300 Final Exam Practice Questions

6. Immediately after an initial electroconvulsive therapy (ECT) procedure, a client states, Im not hungry and just want to stay in bed and sleep. On the basis of this information, which is the most appropriate nursing intervention? A. Allow the client to remain in bed. B. Encourage the client to join the milieu to promote socialization. C. Obtain a physicians order for parenteral nutrition. D. Involve the client in physical activities to stimulate circulation.

A. Allow the client to remain in bed.

2. During a therapeutic group, two clients engage in an angry verbal exchange. The nurse leader interrupts the exchange and excuses both of the clients from the group. The nurse has demonstrated which leadership style? A. Autocratic B. Democratic C. Laissez-faire D. Bureaucratic

A. Autocratic

2. In defiance of parental wishes, a Japanese teenager succumbs to peer pressure and gets a tattoo. According to Bowens family systems theory, how should the community health nurse interpret the teenagers action? A. The teenager is attempting to differentiate self. B. The teenager is triangulating self. C. The teenager is cutting self off emotionally. D. The teenager is exhibiting antisocial traits.

A. The teenager is attempting to differentiate self.

7. A man diagnosed with alcohol dependence experiences his first relapse. During his AA meeting, another group member states, I relapsed three times, but now have been sober for 15 years. Which of Yaloms curative group factors does this illustrate? A. Imparting of information B. Instillation of hope C. Catharsis D. Universality

B. Instillation of hope

10. A nursing assistant has failed a prerequisite course toward admission to nursing school and states, I will always be only a nursing assistant and never an RN. Her nursing advisor understands this is an example of which automatic thought? A. Arbitrary inference B. Overgeneralization C. Dichotomous thinking D. Personalization

B. Overgeneralization

4. A client diagnosed with schizophrenia functions well and is bright, spontaneous, and interactive during hospitalization but then decompensates after discharge. What does the milieu provide that may be missing in the home environment? A. Peer pressure B. Structured programming C. Visitor restrictions D. Mandated activities

B. Structured programming

15. A mother tells her teenager that in order for college tuition to be paid, the teenager must quit smoking. They develop a written agreement stipulating time frames and consequences. This is an example of which technique of behavior modification? A. Shaping B. Modeling C. Contracting D. Premack principle

C. Contracting

18. A client is angry because her husband has forgotten their anniversary. The following week, the client is still unwilling to discuss this with her husband because she is afraid she will lose control. How should the nurse interpret this clients means of coping with anger? A. Coping by attacking B. Coping by surrendering C. Coping by avoiding D. Coping by belittling

C. Coping by avoiding

14. A new nursing graduate asks the psychiatric nurse manager how to best classify suicide. Which is the nurse managers best reply? A. Suicide is a DSM-5 diagnosis. B. Suicide is a mental disorder. C. Suicide is a behavior. D. Suicide is an antisocial affliction

C. Suicide is a behavior.

15. A nursing student is developing a plan of care for a suicidal client. Which documented intervention should the student implement first? A. Communicate therapeutically. B. Observe the client. C. Provide a hazard-free environment. D. Assess suicide risk.

D. Assess suicide risk.

17. Which assumption is most reflective of a behavioral theory model? A. Mental illness is characterized by structural and biochemical alterations. B. Thought processes influence behaviors. C. All personality development has a social context. D. There is a basic relationship between stimulus and response

D. There is a basic relationship between stimulus and response

17. Which client statement would exemplify the level of cognitive function that you would expect to see in mild anxiety? A. Right now I feel as sharp as a tack. B. Im having a tough time focusing. C. Sometimes I feel like Im having an out-of-body experience. D. All I seem to focus on is my anger.

A. Right now I feel as sharp as a tack.

4. A nursing student states, The instructor gave me a failing grade on my research paper. I know its because the instructor doesnt like me. Which cognitive error does a nurse recognize in this students statement? A. Dichotomous thinking B. Catastrophic thinking C. Magnification D. Overgeneralization

C. Magnification

20. A client is newly committed to an inpatient psychiatric unit. Which nursing intervention best lowers this clients risk for suicide? A. Encouraging participation in the milieu to promote hope B. Developing a strong personal relationship with the client C. Observing the client at intervals determined by assessed data D. Encouraging and redirecting the client to concentrate on happier times

C. Observing the client at intervals determined by assessed data

6. A 2-year-old engages in frequent temper tantrums that usually result in the parents giving in to demands. During family therapy, how should a nurse counsel the parents? A. You are shaping your childs behavior. B. Your child has modeled your behavior. C. You are positively reinforcing your childs behavior. D. You are negatively reinforcing your childs behavior.

C. You are positively reinforcing your childs behavior.

16. A client states, I keep having horrible nightmares about the car accident that killed my daughter. I shouldnt have taken her with me to the store. Using a cognitive approach, which nursing reply would be most therapeutic? A. Are other issues from your past affecting your ability to move on? B. Describe your current feelings about your loss. C. Lets talk about something that will help you move on. D. Can anyone predict when a car accident will happen?

D. Can anyone predict when a car accident will happen?

6. A nurse working on an inpatient psychiatric unit is assigned to conduct a 45-minute education group. What should the nurse identify as an appropriate group topic? A. Dream analysis B. Creative cooking C. Paint by number D. Stress management

D. Stress management

6. A single, pregnant teenager in a parenting class discloses her ambivalence toward the pregnancy and the subsequent guilt that these thoughts generate. A mother of three admits to having felt that way herself. Which of Yaloms curative group factors does this illustrate? A. Imparting of information B. Instillation of hope C. Altruism D. Universality

D. Universality

18. A nurse should recognize which intervention as most appropriate within a behavioral therapy program? A. A child is given a Popsicle for staying dry and clean. B. A child is put in time-out after soiling his or her undergarments. C. A child is allowed to remain in soiled undergarments. D. A child is taught the advantages of staying dry and clean.

A. A child is given a Popsicle for staying dry and clean.

21. Which of the following observed client behaviors would lead a nurse to evaluate a member as assuming a maintenance group role? Select all that apply. A. A client decreases conflict within the group by encouraging compromise. B. A client offers recognition and acceptance of others. C. A client outlines the task at hand and proposes solutions. D. A client listens attentively to group interaction. E. A client uses the group to gain sympathy from others.

A. A client decreases conflict within the group by encouraging compromise. B. A client offers recognition and acceptance of others. D. A client listens attentively to group interaction.

12. A mother states, You are old enough to clean your own bedroom. Later inspection finds the floor clear, but with everything stacked in a chair. The mother praises the child for clearing the floor. This is consistent with which technique of behavior modification? A. Shaping B. Extinction C. Stimulus generalization D. Reciprocal inhibition

A. Shaping

15. A couple is in counseling related to their dysfunctional relationship. Their daughter has recently made a suicide gesture. The nurse should recognize that this might be an example of which family system concept? A. Triangulation B. Pseudohostility C. Double-bind communication D. Pseudomutuality

A. Triangulation

3. A third-grader feigns illness in order to avoid doing homework. The teacher recommends an educational program that uses a token economy. How should a school nurse explain a token economy to this childs parent? A. Your child will receive green tokens for completing homework that can be cashed in for desired rewards. B. Your child will receive red tokens when homework is incomplete and this will result in school suspension. C. Your child will receive a time out for each homework assignment not completed. D. Your child, with your assistance, will envision receiving rewards for completed homework.

