FINAL EXAM 11, 21, 18, 24, 36
A child diagnosed with ADHD will begin medication therapy. The nurse should prepare a plan to teach the family about which classification of medications? a. CNS stimulants c. Antipsychotics b. Tricyclic antidepressants d. Anxiolytics
A
A nurse plans health education for a patient who will be receiving warfarin for several weeks after knee-replacement surgery. Which substance should the nurse caution the patient to avoid? a. Fish oil b. Black cohosh c. Lavender d. Mandarin
A
A nurse provides care for an adolescent patient diagnosed with an eating disorder. Which behavior by this nurse indicates that additional clinical supervision is needed? a. The nurse interacts with the patient in a protective fashion. b. The nurse's comments to the patient are compassionate and nonjudgmental. c. The nurse teaches the patient to recognize signs of increasing anxiety and ways to intervene. d. The nurse refers the patient to a self-help group for individuals with eating disorders.
A
A parent diagnosed with schizophrenia and 13-year-old child live in a homeless shelter. The child formed a trusting relationship with a shelter volunteer. The child says, "My three friends and I got an A on our school science project." The nurse can assess that the child a. displays resiliency. b. has a passive temperament. c. is at risk for PTSD. d. uses intellectualization to deal with problems.
A
A patient asks, "What is the major difference between conventional health care and complementary and alternative medicine (CAM)?" The nurse's best reply is that conventional health care a. focuses on what is done to the patient, whereas CAM focuses on body-mind interaction with an actively involved patient. b. has been tested by research so less regulation is needed, but CAM is religiously based and highly regulated. c. is controlled by the health care industry, but CAM is the people's medicine and not motivated by profit. d. is holistic and focused on health promotion, whereas CAM treats illnesses and is symptom-specific.
A
A patient diagnosed with anorexia nervosa virtually stopped eating 5 months ago and lost 25% of body weight. A nurse asks, "Describe what you think about your present weight and how you look." Which response by the patient is most consistent with the diagnosis? a. "I am fat and ugly." b. "What I think about myself is my business." c. "I'm grossly underweight, but that's what I want." d. "I'm a few pounds' overweight, but I can live with it."
A
A patient diagnosed with borderline personality disorder was hospitalized several times after multiple episodes of head banging and carving on both wrists. The patient remains impulsive. Which nursing diagnosis is the initial focus of this patient's care? a. Self-mutilation b. Impaired skin integrity c. Risk for injury d. Powerlessness
A
A patient diagnosed with major depressive disorder tells the nurse, "I want to try supplementing my selective serotonin reuptake inhibitor (SSRI) with St. John's wort." Which action should the nurse take first? a. Advise the patient of the danger of serotonin syndrome. b. Suggest that aromatherapy may produce better results. c. Assess the patient for depression and risk for suicide. d. Suggest the patient decrease the antidepressant dose.
A
A patient reports good results from taking an herb to manage migraine headache pain. The nurse confirms there are no hazardous interactions between the herb and the patient's current prescription drugs. Select the nurse's best comment to the patient. a. "Thanks for telling me. I'll make a note in your medical record that you take it." b. "You are experiencing a placebo effect. When we believe something will help, it usually does." c. "Self-management of health problems can be dangerous. You should have notified me sooner." d. "Research studies show that herbals actually increase migraine pain by inflaming nerve cells in the brain."
A
A patient says, "I get in trouble sometimes because I make quick decisions and act on them." Select the nurse's most therapeutic response. a. "Let's consider the advantages of being able to stop and think before acting." b. "It sounds as though you've developed some insight into your situation." c. "I bet you have some interesting stories to share about overreacting." d. "It's good that you're showing readiness for behavioral change."
A
During an assessment interview, a patient diagnosed with inflammatory bowel disease accompanied by frequent episodes of diarrhea says, "I've been using probiotics in small doses for about a week." When the nurse assesses mental status, expected findings would be a. intact cognitive function. b. slow verbal responses. c. paranoid thinking. d. slurred speech.
A
For which patient would it be most important for the nurse to urge immediate discontinuation of kava? A patient with a comorbid diagnosis of a. cirrhosis. b. osteoarthritis. c. multiple sclerosis. d. chronic back pain.
