300 Final Prep (Self-assessments & Quizzes)

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?

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

During a nurse-client interaction, which nursing statement may belittle the client's feelings and concerns?

"Don't worry. Everything will be alright."

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?

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

A client is trying to explore and solve a problem. Which nursing statement would be an example of verbalizing the implied?

"You seem to be motivated to change your behavior"

What is the average mortality rate with ECT (modified)?

3-4 per 100,000

A nurse should recognize which intervention as most appropriate within a behavioral therapy program?

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

When scheduling electroconvulsive therapy (ECT), which client should the nurse prioritize?

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

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 client offers recognition and acceptance of others, a client listens attentively to group interaction, a client decreases conflict within the group by encouraging compromise

The nursing staff is discussing the concept of competency. Which information about competency should a nurse recognize as true?

A competent client has the ability to make reasonable judgments and decisions.

Which of the following are accurate descriptors of a therapeutic community? (Select all that apply.)

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

Which of these interactions between a nurse and a patient utilizes a biopsychosocial model? Please choose from one of the following options.

A nurse caring for a patient with ulcers and asks questions about stress management

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 parenting group

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?

Accompanying the client to a 1-hour visit to the local zoo's spider room

Which of the following is NOT a recommended preparation for ECT?

Administration of an anticonvulsant 30 minutes before ECT

Serotonin deficiency in the CNS may result in what kind of disorder?

Aggression disorder

A lucid client diagnosed with schizophrenia regularly receives fluphenazine decanoate (Prolixin Decanoate) from a home health nurse. The client refuses medication at one regularly scheduled home visit. Which nursing intervention is ethically appropriate?

Allow the client to decline the medication and document.

Which of the following is the commonest side effect of electroconvulsive therapy (ECT)?

Amnesia

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?

Autocratic

Group therapy is strongly encouraged, but not mandatory, on an inpatient psychiatric unit. The unit manager's policy is that clients can make a choice about whether or not to attend group therapy. Which ethical principle does the unit manager's policy preserve?

Autonomy

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?

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

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?

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

A pt has symptoms of acute anxiety r/t the death of a parent in an automobile accident 2 hrs earlier. The RN should anticipate administering a med from which group?

Benzodiazepines

A client states, "I just failed my college English course. I've never failed a class before so when my parents find out they are going to disown me. They'll hate me and never forgive me for this." The nurse recognizes this client's statement as which type of automatic thought?

Catastrophic thinking

When planning group therapy, a nurse should identify which configuration as most optimal for a therapeutic group?

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

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?

Cognitive rehearsal

What do people face during each psychosocial stage that can serve as a turning point in personality development?

Conflict

A client is admitted to an ED experiencing memory deficits and decreased motor function, What alteration in brain chemistry should an RN correlate with the presentation?

Decreased levels of ACh

A new psychiatric nurse states, "This client's use of defense mechanisms should be eliminated." Which is a correct evaluation of this nurse's statement?

Defense mechanisms can be self-protective responses to stress and need not be eliminated.

An RN should recognize that a decrease in norepi levels would play a significant role in which mental illness?

Depression

A 29-year-old client living with parents has few interpersonal relationships. The client states, "I have trouble trusting people." Based on Erikson's developmental theory, which should the nurse recognize as a true statement about this client?

Developmental deficits in earlier life stages have impaired the client's adult functioning.

Which client data indicate that a suicidal client is participating in a plan for safety?

Disclosing a plan for suicide to staff

A client is admitted to a psych unit with the diagnosis of schizophrenia. Which of the client's NTs should an RN expect to be elevated?

Dopamine

A drug causes muscarinic-receptor blockade (anticholinergic). An RN will assess the pt for:

Dry mouth

Which assessment results should a nurse evaluate and report in the process of clearing a client for electroconvulsive therapy (ECT)? (Select all that apply.)

ECG, CBC values, pulmonary function study results, urinalysis

To promote self-reliance, how should a psychiatric nurse best conduct medication administration?