A. Your child will receive green tokens for completing homework that can be cashed in for desired rewards.

11. A nursing instructor is teaching about suicide in the elderly population. Which information should the instructor include? A. Elderly people use less lethal means to commit suicide. B. Although the elderly make up less than 13% of the population, they account for 16% of all suicides. C. Suicide is the second leading cause of death among the elderly. D. It is normal for elderly individuals to express a desire to die, because they have come to terms with their mortality.

B. Although the elderly make up less than 13% of the population, they account for 16% of all suicides.

4. A client is diagnosed with an anxiety disorder. The nurse counselor recommends intervention with the behavioral technique of reciprocal inhibition. The client asks, Whats that? Which is the most appropriate nursing reply? A. At the beginning of this intervention, a contract will be drawn up explicitly stating the behavior change agreed upon. B. By introducing an adaptive behavior that is mutually exclusive to your maladaptive behavior, we will expect subsequent behavior to improve. C. Through a series of increasingly anxiety-provoking steps, we will gradually increase your tolerance to anxiety. D. In one intense session, you will be exposed to a maximum level of anxiety that you will learn to tolerate.

B. By introducing an adaptive behavior that is mutually exclusive to your maladaptive behavior, we will expect subsequent behavior to improve.

1. During a therapeutic group, a client talks about personal accomplishments in an effort to gain attention. Which group role, assumed by this client, should the nurse identify? A. The task role of gatekeeper B. The individual role of recognition seeker C. The maintenance role of dominator D. The task role of elaborator

B. The individual role of recognition seeker

7. What is the best rationale for including the clients family in therapy within the inpatient milieu? A. To structure a program of social and work-related activities B. To facilitate discharge from the hospital C. To provide a concrete demonstration of caring D. To encourage the family to model positive behaviors

B. To facilitate discharge from the hospital

14. A client is scheduled for an initial electroconvulsive therapy (ECT) procedure. Which information should a nurse include when teaching about the potential side effects of this procedure? A. You may experience transient tangential thinking. B. You may experience some memory deficit surrounding the ECT. C. You may experience avolution for the remainder of the day. D. You may experience a higher risk for subsequent seizures.

B. You may experience some memory deficit surrounding the ECT.

21. Which client data indicate that a suicidal client is participating in a plan for safety? A. Compliance with antidepressant therapy B. A mood rating of 9/10 C. Disclosing a plan for suicide to staff D. Expressing feelings of hopelessness to nurse

C. Disclosing a plan for suicide to staff

13. A suicidal client says to a nurse, Theres nothing to live for anymore. Which is the most appropriate nursing reply? A. Why dont you consider doing volunteer work in a homeless shelter? B. Lets discuss the negative aspects of your life. C. Things will look better in the morning. D. It sounds like you are feeling pretty hopeless.

D. It sounds like you are feeling pretty hopeless.

10. In the role of milieu manager, which activity should the nurse prioritize? A. Setting the schedule for the daily unit activities B. Evaluating clients for medication effectiveness C. Conducting therapeutic group sessions D. Searching newly admitted clients for hazardous objects

D. Searching newly admitted clients for hazardous objects

17. During the sixth week of a 10-week parenting skills group, a nurse observes as several members get into a heated dispute about spanking. As a group, they decide to create a pros-and-cons poster on the use of physical discipline. At this time, what is the role of the group leader? A. To referee the debate B. To adamantly oppose physical discipline measures C. To redirect the group to a less controversial topic D. To encourage the group to solve the problem collectively

D. To encourage the group to solve the problem collectively

15. The nurse should utilize which group function to help an extremely withdrawn, paranoid client increase feelings of security? A. Socialization B. Support C. Empowerment D. Governance

B. Support

20. According to behavioral theory, the treatment of phobic symptoms should involve which action? A. The manipulation of the environment B. The use of desensitization C. The use of family therapy D. The uncovering of past events

B. The use of desensitization

6. A welder has been selected as employee of the year. The welder wants to ask for a promotion but is hampered by poor self-esteem. The employee health nurse provides assistance. Which technique should the nurse use to help the employee request the promotion? A. Socratic questioning B. Activity scheduling C. Distraction D. Cognitive rehearsal

D. Cognitive rehearsal

7. A child always chooses to ask mother over father when seeking special privileges. The father is more apt to disagree than agree with the childs requests, whereas the mother usually consents. The childs choice is the result of which component of operant conditioning? A. Conditioned stimuli B. Unconditioned stimuli C. Aversive stimuli D. Discriminative stimuli

D. Discriminative stimuli

2. A client on an inpatient unit angrily states to a nurse, Peter is not cleaning up after himself in the community bathroom. You need to address this problem. Which is the appropriate nursing response? A. Ill talk to Peter and present your concerns. B. Why are you overreacting to this issue? C. You should bring this to the attention of your treatment team. D. I can see that you are angry. Lets discuss ways to approach Peter with your concerns.

D. I can see that you are angry. Lets discuss ways to approach Peter with your concerns.

21. A client is experiencing auditory hallucinations. Using a cognitive strategy, the nurse would encourage the client to do which of these? A. Try singing Happy Birthday until the voices are gone. B. Document what the voices are saying, to note cause and effect. C. Try listening to music using headphones for distraction. D. Remind yourself that the voices are symptoms of your disease.

D. Remind yourself that the voices are symptoms of your disease.

10. An instructor is teaching about differentiated parent and adult child relationships. Students are instructed to give an example of a well-differentiated parent and adult child relationship. Which student example meets the instructor requirement? A. An adult child considers, but is not governed by, the advice of his or her parents. B. An adult child appears to listen, but ignores, the advice of his or her parents. C. An adult child respects and is governed by the wishes of his or her parents. D. An adult child never requests advice or feedback from his or her parents.

A. An adult child considers, but is not governed by, the advice of his or her parents.

19. During a course of 12 electroconvulsive therapy (ECT) procedures, an anxious client diagnosed with major depression refuses to bathe or attend group therapy. He reports some memory problems and says he has trouble figuring out what time of day it is. At this time, which of the following nursing diagnoses should be assigned to this client? Select all that apply. A. Anxiety R/T post-ECT confusion and memory loss B. Risk for injury R/T post-ECT confusion and memory loss C. Risk for activity intolerance R/T post-ECT confusion and memory loss D. Altered sensory perception R/T post-ECT confusion and memory loss E. Social isolation R/T post-ECT confusion and memory loss

A. Anxiety R/T post-ECT confusion and memory loss B. Risk for injury R/T post-ECT confusion and memory loss C. Risk for activity intolerance R/T post-ECT confusion and memory loss E. Social isolation R/T post-ECT confusion and memory loss

19. Which nursing intervention strategy is most appropriate to implement initially with a suicidal client? A. Ask a direct question such as, Do you ever think about killing yourself? B. Ask client, Please rate your mood on a scale from 1 to 10. C. Establish a trusting nurseclient relationship. D. Apply the nursing process to the planning of client care.

