Psychobiological Disorders

An older adult client is talking to the nurse about his Vietnam experiences and shares that he still has flashbacks. While sitting with him the nurse notices that he is jumpy and exhibits startle reactions and poor concentration. The nurse identifies these as symptoms of: 1.Delusions 2.Hallucinations 3.Posttraumatic stress disorder (PTSD) 4.Obsessive-compulsive disorder (OCD)

3.Posttraumatic stress disorder (PTSD)

Clients addicted to alcohol often use the defense mechanism of denial. What is the reason that this defense is so often used? 1.It reduces their feelings of guilt. 2.It creates the appearance of independence. 3.It helps them live up to others' expectations. 4.It makes them look better in the eyes of others

1.It reduces their feelings of guilt.

A client who has been hospitalized with schizophrenia tells the nurse, "My heart has stopped and my veins have turned to glass!" What should the nurse conclude that the client is experiencing? 1.Echolalia 2.Hypochondriasis 3.Somatic delusion 4.Depersonalization

3.Somatic delusion

A client with agitation and mood swings approaches the nurse and shouts, "I've been watching you for a few days. You think you're so damned perfect and good. I think you stink!" What is the most appropriate response by the nurse? 1."Do you mean that I smell?" 2."You seem to be angry with me." 3."Wow, you're in a really bad mood." 4."I can't really be all that bad, can I?"

2."You seem to be angry with me."

Some clients repeatedly perform ritualistic behaviors throughout the day to limit anxious feelings. The nurse determines that these behaviors are: 1.Obsessions 2.Compulsions 3.Under personal control 4.Related to rebelliousness

2.Compulsions

The parents of an overweight adolescent girl tell the nurse that they are concerned that their daughter feels inferior to her sister, who is an attractive, successful college senior. They ask the nurse what they can do about this problem. The nurse should: 1.Suggest that they appear to be creating a problem where none exists 2.Tell them to avoid talking about their older child's accomplishments 3.Encourage the parents to give the adolescent recognition for her strong points 4.Advise the parents to tell the adolescent to view her sister's success as a challenge

3.Encourage the parents to give the adolescent recognition for her strong points

A nurse is caring for a client with the diagnosis of bipolar disorder, manic episode. The health care provider prescribes divalproex sodium (Depakote) 375 mg twice a day by mouth. The Depakote is labeled "250 mg/5 mL." How many milliliters of solution should the nurse administer per dose? Record your answer using one decimal place. __________ mL

7.5 mL

Which nursing action is most important when providing counseling to an adolescent with anorexia nervosa? 1.Avoiding talk of food 2.Limiting discussion of trivial topics 3.Helping the client express concerns about body image 4.Identifying the role played by the parents in the development of the disorder

3.Helping the client express concerns about body image

A client is admitted to a psychiatric hospital with the diagnosis of schizoid personality disorder. Which initial nursing intervention is a priority for this client? 1.Helping the client enter into group recreational activities 2.Convincing the client that the hospital staff is trying to help 3.Helping the client learn to trust the staff through selected experiences 4.Arranging the client's contact with others so it is limited while she is in the hospital

3.Helping the client learn to trust the staff through selected experiences

A client has just awakened from her first electroconvulsive therapy (ECT) treatment. What is the most appropriate initial intervention by the nurse? 1.Immediately getting the client out of bed and back into the unit's routine 2.Sitting the client up and arranging for the dietary staff to deliver a lunch tray 3.Orienting the client to time and place and explaining that the treatment is over 4.Taking the client's pulse and blood pressure every 15 minutes until the client is fully awake

3.Orienting the client to time and place and explaining that the treatment is over

A client undergoing alcohol detoxification asks about attending Alcoholics Anonymous (AA) meetings after discharge. What is the nurse's best initial reply? 1."You'll find that you'll need their support." 2."How do you feel about going to those meetings?" 3."They'll help you to learn how to cope with your problem." 4."Don't you think it's better to wait until you're sure that you're ready?"

2."How do you feel about going to those meetings?"

During a special meeting to discuss the unexpected suicide of a recently discharged client, a nurse overhears another client moan softly, "I'm next. Oh my God, I'm next. They couldn't protect him, and they can't protect me, either." What is the most therapeutic response by the nurse? 1."That person was a lot sicker than you are." 2."You seem to be afraid that you'll hurt yourself." 3."That was different. He was at home, but you're here." 4."There's no need to worry. We'll protect you even after you're discharged."

2."You seem to be afraid that you'll hurt yourself."

A nurse is caring for a female client during the manic phase of a bipolar disorder. What should the nurse do to help the client with personal hygiene? 1.Suggest that she wear hospital clothing 2.Guide her to dress appropriately in her own clothing 3.Allow her to apply makeup in whatever manner she chooses 4.Keep makeup away from her because she will apply it too freely

2.Guide her to dress appropriately in her own clothing

A client has been in an acute care psychiatric unit for 3 days and is receiving haloperidol (Haldol) tablets orally to reduce agitation and preoccupation with auditory hallucinations. There has been no decrease in the client's agitation or preoccupation with auditory hallucinations since the medication was started. What should the nurse's priority intervention be? 1.Asking the health care provider to change the medication 2.Making certain that the client is swallowing the medication 3.Concluding that a therapeutic level of the drug has not been achieved 4.Securing a prescription for as-needed sedation until the client calms down

2.Making certain that the client is swallowing the medication

Many clients who call a crisis hotline are extremely anxious. The nurse answering the hotline phone considers that the characteristic distinguishing posttraumatic stress disorders from other anxiety disorders is: 1.Lack of interest in family and others 2.Reexperiencing the trauma in dreams and flashbacks 3.Avoidance of situations and activities that resemble the stress 4.Depression and a blunted affect when discussing the traumatic situation

2.Reexperiencing the trauma in dreams and flashbacks

A client experiencing hallucinations tells a nurse, "The voices are telling me I'm no good." The client asks whether the nurse hears the voices. What is the most appropriate response by the nurse? 1."I don't hear the voices, but I believe that you can hear them." 2."It is the voice of your conscience, and only you can control that." 3."Those voices are coming from within you; only you can hear them." 4."The voices are a symptom of your illness; don't pay attention to them."

