Relevant NurseLabs Psych Questions

A male client is admitted to a psychiatric facility by court order for evaluation for antisocial personality disorder. This client has a long history of initiating fights and abusing animals and recently was arrested for setting a neighbor's dog on fire. When evaluating this client for the potential for violence, nurse Perry should assess for which behavioral clues? A. A rigid posture, restlessness, and glaring B. Depression and physical withdrawal C. Silence and noncompliance D. Hypervigilance and talk of past violent acts

A. A rigid posture, restlessness, and glaring Behavioral clues that suggest the potential for violence include a rigid posture, restlessness, glaring, a change in usual behavior, clenched hands, overtly aggressive actions, physical withdrawal, noncompliance, overreaction, hostile threats, recent alcohol ingestion or drug use, talk of past violent acts, inability to express feelings, repetitive demands and complaints, argumentativeness, profanity, disorientation, inability to focus attention, hallucinations or delusions, paranoid ideas or suspicions, and somatic complaints.

A female client who's at high risk for suicide needs close supervision. To best ensure the client's safety, Nurse Mary should: A. Check the client frequently at irregular intervals throughout the night. B. Assure the client that the nurse will hold in confidence anything the client says. C. Repeatedly discuss previous suicide attempts with the client. D. Disregard decreased communication by the client because this is common with suicidal clients.

A. Check the client frequently at irregular intervals throughout the night. Checking the client frequently but at irregular intervals prevents the client from predicting when observation will take place and altering behavior in a misleading way at these times. Once the patient is deemed to be at risk for suicide, then intervention steps must be initiated right away.

When is it appropriate for the nurse to introduce information regarding the termination of the relationship? A. An orientation phase B. right before the last meeting C. When the goals are being identified D. When the client is emotionally ready

A. Information regarding the termination phase should be introduced during the orientation phase

Therapeutic use of the milieu sets The town for the nurse - client relationship. Which phase of the nurse - client relationship provides the nurse with the opportunity to establish a professional therapeutic environment for the patient? A. Orientation B. resolution C. Termination D. Working

A. The orientation phase

One of the clients on the psychiatric unit has made comments to the nursing student that he finds her cute and wants to know more about her. Which of the following terms is applied to the situation when the client unconsciously shows the same types of feelings for the nurse that he or she has for a significant other? A. Transference B. Countertransference C. Exploitation D. Self-disclosure

A. Transference

A male client tells the nurse he was involved in a car accident while he was intoxicated. What would be the most therapeutic response from nurse Julia? A. "Why didn't you get someone else to drive you?" B. "Tell me how you feel about the accident." C. "You should know better than to drink and drive." D. "I recommend that you attend an Alcoholics Anonymous meeting."

B. "Tell me how you feel about the accident." A. Don't ask WHY C. Don't JUDGE D. Don't ADVISE

Nurse Mary is assigned to care for a suicidal client. Initially, which is the nurse's highest care priority? A. Assessing the client's home environment and relationships outside the hospital. B. Exploring the nurse's own feelings about suicide. C. Discussing the future with the client. D. Referring the client to a clergyperson to discuss the moral implications of suicide.

B. Exploring the nurse's own feelings about suicide. The nurse's values, beliefs, and attitudes toward self-destructive behavior influence responses to a suicidal client; such responses set the overall mood for the nurse-client relationship. Therefore, the nurse initially must explore personal feelings about suicide to avoid conveying negative feelings to the client.

Nurse Pauline is aware that Dementia unlike delirium is characterized by: A. Slurred speech B. Insidious onset C. Clouding of consciousness D. Sensory perceptual change

B. Insidious onset

Two nurses are co-leading group therapy for seven clients in the 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. Orientation phase C. Working phase D. Termination phase

B. Orientation phase This would not be working phase because the clients feelings are not explored yet

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 activities of daily living. B. The client will maintain safety. C. The client will remain oriented. D. The client will understand communication.

