Evolve Adaptive Quiz - Management of Care for Clients with Psychiatric Conditions

A client arrives at the mental health clinic disheveled, agitated, and demanding that the nurse "do something to make these feelings stop." What clinical manifestation is evident? 1. Feelings of panic 2. Suicidal tendencies 3. Narcissistic ideation 4. Demanding personality

1. Feelings of panic

A 4-year-old child is found to have attention deficit-hyperactivity disorder (ADHD). What information about the child's behavior should the nurse expect when obtaining a health history from the parents? Select all that apply. 1. Impulsiveness 2. Excessive talking 3. Spitefulness and vindictiveness 4. Deliberate annoyance of others 5. Playing video games for hours on end 6. Failure to follow through or finish tasks

1. Impulsiveness 2. Excessive talking 5. Playing video games for hours on end 6. Failure to follow through or finish tasks

Clients addicted to alcohol often use the defense mechanism of denial. What is the reason that this defense is so often used? 1. It reduces their feelings of guilt. 2. It creates the appearance of independence. 3. It helps them live up to others' expectations. 4. It makes them look better in the eyes of others.

1. It reduces their feelings of guilt.

What childhood problem has legal as well as emotional aspects and cannot be ignored? 1. School phobia 2. Fear of animals 3. Fear of monsters 4. Sleep disturbances

1. School phobia

A client with a long history of alcohol abuse is admitted to the detoxification unit of an alcohol rehabilitation center. The nurse manager should assign the client to a room with what qualities? 1. Well lit and away from areas of activity 2. Without windows and close to the nurses' station 3. Illuminated by adequate lighting from the corridor 4. With dim lighting and shared by a quiet, withdrawn client

1. Well lit and away from areas of activity

A mental health nurse is working on a unit where many clients have the diagnosis of alcoholism. Which defense mechanism does the nurse identify as most commonly used by clients who are alcoholics? 1. Denial 2. Projection 3. Displacement 4. Compensation

1. Denial

What does a nurse recall that language development in the autistic child resembles? 1. Echolalia 2. Stuttering 3. Scanning speech 4. Pressured speech

1. Echolalia

A salesman with a history of heavy drinking is on a detoxification unit. He asks the nurse's permission to skip the Alcoholics Anonymous (AA) meeting held each day. What is the nurse's initial response? 1. "What are your feelings about going to AA meetings?" 2. "What is it that you dislike about going to AA meetings?" 3. "It's all right to wait until you feel like going to AA meetings." 4. "An important part of your treatment is attending AA meetings."

1. "What are your feelings about going to AA meetings?"

What is the primary reason that the nurse encourages the family of an alcoholic to become involved in the treatment program? Correct1. Alcoholism involves the entire family. 2. Alcoholics try to hide their drinking from their families. 3. Family members provide insights into the dynamics behind the drinking. 4. Family members have been most successful in providing necessary support

1. Alcoholism involves the entire family.

A female client with obsessive-compulsive disorder has become immobilized by her elaborate handwashing and walking rituals. Which feelings does the nurse recall are often the basis of obsessive-compulsive disorder? 1. Anxiety and guilt 2. Anger and hostility 3. Embarrassment and shame 4. Hopelessness and powerlessness

1. Anxiety and guilt

A nurse is caring for several clients who are going through withdrawal from alcohol. What is the primary reason for the ingestion of alcohol by clients with a history of alcohol abuse? 1. Are dependent on it 2. Lack the motivation to stop 3. Have no other coping mechanism 4. Enjoy the associated socialization

1. Are dependent on it

A nurse is caring for a client with the diagnosis of somatoform disorder, conversion type. What type of affect does the nurse expect this client to exhibit? Select all that apply. 1. Calm 2. Cheerful 3. Depressed 4. Frightened 5. Matter-of-fact

