Substance Abuse and Abuse NCLEX Practice Quiz: 75 Questions

67. Question Which of these statements by the nurse reflects the best use of therapeutic interaction techniques? A. "You look upset. Would you like to talk about it?" B. "I'd like to know more about your family. Tell me about them." C. "I understand that you lost your partner. I don't think I could go on if that happened to me." D. "You look very sad. How long have you been this way?"

A. "You look upset. Would you like to talk about it?"

34. Question What are the appropriate interventions for caring for the client in alcohol withdrawal. Select all that apply. A. Monitor vital signs. B. Provide stimulation in the environment. C. Maintain NPO status. D. Provide reality orientation as appropriate. E. Address hallucinations therapeutically.

A. Monitor vital signs. D. Provide reality orientation as appropriate. E. Address hallucinations therapeutically.

60. Question The nurse is discussing electroconvulsive therapy (ECT) with a client who asks how long it will be before she feels better. The nurse explains that the beneficial effects of ECT usually occur within: A. One week B. Three weeks C. Four weeks D. Six weeks

A. One week

37. Question Which of the following communication guidelines should the nurse use when talking with a client experiencing mania? A. Address the client in a light and joking manner. B. Focus and redirect the conversation as necessary. C. Allow the client to talk about several different topics. D. Ask only open ended questions to facilitate conversations.

B. Focus and redirect the conversation as necessary.

41. Question Nurse Sharie is assessing a parent who abused her child. Which of the following risk factors would the nurse expect to find in this case? A. Flexible role functioning between parents. B. History of the parent having been abused as a child. C. Single-parent home situation. D. Presence of parental mental illness.

B. History of the parent having been abused as a child.

28. Question When planning the discharge of a client with chronic anxiety, the nurse directs the goals at promoting a safe environment at home. The most appropriate maintenance goal should focus on which of the following? A. Continued contact with a crisis counselor. B. Identifying anxiety-producing situations. C. Ignoring feelings of anxiety. D. Eliminating all anxiety from daily situations.

B. Identifying anxiety-producing situations.

23. Question The nurse reviews the activity schedule for the day and plans which activity for the manic client? A. Brown-bag luncheon and book review B. Tetherball C. Paint-by-number activity D. Deep breathing and progressive relaxation group

B. Tetherball

69. Question A client was admitted to the psychiatric unit for severe depression. After several days, the client continues to withdraw from other clients. Which of the following would be the most appropriate statement by the nurse to promote interaction with other clients? A. "Your doctor thinks it's good for you to spend time with others." B. "It is important for you to participate in group activities." C. "Painting this picture will help you feel better." D. "Come play Chinese Checkers with Gerry and me."

D. "Come play Chinese Checkers with Gerry and me."

66. Question Which statement by the client during the initial assessment in the emergency department is most indicative of suspected domestic violence? A. "I am determined to leave my house in a week." B. "No one else in the family has been treated like this." C. "I have only been married for two (2) months." D. "I have tried leaving, but have always gone back."

D. "I have tried leaving, but have always gone back."

24. Question A hospitalized client is being considered for ECT. The client appears calm, but the family is anxious. The client's mother begins to cry and states "My son's brain will be destroyed. How can the doctor do this to him?" The nurse's best response is: A. "It sounds as though you need to speak with the psychiatrist" B. "Your son has decided to have this treatment. You should be supportive of him." C. "Perhaps you'd like to see the ECT room and speak to the staff." D. "It sounds as though you have some concerns about the ECT procedure. Why don't we sit down together and discuss any concerns you may have."

D. "It sounds as though you have some concerns about the ECT procedure. Why don't we sit down together and discuss any concerns you may have."

12. Question Johnette is reviewing her lessons in Pharmacology. She is aware that the general classification of drugs belonging to the opioid category is analgesic and: A. Tranquilizing B. Hallucinogenic C. Stimulant D. Depressant

D. Depressant

40. Question Which of the following short-term goals is most appropriate for a client with bipolar disorder who is having difficulty sleeping? A. Obtain medication for sleep B. Work on solving a problem C. Exercise before bedtime D. Develop a sleep ritual

D. Develop a sleep ritual

When a husband takes out his work frustrations and anger by abusing his wife at home, the nurse will identify this crisis as which type? A. Psychiatric emergency crisis B. Developmental crisis C. Anticipated life transition D. Dispositional crisis

D. Dispositional crisis

53. Question During a prenatal assessment, the clinic nurse suspects that her client was abused. Which of the following questions would be most appropriate? A. "Are you being threatened or hurt by your partner?" B. "Are you frightened of your partner?" C. "Is something bothering you?" D. "What happens when you and your partner argue?"

