Midterm: Review Questions pt. 1
Immediately after an initial ECT procedure, a client states, "I'm not hungry and just want to stay in bed and sleep." Based on this info, which nursing intervention is appropriate? a. Allow the client to remain in bed b. Involve the client in physical activities to stimulate circulation c. Obtain a physician's order for parenteral nutrition d. Encourage the client to join the milieu to promote socialization
a
A nurse administers ordered pre-op glycopyrrolate 30 mins prior to a clients ECT procedure. Which statement described the rationale for administering this med? a. Glycopyrrolate decreases anxiety during the ECT procedure b. Glycopyrrolate induces an unconscious state to prevent pain during the ECT procedure c. Glycopyrrolate decreases secretions to parent aspiration during the ECT procedure d. Glycopyrrolate prevents severe muscle contractions during the ECT\
c
A high school basketball player sustains a serious knee injury and states to the school nurse, "I will never go to college if I dont receive a basketball scholarship." Which nursing reply would assist the student to see a broader range of possibilites? a. I know you are feeling helpless now, but you are looking at this from only one perspective b. Can your family afford knee surgery? c. You may beed to prioritize your academics and not focus on basketball d/ Lets look at the alternatives for funding your college education
d
Which statement demonstrates the cognitive approach the nurse is using hen eating a client about panic disorder? a. Keep a journal to note feelings surrounding the panic attacks b. You might want to stay in the house when you notice the symptoms beginning c. Medications such as lorazepam (Ativan) should be taken when symptoms start d. Remind yourself that symptoms of a panic attack are time limited and will end
d
The nurse is implementing a one-on-one suicide observation level with a client diagnosed with major depressive disorder (MDD). The client states, "I'm feeling a lot better, so you can stop watching me. I have taken up too much of your time already." Which is the best nursing reply? a. "Because we are concerned about your safety, we will continue to observe you." b. "I am glad you are feeling better. The treatment team will consider your request." c. "I really appreciate your concern, but I have been ordered to watch you." d. "I will forward your request to the your psychiatrist because it is his decision."
A
The nurse is preparing a teaching plan for the parent of a child diagnosed with attention-deficit hyperactivity disorder. The parent voices concern over the child's poor appetite and inability to gain weight. Which of the following interventions would be the most appropriate to address the parent's concerns? a. Administer the child's medication immediately after meals. b. Administer the child's medication at bedtime. c. Skip a dose of medication when the child does not eat well. d. Assure the parent that the child will eat when hungry.
A
When planning group therapy, the nurse identifies which configuration as most optimal for a therapeutic group? a. Closed membership, circle of chairs, group size of 5 to 10 members b. Open-ended membership, chairs around a table, group size of 10 to 15 members c. Open-ended membership, circle of chairs, group size of 5 to 10 members d. Closed membership, chairs around a table, group size of 10 to 15 members
A
Which client response should a nurse expect during the working phase of the nurse-client relationship? A. The client gains insight and incorporates alternative behaviors. B. The client and nurse establish rapport and mutually develop treatment goals. C. The client explores feelings related to reentering the community. D. The client explores personal strengths and weaknesses that impact behaviors.
A
Which client statement may indicate a transference reaction? A. I need a real nurse. You are young enough to be my daughter and I dont want to tell you about my personal life. B. I deserve more than I am getting here. Do you know who I am and what I do? Let me talk to your supervisor. C. I dont seem to be able to relate to people. I would rather stay in my room and be by myself. D. My mother is the source of my problems. She has always told me what to do and what to say.
A
Which neurotransmitter would the nurse expect to be elevated in a client with a diagnosis of catatonia? a. Dopamine b. Histamine c. Norepinephrine d. Serotonin
A
Which of the following best defines secondary depression? a. Depressive symptoms that occur as a consequence of an adverse effect of certain medications. b. Depressive symptoms as a result of MDD exacerbation and elevated serotonin levels. c. Depressive symptoms that occur with abrupt discontinuation of antidepressants. d. Depressive symptoms that occur as a result of psychomotor retardation.
A
Which response by the instructor is accurate regarding blood pressure cuff placement on the client's lower leg during an electroconvulsive therapy (ECT) procedure? a. "The cuff functions to prevent succinylcholine from reaching the foot." b. "The cuff position gives a more accurate blood pressure reading during the treatment." c. "The cuff has to be placed on the leg because both arm are used for IV fluids." d. "The cuff is placed on the leg so that arms can easily be restrained during seizure."
