NUR 323 Exam #3 Practice Questions
A nurse is caring for a client who has substance-induced psychotic disorder and is experiencing auditory hallucinations. The client states, "The voices won't leave me alone!" Which of the following statements should the nurse make? (SATA) (ATI Chapter 15) A. "When did you start hearing the voices?" B. "The voices are not real, or else we would both hear them." C. "It must be scary to hear voices" D. "Are the voices telling you to hurt yourself?" E. "Why are the voices talking only to you?"
A. "When did you start hearing the voices?" C. "It must be scary to hear voices" D. "Are the voices telling you to hurt yourself?"
A nurse is completing an admission assessment for a client who has schizophrenia. Which of the following findings should the nurse document as positive symptoms? (SATA) (ATI Chapter 15) A. Auditory hallucination B. Lack of motivation C. Use of clang associations D. Delusion of persecution E. Constantly waving arms F. Flat affect
A. Auditory hallucination C. Use of clang associations D. Delusion of persecution E. Constantly waving arms
A nurse is reviewing the medical record of a client who has conversion disorder. Which of the following findings should the nurse identify as placing the client at risk for conversion disorder? (ATI Chapter 20) A. Death of a child 2 months ago B. Recent weight loss of 30 lb C. Retirement 1 year ago D. History of migraine headaches
A. Death of a child 2 months ago
A nurse is assessing a client who has illness anxiety disorder. Which of the following findings should the nurse expect? (Select all that apply.) (ATI Chapter 20) A. Obsessive thoughts about disease B. History of childhood abuse C. Avoidance of health care providers D. Depressive disorder E. Narcissistic personality
A. Obsessive thoughts about disease B. History of childhood abuse C. Avoidance of health care providers D. Depressive disorder
A nurse is caring for a client who has schizoaffective disorder. Which of the following statements indicates the client is experiencing depersonalization? (ATI Chapter 15) A. "I am a superhero and am immortal." B. "I am no one, and everyone is me." C. "I feel monsters pinching me all over." D. "I know that you are stealing my thoughts."
B. "I am no one, and everyone is me."
A nurse is discussing the risk factors for somatic symptom disorder with a newly licensed nurse. Which of the following risk factors should the nurse include? (Select all that apply.) (ATI Chapter 20) A. Age older than 65 years B. Anxiety disorder C. Female gender D. Coronary artery disease E. Obesity
B. Anxiety disorder C. Female gender
A nurse is speaking with a client who has schizophrenia when he suddenly seems to stop focusing on the nurse's questions and begins looking at the ceiling and talking to himself. Which of the following actions should the nurse take? (ATI Chapter 15) A. Stop the interview at this point, and resume later when the client is better able to concentrate B. Ask the client, "Are you seeing something on the ceiling?" C. Tell the client, "You seem to be looking at something on the ceiling. I see something there, too." D. Continue the interview without comment on the client's behavior.
B. Ask the client, "Are you seeing something on the ceiling?"
A nurse is caring for a client on an acute mental health unit. The client reports hearing voices that are telling her to "kill your doctor." Which of the following actions should the nurse take first? (ATI Chapter 15) A. Use therapeutic communication to discuss the hallucination with the client. B. Initiate one-to-one observation of the client C. Focus the client on reality D. Notify the provider of the client's statement.
B. Initiate one-to-one observation of the client
A client on the psychiatric unit has a diagnosis of antisocial personality disorder. Which of the following characteristics is consistent with this diagnosis? (Chapter 31) a. Lack of guilt for wrongdoing b. Insight into his own behavior c. Ability to learn from past experiences d. Compliance with authority
a. Lack of guilt for wrongdoing
A nurse is caring for a client who has avoidant personality disorder. Which of the following statements is expected from a client who has this type of personality disorder? (ATI Chapter 16) a. "I'm scared that you're going to leave me." b. "I'll go to group therapy if you'll let me smoke." c. "I need to feel that everyone admires me." d. "I sometimes feel better if I cut myself."
a. "I'm scared that you're going to leave me." -clients who have avoidant personality disorder often have a fear of abandonment
A nurse is caring for an adolescent client who has anorexia nervosa with recent rapid weight loss and a current weight of 90 lbs. Which of the following statements indicates the client is experiencing the cognitive distortion of catastrophizing? (ATI Chapter 19) a. "Life isn't worth living if I gain weight." b. "Don't pretend like you don't know how fat I am." c. "If I could be skinny, I know I'd be popular." d. "When I look in the mirror, I see myself as obese."
a. "Life isn't worth living if I gain weight."
A nurse is obtaining a nursing history from a client who has a new diagnosis of anorexia nervosa. Which of the following questions should the nurse include in the assessment? (select all that apply)(ATI Chapter 19) a. "What is your relationship like with your family?" b. "Why do you want to lose weight?" c. "Would you describe your current eating habits?" d. "At what weight do you believe you would look better?" e. "Can you discuss your feelings about your appearance?"
a. "What is your relationship like with your family?" c. "Would you describe your current eating habits?" e. "Can you discuss your feelings about your appearance?"