A. "Are you being threatened or hurt by your partner?"

11. Question The community nurse practicing primary prevention of alcohol abuse would target which groups for educational efforts? A. Adolescents in their late teens and young adults in their early twenties. B. Elderly men who live in retirement communities. C. Women working in careers outside the home. D. Women working in the hom

A. Adolescents in their late teens and young adults in their early twenties.

3. Question Nurse Tara is teaching a community group about substance abuse. She explains that a genetic component has been implicated in which of the following commonly abused substances? A. Alcohol B. Barbiturates C. Heroin D. Marijuana

A. Alcohol

54. Question Which situation would Nurse Sally identify as placing a client at high risk for caregiver abuse? A. Antonia, an adult child, quits her job to move in and care for a parent with severe dementia. B. Mr. Wright, an elderly man with severe heart disease, resides in a personal care home and is frequently visited by his adult child. C. Mrs. Hale, an elderly parent with limited mobility, lives alone and receives help from several adult children. D. Antoinette cares for her husband who is in early stages of Alzheimer's disease and has a network of available support persons.

A. Antonia, an adult child, quits her job to move in and care for a parent with severe dementia.

26. Question Which of the following nursing interventions is applicable for a hospitalized client with mania who is exhibiting manipulative behavior. Select all that apply. A. Communicate expected behaviors to the client. B. Enforce rules and inform the client that he or she will not be allowed to attend group therapy sessions. C. Ensure that the client knows that he or she is not in charge of the nursing unit. D. Be clear with the client regarding the consequences of exceeding limits set regarding behavior. E. Assist the client in testing out alternative behaviors for obtaining needs.

A. Communicate expected behaviors to the client. D. Be clear with the client regarding the consequences of exceeding limits set regarding behavior. E. Assist the client in testing out alternative behaviors for obtaining needs.

43. Question During a well-child checkup, a mother tells Nurse Rio about a recent situation in which her child needed to be disciplined by her husband. The child was slapped in the face for not getting her husband breakfast on Saturday, despite being told on Thursday never to prepare food for him. Nurse Rio analyzes the family system and concludes it is dysfunctional. All of the following factors contribute to this dysfunction except: A. Conflictual relationships of parents B. Inconsistent communication patterns C. Rigid, authoritarian roles D. Use of violence to establish control

A. Conflictual relationships of parents

36. Question Which of the following psychological symptoms would the nurse expect to find in a hospitalized client who is the only survivor of a train accident? A. Denial B. Indifference C. Perfectionism D. Trust

A. Denial

20. Question A client with a diagnosis of major depression, recurrent with psychotic features is admitted to the mental health unit. To create a safe environment for the client, the nurse most importantly devises a plan of care that deals specifically with the client's: A. Disturbed thought processes B. Imbalanced nutrition C. Self-care deficit D. Deficient knowledge

A. Disturbed thought processes

52. Question Which nursing assessment findings are physical signs of sexual abuse of a female child? Select all that apply. A. Enuresis B. Red and swollen labia and rectum C. Vaginal tears D. Injuries in different stages of healing E. Cigarette burns F. Lice infestation

A. Enuresis B. Red and swollen labia and rectum C. Vaginal tears

55. Question The interventions common to treatment plans for survivors include which of the following? Select all that apply. A. Establish trust and rapport. B. Identify areas of control. C. Remove the client from home. D. Support the client in the decisions he/she makes. E. Encourage the client to pursue legal action.

A. Establish trust and rapport. B. Identify areas of control. D. Support the client in the decisions he/she makes.

42. Question A group of nursing students at Nurseslabs University is currently learning about family violence. Which of the following is true about the topic mentioned? A. Family violence affects every socioeconomic level. B. Family violence is caused by drugs and alcohol abuse. C. Family violence predominantly occurs in lower socioeconomic levels. D. Family violence rarely occurs during pregnancy.