A. Ask a direct question such as, Do you ever think about killing yourself?

24. A client has been brought to the emergency department for signs and symptoms of Chronic Obstructive Pulmonary Disease (COPD). The client has a history of a suicide attempt 1 year ago. Which nursing intervention would take priority in this situation? A. Assessing the clients pulse oximetry and vital signs B. Developing a plan for safety for the client C. Assessing the client for suicidal ideations D. Establishing a trusting nurseclient relationship

A. Assessing the clients pulse oximetry and vital signs

19. Using a cognitive approach, a nurse would choose which intervention for assisting clients to manage their anger without the use of violence? A. Assist the client to identify thoughts that trigger anger and substitute reality-based thinking. B. Provide consequences, such as removal from group therapy, in response to angry outbursts. C. Administer antipsychotic medications and use limit-setting such as a room restriction. D. Administer anti-anxiety medication and encourage participation in a group on medication actions.

A. Assist the client to identify thoughts that trigger anger and substitute reality-based thinking.

4. During a community meeting, a nurse encourages clients to present unit problems and discuss possible solutions. Which type of leadership style is the nurse demonstrating? A. Democratic B. Autocratic C. Laissez-faire D. Bureaucratic

A. Democratic

15. A nursing instructor is teaching about dichotomous thinking. Which student statement indicates that learning has occurred? A. Dichotomous thinking is when an individual views situations as being good or bad or black or white. B. Dichotomous thinking is when an individual takes complete responsibility for situations without considering other circumstances. C. Dichotomous thinking is when an individual exaggerates the negative significance of an event. D. Dichotomous thinking is when an individual undervalues the positive significance of an event.

A. Dichotomous thinking is when an individual views situations as being good or bad or black or white.

18. Which assessment results should a nurse evaluate and report in the process of clearing a client for electroconvulsive therapy (ECT)? Select all that apply. A. Electrocardiographic records B. Pulmonary function study results C. Electroencephalogram analysis D. Complete blood count values E. Urinalysis results

A. Electrocardiographic records B. Pulmonary function study results D. Complete blood count values E. Urinalysis results

5. To promote self-reliance, how should a psychiatric nurse best conduct medication administration? A. Encourage clients to request their medications at the appropriate times. B. Refuse to administer medications unless clients request them at the appropriate times. C. Allow the clients to determine appropriate medication times. D. Take medications to the clients bedside at the appropriate times.

A. Encourage clients to request their medications at the appropriate times.

3. A newly admitted client asks, Why do we need a unit schedule? Im not going to these groups. Im here to get some rest. Which is the most appropriate nursing reply? A. Group therapy provides the opportunity to learn and practice new coping skills. B. Group therapy is mandatory. All clients must attend. C. Group therapy is optional. You can go if you find the topic helpful and interesting. D. Group therapy is an economical way of providing therapy to many clients concurrently.

A. Group therapy provides the opportunity to learn and practice new coping skills.

25. After a teenager reveals that he is gay, the father responds by beating him. The next morning, the teenager is found hanging in his closet. Which paternal grief responses should a nurse anticipate? Select all that apply. A. I cant believe this is happening. B. If only I had been more understanding. C. How dare he do this to me! D. Im just going to have to accept that he was gay. E. Well, that was a selfish thing to do.

A. I cant believe this is happening. B. If only I had been more understanding. C. How dare he do this to me!

25. Which of the following client statements would indicate that teaching about benzodiazepines has been successful? Select all that apply. A. I cant drink alcohol when taking lorazepam (Ativan). B. If I abruptly stop taking buspirone (BuSpar), I may have a seizure. C. Valium can make me drowsy, so I shouldnt drive for awhile. D. My new diet cannot include aged cheese or pickled herring. E. When the fluoxetine (Prozac) begins working, I can stop the alprazolam (Xanax).

A. I cant drink alcohol when taking lorazepam (Ativan). C. Valium can make me drowsy, so I shouldnt drive for awhile.

8. During a group discussion, members freely interact with each other. Which member statement is an example of Yaloms curative group factor of imparting information? A. I found a Web site explaining the different types of brain tumors and their treatment. B. My brother also had a brain tumor and now is completely cured. C. I understand your fear and will be by your side during this time. D. My mother was also diagnosed with cancer of the brain.

A. I found a Web site explaining the different types of brain tumors and their treatment.

9. Prayer group members at a local Baptist church are meeting with a poor, homeless family they are supporting. Which member statement is an example of Yaloms curative group factor of altruism? A. Ill give you the name of a friend that rents inexpensive rooms. B. The last time we helped a family, they got back on their feet and prospered. C. I can give you all of my baby clothes for your little one. D. I can appreciate your situation. I had to declare bankruptcy last year.

A. Ill give you the name of a friend that rents inexpensive rooms.

26. A nursing student is developing a study guide related to historical facts about suicide. Which of the following facts should the student include? Select all that apply. A. In the Middle Ages, suicide was viewed as a selfish and criminal act. B. During the Roman Empire, suicide was followed by incineration of the body. C. Suicide was an offense in ancient Greece, and a common-site burial was denied. D. During the Renaissance, suicide was discussed and viewed more philosophically. E. Old Norse traditionally set a person who committed suicide adrift in the North Sea.

A. In the Middle Ages, suicide was viewed as a selfish and criminal act. C. Suicide was an offense in ancient Greece, and a common-site burial was denied. D. During the Renaissance, suicide was discussed and viewed more philosophically.

11. A high school basketball player sustains a serious knee injury and states to the school nurse, I will never get to college if I dont receive a basketball scholarship. Which nursing reply would assist the student to see a broader range of possibilities? A. Lets look at the alternatives for funding your college education. B. I know you are feeling helpless now, but you are looking at this from only one perspective. C. Can your family afford knee surgery? D. You now need to prioritize your academics and not focus on basketball.

A. Lets look at the alternatives for funding your college education.

9. A nursing student evaluates her group project partner as irresponsible because of minimal participation in planning. When told of this situation, the nursing instructor plans to use the cognitive technique of examining the evidence. Which response exemplifies this technique? A. Lets look at the potential reasons why your partner has not participated. B. How would you define irresponsibility? C. Has it occurred to you that your partner may be working on the project at home? D. Are you telling me that you feel totally responsible for this project?

A. Lets look at the potential reasons why your partner has not participated.

17. A nurse should recognize that electroconvulsive therapy (ECT) would potentially improve the symptoms of clients with which of the following diagnoses? Select all that apply. A. Major depressive disorder B. Bipolar I disorder: manic episode C. Schizoaffective disorder D. Obsessive-compulsive disorder E. Body dysmorphic disorder

A. Major depressive disorder B. Bipolar I disorder: manic episode C. Schizoaffective disorder

3. A successful business executive continually thinks that job accomplishments are not adequate. A nurse recognizes that the clients thinking is reflective of which cognitive error? A. Minimization B. Dichotomous thinking C. Arbitrary inference D. Personalization

A. Minimization

2. Immediately after electroconvulsive therapy, in which position should a nurse place the client? A. On his or her side to prevent aspiration B. In semi-Fowlers position to promote oxygenation C. In Trendelenburgs position to promote blood flow to vital organs D. In prone position to prevent airway blockage

A. On his or her side to prevent aspiration

20. Which of the following conditions would place a client at risk for injury during electroconvulsive therapy (ECT)? Select all that apply. A. Severe osteoporosis B. Acute and chronic pulmonary disorders C. Hypothyroidism D. Recent cardiovascular accident E. Prostatic hypertrophy

A. Severe osteoporosis B. Acute and chronic pulmonary disorders D. Recent cardiovascular accident

4. A chronically depressed and suicidal client is admitted to a psychiatric unit. The client is scheduled for electroconvulsive therapy (ECT). During the course of ECT, a nurse should recognize the continued need for which critical intervention? A. Suicide assessment must continue throughout the ECT course. B. Antidepressant medications are contraindicated throughout the ECT course. C. Discourage expressions of hopelessness throughout the ECT course. D. Encourage a high-caloric diet throughout the ECT course.