A
Soon after parents announced they were divorcing, a child stopped participating in sports, sat alone at lunch, and avoided former friends. The child told the school nurse, "If my parents loved me, they would work out their problems." Which nursing diagnosis has the highest priority? a. Social isolation b. Decisional conflict c. Chronic low self-esteem d. Disturbed personal identity
A
The child prescribed an antipsychotic medication to manage violent behavior is one most likely diagnosed with a. ADHD. b. posttraumatic stress disorder (PTSD). c. communication disorder. d. an anxiety disorder.
A
What is the priority intervention for a nurse beginning to work with a patient diagnosed with a schizotypal personality disorder? a. Respect the patient's need for periods of social isolation. b. Prevent the patient from violating the nurse's rights. c. Teach the patient how to select clothing for outings. d. Engage the patient in community activities.
A
What is the priority nursing diagnosis for a patient diagnosed with antisocial personality disorder who has made threats against staff, ripped art off the walls, and thrown objects? a. Risk for other-directed violence b. Risk for self-directed violence c. Impaired social interaction d. Ineffective denial
A
Which assessment finding would cause the nurse to consider a child to be most at risk for the development of mental illness? a. The child has been raised by a parent with recurring major depressive disorder. b. The child's best friend was absent from the child's birthday party. c. The child was not promoted to the next grade one year. d. The child moved to three new homes over a 2-year period.
A
Which intervention is appropriate for an individual diagnosed with an antisocial personality disorder who frequently manipulates others? a. Refer requests and questions related to care to the case manager. b. Encourage the patient to discuss feelings of fear and inferiority. c. Provide negative reinforcement for acting-out behavior. d. Ignore, rather than confront, inappropriate behavior.
A
Which nursing diagnosis is universally applicable for children diagnosed with autism spectrum disorders? a. Impaired social interaction related to difficulty maintaining relationships b. Chronic low self-esteem related to excessive negative feedback c. Deficient fluid volume related to abnormal eating habits d. Anxiety related to nightmares and repetitive activities
A
A patient in good health and without any major health needs says, "I want to try some techniques to improve my mental and physical well-being but I'm overwhelmed by all the suggestions on the Internet." Which techniques would be appropriate for the nurse to suggest? (Select all that apply.) a. Yoga b. Exercise c. Meditation d. Aromatherapy e. Acupuncture f. Spinal manipulation
ABCD
For which patients diagnosed with personality disorders would a family history of similar problems be most likely? (Select all that apply.) a. Obsessive-compulsive b. Antisocial c. Borderline d. Schizotypal e. Narcissistic
ABCD
Which important points should the nurse teach a patient about using herbal preparations? (Select all that apply.) a. Check active and inactive ingredients. b. Discontinue use if side or adverse effects occur. c. Avoid herbals during pregnancy and breast-feeding. d. Buying from online sources is preferable and cheaper. e. Inform your health care provider about the use of herbals.
ABCE
A patient reports frequent sleep disturbances. Which interventions could be considered to help improve the patient's sleep pattern? (Select all that apply.) a. Melatonin b. Chamomile c. Vitamin C d. Valerian e. SAM-e
ABD
A patient who emigrated from India is hospitalized. The patient and family use ayurvedic medicine. The nurse wants to adjust this patient's care so that it is more comfortable and familiar. What changes from usual Western practice should be considered? (Select all that apply.) a. In preparation for discharge, include a significant focus on preventive practices. b. Spend time exploring the patient's life overall, focusing on broader issues than health. c. Involve the patient's entire family and treatment team in decisions about treatment options. d. Anticipate that the patient will prefer and value interventions with high technology features. e. Provide relevant health-related information and then encourage the patient to determine which course of action to pursue.
ABE
Which assessment findings present familial risks for a child to develop a psychiatric disorder? (Select all that apply.) a. Having a mother diagnosed with schizophrenia b. Being the oldest child in a family c. Living with an alcoholic parent d. Being an only child e. Living in an urban community
AC
A child reports to the school nurse of being verbally bullied by an aggressive classmate. What is the nurse's best first action? a. Give notice to the chief administrator at the school regarding the events. b. Encourage the victimized child to share feelings about the experience. c. Encourage the victimized child to ignore the bullying behavior. d. Discuss the events with the aggressive classmate.
