Psychiatric Nursing
A client is scheduled for electroconvulsive therapy (ECT) in the morning. It is not important that the evening nurse ensures that the client does which of the following? a. Sign an informed consent b. s placed on seizure precaution c. Remember to take the morning medication d. has a family member who will bring home any valuables
A
A client with persistent, severe schizophrenia has been treated with phenothiazines for the past 17 years. Now the client's speech is garbled as a result of drug-induced rhythmic tongue protrusion. What is another name for this extrapyramidal symptom? a. Tardive dyskinesia b. Dystonia c. Neuroleptic malignant syndrome d. Akathisia
A
A schizophrenic client states, "I hear the voice of King Tut." Which response by the nurse would be 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 voice as long as it doesn't belong to anyone real." d. "King Tut has been dead for years."
A
Catherine, a client is admitted with a diagnosis of delusions of grandeur. 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
Cory, a client comes to the emergency department while experiencing a panic attack. The nurse can best respond to a client having a panic attack by: a. staying with the client until the attack subsides. b. telling the client everything is under control. c. telling the client to lie down and rest. d. talking continually to the client by explaining what's happening.
A
During a group therapy session, a client diagnosed with mania consistently disrupts the group's interactions. Which intervention should the nurse implement first? a. Setting limits on the client's behavior b. Asking the client to leave the group session c. Asking another nurse to escort the client out of the group session d. Telling the client that they will not be able to attend any future group sessions
A
During a panic attack, Hero, a male patient runs to the nurse and reports breathing difficulty, chest pain, and palpitations. The patient is pale, with the mouth wide open and eyebrows raised. What should the nurse do first? a. Assist the patient to breath deeply into a paper bag. b. Orient the patient to person, place and time. c. Set limits for acting out delusional behaviors. d. Administer an I.M. anxiolytic agent.
A
Femie, a 23-year-old client is diagnosed with dependent personality disorder. Which behavior is most likely evidence of ineffective individual coping? a. Inability to make choices and decisions without advice b. Showing interest only in solitary activities c. Avoiding developing relationships d. Recurrent self-destructive behavior with history of depression
A
Gelyn, 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. "Describe the man who's out to get you. What does he look like?" c. "There is no reason to be afraid of that man. This hospital is very secure." d. "There is no need to be concerned with a man who isn't even real."
A
In a group therapy setting, Aj, a male member is very demanding, repeatedly interrupting others and taking most of the group time. The nurse's best response would be: a. "Will you briefly summarize your point because others need time also?" b. "Your behavior is obnoxious and drains the group." c. To ignore the behavior and allow him vent d. "I'm so frustrated with your behavior."
A
Krisha, diagnosed with bulimia tells the nurse that she eats excessively when she is upset and then vomits so she won't gain a lot of weight. Which of the following nursing diagnostic categories would be most appropriate for her? a. Ineffective coping. b. Imbalanced nutrition: more than body requirements. c. Anxiety. d. Disabled family coping.
A
Lily goes to Prince's bedside to greet him. Mildred corrects Lily of her greeting which is NOT appropriate to Prince? a. "Hi, Prince!, so you got drunk last night" b. "Hi, Prince!, I heard you enjoyed yourself last night" c. "Hi, Prince!, I heard you had a drinking spree last night" d. "Hi, Prince!, How was your drinking affair last night"
A
Ofel, a client with paranoid type schizophrenia becomes angry and tells the nurse to leave her alone. The nurse should: a. tell her that she'll leave for now but will return soon. b. ask her if it's okay if she sits quietly with him. c. ask her why he wants to be left alone. d. tell her that she won't let anything happen to him.
