Chap 27 Prep-U BOYD

The nurse is interviewing an 11-year-old girl diagnosed with bulimia. An appropriate question to ask the child during the initial interview is

"Are you feeling sad?"

A nursing instructor is teaching students about borderline personality disorder (BPD) and identifies a need for further instruction when a student makes which statement?

"Family members feel the need to disagree with the client with BPD to help make them resilient."

A nursing instructor is teaching about using behavioral interventions when caring for clients with borderline personality disorder. Which statement by a student indicates a need for further instruction?

"Grossly disrespectful behaviors are better ignored."

During a therapy session, a client with anorexia tells the nurse, "I measured my thighs today. They are a quarter-inch larger than they were yesterday. I feel like a pig; I'm so fat." Which of the following potential responses by the nurse is most therapeutic?

"Has something occurred that caused you to measure your thighs?"

The nurse is teaching a client with bulimia to use self-monitoring techniques. Which client statement would let the nurse know that this has been effective?

"I am learning to recognize events and emotions that trigger my binges and am working on responses other than binging and purging."

A 17-year-old client comes to the community crisis clinic with multiple superficial cuts on her wrist. She is crying uncontrollably and states that her boyfriend has left her and she doesn't want to live without him. What would be the most therapeutic initial nursing response?

"I can see that you are feeling anxious. I will stay with you until you feel better."

An 11-year-old child talks to the school nurse about a single episode of disruptive behavior in class. The child states, "I had a stomach ache and felt like vomiting. I couldn't help it. I was just so mad at my dad." Which would be the most appropriate response by the nurse?

"I can see that you're angry. Let's look at better ways to express it."

A client is being discharged from treatment for addiction to cocaine. Which statement made by the client would cause the most concern for the nurse?

"I can still hang out with my old friends. I am just not going to use."

The nurse is assessing the drinking history of a client being admitted for alcohol abuse. Which statement would the nurse expect the client to make?

"I don't really have a problem with alcohol. I've just been having a streak of bad luck lately."

A client with borderline personality disorder starts flirting with the nurse, saying he dreams about her at night and wants to kiss her. What would be the best response by the nurse?

"I feel uncomfortable with what you said. Our relationship is professional, and it will always stay that way."

The nurse is assessing a client and suspects that the client may have obsessive-compulsive personality disorder based on which statement?

"I need to have everything perfect. My life is organized down to the second."

A client with anorexia weighs less than 85% of her normal body weight. She says, "I'm so fat, I can't even get through this doorway, much less fit into any of my clothes." Which is the nurse's most therapeutic response?

"I understand what you are saying. However, you are under your ideal body weight, and it is causing you to have the medical problems that we have talked about."

A nurse is developing a nurse-client relationship with a client diagnosed with borderline personality disorder (BPD). Which statement by the nurse demonstrates that the nurse understands the client's fears of abandonment and intimacy?

"I will be seeing you during the daytime for this week." Rationale: A key to helping clients with BPD is recognizing their fears of both abandonment and intimacy as they relate to the nurse-client relationship. Informing the client of the length of this relationship allows the client to engage in, and prepare for, termination with minimal pain of abandonment. Therefore, the statement about seeing the client during the daytime for a week demonstrates understanding of this concept. The other statements are open-ended and do not address the length of the relationship

Which nursing statement is most effective in communicating a positive expectation of the client?

"I will sit here quietly with you while you eat."

The nurse has been teaching a client about bulimia. Which of the following statements by the client indicates that the education has been effective?

"I'll eat small meals and snacks regularly."

A client with borderline personality disorder says to the nurse, "I feel so comfortable talking with you. You seem to have a special way about you that really helps me." Which would be the most appropriate response by the nurse?

"I'm here to help you just as all the staff members are."

Which statement is an example of catastrophizing?

"If I fail this course, my life is over."

The mother of a 6-year-old boy with attention deficit hyperactivity disorder asks to speak to the nurse about her son's disruptive behavior. The nurse would be most therapeutic by saying which of the following?

"It must be difficult to handle your son at home."

The nurse is conducting a health promotion class on drug awareness with a group of junior high school students. Which of the following teaching points should the nurse include in this session?

"Marijuana use can result in psychological dependence, which can have a very negative effect on your life."

A 14-year-old girl is being treated for conduct disorder. She refuses to attend class today, stating that yesterday the other nurse told her she did not have to go to class if she did not want to. Which would be the best response by the nurse?

"Missing class is against the rules."

The adult children of a woman with narcissistic personality disorder meet with the therapist as part of their mother's treatment. The nurse is not surprised when the daughter makes which of the following comments that describes behavior typical of the client with this disorder?

"My mother never really seemed to see me as a person with my own thoughts and problems."

A mental health nurse is working with a client with antisocial personality disorder. The nurse has just reviewed the unit rule of one cigarette per break. While telling him about the unit rules, he asks, "Well, if I have not done anything bad all day, can I have two cigarettes instead of one?" The most therapeutic nursing response would be which of the following?

"No, only one cigarette is allowed per break time."

When documenting the mental status exam findings in the chart of a client with anorexia, the nurse notes poor judgment and insight. Which client statement would support this impression?

"Others are just trying to keep me from looking good."

The nurse is educating the parents of a client with a personality disorder. They are concerned that their 22-year-old son has never shown an interest in a romantic relationship, has no real hobbies or friends, and is happy being the only guard in a factory on the night shift. Which of the following potential comments by the nurse is accurate?

"People with schizoid personality disorder, which your son has, tend to be lifelong loners."

A 10-year-old child with Tourette's disorder is receiving haloperidol as part of his treatment plan. When assessing the child at a follow up visit, which statement by the child would lead the nurse to suspect that he is experiencing a side effect of the drug?

"Sometimes I feel like I'm so sleepy."

A client is readmitted to the substance abuse program for the second time in 6 months for alcohol abuse. On admission, he tells the nurse, "I am so ashamed." What should the nurse reply?

"Tell me what has happened since your last admission."

A client with borderline personality disorder has had 21 admissions to the mental health unit, each of which was precipitated by a suicide attempt resulting in superficial cuts. During this admission, the client has developed a relationship with a highly supportive nurse, and has progressed to having a pass to spend an afternoon in a nearby shopping mall. Later the day that the client uses the pass, the nurse is shocked when the emergency department calls to say that the client has just been brought in with multiple self-inflicted lacerations. The nurse asks a supervisor, "Everything was going well. How could this happen?" What response by the supervisor reflects an understanding of borderline personality disorder?

"The client's behavior seems personal, but it's really not. Clients with borderline personality disorder act out to relieve anxiety. I suspect having the pass provoked a great deal of anxiety."

A client who has a diagnosis of histrionic personality disorder has an established pattern of portraying herself as "the exception to the rule" in the course of her care and treatment. Today, the client has returned to the inpatient unit and has been confronted by the nurse with the fact that she neither got a pass nor told anyone that she was leaving. The client has responded, "But those rules are more for the schizophrenics and crazy people, right?" How should the nurse respond?

"The rules apply to everybody equally and you're expected to follow them."

The nurse is talking to a client with schizoid personality disorder about finding a job. Which suggestion by the nurse would be most helpful?

"There is a job posting at the hospital for a file clerk in medical records."

Which statement by the client with borderline personality disorder (BPD) is an example of catastrophizing?

"This is the most awful thing that has ever happened to me."

The wife of a client who is alcoholic asks the nurse how to respond to him in a helpful way when he is disruptive in family life. Which is the nurse's best response?

"Try to maintain a normal home environment for yourself and the children."

The nurse has been teaching the client's family about the client's eating disorder, anorexia nervosa. Which statement would indicate that teaching was effective?

"We will negotiate resolutions to family conflicts."

Which of the following statements would indicate that medication teaching for the parents of a 6-year-old child with attention deficit hyperactivity disorder (ADHD) has been effective?

"We'll be sure to record his weight on a weekly basis."

When teaching the parents of a child with attention deficit hyperactivity disorder (ADHD), which of the following statements by the parents would indicate the need for further teaching?

"We'll have him do his homework at the kitchen table with his brothers and sisters."

A nurse who provides care at an inpatient eating disorder clinic is performing an admission assessment of a young woman who has been diagnosed with anorexia nervosa. Which of the following assessment questions is most therapeutic?