A
Which situation should a nurse identify as an example of an autocratic leadership style? a. The unit manager completes the work schedule without input from staff members. b. The president of a club asks members to form research committees. c. The student nurses' association advertises for candidates for president. d. During a community meeting, a nurse listens as clients generate solutions.
A
Which statement is most accurate regarding the assessment of clients diagnosed with psychiatric problems? a. Assessment provides a holistic view of the client, including biopsychosocial-spiritual aspects. b. Medical history is of little significance and can be eliminated from the nursing assessment. c. Psychosocial evaluations are gained by subjective reports rather than objective observations. d. Comprehensive assessments can be performed only by advanced practice nurses.
A
Which therapeutic communication technique is being used in this nurseclient interaction? Client: My father spanked me often. Nurse: Your father was a harsh disciplinarian. A. Restatement B. Offering general leads C. Focusing D. Accepting
A
An experienced psychiatric registered nurse has taken a new position leading groups in a day treatment program. Which group is the nurse most qualified to lead? a. Parenting group b. Psychodrama group c. Family therapy group d. Psychotherapy group
A Registered nurses are not qualified to lead psycho groups
An advanced practice nurse recommends that a client participate in cognitive behavior therapy. The client asks, "What's cognitive behavior therapy and how can it help me?" Which is the nurse's best reply? a. "It is an interpersonal approach that specifically targets magical thinking." b. "It is a focused treatment for the modification of distorted thinking and maladaptive behaviors." c. "Tt is a long-term interpersonal approach that emphasizes the role of early childhood experiences." d. "It is a system of techniques in which you use positive thinking to improve your mood.
B
An unemployed college graduate confides in the clinic nurse that she is experiencing severe anxiety over not finding a teaching position and that she is having difficulty with independent problem-solving. Which nursing intervention is best? a. Encourage her to use other coping mechanisms. b. Assist her with the problem-solving process. c. Complete the problem-solving process for her. d. Encourage her to keep a daily journal of feelings.
B
Beck's original concept for cognitive behavior therapy has been expanded by many theorists, but the foundation remains. Which of the following best describes the historical foundation of cognitive behavior therapy? a. Cognitive behavior therapy has been the forefront of the Freudian framework of psychoanalysis. b. Rejection of passive listening used in psychoanalysis in favor of active, direct dialogues with clients. c. Recognition that cognitive behavior therapy works for depression but not for other emotional disorders. d. Utilization of the psychoanalytic view of seeing depression as "anger turned inward."
B
During a therapeutic group, which nursing action demonstrates a laissez-faire leadership style? a. The nurse shuffles through papers to determine the facility policy on length of group. b. The nurse sits silently as the group members stray from the assigned topic. c. The nurse mandates that all group members reveal an embarrassing personal situation. d. The nurse asks for a show of hands to determine group topic preference
B
How would the nurse differentiate a client diagnosed with a social phobia from a client diagnosed with a schizoid personality disorder (SPD)? a. Clients diagnosed with SPD are distressed by the symptoms experienced in social settings, whereas clients diagnosed with social phobia are not. b. Clients diagnosed with social phobia avoid interactions only in social settings, whereas clients diagnosed with SPD avoid interactions in all areas of life. c. Clients diagnosed with SPD avoid interactions only in social settings, whereas clients diagnosed with social phobias tend to avoid interactions in all areas of life. d. Clients diagnosed with social phobia can manage anxiety without medications, whereas clients diagnosed with SPD can manage anxiety only with medications.
B
How would the nurse differentiate a client diagnosed with panic disorder from a client diagnosed with generalized anxiety disorder (GAD)? a. Depersonalization is commonly seen in panic disorder and absent in GAD. b. Chest pain is a common GAD symptom, whereas this symptom is absent in panic disorders. c. Hyperventilation is a common symptom in GAD and rare in panic disorder. d. GAD is acute in nature, and panic disorder is chronic
B
Learning has occurred when the student identifies that the neurotransmitter serotonin is catabolized by which enzyme? a. Acetylcholinesterase b. Monoamine oxidase c. Cathechol-O-methyltransferase (COMT) d. GABA transaminase
B
Miller and Rahe (1997) identified a correlation between the effects of life change and illness. This research led to the development of the Recent Life Changes Questionnaire (RLCQ). Which principle most limits the effectiveness of this tool? a. Specific physical and psychological illnesses are not identified. b. An individual's personal perception of the event is excluded. c. Numerical values associated with specific events are randomly assigned. d. Stress is viewed as a solely physiological response.
