Mental Health 4
Family members of a client ask the nurse to explain the difference between schizoid and avoidant personality disorders. Which is the appropriate nursing reply? A "Clients diagnosed with avoidant personality disorder desire intimacy but fear it, and clients diagnosed with schizoid personality disorder prefer to be alone." B "Clients diagnosed with schizoid personality disorder exhibit odd, bizarre, and eccentric behavior, whereas clients diagnosed with avoidant personality disorder do not." C "Clients diagnosed with avoidant personality disorder are eccentric, and clients diagnosed with schizoid personality disorder are dull and vacant." D "Clients diagnosed with schizoid personality disorder have a history of psychotic thought processes, whereas clients diagnosed with avoidant personality disorder remain based in reality."
A "Clients diagnosed with avoidant personality disorder desire intimacy but fear it, and clients diagnosed with schizoid personality disorder prefer to be alone."
A nurse is assessing a client who has a history of alcohol use disorder. Which of the following questions should the nurse include to determine how the use of alcohol affects the client's psychosocial behaviors? A "Has alcohol use affected your performance at work?" B "Do you take any over the counter medications?" C "Do you receive treatment for any mental health disorders?" D "What type of alcohol do you drink?"
A "Has alcohol use affected your performance at work?"
A home health nurse is speaking to a group of acute care nurses about domestic violence. Which of the following statements by one of the acute care nurses indicates a need for clarification? A "I have heard that abusers think of themselves as very important and have high self-esteem" B "Domestic violence escalates during pregnancy" C "I know that abusers lack social support and social skills" D"I have heard that abusers keep their victims isolated from others"
A "I have heard that abusers think of themselves as very important and have high self-esteem"
A nurse is assessing a child and suspects child abuse. Which assessment finding support the nurse's assumption? A A circular burn on the child's arm B A bump on the child's forehead C Redness on the child's legs D The child does not want to listen to instructions
A A circular burn on the child's arm
A group of nurses is discussing how food is used in their families and the effects this might have on their ability to work with clients diagnosed with eating disorders. Which nurse is most likely to be most effective with these clients? A A nurse that refuses to engage in power struggles over food B A nurse that allows her children to be "picky" eaters C A nurse that stresses the importance of balanced meals daily DA nurse that grew up in a house with very little food
A A nurse that refuses to engage in power struggles over food
Which of the following is an FDA approved medication for the pharmacological intervention of Autism Spectrum Disorder (ASD)? A Aripiprazole B Zoloft C Methylphenidate D Prozac
A Aripiprazole
A nurse is admitting a 14-year-old with conduct disorder. What would the nurse anticipate finding in this assessment? A Bullying of others B Vulnerable demeanor C Repetitive counting D Ritualistic activities
A Bullying of others
A patient has anorexia nervosa. The history shows the patient virtually stopped eating 5 months ago and has lost 25% of body weight. The serum potassium is 2.7 mg/dL. This patient is at risk of what complication? A Cardiac Arrhythmia B Increased Bone Density C Increased Heart Rate D Possible decrease in cortisol
A Cardiac Arrhythmia
A nurse questions the order to begin nourishing an emaciated client slowly. The prescriber explains the reason behind this choice is: A Clients may die from being nourished too quickly B Introducing food slowly encourages client compliance C There is no medical justification for this D Introducing nourishment quickly causes client anxiety
A Clients may die from being nourished too quickly
A nurse is caring for a client who has schizophrenia. The client states, "The weather channel lady loves me and she is going to quit her show to be with me!" The nurse should document that the client is experiencing which of the following types of delusions? A Erotomanic B Persecution C Control D Somatic
A Erotomanic
An unlicensed assistive personnel (UAP) is working with clients that have diagnosis of obsessive compulsive disorder. The UAP understands the reason not to stop the carrying out of compulsions is: A If this is not done therapeutically the client will have an escalation in anxiety B The RNs don't trust the UAPs C Stopping compulsions is not part of the treatment plan D The obsessions are the client's problems not the compulsions
A If this is not done therapeutically the client will have an escalation in anxiety
A nurse is admitting an older adult client who has a suspected cognitive disorder. Which of the following inventories should be included as part of the admission assessment? A Mental status examination (MSE) B Scale for Assessment of Negative Symptoms (SANS) C Abnormal Involuntary Movements Scale (AIMS) D Brief Patient Health Questionnaire (Brief PHQ)
A Mental status examination (MSE)
A client with anorexia nervosa is at increased risk for which of the following? A Osteopenia B Increased testosterone C Hyperglycemia D Hypertension
A Osteopenia
A nurse is performing an admission assessment for an adolescent client with a diagnosis of schizophrenia. Which of the following findings should the nurse identify as a positive symptom? A Somatic Delusions B Anhedonia C Waxy Posture (immobile posturing) D Anergia
A Somatic Delusions
A client prescribed sertraline asks about alternative therapies to treat the depression that she is experiencing regarding her current family situation. Which statement by the student nurse indicates a need for intervention? A St John's wort is an excellent treatment for depression B Electroconvulsive Therapy (ECT) works well with some types of depression C Over the counter medications can interact with your current antidepressant medication D Family therapy may help you address your feelings
A St John's wort is an excellent treatment for depression
After an adolescent diagnosed with attention-deficit/hyperactivity disorder (ADHD) begins methylphenidate therapy, the nurse notes that the adolescent loses 10 pounds in a 2-month period. Which is the best explanation for this weight loss? A The pharmacological action of methylphenidate causes a decrease in appetite. B Hyperactivity seen in ADHD causes increased caloric expenditure. C Side effects of methylphenidate cause nausea; therefore, caloric intake is decreased. D Increased ability to concentrate allows the client to focus on activities rather than food
A The pharmacological action of methylphenidate causes a decrease in appetite.