"What do you think about how much you weigh right now?"

Jamie is 16 years old and her identical twin sister was just diagnosed with anorexia nervosa. Jamie tells the nurse she is concerned that she may also develop the disorder. Which of the following responses by the nurse is the most appropriate?

"While eating disorders have shown a genetic link, other factors also play a role in its development."

A client with conduct disorder starts yelling at another client and calling the client insulting names. Which is the most appropriate response by the nurse?

"Yelling at others is unacceptable. You need to let staff know you're upset."

A client with antisocial personality disorder is begging to use the phone to call his wife, even though it is against the unit rules. The client begs, "It is just this once, and she will be so hurt if I don't call her." Which would be the most appropriate response by the nurse?

"You may not use the phone to call your wife."

The nurse is caring for a client with antisocial personality disorder. Which statement is most appropriate for the nurse to make when explaining unit rules and expectations to the client?

"You'll be expected to attend group therapy each day."

The parents of an autistic child ask the nurse, "Will my child ever be normal?" Which would be the most appropriate response by the nurse?

"Your child will probably always have some autistic traits."

Personality disorders occur in approximately what percentage of the general population?

10%

In a person who abuses alcohol or is a chronic drinker, the alcohol withdrawal syndrome usually begins within which time frame from abrupt discontinuation or attempt to decrease consumption?

12 hours

The body can metabolize how much beer per hour without intoxication?

12 oz

A client with a diagnosis of antisocial personality disorder would exhibit a history of conduct disorder before which age?

15 years

An individual with which BMI would be classified as having mild anorexia nervosa?

17.4 kg/m2

A client comes to the health clinic for a physical exam. He is complaining that he is not happy with himself about being overweight. He has been depressed for several weeks. When discussing his weight goal, he asks the nurse, "What is a normal or healthy BMI?" The nurse's correct response would include which of the following?

18 to 24.9

A nurse is preparing a presentation for a group of staff nurses on personality disorders. When describing antisocial personality disorders, the nurse would explain that for a person to be diagnosed with the disorder, the person must be at least which age?

18 years

A client with alcohol abuse is to receive disulfiram. The client's last drink was at 4 PM. The client should receive the medication no earlier than at which time?

4 am Rationale: A client should not receive disulfiram until he or she has abstained from alcohol for at least 12 hours, in this case, 4 AM.

The nurse is assessing a child's fine motor skills. By which age should a child be able to dress himself with minimal assistance?

5

A client is hospitalized for anorexia nervosa and has started a refeeding protocol. After consuming a meal, the nurse would monitor the client for approximately which time frame?

60 minutes

Assessment of an 8-year-old girl reveals communication difficulties and an inability to manage age-appropriate tasks. The child undergoes standardized testing. An intelligent quotient (IQ) of which of the following would support a diagnosis of intellectual disability?

65 Rationale:

When describing intellectual disability to a group of parents, the nurse would identify which of the following intelligent quotients (or less) as the usual threshold?

70

When describing intellectual disability to a group of parents, the nurse would identify which of the following intelligent quotients (or less) as the usual threshold?

70 Rationale: The usual threshold for intellectual disability is an intelligence quotient (IQ) of 70 or less (i.e., two standard deviations below the population mean).

Which of the following is a normal Global Assessment of Functioning (GAF) score?

70-100 is considered normal

A client who has been abusing opioids for about one year has run out of the drug. The last time he used the drug was at 12 noon. The client would most likely develop signs and symptoms of withdrawal by which time?

9 PM Rationale: Signs and symptoms of opioid withdrawal begin about 8 to 12 hours after the last time of use, or in this case, between 8 PM and 12 midnight

Which of the following clients being treated for anorexia displays assessment values that warrant hospitalization?

A 25-year-old whose weight is 70% of ideal and who has a serum magnesium level 1.2 mg/dL

The etiology of personality disorders is thought to be which of the following?

A combination of psychosocial and biologic variables

The parents of a teenage girl who has just been diagnosed with anorexia nervosa are distraught at this development, stating, "We have no idea where this all came from." The anorexia nervosa client is typically what?

A high achiever who is well behaved

Wernick-Korsakoff syndrome is a neurologic condition that can result from heavy drinking. Which of the following medications is used to prevent Wernicke-Korsakoff syndrome?

Thiamine (vitamin B1)

Ground rules for nurses to follow when establishing rapport with children include what?

Accepting the child and discussing undesirable behavior

Which of the following is the underlying issue in kleptomania?

Act of stealing

Which of the following behavioral patterns noted in clients diagnosed with borderline personality disorder (BPD) are associated with learned helplessness?

Active passivity

A client's history reveals that he continues to use cocaine despite the negative consequences. The nurse identifies this as which of the following?

Addiction

After teaching a group of students about borderline personality disorder, the instructor determines that the education was successful when the group identifies that symptoms typically begin in which age group?

Adolescence

A client comes to the clinic for a follow-up visit. The client refuses to hold a conversation with the primary nurse seen last time and appears somewhat angry. Just the day before, the same client saw the same nurse in the grocery store and was so excited that he ran up to her and gave her a big bear hug. This change in behavior is an example of which of the following?

Affective instability

Which of the following is a core characteristic of BPD, and is evidenced by erratic emotional responses to situations with intense sensitivity to criticism?

Affective instability

While shopping in a grocery store, a client with borderline personality disorder (BPD) greets the brother of a neighbor with a great big hug. Then about five minutes later, the client walks past the brother and ignores him. The client is demonstrating which of the following?

Affective instability

Which of the following substances is abused most often in the United States?

Alcohol

Supported by research results, the mental health nurse includes alcohol-related problem assessment questions when interviewing:

All clients regardless of age and gender

The nurse is performing a history and physical examination on a client with chronic alcoholism. The client has a history of gastritis, esophagitis, elevated liver enzymes, cardiomyopathy, and pancreatitis. Which of these conditions are attributable to his history of alcohol abuse?

All the conditions are attributable to the alcohol abuse

The school nurse is evaluating a 16-year-old student who came to the office complaining of dizziness. The student is very thin and was pacing in the office while waiting to see the nurse. The nurse asks her to step on the scale. The student asks if she can go to the bathroom first to empty her bladder, stating, "That can make a big difference." The student's comment raises the nurse's suspicion that the student has;

Anorexia nervosa

Fluoxetine (Prozac) has been approved for the treatment of anorexia nervosa. Prozac is from which of the following drug classifications?

Antidepressant

Treatment of eating disorders often combines psychotherapy and psychopharmacology. Which of the following classes of medications can be used to treat eating disorders?

Antidepressants

Which of the following diagnoses is associated with a pervasive disregard for and violation of the rights of others?

Antisocial personality

The nurse is interviewing a client with a history of violence. He boasts that he "put a kid in a wheelchair" once when he was younger and has maimed others. He states, "Who cares? Life's tough." Violence and insensitivity are associated with which of the following personality disorders?

Antisocial personality disorder

Impaired attachment in infancy and childhood may manifest in which of the following ways later in life?

Anxiety and aggression

An unconscious client is admitted to the emergency department after a motor vehicle accident. The client's blood alcohol level upon admission was 1.7. The client's family soon arrives, reporting that the client is an uncle who is visiting from out of town. They cannot give much more history other than that he is a "social drinker." After being transported to the unit, the client starts sweating and has elevated vital signs. What information should the nurse request of the family?

Are there other indications that the client may be a heavy drinker?

A client with dependent personality disorder has a goal to increase her problem-solving skills. Which client behavior would indicate progress toward meeting that goal?

Asking questions

A client with antisocial personality disorder uses manipulation to try leaving the unit with another client's family members after visiting hours. Which of the following interventions is best to deal with the manipulative behavior?

Assist the client to identify patterns of behavior and consequences as determined by the team plan.

A nurse is providing care to a client with borderline personality disorder. When providing for the client's biopsychosocial needs, the nurse would address which of the following in the biologic domain?

Assisting with sleep measures

Which phenomenon may contribute to the genetic transmission of psychiatric disorders?

Assortative mating

A child is diagnosed with attention deficit hyperactivity disorder and is to receive pharmacologic therapy. Which of the following would the nurse expect to be prescribed as a first line agent?

Atomoxetine

The child psychiatric assessment differs from that of adults in which of the following ways?