A. Family violence affects every socioeconomic level.

51. Question Sheila tells the community nurse that her boyfriend has been abusive and she is afraid of him, but she doesn't want to leave. The client asks the nurse for assistance. Which nursing interventions are appropriate in this situation? Select all that apply. A. Help Sheila to develop a plan to ensure safety, including phone numbers for emergency help. B. Help Sheila to get her boyfriend into an appropriate treatment program. C. Communicate acceptance, avoiding any implication that Sheila is at fault for not leaving. D. Help Sheila to explore available options, including shelters and legal protection. E. Tell Sheila that she should leave because things will not improve. F. Reinforce concern for Sheila's safety and her right to be free of abuse.

A. Help Sheila to develop a plan to ensure safety, including phone numbers for emergency help. C. Communicate acceptance, avoiding any implication that Sheila is at fault for not leaving. D. Help Sheila to explore available options, including shelters and legal protection. F. Reinforce concern for Sheila's safety and her right to be free of abuse.

15. Question During an initial assessment of a client admitted to a substance abuse unit for detoxification and treatment, the nurse asks questions to determine patterns of use of substances. Which of the following questions are most appropriate at this time? Select all that apply. A. How long have you used substances? B. How often do you use substances? C. How do you get substances into your body? D. Do you feel bad or guilty about your use of substances? E. How much of each substance do you use? F. Have you ever felt you should cut down substance use? G. What substances do you use?

A. How long have you used substances? B. How often do you use substances? C. How do you get substances into your body? E. How much of each substance do you use? G. What substances do you use?

29. Question The nurse is monitoring a client who abuses alcohol for signs of alcohol withdrawal. Which of the following would alert the nurse to the potential for delirium tremens? A. Hypertension, changes in LOC, hallucinations B. Hypotension, ataxia, hunger C. Stupor, agitation, muscular rigidity D. Hypotension, coarse hand tremors, agitation

A. Hypertension, changes in LOC, hallucinations

27. Question A woman comes into the ER in a severe state of anxiety following a car accident. The most appropriate nursing intervention is to: A. Remain with the client. B. Put the client in a quiet room. C. Teach the client deep breathing. D. Encourage the client to talk about their feelings and concerns.

A. Remain with the client.

63. Question The nurse is planning care for a client who has a phobic disorder manifested by a fear of elevators. Which goal would need to be accomplished first? A. The client will demonstrate the relaxation response when asked. B. The client will verbalize the underlying cause of the disorder. C. The client will ride the elevator in the company of the nurse. D. The client will roleplay the use of an elevator.

A. The client will demonstrate the relaxation response when asked.

25. Question The manic client announces to everyone in the dayroom that a stripper is coming to perform this evening. When the nurse firmly states that this will not happen, the manic client becomes verbally abusive and threatens physical violence to the nurse. Based on the analysis of this situation, the nurse determines that the most appropriate action would be to: A. With assistance, escort the manic client to her room and administer Haldol as prescribed if needed. B. Tell the client that smoking privileges are revoked for 24 hours. C. Orient the client to time, person, and place D. Tell the client that the behavior is not appropriate.

A. With assistance, escort the manic client to her room and administer Haldol as prescribed if needed.

31. Question The nurse determines that the wife of an alcoholic client is benefiting from attending Al-Anon group when she hears the wife say: A. "My attendance at the meetings has helped me to see that I provoke my husband's violence." B. "I no longer feel that I deserve the beatings my husband inflicts on me." C. "I can tolerate my husband's destructive behavior now that I know they are common with alcoholics." D. "I enjoy attending the meetings because they get me out of the house and away from my husband."

B. "I no longer feel that I deserve the beatings my husband inflicts on me."

21. Question A depressed client is ready for discharge. The nurse feels comfortable that the client has a good understanding of the disease process when the client states: A. "I'll never let this happen to me again. I won't let my boss or my job or my family get to me!" B. "It's important for me to eat well, exercise, and to take my medication. If I begin to lose my appetite or not sleep well, I've got to get in to see my doctor." C. "I've learned that I'm a good person and that I am worthy of giving and receiving love. I don't need anyone; I have myself to rely on!" D. "I don't know what happened to me. I've always been able to make decisions for myself and for my business. I don't ever want to feel so weak or vulnerable again!"

B. "It's important for me to eat well, exercise, and to take my medication. If I begin to lose my appetite or not sleep well, I've got to get in to see my doctor."

30. Question The spouse of a client admitted to the mental health unit for alcohol withdrawal says to the nurse "I should get out of this bad situation." The most helpful response by the nurse would be: A. "I agree with you. You should get out of this situation." B. "What do you find difficult about this situation?" C. "Why don't you tell your husband about this?" D. "This is not the best time to make that decision."