1."I don't hear the voices, but I believe that you can hear them."

The night nurse reports that a young client with paranoid schizophrenia has been awake for several nights. The day nurse reviews the client's record and finds that this client did not have an interrupted sleep pattern disorder before transfer from a private room to a four-bed room 3 days ago. What factor should the nurse identify as most likely related to the client's sleeplessness? 1.Fear of the other clients 2.Concern about family at home 3.Watching for an opportunity to escape 4.Trying to work out emotional problems

1.Fear of the other clients

A teenager with anorexia nervosa is admitted to the adolescent unit of a mental health facility and signs a contract calling for her to gain weight or lose privileges. There is no weight gain after a week. What should the nurse explain to the client? 1.The prearranged consequences will go into effect. 2.Death from starvation could occur if the client does not eat. 3.Stricter goals will be instituted if the initial goals are not met. 4.It may be necessary to become involved with meal preparation

1.The prearranged consequences will go into effect.

When talking with a female client who displays many of the emotional and physiological symptoms of panic disorder, the nurse should: 1.Use short sentences and an authoritative voice 2.Describe to her the possible reasons for her anxiety 3.Keep asking questions because she is probably not going to volunteer much information 4.Suggest that she refrain from crying because most of the time crying makes matters worse

1.Use short sentences and an authoritative voice

What should the nurse include when planning activities for an older nursing home resident with a diagnosis of dementia? 1.Varied activities that will keep the resident occupied 2.Familiar activities that the resident can complete successfully 3.Challenging activities to maintain the resident's contact with reality 4.Ways to ensure that the resident actively participates in the unit's daily activities.

2.Familiar activities that the resident can complete successfully

A 10-year-old child in whom autism was diagnosed at the age of 3 attends a school for developmentally disabled children and lives with his parents. The child has frequent episodes of self-biting and head-banging and needs help with feeding and toileting. The priority nursing goal for this child is: 1.Controlling repetitive behaviors 2.Being able to feed independently 3.Remaining safe from self-inflicted injury 4.Developing control of urinary elimination

3.Remaining safe from self-inflicted injury

A nurse enters a client's room and notes that the client appears preoccupied. Turning to the nurse, the client says, "They're saying terrible things about me. Can't you hear them?" What is the most therapeutic response by the nurse? 1."It seems you heard them before." 2."Try to get control of your feelings." 3."There's no one here but me, and I don't hear anything." 4."I don't hear anyone else talking, but I can see that you're upset."

4."I don't hear anyone else talking, but I can see that you're upset."

A client with generalized anxiety disorder says to the nurse, "What can I do to keep myself from overreacting to stress?" What is the best response by the nurse? 1."Work on problem-solving skills." 2."Improve your time-management skills." 3."Ignore situations that you cannot change." 4."Work on identifying and developing coping strategies."

4."Work on identifying and developing coping strategies."

A male client with the diagnosis of antisocial personality disorder takes a female nurse by the shoulders, kisses her, and shouts, "I like you." What is the most appropriate response by the nurse? 1."Thank you. I like you, too." 2."I wish you wouldn't do that." 3."Don't ever touch me like that again. I don't like it" 4."Your behavior is inappropriate. Don't do that again."

4."Your behavior is inappropriate. Don't do that again."

A client who has been admitted to the hospital for an elective prostatectomy is extremely anxious and has hand tremors. The client's partner informs the nurse that the client has been drinking heavily for the last 5 years. While the client is unpacking the nurse sees him hiding a bottle of whiskey in the rear of a drawer. How should the nurse respond initially to this behavior? 1.Trying to catch the client drinking the alcohol 2.Confiscating the alcohol when the client is not looking 3.Waiting for the client to bring up the subject of drinking 4.Asking the client how much alcohol he consumes in a week

4.Asking the client how much alcohol he consumes in a week

A client with the diagnosis of obsessive-compulsive disorder uses paper towels to open doors to avoid touching dirty doorknobs. How should the nurse respond initially to this behavior? 1.By explaining that the towels are dirty 2.By preventing the client from using towels 3.By removing the paper towels from the area 4.By allowing the behavior for the time being

4.By allowing the behavior for the time being

A 16-year-old high school student who has anorexia nervosa tells the clinic nurse that she thinks she that is pregnant even though she has had intercourse only once, more than a year ago. What is the most appropriate inference for the nurse to make about the student? 1.Using magical thinking 2.Submitting to peer pressure 3.Lying about the last time she had intercourse 4.Lacking knowledge that anorexia can cause amenorrhea

4.Lacking knowledge that anorexia can cause amenorrhea

A 7-year-old boy is brought to the clinic by the mother, who tells the nurse that her child has been having trouble in school, has difficulty concentrating, and is falling behind in schoolwork since she and her husband separated 6 months ago. The mother reports that lately her child has not been eating dinner, and she often hears him crying when he is alone. What basis for these behaviors should the nurse consider? 1.The child feels different from his classmates. 2.The child will be happier living with the father. 3.The child is working through feelings of shame. 4.The child may be blaming himself for his parents' breakup.

4.The child may be blaming himself for his parents' breakup.