Psych 21-24 practice
The adult child of a client with dementia asks the nurse how to respond when the client repeatedly states they had a busy day at work but the client has not worked in over 20 years. Which is the best guidance that the nurse could offer? A.Go along with the client's thought of it having been a busy day, but do not refer to the client's work. B.Give the client 5 to 10 minutes of rest, and the client will have no memory of the incident. C.Reorient the client that they are at home and did not go to work today. D.Ask the client to explain what the client did at work today that kept them so busy.
A
The family members of a client with somatic symptom illness report to the nurse that every time they invite the client to join in an activity, the client declines, saying things like, "I wish I could, but I feel so terrible." Which approach will the nurse suggest to encourage activity? A."I know this is difficult, but exercise is important. It will be a short walk." B."You are fine, the doctor said so. Let's go." C."I'll let you rest. Let me know when you feel better." D."What does your pain feel like right now?"
A
The nurse is performing a family assessment to determine why an adolescent is engaging in risky behaviors. The parent states, "I just don't understand why my child would want to drink alcohol when my spouse is an alcoholic and has had several DUI's as well as being abusive to the children and I." Which is the best response by the nurse? A."Parents that engage in risky behaviors are more likely to have children that engage in these behaviors." B."If the spouse doesn't know right from wrong, how can you expect the child to behave any differently?" C."I realize this is unusual behavior because you would think the child would not want to repeat those behaviors." D."You never know what type of things children will pick up. You have to be the best parent for you and your spouse."
A
The nurse is working with an aggressive adolescent with behavioral disorder, and the client has been resistant to the treatment plan. Which action can the nurse take to keep the negative emotions from interfering with a positive outcome for the client? A.Consider another area of nursing since this is likely to continue to happen. B.Discuss feelings, fears, and frustrations with colleagues regarding the client. C.Inform the client that their behaviors are causing frustration and anger. D.Have another nurse care for the client to refrain from showing bias.
A
The nursing is caring for a child in the pediatric outpatient clinic being treated with imipramine for the treatment of enuresis. Which report by the parent is of most concern to the nurse? A.The child is having decreased urinary output and difficulty urinating. B.The child reports nausea after taking the pill relieved with food. C.The parent states the child is having a bowel movement every other day. D.The parent states the child is sleepy for about 2 hours after taking the pill.
A
A nurse is providing education to a group of parents who have children with attention-deficit/hyperactivity disorder (ADHD). Which information will the nurse include in the education? Select all that apply. A.ADHD is not the fault of the parents or the child. B.Children with ADHD do not qualify for special school services. C.Placing your child on medication alone will be adequate treatment. D.Take the time to learn how to rebuild a child's self-esteem. E.Support groups can provide information and encouragement from others.
A,D,E
A client reports severe pain during intercourse since being sexually assaulted 3 years ago. Which is the first step in confirming the diagnosis of a pain disorder? A.Ruling out a physical cause of pain B.Assessing the client for posttraumatic stress disorder C.Asking the client to keep a journal of their feelings regarding the assault D.Evaluating the client's understanding of a pain disorder
A
A 14-year-old client is being treated for conduct disorder. The client refuses to attend class today and states that "Yesterday, the other nurse told them they didn't have to go to class if they didn't want to." Which is the best response by the nurse? A."You are obligated to attend class. Missing class is against the rules." B."You and I both know that the nurse didn't say that." C."Why do you keep fighting the system, just go along with the rules." D."Fine, but you're confined to your room and not allowed to socialize."
A
A client is brought to the clinic by a family member who reports the client is unable to identify ordinary objects, such as a pen or notebook. After assessment of the client's abilities, which will the nurse document on the electronic health record? A.The client is experiencing agnosia. B.The client has aphasia. C.The client has amnesia. D.The client is experiencing apraxia.
A
A client with a tic disorder tells the nurse that they are experiencing more complex motor tics and verbal tics lately but they get better when occupied with a task. Which question will be most appropriate to ask the client to determine the best option for decreasing these symptoms? A."Have you been experiencing an increase in stress lately?" B."Is there any changes that you have made to your diet?" C."Have you developed any new allergies?" D."Are you taking any new medications?
