PN Mental Health Final Questions
A nurse on a crisis hotline is speaking to a client who says, "I just took an entire bottle of amitriptyline." Which of the following responses should the nurse make? a. "I'm glad you called, and I want to send an ambulance to help you." b. "You must have been feeling pretty depressed to do that." c. "Were you trying to kill yourself by taking an overdose?" d. "Do you know how many pills you took?"
a. "I'm glad you called, and I want to send an ambulance to help you."
A nurse is teaching the family of an older adult client who has a new diagnosis of dementia. Which of the following statements should the nurse include include in the teaching? a. "The signs of dementia are progressive and irreversible." b. "An altered level of consciousness is associated with dementia." c. "Dementia is characterized by a sudden onset of confusion." d. "Dementia can be triggered by a high fever or dehydration."
a. "The signs of dementia are progressive and irreversible."
A nurse is caring for a client who has major depressive disorder and has attempted suicide. The client tells the nurse, "I should have died because I am totally worthless." Which of the following is the best therapeutic response? a. "You've been feeling that your life has no meaning." b. "Why do you feel you are worthless?" c. "It's not unusual for depressed people to feel that way." d. "You have a great deal to live for."
a. "You've been feeling that your life has no meaning."
Dysthymia is a persistent depressive disorder in which the person has persistent depression for at least: a. 2 years b. One month c. Six months d. One year
a. 2 years
The nurse planning interventions for 4 patients would prioritize a patient with which of the following to be seen first? a. A patient with suicidal ideation b. A patient with low self esteem c. A patient with self care deficit in bathing d. A patient with borderline personal disorder (BPD)
a. A patient with suicidal ideation
Which of the following behaviors by the nurse is considered a violation of professional boundaries? a. Accepting a gift from the client. b. Showing concern for the client. c. Speaking with the client in a private area. d. Listening to the client speak of his intimacy issues.
a. Accepting a gift from the client.
What is the most important factor in establishing a safe, trusting environment for a mental health client? a. Accepting and non-judgemental attitude of nurse. b. Nurse admission data collection is complete and accurate. c. The nursing care plan is completed and includes specific goals and interventions. d. The physician orders are complete and include antipsychotic or anti-anxiety medications.
a. Accepting and non-judgemental attitude of nurse.
Medications which are effective in the treatment of bulimia nervosa include which of the following? a. Antidepressants b. Sedatives c. Anticholinergic medications d. Antipsychotics
a. Antidepressants
Treatment for extrapyramidal side effects of antipsychotic medications includes administration of which of the following? a. Antiparkinsonian medications b. Phenothiazines c. Haloperidol (Haldol) d. Atypical antipsychotic drug agents
a. Antiparkinsonian medications
Intense fear of spiders is known as: a. Arachnophobia b. Aeroacrophobia c. Aichmophobia d. Algophobia
a. Arachnophobia
A client is being treated for an anxiety disorder. Which types of medications are used to treat anxiety disorders? (Select all that apply.) a. Barbiturates b. Beta blockers c. Benzodiazepines d. Alpha blockers e. Selective Serotonin Reuptake Inhibitor (SSRIs)
a. Barbiturates b. Beta blockers c. Benzodiazepines e. Selective Serotonin Reuptake Inhibitor (SSRIs)
When planning nursing care for a client with a dependent personality disorder, the nurse recognizes which of the following as characteristic behavior for someone with this disorder? The client: a. Believes he or she cannot function without help of others b. Exaggerates the potential dangers of ordinary situations c. Perceives his or her behavior to be embarrassing d. Demands excessive attention from others
a. Believes he or she cannot function without help of others
Symptoms of paranoid personality disorder include all of the following EXCEPT: a. Bland facial expression b. Rigid and inflexible c. Avoidance of close relationships d. Projection of faults on others
a. Bland facial expression
Which of the following is an acceptable term to describe affect? a. Blunted. b. Fearful. c. Sad. d. Irritable.
a. Blunted.
Carly has been diagnosed with somatic symptom disorder. As the nurse is talking with Carly and her family, which of the following statements suggest primary or secondary gains that the physical symptoms are providing for the client? a. Carly's mother reports that someone from the family stays with Carly each night because the physical symptoms are incapacitating b. Carly states that even though medical tests have not found anything wrong, she is convinced her headaches are indicative of a brain tumor c. Carly states she noticed feeling hotter than usual the last time she had a headache d. The family agrees that Carly began having physical symptoms after she lost her job
a. Carly's mother reports that someone from the family stays with Carly each night because the physical symptoms are incapacitating
During a discussion between a nurse and client, the client starts yelling at the nurse Which of the following is the most appropriate action for the nurse to take? a. Change the topic of the discussion. b. Tell the client he will be secluded. he continues behaving this way. c. Touch the clients arm and ask him to calm down. d. Walk away from the client without responding.
a. Change the topic of the discussion.