Which of the following is least likely to predispose a child to Tourette's disorder? (Chapter 32) a. Absence of parental bonding b. Family history of the disorder c. Abnormalities of brain neurotransmitters d. Structural abnormalities of the brain
a. Absence of parental bonding
A client is brought to the emergency department unconscious by a friend who says he was injecting heroin. The client is assessed to have a weak pulse. Which of these interventions are priorities? (Chapter 23) a. Administer naloxone and rescue breathing. b. IV benzodiazepines and continuous monitoring of vital signs. c. Ask the friend how much heroin he took and confirm with a laboratory drug screen. d. Initiate cardiopulmonary resuscitation and prepare to use an external defibrillator.
a. Administer naloxone and rescue breathing.
A client on the psychiatric unit tells the nurse that the CIA is looking for him and will kill him if they find him. The client's false belief is an example of a: (Chapter 24) a. Delusion of persecution. b. Delusion of reference. c. Delusion of control or influence. d. Delusion of grandeur.
a. Delusion of persecution.
A client who has been admitted to the chemical dependence treatment unit after being discliplined for drinking on the job states to the nurse, "I don't have a problem with alcohol. I can handle my booze better than anyone I know." Which defense mechanism is the client using? (Chapter 23) a. Denial b. Projection c. Displacement d. Rationalization
a. Denial
Recent research on the RAISE approach to the treatment of schizophrenia incorporates which of the following elements as important to improving outcomes? (Select all that apply.) (Chapter 24) a. Early intervention at the first episode of psychosis b. Support for employment or educational pursuits c. Rapid high-dose loading with antipsychotic medication d. Court-ordered sanctions for treatment e. Recovery-focused psychotherapy
a. Early intervention at the first episode of psychosis b. Support for employment or educational pursuits e. Recovery-focused psychotherapy
What is the ultimate goal of therapy for a client with dissociative identity disorder? (Chapter 29) a. Integration of the personalities into one b. The ability to switch from one personality to another voluntarily c. The ability to select one personality as the dominant self d. Recognition that the various personalities exist
a. Integration of the personalities into one
Which of the following symptom profiles would you expect when assessing a client with somatic symptom disorder? (Chapter 29) a. Multiple somatic symptoms in several body systems b. Fear of having a serious disease c. Loss or alteration in sensorimotor functioning d. Belief that his or her body is deformed or defective in some way
a. Multiple somatic symptoms in several body systems
Which of the following behavioral patterns is characteristic of individuals with narcissistic personality disorder? (Chapter 31) a. Overly self-centered and exploitative of others b. Suspicious and mistrustful of others c. Rule conscious and disapproving of change d. Anxious and socially isolated
a. Overly self-centered and exploitative of others
A client presents in the emergency department with complaints of suicidal ideation. The following information is collected by the nurse. Which of these assessment findings suggests that bulimia nervosa might be a health problem? (Select all that apply.) (Chapter 30) a. Parotid glands appear enlarged. b. Teeth have a "moth-eaten" pattern of tooth decay. c. Client reports that she takes laxatives daily. d. Client's weight is within the expected range.
a. Parotid glands appear enlarged. b. Teeth have a "moth-eaten" pattern of tooth decay. c. Client reports that she takes laxatives daily. d. Client's weight is within the expected range.
The nurse is reviewing discharge instructions with a client who is being discharged following a total knee replacement. Knowing that the client has a history of bipolar disorder, the nurse asks the client what needs they perceive they have for follow-up care related to this mental illness. This is an example of: (Chapter 21) a. Patient-centered care. b. Diagnostic overshadowing. c. Stigmatization. d. Discrimination.
a. Patient-centered care.
A client diagnosed with borderline personality disorder manipulates the staff in an effort to fulfill her own desires. All of the following may be examples of manipulative behaviors in the borderline patient except: (Chapter 31) a. Refusal to stay in a room alone, stating, "It's so lonely." b. Asking the nurse for cigarettes after 30 minutes, knowing the assigned nurse has explained she must wait 1 hour. c. Stating to the nurse, "I really like having you for my nurse. You're the best one around here." d. Cutting arms with razor blade after discussing dismissal plans with physician.
a. Refusal to stay in a room alone, stating, "It's so lonely."
Which of the following nursing diagnoses would be considered the priority in planning care for the child with severe autism spectrum disorder? (Chapter 32) a. Risk for self-mutilation evidenced by banging head against wall b. Impaired social interaction evidenced by unresponsiveness to people c. Impaired verbal communication evidenced by absence of verbal expression d. Disturbed personal identity evidenced by inability to differentiate self from others
a. Risk for self-mutilation evidenced by banging head against wall
A client is admitted to the hospital after an extended period of binge alcohol drinking. His wife reports that he has been a heavy drinker for several years. Laboratory reports reveal he has a blood alcohol level of 250 mg/dL. He is placed on the chemical addiction unit for detoxification. When would the first signs of alcohol withdrawal symptoms be expected to occur? (Chapter 23) a. Several hours after the last drink b. 2 to 3 days after the last drink c. 4 to 5 days after the last drink d. 6 to 7 days after the last drink
a. Several hours after the last drink
A client presents in the emergency department loudly proclaiming with rapid speech, "If I don't get more pain medication right now I'm going to call the attorney general and sue the entire healthcare network." Which of the following should the nurse include in the initial screening and assessment? (Select all that apply.) (Ch a. Substance use b. Pain c. Mental illness d. Prior history of convictions e. Availability of an inpatient psychiatric bed
a. Substance use b. Pain c. Mental illness
A nurse who is helping a client in the preparation stage of the Psychological Recovery model might include which of the following interventions? (Chapter 20) a. Teach about the effects of the illness and how to recognize, monitor, and manage symptoms. b. Help the client identify triggers that cause distress or discomfort. c. Help the client establish a daily maintenance list. d. Listen actively while the client composes his or her personal story.
a. Teach about the effects of the illness and how to recognize, monitor, and manage symptoms.