A
Persistent irrational fear is typical of which condition? a. Phobia b. Anxiety disorder c. Paranoia d. Delusions
A
Propranolol (Inderal) is used in the mental health setting to manage which of the following conditions? a. Antipsychotic-induced akathisia and anxiety b. The manic phase of bipolar illness as a mood stabilizer c. Delusions for clients suffering from schizophrenia d. Obsessive-compulsive disorder (OCD) to reduce ritualistic behavior
A
Sonny, a male patient with antisocial personality disorder smokes where it is prohibited and refuses to follow other unit and hospital rules. The patient gets others to do the laundry and other personal chores, splits the staff, and will work only with certain nurses. The plan of care for this patient should focus primarily on: a. A consistently enforcing unit rules and hospital policy. b. Isolating the patient to decrease contact with easily manipulated patients. c. Engaging in power struggles with the patient to minimize manipulative behavior. d. Using behavior modification to decrease negative behavior by using negative reinforcement.
A
The nurse is caring for Yong, a client, a Vietnam veteran, who exhibits signs and symptoms of posttraumatic stress disorder. Signs and symptoms of posttraumatic stress disorder include: a. hyperalertness and sleep disturbances. b. memory loss of traumatic event and somatic distress. c. feelings of hostility and violent behavior. d. sudden behavioral changes and anorexia.
A
The nurse is planning care for Chester, 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
The nurse is planning care for a hallucinating and delusional client who has been rescued from a suicide attempt. Which intervention should the nurse incorporate into the nursing care plan?* a. Initiate one-to-one suicide precautions immediately. b. Ask the client to report suicidal thoughts immediately c. Begin suicide precautions with 30-minute checks. d. Check the client's location every 15 minutes
A
The nurse knows that the doctor in charge has ordered the liquid form of the drug chlorpromazine 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 infections d. Has a longer duration of action
A
Violet, 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
What type of touch is used when it involves tight hugs and kisses between relatives a. Love-intimacy touch b. Friendship -warmth touch c. Social -polite touch d. Functional -professional
A
When assessing Edna, a patient with anorexia nervosa, the nurse would expect to find which of the following? a. Lanugo, hypothermia, and hypotension. b. Constipation, dysmenorrheal, and hypertension. c. Diarrhea, dry skin and menorrhagia. d. Hyperthermia, oliguria and bradycardia.
A
When assessing Toni, a 17-year-old male patient with depression for suicide risk, which of the following questions would be best? a. "Are you thinking about killing yourself?" b. "What movies about death have you watched lately?" c. "Can you tell me what you think about suicide?" d. "Has anyone in your family ever committed suicide?"
A
When developing a teaching plan for a high school health class about anorexia nervosa, which of the following would the nurse include as the primary group affected by this disease? a. Women, age at onset between 12 to 20 years. b. Men, onset during the college years. c. Women, onset typically after 30 years of age. d. Men, onset before 20 years of age.
A
When planning the care for Gerly who is abused, which of the following measures would be most important to include? a. Helping the patient develop a safety plan. b. Explaining to the patient her personal and legal rights. c. Teaching her about abuse and the cycle of violence. d. Being compassionate and empathetic.
A
A client is suicidal. As a nurse which precautions must you employ? 1. place client near the station 2. always keep the door open 3. make sure of regular visits 4. keep visits irregular 5. remove sharps and ties a. 1,2,3,4 b. 1,2,4,5 c. 2,3,4,5 d. all of the above
B
Aida, a client is admitted to the inpatient unit of the mental health center with a diagnosis of paranoid schizophrenia. She's shouting that the government of France is trying to assassinate her. 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
Alvin, a client with paranoid schizophrenia has been experiencing auditory hallucinations for many years. One approach that has proven to be effective for hallucinating clients is to: a. take an as-needed dose of psychotropic medication whenever they hear voices. b. practice saying "Go away" or "Stop" when they hear voices. c. sing loudly to drown out the voices and provide a distraction. d. go to their room until the voices go away.
B
Barbie, a female patient with a conversion disorder who reports blindness, ophthalmologic examinations reveal that no organic disorder is causing progressive vision loss. The most likely source of this patient's blindness is: a. A family history of major depression. b. Having been forced to watch a loved one's torture. c. Noncompliance with a psychotropic medication regimen. d. Daily use of antianxiety agents and alcoholic beverages.