All of the following are examples of benzodiazepine antianxiety medications EXCEPT: a. Citalopram (Celexa) b. Chlordiazepoxide (Librium) c. Diazepam (Valium) d. Alprazolam (Xanax)
a. Citalopram (Celexa)
Signs and symptoms of panic attacks include all of the following EXCEPT: a. Constipation b. Tachycardia c. Fear of dying d. Numbness and tingling of hands
a. Constipation
Signs and symptoms of Generalized Anxiety Disorder include which of the following? a. Difficulty in concentrating b. Feeling calm and peaceful c. Feeling that everything is okay and fine in the world. d. Eating and sleeping in normal patterns- no disturbance in sleep or in eating
a. Difficulty in concentrating
A nurse is caring for a client who has severe manifestations of schizophrenia and is medicated PRN for agitation with haloperidol. The nurse should assess the client for which of the following adverse effects? a. Dysrhythmias b. Cataracts c. Bleeding d. Pancreatitis
a. Dysrhythmias
Repeating the speech of another person is termed which of the following? a. Echolalia b. Derailment c. Echopraxia d. Waxy flexibility
a. Echolalia
Which of the following are true about suicidal patients? a. Eight out of 10 people who kill themselves have given definite clues. b. People who talk about suicide do not commit suicide. Suicide happens without warning. c. Once a person is suicidal, he or she is always suicidal. d. You cannot stop a suicidal person. He or she is fully intent on dying.
a. Eight out of 10 people who kill themselves have given definite clues.
Which of the following data is suggestive of a diagnosis of anorexia nervosa? a. Extreme weight loss from self imposed restricted food intake b. Periodic patterns of weight gain and loss over the past year c. Refusal to speak about food and nutrition d. Periods of overeating and self induced vomiting without weight gain
a. Extreme weight loss from self imposed restricted food intake
Signs and symptoms of a specific phobia disorder include: a. Fainting or panic response b. Enjoying large crowds c. Driving over bridges d. Laughing inappropriately
a. Fainting or panic response
A client with obsessive-compulsive personality disorder is described by other staff as being perfectionistic, inflexible, and a "master at procrastination." The nurse learns that the client is nearly immobilized during times that call for the client to make a decision. The nurse realizes that the most likely hypothesis is this behavior is related to: a. Fear of making a mistake b. Wanting someone else to be responsible c. Needing to be the center of attention d. A need to make others uncomfortable
a. Fear of making a mistake
Which client receiving typical antipsychotic medication would be assessed as displaying behaviors characteristic of tardive dyskinesia? The individual who: a. Grimaces and smacks her lips b. Is experiencing muscle rigidity and tremors c. Has excessive salivation and drooling d. Falls asleep in her chair and refuses to eat lunch
a. Grimaces and smacks her lips
Which of the following correctly describes the person with a narcissistic personality disorder? a. Has a grandiose sense of self importance b. Is hypersensitive of rejection or negative comments c. Insecure, fear of being alone d. Has unrealistic expectations of others
a. Has a grandiose sense of self importance
Which of the following is FALSE regarding telemental health? a. It is the best method for use with children and adolescents b. it is cost effective c. It may lack the ability to establish an effective rapport d. it is generally available 24 hours per day
a. It is the best method for use with children and adolescents
Negative symptoms of schizophrenia include: a. Lack of motivation b. Hallucinations c. Illusions d. Clang associations
a. Lack of motivation
A nurse in an emergency department is assessing a client who has been taking haloperidol for 3 months. The client has a temperature of 39.5° C (103.4° F), blood pressure of 150/110 mm Hg, and muscle rigidity. Which of the following complications should the nurse suspect? a. Neuroleptic malignant syndrome b. Serotonin syndrome c. Tardive dyskinesia d. An allergic reaction to the medication.
a. Neuroleptic malignant syndrome
Examples of Objective data include all of the following EXCEPT: a. Occupation b. Physical exam c. Behaviors d. Appearance
a. Occupation
Examples of subjective data obtained during a nursing interview include all of the following EXCEPT: a. Patient name and date of birth. b. General information about the client. c. Current or past substance use. d. Current occupational or work situation.
a. Patient name and date of birth.
Poor oral nutrition and calluses on the back of the hands are characteristic of: a. Purging behavior b. Pica c. Binge eating d. Malnutrition
a. Purging behavior
A nurse is caring for a young adult client following the sudden death of his wife. The client feels paralyzed in his ability to cope with work and family responsibilities. Which of the following types of crisis is the client experiencing? a. Situational b. Developmental c. Adventitious d. Maturational
a. Situational
Arranging discharge placement is the responsibility of which of the following? a. Social Worker b. Psychotherapist c. Regisitered Nurse d. Occupational therapist
a. Social Worker
A 32-year-old client is admitted to the ED after being alternately hyperalert and difficult to arouse. His symptoms all started within the last few hours, during which time he became disoriented and confused. His behavior was agitated and restless, and his memory was impaired, especially for recent events. The client displayed some delusions and misinterpretations of his surroundings. a. Take the client's vital signs b. Obtain a prn order for a psychotropic medication c. Restrain the client to prevent injury d. Ask the client for information about his medications
a. Take the client's vital signs
A nurse in a psychiatric unit is admitting a client who attacked a neighbor. The nurse should know that the client can be kept in the hospital after the 72-hr hold is over for which of the following conditions? a. The client is a continuing danger to herself or others. b. The client states that she plans to move out of the state immediately. c. The client is unwilling to accept that treatment is needed. d. The client states that she does not like the neighbor.
a. The client is a continuing danger to herself or others.