Attention to developmental milestones

A client is being treated on the inpatient unit for alcoholism. Disulfiram (Antabuse) has been prescribed for a client receiving treatment for alcoholism. Which of the following should be included in the client's plan of care?

Avoid all products containing alcohol

The nurse understands that before a client with an eating disorder can accept her body image, she must first learn effective coping skills. Which statement best describes the relationship between body image and coping skills?

Being able to cope in healthy ways improves the ability to accept a realistic body image.

Which of the following pieces of data obtained during an assessment would cause the nurse to consider a child at risk for a psychiatric disorder?

Being raised by a mother with depression

Teenagers receiving treatment for psychiatric disorders can at times act suspicious and skeptical. The nurse understands what as a major reason for this type of behavior?

Belief that they will be blamed for their problems

Safe alcohol withdrawal usually is accomplished with the administration of which medication classification?

Benzodiazepines

Which of the following agents would be helpful in alleviating the physical complications associated with alcohol withdrawal?

Benzodiazepines

A client is an overweight 32-year-old man who regularly binges on large amounts of food. After he binges, Brandon feels guilty and ashamed about eating the food. Despite the bad feelings, Brandon binges almost daily. Which of the following would the nurse most likely suspect?

Binge eating disorder

A 15-year-old female is admitted for treatment of anorexia nervosa. Which is characteristic of anorexia nervosa?

Body weight less than normal for age, height, and overall physical health

A client is admitted to the mental health unit after his wife brings him to the emergency department. Upon arrival the wife explained that her husband had been crying all weekend and stating that he wanted to die. Upon further assessment the wife reports that her husband always has difficulty controlling his anger, and frequently worries that she will leave him. Recently, he has been getting drunk every night, which he never used to do. What diagnosis should the nurse suspect applies to this patient?

Borderline personality disorder

The nurse is counseling a 35-year-old man with a personality disorder. He states that his problems are not his fault and that he is a victim of circumstances and "fate." The nurse recognizes that clients who tend to view themselves as victims and assume little responsibility for their problems may have which of the following personality disorders?

Borderline personality disorder

Which of the following would the nurse expect to implement first for a child diagnosed with encopresis?

Bowel catharsis

A client is suspected of having anorexia nervosa and meets the diagnostic criteria for the disorder. When conducting the physical examination, which of the following would the nurse most likely assess?

Bradycardia Rationale: Associated physical exam findings include cold intolerance, complaints of constipation and abdominal pain, hypotension and bradycardia.

The nurse is assisting a child with ADHD to complete his ADLs. Which is the best approach for nurse to use with this child?

Break tasks into small steps.

While a nurse talks to the mother of a 15-year-old girl, the mother expresses concern over her daughter's eating and exercise habits. The mother says that as soon as her daughter comes home from school, she exercises for two to three hours every day. She says her daughter eats very little at dinner, but in the morning she notices that large amounts of food are missing from the kitchen. Her daughter was complaining of tooth pain, and when the mother took her to the dentist, her daughter had over 10 cavities. Which of the following disorders is her daughter most likely suffering from?

Bulimia nervosa

A nurse is working in an intensive care unit and observes that some clients do not respond to injections of diazepam (Valium) when the injections are given by another nurse. That nurse returns from lunch exhibiting slurred speech and euphoria. Which of the following is the best action for the ICU nurse to take?

Call the manager and report the observations.

A client with a personality disorder is upset and calls the nurse a "stupid cow". Which of the following is the most effective initial response to this client's behavior?

Calmly discuss the inappropriateness of displacing anger to others.

The nurse is counseling a 28-year-old client, Carol, with avoidant personality disorder. Carol has a good job and can superficially participate in social situations; however, she avoids them to the extent possible and frequently is anxious and lonely. Carol would like to accept a job promotion and eventually have a husband and family, but she can't because of the symptoms associated with avoidant personality disorder. Which of the following therapeutic goals does the nurse establish as a priority?

Carol will experience increased self-esteem.

A personality disorder is defined as a collection of personality traits that is what?

Causing behavioral dysfunction and inner distress

One of the biosocial theories of the etiology of borderline personality disorder involves the role of an invalidating environment, a social situation that negates private emotional responses and communication. The most severe form of invalidation occurs in which of the following situations?

Child sexual abuse

When completing a biopsychosocial psychiatric assessment of a child, which of the following would be included in the developmental assessment?

Child's Apgar score Rationale: A developmental assessment includes the child's Apgar score, language, mother's pregnancy and delivery, and physical maturation. When assessing attachment and temperament or significant behavior patterns, attachment, concentration, excitability, responses to discipline, and eating patterns are evaluated

A 30-year-old woman is in therapy for bulimia, depression, and anxiety. She relates that she feels unable to cope with the demands of her job and that her boyfriend recently ended their long-term relationship. She states that she frequently binges when her stress levels are high. She denies feeling suicidal but states, "I'm a mess. I'm just not smart enough to figure out how to run my life!" Which of the following nursing diagnoses would best identify the client's problems?

Chronic Low Self-Esteem related to unrealistic self-expectations

When educating the public regarding substance-related disorders, the mental health nurse explains that the condition of drug dependence is a state defined as:

Chronic or recurrent drug intoxication, characterized by psychological and physical dependence

A nurse is assessing a client with borderline personality disorder. During the assessment the nurse notes that the client is using projective identification. Which of the following would support this interpretation?

Client attributes own feelings falsely to others.

The difference between clients with anorexia nervosa and bulimia nervosa is which of the following?

Clients who are anorexic are proud of their control over eating, whereas bulimic clients are ashamed of their behavior.

A nurse is explaining the differences between obsessive compulsive disorder (OCD) and obsessive compulsive personality disorder (OCPD) to a group of nursing students. Which of the following would the nurse most likely include?

Clients with OCPD are able to delay satisfaction.

Dialectical behavior therapy (DBT) combines behavior therapy with which type of therapy?

Cognitive therapy

A 35-year-old client with a diagnosis of antisocial personality disorder is being seen by a psychiatrist. He has been arrested three times for aggravated battery within the last year. Which personality disorder may have been seen in this client prior to age 18?

Conduct

To be diagnosed with antisocial personality disorder (APD) as an adult, characteristics of which mental health disorder must be met?

Conduct disorder

Which of the following is the most widely accepted theory about anorexia nervosa?

Conflicts of separation-individuation and autonomy Rationale: Historically, the most widely accepted explanation of anorexia nervosa was the psychoanalytic paradigm that focused on conflicts of separation-individuation and autonomy. Other theories address learned behavior from internalized peer pressure, changes in brain structure and neuroendocrine and neurotransmitter changes, but none of these are most widely accepted

In response to a client's manipulative behavior, the nurse should provide

Consistent limits

All of the following are behaviors associated with purging except :

Consuming large amounts of food Rationale: means the compensatory behaviors designed to eliminate food by means of self-induced vomiting or misuse of laxatives, enemas, and diuretics.

Preschoolers with disorganized attachment will display:

Contradictory behavior

When working with the client with bulimia, the nurse should be aware that the nurse's own feelings and needs may affect care. Feelings that may be aroused in the nurse may include what?

Control Rationale: Often, nurses feel the need to offer control for a client who is helpless in controlling food, anxiety, and life.

When working with the family of a client with anorexia nervosa, which of the following issues must be addressed?

Control issues

Individuals with anorexia nervosa concentrate on which of the following body cues?

Controlling food intake

Which of the following is the most common defense mechanism used by a client diagnosed with a substance use problem?

Denial

A client was admitted to the eating disorder unit with bulimia nervosa. When the nurse assesses for a history of complications of this disorder, which of the following are expected?

Dental erosion and chronic edema

The nurse is conducting an admission assessment of a 41-year-old woman. Each time that the nurse asks the woman a question, she either defers to her husband to answer the question or provides a noncommittal answer that her husband then clarifies. Such behavior is consistent with which of the following personality disorders?

Dependent personality disorder

A nurse is developing a presentation for an adolescent community group on mental health and illness, focusing on mood disorders. Which of the following would the nurse most likely include as a major mental health issue in adolescents?

Depression

Which of the following is the most common disorder found in clients with bulimia nervosa?

Depression

Which mental health disorder is most commonly seen in a shoplifter?