A. Suicide assessment must continue throughout the ECT course.

12. A nurse is caring for a client who has threatened to commit suicide by hanging. The client states, Im going to use a knotted shower curtain when no one is around. Which information would determine the nurses plan of care for this client? A. The more specific the plan is, the more likely the client will attempt suicide. B. Clients who talk about suicide never actually commit it. C. Clients who threaten suicide should be observed every 15 minutes. D. After a brief assessment, the nurse should avoid the topic of suicide.

A. The more specific the plan is, the more likely the client will attempt suicide.

9. A client scheduled for electroconvulsive therapy (ECT) at 9:00 a.m. is discovered eating breakfast at 8:00 a.m. On the basis of this observation, which is the most appropriate nursing action? A. The nurse notifies the clients physician of the situation and cancels the ECT. B. The nurse removes the breakfast tray and assists the client to the ECT procedure room. C. The nurse allows the client to finish breakfast and reschedules ECT for 10:00 a.m. D. The nurse increases the clients fluid intake to facilitate the digestive process.

A. The nurse notifies the clients physician of the situation and cancels the ECT.

24. A nurse practitioner uses cognitive therapy with depressed clients. The nurse asks clients to keep a daily record of dysfunctional thoughts. Which of the following are appropriate nursing replies to a client questioning the purpose of this exercise? Select all that apply. A. The purpose of this exercise is to identify automatic thoughts. B. The purpose of this exercise is to identify rational alternatives. C. The purpose of this exercise is to modify cognitive errors. D. The purpose of this exercise is to eliminate irrational beliefs. E. The purpose of this exercise is to monitor thoughts related to self-esteem.

A. The purpose of this exercise is to identify automatic thoughts. B. The purpose of this exercise is to identify rational alternatives. C. The purpose of this exercise is to modify cognitive errors.

15. When scheduling electroconvulsive therapy (ECT), which client should the nurse prioritize? A. A client in bed in a fetal position who is experiencing active suicidal ideations B. A client with an irritable mood and exhibiting angry outbursts C. A client experiencing command hallucinations and delusions of reference D. A client experiencing manic episodes of bipolar disorder

A. A client in bed in a fetal position who is experiencing active suicidal ideations

6. A clinic nurse is caring for a 40-year-old client who lives with his parents. The clients mother continues to do the clients laundry and provides spending money. Based on this situation, which family dynamic does the nurse recognize? A. Taking over B. Communicating indirectly C. Belittling feelings D. Making assumptions

A. Taking over

10. During an inpatient educational group, a client shouts out, This information is worthless. Nothing you have said can help me. These statements indicate to the nurse leader that the client is assuming which group role? A. The group role of aggressor B. The group role of initiator C. The group role of gatekeeper D. The group role of blocker

A. The group role of aggressor

18. A 10-week, prenuptial counseling group composed of five couples is terminating. At the last group meeting, a nurse notices that the two most faithful and participative couples are absent. When considering concepts of group development, what might explain this behavior? A. They are experiencing problems with termination, leading to feelings of abandonment. B. They did not think any new material would be covered at the last session. C. They were angry with the leader for not extending the length of the group. D. They were bored with the material covered in the group.

A. They are experiencing problems with termination, leading to feelings of abandonment.

7. An advanced practice nurse is counseling a client diagnosed with generalized anxiety disorder. The nurse plans to use activity scheduling to address this clients concerns. What is the purpose of this nursing intervention? A. To identify important areas needing concentration during therapy B. To increase self-esteem and decrease feelings of helplessness C. To modify maladaptive behaviors by the use of role-play D. To divert away from intrusive thoughts and depressive ruminations

A. To identify important areas needing concentration during therapy

14. The director of nursing (DON) sets up a meeting with the newly appointed nurse manager, who, to this point, has done an excellent job. The nurse manager anticipates job termination. What is the best description of the cognitive error being employed by the nurse manager? A. Thinking from an all-or-nothing perspective B. Always thinking the worst will occur without considering positive outcomes C. Viewing only selected negative evidence while editing out positive aspects D. Undervaluing the positive significance of an event

B. Always thinking the worst will occur without considering positive outcomes

14. A nursing instructor is teaching about the behavior technique of modeling. When asked to give an example of this behavioral intervention, which student statement meets the learning objective? A. A child is first rewarded for using a spoon to eat and then rewarded for using a fork, and finally rewarded for cutting food with a knife. B. An adolescent imitates Dad by using and caring for tools appropriately. C. A client and therapist agree to conditions of therapy, stating explicitly in writing the behavior change that is desired. D. A mother tells her child that television can be watched only after homework is completed.

B. An adolescent imitates Dad by using and caring for tools appropriately.

13. A client states, My doctor has told me I am a candidate for electroconvulsive therapy (ECT). Where will the treatment take place, and how much time would this entail? Which is the most accurate nursing reply? A. Clients typically receive ECT in their hospital room, daily for 1 month. B. Clients typically undergo 6 to 12 ECT procedures, three times a week in an outpatient setting. C. Clients typically receive an unlimited number of treatments, in the hospital procedure room. D. Clients typically receive two to three treatments, in either an outpatient or inpatient setting.

B. Clients typically undergo 6 to 12 ECT procedures, three times a week in an outpatient setting.

3. A nursing instructor is teaching about electroconvulsive therapy (ECT). Which student statement indicates that learning has occurred? A. During ECT a state of euphoria is induced. B. ECT induces a grand mal seizure. C. During ECT a state of catatonia is induced. D. ECT induces a petit mal seizure.

B. ECT induces a grand mal seizure.

22. Which of the following behavioral skills should a nurse implement when leading a group that is functioning in the orientation phase of group development? Select all that apply. A. Encouraging members to provide feedback to each other about individual progress B. Ensuring that rules established by the group do not interfere with goal fulfillment C. Working with group members to establish rules that will govern the group D. Emphasizing the need for and importance of confidentiality within the group E. Helping the members to resolve conflicts and foster cohesiveness within the group

B. Ensuring that rules established by the group do not interfere with goal fulfillment C. Working with group members to establish rules that will govern the group D. Emphasizing the need for and importance of confidentiality within the group

19. An adolescent client was recently admitted to the psychiatric unit because of impulsivity and acting-out behavior at school. The nurse should initially implement which nursing action? A. Redirect the client to activities to decrease stress. B. Explain the unit rules and consequences of breaking the rules. C. Place the client on close observation to insure a trusting relationship. D. Administer an anti-anxiety medication.