Encourage clients to request their medications at the appropriate times.

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.)

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

The nurse-client therapeutic relationship includes which of the following characteristics? (Select all that apply.)

Ensuring therapeutic termination, collaborating to set appropriate goals, promoting client insight into problematic behavior, meeting both the physical and psychological needs of the client

What is the priority nursing action during the orientation (introductory) phase of the nurse-client relationship?

Establish rapport and develop treatment goals.

A physically healthy, 35-year-old single client lives with parents who provide total financial support. According to Erikson's theory, which developmental task should a nurse assist the client to accomplish?

Establishing a career, personal relationships, and societal connections

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 nurse's response should be guided by which basic assumption of milieu therapy?

Every interaction is an opportunity for therapeutic intervention.

Asking at-risk individuals if they are suicidal increases the risk of acting out suicidal thoughts.

False

In the United States, most suicides occur within the African-American male population.

False

Suicide is complicated and tragic and it is often not preventable.

False

Which therapeutic communication technique is being used in this nurse-client interaction? Client: "When I am anxious, the only thing that calms me down is alcohol." Nurse: "Other than drinking, what alternatives have you explored to decrease anxiety?"

Formulating a plan of action

A brother calls to speak to his sister who has been admitted to the psychiatric unit. The nurse connects him to the community phone and the sister is summoned. Later the nurse realizes that the brother was not on the client's approved call list. What law has the nurse broken?

HIPAA

Which is the best nursing action when a client demonstrates transference toward a nurse?

Helping the client to clarify the meaning of the current nurse-client relationship

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?

Hopelessness R/T altered mood AEB client statements

According to Freud, which part of our personality are we born with that allows our basic needs to be met?

Id

What did Freud call the process through which children come to identify with their same-sex parent?

Identification

A student RN is studying the effect of the drug isocarboxazid (Marplan) on neurobiology. The student should recognize that the NT serotonin is catabolized by which enzyme?

MAO (monoamine oxidase)

A nursing student states, "The instructor gave me a failing grade on my research paper. I know it's because the instructor doesn't like me." Which cognitive error does a nurse recognize in this student's statement?

Magnification

According to Maslow's hierarchy of needs, the nursing strategies a psychiatric nurse would use to assist in meeting self-esteem needs of elderly clients would include:

Maintaining level of control and independence

Which therapeutic communication technique is being used in this nurse-client interaction? Client: "When I get angry, I get into a fistfight with my wife or I take it out on the kids." Nurse: "I notice that you are smiling as you talk about this physical violence."

Making observations

A nurse is educating a patient about the difference between mental health and mental illness. Which statement by the patient reflects an accurate understanding of mental health?

Mental health is successful adaptation to stressors in the internal and external environment.

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?

Modeling

An RN caring for a pt taking an SSRI will develop outcome criteria related to:

Mood improvement

During family counseling a child states, "I just want to surf like other kids. Mom says it's okay, but Dad says I'm 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?

Mother-child subsystem

An RN concludes that a restless, agitated client is manifesting "fight-or-flight" response. The RN should associate this response with which NT?

Norepi

People with depression often have lower than normal levels of which NTs?

Norepi, serotonin, dopamine

A nurse maintains an uncrossed arm and leg posture. This nonverbal behavior is reflective of which letter of the SOLER acronym for active listening?

O

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.

Occupational therapist, social worker, mental health technician, recreational therapist

This term refers to Freud's idea that children have an unconscious desire to possess their opposite-sex parent

Oedipus complex

Which phase of the nurse-client relationship begins when the individuals first meet and is characterized by an agreement to continue to meet and work on setting client-centered goals?

Orientation

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?

Overgeneralization

A 6-year-old boy uses his father's flashlight to explore his 3-year-old sister's genitalia. According to Freud, in which stage of psychosocial development should a nurse identify this behavior as normal?

Phallic

According to Maslow's Hierarchy of Needs, what is the first need that must be met?