Depression Rationale: Most COMMON symptoms of a compulsive shoplifter

The nurse is caring for a client diagnosed with bulimia. Which of the following would be most important for the nurse to do first?

Develop a therapeutic relationship

Which of the following is an example of a benzodiazepine?

Diazepam (Valium)

Those with borderline personality disorder (BPD) have a tendency to view things as absolute with no perception of compromise. This type of thinking would be documented as which of the following?

Dichotomous

Clients with borderline personality disorder (BPD) usually exhibit which type of thinking?

Dichotomous Rationale: Those with BPD usually exhibit dichotomous thinking, or a tendency to view things as absolute, either black or white, good or bad, with no perception or compromise

A client with an eating disorder states, "I've gained 2 pounds, so soon I'll be up by 100 pounds." The nurse interprets this as which of the following?

Dichotomous thinking

A client with borderline personality disorder (BPD) who evaluates experiences, people, and objects in terms of mutually exclusive categories (e.g., good or bad, success or failure) is demonstrating which type of thinking?

Dichotomous thinking

A nurse is presenting information to a community group about health. Which information should the nurse provide regarding calorie restriction diets at an early age in children?

Dieting at an early age may lead to the development of eating disorders.

Based on psychological theories, which of the following is believed by to be critical to understanding personality disorders?

Difficult temperament

A client is brought to the emergency department by law enforcement after suspicion of driving under the influence. A blood alcohol level is drawn and is found to be 0.10 mg%. Which of the following would the nurse expect to assess?

Difficulty coordinating movements

When teaching a client with antisocial personality disorder, which approach would be most appropriate for the nurse to use?

Direct

A client who chooses to avoid a disturbing life event (e.g., being raped) is exhibiting which type of cognitive dysfunction?

Dissociation

Which of the following occurs when thinking, feeling, or behaviors occur outside a person's awareness?

Dissociation

A child is suspected of having obsessive-compulsive disorder. Which of the following would be the first step in assessing the child?

Distinguishing between normal childhood rituals and worries and those that are pathologic

When working with a client with anorexia nervosa, which of the following nursing diagnoses is most difficult to resolve successfully?

Disturbed body image

Which nursing diagnosis would be most difficult to successfully resolve in a client who had anorexia nervosa?

Disturbed body image

It has been hypothesized that an increase in which neurotransmitter may be responsible for psychotic states seen in borderline personality disorder?

Dopamine

The ingestion of mood-altering substances stimulates which neurotransmitter pathway in the limbic system to produce a "high" that is a pleasant experience?

Dopamine

Clients diagnosed with anorexia nervosa undergo an intense physical and emotional process that overrides all physiologic body cues. This would be documented as which of the following?

Drive for thinness

The nurse is assessing a client with an eating disorder. Which personality characteristic would the nurse expect to detect when interacting with the client?

Eager to please

Which is likely to be most effective for adolescents with conduct disorder?

Early intervention

Which of the following is an important indicator of anorexia nervosa?

Early onset of menses

An infant who has regular patterns of sleeping and eating and appears to have established an emotional bond with his or her mother demonstrates which type of temperament?

Easy temperament

A client meets some (but not all) of the diagnostic criteria for anorexia nervosa. Despite having lost considerable weight, the client's weight is within the normal range. The nurse understands that based on DSM-5 criteria, this client would most likely be diagnosed with which of following?

Eating disorder not otherwise specified

A client diagnosed with schizoid personality disorder is described by family members as being

Eccentric and a loner

A child is diagnosed with encopresis. Which of the following would be most important for the nurse to do first?

Educate the parents and child about normal bowel function.

The psychiatric nurse documents that according to the cognitive development theory, a 20-year-old client who refuses to compromise and consistently demands her own way is exhibiting

Egocentric behavior

A teenager with a personality disorder has been admitted to a mental health facility. During the admission interview, the teen tells the nurse that his parents recently separated and that he is to blame. What attitude is this client exhibiting?

Egocentrism

Which of the following would be most supportive for family and friends of a client with an eating disorder?

Emotional support, love, and attention

The nurse is teaching the family of a client who has bulimia about nutritional needs. Which dietary pattern would be most helpful to assist the client in recovering from bulimia?

Encourage the entire family to engage in a balanced and regular dietary pattern.

Which of the following terms describes a lack of clear role boundaries?

Enmeshment

Which of the following is considered a part of the social domain of the biopsychosocial interventions for the client diagnosed with borderline personality disorder (BPD)?

Environmental management

The nurse caring for a child with a mental health disorder knows the importance of assessing for psychosocial development as well assessing the biologic and psychological domains. Which model is the most commonly used to assess the psychosocial development of a child?

Erikson's

The nurse formulates a nursing diagnosis of impaired social interaction related to disorganized thinking for a client with schizotypal personality disorder. What is the priority nursing intervention for this nursing diagnosis?

Establishing a one-on-one relationship with the client

Which of the following is a nursing priority when caring for the client with anorexia nervosa?

Establishing a trusting relationship

Which of the following addresses the psychological domain of biospychosocial interventions for a client with borderline personality disorder?

Establishment of personal boundaries

The nurse is caring for an adolescent female who reports amenorrhea, weight loss, and depression. Which additional assessment finding would suggest that the woman has an eating disorder?

Excessive exercise

When developing the plan of care for the family of a child with a neurodevelopmental disorder, which of the following would be least appropriate to include?

Excluding the parents from being included in the plan of care

A nurse working with a client with borderline personality disorder could establish which of the following as outcome criteria?

Experience troubling thoughts without self-mutilation.

The parents of a toddler are distraught that he has been diagnosed with autism spectrum disorder. When providing care for the child and his parents, which of the following would the nurse need to keep in mind about the etiology of this disorder?

Expression of multiple genes involved with neurogenesis seem to play a role.

Which of the following is a psychosocial explanation for the development of personality disorders?

Failure to complete a developmental task jeopardizes future personality development.

The nurse is performing a developmental assessment of a child who has just been admitted to the mental health unit. When asking the patient to pick up some sticks placed on a table, what part of the examination is the nurse performing?

Fine motor functioning

When a child is asked to draw a picture during a mental status examination, the nurse is testing which of the following?

Fine motor functioning

During a physical assessment, the nurse would recognize that there is the potential for medication-induced weight loss in a client who is being treated with which of the following medications?

Fluoxetine (Prozac) Rationale: Atypical antipsychotics are often associated with weight gain, while some antidepressants such as fluoxetine (Prozac) tend to induce weight loss.

Brain dysfunction associated with borderline personality disorder (BPD) occurs in the limbic system and which lobe of the brain?

Frontal

Brain images of people with ADHD have suggested decreased metabolism in which of the following cerebral lobes?

Frontal

Functional status is evaluated in children and adolescents using which of the following?

GAF scale Rationale: Functional status is evaluated in children and adolescents using the Global Assessment of Functioning (GAF) scale, which tallies behaviors related to school, peers, activity level, mood, speech, family relationships, behavioral problems, self-care skills, and self-concept.

After teaching a group of nursing students about intellectual ability, the instructor determines that the teaching was successful when the students identify which of the following as the most common etiology?

Genetic syndromes

What would the nurse expect to assess in a client with narcissistic personality disorder?

Grandiose and superior self-concept

The nurse is caring for a client who uses phencyclidine (PCP). PCP is classified as which type of substance?

Hallucinogen

Which would most likely be a type of behavior that would be manifested by a client who has histrionic personality disorder?

Having a tantrum if not getting enough attention

The nurse is assessing a client she suspects may have a drinking problem. She asks the client how much alcohol he drinks per day. The client replies, "The important point is that even if I have 10 drinks, I don't get drunk. I can hold my liquor." The client's reply suggests which of the following?

He has become tolerant to alcohol.

Samuel is a 6-year-old boy who has been diagnosed with autism spectrum disorder. Which of the following symptoms would you expect Samuel to display?

He spends time alone with little interest in making friends.

A Global Assessment of Functioning (GAF) score of 80 would indicate which of the following?