B. Explain the unit rules and consequences of breaking the rules.

17. A nursing instructor is teaching about the importance of healthy family-member expectations for newly blended families. Which student statement indicates a need for further instruction? A. Healthy family-member expectations should be flexible. B. Healthy family-member expectations should be conforming. C. Healthy family-member expectations should be individual. D. Healthy family-member expectations should be realistic.

B. Healthy family-member expectations should be conforming.

10. After years of dialysis, an 84-year-old states, Im exhausted, depressed, and done with these attempts to keep me alive. Which question should the nurse ask the spouse when preparing a discharge plan of care? A. Have there been any changes in appetite or sleep? B. How often is your spouse left alone? C. Has your spouse been following a diet and exercise program consistently? D. How would you characterize your relationship with your spouse?

B. How often is your spouse left alone?

12. During a group session, which client statement demonstrates that the group has progressed to the middle, or working, phase of group development? A. Its hard for me to tell my story when Im not sure about the reactions of others. B. I think Joes Antabuse suggestion is a good one and might work for me. C. My situation is very complex, and I need professional, not peer, advice. D. I am really upset that you expect me to solve my own problems.

B. I think Joes Antabuse suggestion is a good one and might work for me.

22. Which statement indicates that the nurse is acting as an advocate for a client who was hospitalized after a suicide attempt and is now nearing discharge? A. I must observe you continually for 1 hour in order to keep you safe. B. Lets confer with the treatment team about the resources that you may need after discharge. C. You must have been very upset to do what you did today. D. Are you currently thinking about harming yourself?

B. Lets confer with the treatment team about the resources that you may need after discharge.

2. An adolescent comes from a dysfunctional family where physical and verbal abuse prevails. At school this adolescent bullies and fights with classmates. According to principles of behavior therapy, what is the probable source of this behavior? A. Shaping B. Modeling C. Premack principle D. Reciprocal inhibition

B. Modeling

11. A nurse attends an interdisciplinary team meeting on an inpatient unit. Which of the following individuals are typically included as members of the interdisciplinary treatment team in psychiatry? Select all that apply. A. Respiratory therapist B. Occupational therapist C. Recreational therapist D. Social worker E. Mental health technician

B. Occupational therapist C. Recreational therapist D. Social worker E. Mental health technician

9. Parents of a 3-year-old have noticed an improvement in behavior because of using a time out behavioral approach. What aspect of time out therapy may be responsible for this childs improved behavior? A. Negative reinforcement discourages maladaptive behavior. B. Positive reinforcement is removed. C. Covert sensitization is being applied. D. Reciprocal inhibition is eliminated.

B. Positive reinforcement is removed.

5. A nurse recently admitted a client to an inpatient unit after a suicide attempt. A health-care provider orders amitriptyline (Elavil) for the client. Which intervention related to this medication should be initiated to maintain this clients safety upon discharge? A. Provide a 6-month supply of Elavil to ensure long-term compliance. B. Provide a 1-week supply of Elavil with refills contingent on follow-up appointments. C. Provide a pill dispenser as a memory aid. D. Provide education regarding the avoidance of foods containing tyramine.

B. Provide a 1-week supply of Elavil with refills contingent on follow-up appointments.

9. A stockbroker commits suicide after being convicted of insider trading. In speaking with the family, which statement by the nurse demonstrates accurate and appropriate sharing of information? A. Your grieving will subside within 1 year; until then I recommend antidepressants. B. Support groups are available specifically for survivors of suicide, and I would be glad to help you locate one in this area. C. The only way to deal effectively with this kind of grief is to write a letter to the brokerage firm to express your anger with them. D. Since stigmatization often occurs in these situations, it would be best if you avoid discussing the suicide with anyone.

B. Support groups are available specifically for survivors of suicide, and I would be glad to help you locate one in this area.

16. Which is a correctly written, appropriate outcome for a client with a history of suicide attempts who is currently exhibiting symptoms of low self-esteem by isolating self? A. The client will not physically harm self. B. The client will express three positive self-attributes by day 4. C. The client will reveal a suicide plan. D. The client will establish a trusting relationship

B. The client will express three positive self-attributes by day 4.

12. A nursing student is observing an electroconvulsive therapy (ECT) procedure. The student notices a blood pressure cuff on the clients lower leg. The student questions the instructor about the cuff placement. Which is the most accurate instructor reply? A. The cuff has to be placed on the leg because both arms are used for intravenous fluids. B. The cuff functions to prevent succinylcholine from reaching the foot. C. The cuff position gives a more accurate blood pressure reading during the treatment. D. The cuff is placed on the leg so that arms can easily be restrained during seizure.

B. The cuff functions to prevent succinylcholine from reaching the foot.

13. During family counseling, a husband tells his wife to spend more time with the family, and she responds by stating, Okay, Ill turn in my resignation tomorrow. The husband replies, I knew it! Youve always been a quitter! How should the nurse interpret the husbands statement? A. The husband is expressing an emotional cutoff. B. The husband is expressing double-bind communication. C. The husband is expressing indirect messages. D. The husband is expressing avoidance behaviors.

B. The husband is expressing double-bind communication.

1. A nursing instructor is teaching about the didactic aspects of cognitive therapy. Which student statement indicates a deficit in meeting the learning objectives of this content? A. The therapist provides information about the process of cognitive therapy. B. The therapist uses guided imagery in an effort to elicit automatic thoughts. C. The therapist provides information about how cognitive therapy works. D. The therapist uses reading assignments to reinforce learning.

B. The therapist uses guided imagery in an effort to elicit automatic thoughts.

23. A nursing instructor is lecturing about cognitive therapy. Which of the following are objectives when implementing this therapy? Select all that apply. A. To modify automatic thoughts to promote minimization of negative cognitions B. To apply a variety of methods to create change in an individuals thinking C. To apply cognitive principles in order to change an individuals basic schema D. To modify belief systems in an effort to bring about emotional change E. To modify belief systems in an effort to bring about behavioral change

B. To apply a variety of methods to create change in an individuals thinking D. To modify belief systems in an effort to bring about emotional change E. To modify belief systems in an effort to bring about behavioral change

9. After hearing parents discuss divorce, a 5-year-old develops behavioral problems. Upon dealing with the childs behavioral issues, the marital relationship conflict decreases. The pediatric clinic nurse should recognize that this is an example of which family system concept? A. Differentiation of self B. Triangulation C. Fusion D. Emotional cutoff

B. Triangulation

12. Which of the following are accurate descriptors of a therapeutic community? Select all that apply. A. The unit schedule includes unlimited free time for personal reflection. B. Unit responsibilities are assigned according to client capabilities. C. A flexible schedule is determined by client needs. D. The individual is the sole focus of therapy. E. A democratic form of government exists.

B. Unit responsibilities are assigned according to client capabilities. E. A democratic form of government exists.

5. Which situation should a nurse identify as an example of an autocratic leadership style? A. The president of Sigma Theta Tau assigns members to committees to research problems. B. Without faculty input, the dean mandates that all course content be delivered via the Internet. C. During a community meeting, a nurse listens as clients generate solutions. D. The student nurses association advertises for candidates for president.