B
What is the priority nursing action during the orientation (introductory) phase of the nurse-client relationship? A. Acknowledge the client's actions and generate alternative behaviors. B. Establish rapport and develop treatment goals. C. Attempt to find alternative placement. D. Explore how thoughts and feelings about this client may adversely impact care.
B
When an individual's stress response is sustained over a long period, the nurse anticipates which physiological effect? a. Increased libido b. Decreased resistance to disease c. Decreased blood pressure d. Increased inflammatory response
B
Which statement regarding nursing interventions is accurate? a. Nursing interventions are directed solely by written physician's orders. b. Nursing interventions occur independently but align with overall treatment team goals. c. Nursing interventions are standardized by policies and procedures with client input. d. Nursing interventions are independent of the treatment team's goals.
B
How would the nurse best describe the major maladaptive client response to panic disorder? a. Clients develop compulsions to deal w/ anxiety b. Clients perceive having no control over life situations c. Clients use illegal drugs to ease symptoms d. Clients overuse medical care bc of physical symptoms
B major response, can lead to non-participation in decision-making and doubts regarding role performance
Which of the following statements regarding role-playing is correct? Select all that apply. a. Role-playing is a type of distractor from negative thinking. b. Role-play is limited to strong relationships between client and therapist. c. The situation is played out to help the client recognize their automatic thinking. d. The client assumes the role of the antagonist that produces the maladaptive response. e. Role-play teaching increases awareness of controlled breathing.
B, C
A client's spouse of 34 years dies unexpectedly. The client cries often and becomes socially isolated. The client's therapist stresses the importance of proper sleep, nutrition, and exercise. What is the best rationale for the therapist's advice? a. Sleep, nutrition, and exercise will alleviate symptoms of depression. b. Sleep, nutrition, and exercise affect imbalances in neurotransmitters. c. The client is susceptible to illness due to effects of stress on the immune system. d. An interpersonal approach is indicated for depressed clients.
C
A depressed client states, "I have a chemical imbalance in my brain. I have no control over my behavior. Medications are my only hope to feel normal again." Which response by the nurse is best? a. "Researchers have been unable to demonstrate a link between biology and genetics." b. "Biological factors are the sole cause of depression, so medications will improve your mood." c. "Medications are one way to address chemical imbalances. Environmental and interpersonal factors can also have an impact on biological factors." d. "Environmental factors have been shown to exert the most influence in the development of depression."
C
A family member is seeking advice about an elderly parent who seems to worry unnecessarily about everything. The family member asks, "Should I seek psychiatric help for my mother?" Which is the nurse's most appropriate reply? a. "My mother also worries unnecessarily. I think it is part of the aging process." b. "From what you have told me, you should get her to a psychiatrist as soon as possible." c. "Anxiety is considered abnormal when it is out of proportion to the stimulus causing it and when it impairs functioning." d. "Anxiety is a complex phenomenon and is effectively treated only with psychotropic medications."
C
A man diagnosed with alcohol use disorder experiences his first relapse. During his Alcoholics Anonymous (AA) meeting, another group member states, "I relapsed three times, but now have been sober for 15 years." Which of Yalom's curative group factors does this illustrate? a. Universality b. Imparting of information c. Instillation of hope d. Imparting of information
C
A nurse moving out of state speaks to a client about the need to work with a new nurse. The client states, Im not well enough to switch to a different nurse. What does this client response indicate to the nurse? A. The client is using manipulation to receive secondary gain. B. The client is using the defense mechanism of denial. C. The client is having trouble terminating the relationship. D. The client is using splitting as a way to remain dependent on the nurse.
C
A patient who is older with chronic schizophrenia takes an antipsychotic and propranolol, a beta-adrenergic blocking agent, for hypertension. Given the combined side effects of these drugs, which client teaching should the nurse provide? a. "Make sure you concentrate on taking slow, deep, cleansing breaths." b. "Wear sunscreen and try to avoid midday sun exposure." c. "Rise slowly when you change position from lying to sitting or sitting to standing." d. "Watch your diet and try to engage in some regular physical activity."