B
Benztropine (Cogentin) is used to treat the extrapyramidal effects induced by antipsychotics. This drug exerts its effect by: a. decreasing the anxiety causing muscle rigidity. b. blocking the cholinergic activity in the central nervous system (CNS). c. increasing the level of acetylcholine in the CNS. d. increasing norepinephrine in the CNS.
B
During data collection, 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
During the initial interview, Kriszel who has a compulsive eating disorder remarks, "I can't stand myself and the way I look." Which of the following statements by the nurse would be most therapeutic? a. "Don't worry, you'll soon be back in shape." b. "Tell me more about your feelings." c. "Everyone who has the same problem feels like you do." d. "I don't think you look bad at all."
B
For several years, a client with chronic schizophrenia has received 10 mg of fluphenazine hydrochloride (Prolixin) by mouth four times per day. Now the client has a temperature of 102° F (38.9° C), a heart rate of 120 beats/minute, a respiratory rate of 20 breaths/minute, and a blood pressure of 210/140 mm Hg. Because the client also is confused and incontinent, the nurse suspects malignant neuroleptic syndrome. What steps should the nurse take? a. Give the next dose of fluphenazine, call the physician, and monitor vital signs. b. Withhold the next dose of fluphenazine, call the physician, and monitor vital signs. c. Give the next dose of fluphenazine and restrict the client to the room to decrease stimulation. d. Withhold the next dose of fluphenazine, administer an antipyretic agent, and increase the client's fluid intake.
B
Grover, a male patient receiving fluphenazine (Prolixen) therapy develops pseudoparkinsonism. The doctor is likely to prescribe which drug to control this extrapyramidal effect? a. Phenytoin (Dilantin) b. Amantadine (Symmetrel) c. Benztropine (Cogentin) d. Diphenhydramine
B
Head Nurse Mildred wished that Nurse Lily should have used a/an: a. non-verbal communication b. therapeutic communication c. empathic communication d. casual communication
B
Helgar, 25, admits to you that he has multiple sexual partners. Which among the following will you do regarding this? a. Counsel him that it is shameful for men to have multiple sexual partners. b. Educate him regarding safe sex practices. c. Terminate care right away for it is dangerous to be dealing with people like him. d. Refer him to a psychiatrist.
B
Jiffery, a client with a diagnosis of paranoid schizophrenia comments to the nurse, "How do I know what is really in those pills?" Which of the following is the best response? A. Say, "You know it's your medicine." B. Allow him to open the individual wrappers of the medication. C. Say, "Don't worry about what is in the pills. It's what is ordered." D. Ignore the comment because it's probably a joke.
B
Lhoy, 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) I.M. B. administer as needed dose of benztropine (Cogentin) I.M. as ordered. C. administer as needed dose of benztropine (Cogentin) by mouth as ordered. D. administer as needed dose of haloperidol (Haldol) by mouth.
B
One of the myths about sexual abuse of young children is that it usually involves physically violent acts. Which of the following behaviors is more likely to be used by the abusers? a. Asking for the child's consent for sex. b. Coercion as a result of the trusting relationship. c. Tying the child down. d. Bribery with money.
B
Salty, a client in the manic phase of bipolar disorder constantly belittles other clients and demands special favors from the nurses. Which nursing intervention would be most appropriate for this client? a. Ask other clients and staff members to ignore the client's behavior. b. Set limits with consequences for belittling or demanding behavior. c. Offer the client an antianxiety drug when belittling or demanding behavior occurs. d. Offer the client a variety of stimulating activities to distract him from belittling or making demands of
B
Seng, a 24-year-old client is experiencing an acute schizophrenic episode. She has vivid hallucinations that are making him agitated. The nurse's best response at this time would be to: a. take the client's vital signs. b. explore the content of the hallucinations. c. tell him his fear is unrealistic. d. engage the client in reality-oriented activities.
B
The charge nurse in an acute care setting assigns to Lemuel, a male client, who's on one-to-one suicide precautions, to a psychiatric aide. This assignment is considered: a. Poor nursing practice because a registered nurse should work with this client. b. Reasonable nursing practice because one-to-one supervision requires the total attention of a staff member. c. Outside the responsibility of an aide. d. Illegal to delegate to an aide.