Physiological

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 nurse's priority intervention at this time?

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

Which is the most significant consequence of the excessive use of defense mechanisms?

Problem-solving will be limited

A client has a history of excessive drinking, which has led to multiple arrests for driving under the influence (DUI). The client states, "I work hard to provide for my family. I don't see why I can't drink to relax." The nurse recognizes the use of which defense mechanism?

Rationalization

According to psychoanalytic theory, treatment of symptoms should involve which nursing action?

Recognizing and discussing the client's use of ego defense mechanisms

A psychiatric nurse working on an inpatient unit receives a call asking if an individual has been a client in the facility. Which nursing response reflects appropriate legal and ethical obligations?

Refusing to give any information to the caller, citing rules of confidentiality

Which of the following are included during the first phase intervention of suicidal patients? (Select all that apply.)

Remove anything that the patient may use to hurt or kill himself or herself, arrange for involuntary commitment to a healthcare facility

What is the main goal of the working phase of the nurse-client therapeutic relationship?

Resolution of the client's problems

Which therapeutic communication technique is being used in this nurse-client interaction? Client: "My father spanked me often." Nurse: "Your father was a harsh disciplinarian."

Restatement

Too much dopamine in the mesolimbic area can result in which disorder?

Schizophrenia

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 family's parent and child subsystems?

The boundaries are enmeshed

A nurse moving out of state speaks to a client about the need to work with a new nurse. The client states, "I'm not well enough to switch to a different nurse." What does this client response indicate to the nurse?

The client is having trouble terminating the relationship

A geriatric client is confused and wandering in and out of every door. Which scenario reflects the least restrictive alternative for this client?

The client is monitored by an ankle bracelet.

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?

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

A client is newly admitted to an inpatient psychiatric unit. Which of the following is most critical to assess when determining risk for suicide?

The client's history of suicide attempts

A client has undergone psychological testing. With which member of the interdisciplinary team should a nurse collaborate to review these results?

The clinical psychologist

An employee uses the defense mechanism of displacement when the boss openly disagrees with suggestions. What behavior would be expected from this employee?

The employee criticizes a coworker

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?

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

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?

The nurse notifies the client's physician of the situation and cancels the ECT.

The nurse is encouraging a child, diagnosed with autism, to verbalize needs. Which nursing intervention reflects the behavior therapy of shaping?

The nurse rewards the child incrementally as improvement in speech occurs.

What is the most essential task for a nurse to accomplish prior to forming a therapeutic relationship with a client?

To clarify personal attitudes, values, and beliefs

What is the purpose of a nurse providing appropriate feedback?

To give the client critical information

A nurse administers pure oxygen to a client during and after electroconvulsive therapy. What is the nurse's rationale for this procedure?

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

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?

Triangulation

After hearing parents discuss divorce, a 5-year-old develops behavioral problems. Upon dealing with the child's behavioral issues, the marital relationship conflict decreases. The pediatric clinic nurse should recognize that this is an example of which family system concept?'

Triangulation fusion

95% of people who commit suicide have a mental illness.

True

A hungry, homeless client, diagnosed with schizophrenia, refuses to participate in an admission interview. When the nurse postpones the admission interview, verbally assures safety, and provides a warm meal, he or she is promoting which of the following?

Trust

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 Yalom's curative group factors does this illustrate?

Universality

When assessing how well a client has managed to meet Maslow's fourth-level needs related to self-esteem, the nurse would consider the individual's

competence

Self-actualization refers to:

the motivation to develop to one's full potential as a human being

Which nursing statement about the concept of neuroses is most accurate?

"An individual experiencing neurosis feels helpless to change his or her situation."

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?

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

A nursing instructor is teaching about electroconvulsive therapy (ECT). Which student statement indicates that learning has occurred?

"ECT induces a grand mal seizure."

A newly admitted client asks, "Why do we need a unit schedule? I'm not going to these groups. I'm here to get some rest." Which is the most appropriate nursing reply?