Healthy functioning Rationale: A score of 70 to 100 usually indicates that the child is functioning well in relation to school, peers, family, and community. A GAF score of 51 to 69 indicates moderate impairment. A score of 30 may indicate that the child is severely homicidal or suicidal and has made previous attempts

The nurse is performing the history and physical examination on a client who is being admitted for anorexia nervosa. The client, a 23-year-old woman, is 5'2" and weighs 88 lbs. The nurse assesses her history of weight gain and loss, typical daily food intake, electrolyte and other blood studies, and elimination patterns. She observes typical physical findings such as dry skin, lanugo, and brittle hair and nails. Which of the following factors is a priority for the nurse to assess next?

Heart rate and rhythm

Which section of the mental health examination focuses on level of consciousness and judgment?

Thinking and perception

The nurse is speaking with a group of newly recovering alcoholics and drug users in an outpatient rehabilitation program. Which of the following issues should the nurse raise before the clients leave for the day?

Help them to identify appropriate diversional activities.

Sandra is a 36-year-old woman who tends to be highly emotional. She strives to be the center of attention whenever other people are around. At work, she often flirts with her boss in an attempt for approval. What condition is Sandra suffering from?

Histrionic personality disorder

Which of the following occurs when a person lacks aspects of personal identity or when personal identity is poorly developed?

Identity diffusion

The nurse in charge of an inpatient psychiatric unit finds herself irritated with a client who has borderline personality disorder. Which of the following steps should the nurse take?

Ignore the feelings because clients with borderline personality disorder often test for a response.

A client has a blood alcohol level of 0.05%. The nurse would expect which behavior to occur?

Impaired judgment

When documenting observations of the behaviors exhibited by a client diagnosed with borderline personality disorder (BPD), the nurse uses terms that include?

Impulsive, self-destructive, unstable

Gambling, binge eating, and engaging in unsafe sex are examples of which of the following?

Impulsivity

After teaching a group of nursing students about different personality disorders, the instructor determines that the education was successful when the students identify which of the following as characteristic of schizotypal personality disorder?

Increased eccentricity

Which of the following nursing diagnoses would be least likely to be made when working with a client with personality disorder?

Ineffective Communication related to lack of orientation to reality

A client has been using paint thinner and glue to receive a "high." The nurse knows that these substances are

Inhalants

A nurse is conducting a presentation for a group of parents about autism spectrum disorder. When describing this condition, the nurse would identify that approximately 50% of those with this condition also experience which of the following?

Intellectual disability

During a mental status examination of a child, the nurse observes the child's sentence structure and vocabulary for a general sense of:

Intellectual functioning

A client diagnosed with anorexia nervosa has difficulty identifying feelings and responds inappropriately to cues. The nurse identifies this as an issue related to which of the following?

Interoceptive awareness

A client with borderline personality disorder (BPD) who is receiving dialectical behavior therapy as part of his treatment program is participating in a skills group. The client is learning how to be assertive and problem solve. Which type of skills group is the client involved with?

Interpersonal effectiveness skills

The nurse teaches an antisocial client to take a time-out in his room when challenged by another person instigating an argument. What is the main reason for the time-out?

It allows an opportunity for the client to regain control of emotions.

When discussing methadone treatment with a client, the nurse teaches what?

It decreases the severity of heroin withdrawal symptoms.

All of the following are positive aspects regarding methadone for heroin addiction except ...

It is available in IV form.

For which reason is it crucial for nurses to advocate for children and adolescents regarding psychiatric disorders?

It is much more difficult to diagnose psychiatric disorders in children and adolescents.

The nurse is teaching a client with paranoid personality disorder to validate ideas with another person before taking action on him. Which is the best rationale for this intervention?

It will assist the client to start basing decisions and actions on reality.

A nurse is teaching parents of a child with a disruptive behavior disorder how to use "time out." The nurse determines the education was successful when the parents identify which of the following as the first step?

Labeling the behavior

Emotional regulation skills are taught to those diagnosed with BPD to manage which of the following?

Labile moods

Which of the following is an appropriate form of exercise for a young woman being treated with an eating disorder?

Lifting weights Rationale: Rigorous aerobic exercise generally is contraindicated when weight gain is a goal. Allowing the client to engage in moderate resistance training (eg, weight lifting), however, would increase lean body mass as the client gains weight and minimize the gain in "fat weight," which is a great fear of the client

Which of the following would be consistent with the use of the Five Senses Exercise to help a client with borderline personality disorder (BPD) avoid self-destructive behaviors?

Light a scented candle Rationale: Linehan suggests using the Five Senses Exercise, which includes lighting a scented candle. The other interventions would not be soothing or beneficial

Which type of therapy is ideal for the client diagnosed with avoidant personality disorder (APD)?

Long-term therapy

A client is being treated for alcoholism. Which of the following medications is used to prevent alcohol withdrawal symptoms?

Lorazepam (Ativan)

A client who exhibits mild symptoms of a personality disorder will experience exacerbation of the symptomology when

Losing the job he's had for 6 years

While at a club, a 15-year-old boy consumed a pill handed to him by a friend. His friends brought him to the emergency room after he collapsed at the club. When the nurse takes his temperature, a reading of 105°F is obtained. The pill was most likely which of the following?

MCMA (ecstasy)

A nurse is exploring treatment options with a client addicted to heroin. Which information regarding the use of methadone is important for the nurse to include?

Methadone will meet the physical need for opiates without producing cravings for more.

ADHD is characterized by inattentiveness, overactivity, and impulsiveness. Which of the following would the nurse identify related to inattentiveness?

Missing details

A client is admitted for a drug overdose with a barbiturate. Which is the priority nursing action when planning care for this client?

Monitor respiratory function.

A client is receiving treatment for opioid toxicity. Which drug reverses opioid toxicity?

Naloxone (Narcan)

After teaching a group of students about medications used to treat ADHD, the instructor determines that the education was successful when the group identifies atomoxetine as which of the following?

Noradrenergic reuptake inhibitor

When the nurse is not informed of developmental and cultural issues related to the client's background, which of the following may be expected?

Normal patterns of behavior may be labeled as deviant, immoral, or insane.

A woman brings her 28-year-old husband into treatment. She states that he makes her produce receipts for all the household items and food that she buys and makes lists and rules for her to follow each week. He refuses to discard old items even though they have no value. She states that they have a "comfortable" income, and she can no longer accept his rigid and controlling behaviors. Based on these data, the nurse suspects that the husband has which of the following?

Obsessive-compulsive personality disorder (OCD)

Which nursing intervention would be most likely to help the client with anorexia to establish healthy eating patterns?

Offer liquid protein supplements if the client is unable to complete meal.

The nurse is counseling a family whose child has autism. When describing this condition, which of the following would the nurse most likely include?

Onset before child is 2.5 years old

After reviewing information about the various impulse control disorders, a nurse demonstrates understanding of the information by identifying which disorder as involving a persistent pattern of disobedience and argumentativeness?

Oppositional defiant disorder

While assessing the family dynamics of a client with an eating disorder, which of the following does the nurse most likely discover?

Overcontrolling parents

A nurse is assessing a client with anorexia nervosa. Which of the following would the nurse be least likely to find?

Overly oily skin

Which of the following is a typical characteristic of parents of clients diagnosed with anorexia nervosa?

Overprotect their children

A nurse caring for a client with borderline personality disorder (BPD) consistently informs the client of the length of the relationship and routinely prepares the client for termination and the end of hospitalization. Which of the following is the nurse trying to prevent?

Pain of abandonment

A client is diagnosed with a personality disorder manifested by odd, eccentric behavior. Which of the following would be associated with this manifestation?

Paranoid

James has been suspicious of other clients on the unit, is often angry at others' comments, and carries a grudge against his roommate because the roommate accidentally used James' bath towel. Which of the following personality disorders is most likely James' diagnosis?

Paranoid

Mark is a 25-year-old man who is suspicious of his friends and wife. He constantly accuses his wife of cheating on him even though she has always been faithful to him. He accuses his friends of making statements that are insulting to his character. What condition might Mark be suffering from?

Paranoid personality disorder

A client is admitted with a diagnosis of schizotypal personality disorder. Which characteristic would this client exhibit during social situations?

Paranoid thoughts

A client is admitted with a diagnosis of schizotypal personality disorder. Which characteristics would this client exhibit during social situations?

Paranoid thoughts

The most serious consequence of behaviors seen in borderline personality disorder includes which of the following?

Parasuicidal behavior

Which is the most commonly used treatment for oppositional defiant disorder?