B
The nurse is aware that the goal of crisis intervention is: a. To solve the client's problems for him. b. Psychological resolution of the immediate crisis. c. To establish a means for long-term therapy. d. To provide a means for admission to an acute care facility.
B
The nurse is caring for Shakira, a client in an acute manic state. What's the most effective nursing action for this client? a. Assigning him to group activities. b. Reducing his stimulation. c. Assisting him with self-care. d. Helping him express his feelings.
B
The nurse is caring for Sheryl, a client who experiences false sensory perceptions with no basis in reality. These perceptions are known as: a. delusions. b. hallucinations. c. loose associations. d. neologisms
B
The nurse is teaching a new group of mental health aides. The nurse should teach the aides that setting limits is most important for: a. a depressed client. b. a manic client. c. a suicidal client. d. an anxious client.
B
The nurse is with the parents of Kevin, a 16-year-old boy who recently attempted suicide. The nurse cautions the parents to be especially alert for which of the following in their son? a. Decision to try out for an extracurricular activity. b. Giving away valued personal items. c. Desire to spend more time with friends. d. Expression of a desire to date.
B
What occurs during the working phase of the nurse-patient relationship? a. The nurse assesses the patient's needs and develops a plan of care. b. The nurse and patient together evaluate and modify the goals of the relationship. c. The nurse and patient discuss their feelings about terminating the relationship. d. The nurse and patient explore each other's expectations of the relationship.
B
When caring for Martin, a male adolescent patient diagnosed with depression, the nurse should remember that depression manifests differently in adolescents and adult. In an adolescent, signs and symptoms of depression are likely to include: a. Helplessness, hopelessness, hypersomnolence, and anorexia. b. Truancy, a change of friends, social withdrawal, and oppositional behavior. c. Curfew breaking, stealing from family members, truancy, and oppositional behavior. d. Hypersomnolence, obsession with body image, and valuing of peer's opinion.
B
Which of the following medications would the nurse anticipate administering as a treatment for tic disorders, including Tourette disorder? a. Lithium. b. Clonidine. c. Chlorpromazine. d. Imipramine.
B
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
A client has been very despondent, withdrawn, and apathetic for about 6 months. Recently, the client began to attend an outpatient clinic for treatment of depressive disorder. Fluoxetine HCL (Prozac) is prescribed, and after 3 days the client shows improvement. What is the most appropriate nursing intervention at this time? a. Encourage the client to interact with other clients b. Assess the client's knowledge about the medication c. Evaluate the potential for self-destructive behavior d. Discuss long term plan for discharge and follow-up
C
A client is hospitalized with obsessive-compulsive disorder. The nurse notes that the client is vigorously washing his hands. Which response by the nurse would be the most appropriate? a. "Your hands look clean already. Why are you still washing them?" b. "You should stop washing your hands because they will get chapped." c. "It's time to go to the dining room. I'll walk with you." d. "I'll get some lotion for your hands so that they won't get chapped."
C
A nurse places Paolo, a male client in full leather restraints. How often must the nurse check the client's circulation? a. Once per hour. b. Once per 8-hour shift. c. Every 15 minutes. d. Every 2 hours.
C
Bitter, a client diagnosed with depression tells the nurse, "I won't allow myself to cry because it upsets the whole family when I cry." This is an example of: a. manipulation. b. insight. c. rationalization. d. repression.
C
Daryl, 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 sitting still, 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
Desiree who has been sexually abused has difficulty putting feelings into words. Which of the following would the nurse employ with the child? a. Role-playing. b. Giving the patient's drawings to the abuser. c. Engaging in play therapy. d. Reporting the abuse to a prosecutor.
C
Dingdong and Marian, a husband and wife seek emergency crisis intervention because he slapped her repeatedly the night before. The husband says he grew up in a household where his father frequently abused both his mother and him. When interviewing with this couple, the nurse in charge 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
Ed, a psychotic client reports to the evening nurse that the day nurse put something suspicious in his water with his medication. The nurse replies, "You're worried about your medication?" The nurse's communication is: a. an example of presenting reality. b. reinforcing the client's delusions. c. focusing on emotional content. d. a nontherapeutic technique called mind reading.