The nurse working with a client diagnosed with Bulimia Nervosa asks the client to recall a time in life when food could be consumed without purging. Which best explains the purpose of the nurse's question? A To emphasize that the client is capable of consuming food without purging B To incorporate specific foods into the meal plan to reflect pleasant memories C To encourage autonomy in the treatment plan D To gain insight into the disorder
A To emphasize that the client is capable of consuming food without purging
A nurse is educating staff on personality disorders. Which statement by the staff indicates understanding? A. Antisocial personality disorder can start as conduct disorder B. It is very easy to categorize the clients based on their disorder C. All clients with personality disorders were the victims of abuse D. All clients with personality disorders take advantage of others
A. Antisocial personality disorder can start as conduct disorder
A client is experiencing command hallucinations and appears to be frightened. Which of the following actions are appropriate nursing interventions? A. Keep the client physically safe B. Ignore the client's feelings in response to altered perceptions C. Assure the client that they are not experiencing something real D. Inform the client that their hallucinations are just bad dreams
A. Keep the client physically safe
Conduct disorder may be a precursor to the diagnosis of which personality disorder
Antisocial personality disorder
The nurse tells the parents of an adolescent diagnosed with anorexia nervosa, "The social worker will be contacting you to schedule a family meeting." One of the client's parents states, "Why is that necessary? Our child is the one who needs treatment." Which response by the nurse is best? A "We expect every client and their family to attend two family sessions." B "Family intervention and support are important in managing eating disorders." C "The sessions are used to educate all family members about eating disorders. D "During the meeting you will be able to resolve conflicts with your child."
B "Family intervention and support are important in managing eating disorders."
A child has been diagnosed with autism spectrum disorder (ASD). The distraught mother cries out, "I'm such a terrible mother. What did I do to cause this?" Which nursing reply is most appropriate? A "Researchers really don't know what causes autistic disorder, but the relationship between autistic disorder and fetal alcohol syndrome is being explored." B "Poor parenting doesn't cause autism. Research has shown that abnormalities in brain structure and/or function are to blame. This is beyond your control." C "Research has shown that the mother appears to play a greater role in the development of this disorder than does the father." D "Lack of early infant bonding with the mother has shown to be a cause of autistic disorder. Did you breastfeed or bottle feed?"
B "Poor parenting doesn't cause autism. Research has shown that abnormalities in brain structure and/or function are to blame. This is beyond your control."
A client is pacing the hall near the nurse's station, swearing loudly. An appropriate initial intervention for the nurse would be to address the client by name and say: A "Please quiet down." B "You seem upset. Would you like to tell me about it?" C "Hey, why are you so upset?" D "You need to go to your room to get control of yourself."
B "You seem upset. Would you like to tell me about it?"