B. The client will maintain safety. SAFETY IS A PRIORITY!!

Anthony is very hostile toward one of the staff for no apparent reason. He is manifesting: A. Splitting B. Transference C. Countertransference D. Resistance

B. Transference Transference is a positive or negative feeling associated with a significant person in the client's past that are unconsciously assigned to another. Transference occurs when a person redirects some of their feelings or desires for another person to an entirely different person. Transference can also happen in a healthcare setting. For example, transference in therapy happens when a patient attaches anger, hostility, love, adoration, or a host of other possible feelings onto their therapist or doctor. Therapists know this can happen. They actively try to monitor it.

Which role of the nurse client relationship is being exhibited when the nurse informs the client and then supports him or her and whatever decision he or she makes? A. Caregiver B. advocate C. Parent surrogate D. Teacher

B. advocate

Nurse Sarah ensures a therapeutic environment for all the clients. Which of the following best describes a therapeutic milieu? A. A therapy that rewards adaptive behavior. B. A cognitive approach to change behavior. C. A living, learning or working environment. D. A permissive and congenial environment.

C. A living, learning or working environment. A therapeutic milieu refers to a broad conceptual approach in which all aspects of the environment are channeled to provide a therapeutic environment for the client. The six environmental elements include structure, safety, norms; limit setting, balance, and unit modification. A therapeutic milieu is a structured environment that creates a safe, secure place for people who are in therapy.

80-year-old Mr. Stevens is accompanied to the clinic by his son, who tells the nurse that the client's constant confusion, incontinence, and tendency to wander are intolerable. The client was diagnosed with chronic cognitive impairment disorder. Which nursing diagnosis is most appropriate for the client's son? A. Risk for other-directed violence. B. Disturbed sleep pattern. C. Caregiver role strain. D. Social isolation.

C. Caregiver role strain. The son's description exemplifies some of the problems commonly encountered by a primary caregiver who is caring for someone with a cognitive impairment disorder.

The student nurses are talking about a client on the psychiatric unit he looks like the actor George Clooney. During the hours spent with the client, one of the students become physically attracted to him. Which of the following terms describes the relationship that has occurred when the nurse response the client based on personal unconscious needs and conflicts? A. Self-disclosure B. transference C. Countertransference D. Exploitation

C. Countertransference

Nurse Jannah is monitoring a male client who has been placed in restraints because of violent behavior. Nurse determines that it will be safe to remove the restraints when: A. The client verbalizes the reasons for the violent behavior. B. The client apologizes and tells the nurse that it will never happen again. C. No acts of aggression have been observed within 1 hour after the release of two of the extremity restraints. D. The administered medication has taken effect.

C. No acts of aggression have been observed within 1 hour after the release of two of the extremity restraints.

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

Nurse Tony should first discuss terminating the nurse-client relationship with a client during the: A. Termination phase when discharge plans are being made. B. Working phase when the client shows some progress. C. Orientation phase when a contract is established. D. Working phase when the client brings it up.

C. Orientation phase when a contract is established.

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. We ask open-ended questions UNLESS its about self-harm or suicide. (Asking pt "Have you ever thought about killing yourself?" is okay)

Mrs. Jordan is an elderly client diagnosed with Alzheimer's disease. She becomes agitated and combative when a nurse approaches to help with morning care. The most appropriate nursing intervention in this situation would be to: A. Tell the client 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. Maintaining a calm approach when intervening with an agitated client is extremely important. Use a rather low voice and speak slowly to patients to increase the possibility of understanding. RESTRAINTS IS THE LAST RESORT!!

Which factors are the 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 of depression.

C. The client's perception of the triggering event and availability of situational supports. The most important factors to determine in these situations are the client's perception of the crisis event and the availability of support (including family and friends) to provide basic needs.

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 you some medication to help calm you?" 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?" By acknowledging the observed behavior and asking the client to express his feelings the nurse can best assist the client to become aware of his anxiety. Recognition acknowledges a patient's behavior and highlights it without giving an overt compliment.