C
After undergoing two of nine electroconvulsive therapy (ECT) procedures, a client states, "I can't even remember eating breakfast, so I want to stop ECT." Which reply by the nurse is appropriate? a. "You'll need to talk with your doctor about what you're thinking." b. "Memory loss is a rare side effect of the treatment. I don't think it should be a concern." c. "It is within your right to discontinue the treatments, but let's talk about your concerns." d. "After you begin the course of treatments, you must complete all of them."
C
As part of discharge teaching, which guideline regarding lithium therapy will the nurse plan to include? a. Avoid excessive use of decaffeinated beverages. b. Maintain a consistently low intake of sodium. c. Consume at least 2500 mL of fluid daily d. Monitor blood sugar levels twice daily.
C
In the treatment of anxiety disorders, benzodiazepines (e.g.. lorazepam [Ativan], alprazolam [Xanax]) are indicated for __________use and have _____ potential for misuse. a. Long-term; low b. Short-term; low c. Short-term; high d. Long-term; high
C
Which client statement indicates that termination of the therapeutic nurseclient relationship has been handled successfully? A. I know I can count on you for continued support. B. I am looking forward to discharge, but I am surprised that we will no longer work together. C. Reviewing the changes that have happened during our time together has helped me put things in perspective. D. I dont know how comfortable I will feel when talking to someone else
C
Which client statement indicates the nurse's teaching about the effect of circadian rhythms is effective? a. "When I dream about my mother's horrible train accident, I become hysterical." b. "Every February, I tend to experience periods of sadness." c. "I'm a morning person, so I get my best work done in the a.m." d. "I get really irritable during my menstrual cycle."
C
Which client statement should a nurse identify as a typical response to stress most often experienced in the working phase of the nurse-client relationship? A. "I can't bear the thought of leaving here and failing." B. "I might have a hard time working with you. You remind me of my mother." C. "I can't tell my husband how I feel; he wouldn't listen anyway." D. "I'm not sure that I can count on you to protect my confidentiality."
C
Which hormone is used experimentally to increase socialization? a. Growth hormone b. Prolactin c. Oxytocin d. Gonadotropic hormones
C
Which neurotransmitter is associated with the fight-or-flight response of a restless, agitated client? a. Serotonin b. Acetylcholine c. Norepinephrine d. Dopamine
C
A client has a hx of excessive fear of water. Which term should the nunrse use to describe this specific phobia, and under what subtype is this phobia identified? a. Acrophobia a situational type b. Acrophobia a natural environment type c. Aquaphobia a natural environment type of phobia d. Aquaphobia a situational type of phobia
C Natural environment: fears about objects or situations that occur in the natural environment
he nurse anticipates the client with an increased thyroid-stimulating hormone (TSH) level will exhibit which symptoms? Select all that apply. a. Hyperexcitability b. Increased libido c. Depression d. Fatigue e. Mania
C, D
Which conditions place a client at risk for injury during electroconvulsive therapy (ECT)? Select all that apply. a. Hypthyroidism b. Prostatic hypertrophy c. Severe osteoporosis d. Acute and chronic pulmonary disorders e. Recent cardiovascular accident
C, D, E
Which of the following are characteristics of accurately developed client outcomes? Select all that apply. a. Client outcomes are formulated by each nurse, independent of other team members. b. Client outcomes are not restricted by time frames. c. Client outcomes are realistically based on client capability. d. Client outcomes are formally approved the the psychiatrist and nurse practitioner. e. Client outcomes are specific and measurable.
C, D, E
A cab driver stuck in traffic is suddenly lightheaded, tremulous, and diaphoretic and experiences tachycardia and dyspnea. An extensive work-up in an emergency department reveals no pathology. Which medical diagnosis is suspected, and which nursing diagnosis is the priority? a. Generalized anxiety disorder and a nursing diagnosis of fear b. Pain disorder and a nursing diagnosis of altered role performance c. Altered sensory perception and a nursing diagnosis of panic disorder d. Panic disorder and a nursing diagnosis of panic anxiety
D
A client diagnosed with Panic Disorder states, "When an attack happens, I feel like I am going to die." Which is the nurse's most appropriate reply? a. "Death from a panic attack happens so infrequently that there is no need to worry." b. "Most people who experience panic attacks have feelings of impending doom." c. "Tell me why you think you are going to die every time you have a panic attack." d. "I know it's frightening, but try to remind yourself that it will only last a short time."