C
Gay-gay, a client who has been hospitalized with disorganized type schizophrenia for 8 years can't complete activities of daily living (ADLs) without staff direction and assistance. The nurse formulates a nursing diagnosis of Self-care deficient: Dressing/grooming related to inability to function without assistance. What is an appropriate goal for this client? a. "Client will be able to complete 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
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
Mai-mai, 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
Marbey is at risk for injury as a result of environmental conditions interacting with his adaptive and defensive resources. The nurse recognizes the following risks for injury that include the following, except: a. Inability to perceive potentially harmful situation b. Poor hand coordination c. Decreased interfering behavior d. Impulsive behavior
C
Mirriam, a busy attorney with a successful law practice is admitted to an acute care facility with epigastric pain. Since admission, the patient has called the nurse 15 minutes with one request or another. This patient is exhibiting: a. Repression b. Somatization c. Regression d. Conversion
C
Most antipsychotic medications exert which of following effects on the central nervous system (CNS)? a. Stimulate the CNS by blocking postsynaptic dopamine, norepinephrine, and serotonin receptors. b. Sedate the CNS by stimulating serotonin at the synaptic cleft. c. Depress the CNS by blocking the postsynaptic transmission of dopamine, serotonin, and norepinephrine. d. Depress the CNS by stimulating the release of acetylcholine.
C
Orly, a client with borderline personality disorder becomes angry when he is told that today's psychotherapy session with the nurse will be delayed 30 minutes because of an emergency. When the session finally begins, the client expresses anger. Which response by the nurse would be most helpful in dealing with the client's anger? A. "If it had been your emergency, I would have made the other client wait." B. "I know it's frustrating to wait. I'm sorry this happened." C. "You had to wait. Can we talk about how this is making you feel right now?" D. "I really care about you and I'll never let this happen again."
C
Rochelle, a client whose husband recently left her is admitted to the hospital with severe depression. The nurse suspects that the client is at risk for suicide. Which of the following questions would be most appropriate and helpful for the nurse to ask during an assessment for suicide risk? a. "Are you sure you want to kill yourself?" b. "I know if my husband left me, I'd want to kill myself. Is that what you think?" c. "How do you think you would kill yourself?" d. "Why don't you just look at the positives in your life?"
C
The nurse at the mental health clinic is meeting a new patient who is Kezia, a 7-year-old girl with Tourette syndrome. Which of the following would the nurse expect to assess? a. Isolated verbal tics. b. Alternating simple and complex motor tics. c. Multiple motor and verbal tics. d. Primarily motor tics.
C
The nurse in-charge is displaying assertive behavior when she: a. Says what's on her mind at the expense of others. b. Expresses an air of superiority. c. Avoids unpleasant situations and circumstances. d. Stands up for her rights while respecting the rights of others.
C
The nurse is assessing Renee's methods of coping. A patient who is being abused would be least likely to demonstrate which of the following? a. Self-blame. b. Alcohol abuse. c. Assertiveness. d. Suicidal thoughts
C
The nurse is caring for Guy, 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
The nurse is caring for Marvin, a client experiencing an anxiety attack. Appropriate nursing interventions include: a. turning on the lights and opening the windows so that the client doesn't feel crowded. b. leaving the client alone. c. staying with the client and speaking in short sentences. d. turning on stereo music.
C
The nurse is developing a care plan for Medusa, a client with anorexia nervosa. Which action should the nurse include in the plan? a. Restrict visits with the family 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
The nurse is preparing for the discharge of Charlie, 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 future hospitalizations.