B. "What do you find difficult about this situation?"

10. Question The newly hired nurse at Nurseslabs Medical Center is assessing a client who abuses barbiturates and benzodiazepine. The nurse would observe for evidence of which withdrawal symptoms? A. Respiratory depression, stupor, and bradycardia B. Anxiety, tremors, and tachycardia C. Muscle aches, cramps, and lacrimation D. Paranoia, depression, and agitation

B. Anxiety, tremors, and tachycardia

35. Question Which of the following nursing actions would be included in a care plan for a client with PTSD who states the experience was "bad luck"? A. Encourage the client to verbalize the experience. B. Assist the client in defining the experience. C. Work with the client to take steps to move on with his life. D. Help the client accept positive and negative feelings.

B. Assist the client in defining the experience.

5. Question Ryan who is a chronic alcohol abuser is being assessed by Nurse Gina. Which problems are related to thiamine deficiency? A. Cardiovascular symptoms, such as decreased hemoglobin and hematocrit levels. B. CNS symptoms, such as ataxia and peripheral neuropathy. C. Gastrointestinal symptoms, such as nausea and vomiting. D. Respiratory symptoms, such as cough and sore throat.

B. CNS symptoms, such as ataxia and peripheral neuropathy.

8. Question Which of the following would best indicate to the nurse that a depressed client is improving? A. Reduced levels of anxiety B. Changes in vegetative signs C. Compliance with medications D. Requests to talk to the nurse

B. Changes in vegetative signs

14. Question Kendall, the sister of a client with a substance-related disorder, tells the nurse she calls out sick for her sister Kylie occasionally when the latter has too much to drink and cannot work. This behavior can be described as: A. Caretaking B. Codependent C. Helpful D. Supportive

B. Codependent

A nurse is teaching a stress-management program for a client. Which of the following beliefs will the nurse advocate as a method of coping with stressful life events? A. Avoidance of stress is an important goal for living. B. Control over one's response to stress is possible. C. Most people have no control over their level of stress. D. Significant others are important to provide care and concern.

B. Control over one's response to stress is possible.

2. Question Elsa is being treated in a chemical dependency unit. She tells the nurse that she only uses drugs when under stress and therefore does not have a substance problem. Which defense mechanism is the client using? A. Compensation B. Denial C. Suppression D. Undoing

B. Denial

47. Question Nurse Angela is working in the emergency department of Nurseslabs Medical Center. She is conducting an interview with a victim of spousal abuse. Which step should the nurse take first? A. Contact the appropriate legal services. B. Ensure privacy for interviewing the victim away from the abuser. C. Establish a rapport with the victim and the abuser. D. Request the presence of a security guard.

B. Ensure privacy for interviewing the victim away from the abuser.

16. Question The nurse is planning activities for a client who has bipolar disorder with aggressive social behavior. Which of the following activities would be most appropriate for this client? A. Ping pong B. Writing C. Chess D. Basketball

B. Writing

32. Question The client has been hospitalized and is participating in a substance abuse therapy group sessions. On discharge, the client has consented to participate in AA community groups. The nurse is monitoring the client's response to the substance abuse sessions. Which statement by the client best indicates that the client has developed effective coping response styles and has processed information effectively for self use? A. "I know I'm ready to be discharged. I feel I can say 'no' and leave a group of friends if they are drinking... 'No Problem.'" B. "This group has really helped a lot. I know it will be different when I go home. But I'm sure that my family and friends will all help me like the people in this group have... They'll all help me... I know they will... They won't let me go back to my old ways." C. "I'm looking forward to leaving here. I know that I will miss all of you. So, I'm happy and I'm sad, I'm excited and I'm scared. I know that I have to work hard to be strong and that everyone isn't going to be as helpful as you people." D. "I'll keep all my appointments; go to all my AA groups; I'll do everything I'm supposed to... Nothing will go wrong that way."

C. "I'm looking forward to leaving here. I know that I will miss all of you. So, I'm happy and I'm sad, I'm excited and I'm scared. I know that I have to work hard to be strong and that everyone isn't going to be as helpful as you people."

A teenage female is admitted with the diagnosis of anorexia nervosa. Upon admission, the nurse finds a bottle of assorted pills in the client's drawer. The client tells the nurse that they are antacids for stomach pains. The best response by the nurse would be: A. "These pills aren't antacids since they are all different." B. "Some teenagers use pills to lose weight." C. "Tell me about your week prior to being admitted." D. "Are you taking pills to change your weight?"