A nurse observes dental deterioration when assessing a client diagnosed with bulimia nervosa. What explains this assessment finding? a. The emesis produced during purging is acidic and corrodes the tooth enamel b. Purging causes the depletion of dietary calcium c. Food is rapidly ingested without proper mastication d. Poor dental and oral hygiene leads to dental caries
a. The emesis produced during purging is acidic and corrodes the tooth enamel
The nurse is working with the family of a client with obsessive-compulsive disorder. Which of the following should the nurse incorporate in the teaching plan? a. The thoughts, images, and impulses worsen with stress b. OCD is a chronic disorder and not responsive to treatment c. The thoughts, images, and impulses are voluntary d. The family should pay immediate attention to symptoms
a. The thoughts, images, and impulses worsen with stress
A standard assessment tool is generally utilized to document components of a psychosocial assessment and objective data in the medical record a. True b. False
a. True
Active listening engages the nurse attentively in both mind and body to capture what the client is conveying in both verbal and non-verbal messages. a. True b. False
a. True
Acute stress is triggered by an overwhelming sense of danger or threat over which we feel a lack of control. a. True b. False
a. True
Psychotherapy is a dialogue between a client and a mental health practitioner with a goal of reducing symptoms of an emotional disturbance disorder. a. True b. False
a. True
The Nursing Process is a scientific and systematic method for providing effective, individualized nursing care, and serves as an aid in resolving client problems. a. True b. False
a. True
A nurse is caring for a client who was admitted with acute psychosis and is being treated with haloperidol. The nurse should suspect that the client may be experiencing tardive dyskinesia when the client exhibits all EXCEPT which of the following? a. Urinary retention and constipation b. Tongue thrusting and lip smacking c. Facial grimacing and eye blinking d. Involuntary pelvic rocking and hip thrusting movements
a. Urinary retention and constipation
Which of the following methods is best for documenting subjective data a. Use pt states and use patient words in documentation b. Document patient behavior as "aggressive" , but do not document actual behaviors. c. Do not make judgement between pt objective and subjective information, document whatever the patient says. d. Document that patient information contradicts other available information.
a. Use pt states and use patient words in documentation
The nurse is admitting a schizophrenic patient. The client's perception of the present problem is best documented by the nurse: a. Using the patient's own words. b. With information obtained by significant other. c. By copying the physician observations. d. By documenting observations of patient behaviors made over several hours
a. Using the patient's own words.
Which of the following terms should NOT be used to describe a client's attitude? a. Violent. b. Uncooperative. c. Apathetic. d. Suspicious.
a. Violent.
Signs and symptoms of Obsessive Compulsive Disorders include: a. Washing your hands 30 times a day while in your own home b. Leaving for work and turning around to check if the garage door is down c. Checking windows and doors twice to make sure they are locked before going to bed d. Changing your clothes three times before going to a party.
a. Washing your hands 30 times a day while in your own home
If the client exhibits sexually explicit behavior or remarks, the nurse should do which of the following FIRST? a. be direct in letting the client know that the behavior is disturbing and unacceptable. b. Terminate the interaction and walk away. c. discuss the underlying issue with the client. d. Tell the client you will not speak with him if he behaves in that manner.
a. be direct in letting the client know that the behavior is disturbing and unacceptable.
Which of the following therapies does not foster awareness, but emphasizes the principles of learning with positive or negative reinforcement? a. behavioral therapy b. psychodynamic therapy c. humanistic therapy d. cognitive behavioral therapy
a. behavioral therapy
Which of the following therapies is most successful in disorders such as attention deficit disorder and some addictive disorders? a. behavioral therapy b. humanistic therapy c. psychodynamic therapy d. cognitive behavioral therapy
a. behavioral therapy
Foods to avoid when taking an MAOI drug agent include a a. bologna sandwich b. turkey sandwich c. grilled salmon d. hamburger
a. bologna sandwich
Which therapy is based on a cognitive model that focuses on identifying and correcting distorted thinking patterns that can lead to emotional distress and problem behaviors? a. cognitive behavioral therapy b. psychodynamic therapy c. humanistic therapy d. behavioral therapy
a. cognitive behavioral therapy
One of the most important ingredients of the therapeutic relationship is a. empathy b. critical thinking c. maintaining social distancing d. establishing ground rules
a. empathy
The therapy which centers on the client's view of the world and his or her problems is a. humanistic therapy b. psychodynamic therapy c. behavioral therapy d. cognitive behavioral therapy
a. humanistic therapy
Serious issues with the elderly who are prescribed psychotropic medications include a. increased risk of cumulative effects b. lack of research in the area of psychotropic medication side effects c. guidelines limit the use of psychotropic medications for older adults d. psychotropic medications are the cause of all falls in the elderly
a. increased risk of cumulative effects
The role of the nurse working with mental health patients is to a. monitor behaviors b. perform psychological testing c. conduct psychotherapy sessions d. assist with electroconvulsive therapy procedures
a. monitor behaviors
A nurse is discussing legal exceptions to client confidentiality with nursing staff. Which of the following statements by a staff member indicates an understanding of the teaching? a. "Health care workers are not required to answer a court's requests for information about a client's disclosure." b. "I must share patient information with the physician and nursing staff assigned to care for the patient." c. "Staff members are required to divulge information to attorneys if they call for information." d. "The legal requirement for client confidentiality ceases if the client is deceased."
b. "I must share patient information with the physician and nursing staff assigned to care for the patient."
A nurse observes that a client who has depression is sitting alone in the room crying. As the nurse approaches, the client states, "I'm feeling really down and don't want to talk to anyone right now." Which of the following is the best therapeutic response? a. "Why are you feeling so down?" b. "I'll just sit here with you for a few minutes then." c. "I understand. I've felt like that before, too." d. "It might help you feel better if you talk about it."
b. "I'll just sit here with you for a few minutes then."
