardiac effects. c) Have blood levels screened weekly for leukopenia. d) Don't take an MAO inhibitor with aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs).

a) Don't take any prescribed or over-the-counter medications without consulting a physician and pharmacist.

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) waxy flexibility. b) somatic delusions. c) neologisms. d) nihilistic delusions.

a) waxy flexibility.

One of the causes of schizophrenia involves an overstimulation of: a) epinephrine. b) dopamine. c) serotonin. d) norepinephrine.

b) dopamine.

The nurse is facilitating a group of clients with schizophrenia when one client says, "I like to drive my car, bar, tar, far." This client is exhibiting: a) echolalia. b) neologisms c) echopraxia. d) clang association.

d) clang association.

A client with bipolar disorder, mania, has flight of ideas and grandiosity and becomes easily agitated. To prevent harmful behaviors, which of the following should the nurse do initially? a) Tell the client to seek out staff when feeling agitated. b) Encourage the client to stay in his room. c) Instruct the client to ask for medication when agitated. d) Seclude the client at the first sign of agitation.

a) Tell the client to seek out staff when feeling agitated.

A client with schizophrenia tells a nurse he hears the voices of his dead parents. To help the client ignore the voices, the nurse should recommend that he: a) listen to a personal stereo through headphones and sing along with the music. b) call a friend and discuss the voices and his feelings about them. c) engage in strenuous exercise. d) sit in a quiet, dark room and concentrate on the voices.

a) listen to a personal stereo through headphones and sing along with the music.

A client with schizophrenia is withdrawn and suspicious of others, and projects blame. The client's behavior reflects problems in which stage of development as identified by Erikson? a) initiative versus guilt b) trust versus mistrust c) intimacy versus isolation d) autonomy versus shame and doubt

b) trust versus mistrust

A 23-year-old client diagnosed with schizophrenia cheerfully announces, "My mom and I are so excited that I am pregnant. She is willing to help us take care of the baby too." Which reason should cause the nurse to be concerned about this situation? a) The client will have difficulty financially supporting the baby. b) The mother is not likely to provide enough help for what the client needs. c) Symptom management will be difficult in early pregnancy without medications. d) The client did not say that the father of the baby was excited about this.

c) Symptom management will be difficult in early pregnancy without medications.

In the community room, a nurse observes a client who suffers from depression. She sees the client pace swiftly around the room, swing both arms, and rub both hands together. What term should the nurse use to describe these behaviors to members of the health care team? a) Mania b) Psychomotor agitation c) Compulsions d) Tardive dyskinesia

b) Psychomotor agitation

While looking out the window at trees, a client with schizophrenia remarks, "That school across the street has creatures in it that are waiting for me." Which term best describes what the creatures represent? a) Hallucination b) Projection c) Delusion d) Anxiety attack

c) Delusion

A man with a 5-year history of multiple psychiatric admissions is brought to the emergency department by the police. This client was found wandering the streets disheveled, shoeless, and confused. Based on his previous medical records and current behavior, he is diagnosed with schizophrenia. The nurse should assign highest priority to which nursing diagnosis? a) Impaired verbal communication b) Dressing or grooming self-care deficit c) Disturbed thought processes d) Risk for injury

d) Risk for injury

What should be charted by the nurse when the client has an involuntary commitment or formal admission status? a) Nothing should be charted. The forms are in the chart; there is no need to duplicate. b) The client's willingness to cooperate with seclusion should be charted. c) The name of the physician officially signing the certificates should be charted. d) The client's receipt of information about status and rights should be charted.

d) The client's receipt of information about status and rights should be charted.

One of the causes of schizophrenia involves an overstimulation of: a) norepinephrine. b) epinephrine. c) dopamine. d) serotonin.

c) dopamine.

A nurse knows that a physician has ordered the liquid form of the drug chlorpromazine rather than the tablet form because the liquid: a) has a longer duration of action. b) has a more predictable onset of action. c) produces fewer drug interactions. d) produces fewer anticholinergic effects.

b) has a more predictable onset of action.

A nurse is planning care for a client with a diagnosis of schizophrenia who has been admitted to the psychiatric unit. Which nursing diagnosis should receive the highest priority? a) Compromised family coping b) Risk for other-directed violence c) Impaired verbal communication d) Imbalanced nutrition: Less than body requirements

b) Risk for other-directed violence

A female client with bipolar disorder who has been taking risperidone 2 mg orally twice a day informs the nurse that she is 8 weeks pregnant. The clients asks if she should continue the medication. What is the nurse's best response? a) "Your health care provider will slowly wean you off risperidone over the next several weeks." b) "The benefits of you staying on this medication that has controlled your symptoms outweighs the risk the fetus." c) "Risperidone is safe to take during pregnancy, but you will not be able to breastfeed your baby." d) "You should immediately stop this medication to decrease the risk of a major birth defect."

b) "The benefits of you staying on this medication that has controlled your symptoms outweighs the risk the fetus."