A
A young adolescent client arrives in the outpatient clinic and demonstrates various motor and vocal tics. The client is emotional and states that other children avoid them and call them horrible names. Which prescription by the health care provider will the nurse educate the client and parent about? A.Risperidone B.Lithium C.Atomoxetine D.Methylphenidate
A
An adolescent is displaying behaviors associated with conduct disorder such as stealing, fighting, skipping school, and not adhering to the rules at home. Which factor(s) stated by the client does the nurse correlate with the behaviors exhibited by the adolescent? Select all that apply. A."We live in a rundown apartment on a bad side of town." B."If I don't do what my parent says, I get beaten." C."My parents are into drugs and alcohol." D."My parents are strict and set firm limits." E."Our family is dysfunctional and no one gets along."
A,B,C,E
The nurse is performing a history and physical assessment for a client in the clinic with moderate dementia. When asking questions, the client gets agitated and asks the nurse why are all of these questions being asked. Which is the best action(s) for the nurse to take to obtain the data needed? Select all that apply. A.Take frequent breaks during the interview process. B.Give the client ample time to answer the questions asked. C.Provide simple explanations to the client as often as required. D.If the client does not respond to a question, continue to ask until answered. E.Ask simple questions instead of compound questions.
A,B,C,E
The adolescent client is exhibiting "bullying behaviors." Which may be concern(s) that a nurse has when caring for clients who have conduct disorders? Select all that apply. A.Having conflicted feelings regarding holding clients accountable for their behaviors without having a punitive attitude B.Believing that the client should be able to refrain from hostility and aggression through use of will power C.Believing that aggression is the most productive way to deal with anger D.Having anxiety and fears for the nurse's personal safety E.Discussing feelings, fears, or frustrations with colleagues
A,B,D
The nurse is creating a plan of care for a client with somatic symptom disorder. Which long-term treatment outcome(s) for this client will be most achievable and measurable? Select all that apply. A.The client will identify the relationship between stress and physical symptoms. B.The client will verbally express emotional feelings. C.The client will learn to vary their schedule. D.The client will assume responsibility for self-care activities. E.The client will demonstrate alternative ways to deal with stress, anxiety, and other feelings.
A,B,D,E
The nurse is assessing a 2-year-old child during a wellness checkup. Which statement(s) by the parent indicate that the child needs to be screened for autism spectrum disorder? Select all that apply. A."My child rarely makes eye contact with me or siblings." B."There is no spontaneous play at all and will only plays with one object. C."Will answer questions when asked with a one-word response." D."My child loves to have a difference in routines daily." E."I notice that my child has very few facial expressions to situations."
A,B,E
The parents of a child with attention-deficit/hyperactivity disorder (ADHD) express to the nurse, "We get so frustrated when our child never listens to us." Which parenting strategies will the nurse discuss with the parents? Select all that apply. A.Use a point system for positive and negative behavior. B.Use appropriate time-out strategies for behavior control. C.Provide occasional rewards and consequences for behavior. D.Resist giving praise until fully compliant with requests. E.Give verbal reprimands for negative behavior.
A,B,E
The nurse is talking with an adolescent client who has been externalizing behaviors indicating a conduct disorder. Which client statement(s) indicate that externalizing behaviors are being experienced? A."When I get dropped off at school, I skip and go drink with my friends." B."I'm always tired and sleepy. Just don't feel like going anywhere or doing things." C."I set fire to a trash can on school property when I threw my cigarette in it." D."I got caught cheating on an exam. I cheat all of the time, why should I study?" E."My stomach hurts and I feel nauseated all of the time."
A,C,D
The nurse is educating parents of a child with attention-deficit/hyperactivity disorder (ADHD)about the prescription for atomoxetine. Which client statement(s) indicate that the education is effective? Select all that apply. A."We need to monitor appetites since the medication may suppress appetite."B."Prior to the administration of the medication, a chest x-ray will be done."C."We will need to bring our child in for routine liver function testing." D."It is better to give the medication with food." E."If our child reports a dry mouth, we can give sugar free candy or gum."