A history reveals that a client virtually stopped eating 5 months ago and lost 25% of body weight. The nurse says, "Describe what you think about your present weight and how you look." Which response would be most consistent for a client with anorexia nervosa? a. "What I think about myself is my business." b. "I'm fat and ugly" c. I am grossly underweight, but I cover it well." d. "I'm a few pounds overweight, but I can live with it."
b. "I'm fat and ugly"
The family of a client diagnosed with conversion disorder asks the nurse, "Will her paralysis ever go away?" Which of these responses by the nurse is evidence-based? a. "Technically, she could walk now since she is intentionally faking paralysis." b. "Most symptoms of conversion disorder resolve within a few weeks." c. "The only people who recover are those that develop conversion disorder symptoms without a precipitating stressful event." d. "Typically people who have conversion disorder symptoms that include paralysis will be paralyzed for the rest of their lives."
b. "Most symptoms of conversion disorder resolve within a few weeks."
A nurse observes a client's spouse sitting alone in the waiting room crying. When approached, the spouse says, "I am really concerned about my husband." Which of the following is a therapeutic nursing response? a. "Your husband is making really good progress." b. "Tell me what is concerning you." c. "Crying helps us let things out and we feel better." d. "Did your husband say something to upset you?"
b. "Tell me what is concerning you."
A client comes to the clinic frequently with complaints of abdominal pain. All medical tests are negative. The client insists that she has cancer. Which of the following statements should the nurse make to the client? a. "Why do you fear that you have cancer?" b. "This must be very distressing for you." c. "You should seek counselling for your problems." d. "You need to get a hobby to take your mind off of your fears."
b. "This must be very distressing for you."
A client has been taking clonazepam (Klonopin) for chronic anxiety for three years. The client tells the nurse they want to stop the medication. What is the best response by the nurse? a. "I don't think it is a good idea to stop your medication." b. "You will need to gradually decrease your dose before stopping." c. "There are not any serious complications to stopping this drug." d. "Medications for anxiety must be taken for the rest of your life."
b. "You will need to gradually decrease your dose before stopping."
For which behavior(s) would limit setting be most essential? a. A patient clings to the nurse and asks for advice about inconsequential matters b. A young woman urges a suspicious patient to hit anyone who stares at him. c. A woman is flirtatious and provocative toward staff members of the opposite sex d. An elderly man displays hypervigilance and refuses to attend unit activities
b. A young woman urges a suspicious patient to hit anyone who stares at him.
What will the nurse instruct patients who are on daily disulfiram (Antabuse) to avoid? a. All forms of cough syrup b. Alcohol c. Benzodiazepines d. Aspirin products
b. Alcohol
What would the nurse teach a client to avoid when taking barbiturates? a. Bananas b. Alcohol c. Caffeine d. Nicotine
b. Alcohol
A patient admitted 48 hours ago has a diagnosis of GI bleeding and is receiving IV hydration and transfusions. When making rounds, the nurse observes the patient to be having a tonic-clonic seizure. What may be the cause of the seizure? a. Alkalosis b. Alcohol withdrawal c. Low blood counts secondary to bleeding d Inadequate nutrition
b. Alcohol withdrawal
What is a banana bag (in medicine)? a. A new designer handbag introduced by Banana Republic b. An intravenous (IV) infusion of thiamine, folate, magnesium sulfate, and multivitamins in a saline solution c. A special container made to bring your bananas home from the store d. A new kind of banana bread recipe
b. An intravenous (IV) infusion of thiamine, folate, magnesium sulfate, and multivitamins in a saline solution
During the night shift, a client with Alzheimer's is found climbing into the bed of another patient. Which of the following actions should the nurse take? a. Move the client to a room at the end of the hall. b. Assist the client back to the correct room. c. Reorient the client to time and place. d. Assist the client back to the correct room and place the client in restraints to prevent further wandering.
b. Assist the client back to the correct room.
A client frequently impulsively acts out suicidal impulses, including grabbing the coffee jar to smash it and attempting to hang herself with her bra. The nurse would view the client's behaviors as most consistent with: a. Histrionic personality disorder b. Borderline personality disorder c. Antisocial personality disorder d. Narcissistic personality disorder
b. Borderline personality disorder
When a client remains in one position until someone changes it, it is termed which of the following? a. Posturing b. Catalepsy c. Waxy flexibility d. Catatonia
b. Catalepsy
A belief that elements in the environment such as TV or newspapers are sending special messages to the client is termed which of the following? a. Thought withdrawal b. Delusions of reference c. Thought broadcasting d. Thought insertion
b. Delusions of reference
A health professional colleague is suspected of having a substance abuse problem because of the person's frequent absenteeism, mood swings when at work, diminished alertness, and poor patient care. Which actions will the nurse take? (Select all that apply.) a. Confront the individual b. Document specific examples of inappropriate actions c. Avoid assigning this individual to patients with narcotic medication orders or high acuities d. Submit a confidential report to an appropriate supervisor e. Notify law enforcement of the suspicions
b. Document specific examples of inappropriate actions d. Submit a confidential report to an appropriate supervisor
It is not important for the LVN to review the Nursing Care Plan because that is the responsibility of the RN. a. True b. False
b. False
Telemental health is the use of facetime with a mental health client. a. True b. False
b. False
A nurse is assessing a parent who lost a 12-year-old child in a car crash 2 years ago. Which of the following findings indicates the client is exhibiting manifestations of prolonged grieving? a. Talks about the child in the past tense b. Has lost interest in all social activities and continues to blame herself for allowing the child to get in the car with a neighbor c. Volunteers at a local children's hospital d. Occasionally becomes tearful when she sees a child that looks like her 12 year old