B
A nurse set limits while interacting with a patient demonstrating behaviors associated with borderline personality disorder. The patient tells the nurse, "You used to care about me. I thought you were wonderful. Now I can see I was wrong. You're evil." This outburst can be assessed as a. denial. b. splitting. c. defensive. d. reaction formation.
B
A nursing diagnosis appropriate to consider for a patient diagnosed with any of the personality disorders is a. nonadherence. b. impaired social interaction. c. disturbed personal identity. d. diversional activity deficit.
B
Acupuncture is a traditional Chinese medical treatment based on the belief that a. insertion of needles in key locations will drain toxic energies. b. pressure on meridian points will correct problems in energy flow. c. insertion of needles modulates the flow of energy along body meridians. d. taking small doses of noxious substances will alleviate specific symptoms.
C
As a nurse prepares to administer medication to a patient diagnosed with a borderline personality disorder, the patient says, "Just leave it on the table. I'll take it when I finish combing my hair." What is the nurse's best response? a. Reinforce this assertive action by the patient. Leave the medication on the table as requested. b. Respond to the patient, "I'm worried that you might not take it. I'll come back later." c. Say to the patient, "I must watch you take the medication. Please take it now." d. Ask the patient, "Why don't you want to take your medication now?"
C
Assessment data for a 7-year-old reveals an inability to take turns, blurting out answers to questions before a question is complete, and frequently interrupting others' conversations. How should the nurse document these behaviors? a. Disobedience b. Hyperactivity c. Impulsivity d. Anxiety
C
Consider this comment to three different nurses by a patient diagnosed with an antisocial personality disorder, "Another nurse said you don't do your job right." Collectively, these interactions can be assessed as a. seductive. b. detached. c. manipulative. d. guilt-producing.
C
One month ago, a patient diagnosed with borderline personality disorder and a history of self-mutilation began dialectical behavior therapy. Today the patient phones to say, "I feel empty and want to hurt myself." The nurse should a. arrange for emergency inpatient hospitalization. b. send the patient to the crisis intervention unit for 8 to 12 hours. c. assist the patient to choose coping strategies for triggering situations. d. advise the patient to take an antianxiety medication to decrease the anxiety level.
C
Others describe a worker as very shy and lacking in self-confidence. This worker stays in an office cubicle all day, never coming out for breaks or lunch. Which term best describes this behavior? a. Narcissistic b. Histrionic c. Avoidant d. Paranoid
C
Over the past year, a woman has cooked gourmet meals for her family but eats only tiny servings. This person wears layered loose clothing. Her current weight is 95 pounds, a loss of 35 pounds. Which medical diagnosis is most likely? a. Binge eating b. Bulimia nervosa c. Anorexia nervosa d. Eating disorder not otherwise specified
C
The history shows that a newly admitted patient is impulsive. The nurse would expect behavior characterized by a. adherence to a strict moral code. b. manipulative, controlling strategies. c. acting without thought on urges or desires. d. postponing gratification to an appropriate time.
C
The parent of a child diagnosed with Tourette's disorder says to the nurse, "I think my child is faking the tics because they come and go." Which response by the nurse is accurate? a. "Perhaps your child was misdiagnosed." b. "Your observation indicates the medication is effective." c. "Tics often change frequency or severity. That doesn't mean they aren't real." d. "This finding is unexpected. How have you been administering your child's medication?"
C
What is an appropriate initial outcome for a patient diagnosed with a personality disorder who frequently manipulates others? The patient will a. identify when feeling angry. b. use manipulation only to get legitimate needs met. c. acknowledge manipulative behavior when it is called to his or her attention. d. accept fulfillment of his or her requests within an hour rather than immediately.
C
What is the nurse's priority focused assessment for side effects in a child taking methylphenidate for ADHD? a. Dystonia, akinesia, and extrapyramidal symptoms b. Bradycardia and hypotensive episodes c. Sleep disturbances and weight loss d. Neuroleptic malignant syndrome
C
When a 5-year-old is disruptive, the nurse says, "You must take a time-out." The expectation is that the child will a. go to a quiet room until called for the next activity. b. slowly count to 20 before returning to the group activity. c. sit on the edge of the activity until able to regain self-control. d. sit quietly on the lap of a staff member until able to apologize for the behavior.