D
A client was admitted with a single episode of major depression that was moderate. During her stay, she was started on Prozac (fluoxetine) at 40mg PO qd. The nurse's discharge teaching should include all of the following except: a. "Continue taking Prozac as prescribed. You will continue to see improvement over the next few weeks." b. "Make sure that you follow up with outpatient psychotherapy as you and the social worker have arranged." c. "You may be able to discontinue the medication within 6 months to 1 year, but only under a doctor's supervision. However, there is a chance of recurring episodes." d. "You should avoid foods with tyramine, including beer, beans, processed meats, and red wine."
D
A decrease in norepinephrine levels plays a significant role in which disorder? a. Mania b. Schizophrenia c. Anxiety d. Major depressive disorder
D
A mother who has learned that her child was killed in a tragic car accident states, "I can't bear to go on with my life." Which nursing statement conveys empathy? A. "This situation is very sad, but time is a great healer." B. "You are sad, but you must be strong for your other children." C. "Once you cry it all out, things will seem so much better." D. "It must be horrible to lose a child; I'll stay with you until your husband arrives."
D
A nurse states to a client, Things will look better tomorrow after a good nights sleep. This is an example of which communication technique? A. The therapeutic technique of giving advice B. The therapeutic technique of defending C. The nontherapeutic technique of presenting reality D. The nontherapeutic technique of giving false reassurance
D
A nursing student questions an instructor regarding the order for fluvoxamine (Luvox), 300 mg daily, for a client diagnosed with OCD. Which instructor reply is most accurate? a. "The dosage of fluvoxamine (Luvox) is outside the therapeutic range and needs to be questioned." b. "The dose of fluvoxamine (Luvox) is low due to the side effect of daytime drowsiness and nighttime insomnia." c. "High doses of tricyclic medications will be required for effective treatment of OCD." d. "SSRI doses, more than what is effective for treating depression, may be required for OCD."
D
An isolative client was admitted 4 days ago with a diagnosis of major depressive disorder (MDD). Which nursing statement would best motivate this client to attend a therapeutic group being held in the milieu? a. "It must be difficult for you to attend group when you feel so bad." b. "Let me tell you about the benefits of attending this group." c. "We'll go to the day room when you are ready for group." d. "I'll walk with you to the day room. Group is about to start."
D
The nurse admits an older client who is experiencing memory loss, confused thinking, and apathy. A psychiatrist suspects depression. What is the rationale for performing a Mini-Mental Status Examination (MMSE)? a. To rule out bipolar disorder b. To rule out schizophrenia c. To rule out a personality disorder d. To rule out a neurocognitive disorder (NCD)
D
The school nurse is assessing a female high school student who is distraught because her parents can't afford horseback riding lessons. The nurse recognizes the student's perception is that the problem is: a. Endangering her well-being. b. Exceeds her capacity to cope. c. Based on immaturity. d. Personally relevant.
D
The student comes in to the instructor's office and reports that they wish to drop out of nursing school due to the overwhelming work. The instructor advises the student to write assignments on a calendar to help break down what needs to be done and when. What technique is the instructor using? a. Activity scheduling b. Behavioral rehearsal c. Distraction d. Graded task assignments
D
What is the most essential task for a nurse prior to forming a therapeutic relationship with a client? A. Determine the client's length of stay. B. Establish personal goals for the interaction. C. Obtain thorough assessment data. D. Clarify personal attitudes, values, and beliefs.
D
What is the priority reason for the nurse to perform a full physical health assessment on a client assmited w/ a dx of MDD? a. Physical health complication are likely to arise from antidepressant therapy b. Depressed clients avoid addressing physical health and ignore medical problems c. The attention during the assessment is beneficial in decreasing social isolation d. Depression is a symptom of several medical conditions
D
What is the purpose of a nurse providing appropriate feedback? A. To give the client good advice B. To advise the client on appropriate behaviors C. To evaluate the clients behavior D. To give the client critical information
D
When is self-disclosure by the nurse appropriate in a therapeutic nurseclient relationship? A. When it is judged that the information may benefit the nurse and client B. When the nurse has a duty to warn C. When the nurse feels emotionally indebted toward the client D. When it is judged that the information may benefit the client
D
Which client diagnosis would the nurse associate with a decrease in gamma-aminobutyric acid (GABA) levels? a. Schizophrenia b. Depression c. Alzheimer's disease d. Panic disorder
D
Which is the best nursing action when a client demonstrates transference toward a nurse? A. Promoting safety and immediately terminating the relationship with the client B. Encouraging the client to ignore these thoughts and feelings C. Immediately reassigning the client to another staff member D. Helping the client to clarify the meaning of the current nurse-client relationship
D
Which medication does not require periodic blood-level monitoring? a. lithium carbonate (Eskalith) b. clozapine (Clozaril) c. valproic acid (Depakote) d. sertaline (Zoloft)
D
Which of the following is the nurse's most therapeutic statement when the client and nurse move from the orientation stage to the working stage of the therapeutic relationship? A. "I think we need to focus on your relationship issues first." B. "A long-term goal for someone your age would be to develop better job skills." C. "I want to assure you that I will maintain your confidentiality." D. "Which of the problems that we identified would you like for us to address first?"