b. Has lost interest in all social activities and continues to blame herself for allowing the child to get in the car with a neighbor
A person who creates an overly dramatic scene of emotional behavior to attract attention is typical of which type of personality disorder? a. Schizotypal b. Histrionic c. Narcissistic d. Dependent
b. Histrionic
Which of the following terms would be characteristics common to all personality disorders? a. Cold, aloof and suspicious tendencies b. Inflexibile and maladaptive behaviors c. Lack of remorse or guilt d. Delusions regarding own abilities
b. Inflexibile and maladaptive behaviors
As the nurse administers benzodiazepines to her clients with anxiety, she knows to teach them that: a. There are no foods to avoid when taking benzodiazepines b. Kava kava and St. John's wort may potentiate action c. These medications have no risk for any dependency d. It is fine to have alcoholic drinks frequently with these meds
b. Kava kava and St. John's wort may potentiate action
A nurse is working with a client diagnosed with somatic symptom disorder. What predominant symptoms should a nurse expect to assess? a. Amnestic episodes in which the client is pain free b. Persistent thoughts about the seriousness of one's symptoms c. Lack of physical symptoms d. Excessive time spent discussing psychosocial stressors
b. Persistent thoughts about the seriousness of one's symptoms
The nurse manager on the psychiatric unit was explaining to the new staff the differences between typical and atypical antipsychotics. She correctly stated that atypical antipsychotics: a. Are risk free for neuroleptic malignant syndrome (NMS) b. Produce fewer extrapyramidal effects c. Remain in the system longer d. Act more quickly to reduce delusions
b. Produce fewer extrapyramidal effects
A client has been taking chlorpromazine (Thorazine) for the past 2 weeks. He drools, has hand tremors, and walks with a shuffling gait. The nurse would correctly attribute these behaviors to: a. Tardive dyskinesia b. Pseudoparkinsonism c. Akinesia d. Neuroleptic malignant syndrome
b. Pseudoparkinsonism
Which of the following symptoms would you expect to see in a client with anorexia nervosa? a. Tachycardia, hypotension, hyperthermia b. Tachycardia, hypotension, hypothermia c. Bradycardia, hypertension, hyperthermia d. Bradycardia, hypertension, hypothermia
b. Tachycardia, hypotension, hypothermia
Which strategy should the nurse incorporate in the nursing care plan for a client with generalized anxiety disorder? a. Tell the client to calm down when anxiety is apparent b. Teach the importance of limiting caffeine, nicotine, and CNS stimulants c. Encourage the client to discuss painful childhood issues d. Inform the client that he will need to remain calm if he wishes to attend group therapy
b. Teach the importance of limiting caffeine, nicotine, and CNS stimulants
A nurse is providing discharge teaching to a client who has bipolar disorder and will be discharged with a prescription for lithium. The nurse should teach the client that which of the following factors puts her at the most risk for lithium toxicity? a. The client eats foods high in tyramines. b. The client runs 4 miles outdoors every afternoon. c. The client drinks 2 liters of liquids daily. d. The client eats 2 to 3 gm of sodium-containing foods daily.
b. The client runs 4 miles outdoors every afternoon.
What must be administered for a patient in alcohol withdrawal to prevent Wernicke's encephalopathy? a. Chlordiazepoxide (Librium) b. Thiamine c. Diazepam (Valium) d. Bromocriptine (Parlodel)
b. Thiamine
A nurse is caring for an older adult client who has dementia and handles anxiety by confabulating. The nurse should recognize confabulation when the client a. reminisces about the past. b. makes up stories when he is unable to remember actual events. c. refuses to leave home to see a provider. d. displays compulsive and ritualistic behaviors.
b. makes up stories when he is unable to remember actual events.
Examples of external stressors include all of the following except: a. work related or school deadlines b. personality traits c. major life events d. physical environment
b. personality traits
The wife of a client diagnosed with paranoid schizophrenia asks, "I've been told that my husband's illness is probably related to imbalanced brain chemicals. Can you be more specific?" The response based on the dopamine hypothesis is: a. "An increase in the brain chemical dopamine explains the presence of lack of motivation and disordered affect." b. "Decreased amounts of the brain chemical dopamine explain the presence of delusions and hallucinations." c. "An increase in the brain chemical dopamine explains the presence of delusions and hallucinations." d. "Breakdown of dopamine produces LSD, which in large amounts produces psychosis."
c. "An increase in the brain chemical dopamine explains the presence of delusions and hallucinations."
Which statement by a client with generalized anxiety disorder for whom lorazepam (Ativan) is prescribed prn suggests the client understands the purpose of the medication? a. "I wonder if I will have to take this medication for the rest of my life?" b. "I don't want anyone to know I'm on this medication." c. "I can talk with my therapist more easily after my medication takes effect." d. "I'm going to ask for my prn so I can sleep instead of go to group."
c. "I can talk with my therapist more easily after my medication takes effect."
A client becomes very dejected and states, "No one really cares what happens to me. Life isn't worth living anymore." Which of the following responses is the best therapeutic response? a. "Tell me who you think doesn't care about you." b. "Of course people care. Your family comes to visit every day." c. "I care about you, and I am concerned that you feel so sad." d. "Why do you feel that way?"
c. "I care about you, and I am concerned that you feel so sad."
A nurse is caring for several clients. Which of the following client statements should the nurse identify as expected factitious disorder (Munchausen's by proxy) imposed on another? a. "I had to pretend I was injured in order to get disability benefits." b. "I became deaf when I heard that my partner was having an affair with my best friend." c. "I needed to make my child sick so that someone else would take care of them for a while." d. "I know that my abdominal pain is caused by a malignant tumor."
c. "I needed to make my child sick so that someone else would take care of them for a while."