A client admitted to the emergency department smells strongly of alcohol, and his wife reports he has been a heavy drinker for the last 25 years. After the nurse completes an assessment, the physician asks if there are any physical signs of long-term chronic alcohol abuse. Which of these findings should the nurse include in reporting to the physician? (Select all that apply.) (Chapter 23) a. The client reports weak leg muscles, and his gait is unsteady. b. The client's abdomen is distended. c. The client reports he was coughing up some blood. d. The client reports he has double vision. e. Blood tests reveal a low white blood cell count.
a. The client reports weak leg muscles, and his gait is unsteady. b. The client's abdomen is distended. c. The client reports he was coughing up some blood. d. The client reports he has double vision. e. Blood tests reveal a low white blood cell count.
The Maudsley approach to the treatment of adolescents with anorexia nervosa advances which of the following fundamental concepts? (Chapter 30) a. The patient's family should be actively involved in each phase of treatment. b. Parents should be prohibited from involvement in helping their child eat since there are often control issues. c. Adolescents need to work on developing healthy self-identities before they can begin to gain weight. d. Individual psychotherapy is the most effective treatment for adolescents with anorexia nervosa.
a. The patient's family should be actively involved in each phase of treatment.
A client with schizophrenia has physician's orders for haloperidol (Haldol) 5 mg IM STAT and then 3 mg PO tid; 2 mg benztropine PO bid prn. Why is benztropine ordered? (Chapter 24) a. To treat extrapyramidal symptoms b. To prevent neuroleptic malignant syndrome c. To decrease psychotic symptoms d. To induce sleep
a. To treat extrapyramidal symptoms
A client was admitted to the intensive care unit after a single-car accident in which he struck a cement wall. He is now responsive and wants to be discharged within the next couple of days. Which of the following are priorities for screening? (Select all that apply.) (Chapter 21) a. Traumatic brain injury b. Chronic pain c. Sexual dysfunction d. Depression and risk for suicide
a. Traumatic brain injury d. Depression and risk for suicide
A charge nurse is preparing a staff education session on personality disorders. Which of the following personality characteristics associated with personality disorders should the charge nurse include in the teaching? SELECT ALL THAT APPLY (ATI Chapter 16) a. difficulty in getting along with other members of a group b. belief in the ability to become invisible during times of stress c. display of defense mechanisms when routines are changed d. claiming to be more important than other persons e. difficulty understanding why it is inappropriate to have a personal relationship with staff
a. difficulty in getting along with other members of a group c. display of defense mechanisms when routines are changed e. difficulty understanding why it is inappropriate to have a personal relationship with staff
A nurse is providing teaching to the family of a client who has substance use disorder. Which of the following statements by a family member indicates an understanding of the teaching? (Select all that apply) (ATI Chapter 18_) a. "We need to understand that our sibling is responsible for their disorder." b. "Eliminating codependent behavior will promote recovery." c. "Our sibling should participate in an Al-Anon group to assist with recovery." d. " The primary goal of treatment is abstinence from substance use." e. "Our sibling needs to discuss personal feelings about substance use to help with recovery."
b. "Eliminating codependent behavior will promote recovery." d. " The primary goal of treatment is abstinence from substance use." e. "Our sibling needs to discuss personal feelings about substance use to help with recovery."
The nurse is caring for a client who has been hospitalized with anorexia nervosa and is severely malnourished. The client continues to refuse to eat. What is the most appropriate response by the nurse? (Chapter 30) a. "You know that if you don't eat, you will die." b. "If you continue to refuse to take food orally, you will be fed through a nasogastric tube." c. "You might as well leave if you are not going to follow your therapy regimen." d. "You don't have to eat if you don't want to. It is your choice."
b. "If you continue to refuse to take food orally, you will be fed through a nasogastric tube."
A client has sought help for his concern that he is binge eating and feels like it has "gotten out of control." He asks the nurse what can be done to help him. Which of the following is the most accurate response? (Chapter 30) a. "Nothing can be done." b. "Some medications and psychological treatments have demonstrated effectiveness in reducing binge eating behaviors." c. "The primary problem is obesity. I can help you set up a calorie-restricted diet." d. "Medications can help with weight loss, but there are no medications effective for reducing binge eating."
b. "Some medications and psychological treatments have demonstrated effectiveness in reducing binge eating behaviors."