The students in the concepts and theories course I talked to said nursing is better than art and is a science. Which pattern of knowing is derived from the art of nursing? A. Ethical B. personal knowing C. Empirical D. Aesthetic

D. Aesthetic is Derived from the art of nursing

A male client is found sitting on the floor of the bathroom in the day treatment clinic with moderate lacerations on both wrists. Surrounded by broken glass, he sits staring blankly at his bleeding wrists while staff members call for an ambulance. How should Nurse Anuktakanuk approach her initially? A. Enter the room quietly and move beside him to assess his injuries. B. Call for staff back-up before entering the room and restraining him. C. Move as much glass away from him as possible and sit next to him quietly. D. Approach him slowly while speaking in a calm voice, calling his name, and telling him that the nurse is here to help him.

D. Approach him slowly while speaking in a calm voice, calling his name, and telling him that the nurse is here to help him.

Mrs. Mendoza is a 75-year-old client who 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 in memory gaps with fantasy.

D. Fills in memory gaps with fantasy. D. Fills in memory gaps with fantasy. Confabulation is a communication device used by patients with dementia to compensate for memory gaps. Confabulation is a type of memory error in which gaps in a person's memory are unconsciously filled with fabricated, misinterpreted, or distorted information. When someone confabulates, they are confusing things they have imagined with real memories. A person who is confabulating is not lying. They are not making a conscious or intentional attempt to deceive. Rather, they are confident in the truth of their memories even when confronted with contradictory evidence.

Nurse Josefina is caring for a client who has been diagnosed with delirium. Which statement about delirium is true? A. It's characterized by an acute onset and lasts about 1 month. B. It's characterized by a slowly evolving onset and lasts about 1 week. C. It's characterized by a slowly evolving onset and lasts about 1 month. D. It's characterized by an acute onset and lasts hours to a number of days.

D. It's characterized by an acute onset and lasts hours to a number of days. Delirium has an acute onset and typically can last from several hours to several days. Delirium, also known as the acute confusional state, is a clinical syndrome that usually develops in the elderly. It is characterized by an alteration of consciousness and cognition with reduced ability to focus, sustain, or shift attention.

A student nurse was asked which of the following best describes dementia. Which of the following best describes the condition? A. Memory loss occurring as part of the natural consequence of aging. B. Difficulty coping with physical and psychological change. C. Severe cognitive impairment that occurs rapidly. D. Loss of cognitive abilities, impairing ability to perform activities of daily living.

D. Loss of cognitive abilities, impairing ability to perform activities of daily living.

Nurse Monet is caring for a female client who has suicidal tendencies. When accompanying the client to the restroom, Nurse Monet should... A. Give her privacy. B. Allow her to urinate. C. Open the window and allow her to get some fresh air. D. Observe her.

D. Observe her.

A family member expresses concern to a nurse about behavioral changes in an elderly aunt. Which would cause the nurse to suspect a cognitive impairment disorder? A. Decreased interest in activities that she once enjoyed. B. Fearfulness of being alone at night. C. Increased complaints of physical ailments. D. Problems with preparing a meal or balancing her checkbook.

D. Problems with preparing a meal or balancing her checkbook.

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

Which nursing intervention is best for facilitating communication with a psychiatric client who speaks a foreign language? A. Rely on nonverbal communication 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

A patient with mild dementia has a new prescription for donepezil (Aricept). Which nursing action will be most effective in ensuring compliance with the medication? a. Having the patient's spouse administer the medication b. Setting the medications up weekly in a medication box c. Calling the patient daily with a reminder to take the medication d. Posting reminders to take the medications in the patient's house

a. Having the patient's spouse administer the medication Because the patient with mild dementia will have difficulty with learning new skills and forgetfulness, the most appropriate nursing action is to have someone else administer the drug. The other nursing actions will not be as effective in ensuring that the patient takes the medications.