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

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?

"Healthy family-member expectations should be conforming."

Which statement describes achievement of Erikson's generativity versus stagnation developmental stage?

"I've been a girl scout leader for troop 259 for 7 years."

Which nursing statement about the concept of psychoses is most accurate?

"Individuals experiencing psychoses experience little distress."

After undergoing two of nine electroconvulsive therapy (ECT) procedures, a client states, "I can't even remember eating breakfast, so I want to stop the ECT." Which is the most appropriate nursing reply?

"It is within your right to discontinue the treatments, but let's talk about your concerns."

A suicidal client says to a nurse, "There's nothing to live for anymore." Which is the most appropriate nursing reply?

"It sounds like you are feeling pretty hopeless."

The healthcare provider is counseling a patient who is diagnosed with depression. Which of the following statements made by a patient should the healthcare provider recognize as a sign of transference?

"It's amazing how much you remind me of my favorite teacher."

A depressed client states, "I have a chemical imbalance in my brain. I have no control over my behavior. Medications are my only hope to feel normal again." Which RN response is appropriate?

"Medications are one way to address chemical imbalances. Environmental and interpersonal factors can also have an impact on biological factors."

A nursing instructor is teaching students about self-help groups like Alcoholics Anonymous (AA). Which student statement indicates that learning has occurred?

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

A client diagnosed with paranoid schizophrenia becomes agitated when asked to play a game. The client responds, "Do you want to be my girlfriend!?" Which nursing response is most appropriate?

"Remember, we have a professional relationship. Are you feeling uncomfortable?"

Which client statement indicates that termination of the therapeutic nurse-client relationship has been handled successfully?

"Reviewing the changes that have happened during our time together has helped me put things in perspective."

Which statement reflects a student nurse's accurate understanding of the concepts of mental health and mental illness?

"The concepts are multidimensional and culturally defined."

A nursing student is observing an electroconvulsive therapy (ECT) procedure. The student notices a blood pressure cuff on the client's lower leg. The student questions the instructor about the cuff placement. Which is the most accurate instructor reply?

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

A client diagnosed with MDD asks, "What part of my brain controls my emotions?" Which RN response is appropriate?

"The limbic system is largely responsible for one's emotional state."

A client who is learning about electroconvulsive therapy (ECT) asks a nurse, "Isn't this treatment dangerous?" Which is the most appropriate nursing reply?

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

A student nurse is learning about the appropriate use of touch when communicating with clients diagnosed with psychiatric disorders. Which statement by the instructor best provides information about this aspect of therapeutic communication?

"Touch carries a different meaning for different individuals."

Which example of a therapeutic communication technique would be effective in the planning phase of the nursing process?

"We've discussed past coping skills. Let's see if these coping skills can be effective now."

As the client and nurse move from the orientation stage to the working stage of the therapeutic relationship, which is the nurse's most therapeutic statement?

"Which identified problems would you like for us to initially address?"

Devastated by a divorce from an abusive husband, a wife completes grief counseling. Which statement by the wife should indicate to a nurse that the client is in the acceptance stage of grief?

"Yes, it was a difficult relationship, but I think I have learned from the experience."

A client has made the decision to leave her alcoholic husband. She is feeling very depressed. Which nontherapeutic statement by the nurse conveys sympathy?

"You are feeling very depressed. I felt the same way when I decided to leave my husband."

A client tells the nurse, "I feel bad because my mother does not want me to return home after I leave the hospital." Which nursing response is therapeutic?

"You feel that your mother does not want you to come back home?"

Which client should a nurse identify as a potential candidate for involuntarily commitment?

A client threatening to commit suicide

Which situation contradicts the ethical principle of veracity?

A nurse tricks a client into seclusion by asking the client to carry linen to the seclusion room.

Immediately after an initial electroconvulsive therapy (ECT) procedure, a client states, "I'm not hungry and just want to stay in bed and sleep." On the basis of this information, which is the most appropriate nursing intervention?