A client who has been admitted to the alcohol rehabilitation unit after being fired for drinking on the job states to the nurse, "I don't have a problem with alcohol. My boss is a jerk! I haven't missed any more days than my coworkers." What is the nurse's best response? (Chapter 23) a. "Maybe your boss is mistaken, Dan." b. "You are here because your drinking was interfering with your work." c. "Get real! You're an alcoholic and you know it!" d. "Why do you think your boss is a jerk?"
b. "You are here because your drinking was interfering with your work."
Which of the following behavioral patterns is characteristic of individuals with schizotypal personality disorder? (Chapter 31) a. Belittling themselves and their abilities b. A lifelong pattern of social withdrawal c. Suspicious and mistrustful of others d. Overreacting inappropriately to minor stimuli
b. A lifelong pattern of social withdrawal
A client has been diagnosed with schizophrenia. He has been socially isolated and is hearing voices telling him to kill his parents. He has been admitted to the psychiatric unit from the emergency department. The initial nursing intervention for Josh is to: (Chapter 24) a. Give him an injection of haloperidol. b. Assess his safety toward himself and others. c. Place him in restraints. d. Order him a nutritious diet.
b. Assess his safety toward himself and others.
A client is hospitalized on the psychiatric unit with a history and current diagnosis of bulimia nervosa. Which of the following symptoms would be congruent with this client's diagnosis? (Chapter 30) a. Binging, purging, obesity, hyperkalemia b. Binging, purging, normal weight, hypokalemia c. Binging, laxative abuse, amenorrhea, severe weight loss d. Binging, purging, severe weight loss, hyperkalemia
b. Binging, purging, normal weight, hypokalemia
Which of the following groups is most commonly used for drug management of the child with attention deficit-hyperactivity disorder? (Chapter 32) a. CNS depressants (e.g., diazepam [Valium]) b. CNS stimulants (e.g., methylphenidate [Ritalin]) c. Anticonvulsants (e.g., phenytoin [Dilantin]) d. Major tranquilizers (e.g., haloperidol [Haldol])
b. CNS stimulants (e.g., methylphenidate [Ritalin])
A nurse on the psychiatric unit documents that the client was attempting to use "splitting" behaviors with staff. This should be interpreted to mean that the client is: (Chapter 31) a. Trying to keep staff away from other patients. b. Characterizing staff members as either all good or all bad. c. Having brief psychotic episodes. d. Manifesting two or more distinct subpersonalities when communicating with staff.
b. Characterizing staff members as either all good or all bad.
Which of the following medications is the physician most likely to order for a client experiencing alcohol withdrawal syndrome? (Chapter 23) a. Haloperidol (Haldol) b. Chlordiazepoxide (Librium) c. Methadone (Dolophine) d. Cannabidiol (Epidiolex)
b. Chlordiazepoxide (Librium)
Which of the following is the primary goal in working with an actively psychotic, suspicious client? (Chapter 24) a. Promote interaction with others. b. Decrease his anxiety and increase trust. c. Improve his relationship with his parents. d. Encourage participation in therapy activities.
b. Decrease his anxiety and increase trust.
The nurse manager recognizes a need to improve mental health and substance use screening and referral services for their clients in the public health clinic. Which of the following is a priority to begin an effective process for implementation? (Chapter 21) a. Provide a list of referral sources that are readily available to staff. b. Educate staff about the importance of prioritizing these public health concerns. c. Explore the literature for evidence-based screening tools. d. Inform the staff that they have been stigmatizing patients and this will not be tolerated.
b. Educate staff about the importance of prioritizing these public health concerns.
A client is voluntarily admitted to the hospital with suicide ideation. He tells the nurse, "I thought I was recovered from this depression but this is my sixth episode. I guess I can't do anything right so I may as well just end it all." Which of these actions by the nurse is a priority? (Chapter 20) a. Educate the client that depression is not an illness that one can recover from, they must instead learn how to manage it with a comprehensive treatment strategy. b. Educate the client that recovery is a process that sometimes has setbacks and reinforce his decision to seek hospitalization. c. Assess the client's perception of what he's been doing that "is not right." d. Assess why the client believes he is depressed.
b. Educate the client that recovery is a process that sometimes has setbacks and reinforce his decision to seek hospitalization.
A client reports to the nurse that his foot is on fire and he thinks the demons are trying to burn off his flesh. The priority nursing intervention for this symptom is to: (Chapter 24) a. Administer prn haloperidol as ordered. b. Evaluate the client's foot to rule out physical causes for his complaint. c. Administer prn benztropine as ordered. d. Ask the client if he would like to speak with a chaplain.
b. Evaluate the client's foot to rule out physical causes for his complaint.