When assessing a patient with Alzheimer's disease (AD) who is being admitted to a long-term care facility, the nurse learns that the patient has had several episodes of wandering away from home. Which nursing action will the nurse include in the plan of care? a. Place the patient in a room close to the nurses' station. b. Ask the patient why the wandering episodes have occurred. c. Have the family bring in familiar items from the patient's home. d. Reorient the patient to the new living situation several times daily.

a. Place the patient in a room close to the nurses' station. Do not ask "why" questions. And reorientation does not help with a wandering pt.

When developing a plan of care for a hospitalized patient with moderate dementia, which intervention will the nurse include? a. Provide complete personal hygiene care for the patient. b. Remind the patient frequently about being in the hospital. c. Reposition the patient frequently to avoid skin breakdown. d. Place suction at the bedside to decrease the risk for aspiration.

b. Remind the patient frequently about being in the hospital.

When teaching the children of a patient who is being evaluated for Alzheimer's disease (AD) about the disorder, the nurse explains that a. the most important risk factor for AD is a family history of the disorder. b. new drugs have been shown to reverse AD dramatically in some patients. c. a diagnosis of AD can be made only when other causes of dementia have been ruled out. d. the presence of brain atrophy detected by MRI confirms the diagnosis of AD in patients with dementia.

c. a diagnosis of AD can be made only when other causes of dementia have been ruled out. The diagnosis of AD is one of exclusion. Age is the most important risk factor for development of AD. Drugs can slow the deterioration but do not dramatically reverse the effects of AD. Brain atrophy is a common finding in AD, but it can occur in other diseases as well and does not confirm an AD diagnosis.

. A long-term care patient with moderate dementia develops increased restlessness and agitation. The nurse's initial action should be to a. reorient the patient to time, place, and person. b. administer the PRN dose of lorazepam (Ativan). c. assess for factors that might be causing discomfort. d. have a nursing assistant stay with the patient to ensure safety.

c. assess for factors that might be causing discomfort. ASSESS FIRST!!

A client diagnosed with terminal cancer is making plans to take flying lessons because that has always been her personal goal, and it will allow her to visit older adult parents. What stage of death and dying, according to Kübler-Ross, is best illustrated in this description? a. Anger b. Depression c. Acceptance d. Bargaining

d. Bargaining This example demonstrates characteristics of bargaining, such as a desire to fulfill wished, make a will, visit relatives, and putt affairs in order. This stage is unlike the acceptance stage, during which the client feels tranquil and is prepared to die with all arrangements in order.

When providing community health care teaching regarding the early warning signs of Alzheimer's disease, which signs should the nurse advise family members to report (select all that apply)? A) Misplacing car keys B) Losing sense of time C) Difficulty performing familiar tasks D) Problems with performing basic calculations E) Becoming lost in a usually familiar environment

B) Losing sense of time C) Difficulty performing familiar tasks D) Problems with performing basic calculations E) Becoming lost in a usually familiar environment

Katrina, a newly admitted client is extremely hostile toward a staff member she has just met, without apparent reason. According to Freudian theory, the nurse should suspect that the client is experiencing which of the following phenomena? A. Intellectualization B. Transference C. Triangulation D. Splitting

B. Transference Transference is the unconscious assignment of negative or positive feelings evoked by a significant person in the client's past to another person. Transference occurs when a person redirects some of their feelings or desires for another person to an entirely different person.

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

A female client with borderline personality disorder is admitted to the psychiatric unit. Initial nursing assessment reveals that the client's wrists are scratched from a recent suicide attempt. Based on this finding, the nurse Lenny should formulate a nursing diagnosis of: A. Ineffective individual coping related to feelings of guilt. B. Situational low self-esteem related to feelings of loss of control. C. Risk for violence: Self-directed related to impulsive mutilating acts. D. Risk for violence: Directed toward others related to verbal threats.

C. Risk for violence: Self-directed related to impulsive mutilating acts.

What herbal medication for depression, widely used in Europe, is now being prescribed in the United States? A. Ginkgo biloba B. Echinacea C. St. John's wort D. Ephedra

C. St. John's wort