C. "Tell me about your week prior to being admitted."

8. Question When planning the therapeutic milieu, it is most important to select group activities which: A. Match the clients' preferences. B. Are consistent with clients' skills. C. Achieve clients' therapeutic goals. D. Build skills of group participation.

C. Achieve clients' therapeutic goals.

59. Question An elderly man is admitted to the hospital. He was alert and oriented during the admission interview. However, his family states that he becomes disruptive and disoriented around dinnertime. One night he was shouting furiously and didn't know where he was. He was sedated and the next morning he was fine. At dinnertime, the disruptive behavior returned. The client is diagnosed as having sundown syndrome. The client's son asks the nurse what causes sundown syndrome. The nurse's best response is that it is attributed to A. An underlying depression B. Inadequate cerebral flow C. Changes in the sensory environment D. Fluctuating levels of oxygen exchange

C. Changes in the sensory environment

6. Question Nurse Wilma is teaching a client about disulfiram (Antabuse), which the client is taking to deter his use of alcohol. She explains that using alcohol when taking this medication can result in: A. Abdominal cramps and diarrhea B. Drowsiness and decreased respiration C. Flushing, vomiting, and dizziness D. Increased pulse and blood pressure

C. Flushing, vomiting, and dizziness

74. Question A student nurse is caring for a 75-year-old client who is very confused. The student's communication tools should include: A. Written directions for bathing. B. Speaking very loudly. C. Gentle touch while guiding ADLs (activities of daily living). D. Flat facial expression.

C. Gentle touch while guiding ADLs (activities of daily living).

49. Question A community nurse conducts a primary prevention, home-visit assessment for a newborn and mother. Mrs. Smith has three other children, the oldest of whom is age 12. She tells the nurse that her 12-year-old daughter is expected to prepare family meals, to look after the young children, and to clean the house once a week. Which of the following is the most appropriate nursing diagnosis for this family situation? A. Delayed growth and development, related to performance expectations of the child. B. Anxiety (moderate), related to difficulty managing the home situation. C. Impaired parenting, related to the role reversal of mother and child. D. Social isolation, related to lack of extended family assistance.

C. Impaired parenting, related to the role reversal of mother and child.

48. Question Mariefer is studying about abuse for the upcoming exam. For her to fully instill the topic, she should know that the priority nursing intervention for a child or elder victim of abuse is: A. Assess the scope of the abuse problem. B. Analyze family dynamics. C. Implement measures to ensure the victim's safety. D. Teach appropriate coping skills.

C. Implement measures to ensure the victim's safety.

4. Question Nurse Julie recommends that the family of a client with substance-related disorder attend a support group, such as Al-Anon and Alateen. The purpose of these groups is to help family members understand the problem and to: A. Change the problem behaviors of the abuser. B. Learn how to assist the abuser in getting help. C. Maintain focus on changing their own behaviors. D. Prevent substance problems in vulnerable family members.

C. Maintain focus on changing their own behaviors.

22. Question The nurse assesses a client with the admitting diagnosis of bipolar affective disorder, mania. The symptom presented by the client that requires the nurse's immediate intervention is the client's: A. Outlandish behaviors and inappropriate dress. B. Grandiose delusions of being a royal descendant of King Arthur. C. Nonstop physical activity and poor nutritional intake. D. Constant, incessant talking that includes sexual innuendos and teasing the staff.

C. Nonstop physical activity and poor nutritional intake.

1. Question Nurse Rob has observed a co-worker arriving to work drunk at least three times in the past month. Which action by Nurse Rob would best ensure client safety and obtain necessary assistance for the co-worker? A. Ignore the co worker's behavior, and frequently assess the clients assigned to the co-worker. B. Make general statements about safety issues at the next staff meeting. C. Report the coworker's behavior to the appropriate supervisor. D. Warn the co-worker that this practice is unsafe.

C. Report the coworker's behavior to the appropriate supervisor.

7. Question The nurse administers bromocriptine (Parlodel) to Bryan who is undergoing detoxification for amphetamine abuse. The rationale for this medication is to: A. Aid in GABA inhibition B. Prevent norepinephrine excess C. Restore depleted dopamine levels D. Treat psychotic symptoms

C. Restore depleted dopamine levels

71. Question A client with paranoid thoughts refuses to eat because he believes the food has poisoned. The most appropriate initial action is to A. Taste the food in the client's presence. B. Suggest that food be brought from home. C. Simply state the food is not poisoned. D. Inform the client he will be tube fed if he does not eat.