Parent training models of behavioral interventions

Which of the following is likely the etiologic basis of the compulsive patterns seen in people with obsessive-compulsive personality disorder (OCPD)?

Parental overcontrol Rationale: The basis of the compulsive patterns seen in OCPD is parental overcontrol and overprotection that is consistently restrictive and sets distinct limits on the child's behavior.

A nurse working in a psychiatric facility for children understands the importance of meeting with parents alone after meeting with the child. Which of the following is the main reason for doing this?

Parents need to be able to speak freely without preoccupation with the child's feelings.

Which of the following disorders involves problems with forming sounds associated with speech?

Phonologic disorder

A nurse is educating a client with borderline personality disorder (BPD) on the four-square method of breathing. This client also dissociates. The nurse determines that the education was successful when the client states that he will do which of the following first?

Plant both feet firmly on the ground

Which of the following statements accurately reflects the prognosis for a client with a personality disorder?

Prognosis varies based on the degree of functional impairment and the client's motivation to change.

Which defense mechanism is used by people diagnosed with borderline personality disorder to protect their fragmented self-image?

Projective identification

Cheryl has borderline personality disorder and lives at home with her parents. She has been in the psychiatric unit for 2 weeks and is scheduled to be discharged tomorrow. Which of the following would be most therapeutic when Cheryl's parents come in to discuss discharge plans?

Provide empathy to the parents, educate them about borderline personality disorder, and discuss their concerns about caring for Cheryl when she gets home

The nurse on an inpatient psychiatric unit is developing the plan of care for a 17-year-old girl admitted with anorexia nervosa. The client's weight is 20% below normal. She engages in many rituals related to eating, asks to be weighed several times per day, and complains that her access to the bathroom is limited. The nurse develops a contract with her. The purpose of the contract is to do which of the following?

Provide the client with a feeling of responsibility and control over her behavior

Which of the following medications has been found to be worthy of a trial in clients with bulimia nervosa who have obsessive-compulsive traits?

Prozac (fluoxetine)

Upon admission, a client with a personality disorder identified the following as areas of concern for which the client would like help. According to studies, which will most likely be addressed by the health care team?

Psychological distress

An 8-year-old boy has been diagnosed with ADHD. His mother is shocked that he will be prescribed a psychostimulant, stating, "His whole problem is that he's too stimulated, not understimulated!" Which of the following facts should underlie the nurse's response to the mother?

Psychostimulants stimulate the areas of the brain that control attention, impulses, and self-regulation of behavior.

A client is being discharged on disulfiram (Antabuse). Which instruction for Antabuse should the client receive?

Read products labels carefully to avoid all products containing alcohol.

A nurse is working with an adolescent diagnosed with conduct disorder. The nurse is engaged in social skills training. If successful, which outcome would the nurse expect?

Recognition of how actions affect others

A nurse suspects a coworker is signing out narcotics for clients and is using them herself. Which action should be taken by the nurse who has these suspicions?

Report the observations to the supervisor.

When establishing a relationship with a client who has borderline personality disorder, which is most important for the nurse to do?

Respect the client's boundaries at all times.

A client is brought to the emergency department with a suspected heroin overdose. Which of the following would support this suspicion?

Respiratory depression

The immediate goal of nursing interventions in the care of a client with anorexia nervosa is which of the following?

Restoring nutritional status to normal

Which of the following would be a priority nursing diagnosis for a client diagnosed with borderline personality disorder (BPD)?

Risk for Self-Mutilation

The client with bulimia complains of feeling helpless and having a black future and says, "What's the use?" As the nurse plans the client's care, the most important priority diagnosis based on these data is what?

Risk for self-directed violence

When working with the parents of child with separation anxiety disorder, the nurse would include teaching about which of the following?

SSRIs

Susan has been admitted to the inpatient unit for treatment of borderline personality disorder. Prior to admission, she was found in her parents' bedroom, burning her arm with an iron. This injury required a brief stay in the hospital's burn unit prior to transfer to your psychiatric unit. Which of the following is your highest nursing care priority, based on the above information, for Susan during the first 24 hours of her admission?

Safety and protection from self-harm

Sandra was diagnosed with cocaine abuse at age 30. When she was 23, Sandra was diagnosed with major depressive episode, and she has continued to have depression off and on since then. Which of the following would reflect this situation?

Sandra most likely has a dual diagnosis since she has both a substance dependence and depression.

A community health nurse is planning a substance abuse prevention program. Which group would be the best target audience for the nurse to plan a program?

School-age children in an after-school program

Clients with borderline personality disorder (BPD) are usually admitted to inpatient setting because they exhibit which of the following?

Self-harm

A client has been diagnosed with bulimia. Which behavioral technique would be useful for the client?

Self-monitoring

A client in the emergency department has self-inflicted wounds on both arms. Assessment reveals that the client was diagnosed with borderline personality disorder 6 months ago, for which she has been receiving outpatient treatment. Today, she appears anxious and tells the nurse that her therapist recently announced a move to another city and that the client would need to find another therapist. What is the highest priority nursing diagnosis for this client?

Self-mutilation

Which thought process would cause a client with antisocial personality disorder to want to do everything for himself?

Sense of mistrust of others

An adult male is admitted to the inpatient detoxification unit for acute alcohol withdrawal and is experiencing diaphoresis, tachycardia, and illusions. An appropriate nursing diagnosis for the client at this time is what?

Sensory perceptual alterations related to alcohol withdrawal

People diagnosed with bulimia nervosa have lower levels of which neurotransmitter?

Serotonin

A 7-year-old boy being treated for depression will most likely be given which of the following first-line pharmacologic treatments?

Serotonin reuptake inhibitors

An adolescent female has been diagnosed with anorexia nervosa. Which of the following interventions should be included in the client's plan of care?

Set up a strict eating plan for the client

A client on an inpatient psychiatric unit has features of borderline personality disorder: She is frequently angry, has an unstable sense of herself, and is highly impulsive. She can be verbally abusive to staff, who feel manipulated by her behaviors. Which of the following interventions does the nurse determine as a priority?

Setting limits

A client who is absuing drugs is to undergo brief intervention. The nurse understands that this technique is most effective for a client who exhibits which of the following?

Short history of drug use

When performing a spiritual assessment on a child, the nurse and child discuss church attendance and practices that are most important to the child. Which domain is the nurse addressing when doing this assessment?

Social

A student nurse is assessing a client with borderline personality disorder and notes that this client has a tendency to view others and situations with extremes of "bad" or "good." The nurse documents this assessment finding as:

Splitting

When clients diagnosed with borderline personality disorder (BPD) see nurses as either all good or all bad, the client is using which primitive defense?

Splitting

A 21-year-old client admits to recently using diuretics and laxatives to lose weight quickly. She doesn't want to feel fat in her bathing suit on vacation. Her sodium level is 150 mEq/L; her potassium level is 3.2 mEq/L. She is 5' tall, weighs 100 lbs, and has lost 15 lbs in 3 weeks. Which of the following goals is a priority at this time?

Stabilize her electrolyte levels. Rationale: Restoring nutritional balance is a priority for clients with severe eating disorders. Clients who are clearly malnourished need to become physiologically stabilized until they are no longer at risk for severe medical complications related to starvation

Which of the following is a disturbance of the normal fluency and time patterning of speech?

Stuttering

A nursing student is aware that which of the following accounts for more deaths, illnesses, and disabilities across the life span than any other preventable condition?

Substance abuse disorders

Which of the following statements most accurately describes the etiology of substance-related disorders?

Substance-related disorders result from the interplay of biologic, genetic, and psychosocial factors.

Fluoxetine (Prozac) includes a black box warning concerning which of the following?

Suicidality in children and adolescents

The parents of a child with ADHD bring the child for a follow-up visit. During the visit, they tell the nurse that the child receives his first dose of methylphenidate (Ritalin) at about 7:30 AM every morning before leaving for school. The teacher and school nurse have noticed a return in the child's overactivity and distractibility just before lunch. The child's second dose is scheduled for about 12 noon. Which of the following might the nurse suggest as a possible solution to control the child's symptoms a bit more effectively?

Switching to a longer acting preparation.

A 7-year-old boy experiences tics, which have become increasingly frequent in recent months. How should the nurse educate the boy's teacher to respond to his tics?