D
Which statement best describes how the perspective on psychopharmacological use of phenothiazines has historically changed? a. Phenothiazines were originally used for postoperative care and found to improve the client's ability to recover from anesthesia. b. Phenothiazines were originally used for individuals with diabetes to control their appetite and blood sugars. c. Phenothiazines were originally used for infection control and found to improve a client's treatment compliance. d. Phenothiazines were originally used as a preoperative medication and found to improve the patient's anxiety
D
Which therapeutic communication technique is being used in this nurseclient interaction? Client: When I get angry, I get into a fistfight with my wife or I take it out on the kids. Nurse: I notice that you are smiling as you talk about this physical violence. A. Encouraging comparison B. Exploring C. Formulating a plan of action D. Making observations
D
a first-time mother is crying and asks the nurse, "How can I go to work if I can't afford child care?" Which is the nurse's initial action to assist the client with problem-solving? a. Determine the risks and benefits for each alternative b. Evaluate the outcome of the implemented alternative c. Formulate goals for resolution of the problem d. Assess the facts of the situation
D
A client diagnosed with OC spends hours bathing and grooming. During one-on-one interaction, the client discusses the rituals in detail, but avoids and feelings that the rituals generate. What defense mechanism should the nurse identify? a. Rationalization b. Dissociation c. Sublimation d. Intellectualization
D -Dissociation is not a defense mechanism -It is intellectualization bc they are avoiding expressing their emotions associated w/ a stressful situation
Which nurse group leader activity. Is the most important in the final termination phase of group development? a. The group leader encourages members to rely on each other for problem-solving b. The group leader establishes the rules that will govern the group after discharge c. The group leader presents and discussess the concept of group termination d. The group leader helps the members to process feelings of loss
D Discharge planning starts before the end, in the orientation phase
A client living on the beachfront seeks help with an extreme fear of crossing bridges, which interferes with daily life. A psychiatric-mental health nurse practitioner decides to try systematic desensitization. Which explanation of this therapy should the nurse convey to the client? a. "Through a series of increasingly anxiety-provoking steps, we will gradually increase your tolerance to anxiety." b. "Because anxiety and relaxation are mutually exclusive states, we can attempt to substitute a relaxation response for the anxiety response." c. "In one intense session, you will be exposed to a maximum level of anxiety that you will learn to tolerate." d. "Using your imagination, we will attempt to achieve a state of relaxation that you can replicate when faced with crossing a bridge."
A
A client with schizophrenia has recently begun a new medication, clozapine (Clozaril). About which potentially fatal side effect will the nurse teach the client? a. Agranulocytosis b. Akinesia c. Dystonia d. Akathisia
A
A nurse administers pure oxygen to a client during and after electroconvulsive therapy (ECT). Which statement describes the rationale for this procedure? a. To prevent anoxia due to medication-induce paralysis of respiratory muscles. b. To prevent increased intracranial pressure resulting from anoxia c. To prevent blocked airway resulting from seizure activity d. To prevent hypotension, bradycardia, and bradypnea due to electrical stimulation
A
A nursing instructor asks students when diseases of adaptation are likely to occur. Which student response indicates that teaching is effective? a. "When an individual's physiological and psychological resources are depleted." b. "When an individual has limited experience dealing with stress." c. "When an individual experiences existing conditions that exacerbate stress." d. "When an individual inherits maladaptive genes."