A nurse caring for a client who has depression observes the client comes to breakfast freshly bathed, wearing clean clothes, and with combed and styled hair. Which of the following responses by the nurse is therapeutic? a. "Why are you all dressed up today? Is it a special occasion?" b. "Finally, it is about time that you showered and combed your hair." c. "I see you have done some grooming today." d. "Everyone feels better after showering."
c. "I see you have done some grooming today."
A nurse is caring for a client who is depressed and refuses to participate in group therapy or perform activities of daily living. Which of the following statements should the nurse make to the client? a. "If you don't participate in your care, you will not get better." b. "The unit rules state that you may not remain in bed." c. "I will assist you in getting out of bed and getting dressed." d. "You can remain in bed until you feel well enough to join the group."
c. "I will assist you in getting out of bed and getting dressed."
A teenage female is admitted with the diagnosis of anorexia nervosa. Upon admission, the nurse finds a bottle of assorted pills in the client's drawer. The client tells the nurse that they are antacids for stomach pains. The best response by the nurse would be a. "You are lying. These pills aren't antacids since they are all different." b. "Are you taking pills to change your weight?" c. "Tell me about your week prior to being admitted." d. "Some teenagers use pills to lose weight."
c. "Tell me about your week prior to being admitted."
A nurse who works in a psychiatric unit is caring for a client who has bipolar disorder. The client comes to the nurse's station at 0300 demanding that the nurse call the provider immediately. Which of the following responses by the nurse is most appropriate? a. "I can't call a doctor in the middle of the night unless it's an emergency." b. "You are being unreasonable, and I will not call your doctor at this hour." c. "You must be very upset about something." d. "Go back to your room, and I'll try to get in touch with your doctor."
c. "You must be very upset about something."
A nurse is caring for a client who has schizophrenia and tells the nurse, "They lie about me all the time and they are trying to poison my food." Which of the following statements should the nurse make? a. "You are mistaken. Nobody is lying about you or trying to poison you." b. "Who is lying about you and trying to poison you?" c. "You seem to be having very frightening thoughts." d. "Why do you think you are being lied about and poisoned?"
c. "You seem to be having very frightening thoughts."
A nurse is caring for a client who has schizophrenia and tells the nurse, "They lie about me all the time and they are trying to poison my food." Which of the following statements should the nurse make? a. "You are mistaken. Nobody is lying about you or trying to poison you." b. "Why do you think you are being lied about and poisoned?" c. "You seem to be having very frightening thoughts." d. "Who is lying about you and trying to poison you?"
c. "You seem to be having very frightening thoughts."
A client who has been diagnosed as having paranoid schizophrenia is highly suspicious and delusional. He hears voices telling him terrorists are plotting to assassinate him. He refuses to eat, saying the food is poisoned. The nursing action that best addresses his needs is to: a. Explain that others eat the food and are not harmed b. Assist client with personal hygiene and grooming c. Allow client to select food from vending machines d. Not allow client to verbalize delusional thoughts
c. Allow client to select food from vending machines
What measure will facilitate communication with a client who is depressed and evidencing psychomotor retardation and withdrawal? a. Ask client to indicate yes or no with finger signals b. Give directions rather than asking questions c. Arrange to spend time with client at prearranged intervals d. Speak loudly and rapidly to the client to focus his or her attention
c. Arrange to spend time with client at prearranged intervals
Clients with avoidant personality disorder exhibit which of the following characteristics? a. Impulsive outbursts of anger b. Extreme dress and behavior c. Extreme shyness d. Promiscuity
c. Extreme shyness
Positive symptoms of schizophrenia include: a. Depression b. Blunt affect c. Hallucinations d. Lack of energy
c. Hallucinations
To evaluate outcomes for a client with schizophrenia receiving typical antipsychotic drug therapy, the nurse would look for improvement in: a. Cognitive functioning b. Affective mobility c. Hallucinations d. Self-care activity
c. Hallucinations
A nurse caring for a client who has bulimia nervosa with purging behavior. Which of the following is an expected finding? a. Amenorrhea b. Yellowing of the skin c. Hypokalemia d. Presence of lanugo on the face
c. Hypokalemia
A client diagnosed with dissociative identity disorder (DID) switches personalities when confronted with destructive behavior. The nurse recognizes that this dissociation serves which function? a. It is a means to attain secondary gain b. It is a means to explore feelings of excessive and inappropriate guilt c. It serves to isolate painful events so that the primary self is protected d. It serves to establish personality boundaries and limit inappropriate impulses
c. It serves to isolate painful events so that the primary self is protected
Signs and symptoms of illness anxiety disorder include all of the following EXCEPT: a. Preoccupation with the body and body functioning b. Physician shopping c. Laboratory tests and x-rays support something is wrong d. Repeated health care visits seeking verification of symptoms
c. Laboratory tests and x-rays support something is wrong
A nurse in a long-term care facility is caring for a client who has moderate Alzheimer's disease. Which of the following is an appropriate action? a. Bring the client to the day room and have the nurse choose the activity for the patient. b. Use an overhead loudspeaker to announce events. c. Post a written schedule of daily activities in the patient room. d. Allow the client to choose free-time activities
c. Post a written schedule of daily activities in the patient room.