C
When a patient diagnosed with a personality disorder uses manipulation to get needs met, the staff applies limit-setting interventions. What is the correct rationale for this action? a. It provides an outlet for feelings of anger and frustration. b. It respects the patient's wishes, so assertiveness will develop. c. External controls are necessary due to failure of internal control. d. Anxiety is reduced when staff assumes responsibility for the patient's behavior.
C
When group therapy is prescribed as a treatment modality, the nurse would suggest placement of a 9-year-old in a group that uses a. guided imagery. b. talk focused on a specific issue. c. play and talk about a play activity. d. group discussion about selected topics.
C
Which behavior indicates that the treatment plan for a child diagnosed with an autism spectrum disorder was effective? The child a. plays with one toy for 30 minutes. b. repeats words spoken by a parent. c. holds the parent's hand while walking. d. spins around and claps hands while walking.
C
Which characteristic of personality disorders makes it most necessary for staff to schedule frequent team meetings in order to address the patient's needs and maintain a therapeutic milieu? a. Ability to achieve true intimacy b. Flexibility and adaptability to stress c. Ability to provoke interpersonal conflict d. Inability to develop trusting relationships
C
Which complementary and alternative therapy may be safely combined with traditional Western medicine in the treatment of anxiety disorder? a. Electroconvulsive therapy b. Mega doses of vitamins c. Meditative practices d. Herbal therapy
C
Which patient would most likely benefit from taking St. John's wort? A patient with a. mood swings. b. hypomanic symptoms. c. mild depressive symptoms. d. panic disorder with agoraphobia.
C
Which statement made by a patient diagnosed with borderline personality disorder indicates the treatment plan is effective? a. "I think you are the best nurse on the unit." b. "I'm never going to get high on drugs again." c. "I felt empty and wanted to hurt myself, so I called you." d. "I hate my mother. I called her today, and she wasn't home."
C
A nurse prepares the plan of care for a 15-year-old diagnosed with moderate intellectual developmental disorder. What are the highest outcomes that are realistic for this patient? Within 5 years, the patient will (Select all that apply) a. graduate from high school. b. live independently in an apartment. c. independently perform own personal hygiene. d. obtain employment in a local sheltered workshop. e. correctly use public buses to travel in the community.
CDE
A 4-year-old cries for 5 minutes when the parents leave the child at preschool. The parents ask the nurse, "What should we do?" Select the nurse's best response. a. "Ask the teacher to let the child call you at play time." b. "Withdraw the child from preschool until maturity increases." c. "Remain with your child for the first hour of preschool time." d. "Give your child a kiss before you leave the preschool program."
D
A child diagnosed with ADHD had this nursing diagnosis: impaired social interaction related to excessive neuronal activity as evidenced by aggression and demanding behavior with others. Which finding indicates the plan of care was effective? The child a. has an improved ability to identify anxiety and use self-control strategies. b. has increased expressiveness in communication with others. c. shows increased responsiveness to authority figures. d. engages in cooperative play with other children.
D
A health care provider recently convicted of Medicare fraud says to a nurse, "Sure I overbilled. Everyone takes advantage of the government. There are too many rules to follow and I deserve the money." These statements show a. shame. b. suspiciousness. c. superficial remorse. d. lack of guilt feelings.
D
A nurse assesses a 3-year-old diagnosed with an autism spectrum disorder. Which finding is most associated with the child's disorder? The child a. has occasional toileting accidents. b. interrupts or intrudes on others. c. cries when separated from a parent. d. continuously rocks in place for 30 minutes.
D
A nurse determines desired outcomes for a patient diagnosed with schizotypal personality disorder. Select the best outcome. The patient will a. adhere willingly to unit norms. b. report decreased incidence of self-mutilative thoughts. c. demonstrate fewer attempts at splitting or manipulating staff. d. demonstrate ability to introduce self to a stranger in a social situation.
D
A patient diagnosed with borderline personality disorder self-inflicted wrist lacerations after gaining new privileges on the unit. In this case, the self-mutilation may have been due to a. an inherited disorder that manifests itself as an incapacity to tolerate stress. b. use of projective identification and splitting to bring anxiety to manageable levels. c. a constitutional inability to regulate affect, predisposing to psychic disorganization. d. fear of abandonment associated with progress toward autonomy and independence.