B. Without faculty input, the dean mandates that all course content be delivered via the Internet.

19. An experienced psychiatric registered nurse has taken a new position leading groups in a day treatment program. Without further education, which group is this nurse most qualified to lead? A. A psychodrama group B. A psychotherapy group C. A parenting group D. A family therapy group

C. A parenting group

10. A client is in therapy with a nurse practitioner for the treatment of arachnophobia. The nurse practitioner decides to use the technique of flooding. Which intervention best exemplifies this technique? A. Giving rewards for demonstrating a decrease in fear of spiders B. Encouraging the client to sit through the movie Spiderman C. Accompanying the client to a 1-hour visit to the local zoos spider room D. Offering a computer program that progressively presents anxiety-producing spider scenarios

C. Accompanying the client to a 1-hour visit to the local zoos spider room

18. A nurse is caring for four clients diagnosed with major depressive disorder. When considering each clients belief system, the nurse should conclude which client would potentially be at highest risk for suicide? A. Roman Catholic B. Protestant C. Atheist D. Muslim

C. Atheist

16. A client with cognitive deficits is extremely suicidal. The client has not responded to antidepressants and the treatment team is considering electroconvulsive therapy (ECT). What client information would impact the feasibility of this treatment option? A. Because the client is extremely suicidal, ECT is an appropriate option. B. Because antidepressant medications have been ineffective, ECT is a good alternative. C. Because informed consent is required for ECT, cognitive deficits could preclude this option. D. Because of the clients cognitive deficits, a signed consent is waived.

C. Because informed consent is required for ECT, cognitive deficits could preclude this option.

8. How does a democratic form of self-government in the milieu contribute to client therapy? A. By setting punishments for clients who violate the community rules B. By dealing with inappropriate behaviors as they occur C. By setting community expectations wherein all clients are treated on an equal basis D. By interacting with professional staff members to learn about therapeutic interventions

C. By setting community expectations wherein all clients are treated on an equal basis

22. A client diagnosed with borderline personality disorder states, Get out of here. No one cares about me or my situation! Which nursing reply is an example of a cognitive intervention? A. You have an anti-anxiety medication ordered. It may make you feel better. B. It sounds like you are feeling really frustrated. C. Can you explain further your thinking about your situation? D. No one cares about you?

C. Can you explain further your thinking about your situation?

16. When planning group therapy, a nurse should identify which configuration as most optimal for a therapeutic group? A. Open-ended membership; circle of chairs; group size of 5 to 10 members B. Open-ended membership; chairs around a table; group size of 10 to 15 members C. Closed membership; circle of chairs; group size of 5 to 10 members D. Closed membership; chairs around a table; group size of 10 to 15 members

C. Closed membership; circle of chairs; group size of 5 to 10 members

1. An angry client on an inpatient unit approaches a nurse, stating, Someone took my lunch! People need to respect others, and you need to do something about this now! The nurses response should be guided by which basic assumption of milieu therapy? A. Conflict should be avoided at all costs on inpatient psychiatric units. B. Conflict should be resolved by the nursing staff. C. Every interaction is an opportunity for therapeutic intervention. D. Conflict resolution should be addressed only during group therapy.

C. Every interaction is an opportunity for therapeutic intervention.

3. A home health nurse is visiting an Asian family. A married couple, their three children, and the maternal grandparents all live in the home. How should the nurse interpret the presence of the grandparents in the home? A. The parents have diffuse boundaries and have allowed the grandparental subsystem to be present. B. The grandparental subsystem is not successfully managing separation from the parental subsystem. C. Extended family living arrangements are common in some cultures. D. The nuclear family living arrangement is the preferred environment for childrearing.

C. Extended family living arrangements are common in some cultures.

8. When a clients husband comes home late from work, the wife immediately fears infidelity. The advanced practice nurse therapist encourages the wife to consider other explanations for her husbands tardiness. What technique is the nurse using? A. Examination of the evidence B. Decatastrophizing C. Generating alternatives D. Reattribution

C. Generating alternatives

20. A client recovering from alcohol toxicity is using minimization. Which statement reflects this cognitive distortion? A. I cant give up alcohol right now because I just gave up smoking. B. I just read that red wine has health benefits. C. I may have a minor problem, but I can handle it. D. I dont drink as much as my wife, and nobody thinks she has a problem.

C. I may have a minor problem, but I can handle it.

20. A nursing instructor is teaching about psychodrama, a specialized type of therapeutic group. Which student statement indicates that further teaching is necessary? A. Psychodrama provides a safe setting in which to discuss painful issues. B. In psychodrama, the client is the protagonist. C. In psychodrama, the client observes actor interactions from the audience. D. Psychodrama facilitates resolution of interpersonal conflicts.

C. In psychodrama, the client observes actor interactions from the audience.

4. A client with a history of three suicide attempts has been taking fluoxetine (Prozac) for 1 month. The client suddenly presents with a bright affect, rates mood at 9/10, and is much more communicative. Which action should be the nurses priority at this time? A. Give the client off-unit privileges as positive reinforcement. B. Encourage the client to share mood improvement in group. C. Increase frequency of client observation. D. Request that the psychiatrist reevaluate the current medication protocol.

C. Increase frequency of client observation.

5. After undergoing two of nine electroconvulsive therapy (ECT) procedures, a client states, I cant even remember eating breakfast, so I want to stop the ECT. Which is the most appropriate nursing reply? A. After you begin the course of treatments, you must complete all of them. B. Youll need to talk with your doctor about what youre thinking. C. It is within your right to discontinue the treatments, but lets talk about your concerns. D. Memory loss is a rare side effect of the treatment. I dont think it should be a concern.

C. It is within your right to discontinue the treatments, but lets talk about your concerns.

16. An adolescent, his mother, and his soon-to-be stepfather have been in counseling with the nurse. Which statement by the nurse fosters positive relationships within this new family structure? A. Stepchildren should be consistently disciplined by only one parent. B. It is most important to give your full attention to the childs adjustment since it is most difficult for them. C. Keeping the lines of communication open between everyone in the family is important in establishing healthy relationships. D. Children need to decide who will be their disciplinarian because this new situation will be stressful.

C. Keeping the lines of communication open between everyone in the family is important in establishing healthy relationships.

12. During family counseling a child states, I just want to surf like other kids. Mom says its okay, but Dad says Im too young. The mother allows surfing when the father is absent. In the structural model of family therapy, what family interactional pattern should the nurse recognize? A. Multigenerational transmission B. Disengagement C. Motherchild subsystem D. Emotional cutoff

C. Motherchild subsystem

12. A labor and delivery nurse listens to a new mother relate thoughts regarding her healthy, 8-pound baby girl. Which statement by the mother indicates to the nurse the use of the cognitive error, selective abstraction? A. My baby is refusing to nurse, and I know its because she hates me. B. My baby needs to be under the bilirubin lights, but I resent her time away from me. C. My baby is wonderful, but Im depressed because I wanted twins. D. My baby has an elevated bilirubin, and I know it will get worse and she will die.

C. My baby is wonderful, but Im depressed because I wanted twins.

1. A fatherless, 11-year-old African American girl lives with her grandmother after the death of her mother. Her older stepbrother is very involved in her life. How should the community health nurse view this family constellation, and why? A. Abnormal; the grandmother should be concerned with issues other than childrearing. B. Abnormal; a two-parent household is the most advantageous arrangement for parenting. C. Normal; cultural variations exist in the family life cycle. D. Normal; because of their wisdom, older adults make better parenting figures.