Allow the client to remain in bed.

Utilizing Maslow's Hierarchy of Needs, the nurse gives priority to which of the following nursing diagnoses?

Altered nutrition: less than body requirements

Which is an example of the ego defense mechanism of regression?

An adult throws a temper tantrum when he does not get his way

A 26 month old child displays negative behavior, refuses toilet training, and often shouts No! when given directions. Using Freuds stages of psychosexual development, an RN would assess the child's behavior is based on which stage?

Anal

A college student is hospitalized after suicide attempt. During an interview, the father reveals that his ex-wife was punitive and scolded his daughter during toilet training. Freud would describe this student as fixated in which stage of psychosocial development?

Anal

A patient is obsessed with cleanliness and control. On which stage of Freud's Stages of Psychosexual Development has the patient become fixated?

Anal stage

A nursing student is developing a plan of care for a suicidal client. Which of the following should the student implement first?

Assess suicide risk.

A client with a history of a suicide attempt has been discharged and is being followed in an outpatient clinic. At this time, which is the most appropriate nursing intervention for this client?

Assist the client to develop more effective coping mechanisms.

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?

Extended family living arrangements are common in some cultures.

Once a depressed suicidal patient's safety has been assessed and assured, the use of an antidepressant remains contraindicated.

False

Which should the nurse recognize as a DSM-5 disorder?

Generalized anxiety disorder (NOT obesity, HTN, or grief)

If an individual is "two-faced," which characteristic essential to the development of a therapeutic relationship should a nurse identify as missing?

Genuineness

Which of the following activities are associated with suicidal potential? (Select all that apply.)

Getting the house and affairs together, writing a suicide note, unexpectedly visiting friends and family members, making a will, purchasing a gun, hose, or rope

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 nurse's priority at this time?

Increase frequency of client observation.

A 10 yr old child wins the science fair competition and is chosen as a cheerleader for the basketball team. An RN should recognize that this child is in the process of successfully accomplishing which stage of Erikson's developmental theory?

Industry vs inferiority

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 Yalom's curative group factors does this illustrate?

Instillation of hope

The RN would evaluate that an 85 yr old pt who displays satisfaction in a life well lived is adapting to the need for:

Integrity vs despair

A jilted college student is admitted to a hospital following a suicide attempt and states, "No one will ever love a loser like me." According to Erikson's theory of personality development, a nurse should recognize a deficit in which developmental stage?

Intimacy versus isolation

A married 26 yr old client works as a schoolteacher. She and her husband have just had their 1st child. An RN should recognize that this client is successfully accomplishing which stage of Erikson's developmental theory?

Intimacy vs isolation

An inpatient psychiatric physician refuses to treat clients without insurance and prematurely discharges those whose insurance benefits have expired. Which violation of an ethical principle should a nurse recognize in this situation?

Justice

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?

Paradoxical intervention

A teenage boy is attracted to a female teacher. Without objective evidence, a school nurse overhears the boy state, "I know she wants me." This statement reflects which defense mechanism?

Projection

A mental health technician asks the nurse, "How do psychiatrists determine which diagnosis to give a patient?" Which of these responses by the nurse would be most accurate?

Psychiatrists use pre-established criteria from the APA's Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

A process by which NT molecules detach from a postsynaptic neuron and are reabsorbed by a presynaptic neuron so they can be recycled and used again

Reuptake

A nurse administers ordered preoperative glycopyrrolate (Robinul) 30 minutes prior to a client's electroconvulsive therapy (ECT) procedure. What is the rationale for administering this medication?

Robinul decreases secretions to prevent aspiration during the ECT procedure.

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.)

Schizoaffective disorder, bipolar 1 disorder: manic episode, major depressive disorder

Which client should an RN associate with a decrease in GABA?

Schizophrenia

In the role of milieu manager, which activity should the nurse prioritize?