The nurse has taken report for the evening shift on an adolescent inpatient unit. Which client should the nurse address first? A A client diagnosed with Oppositional Defiant Disorder being sexually inappropriate with staff B A client diagnosed with Conduct Disorder who is verbally abusing a peer in the milieu C A client diagnosed with Conduct Disorder who is demanding special attention from staff D A client diagnosed with ADHD who has a history of self-mutilation
B A client diagnosed with Conduct Disorder who is verbally abusing a peer in the milieu
A nurse is caring for a client who has a new prescription for risperidone. Which of the following rating scales should the nurse complete prior to administering the first dose of risperidone? A Beck's Depression Inventory B Abnormal Involuntary Movement Scale C Hamilton Depression Scale D The Body Attitude Test
B Abnormal Involuntary Movement Scale
Symptoms of amphetamine withdrawal include: A Tremors, nausea/vomiting, malaise, weakness, and tachycardia B Anxiety, depressed mood, irritability, and craving for the substance C Fighting, grandiosity, hypervigilance, and pupillary dilation D Aggressiveness, slurred speech, nystagmus, and a flushed face
B Anxiety, depressed mood, irritability, and craving for the substance
A nurse is planning care for a client who has a diagnosed anxiety disorder. Which of the following intervention should the nurse implement to promote occupational functioning? A Help the client to identify prior accomplishments B Assist the client in identifying triggers C Identify the client's spirituality D Encourage the client to identify positive self attributes
B Assist the client in identifying triggers
People living with bulimia nervosa tend to be: A Underweight B Average weight C Obese D Morbidly obese
B Average weight
A nurse assessing a client with post-traumatic stress disorder (PTSD) would expect the client to report which finding? A Increased appetite B Fatigue C Manipulative behavior D Hypersomnia
B Fatigue
A nurse is caring for a newly admitted client who has obsessive-compulsive disorder (OCD). Which of the following actions should the nurse take first? A Provide a structured schedule for the client B Identify stressors that precipitate rituals C Instruct the client on meditation D Discuss alternative coping strategies with the client
B Identify stressors that precipitate rituals
A nurse in the emergency department is implementing a plan of care for an older adult client who is experiencing delirium tremens (Severe alcohol withdrawal symptoms such as shaking, confusion, and hallucinations). Which of the following actions should the nurse take first? A Administer clonidine B Lower the bed and raise the side rails C Obtain a medical history D Complete CIWA scale
B Lower the bed and raise the side rails
What is the difference between conduct disorder (CD) and oppositional defiance disorder (ODD)? A CD is mild and involves inattention B ODD does not involve physical aggression C CD is only present in boys D ODD is only diagnosed before age 5
B ODD does not involve physical aggression
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 Dramatic speech, impulsive D Suspicious, holds grudges
B Perfectionist, inflexible
A client is diagnosed with PTSD. Which treatment modality exposes the client to repeated and prolonged mental recounting of the traumatic event? A Cognitive therapy B Prolonged exposure therapy C Group therapy D Eye movement desensitization and reprocessing
B Prolonged exposure therapy
A nurse is assessing a 5-year-old client with autism spectrum disorder. For which of the following manifestations will the nurse assess? A Sedation B Repetitive hand gestures C Somatic illness problems D Elation
B Repetitive hand gestures
A nurse is planning care for a client who has antisocial personality disorder. Which of the following actions should the nurse plan to take? A Give positive feedback when client is assertive with staff or clients. B Set limits to prevent exploitation of other clients. C Discourage flamboyant or seductive behaviors. D Monitor the client closely to prevent self-mutilation
B Set limits to prevent exploitation of other clients.
Personality traits most likely to be documented regarding a patient demonstrating characteristics of a paranoid personality disorder are: A Affable, generous B Suspicious, holds grudges C Dramatic speech, impulsive D Perfectionist, inflexible
B Suspicious, holds grudges
Which finding is the nurse most likely to assess in a child diagnosed with separation anxiety disorder? A The child has a history of antisocial behaviors. B The child's mother is diagnosed with an anxiety disorder. C The child previously had an extroverted temperament. D The child's parents have inconsistent parenting styles.
B The child's mother is diagnosed with an anxiety disorder.
Jane is a 4-year-old who wakes up screaming in her room, she is frantic, states she wants her mom who had to leave hours ago to go home. All of the therapeutic techniques may be effective except: A Offering hope and age appropriate humor B Turning off the lights to calm her down C Active listening to the client, recognizing their fears. D Making observations around the room, discussing them with the client to calm her down.
