Exam 1

A client with sleep disturbances, feelings of worthlessness, and inability to concentrate was let go from her place of employment a month ago. While interacting with the nurse, the client states, "My boss was wonderful! He was understanding and a really nice man." The nurse interprets this statement as indicating which of the following defense mechanisms? -Repression. -Suppression. -Intellectualization. -Reaction formation.

-Reaction formation.

A male client who is very depressed exhibits psychomotor retardation, a flat affect, and apathy. The nurse observes the client to be in need of grooming and hygiene. Which of the following nursing actions would be most appropriate? -Explaining the importance of hygiene to the client. -Asking the client if he is ready to shower. -Waiting until the client's family can participate in the client's care. -Stating to the client that it's time for him to take a shower.

-Stating to the client that it's time for him to take a shower.

A local community was just devastated by a tornado. Which of the following individuals has the highest risk for an adverse outcome? A. A poor Hispanic female with poor coping skills B. An affluent Caucasian male with poor coping skills C. A poor Caucasian female with a high-stress job D. An affluent African-American male with a high-stress job

A. A poor Hispanic female with poor coping skills

Our own values and beliefs can put us at odds with patients that are not living the way we think they should behave. A. True B. False

A. True

The prime objective of the crisis intervener is to do which of the following? A) Decide for the client until the client can do so independently. B) Help the client find ways to solve the immediate problem. C) Give anticipatory guidance to avert future crises. D) Mobilize the family to provide needed support.

B) Help the client find ways to solve the immediate problem.

A nursing student has difficulty with the rigorous workload of courses during the first semester of nursing school and does not pass all required classes. The type of crisis the student is experiencing is which of the following? A) Maturational crisis B) Situational crisis C) Social crisis D) Adventitious crisis

B) Situational crisis

A nurse notes that a patient is having a hard dealing with their diagnosis. The patient states that he is feeling alone with no one who understands. Which type of communication could be the most useful for the patient? A. Silence B. Empathy C. Reflection D. Summarization

B. Empathy The patient is feeling alone and afraid. Although silence could be useful to let the patient get out all of their feelings, empathy could be the best form of communication to ease the feeling of being alone. Reflecting and Summarization could lead to the patient feeling patronized.

A nurse is working with a family in crisis. Which of the following actions should the nurse accomplish first? A) Teach the family about crisis and its resolution. B) Discuss available resources. C) Identify which family member is experiencing crisis symptoms. D) Plan interventions that will ensure the security of all family members.

C) Identify which family member is experiencing crisis symptoms.

Pat has learned that she is dying. Pat starts to cry. The nurse understands therapeutic communication when the nurse: A. Asks clarifying question to encourage the pt to explain why she is crying. B. Asks the pt to talk about what exactly is making her sad. C. The nurse leaves the room to give Pat some privacy and alone time. D. The nurse allows Pat to cry on her shoulder.

D. The nurse allows Pat to cry on her shoulder.

An active crisis state is approximately 4 to 6 weeks. This means what? A) The experience of acute crisis involving confusion and disorganization will subside in approximately 4 to 6 weeks. B) After 4 to 6 weeks, the person will have achieved optimum functioning with effective crisis intervention. C) It will take 4 to 6 weeks for the client to gain an understanding of his or her perception that is causing the crisis. D) New coping skills must be learned within 4 to 6 weeks or the client will not experience positive resolution of the crisis state.

A) The experience of acute crisis involving confusion and disorganization will subside in approximately 4 to 6 weeks.

Following a mass shooting at a high school, critical incident stress debriefing (CISD) is instituted. Which of the following statements regarding CISD is accurate? A) CISD can only be performed by a licensed psychologist. B) CISD takes place within 24 to 72 hours of an incident. C) CISD is completed over a series of at least 10 sessions. D) CISD consists of three phases: fact, thought, and reaction.

B) CISD takes place within 24 to 72 hours of an incident.

Tim and Julia were married two weeks ago. They are both experiencing stress in adjusting to the role of a married couple. Marriage is an example of what? A) Situational crisis B) Adventitious crisis C) Maturational crisis D) Life change crisis

C) Maturational crisis

A person in crisis goes through various phases. Which of the following reflects the third phase of crisis development? A. The person uses usual coping mechanisms from a perceived threat. B. The person becomes disorganized and uses a trial and error approach. C. The trial and error approach may fail and anxiety escalates. D. Stress and anxiety are intolerable.