A client has returned from combat, and is re-experiencing combat in dreams and feels helpless and anxious. What disorder does the nurse suspect this client is experiencing? a. Generalized anxiety disorder b. Obsessive-compulsive disorder c. Post-traumatic stress disorder d. Panic disorder
c. Post-traumatic stress disorder
A nurse asks a client who is suicidal to make a safety contract, but the client declines. Which of the following actions should the nurse identify as the priority? a. Provide the client with plastic eating utensils for meals. b. Lock the doors to the unit and secure windows so they cannot be opened c. Remove any objects from the client's environment that could be used for self-harm. d. Assign a staff member to stay with the client at all times.
c. Remove any objects from the client's environment that could be used for self-harm.
Symptoms of antisocial personality disorder include all of the following EXCEPT: a. Explosive anger b. Arrogance c. Social isolation d. Impulsive and reckless behavior
c. Social isolation
Which strategy should the nurse incorporate in the nursing care plan for a client with generalized anxiety disorder? a. Encourage the client to discuss painful childhood issues b. Tell the client to calm down when anxiety is apparent c. Teach the importance of limiting caffeine, nicotine, and CNS stimulants d. Inform the client that he will need to remain calm if he wishes to attend group therapy
c. Teach the importance of limiting caffeine, nicotine, and CNS stimulants
A client diagnosed with schizophrenia, paranoid type, was admitted to the hospital, and haloperidol (Haldol) was begun. The nurse would assess for neuroleptic malignant syndrome (NMS) if the client had a: a. 30 mm Hg decrease in blood pressure reading b. Respiratory rate of 24 respirations per minute c. Temperature reading of 104º F d. Pulse rate of 70 beats per minute
c. Temperature reading of 104º F
Which of the following is true of factitious disorder (Munchausen's syndrome)? a. It is a pseudoneurologic disturbance b. The person has a lack of conscious control over symptoms c. The person fakes illness to gain attention d. The person may exhibit an attitude of la belle indifference
c. The person fakes illness to gain attention
A nursing instructor is teaching students about the differences between the symptoms of anorexia nervosa and the symptoms of bulimia nervosa. Which student statement indicates that learning has occurred? a. "Clients diagnosed with bulimia nervosa experience hypotension, edema, and lanugo, whereas clients diagnosed with anorexia nervosa do not." b. "Clients diagnosed with anorexia nervosa have eroded tooth enamel, whereas clients diagnosed with bulimia nervosa do not." c. "Clients diagnosed with bulimia nervosa experience amenorrhea, whereas clients diagnosed with anorexia nervosa do not." d. "Clients diagnosed with anorexia nervosa experience extreme nutritional deficits, whereas clients diagnosed with bulimia nervosa do not."
d. "Clients diagnosed with anorexia nervosa experience extreme nutritional deficits, whereas clients diagnosed with bulimia nervosa do not."
A male nurse is assigned to care for a female client who was admitted to the hospital for treatment of injuries following a domestic abuse incident. The client tells the nurse manager she does not want a male nurse as her caregiver. Which of the following nursing responses should the nurse manager make? a. "Your doctor is a man, so it seems like this should not be a problem." b. "The nurse assigned to care for you is very capable and cares for other women in this situation." c. "I can arrange for a female assistive personnel to do your personal hygiene care." d. "I can review the assignments and arrange for a female nurse to care for you."
d. "I can review the assignments and arrange for a female nurse to care for you."
A nurse is caring for a young adult client who says he is experiencing increased anxiety and an inability to concentrate. Which of the following responses should the nurse make? a. "How long has this been going on?" b. "Why do you think you are so anxious?" c. "Have you talked to your parents about this yet?" d. "It sounds like you're having a difficult time."
d. "It sounds like you're having a difficult time."
A nurse is teaching the family of a client who has Alzheimer's disease about donepezil. Which of the following information should the nurse include in the teaching? a. "This medication may cause tachycardia." b. "You should administer the medication each morning." c. "You will need to monitor for constipation." d. "Syncope episodes may occur when taking this medication."
d. "Syncope episodes may occur when taking this medication."
A nurse is caring for a client who has dementia due to Alzheimer's disease and was admitted to a long-term care facility following the death of her partner of 40 years. The client states, "I want to go home; my husband is waiting for me to cook dinner." Which of the following responses by the nurse is appropriate? a. "This is where you live now." b. "This is a safer place for you to live." c. "Your family said there is no one to care for you at home." d. "Tell me what you like to cook for dinner."
d. "Tell me what you like to cook for dinner."
A client with anorexia is refusing to eat. Which of the following is the most appropriate statement for the nurse to make to the client? a. "You will not be allowed to exercise if you do not finish your meals." b. "If you continue to refuse to eat we will feed you through a tube." c. "If you don't eat you will die." d. "That is your choice, but you did make a contract to eat at least half of each meal."
d. "That is your choice, but you did make a contract to eat at least half of each meal."
A nurse is caring for a client who is hospitalized and says to the nurse, "My partner called and told me my boss hired someone to take my place." Which of the following responses should the nurse make? a. "There really isn't much you can do about that until you are discharged." b. "I don't understand why your partner would upset you with news like that." c. "You should call your boss and threaten to sue if you don't get your job back." d. "You must feel very concerned and disappointed by that information."
d. "You must feel very concerned and disappointed by that information."