1. Calm 5. Matter-of-fact

A male client with the dual diagnosis of major depression and polysubstance abuse has been attending group therapy. One day the client tells the nurse, "The things they talk about in group don't really pertain to me." What is the most therapeutic response by the nurse? 1. Confronting the client with realistic feedback 2. Identifying the client's stress-coping tolerance 3. Informing the client that he needs to get more involved 4. Asking the client what therapy he thinks would be more helpful

1. Confronting the client with realistic feedback

Despite repeated nursing interventions to improve reality orientation, a client insists that he is the commander of an alien spaceship. What is the client experiencing? 1. Illusion 2. Delusion 3. Confabulation 4. Hallucination

2. Delusion

During a one-on-one interaction with a client with paranoid-type schizophrenia, the client says to the nurse, "I've figured out how foreign agents have infiltrated the news media. They want to shut me up before I spill the beans." How should the nurse describe this statement when documenting this client's response? 1. Nihilistic delusion 2. Delusions of persecution 3. Delusions of control 4. Delusions of grandeur

2. Delusions of persecution

When a nurse is admitting an older client to the mental health unit, it is important to identify any signs of dementia. What signs and symptoms denote the presence of dementia of the Alzheimer type? Select all that apply. 1. Ambivalence 2. Forgetfulness 3. Flight of ideas 4. Loose associations 5. Expressive aphasia

2. Forgetfulness 5. Expressive aphasia

What characteristic is the nurse likely to identify when planning care for a client who has abused multiple drugs? 1. Lack of concern with reality 2. Inability to delay gratification 3. Sensitivity to the needs of others 4. Lack of awareness of the dangers of drug addiction

2. Inability to delay gratification

The nurse is caring for an 84-year-old man admitted with a diagnosis of severe Alzheimer dementia. In the admission assessment, the nurse notes that the client can no longer recognize familiar objects such as his glasses and toothbrush. What is the best term to describe this situation? 1. Apraxia 2. Aphasia 3. Agnosia 4. Amnesia

3. Agnosia

A mental health nurse is admitting a client with anorexia nervosa. When obtaining the history and physical assessment, the nurse expects the client's condition to reveal what? 1. Edema 2. Diarrhea 3. Amenorrhea 4. Hypertension

3. Amenorrhea

A nurse is caring for a client exhibiting compulsive behaviors. The nurse concludes that the compulsive behavior usually incorporates the use of which defense mechanism? 1. Projection 2. Regression 3. Displacement 4. Rationalization

3. Displacement

A client experiencing nonspecific, excessive, unpleasant feelings of being worried concerning one's safety likely is experiencing which mental health disorder? 1. Phobia 2. Panic disorder 3. Generalized anxiety disorder (GAD) 4. Posttraumatic stress disorder (PTSD)

3. Generalized Anxiety Disorder (GAD)

A nurse uses behavior modification to foster toilet-training efforts in a cognitively impaired child. What reward should the nurse provide to reinforce appropriate use of the toilet? 1. Candy bar 2. Piece of fruit 3. Hug with praise 4. Choice of rewards

3. Hug with praise

A client is exhibiting a pattern of withdrawn behavior. What feelings does the nurse anticipate that this type of behavior will eventually produce? 1. Anger 2. Paranoia 3. Loneliness 4. Repression

3. Loneliness

A client with a history of chronic alcoholism is admitted to the mental health unit. What does the nurse identify as the cause of a client's use of confabulation? 1. Ideas of grandeur 2. Need to get attention 3. Marked loss of memory 4. Difficulty accepting the truth

3. Marked loss of memory

An older adult client is talking to the nurse about his Vietnam experiences and shares that he still has flashbacks. While assessing him the nurse notes that he is jumpy and exhibits startle reactions and poor concentration. With which mental health disorder does the nurse associate these symptoms? 1. Delusions 2. Hallucinations 3. Posttraumatic stress disorder (PTSD) 4. Obsessive-compulsive disorder (OCD)

3. Posttraumatic stress disorder (PTSD)

A client has been instructed to stop smoking. The nurse discovers a pack of cigarettes in the client's bathrobe. What is the nurse's initial action? 1. Notify the healthcare provider. 2. Report this to the nurse manager. 3. Tell the client that the cigarettes were found. 4. Discard the cigarettes without commenting to the client.