D
Which nursing intervention has the highest priority as a patient diagnosed with anorexia nervosa begins to gain weight? a. Assess for depression and anxiety. b. Observe for adverse effects of refeeding. c. Communicate empathy for the patient's feelings. d. Help the patient balance energy expenditures with caloric intake.
B
A patient diagnosed with anorexia nervosa is resistant to weight gain. What is the rationale for establishing a contract with the patient to participate in measures designed to produce a specified weekly weight gain? a. Because severe anxiety concerning eating is expected, objective and subjective data may be unreliable. b. Patient involvement in decision making increases sense of control and promotes adherence to the plan of care. c. Because of increased risk of physical problems with refeeding, the patient's permission is needed. d. A team approach to planning the diet ensures that physical and emotional needs will be met.
B
A patient diagnosed with borderline personality disorder has a history of self-mutilation and suicide attempts. The patient reveals feelings of depression and anger with life. Which type of medication would the nurse expect to be prescribed? a. Benzodiazepine b. Mood stabilizing medication c. Monoamine oxidase inhibitor (MAOI) d. Cholinesterase inhibitor
B
A patient diagnosed with borderline personality disorder has self-inflicted wrist lacerations. The health care provider prescribes daily dressing changes. The nurse performing this care should a. maintain a stern and authoritarian affect. b. provide care in a matter-of-fact manner. c. encourage the patient to express anger. d. be very rigid and challenging.
B
A patient had a venous thrombosis 3 weeks ago and is now taking warfarin. When visiting the laboratory to have a prothrombin time drawn, the patient reports drinking ginseng tea to stimulate the immune system. Which nursing diagnosis applies? a. Impaired memory related to neurological changes b. Deficient knowledge related to potentially harmful drug interactions c. Ineffective denial related to consequences of mismanagement of therapeutic regime d. Effective management of the therapeutic regime related to augmentation of anti-coagulant therapy
B
A patient has tried a variety of CAM approaches to manage health concerns. The nurse asks, "How is going to CAM practitioners different from seeing your medical doctors?" The patient is most likely to respond, "The CAM practitioners a. usually prescribe a course of invasive and sometimes painful treatments." b. spend more time talking with me and not just about my symptoms." c. say I need to become much more spiritual to be well." d. order many tests to determine my diagnoses."
B
A patient report, "Last night I had several mixed drinks at a party. When I got home, I had difficulty falling sleep. I made two cups of herbal tea with lavender. This morning, I feel very groggy and have a headache." The nurse should explain that a. lavender should be delayed at least 1 hour after using alcohol to avoid side effects. b. lavender may increase sedation from other central nervous system depressants. c. herbal teas often cause nervous system side effects such as headaches. d. these feelings are actually a hangover from excessive alcohol intake.
B
A patient says, "I have taken mega doses of vitamins for 3 months to improve my circulation, but I think I feel worse." Which action should the nurse take first? a. Explain to the patient that vitamin mega doses may be harmful and advise caution. b. Assess the patient for symptoms and signs of toxicity from excess vitamin exposure. c. Assess for signs of circulatory integrity to determine whether improvement has occurred. d. Educate the patient that research has not shown that megadoses of vitamins produce benefits.
B
A patient says, "The other nurses won't give me my medication early, but you know what it's like to be in pain and don't let your patients suffer. Could you get me my pill now? I won't tell anyone." Which response by the nurse would be most therapeutic? a. "I'm not comfortable doing that," and then ignore subsequent requests for early medication. b. "I understand that you have pain, but giving medicine too soon would not be safe." c. "I'll have to check with your doctor about that; I will get back to you after I do." d. "It would be unsafe to give the medicine early; none of us will do that."