C. Normal; cultural variations exist in the family life cycle.

3. A client diagnosed with major depressive disorder with psychotic features hears voices commanding self-harm. The client refuses to commit to developing a plan for safety. What should be the nurses priority intervention at this time? A. Obtaining an order for locked seclusion until client is no longer suicidal B. Conducting 15-minute checks to ensure safety C. Placing the client on one-to-one observation while monitoring suicidal ideations D. Encouraging client to express feelings related to suicide

C. Placing the client on one-to-one observation while monitoring suicidal ideations

1. A nurse discovers a clients suicide note that details the time, place, and means to commit suicide. What should be the priority nursing intervention and the rationale for this action? A. Administering lorazepam (Ativan) prn, because the client is angry about the discovery of the note B. Establishing room restrictions, because the clients threat is an attempt to manipulate the staff C. Placing this client on one-to-one suicide precautions, because the more specific the plan, the more likely the client will attempt suicide D. Calling an emergency treatment team meeting, because the clients threat must be addressed

C. Placing this client on one-to-one suicide precautions, because the more specific the plan, the more likely the client will attempt suicide

5. In a family that is in the life cycle stage called The Family with Adolescents, which changes must occur for the family to proceed developmentally? A. Making adjustments within the marital system to meet the responsibilities of parenthood B. Establishing a new identity as a couple by realigning relationships with extended family C. Redefining the level of dependence so that adolescents are provided with greater autonomy D. Reestablishing the bond of the dyadic marital relationship

C. Redefining the level of dependence so that adolescents are provided with greater autonomy

18. When using a cognitive approach, a nurse would include which point in teaching a client about panic disorder? A. You might want to stay in the house when you notice the symptoms beginning. B. Medications such as lorazepam (Ativan) should be taken when symptoms start. C. Remind yourself that symptoms of a panic attack are time limited and will end. D. Keep a journal in order to note feelings surrounding the panic attacks.

C. Remind yourself that symptoms of a panic attack are time limited and will end.

5. A client reports, My friend panicked at the site of spiders. Her therapist used gradual exposure to spiders that initially made her increasingly more anxious. Which technique was the friends therapist most likely using? A. Extinction B. Covert sensitization C. Systematic desensitization D. Reciprocal inhibition

C. Systematic desensitization

7. A 30-year-old client seeking therapy states, My mom cries when she is not included in all my social activities and thinks of my friends as her own. How would the nurse describe the boundaries between this familys parent and child subsystems? A. The boundaries are rigid. B. The boundaries are restructured. C. The boundaries are enmeshed. D. The boundaries are disengaged.

C. The boundaries are enmeshed.

11. A client experienced bradycardia during electroconvulsive therapy (ECT). A nurse assigns a nursing diagnosis of decreased cardiac output R/T vagal stimulation occurring during ECT. Which outcome would the nurse expect the client to achieve? A. The client will verbalize an understanding of the need for moving slowly after treatment. B. The client will maintain an oxygen saturation level of 88% 1 hour after treatment. C. The client will continue adequate tissue perfusion 1 hour after treatment. D. The client will verbalize an understanding of common side effects of ECT.

C. The client will continue adequate tissue perfusion 1 hour after treatment.

23. A client is newly admitted to an inpatient psychiatric unit. Which of the following is most critical to assess when determining risk for suicide? A. Family history of depression B. The clients orientation to reality C. The clients history of suicide attempts D. Family support systems

C. The clients history of suicide attempts

9. A client has undergone psychological testing. With which member of the interdisciplinary team should a nurse collaborate to review these results? A. The psychiatrist B. The psychiatric social worker C. The clinical psychologist D. The clinical nurse specialist

C. The clinical psychologist

11. A nurse believes that the members of a parenting group are in the initial, or orientation, phase of group development. Which group behaviors would support this assumption? A. The group members manage conflict within the group. B. The group members use denial as part of the grief response. C. The group members compliment the leader and compete for the role of recorder. D. The group members initially trust one another and the leader.

C. The group members compliment the leader and compete for the role of recorder.

13. During hospitalization, an attention-seeking client has repeatedly cut herself. After threatening to cut herself again, the nurse states, Here are some Band-Aids so you wont bleed on the sheets. Which is the underlying reason for this nurses response? A. The nurse is using an aversive stimulus in response to the clients manipulative cutting behavior. B. The nurse is using negative reinforcement in response to the clients behavior. C. The nurse is minimizing reinforcement of the clients manipulative behavior with the goal of extinction. D. The nurse lacks empathy for the clients recurring self-injurious behavior.

C. The nurse is minimizing reinforcement of the clients manipulative behavior with the goal of extinction.

3. During a therapeutic group, which nursing action demonstrates a laissez-faire leadership style? A. The nurse mandates that all group members reveal an embarrassing personal situation. B. The nurse asks for a show of hands to determine group topic preference. C. The nurse sits silently as the group members stray from the assigned topic. D. The nurse shuffles through papers to determine the facility policy on length of group.

C. The nurse sits silently as the group members stray from the assigned topic.

10. A client who is learning about electroconvulsive therapy (ECT) asks a nurse, Isnt this treatment dangerous? Which is the most appropriate nursing reply? A. No, this treatment is side-effect free. B. There can be temporary paralysis, but full functioning returns within 3 hours of treatment. C. There are some risks, but a thorough examination will determine your candidacy for ECT. D. Transient ischemic attacks (TIAs) can occur but are rare.

C. There are some risks, but a thorough examination will determine your candidacy for ECT.

8. A nursing instructor is teaching about the medications given prior to and during electroconvulsive therapy (ECT). Which student statement indicates that learning has occurred? A. Atropine (Atro-Pen) is administered to paralyze skeletal muscles during ECT. B. Succinylcholine chloride (Anectine) decreases secretions to prevent aspiration. C. Thiopental sodium (Pentothal) is a short-acting anesthesia to render the client unconscious. D. Glycopyrrolate (Robinul) is given to prevent severe muscle contractions during seizure.

C. Thiopental sodium (Pentothal) is a short-acting anesthesia to render the client unconscious.

1. A nurse administers pure oxygen to a client during and after electroconvulsive therapy. What is the nurses rationale for this procedure? A. To prevent increased intracranial pressure resulting from anoxia B. To prevent hypotension, bradycardia, and bradypnea due to electrical stimulation C. To prevent anoxia due to medication-induced paralysis of respiratory muscles D. To prevent blocked airway resulting from seizure activity

C. To prevent anoxia due to medication-induced paralysis of respiratory muscles

7. The treatment team is making a discharge decision regarding a previously suicidal client. Which client assessment information should a nurse recognize as contributing to the teams decision? A. No previous admissions for major depressive disorder B. Vital signs stable; no psychosis noted C. Able to comply with medication regimen; able to problem-solve life issues D. Able to participate in a plan for safety; family agrees to constant observation

D. Able to participate in a plan for safety; family agrees to constant observation

8. A nurse enters an inpatient room and finds the family disagreeing about the clients living arrangements after discharge. Which information should the nurse provide when teaching techniques to resolve family conflicts? A. All family members should use past incidents to make their point. B. One family member should act as a gatekeeper in order to avoid family confrontation. C. One family member should act as a compromiser to preserve harmony in the family system. D. All family members should respect differing opinions and use compromise and negotiation.