Teach the boy's classmates that his tics are not something that he can control.

The nurse is teaching a client with schizoid personality to function more comfortably with others in the community. Which nursing intervention would be effective to improve the client's social skills?

Teach the client to make necessary requests in writing or over the phone.

The nurse understands that when working with a child with a mental health problem, the family must be included in the care. Which is one of the best ways the nurse can advocate for the child?

Teach the parents age-appropriate expectations of the child.

Which is the main reason why the periodic team meetings are important when caring for a client with antisocial personality?

Team consistency is important to prevent manipulation by the client.

A nurse working with an adolescent understands the importance of using a straightforward approach and making the teenager feel in control. The nurse can best do this by which of the following?

Telling the teenager that he or she does not have to talk about anything that he or she is not ready to reveal

A parent is concerned that his child might suffer from attention deficit hyperactivity disorder (ADHD). Which of the following behaviors reported by the parent would be consistent with this diagnosis?

The child interrupts others.

After complaining of weakness and confusion while at school, a 16-year-old girl was admitted to the hospital where admission assessments revealed hypokalemia. The girl's friends and family strongly suspect that she has bulimia nervosa. In planning her nursing care and treatment, which of the following outcomes should be prioritized?

The client will be free of self-induced vomiting.

The nurse is providing care for a client who has been diagnosed with antisocial personality disorder. Which of the following outcomes should the nurse prioritize when planning this client's care?

The client will exhibit increased impulse control.

The nurse-therapist is conducting a group therapy session in which one of the participants is a male adult who has been diagnosed with narcissistic personality disorder. The nurse recognizes the significance of childhood experiences in the etiology of personality disorders, which for this client may have included what pattern?

The client's mother catered to his every need and the client used temper tantrums to successfully get his way.

After teaching a group of nursing students about kleptomania, the instructor determines that the education was successful when the students state which of the following?

The disorder is difficult to detect and treat.

A client with opioid addiction is prescribed methadone maintenance therapy. When explaining this treatment to the client, which of the following would the nurse need to keep in mind?

The drug helps to satisfy the craving for the opioid.

After teaching a group of students about the different approaches used to treat chemical dependence, the instructor determines that the education was successful when the group identifies which of the following as associated with the social approach?

The environment, not the person, is responsible.

The nurse is talking with the friend of a client with alcoholism. The friend tells the nurse that his relationship with the client was codependent and enabling. Which of the following is an example of codependent behavior?

The friend called the client every night to make sure he got home safely, and went looking for him if he was not at home.

A client is prescribed naltrexone as part of the treatment plan for alcohol and opioid abuse. When developing an education plan for the client about this drug, which of the following would the nurse need to keep in mind?

The individual should be free of opioids for at least one week.

Which of the following behaviors differentiates an individual who is believed to have bulimia nervosa from a person who has anorexia nervosa?

The person engages in episodic binge eating.

The treatment plan for which of the following clients would most likely include a family treatment approach?Those with dependent personality disorders

Those with dependent personality disorders

A technique used to help the client with borderline personality disorder (BPD) control the inappropriate expression of feelings by identifying what feelings and thoughts exist together and then engage in a distracting activity is known as what?

Thought stopping

Clients with borderline personality disorder (BPD) are usually admitted to an inpatient setting because of which of the following?

Threats of self-harm

Which is true of the time-out strategy that may be used for persons with conduct disorder?

Time-out is retreat to a neutral place, so clients can regain self-control.

When a person can ingest an increasing amount of alcohol before he or she experiences a "high" and begins to show effects on cognitive and motor skills, it is termed which of the following?

Tolerance

The nurse has been working with the family of a small child with a psychiatric disorder. The nurse is feeling very frustrated because the parents refuse to implement effective parenting skills that the nurse has taught. What is the best action for the nurse at this time?

Try to remember that the parents are trying to the best of their ability to carry out the suggestions.

A nurse is working with a client who has been diagnosed with borderline personality disorder to help manage her feelings using the communication triad. Which of the following would the nurse encourage the client to do first?

Use an "I" statement to identify the current feeling.

A nurse is conducting a class for a group of high school students about marijuana use and abuse. The nurse determines that the class needs further discussion when they state which of the following?

Use of marijuana does not lead to addiction.

The nurse is conducting an education group for women at risk for self-mutilation. What is the most important goal for this group?

Using strategies to avoid self-harm

All of the following would be included as interventions for eating disorders to establish nutritional eating patterns except:

Weighing the client twice daily

Which of the following is most often the criterion for determining the effectiveness of treatment in the client diagnosed with anorexia nervosa?

Weight gain

Shaundra was admitted to the emergency department for intoxication with alcohol. She has an unsteady gait, myopathy, and neuropathy, and cannot remember past or recent events. When treated with thiamine, her symptoms greatly improve. Shaundra is most likely suffering from ...

Wernicke-Korsakoff syndrome.

The mental health nurse is preparing a presentation about prescription drug abuse to a local community group. When describing the incidence, which age group would the nurse identify as experiencing an increase?

adolescents

The psychiatric nurse is prepared to help a stressed client diagnosed with a personality disorder to manage his inability to control his

anger

Debbie is 5 feet 6 inches tall, weighs 105 lb, exercises 4 hours per day, and does not engage in any binging or purging behaviors. She believes that she is becoming obese and states, "I'm shocked that you think I'm underweight. You don't understand me." Debbie's most likely diagnosis is:

anorexia nervosa, restricting type.

When interviewing a 12-year-old child in an outpatient psychiatric setting, the nurse can establish a high degree of credibility by:

asking about things that are important to the child.

A child born with fetal alcohol syndrome will most likely exhibit:

brain damage

A 70-year-old client comes to the clinic with her daughter for group therapy. The client wants the daughter to do everything with her, is afraid to be left alone, and is having difficulty making any decisions for herself. Interventions for this client would center around the diagnosis of which personality disorder?

dependent

Safety is the nursing priority for a client who is at risk for alcohol withdrawal. A care plan for the client who is in withdrawal must include:

observation for symptoms; vital signs; seizure and fall precautions; medications as ordered.

Which of the following is the leading cause of death in clients diagnosed with anorexia nervosa?

suicide

A client has been admitted to the inpatient unit after using inhalants recently. Which is an antidote to treat inhalant toxicity?

there is no antidote

Assessment reveals that a client with antisocial personality disorder has a difficult temperament. Which of the following would the nurse identify as being a key behavior? Select all that apply

• Aggression • Inattention • Hyperactivity • Impulsivity

Which of the following are hematologic complications associated with alcohol abuse? Select all that apply.

• Anemia • Leukemia • Hematomas

A nurse suspects that a child has oppositional defiant disorder. When reviewing the child's history, which of the following would support this suspicion? Select all that apply.

• Angry outbursts • Blaming others for problems • Disobedience

A nurse working on a unit for children with mental health issues understands the importance of assessing self-concept, even in young children. Some ways to do this when working with young children are which of the following? Select all that apply

• Asking them what they want to do when they grow up • Asking them what they would wish for • Getting them to draw

The nurse working with clients who have borderline personality disorder (BPD) understands that they need help to both recognize genuine respect from others as well as reciprocate that respect for others. How can the nurse model self-respect? Select all that apply

• Be assertive. • Observe personal limits. • Clearly communicate expectations.

A client is brought to the emergency department by a friend who tells the staff that he thinks his friend has overdosed on cocaine. Which findings would help support this suspicion? Select all that apply.

• Chest pain • Seizures • Respiratory depression • Cardiac dysrhythmia

Pharmacology used in the treatment of borderline personality disorder (BPD) controls which of the following? Select all that apply

• Cognitive disturbances • Emotional dysregulation • Anxiety • Impulsive aggression

A nurse is assessing a child who is suspected of having autism spectrum disorder. Which area would be critical to assess? Select all that apply.

• Communication • Behavior • Flexibility

A nurse is conducting an in-service program about personality disorders. When describing dependent personality disorder, which of the following would the nurse include as typical of the person's behavior in interpersonal relationships? Select all that apply.

• Compliant • Conciliatory • Placating • Overly pleasing

When addressing general intelligence during the mental status exam, which of the following components may be tested? Select all that apply

• Concentration • Vocabulary • Organization • Memory

Which of the following are effects of alcohol withdrawal syndrome? Select all that apply.