B Turning off the lights to calm her down
The client states "I just can't fall asleep". The nurse responds, "You are having difficulty falling asleep?" Why is the nurse using the restating technique? A. The nurse wants the client to know they understand B. The nurse is allowing the client to elaborate or clear up misunderstanding C. The nurse is keeping the conversation going D. The nurse wants to focus on one idea
B. The nurse is allowing the client to elaborate or clear up
A patient tells the nurse, "I don't like you, you look like my grandmother." This is an example of what concept? A. Staff splitting B. Transference C. Manipulation D. Delusion
B. Transference
Of the following populations, which would Tourette's be most common in? A 2 year old boys B 2 year old girls C 6-7 year old girls D 6-7 year old boys
C 6-7 year old girls
You are the night nurse who has just gotten report on the following patients. Prioritize which of the patients you would see first. A 29 year old male admitted for pyelonephritis and S.I. who is currently feeling depressed and on suicide precautions B 88 year old female admitted for altered mental status placed on fall precautions C 70 year old male who is a post-surgical hip fracture with a history of dementia D 45 year old male with gall stones and GAD with complaints of anxiety
C 70 year old male who is a post-surgical hip fracture with a history of dementia
A nurse is reviewing the medical histories of four clients. Which of the following clients will be most likely to develop extrapyramidal symptoms from medication therapy? A A client with depression taking selective serotonin reuptake inhibitors B A client with schizoaffective disorder taking an atypical antipsychotic C A client with schizophrenia taking a first-generation antipsychotic D A client with anxiety disorder taking an anxiolytic medication
C A client with schizophrenia taking a first-generation antipsychotic
A nurse is caring for a client who is cognitively impaired. Which of the following rooms will provide a therapeutic environment for this client? A A room adjacent to the nursing station B A room without a window C A room containing personal belongings nearby without contrabands D A room with dim lighting
C A room containing personal belongings nearby without contrabands
A nurse is attempting to differentiate between the symptoms of anorexia nervosa and the symptoms of bulimia. Which statement delineates the difference between these two disorders? A Clients diagnosed with anorexia nervosa have eroded tooth enamel, whereas clients diagnosed with bulimia nervosa do not. B Clients diagnosed with bulimia nervosa experience hypotension, edema, and lanugo, whereas clients diagnosed with anorexia nervosa do not. C Clients diagnosed with anorexia nervosa experience extreme nutritional deficits, whereas clients diagnosed with bulimia nervosa do not. D Clients diagnosed with bulimia nervosa experience amenorrhea, whereas clients diagnosed with anorexia nervosa do not.
C Clients diagnosed with anorexia nervosa experience extreme nutritional deficits, whereas clients diagnosed with bulimia nervosa do not.
The nurse is reviewing the plan of care for a 15-year-old client diagnosed with anorexia nervosa. The treatment team plans to implement cognitive behavior therapy (CBT). Which is the best rationale for the use of CBT for clients diagnosed with anorexia nervosa? A Recognize maladaptive eating patterns as defense mechanisms. B Promote autonomy and control overeating behaviors. C Eliminate emotional components of maladaptive eating patterns. D Allow client to establish goals of the treatment plan.
C Eliminate emotional components of maladaptive eating patterns.
The nurse is reviewing the plan of care for a 15-year-old client diagnosed with anorexia nervosa. The treatment team plans to implement cognitive behavior therapy (CBT). Which is the best rationale for the use of CBT for clients diagnosed with anorexia nervosa? A Recognize maladaptive eating patterns as defense mechanisms. B Promote autonomy and control overeating behaviors. C Eliminate emotional components of maladaptive eating patterns. DAllow client to establish goals of the treatment plan.
C Eliminate emotional components of maladaptive eating patterns.
Possible predisposing factors to Schizoid personality disorder include all of the following except : A A bleak childhood B Notable childhood negligence C Having overly protective parents D Hereditary Factors
C Having overly protective parents
A client taking phenelzine has a blood pressure of 210/119, a HR of 104 bpm, and diaphoresis. The nurse discovers the client has recently taken over the counter medication for allergies and a cold. The nurse recognizes this client is experiencing: A Hypertension B Neuroleptic Malignant Syndrome C Hypertensive crisis D Serotonin Syndrome
C Hypertensive crisis
The following are all common comorbid psychiatric disorders prevalent with ADHD, except: A Anxiety B Depression C Obsessive Compulsive Disorder D Substance Use disorders
C Obsessive Compulsive Disorder
Which nursing intervention is the priority when caring for a child diagnosed with conduct disorder? A Modify the environment to decrease stimulation and provide opportunities for quiet reflection. B Convey unconditional acceptance and positive regard. C Recognize escalating aggressive behaviors and intervene before violence occurs. D Provide immediate positive feedback for appropriate behaviors.
C Recognize escalating aggressive behaviors and intervene before violence occurs.