Which of the following is an example of a conversion disorder? a. Numbness and tingling in the hands and feet when stressed b. Taking laxative before a doctors appointment to demonstrate diarrhea and abdominal pain symptoms c. Chest pain after being mugged at an ATM d. A mother has a child who suffers an anoxic brain injury during birth and the baby develops seizures. The mother then exhibits seizure type activity
d. A mother has a child who suffers an anoxic brain injury during birth and the baby develops seizures. The mother then exhibits seizure type activity
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 private room close to the nursing station b. A semi-private room with a roommate who has a similar diagnosis c. A seclusion room until the client's activity level becomes more subdued d. A private room in a quiet location on the unit
d. A private room in a quiet location on the unit
What effect will occur if a patient being treated with naltrexone (ReVia) for substance abuse ingests opioids? a. Deep sedation b. Nausea, vomiting, and diarrhea c. Increased euphoria d. An absence of the "high" associated with drugs
d. An absence of the "high" associated with drugs
Complications associated with anorexia nervosa include all of the following except: a. Cardiac arrest and death b. Anemia c. Renal disease d. Aspiration pneumonia
d. Aspiration pneumonia
A nurse is discussing the factors for somatic symptom disorder with a newly licensed nurse. Which of the following risk factors should the nurse include? a. Obesity b. Age older than 65 years c. Coronary artery disease d. Childhood trauma
d. Childhood trauma
Neurological tests have ruled out pathology in a client's sudden lower-extremity paralysis. Which nursing care should be included for this client? a. Encourage a discussion of feelings about the lower-extremity problem b. Meet dependency needs until the physical limitations subside c. Challenge the validity of physical symptoms d. Deal with physical symptoms in a detached manner
d. Deal with physical symptoms in a detached manner
A 33-year-old client admitted with bipolar disorder, manic phase, is loud, garishly dressed, hyperverbal, and hyperactive. Which of the principles should the nurse apply when planning care? a. Increasing stimulation tends to focus the client b. Decreasing stimulation tends to diminish symptoms c. Manic clients respond well to peer pressure d. Detailed activities will help the client control behavior
d. Detailed activities will help the client control behavior
Which of the following statements accurately describes dissociative fugue? a. Dissociative fugue is not precipitated by stressful events b. Dissociative amnesia and dissociative fugue are completely different types of disorders c. Dissociative fugue is characterized by a sense of observing oneself from outside the body d. Dissociative fugue is characterized by sudden, unexpected travel or bewildered wandering with inability to recall some or all of one's past
d. Dissociative fugue is characterized by sudden, unexpected travel or bewildered wandering with inability to recall some or all of one's past
Adaptive coping strategies include all of the following EXCEPT: a. Positive self-talk b. Reframing c. Relaxation techniques d. Drinking alcohol to forget your problems.
d. Drinking alcohol to forget your problems.
A community health nurse is providing teaching to the family of a client who has primary dementia. Which of the following manifestations should the nurse tell the family to expect? a. Decreased display of emotions b. Personality traits that are opposite of original traits c. Decreased auditory and visual acuity d. Forgetfulness gradually progressing to disorientation
d. Forgetfulness gradually progressing to disorientation
What does a urinalysis that is positive for the drug tested indicate? a. It indicates illegal drug use b. It verifies drug dependency c. It is a violation of the individual's constitutional rights d. It verifies whether the drug is present in the specimen
d. It verifies whether the drug is present in the specimen
A client who has received lithium for 3 weeks to control acute mania has the following symptoms: coarse hand tremor, diarrhea, vomiting, lethargy, and mild confusion. The priority nursing action should be to: a. Administer prn Cogentin to relieve extrapyramidal symptoms b. Provide reassurance that the symptoms are transient c. Decrease the sodium in the client's diet d. Obtain a stat lithium order; hold the lithium pending results
d. Obtain a stat lithium order; hold the lithium pending results
A nurse at a college campus mental health counseling center is caring for a student who just failed an examination. The student spends the session berating the teacher and the course. The nurse should recognize this behavior as which of the following defense mechanisms? a. Conversion b. Regression c. Undoing d. Projection
d. Projection
A client was prescribed alprazolam (Xanax) for symptoms of anxiety related to a recent divorce and relocation. She stated to the nurse, "A little while after I take the medication, I feel out of it and spacey." What is the likely cause of this feeling? a. The combination of lorazepam with an antidepressant b. Long elimination half-life c. Sensitivity of the mesencephalic reticular activating system d. Rapid absorption and distribution to brain cells
d. Rapid absorption and distribution to brain cells
Which nursing intervention is appropriate when caring for clients diagnosed with either anorexia nervosa or bulimia nervosa? a. Provide privacy during meals b. Encourage the client to keep a journal to document types of food consumed c. Restrict client privileges when provided food is not completely consumed d. Remain with the client for at least 1 hour after the meal
d. Remain with the client for at least 1 hour after the meal
A nurse is caring for a client who is hospitalized for the treatment of severe depression. Which of the following nursing approaches is therapeutic? a. Playing a game of chess with the client b. Encouraging decision-making c. Giving the client a choice between 3-5 activities d. Spending time sitting with the client
d. Spending time sitting with the client
A nurse working the night shift suspects that a colleague is abusing alcohol. Which statement is true? a. It is none of your concern so you should not stick your nose in another nurse's business b. "Good faith" reporting is unfaithful to a colleague c. Reporting will result in loss of the colleague's license d. State guidelines mandate reporting the substance abuse
d. State guidelines mandate reporting the substance abuse
According to an evidence-based approach, what is the most productive way to treat anxiety disorders? a. Provide the client with a powerful medication b. Allow the client to self-medicate with over the counter (OTC) medications c. Immediately start multiple-drug therapy d. Uncover and address the cause of anxiety
d. Uncover and address the cause of anxiety