C. Simply state the food is not poisoned.

A. Conflictual relationships of parents

C. The nurse commends the mother's efforts and also contacts protective services.

70. Question The nurse can best ensure the safety of a demented client who wanders from the room by: A. Repeatedly reminding the client of time and place. B. Explaining the risks of becoming lost. C. Using soft restraints. D. Attaching a wander guard sensor band to the client's wrist.

D. Attaching a wander guard sensor band to the client's wrist.

33. Question A hospitalized client with a history of alcohol abuse tells the nurse, "I am leaving now. I have to go. I don't want any more treatment. I have things that I have to do right away." The client has not been discharged. In fact, the client is scheduled for an important diagnostic test to be performed in 1 hour. After the nurse discusses the client's concerns with the client, the client dresses and begins to walk out of the hospital room. The most important nursing action is to: A. Restrain the client until the physician can be reached. B. Call security to block all areas. C. Tell the client that the client cannot return to this hospital again if the client leaves now. D. Call the nursing supervisor.

D. Call the nursing supervisor.

17. Question A client is admitted to the hospital with a diagnosis of major depression, severe, single episode. The nurse assesses the client and identifies a nursing diagnosis of imbalanced nutrition related to poor nutritional intake. The most appropriate nursing intervention related to this diagnosis is: A. Explain to the client the importance of a good nutritional intake. B. Weight the client 3 times per week before breakfast. C. Report the nutritional concern to the psychiatrist and obtain a nutritional consultation as soon as possible. D. Consult with the nutritionist, offer the client several small meals per day, and schedule brief nursing interactions with the client during these times.

D. Consult with the nutritionist, offer the client several small meals per day, and schedule brief nursing interactions with the client during these times.

56. Question A man is admitted to the nursing care unit with a diagnosis of cirrhosis. He has a long history of alcohol dependence. During the late evening following his admission, he becomes increasingly disoriented and agitated. Which of the following would the client be least likely to experience? A. Diaphoresis and tremors B. Increased blood pressure and heart rate C. Illusions D. Delusions of grandeur

D. Delusions of grandeur

38. Question What information is important to include in the nutritional counseling of a family with a member who has bipolar disorder? A. If sufficient roughage isn't eaten while taking lithium, bowel problems will occur. B. If the intake of carbohydrates increases, the lithium level increases. C. If the intake of calories is reduced, the lithium level will increase. D. If the intake of sodium increases, the lithium level will decrease.

D. If the intake of sodium increases, the lithium level will decrease.

A 34-year-old woman is admitted for treatment of depression. Which of these symptoms would the nurse be least likely to find in the initial assessment? A. Inability to make decisions B. Feelings of hopelessness C. Family history of depression D. Increased interest in sex

D. Increased interest in sex

39. Question In conferring with the treatment team, the nurse should make which of the following recommendations for a client who tells the nurse that everyday thoughts of suicide are present? A. A no-suicide contract B. Weekly outpatient therapy C. A second psychiatric opinion D. Intensive inpatient treatment

D. Intensive inpatient treatment

8. Question Which medication is commonly used in treatment programs for heroin abusers to produce a non-euphoric state and to replace heroin use? A. Diazepam B. Carbamazepine C. Clonidine D. Methadone

D. Methadone

50. Question Mrs. Smith was admitted to the emergency department of Nurseslabs Medical Center with a fractured arm. She explains to the nurse that her injury resulted when she provoked her drunken husband, Mr. Smith, who then pushed her. Which of the following best describes the nurse's understanding of the wife's explanation? A. Mrs. Smith's explanation is appropriate acceptance of her responsibility. B. Mrs. Smith's explanation is an atypical reaction of an abused woman. C. Mrs. Smith's explanation is evidence that the woman may be an abuser as well as a victim. D. Mrs. Smith's explanation is a typical response of a victim accepting blame for the abuser.