A nurse is assessing a client who has alcohol use disorder and is experiencing withdrawal. Which of the following findings should the nurse expect? (Select all that apply) (ATI Chapter 18) a. Bradycardia b. Fine tremors of both hands c. Hypotension d. Vomiting e. Restlessness
b. Fine tremors of both hands d. Vomiting e. Restlessness
Which of the following medications is used to treat Tourette's disorder? (Chapter 32) a. Methylphenidate (Ritalin) b. Haloperidol (Haldol) c. Imipramine (Tofranil) d. Phenytoin (Dilantin)
b. Haloperidol (Haldol)
A nurse is performing an admission assessment of a client who has bulimia nervosa with purging behavior. Which of the following is an expected finding? (Select all that apply) (ATI Chapter 19) a. Amenorrhea b. Hypokalemia c. Yellowing of the skin d. Slightly elevated body weight e. Presence of lanugo on the face
b. Hypokalemia d. Slightly elevated boy weight
A 14-year-old client has just been admitted to the psychiatric unit for anorexia nervosa. She is emaciated and refuses to eat. What is the priority nursing diagnosis for this client? (Chapter 30) a. Complicated grieving b. Imbalanced nutrition: Less than body requirements. c. Interrupted family processes d. Anxiety (severe)
b. Imbalanced nutrition: Less than body requirements.
A client diagnosed with somatic symptom disorder states, "My doctor thinks I should see a psychiatrist. I can't imagine why he would make such a suggestion." What is the most common basis for the client's statement? a. Lack of trust in the physician. b. Lack of understanding about the correlation of symptoms and stress. c. Lack of understanding about the role of a psychiatrist. d. Lack of financial resources.
b. Lack of understanding about the correlation of symptoms and stress.
In establishing trust with a client diagnosed with dissociative identity disorder, the nurse should: (Chapter 29) a. Respond as if the client did not have multiple personalities. b. Listen nonjudgmentally and respond empathically when the client transitions to different personality states. c. Ignore behaviors that the client attributes to other subpersonalities. d. Explain to the client that they must remain in their primary identity state while communicating with the nurse. e. All of the above
b. Listen nonjudgmentally and respond empathically when the client transitions to different personality states.
Which of the following is a true statement about mental health recovery? (Select all that apply.)(Chapter 20) a. Mental health recovery applies only to severe and persistent mental illnesses. b. Mental health recovery serves to provide empowerment to the consumer. c. Mental health recovery is based on the medical model. d. Mental health recovery is a collaborative process.
b. Mental health recovery serves to provide empowerment to the consumer. d. Mental health recovery is a collaborative process.
The ultimate goal of therapy for a client with dissociative identity disorder is most likely achieved through: (Chapter 29) a. Crisis intervention and directed association. b. Psychotherapy and hypnosis. c. Psychoanalysis and free association. d. Insight psychotherapy and dextroamphetamines.
b. Psychotherapy and hypnosis.
A male client with antisocial personality disorder was found in a female patient's room on her bed. When instructed to leave the room, the client states, "I'm sick of you telling me what I can or can't do. If I want to carry on a relationship with a female patient, it's my right. I'll do exactly as I please!" Which of these actions by the nurse is a priority at this point? (Chapter 31) a. Reassure the client that he will have plenty of opportunities with women after he is discharged. b. Reinforce the rules of the treatment program that all clients are expected to follow. c. Escort the client to seclusion. d. Establish a trusting relationship by telling the client that you will make an exception just this once.
b. Reinforce the rules of the treatment program that all clients are expected to follow.
Which of the following ego defense mechanisms describes the underlying psychodynamics of somatic symptom disorder? (Chapter 29) a. Denial of depression b. Repression of anxiety c. Suppression of grief d. Displacement of anger
b. Repression of anxiety
To help the child with mild to moderate intellectual developmental disorder develop satisfying relationships with others, which of the following nursing interventions is most appropriate? (Chapter 32) a. Interpret the child's behavior for others. b. Set limits on behavior that is socially inappropriate. c. Allow the child to behave spontaneously because he or she has no concept of right or wrong. d. This child is not capable of forming social relationships.
b. Set limits on behavior that is socially inappropriate.
The child with attention deficit-hyperactivity disorder has a nursing diagnosis of impaired social interaction. Which of the following nursing interventions are appropriate for this child? (Select all that apply.) (Chapter 32) a. Socially isolate the child when interactions with others are inappropriate. b. Set limits with consequences on inappropriate behaviors. c. Provide rewards for appropriate behaviors. d. Provide group situations for the child.
b. Set limits with consequences on inappropriate behaviors. c. Provide rewards for appropriate behaviors. d. Provide group situations for the child.
A child with ADHD is admitted to a residential treatment program. Which of the following group activities would be most appropriate for the nurse to recommend? (Chapter 32) a. Monopoly b. Volleyball c. Pool d. Checkers
b. Volleyball
A nurse is caring for a client who has borderline personality disorder. The client says, "the nurse on the evening shift is always nice! You are the meanest nurse ever!" The nurse should recognize the client's statement as an example of which of the following defense mechanisms? (ATI Chapter 16) a. regression b. splitting c. undoing d. identification
b. splitting
A nurse is caring for a cleint who has bulimia nervosa and has stopped purging behavior. The client tells the nurse about fears of gaining weight. Which of the following responses should the nurse make? (ATI Chapter 19) a. "Many clients are concerned about their weight. However, the dietitan will ensure that you don't get too many calories." b. "Instead of worrying about your weight, try to focus on other problems at this time." c. " I understand you have concerns about your weight, but first, let's talk about your recent accomplishments." d. "You are not overweight, and the staff will ensure that you do not gain weight while you are in the hospital. We know that is important to you."
c. " I understand you have concerns about your weight, but first, let's talk about your recent accomplishments."