Searching newly admitted clients for hazardous objects

Which of the following conditions would place a client at risk for injury during electroconvulsive therapy (ECT)? (Select all that apply.)

Severe osteoporosis, recent CVA, acute and chronic pulmonary disorders

Our needs for belonging, love, and affection best fall under which category according to Maslow's Hierarchy of Needs

Social needs

An inpatient client, whom the treatment team has determined to be a danger to self, gives notice of intention to leave the hospital. What information should the nurse recognize as having an impact on the treatment team's next action?

State law determines how long a psychiatric facility can hold a client

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?

Stress management

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?

Structured programming

If a child struggles to do well in school, what problem might emerge?

Struggle with feelings of inferiority

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?

Suicide assessment must continue throughout the ECT course.

According to Freud, which part of our personality is the moral part that develops due to the moral and ethical restraints placed on us by our caregivers?

Superego

The nurse should utilize which group function to help an extremely withdrawn, paranoid client increase feelings of security?

Support

Which part of the nervous system should an RN identify as playing a major role during stressful situations?

Sympathetic nervous system

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 friend's therapist most likely using?

Systematic desensitization

The id, ego, and superego can be best characterized as which of the following?

Systems that make up personality

Without authorization, a nurse administers an extra dose of narcotic tranquilizer to an agitated client. The nurse's coworker observes this action but does nothing for fear of repercussion. What is the ethical interpretation of the coworker's lack of involvement?

Taking no action is still considered an action by the coworker.

A clinic nurse is caring for a 40-year-old client who lives with his parents. The client's mother continues to do the client's laundry and provides spending money. Based on this situation, which family dynamic does the nurse recognize?

Taking over

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?

The group role of aggressor

A husband accuses his wife of infidelity. Which situation would indicate to the nurse the husband's use of the ego defense mechanism of projection?

The husband has already admitted to having an affair with a coworker

During family counseling, a husband tells his wife to spend more time with the family, and she responds by stating, "Okay, I'll turn in my resignation tomorrow." The husband replies, "I knew it! You've always been a quitter!" How should the nurse interpret the husband's statement?

The husband is expressing double-bind communication

During family therapy a female patient complains that her husband only meets his sexual needs and never hers. According to Freud, which personality structure should an RN identify as predominantly driving the husband's actions?

The id

Which cerebral structure should a RN instructor describe as the "emotional brain"?

The limbic system

A nurse is caring for a client who has threatened to commit suicide by hanging. The client states, "I'm going to use a knotted shower curtain when no one is around." Which information would determine the nurse's plan of care for this client?

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

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?

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

Which of the following statements should a nurse recognize as true about defense mechanisms? (Select all that apply)

They are mechanisms that are characteristically self-deceptive, they are employed when there is a threat to psychological integrity, they are used in an effort to relieve mild to moderate anxiety

A 26-month-old child displays negative behaviors. The parent says, My child refuses toilet training and shouts, No! when given direction. What do you think is wrong? Select the nurse's best reply.

This is normal for your child's age. The child is striving for independence.

Antidepressants have been linked to development of suicidal thoughts.

True

Any question of suicide also must be coupled with an inquiry into the person's potential for homicide.

True

In adolescents and young adults, suicide constitutes 1 of the top 3 causes of death.

True

Maslow believed that basic needs should be met in order to move to a higher level

True

Psychotherapy such as CBT and Talk therapy are indicated for suicidal patients.

True

Suicide is ranked as the 10th leading cause of death overall in the US.

True

When is self-disclosure by the nurse appropriate in a therapeutic nurse-client relationship?

When it is judged that the information may benefit the client

At what point should the nurse determine that a client is at risk for developing a mental disorder?

When maladaptive responses to stress are coupled with interference in daily functioning

Which of the following information must be included during suicide risk assessment?

Whether the patient has any thoughts of hurting him or herself, patient's specific plans for accomplishing suicidal acts, patient's family history including suicide