D. Mrs. Smith's explanation is a typical response of a victim accepting blame for the abuser.

13. Question When a client abuses a CNS depressant, withdrawal symptoms will be caused by which of the following? A. Acetylcholine excess B. Dopamine depletion C. Serotonin inhibition D. Norepinephrine rebound

D. Norepinephrine rebound

65. Question A mother with a Roman Catholic belief has given birth in an ambulance on the way to the hospital. The neonate is in very critical condition with little expectation of surviving the trip to the hospital. Which of these requests should the nurse in the ambulance anticipate and be prepared to do? A. The refusal of any treatment for self and the neonate until she talks to a reader. B. The placement of a rosary necklace around the neonate's neck and not to remove it unless absolutely necessary. C. Arrange for a church elder to be at the emergency department when the ambulance arrives so a "laying on hands" can be done. D. Pour fluid over the forehead backward towards the back of the head and say "I baptize you in the name of the father, the son and the holy spirit. Amen."

D. Pour fluid over the forehead backward towards the back of the head and say "I baptize you in the name of the father, the son and the holy spirit. Amen."

18. Question In planning activities for the depressed client, especially during the early stages of hospitalization, which of the following plans is best? A. Provide an activity that is quiet and solitary to avoid increased fatigue, such as working on a puzzle or reading a book. B. Plan nothing until the client asks to participate in milieu. C. Offer the client a menu of daily activities and insist the client participate in all of them D. Provide a structured daily program of activities and encourage the client to participate.

D. Provide a structured daily program of activities and encourage the client to participate.

7. Question Mr. Peterson, 35, is admitted for bipolar illness, manic phase, after assaulting his landlord in an argument over Mr. Peterson is staying up all night playing loud music. Mr. Peterson is hyperactive, intrusive, and has rapid, pressured speech. He has not slept in three days and appears thin and disheveled. Which of the following is the most essential nursing action at this time? A. Providing a meal and beverage for Mr. Peterson to eat in the dining room. B. Providing linens and toiletries for Mr. Peterson to attend to his hygiene. C. Consulting with the psychiatrist to order a hypnotic to promote sleep. D. Providing for client safety by limiting his privileges.

D. Providing for client safety by limiting his privileges.

45. Question Joseph, a 12-year-old child, complains to the school nurse about nausea and dizziness. While assessing the child, the nurse notices a black eye that looks like an injury. This is the third time in 1 month that the child has visited the nurse. Each time, the child provides vague explanations for various injuries. Which of the following is the school nurse's priority intervention? A. Contact the child's parents and ask about the child's injury. B. Encourage the child to be truthful with her. C. Question the teacher about the parent's behavior. D. Report suspicion of abuse to the proper authorities.

D. Report suspicion of abuse to the proper authorities.

72. Question The nurse is caring for a severely depressed client who has just been admitted to the in-client psychiatric unit. Which of the following is a priority of care? A. Nutrition B. Elimination C. Rest D. Safety

D. Safety

9. Question Nurse Christine is teaching an adolescent health class about the dangers of inhalant abuse; the nurse warns about the possibility of: A. Contracting an infectious disease, such as hepatitis or AIDS. B. Recurrent flashback events. C. Psychological dependence after initial use. D. Sudden death from cardiac or respiratory depression

D. Sudden death from cardiac or respiratory depression

Nurse Meredith is observing 8-year-old Anna during a community visit. Which of the following findings would lead the nurse to suspect that Anna is a victim of sexual abuse? A. The child is fearful of the caregiver and other adults. B. The child has a lack of peer relationships. C. The child has self-injurious behavior. D. The child has an interest in things of a sexual nature.

D. The child has an interest in things of a sexual nature.

19. Question The depressed client verbalizes feelings of low self-esteem and self-worth typified by statements such as "I'm such a failure... I can't do anything right!" The best nursing response would be: A. To tell the client this is not true; that we all have a purpose in life. B. To remain with the client and sit in silence; this will encourage the client to verbalize feelings. C. To reassure the client that you know how the client is feeling and that things will get better. D. To identify recent behaviors or accomplishments that demonstrate skill ability.

D. To identify recent behaviors or accomplishments that demonstrate skill ability.

61. Question The nurse is assessing a 17-year-old female who is admitted to the eating disorders unit with a history of weight fluctuation, abdominal pain, teeth erosion, receding gums, and bad breath. She states that her health has been a problem but there are no other concerns in her life. Which of the following assessments will be the least useful as the nurse develops the care plan? A. Information regarding recent mood changes B. Family functioning using a genogram C. Ability to socialize with peers D. Whether she has a sexual relationship with a boyfriend

D. Whether she has a sexual relationship with a boyfriend