A nurse manager is discussing the care of a client who has a personality disorder with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching? (ATI Chapter 16) a. "I can promote my client's sense of control by establishing a schedule." b. "I should encourage clients who have a schizoid personality disorder to increase socialization." c. "I should practice limit-setting to help prevent client manipulation." d. "I should implement assertiveness training with clients who have antisocial personality disorder."
c. "I should practice limit-setting to help prevent client manipulation."
A hospitalized client with bulimia nervosa has stopped vomiting in the hospital and tells the nurse she is afraid she is going to gain weight. Which is the most appropriate response by the nurse? (Chapter 30) a. "Don't worry. The dietitian will ensure you don't get too many calories in your diet." b. "Don't worry about your weight. We are going to work on other problems while you are in the hospital." c. "I understand that you are concerned about your weight, and we will talk about the importance of good nutrition, but for now I want you to tell me about your recent invitation to join the National Honor Society. That's quite an accomplishment." d. "You are not fat, and the staff will ensure that you do not gain weight while you are in the hospital, because we know that is important to you."
c. "I understand that you are concerned about your weight, and we will talk about the importance of good nutrition, but for now I want you to tell me about your recent invitation to join the National Honor Society. That's quite an accomplishment."
A client diagnosed with somatic symptom disorder tells the nurse about a pain in her side. She says she has not experienced it before. Which is the most appropriate response by the nurse? (Chapter 29) a. "I don't want to hear about another physical complaint. You know they are all in your head. It's time for group therapy now." b. "Let's sit down here together and you can tell me about this new pain you are experiencing. You'll just have to miss group therapy today." c. "I will report this pain to your physician. In the meantime, group therapy starts in 5 minutes." d. "I will call your physician and see if he will order a new pain medication for your side. The one you have now doesn't seem to provide relief. Why don't you get some rest for now?"
c. "I will report this pain to your physician. In the meantime, group therapy starts in 5 minutes."
A client approaches the nurse and states, "I don't want to go to outpatient group therapy. I don't like groups." Which of these responses by the nurse supports a recovery model focus? (Chapter 20) a. "You need to attend weekly groups to support your ongoing recovery." b. "If you don't comply with treatment you will need to be hospitalized again." c. "Let's discuss some options for follow-up care and explore the advantages and disadvantages." d. "Your psychiatrist recommended this, but we can't force you to comply with treatment."
c. "Let's discuss some options for follow-up care and explore the advantages and disadvantages."
A client recently admitted to the hospital reports to the nurse, "I don't understand why I was brought here. I was simply hanging out in my apartment and the police said I had to come with them." This is an example of what symptom of schizophrenia? (Chapter 24) a. Delusions of reference b. Loose association c. Anosognosia d. Auditory hallucinations
c. Anosognosia
The nurse is interviewing a client on the psychiatric unit. The client tilts his head to the side, stops talking in midsentence, and listens intently. Which of the following is the most appropriate follow-up assessment based on this information? (Chapter 24) a. Ask the patient if he is experiencing loose associations. b. Ask the patient if he needs more medication. c. Ask the patient if he is hearing something or someone other than the nurse's voice. d. Ask the patient if his neck is stiff.
c. Ask the patient if he is hearing something or someone other than the nurse's voice.
A client with BPD reports to the nurse that she is having abdominal pain and is requesting pain medication. Which action by the nurse is a priority? (Chapter 31) a. Explore alternative pain management strategies. b. Confront the client about her manipulation to try to get drugs. c. Assess her pain in more detail. d. Set limits on her attempts to cling to the nurse.
c. Assess her pain in more detail.
A client comes into the emergency department stating that he is "crashing" and feels like he'd "be better off dead." Which of these nursing interventions is a priority? (Chapter 23) a. Instruct the client not to worry; these are temporary signs of withdrawal and should go away in a few days. b. Request an order for amphetamines to ease the client's withdrawal symptoms. c. Assess the client's risk for suicide. d. Instruct the physician that the client may need naloxone.
c. Assess the client's risk for suicide.
The child with autism spectrum disorder has difficulty with trust. With this in mind, which of the following nursing actions would be most appropriate? (Chapter 32) a. Encourage all staff to hold the child as often as possible, conveying trust through touch. b. Assign a different staff member each day so the child will learn that everyone can be trusted. c. Assign the same staff person as often as possible to promote feelings of security and trust. d. Avoid eye contact because it is extremely uncomfortable for the child and may even discourage trust.
c. Assign the same staff person as often as possible to promote feelings of security and trust.
Which of the following physical manifestations would you expect to assess in a client suffering from anorexia nervosa? (Chapter 30) a. Tachycardia, hypertension, hyperthermia b. Bradycardia, hypertension, hyperthermia c. Bradycardia, hypotension, hypothermia d. Tachycardia, hypotension, hypothermia
c. Bradycardia, hypotension, hypothermia
When a client suddenly becomes aggressive and violent on the unit, which of the following approaches would be best for the nurse to use first? (Chapter 24) a. Provide large motor activities to relieve the client's pent-up tension. b. Administer a dose of prn haloperidol to keep the patient calm. c. Call for adequate help to control the situation safely. d. Convey to the client that his behavior is unacceptable and will not be permitted.
c. Call for adequate help to control the situation safely.