B
A patient tells the nurse, "I get sick so much, so I started taking ginseng to boost my immune system." The patient's only other medication is warfarin daily. Which potential complication should be included in the nursing assessment? a. Gastrointestinal distress b. Spontaneous bleeding c. Thromboembolism d. Drowsiness
B
A patient tells the nurse, "I've been having problems getting a good night's sleep. I read some information on the Internet and started taking kava kava." Select the nurse's priority response. a. "The Internet does not have reliable health information for consumers." b. "The Food and Drug Administration warned against using it due to the link to severe liver damage." c. "Melatonin has been shown to have better effects for treating sleep disturbances." d. "Your sleep disturbances are related to your problems with anxiety. Herbs will not help."
B
An appropriate intervention for a patient diagnosed with bulimia nervosa who binges and purges is to teach the patient a. to eat a small meal after purging. b. not to skip meals or restrict food. c. to increase oral intake after 4 PM daily. d. the value of reading journal entries aloud to others.
B
An older male patient has suffered with episodic pruritus and skin eruptions for over 2 years. This patient tells the nurse, "When my skin gets better for a few days, I start worrying that it's going to start itching again soon. I think my worry may actually trigger the problems to start all over again." Which self-help technique should the nurse consider suggesting for this patient? a. Melatonin b. Meditation c. Purification d. Acupuncture
B
Personality traits most likely to be documented regarding a patient demonstrating characteristics of an obsessive-compulsive personality disorder are a. affable, generous. b. perfectionist, inflexible. c. suspicious, holds grudges. d. dramatic speech, impulsive.
B
Select the best desired outcome for a patient who uses valerian. The patient will report a. stress level is lower. b. undisturbed sleep throughout the night. c. increased interest in recreational activities. d. early morning waking without an alarm clock.
B
What is the most challenging nursing intervention with patients diagnosed with personality disorders who use manipulation? a. Supporting behavioral change b. Maintaining consistent limits c. Monitoring suicide attempts d. Using aversive therapy
B
Which CAM method is associated with using allergy injections of small amounts of an allergen in solution? a. Naturopathy b. Homeopathy c. Chiropractic d. Shiatsu
B
At the time of a home visit, the nurse notices that each parent and child in a family has his or her own personal online communication device. Each member of the family is in a different area of the home. Which nursing actions are appropriate? (Select all that apply.) a. Report the finding to the official child protection social services agency. b. Educate all members of the family about potential safety risks in online environments. c. Talk with the parents about parental controls on the children's communication devices. d. Encourage the family to schedule daily time together without communication devices. e. Obtain the family's network password and examine online sites family members have visited.
BCD
A nurse plans care for an individual diagnosed with antisocial personality disorder. Which characteristic behaviors will the nurse expect? (Select all that apply.) a. Reclusive behavior b. Callous attitude c. Perfectionism d. Aggression e. Clinginess f. Anxiety
BD
A nurse prepares to lead a discussion at a community health center regarding children's health problems. The nurse wants to use current terminology when discussing these issues. Which terms are appropriate for the nurse to use? (Select all that apply.) a. Autism b. Bullying c. Mental retardation d. Autism spectrum disorder e. Intellectual development disorder
BDE
A child diagnosed with ADHD shows hyperactivity, aggression, and impaired play. The health care provider prescribed amphetamine salts (Adderall). The nurse should monitor for which desired behavior? a. Increased expressiveness in communication with others b. Abilities to identify anxiety and implement self-control strategies c. Improved abilities to participate in cooperative play with other children d. Tolerates social interactions for short periods without disruption or frustration
C
A desired outcome for a 12-year-old diagnosed with ADHD is to improve relationships with other children. Which treatment modality should the nurse suggest for the plan of care? a. Reality therapy b. Simple restitution c. Social skills group d. Insight-oriented group therapy
C
A kindergartener is disruptive in class. This child is unable to sit for expected lengths of time, inattentive to the teacher, screams while the teacher is talking, and is aggressive toward other children. The nurse plans interventions designed to a. promote integration of self-concept. b. provide inpatient treatment for the child. c. reduce loneliness and increase self-esteem. d. improve language and communication skills.
C
A new psychiatric technician says, "Schizophrenia ... schizotypal! What's the difference?" The nurse's response should include which information? a. A patient diagnosed with schizophrenia is not usually overtly psychotic. b. In schizotypal personality disorder, the patient remains psychotic much longer. c. With schizotypal personality disorder, the person can be made aware of misinterpretations of reality. d. Schizotypal personality disorder causes more frequent and more prolonged hospitalizations than schizophrenia.