3. Tell the client that the cigarettes were found.

When visiting hours are over, a nurse approaches a client with paranoid schizophrenia, who shouts, "You're the one that made my lover leave me." What conclusion does the nurse make about the client? 1. The client is disoriented. 2. The client is actively hallucinating. 3. The client feels a sense of vulnerability. 4. The client needs to have limits set after calming down.

3. The client feels a sense of vulnerability.

In what situation should a nurse anticipate that a client will experience a phobic reaction? 1. When seeking attention from others 2. When thinking about the feared object 3. When coming into contact with the feared object 4. When being exposed to an unfamiliar environment

3. When coming into contact with the feared object

A young adolescent is found to have anorexia nervosa. What does the nurse understand probably precipitated the anorexia nervosa? 1. The acting out of aggressive impulses, resulting in feelings of hopelessness 2. An unconscious wish to punish a parent who tries to dominate the adolescent's life 3. The inability to deal with being the center of attention in the family and a desire for independence 4. An inaccurate perception of hunger stimuli and a struggle between dependence and independence

4. An inaccurate perception of hunger stimuli and a struggle between dependence and independence

An older adult is admitted for evaluation of anemia and unsteady gait. While obtaining a health history, the nurse notes that the client seems to make up stories to fill in for memory lapses. How should the nurse document what the client is doing? 1. Lying 2. Denying 3. Fantasizing 4. Confabulating

4. Confabulating

A nurse is caring for a client with the diagnosis of schizophrenia. During assessment the nurse identifies both positive (type I) and negative (type II) signs and symptoms. Which clinical findings should the nurse document as positive? Select all that apply. 1. Anergy 2. Flat affect 3. Social withdrawal 4. Disorganized thoughts 5. Auditory hallucinations

4. Disorganized thoughts 5. Auditory hallucinations

A client with a history of substance abuse is brought to the emergency department for possible overdose. The client is having seizures, is hypertensive, and has hyperthermia. What drug should the nurse consider that the client may have been abusing? 1. Alcohol 2. Fentanyl 3. Oxycodone 4. Methamphetamine

4. Methamphetamine

A female graduate student who has become increasingly withdrawn and neglectful of her studies and personal hygiene is brought to the psychiatric hospital by her roommate. After a detailed assessment, a diagnosis of schizophrenia is made. Which characteristic is unlikely to be demonstrated by this client? 1. Neologisms 2. Low self-esteem 3. Concrete thinking 4. Organized speech and thoughts

4. Organized speech and thoughts

A client with the diagnosis of alcoholism explains to the nurse that alcohol has a calming effect and states, "I function better when I'm drinking than when I'm sober." What defense mechanism does the nurse identify? 1. Sublimation 2. Suppression 3. Compensation 4. Rationalization

4. Rationalization

An individual whose employment has been terminated because his company has been acquired by another company is brought by a family member to the mental health clinic because of extreme depression. While talking with the nurse the client says, "I'm a useless, worthless person. No wonder I lost my job." What type of delusion does the nurse identify? 1. Reference 2. Persecution 3. Alien control 4. Self-deprecation

4. Self-deprecation

Anorexia nervosa follows a cyclical pattern. Place the following statements in order of progression through this cycle, with 1 as the first step and 4 as the last step. 1. Sociocultural attitudes exert pressure to attain an idolized body. 2. Dieting is an attempt to maintain control. 3. Self-esteem increases as weight is lost. 4. Secondary gains reinforce the anorectic client's behaviors.

Correct Order: 1. Sociocultural attitudes exert pressure to attain an idolized body. 2. Dieting is an attempt to maintain control. 3. Self-esteem increases as weight is lost. 4. Secondary gains reinforce the anorectic client's behaviors.