A client who has been admitted to intensive outpatient treatment for substance use disorder arrives for group therapy and appears groggy with constricted pupils. The client denies using substances. Which of the following would be the best intervention at this time? (Chapter 23) a. Ask the client to empty his pockets. b. Smell his breath for evidence of alcohol. c. Conduct a drug screen to assess for presence of opioids. d. Discharge the client for failure to comply with treatment expectations.
c. Conduct a drug screen to assess for presence of opioids.
Symptoms of alcohol withdrawal include: (Chapter 23) a. Euphoria, hyperactivity, and insomnia. b. Depression, suicidal ideation, and hypersomnia. c. Diaphoresis, nausea and vomiting, and tremors. d. Unsteady gait, nystagmus, and profound disorientation.
c. Diaphoresis, nausea and vomiting, and tremors.
A nurse is caring for a client who has alcohol use disorder. The client is no longer experiencing withdrawl manifestations. Which of the following medications should the nurse anticipate administering to assist the client with maintaining abstinence from alcohol? (ATI Chapter 18) a. Chlordiazepoxide b. Bupropion c. Disulfiram d. Carbamazepine
c. Disulfiram
The nursing history and assessment of an adolescent with conduct disorder might reveal all of the following behaviors except: (Chapter 32) a. Manipulation of others for fulfillment of own desires. b. Chronic violation of rules. c. Feelings of guilt associated with the exploitation of others. d. Inability to form close peer relationships.
c. Feelings of guilt associated with the exploitation of others.
Which medication has been used with some success in clients with anorexia nervosa? (Chapter 30) a. Lorcaserin (Belviq) b. Diazepam (Valium) c. Fluoxetine (Prozac) d. Carbamazepine (Tegretol)
c. Fluoxetine (Prozac)
A nurse is planning care for a client who is experiencing benzodiazepine withdrawl. Which of the following interventions should the nurse identify as the priority? (ATI Chapter 18) a. Orient the client frequently to time, place, and person b. Offer fluids and a nourishing diet as tolerated c. Implement seizure precautions d. Encourage participation in group therapy sessions
c. Implement seizure precautions
A nurse is planning a staff education program on substance use in older adults. Which of the following information should the nurse include in the presentation? (ATI Chapter 18) a. Older adults require higher doses of a substance to achieve a desired effect. b. Older adults commonly use rationalization to cope with a substance use disorder. c. Older adults are at an increased risk for substance use following retirement. d. Older adults develop substance use to mask manifestations of dementia.
c. Older adults are at an increased risk for substance use following retirement.
A client enters the emergency department and reports, "My bed is on fire, and my stomach, and we're all dead." The nurse's initial response is to call the psychiatric unit to secure an inpatient bed for this patient. The nurse's action is an example of: (Chapter 21) a. Prompt, appropriate referral. b. Patient-centered care. c. Stigmatization. d. Collaboration.
c. Stigmatization.
A nurse is assisting an individual with mental illness recovery using the Tidal model. Which of the following is a component of this model? (Chapter 20) a. The wellness toolbox b. The daily maintenance list c. The individual's personal story d. Triggers
c. The individual's personal story
Some obese individuals take amphetamines to suppress appetite and help them lose weight. Which of the following is an adverse effect associated with the use of amphetamines that makes this practice undesirable? (Chapter 30) a. Bradycardia b. Amenorrhea c. Tolerance d. Convulsions
c. Tolerance
A nurse is assisting with a court-ordered evaluation of a client who has antisocial personality disorder. Which of the following findings should the nurse expect? SELECT ALL THAT APPLY (ATI Chapter 16) a. demonstrates extreme anxiety when placed in a social situation b. has difficulty making even simple decisions c. attempts to convince other clients to give him their belongings d. becomes agitated if his personal area is not neat and orderly e. blames others for his past and current problems
c. attempts to convince other clients to give him their belongings e. blames others for his past and current problems
A client on the psychiatric unit has been diagnosed with schizophrenia. He tells the nurse that the CIA is looking for him and will kill him if they find him. The most appropriate response by the nurse is: (Chapter 24) a. "That's ridiculous. No one is going to hurt you." b. "The CIA isn't interested in people like you." c. "Why do you think the CIA wants to kill you?" d. "I know you believe that, but it's really hard for me to believe."
d. "I know you believe that, but it's really hard for me to believe."
A patient diagnosed with antisocial personality disorder approaches the nurse and says, "You're so cute, are you married?" Which of these is the most appropriate response by the nurse? (Chapter 31) a. "I'm married, but that's none of your business." b. "Let's talk about your love life instead." c. "Thank you so much for the compliment but I'm married." d. "Our relationship is strictly professional. It is not appropriate for us to have that kind of discussion."
d. "Our relationship is strictly professional. It is not appropriate for us to have that kind of discussion."