C
The psychiatric nurse understands the concept of crisis. She knows that the following statements are true of crisis excluding: a. Specific identifiable events lead to crisis b. All individuals experience a crisis c. Crisis is acute and is resolved within a short period of time d. Crisis halts the emotional development of a person
C
Unhealthy personal boundaries are a product of dysfunctional families and a lack of positive role models. Unhealthy boundaries may also be a result of: a. Structured limit setting b. A supportive environment c. Abuse and neglect d. Direction and attention
C
What's a nurse most important role in caring for Fernando, an adult client with a mental disorder? a. To offer advice b. To know how to solve the client's problem c. To establish trust and rapport d. To set limits with the client
C
Which intervention would establish a therapeutic relationship with a client diagnosed with major depressive disorder? a. Invite the client to attend an exercise class. b. Ask the client to join others to watch a 2-hour movie. c. Sit with the client in silence. d. Ask the client how his or her day should be scheduled
C
Which nursing diagnosis would be the priority with a client's DSM-IV Axis 1 diagnosis of schizophrenia, paranoid type? a. Altered protection b. Risk for loneliness c. Altered thought process d. Ineffective individual coping
C
Which of the following is NOT a type of therapeutic touch used by the nurse in providing care to psychiatric patients? a. Social-polite touch b. Friendship -warmth c. Sexual -arousal touch d. Love -intimacy touch
C
Yesterday, James, a client with schizophrenia began treatment with haloperidol (Haldol). Today, the nurse notices that the client is holding his head to one side and complaining of neck and jaw spasms. a. Assume that the client is posturing. b. Tell the client to lie down and relax. c. Evaluate the client for adverse reactions to haloperidol. d. Put the client on the list for the physician to see tomorrow
C
A dopamine receptor agonist such as bromocriptine (Parlodel) relieves muscle rigidity caused by antipsychotic medication by: a. blocking dopamine receptors in the central nervous system (CNS). b. blocking acetylcholine in the CNS. c. activating norepinephrine in the CNS. d. activating dopamine receptors in the CNS.
D
A nurse is reviewing with the client's father the discharge plan of a client recently diagnosed with paranoid schizophrenia. Which of the father's statements indicates to the nurse that he understands the diagnoses and prognosis of paranoid schizophrenia? a. "There is a good chance that this will be his only hospitalization." b. "He won't get worse if he continues to take his medication." c. "We will need to keep him at home so we can monitor his illness closely." d. "We will need to watch for signs of depression."
D
A nurse is working with Helen, a female dying client and her family. Which communication technique is most important to use? a. Reflection b. Interpretation c. Clarification d. Active listening
D
During the admission assessment, Andre, a male patient with a panic disorder begins to hyperventilate and says, "I'm going to die if I don't get out of here right now!" What is the nurse's best response? a. "Just calm down. You're getting overly anxious." b. "What do you think is causing your panic attack?" c. "You can rest alone in your room until you feel better." d. "You're having panic attack. I'll stay here with you."
D
Frowline, 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. hallucination.
D
How soon after chlorpromazine (Thorazine) administration should the nurse expect to see a client's delusional thoughts and hallucinations eliminated? a. Several minutes b. Several hours c. Several days d. Several weeks
D
Josh, a 3-year-old child is brought into the physician's office by her parents who are concerned by his behavior. They state that he resists their affection, twirls around frequently, and refuses to respond to other children and adults. Based on the analysis of these behaviors, which of the following would the nurse suspect? a. Tourette syndrome. b. Schizophrenia. c. ADHD. d. Autism.
D
Marbey tells the nurse, "I don't have friends because I'm stupid." Which of the following nursing diagnoses would the nurse identify for him? a. Ineffective coping b. Anxiety c. withdrawal syndrome d. low self esteem
D
Marco, an adult client in an acute care mental health program refuses his morning dose of an oral antipsychotic medication and believes he's being poisoned. The nurse should respond by taking which action? a. Administering the medication by injection. b. Omitting the dose and trying again the next day. c. Crushing the medication and putting it in his food. d. Consulting with the physician about a care plan.
D
Mildred suggested that Lily should use communication technique appropriate for the condition of Prince such as: a. Concluding b. Analyzing c. Questioning d. Rephrasing
D
Prince turned his back away from Nurse Lily, saying "It's none of your business, you ugly duckling." The appropriate response of Nurse Lily would be: a. "What you said hurt me, you alcoholic!" b. "You beast, you are as ugly as I am" c. "You really are a drunkard" d. "I don't think you mean what you have just said. Do You?"