C. The trial and error approach may fail and anxiety escalates.

During the assessment of a person in crisis, the nurse should do which of the following first? A) Keep the client focused on the problem and specific goals leading to its resolution. B) Help the client develop healthier coping skills. C) Assess the client's support system, including religious beliefs and spirituality. D) Determine whether psychiatric symptoms are related to a physical cause.

D) Determine whether psychiatric symptoms are related to a physical cause.

The nurse is evaluating the effectiveness of the crisis intervention. Which of the following indicators suggests that the intervention has been effective? A) The client has developed insight into his use of maladaptive coping strategies. B) The client can verbalize techniques for preventing future crises. C) The client has developed a plan for managing the crisis. D) The client has resumed his usual level of functioning

D) The client has resumed his usual level of functioning

A client has a diagnosis of major depression. Which of the following features would be most crucial for the nurse to assess? -Sleep disturbance. -Feelings of worthlessness. -Difficulty with concentration. -Suicidal ideation.

Suicidal ideation

The client exhibits a flat affect, psychomotor retardation, and depressed mood. The nurse attempts to engage the client in an interaction but the client does not respond to the nurse. Which of the following responses by the nurse would be most appropriate? -"I'll sit here with you for 15 minutes." -"I'll come back a little bit later to talk." -"I'll find someone else for you to talk with." -"I'll get you something to read."

-"I'll sit here with you for 15 minutes."

After a few minutes of conversation, a female client who is depressed wearily asks the nurse, "Why pick me to talk to? Go talk to someone else." Which of the following replies by the nurse would be best? -"I'm assigned to care for you today, if you'll let me." -"You have a lot of potential, and I'd like to help you." -"I'll talk to someone else later." -"I'm your nurse today and I'd like to help you."

-"I'm your nurse today and I'd like to help you."

During a group session, a client who is depressed tells the group that he lost his job. Which of the following responses by the nurse would be best? -"It must have been very upsetting for you." -"Can you tell us about your job?" -"You'll find another job when you're better." -"You were probably just too depressed to work."

-"It must have been very upsetting for you."

A 62-year-old female client with severe depression and psychotic symptoms is scheduled for electroconvulsive therapy (ECT) tomorrow morning. The client's daughter asks the nurse, "How painful will the treatment be for Morn?" The nurse would correctly respond by saying which of the following? -"Your mother will be given something for pain before the treatment." -"The physician will make sure your mother doesn't suffer needlessly. -"Your mother will be asleep during the treatment and will not be in pain." -"Your mother will be able talk to us and tell us if she's in pain."

-"Your mother will be asleep during the treatment and will not be in pain."

A client diagnosed with major depression spends the majority of the day lying in bed with the sheet pulled over his head. Which of the following approaches by the nurse would be most therapeutic? -Wait for the client to begin the conversation. -Initiate contact with the client frequently. -Sit outside the client's room. -Question the client until he responds.

-Initiate contact with the client frequently.

A client states to a nurse, "My husband has supported me every time I've been hospitalized for depression. He'll leave me this time. I'm an awful wife and mother. I'm no good. Nothing I do is right." Based on this information, which of the following nursing diagnoses would the nurse identify when developing the client's plan of care? -Impaired Social Interaction related to unsatisfactory relationships as evidenced by withdrawal. -Low Self-Esteem related to lack of self-worth as evidenced by negative self-statements. -Risk for Self-Directed Violence related to feelings of guilt as evidenced by statements of suicidal ideation. -Ineffective Coping related to hospitalizations as evidenced by impaired judgment,

-Low Self-Esteem related to lack of self-worth as evidenced by negative self-statements.

A client with major depression is to be discharged home tomorrow. When preparing the client's discharge plan, which of the following areas would be most important for the nurse to review with the client? -Future plans for going back to work. -A conflict encountered with another client. -Results of psychological testing. -Medication management with outpatient follow-up.

-Medication management with outpatient follow-up.

A client admitted with a diagnosis of schizoaffective disorder, manic phase who is currently taking fluoxetine (Prozac) valporic acid (Depakote) and olanzapine (Zyprexa) as ordered has had an increase in manic symptoms in the last week. The psychiatrist orders a valporic acid blood level to be drawn stat. The nurse understands the rationale for this order as which of the following? -All clients taking valproic acid need periodic valproic acid levels drawn. -Fluoxetine can decrease the effectiveness of the valproic acid -A decrease in the level of valproic acid could explain the increase in manic symptoms -The valproic acid level is needed before a short course of lorazepam (Ativan) for agitation is ordered.

A decrease in the level of valproic acid could explain the increase in manic symptoms