A client admitted to the inpatient detoxification program for alcohol withdrawal approaches the nurse complaining of nausea and feeling shaky. The nurse notices that the client has hand tremors and appears diaphoretic. Which of these nursing interventions is a priority? (Chapter 23) a. Check the client's temperature. b. Send a urine sample to the laboratory for a random drug screen. c. Ask the client if there is anything that he is particularly stressed about. d. Administer prn benzodiazepine that was ordered for management of withdrawal symptoms.
d. Administer prn benzodiazepine that was ordered for management of withdrawal symptoms.
Screening for substance use and suicide risk should be conducted in which of the following settings? (Chapter 21) a. Emergency departments b. Primary care settings c. Medical units d. All of the above
d. All of the above
A client with bipolar disorder tells the nurse at the community mental health center that he stopped taking his medication and he is getting so much more done. His speech is rapid and he admits that he hasn't gotten much sleep but states he is not tired. He doesn't want to be hospitalized because he is "about to save the world" with his new invention. Which of these interventions by the nurse is a priority? (Chapter 20) a. Administer an IM dose of his previously ordered medication. b. Make arrangements for the client to be admitted to the psychiatric hospital. c. Explore the advantages and disadvantages of medication adherence. d. Assess the client for risk of harm to self and others.
d. Assess the client for risk of harm to self and others.
A client on a medical unit is identified to be having suicidal ideation. Which of the following is a priority in managing his immediate care? (Chapter 21) a. Screen for depression b. Provide sedative medication c. Refer him to another setting d. Continuous monitoring and observation
d. Continuous monitoring and observation
According to researchers, which of the following is a common theme in the health history of the client with BPD? (Chapter 31) a. Autism b. Attention deficit-hyperactivity disorder c. Positive and fulfilling interpersonal relationships d. Early childhood trauma
d. Early childhood trauma
Lucille has a diagnosis of illness anxiety disorder. Which of the following symptoms would be consistent with this diagnosis? (Chapter 29) a. Complains of a multitude of incapacitating physical symptoms b. Manifests with pseudoseizures or pseudocyesis c. Takes substances to induce vomiting to convince the nurse that she needs treatment d. Expresses persistent fears of having life-threatening disease
d. Expresses persistent fears of having life-threatening disease
A nurse is planning care for a client who has anorexia nervosa with binge-eating and purging behavior. Which of the following actions should the nurse include in the client's plan of care? (ATI Chapter 19) a. Allow the client to select preferred meal times b. Establish consequences for purging behavior. c. Provide the client with high-fat diet at the start of treatment d. Implement one-to-one observation during meal times
d. Implement one-to-one observation during meal times
One of the outcomes of diagnostic overshadowing in clients with mental illness is: (Chapter 21) a. Better quality of life. b. Increased access to resources. c. More comprehensive care. d. Increased risk for death.
d. Increased risk for death.
Nursing care for a client with somatic symptom disorder should focus on helping the client to: (Chapter 29) a. Eliminate stressors. b. Discontinue focusing on numerous physical complaints. c. Take medication only as prescribed. d. Learn more adaptive coping strategies.
d. Learn more adaptive coping strategies.
Which of the following assessments by the nurse would convey a need for prn benztropine? (Chapter 24) a. Increased level of agitation b. Complaints of a sore throat c. A yellowish cast to the skin d. Muscle spasms
d. Muscle spasms
Certain family dynamics often predispose adolescents to the development of conduct disorder. Which of the following patterns is thought to be a contributing factor? (Chapter 32) a. Parents who are overprotective b. Parents who have high expectations for their children c. Parents who consistently set limits on their children's behavior d. Parents who are alcohol dependent
d. Parents who are alcohol dependent
A client with a history of childhood physical and sexual abuse was diagnosed with dissociative identity disorder 6 years ago and has been admitted to the psychiatric unit following a suicide attempt. What is the priority nursing diagnosis for this client? (Chapter 29) a. Disturbed personal identity related to childhood abuse b. Disturbed sensory perception related to repressed anxiety c. Impaired memory related to disturbed thought processes d. Risk for suicide related to unresolved grief
d. Risk for suicide related to unresolved grief
A client with a diagnosis of borderline personality disorder exhibits alternating clinging and distancing behaviors with the nurse who has been assigned to her care. The most appropriate nursing intervention with this type of behavior would be to: (Chapter 31) a. Encourage the client to establish trust in one staff person, with whom all therapeutic interaction should take place. b. Secure a verbal contract from the client that she will discontinue these behaviors. c. Withdraw attention if these behaviors continue. d. Rotate staff members who work with the client so that she will learn to relate to more than one person.
d. Rotate staff members who work with the client so that she will learn to relate to more than one person.
A nurse is assisting an individual with mental illness recovery using the Psychological Recovery model. The client says to the nurse, "I have schizophrenia. Nothing can be done. I might as well die." In which stage of the Psychological Recovery model should the nurse assess this individual to be? (Chapter 20) a. The awareness stage b. The preparation stage c. The rebuilding stage d. The moratorium stage
d. The moratorium stage
The primary focus of family therapy for clients with schizophrenia and their families is: (Chapter 24) a. To discuss problem-solving and adaptive behaviors for coping with stress. b. To introduce the family to others with the same problem. c. To keep the client and family in touch with the health-care system. d. To promote family interaction and increase understanding of the illness.
d. To promote family interaction and increase understanding of the illness.