A
A psychiatric nurse is counseling a client who has thought patterns consisting of rapid responses to a situation without rational analysis. Which assessment data will the nurse document? a. "Thought patterns include a predominance of automatic thoughts." b. "Thought patterns are triggered by specific stressful stimuli." c. "Thought patterns contain the client's fundamental beliefs and assumptions." d. "Thought patterns are flexible and based on personal experience,"
A
An increase in dopamine activity might play a significant role in the development of which disorder? a. Schizophrenia b. Body dysmorphic disorder c. Major depressive disorder d. Parkinson's disease
A
In which position would the nurse place the client immediately after electroconvulsive therapy (ECT)? a. On his or her side to prevent aspiration b. In prone position to prevent airway blockage c. In Trendelenburg's position to promote blood flow to vital organs d. In semi-Fowler's position to promote oxygenation
A
The client is hospitalized with coronary artery disease and demonstrates other conditions often associated with diseases of adaptation, including headaches and depression. Currently, the client is demonstrating anxiety and states he is "really worried" about his spouse. Which is the most appropriate nursing response to the situation? a. Encourage the client to talk through his concerns about his spouse. b. Inform the client that he has to learn to cope with stressors. c. Ask the client if he has a pet he would like to see while in the hospital. d. Teach the client how to meditate when he is feeling anxious.
A
The following North American Nursing Diagnosis Association (NANDA) nursing diagnostic stem was developed for a client on an inpatient unit: "Risk for injury." Which assessment data most likely led to the development of this problems statement? a. The client is receiving electro-convulsive therapy (ECT) and is diagnosed with parkinsonism. b. The client expresses hopelessness and helplessness and isolates self. c. The client has disorganized thought processes and delusional thinking. d. The client has a history of four suicide attempts in adolescence.
A
The nurse is discussing treatment options with a client whose life has been negatively impacted by claustrophobia. The nurse would expect which of the following behavioral therapies to be most commonly used in the treatment of phobias? Select all that apply. a. Systematic desensitization b. Imploding (flooding) c. Aversion therapy d. Benzodiazepine therapy e. Assertiveness training
A, B
The nurse-client therapeutic relationship includes which of the following characteristics? Select all that apply. A. Ensuring therapeutic termination B. Promoting client insight into problematic behavior C. Meeting the psychological needs of the nurse and the client. D. Meeting the holistic needs of the client E. Collaborating to set appropriate goals
A, B, D, E
A 20-year-old female has a diagnosis of Premenstrual Dysphoric Disorder. Which of the following should the nurse identify as consistent with this diagnosis? Select all that apply. a. Client reports subjective difficulty concentrating. b. Symptoms are causing significant interference with work, school, and social relationships. c. Client manifests pressured speech when communicating. d. Client-rated mood is 2/10 for the past 6 months. e. Mood swings occur the week before onset of menses.
A, B, E
A nurse is interviewing a distressed client who reports being fired after 15 years of loyal employment. Which of the following questions best assists the nurse to determine the client's appraisal of the situation? Select all that apply. a. "What skills do you possess that might lead to gainful employment?" b. "Why do you think you were fired from your job?" c. "Have you ever experienced a similar stressful situation?" d. "What resources have you used previously in stressful situations?" e. "Who do you think is to blame for this situation?"
A, C, D
A patient began taking lithium for the treatment of bipolar disorder approximately 1 month ago and asks why he has gained 12 pounds since then. Which is the most appropriate nursing response? a. "There's not much you can do about the weight gain. It's better than being emotionally unstable though." b. "Weight gain is a common, but troubling side effect. Let's talk about some strategies for safely improving your nutrition and exercise habits." c. "It is surprising that you have gained weight; weight loss is the typical pattern when taking lithium." d. "Your weight gain is more likely related to food intake and decreased activity than medication."
B
A physically and emotionally healthy client has just been fired. During a routine office visit, he tells the nurse, "Perhaps this was the best thing to happen. Maybe I'll consider pursuing an art degree." The nurse determines the client perceives the stressor of his job loss as: a. Harm/loss. b. A challenge. c. Irrelevant. d. A threat.
B
A client diagnosed with MDD states, "I've been feeling 'down' for 3 months. Will I ever feel like myself again?" Which statement by the nurse best assesses this client's affective symptoms? a. "Have you ever felt this way before?" b. "Help me understand what you mean when you say, 'feeling down'." c. "Have you been diagnosed with any physical disorder within the last 3 months?" d. "People who have mood changes often feel better when Spring comes."
B
A client diagnosed with paranoid schizophrenia becomes agitated when asked to play a game. The client responds, Do you want to be my girlfriend? Which nursing response is most appropriate? A. You are upset now. It would be best if you go to your room until you feel better. B. Remember, we have a professional relationship. Are you feeling uncomfortable? C. We have discussed this before. I am not allowed to date clients. D. I think you should discuss your fantasies with your therapist.