• Delirium tremens • Increased temperature • Tremors • Seizures

A client is diagnosed with anorexia nervosa, restricting type. The nurse interprets this as indicating the use of which of the following? Select all that apply.

• Dieting • Exercising

The nurse understands the importance of establishing boundaries and limitations when working with clients who have borderline personality disorder (BPD) and identifies which of the following strategies for establishing these boundaries? Select all that apply

• Document in the client's chart agreed-upon appointment expectations. • Share the treatment plan with the client. • Confront violations of the agreement in a non-punitive way

A nurse is reviewing the laboratory test results of a client who is suspected of having anorexia nervosa. Which of the following would the nurse identify as supporting this suspicion? Select all that apply.

• Elevated BUN • Low serum estrogen levels • Elevated liver function studies

When reviewing the history of a client with antisocial personality disorder, which of the following would the nurse expect to find? Select all that apply

• Episodes involving scams for personal gain • Lack of remorse for actions • Repeated incidents involving assaults

The nurse understands that which biologic factors may influence the development of an eating disorder? Select all that apply.

• Family history of eating disorders • Dysfunction of the hypothalamus • Norepinephrine imbalances • Decreased serotonin levels

Clients with borderline personality disorder commonly exhibit which of the following symptoms? Select all that apply

• Fear of abandonment • History of unstable, insecure attachments • Constant need for reassurance

Which are important points for the nurse to consider when working with clients with disruptive behavior disorders and their families? Select all that apply.

• Focus on positive actions to improve situations and/or behaviors. • Avoid a "blaming" attitude toward clients and/or families. • Remember to focus on the client's strengths and assets, as well as their problems.

Associated brain dysfunction tied to borderline personality disorder occurs in which of the following areas? Select all that apply

• Frontal lobe • Limbic system

People who are impulse-driven and have difficulty delaying gratification frequently participate in which of the following behaviors? Select all that apply

• Gambling • Shopping beyond their means • Binge eating • Abusing alcohol

The parents of a child diagnosed with ADHD ask the nurse about the Restricted Elimination Diet. When describing this diet, which of the following would the nurse include as being allowed? Select all that apply

• Gluten-free grains • Fish • Nuts

After reviewing the different types of personality disorders, a group of nursing students demonstrates understanding when they identify which of the following as being associated with emotional volatility? Select all that apply

• Histrionic • Narcissistic

A nurse is providing education to a group of parents who have children with ADHD. Which of the following statements would be accurate and should be included in the education? Select all that apply.

• It is important for parents of children with ADHD to learn how to rebuild their child's self-esteem. • Because raising a child with ADHD can be frustrating and exhausting, it often helps parents to attend support groups that can provide information and encouragement from other parents with the same problems. • ADHD is not the fault of the parents or the child, and that techniques and school programs are available to help.

Which of following are clinical characteristics of narcissistic personality disorder? Select all that apply

• Lack of empathy • Preoccupied with fantasy • Arrogance • Grandiosity

Which of the following would the nurse expect to assess in a client with a schizotypal personality disorder? Select all that apply

• Magical beliefs • Hallucination-like perceptions • Referential thinking • Unusual mannerisms

What are some examples of problems that clients with borderline personality disorder (BPD) encounter related to daily living? Select all that apply.

• Maintaining intimate relationships • Keeping a job • Living within the law

A client is experiencing severe alcohol withdrawal. Which of the following would the nurse most likely assess? Select all that apply.

• Marked diaphoresis • Auditory hallucinations

Which of the following is a response pattern of a person diagnosed with borderline personality disorder (BPD)? Select all that apply

• Mood lability • Anger issues • Impulsive behavior • Paranoid ideation • Fear of abandonment

Which of the following would a nurse assess in a client suspected of having paranoid personality disorder? Select all that apply.

• Outwardly argumentative • Needs to be in a position of power in a relationship • Suspiciousness and guarded behavior

A nurse is assessing a client diagnosed with obsessive-compulsive personality disorder (OCPD). Which of the following would the nurse expect to find? Select all that apply

• Overly moralistic • Adherence to a highly structured life • Need for perfection

The nurse is planning the type of approach that will be most effective in developing a therapeutic relationship with the client. The nurse should use a matter-of-fact approach with clients with which types of personality disorders? Select all that apply

• Paranoid • Antisocial • Narcissistic

During the mental status examination, the nurse could assess self-concept by asking the child about which of the following? Select all that apply.

• Play • Three wishes • Favorite stories • Best-liked qualities

Which are general warning signs of substance abuse that a nurse should be alert for in coworkers? Select all that apply.

• Poor work performance • Frequent absenteeism • Unusual behavior • Slurred speech • Isolation from peers

Clients with borderline personality disorder (BPD) will often engage in self-harming behaviors just as they are about to achieve a goal. Some examples of self-harming behaviors are which of the following? Select all that apply

• Pulling on one's hair • Burning finger tips • Cutting own wrists

A nurse is reviewing the history of a client diagnosed with antisocial personality disorder. Which of the following would the nurse expect to find? Select all that apply

• Rationalization for harming an individual • Inflated view of self

A nurse is reviewing the history of a client diagnosed with antisocial personality disorder. Which of the following would the nurse expect to find? Select all that apply.

• Rationalization for harming an individual • Inflated view of self

A client with borderline personality disorder will have an unstable self-image and experience "identity diffusion." Which of the following factors of identity will most likely be disturbed in this client? Select all that apply

• Role absorption • Painful incoherence • Inconsistency • Lack of commitment

Which identity factor is most commonly disturbed in a client with borderline personality disorder and identity diffusion? Select all that apply

• Role absorption • Painful incoherence • Inconsistency • Lack of commitment

When assessing a client with borderline personality disorder, which of the following behaviors would the nurse expect to find? Select all that apply

• Self-directed anger • Learned helplessness • Repeated, frequent crisis episodes • Deceptive competence

When describing the etiology of pyromania to group of nurses, which neurotransmitter would the nurse identify as being linked to this disorder. Select all that apply

• Serotonin • Norepinephrine Rationale: Early research demonstrated low serotonin and norepinephrine levels associated with arson. No other neurtotransmitters have been linked to this disorder.

When developing the plan of care for a client with borderline personality disorder (BPD), which of the following areas would the nurse identify as most likely problematic? Select all that apply

• Sleep • Nutrition • Self-harm

Which nursing interventions are most important in a plan of care for a client with histrionic personality disorder? Select all that apply

• Teach social skills. • Provide factual feedback about behavior.

The nurse is assessing a 16-month-old child during a well-baby checkup. Which of the following behaviors would be consistent with autism spectrum disorder? Select all that apply

• The child displays little eye contact with others. • The child makes few facial expressions toward others. • The child does not like repetition.

When assessing a client, the nurse recognizes which of the following as characteristics of the person with obsessive-compulsive personality disorder (OCPD)? Select all that apply.

• The client is preoccupied by orderliness. • The client is a perfectionist. • The client is guided by routine.

While interviewing a child, the nurse notes phonic tics. Which of the following might the nurse assess? Select all that apply

• Throat clearing • Voicing of obscenities • Grunting

A client is diagnosed with avoidant personality disorder. When assessing the client, which of the following would be evident? Select all that apply

• Timidity • Sensitivity to negative comments • Fear of rejection

A client is diagnosed with avoidant personality disorder. When assessing the client, which of the following would be evident? Select all that apply.

• Timidity • Sensitivity to negative comments • Fear of rejection

The nurse working with women who have borderline personality disorder can do which of the following to help clients build social skills and self-esteem? Select all that apply.

• Use groups to discuss feelings and ways to deal with them. • Offer assertiveness classes. • Offer women's health issues classes.

A group of nursing students is reviewing information about the complications associated with eating disorders. The students demonstrate understanding of the information when they identify which of the following as a possible cardiac complication? Select all that apply

• Ventricular tachycardia • Loss of cardiac muscle • Bradycardia

A client is diagnosed with Korsakoff's amnestic syndrome. Which of the following would the nurse most likely assess? Select all that apply.

• Vision impairment • Confabulation • Attention deficit

Changes in behavior at school may be evidenced by which of the following? Select all that apply.

• Withdrawal from peers • Falling grades • Aggression towards peers • Decreased concentration