Which of the following defense mechanisms describes the underlying cause of somatic symptom disorder? A Denial of depression B Suppression of grief C Repression of anxiety D Displacement of anger
C Repression of anxiety
The nurse working in an acute care psychiatric facility is working with clients that have personality disorders. The nurse knows that cluster A personality disorders (odd, eccentric) tend to exhibit what behaviors? A. Dramatic B. Dependency C. Indifference to social situations D. Splitting between healthcare providers
C. Indifference to social situations
Consider this comment to three different nurses by a patient diagnosed with antisocial personality disorder, "Another nurse said you don't do your job right." Collectively, these interactions can be assessed as: A. Insightful B. Guilt-producing C. Manipulative D. Detached
C. Manipulative
The clearest indication of success in behavior modification related to eating disorders would be... A A client inducing vomiting at a smaller frequency B A client claiming they have gained some needed weight C A client showing patterns of an improved mood D A client showing and demonstrating that they have perceptions of control over their life and treatments
D A client showing and demonstrating that they have perceptions of control over their life and treatments
A clearly underweight client presents constant descriptions of distorted body images and denies that they ever binge eat. You can assume that the client is suffering from: A Bulimia Nervosa B Binge-eating disorder C Obesity D Anorexia Nervosa
D Anorexia Nervosa
A nurse is caring for a client who with an eating disorder. The nurse is demonstrating which of the following ethical concepts when they allow the client to refuse to drink a between meal protein and calorie supplement? A Fidelity B Beneficence C Veracity D Autonomy
D Autonomy
A 28-year-old client with body dysmorphic disorder (BDD) tells the nurse that they plan to have a surgical procedure that will affect their appearance. The nurse understands that this plan is an effort to A Suppress intrusive thoughts B Deal with multiple physical complaints C Treat associated depression D Cure the imagined defect
D Cure the imagined defect
A client is newly diagnosed with obsessive-compulsive disorder and spends 45 minutes washing their hands and completing ritualistic tasks. Which nursing intervention would best address this client's problem? A Lock the room to discourage ritualistic behavior. B Report the behavior to the psychiatrist to obtain an order for medication dosage change. C Distract the client with other activities whenever ritual behaviors begin. D Discuss the anxiety-provoking triggers that precipitate the ritualistic behaviors.
D Discuss the anxiety-provoking triggers that precipitate the ritualistic behaviors.
A nurse is teaching a male client who has a depressive disorder about escitalopram. Which of the following information should the nurse include in the teaching? A This medication may cause muscle rigidity temporarily B You will notice an improvement in mood within 2-3 days C A fever is a common side effect of this medication D This medication may cause an inability to orgasm
D This medication may cause an inability to orgasm
The most important short term goal of a client with avoidant personality disorder would be to: A express feelings verbally B stop initiating arguments C acknowledge own behavior D state a positive personality trait
D state a positive personality trait
Rank the following nursing interventions based on priority of a patient diagnosed with bulimia nervosa A)Draw Blood for CBC and CMP B) Asses for depression C) Obtain Vitals D) Perform ECG E) Teach and encourage on self-care activities
D, C, A, B, E
A nurse is admitting a client who is in the manic phase of bipolar disorder. The nurse should plan to make which of the following room assignments for the client? A. A seclusion room until the client's activity level becomes more subdued B. A semi-private room with a roommate who has a similar diagnosis C. A private room away from the nursing station D. A private room in a quiet location that can easily be monitored
D. A private room in a quiet location that can easily be monitored
The pharmacological action of methylphenidate causes a decrease in appetite. A. They are below normal weight B. They binge when they experience hunger C. They will be highly motivated to seek help D. They are within their normal weight range
D. They are within their normal weight range
A patient with a substance abuse problem makes statements such as, "I don't have a problem with (substance)" or "I can quit any time I want to." The patient also does not perceive any problems related to use of the substance and is unable to admit the impact of the disease on his or her life patterns and functioning. What nursing diagnosis would you assign to this patient?
Denial
An adolescent diagnosed with ADHD is having difficulty maintaining concentration in the in client milieu. Which nursing intervention would help improved the clients task performance
Encourage dividing tasks into smaller attainable steps and reward successful completion
A client diagnosed with borderline personality disorder is admitted to a psychiatric unit, which behavior pattern would the nurse expect to observe
Generates conflict among the staff
The following are characteristics of which Cluster B personality Disorder: Arrogance, Grandiosity, lack of empathy and sensitive to criticism
Narcissistic Personality Disorder
This is a potentially fatal complication that results in the introduction of fluids and carbohydrates for patients who are malnourished.
Refeeding Syndrome
when assessing a client diagnosed with narcissistic personality disorder the nurse expects to identify which characteristic behavior
grandiose sense of self importance
in assessing a client diagnosed with borderline personality disorder, which characteristic would the nurse expect to have
littler tolerance for being alone?