B
A client diagnosed with post-traumatic stress disorder is admitted to an inpatient psychiatric unit for evaluation and medication stabilization. Which therapeutic communication technique used by the nurse is an example of a broad opening? A. What occurred prior to the rape, and when did you go to the emergency department? B. What would you like to talk about? C. I notice you seem uncomfortable discussing this. D. How can we help you feel safe during your stay here?
B
A client experiencing sleep apnea underwent a sleep study. During stage 3 of sleep, a delta rhythm was recorded. The nurse recognizes that a delta rhythm is characterized by which sleep activity? a. Dreaming b. Deep and restful sleep c. Relaxed waking d. Dozing
B
A client is admitted with a diagnosis of persistent depressive disorder (PDD). Which client statement describes a symptom consistent with this diagnosis? a. "Sometimes I hear voices telling me to kill myself." b. "I have been sad most of the time for the past several years." c. "I find myself preoccupied with death." d. "I'm afraid to leave the house."
B
A client who is diagnosed with Major Depressive Disorder (MDD) asks the nurse what causes depression. Which is the nurse's most accurate response? a. "Depression is caused by intrapersonal conflict between the id and the ego." b. "The exact cause of depressive disorders is unknown. A number of things, including genetic, biochemical, and environmental influences, likely play a role." c. "Depression is caused by a deficiency in neurotransmitters, including serotonin and norepinephrine." d. "Depression is a learned state of helplessness caused by ineffective parenting."
B
A hungry, homeless client, diagnosed with schizophrenia, refuses to participate in an admission interview. When the nurse postpones the admission interview, verbally assures safety, and provides a warm meal, he or she is promoting which of the following? A. Sympathy B. Trust C. Veracity D. Manipulation
B
A nurse maintains an uncrossed arm and leg posture. This nonverbal behavior is reflective of which letter of the SOLER acronym for active listening? A. S B. O C. L D. E E. R
B
A 10-week, prenuptial counseling group composed of five couples is terminating. At the last group meeting, a nurse notices that the two most faithful and participative couples are absent. When considering concepts of group development, which might explain their behavior? a. They were bored with the material covered in the group. b. They did not think any new material would be covered at the last session. c. They are feeling abandoned with the termination. d. They were angry with the leader for not extending the length of the group.
C
A 75-year-old client with a long history of depression is currently taking doxepin (Sinequan) 100 mg daily. The client also takes a diuretic for hypertension and is recovering from the flu. Which nursing diagnosis should the nurse assign the highest priority? a. Risk for ineffective thermoregulation R/T anhidrosis b. Risk for constipation R/T excessive fluid loss c. Risk for injury R/T orthostatic hypotension d. Risk for infection R/T suppressed white blood cell count
C
A client has a nursing diagnosis of "Insomnia R/T paranoid thinking AEB midnight awakenings, difficulty falling asleep, and daytime napping." Which is a correctly written and appropriate outcome for this client's problem? a. The client will exercise as needed before bedtime. b. The client's sleep habits will improve during hospitalization. c. The client will sleep 7 uninterrupted hours by day 4 of hospitalization. d. The client will avoid daytime napping and attend all groups.
C
A client is diagnosed with persistent depressive disorder (PDD) (dysthymia). Which should the nurse classify as an affective symptom of this disorder? a. Difficulty concentrating d. Gloomy and pessimistic outlook on life c. Low energy level d. Social isolation with a focus on self
C
A client refuses to go on a cruise to the Bahamas with his spouse because of fearing that the cruise ship will sink and all will drown. Using a cognitive theory perspective, the nurse should use which of these statements to explain the etiology of this fear t his spouse? a. "Your spouse may be unable to resolve internal conflicts, which result in projected anxiety. b. "Your spouse may have high levels of brain chemicals that may distort thinking." c. "Your spouse may be experiencing a distorted and unrealistic appraisal of the situation." d. "Your spouse may have a genetic predisposition to overreacting to potential danger."
C
Electroconvuslice therapy (ECT) is considered the treatment of choice for which client? a. 67 y.o. mania explaining a recent suicide attempt b. 41 y.o. woman describing a suicide plan c. 39 y.o. man experiencing recurrent suicidal ideation d. 23 y.o. woman experiencing PPD
a