C
A nurse reports to the treatment team that a patient diagnosed with an antisocial personality disorder has displayed the behaviors below. This patient is detached and superficial during counseling sessions. Which behavior by the patient most clearly warrants limit setting? a. Flattering the nurse b. Lying to other patients c. Verbal abuse of another patient d. Detached superficiality during counseling
C
A nurse will prepare teaching materials for the parents of a child newly diagnosed with ADHD. Information will focus on which medication likely to be prescribed? a. Paroxetine b. Imipramine c. Methylphenidate d. Carbamazepine
C
A nurse works with a child who is sad and irritable because the child's parents are divorcing. Why is establishing a therapeutic alliance with this child a priority? a. Therapeutic relationships provide an outlet for tension. b. Focusing on the strengths increases a person's self-esteem. c. Acceptance and trust convey feelings of security to the child. d. The child should express feelings rather than internalize them.
C
A patient diagnosed with depression confidently tells the nurse, "I've been supplementing my paroxetine with St. John's wort. It has helped a great deal." What is the nurse's priority action? a. Assess changes in the patient's level of depression. b. Remind the patient to use a secondary form of birth control. c. Educate the patient about the risks of selective serotonin syndrome. d. Suggest adding valerian to the treatment regimen to further improve results.
C
A patient referred to the eating disorders clinic has lost 35 pounds during the past 3 months. To assess eating patterns, the nurse should ask the patient: a. "Do you often feel fat?" b. "Who plans the family meals?" c. "What do you eat in a typical day?" d. "What do you think about your present weight?"
C
A patient shows a nurse this advertisement: "Our product is a scientific breakthrough helpful for depression, anxiety, and sleeplessness. Made from an ancient formula, it stimulates circulation and excretes toxins. Satisfaction guaranteed or your money back." Select the nurse's best response. a. "Over-the-counter products for sleep problems are ineffective." b. "Do not take anything unless it's prescribed by your doctor." c. "Let's do some additional investigation of that product." d. "It sounds like you are trying to self-medicate."
C
A patient tells the nurse, "I prefer to treat my physical problems with herbs and vitamins. They are natural substances, and natural products are safe." Which response by the nurse would be most appropriate? a. "Natural substances tend to be safer than conventional medical remedies." b. "Natural remedies give you the idea that you are controlling your treatment." c. "The word natural can be a marketing term used to imply a product is healthy, but that's not always true." d. "You should not treat your own physical problems. You should see your health care provider for these problems."
C
A patient was diagnosed with anorexia nervosa. The history shows the patient virtually stopped eating 5 months ago and lost 25% of body weight. The serum potassium is currently 2.7 mg/dL. Which nursing diagnosis applies? a. Adult failure to thrive related to abuse of laxatives as evidenced by electrolyte imbalances and weight loss b. Disturbed energy field related to physical exertion in excess of energy produced through caloric intake as evidenced by weight loss and hyperkalemia c. Ineffective health maintenance related to self-induced vomiting as evidenced by swollen parotid glands and hyperkalemia d. Imbalanced nutrition: less than body requirements related to reduced oral intake as evidenced by loss of 25% of body weight and hypokalemia
D
A patient with a history of asthma says, "I've been very nervous lately. I think aromatherapy will help. I am ordering $250 worth of oils from an Internet site that promised swift results." Select the nurse's best action. a. Support the patient's efforts to become informed and to find health solutions. b. Suggest the patient check with friends who have tried aromatherapy for treatment of anxiety. c. Remind the patient, "If you spend that much on oils, you may not be able to buy your prescribed medication." d. Tell the patient, "Aromatherapy can complicate respiratory problems such as asthma. Let's consider some other options."
D
A person's spouse filed charges after repeatedly being battered. The person sarcastically says, "I'm sorry for what I did. I need psychiatric help." Which statement by this person supports an antisocial personality disorder? a. "I have a quick temper, but I can usually keep it under control." b. "I've done some stupid things in my life, but I've learned a lesson." c. "I'm feeling terrible about the way my behavior has hurt my family." d. "I hit because I am tired of being nagged. My spouse deserves the beating."