D
Ruth, a client begins taking haloperidol (Haldol). After a few days, she experiences severe tonic contractures of muscles in the neck, mouth, and tongue. The nurse should recognize this as: a. psychotic symptoms. b. parkinsonism. c. akathisia. d. dystonia.
D
The employer of Sitti, a female client on the psychiatric unit calls the nursing station inquiring about the client's progress. The nurse doesn't know if consent has been given by the client to allow the staff to give information out to caller on the phone. Which response by the nurse would be best? a. "I'm not permitted to discuss her progress." b. "I'll give you the name and telephone number of her physician." c. "I'll have her call you." d. "I can't confirm whether your employee is a client here."
D
The nurse determines that a new mother understands the teaching about prevention of newborn abduction if she states: a. "I will place my baby's crib close to the door." b. "Some health care personnel won't have name badges." c. "It's OK to allow the nurse assistant to carry my newborn to the nursery." d. "I will ask the nurse to attend to my infant if I am napping and my husband is not here."
D
The nurse expects Marbey to have impaired social interaction as the child exhibits excessive talking, short attention span, and low frustration tolerance. Which of the following nursing interventions is NOT useful in his case? a. Call Marbey's name and establish eye contact b. Give instructions to the child slowly using simple language c. Provide positive feedback for completion of each task d. Give complex tasks one at a time
D
The nurse is aware that the primary indication for the use of electroconvulsive therapy (ECT) is: a. Severe agitation b. Antisocial behavior c. Noncompliance with treatment d. Major depression with psychotic features
D
The nurse is caring for Carlo, a client who she believes has been abusing opiates. Assessment findings in a client abusing opiates, such as morphine, include: a. dilated pupils and slurred speech. b. rapid speech and agitation. c. dilated pupils and agitation. d. euphoria and constricted pupils.
D
The nurse is caring for Rachel, a client who is suicidal. When accompanying the client to the bathroom, the nurse should: a. give him privacy in the bathroom. b. allow him to shave. c. open the window and allow him to get some fresh air. d. observe him.
D
The patient started to demonstrate automatisms. This is characterized as: a. repeated purposeful behaviors b. maintenance on an awkward posture c. purposeless imitation d. repeated purposeless movements
D
Toni, a male client in a group therapy is restless. His face is flushed and he makes sarcastic remarks to group members. The nurse responds by saying, "You look angry." The nurse is using which technique? a. A broad opening statement b. Reassurance c. Clarifying d. Making observations
D
When admitting a patient with bulimia nervosa, the nurse should be expects the client to have a history of? a. Is accepting of body size b. Overeats for the enjoyment of eating food c. Overeats in response to losing control of diet d. Binge eats, then purges
D
When monitoring Howard, a male client recently admitted for treatment of cocaine addiction, the nurse notes sudden increase in the arterial blood pressure and heart rate. To correct these problems, the nurse expects the physician to prescribe: a. Norepinephrine (Levophed) and lidocaine (Xylocaine) b. Nifedipine (Procardia) and lidocaine c. Nitroglycerin (Nitro-Bid IV) and esmolol (Brevibloc) d. Nifedipine and nitroglycerin
D
When writing an assessment of a client with mood disorder, the nurse should specify a. How flat the client's affect is b. How suicidal the client is c. How grandiose the client is d. How the client is behaving
D
Which of the following would the nurse expect to include in the teaching plan for the parents of Kyle who is receiving methylphenidate (Ritalin)? a. Allowing concurrent use of any over-the-counter medications with this drug. b. Giving the medication at the same time every evening. c. Having the child take two doses at the same time if the last dose was missed. d. Giving the single-dose form of the medication early in the day.
D
Which type of therapeutic touch is used when you assess skin turgor of the patient during physical assessment? a. Friendship-warmth touch b. Love -intimacy touch c. Social-polite touch d. Functional -professional
D