D. All family members should respect differing opinions and use compromise and negotiation.

8. The family of a suicidal client is very supportive and requests more facts related to caring for their family member after discharge. Which information should the nurse provide? A. Address only serious suicide threats to avoid the possibility of secondary gain. B. Promote trust by verbalizing a promise to keep suicide attempt information within the family. C. Offer a private environment to provide needed time alone at least once a day. D. Be available to actively listen, support, and accept feelings.

D. Be available to actively listen, support, and accept feelings.

16. When asked to identify principles that define the term maladaptive behavior, which nursing student statement indicates that further teaching is needed? A. Behavior is maladaptive when it is age inappropriate. B. Behavior is maladaptive when it interferes with adaptive functioning. C. Behavior is maladaptive when it is identified as inappropriate in the context of ones culture. D. Behavior is maladaptive when it results in change within an otherwise stable subsystem.

D. Behavior is maladaptive when it results in change within an otherwise stable subsystem.

17. A nursing instructor is teaching about suicide. Which student statement indicates that learning has occurred? A. Suicidal threats and gestures should be considered manipulative and/or attention-seeking. B. Suicide is the act of a psychotic person. C. All suicidal individuals are mentally ill. D. Fifty to eighty percent of all people who kill themselves have a history of a previous attempt.

D. Fifty to eighty percent of all people who kill themselves have a history of a previous attempt.

6. During a one-to-one session with a client, the client states, Nothing will ever get better, and Nobody can help me. Which nursing diagnosis is most appropriate for a nurse to assign to this client at this time? A. Powerlessness R/T altered mood AEB client statements B. Risk for injury R/T altered mood AEB client statements C. Risk for suicide R/T altered mood AEB client statements D. Hopelessness R/T altered mood AEB client statements

D. Hopelessness R/T altered mood AEB client statements

5. An advanced practice nurse recommends that a client participate in cognitive therapy. The client asks, Whats cognitive therapy and how can it help me? Which is the nurses most appropriate reply? A. It is a system of techniques in which you use positive thinking to improve your mood. B. It is a long-term interpersonal approach that emphasizes the role of early childhood experiences. C. It is an interpersonal treatment approach that specifically targets magical thinking. D. It is a type of psychotherapy that focuses treatment on the modification of distorted thinking and maladaptive behaviors.

D. It is a type of psychotherapy that focuses treatment on the modification of distorted thinking and maladaptive behaviors.

14. A nursing instructor is teaching students about self-help groups like Alcoholics Anonymous (AA). Which student statement indicates that learning has occurred? A. There is little research to support AAs effectiveness. B. Self-help groups used to be the treatment of choice, but their popularity is waning. C. These groups have no external regulation, so clients need to be cautious. D. Members themselves run the group, with leadership usually rotating among the members.

D. Members themselves run the group, with leadership usually rotating among the members.

1. A kindergarten rule states that if unacceptable behavior occurs, a childs personalized fish will be moved to the sea grass. Children who behave keep their fish out of the sea grass. The school nurse should identify this intervention as based on which principle of behavior therapy? A. Classical conditioning B. Conditioned response C. Positive reinforcement D. Negative reinforcement

D. Negative reinforcement

11. During family counseling a husband states, Every time my wife and I discuss child discipline, we get into shouting matches. The nurse instructs the couple to shout at each other for 2 weeks on Tuesdays and Thursdays for 30 minutes. What intervention is the nurse using? A. Reframing B. Restructuring the family C. Expressive psychotherapy D. Paradoxical intervention

D. Paradoxical intervention

7. A nurse administers ordered preoperative glycopyrrolate (Robinul) 30 minutes prior to a clients electroconvulsive therapy (ECT) procedure. What is the rationale for administering this medication? A. Robinul decreases anxiety during the ECT procedure. B. Robinul induces an unconscious state to prevent pain during the ECT procedure. C. Robinul prevents severe muscle contractions during the ECT procedure. D. Robinul decreases secretions to prevent aspiration during the ECT procedure.

D. Robinul decreases secretions to prevent aspiration during the ECT procedure.

13. A client admitted to a Veterans Administration (VA) hospital with a diagnosis of major depressive disorder tells the nurse, I failed my battalion by giving the wrong order. Fortunately, no one was injured. Which nursing diagnosis should the nurse assign to this client? A. Chronic low self-esteem B. Risk for self-directed violence C. Powerlessness D. Situational low self-esteem

D. Situational low self-esteem

8. Parents decide to try the nurse practitioners suggestion of time out when their child misbehaves. What teaching should the nurse practitioner provide the parents? A. Correct your childs behavior by spanking for a specified time period. B. Ignore the childs negative behavior. C. Add positive reinforcement for acceptable behavior. D. Temporarily move your child to an area where behavior is not being reinforced.

D. Temporarily move your child to an area where behavior is not being reinforced.

2. During the planning of care for a suicidal client, which correctly written outcome should be a nurses first priority? A. The client will not physically harm self. B. The client will express hope for the future by day 3. C. The client will establish a trusting relationship with the nurse. D. The client will remain safe during the hospital stay.

D. The client will remain safe during the hospital stay.

14. A couple has been married for 20 years. They argue constantly, belittle feelings, and continuously contradict each other. During a therapy session, the nurse documents Marital schism. What does the nurse mean by this documentation? A. The couple has a compatible marriage relationship. B. The husband has a dominant relationship over the wife. C. The couple has an enmeshed relationship. D. The couple has an incompatible marriage relationship

D. The couple has an incompatible marriage relationship

13. Which group leader activity should a nurse identify as being most important in the final, or termination, phase of group development? A. The group leader establishes the rules that will govern the group after discharge. B. The group leader encourages members to rely on each other for problem solving. C. The group leader presents and discusses the concept of group termination. D. The group leader helps the members to process feelings of loss.

D. The group leader helps the members to process feelings of loss.

4. A depressed 21-year-old client has lived with his mother ever since the death of his father 3 years ago. After the client received a college acceptance, the mother repeatedly states, Thats wonderful. Ill be fine all alone. How would the nurse interpret the mothers statements? A. The mother is withholding supportive messages. B. The mother is expressing denigrating remarks. C. The mother is communicating indirectly. D. The mother is using double-bind communication.

D. The mother is using double-bind communication.

2. A psychiatric nurse is counseling a client who has thought patterns consisting of rapid responses to a situation without rational analysis. What assessment data will the nurse document on this client? A. Thought patterns are triggered by specific stressful stimuli. B. Thought patterns contain the clients fundamental beliefs and assumptions. C. Thought patterns are flexible and based on personal experience. D. Thought patterns include a predominance of automatic thoughts.

D. Thought patterns include a predominance of automatic thoughts.

11. During a smoking cessation group, the community health nurse explains that in their effort to quit smoking, a reciprocal inhibition approach will be used. The nurse should give the group which example of this technique? A. Before you can smoke, you must first take a half-hour walk. B. When you have the urge to smoke, imagine being short of breath. C. Youll receive $1 for each cigarette not smoked and forfeit $2 for each cigarette smoked. D. When you have the urge to smoke, hold your breath and then rhythmically breathe.

D. When you have the urge to smoke, hold your breath and then rhythmically breathe.