D
A psychiatric clinical nurse specialist uses cognitive-behavioral therapy for a patient diagnosed with anorexia nervosa. Which statement by the staff nurse supports this type of therapy? a. "What are your feelings about not eating foods that you prepare?" b. "You seem to feel much better about yourself when you eat something." c. "It must be difficult to talk about private matters to someone you just met." d. "Being thin doesn't seem to solve your problems. You are thin now but still unhappy."
D
An immigrant from China needs a colonic resection but is anxious and reluctant about surgery. This patient usually follows traditional Chinese health practices. Which comment by the nurse would most likely reduce the patient's anxiety and reluctance? a. "Surgery will help rebalance the yin and yang forces and return you to harmony." b. "The surgery we are recommending will help you achieve final transformation." c. "I know this is new to you, but you can trust us to take very good care of you." d. "If you would like, we could investigate using acupuncture to help control pain."
D
Disturbed body image is a nursing diagnosis established for a patient diagnosed with an eating disorder. Which outcome indicator is most appropriate to monitor? a. Weight, muscle, and fat congruence with height, frame, age, and sex b. Calorie intake is within required parameters of treatment plan c. Weight reaches established normal range for the patient d. Patient expresses satisfaction with body appearance
D
For which behavior would limit setting be most essential? The patient who a. clings to the nurse and asks for advice about inconsequential matters. b. is flirtatious and provocative with staff members of the opposite sex. c. is hypervigilant and refuses to attend unit activities. d. urges a suspicious patient to hit anyone who stares.
D
Outpatient treatment is planned for a patient diagnosed with anorexia nervosa. Select the most important desired outcome related to the nursing diagnosis Imbalanced nutrition: less than body requirements. Within 1 week, the patient will a. weigh self accurately using balanced scales. b. limit exercise to less than 2 hours daily. c. select clothing that fits properly. d. gain 1 to 2 pounds.
D
The nurse caring for an individual demonstrating symptoms of schizotypal personality disorder would expect assessment findings to include a. arrogant, grandiose, and a sense of self-importance. b. attention seeking, melodramatic, and flirtatious. c. impulsive, restless, socially aggressive behavior. d. socially anxious, rambling stories, peculiar ideas.
D
The nursing care plan for a patient diagnosed with anorexia nervosa includes the intervention "monitor for complications of refeeding." Which system should a nurse closely monitor for dysfunction? a. Renal b. Endocrine c. Integumentary d. Cardiovascular
D
The parent of a 6-year-old says, "My child is in constant motion and talks all the time. My child isn't interested in toys but is out of bed every morning before me." The child's behavior is most consistent with diagnostic criteria for a. communication disorder. b. stereotypic movement disorder. c. intellectual development disorder. d. ADHD.
D
When a 5-year-old diagnosed with ADHD bounces out of a chair and runs over and slaps another child, what is the nurse's best action? a. Instruct the parents to take the aggressive child home. b. Direct the aggressive child to stop immediately. c. Call for emergency assistance from other staff. d. Take the aggressive child to another room.
D
When preparing to interview a patient diagnosed with narcissistic personality disorder, a nurse can anticipate the assessment findings will include a. preoccupation with minute details; perfectionist. b. charm, drama, seductiveness; seeking admiration. c. difficulty being alone; indecisive, submissiveness. d. grandiosity, self-importance, and a sense of entitlement.
D
Which child demonstrates behaviors indicative of a neurodevelopmental disorder? a. A 4-year-old who stuttered for 3 weeks after the birth of a sibling b. A 9-month-old who does not eat vegetables and likes to be rocked c. A 3-month-old who cries after feeding until burped and sucks a thumb d. A 3-year-old who is mute, passive toward adults, and twirls while walking
D
A patient wants to learn more about integrative therapies. Which resource should the nurse suggest for the most reliable information? a. Internet b. American Nurses Association (ANA) c. Food and Drug Administration (FDA) d. National Center for Complementary and Integrative Health (NCCIH)
D The NCCIH provides reliable, objective, and scientific information to help in making decisions about use of these practices. NCCIH supports not only research, but also the development and sharing of this kind of information. The FDA has information, but it is not as extensive as NCCIH. The Internet has many resources but some are unreliable. The ANA does not provide extensive information about this topic.