A,C,D,E
The nurse is admitting an adolescent client with a conduct disorder to an inpatient facility. Which will the nurse discuss with the client that will be enforced throughout the stay related to limit setting? Select all that apply. A.Inform the client about the rules or limits. B.Inform the client they will be incarcerated for non-adherence to the rules. C.Occasionally limit enforcement but allow some freedoms. D.Explain the consequences if clients exceed the limit. E.State the expected behavior of the client in the facility.
A,D,E
A nurse has been working with clients with Alzheimer disease for almost 6 months. The nurse expresses frustration to the nurse manager because the same instructions have to be given to clients several times a day. Which suggestion would be most appropriate for the manager to make? A.Cease giving instructions because the clients will not remember them anyway. B.Try to stay supportive and meet the clients' needs at the current moment. C.Seek counseling if personal feelings get in the way of client care. D.Consider transferring to a different client care specialty area.
B
A preadolescent client has been considered a neighborhood bully for several years. Peers avoid them, and the parent says, "I cannot believe a thing my child tells me." Recently, the client was observed shooting at several dogs with a pellet gun and setting fire to a vacant lot for the first time. A nurse would assess these behaviors as being most consistent with which disorder? A.Oppositional defiant disorder B.Conduct disorder C.Defiance of authority D.Pyromania
B
The nurse is identifying outcomes for a client with a somatic symptom illness. Which is an appropriate outcome to include in the plan of care? A.The client will verbalize acceptance of physical symptoms. B.The client will verbally express their emotions. C.The client will be free from stress. D.The client will demonstrate alternative ways to avoid stressful situations.
B
The nurse manager in an long-term care facility is managing the environment to give optimal care to clients with dementia. Which will the nurse include when improving the living environment? A.Open the windows and doors to allow fresh air to circulate through the environment. B.Plan for the same staff to provide care to individuals as much as possible. C.Provide a buffet-style menu with many food choices for the clients. D.Assign peer-led exercise activities on a daily basis.
B
The nurse is working with clients who have disruptive behavior disorders. Which are important point(s) for the nurse to consider when working with these clients and their families? Select all that apply. A.Most behavior disorders are caused by being raised by parents who had behavior disorders in their own childhoods. B.Focus on positive actions to improve situations and/or behaviors. C.Remember to focus on the client's strengths and assets, as well as their problems. D.Avoid a "blaming" attitude toward clients and/or families. E.Transient conduct disorders are common in all children.
B,C,D
The nurse is preparing to bring a child and their parents into the examination room to see the health care provider. Which are the best way(s) for the nurse to assess the child for attention-deficit/hyperactivity disorder (ADHD)? Select all that apply. A.Reviewing the client's record B.Interviewing the client's parents C.Directly observing the child D.Interviewing the client's teachers E.Assessing the client in a group of peers
B,C,D,E
The nurse is performing a health history and physical assessment for a client whom the family members stated that the client is exhibiting new-onset confusion. Which data reported by the family member indicate the possible reason(s) the client is experiencing the confusion or delirium? Select all that apply. A.The client is using over-the-counter vitamins daily. B.The family reports the client has been drinking alcohol to excess. C.The client is drinking very little fluids and has to be encouraged to drink water. D.The client has just had the inside of the house painted. E.The client has broken out in hives and using diphenhydramine. F.The client is only sleeping approximately 2 to 3 hours a night and up several times.
B,C,D,E,F
The nurse is working with a school-age child who is being evaluated for a mental health disorder. The parents of the child ask the nurse why the health care staff is having such a difficult time diagnosing the child. Which is the best response by the nurse? Select all that apply. A.Children and adolescents experience some of the same mental health problems as adults and are diagnosed using the same criteria. B.Children usually lack the abstract cognitive abilities and verbal skills to describe what is happening. C.Behaviors that are appropriate for a child of one developmental level may be inappropriate for a child of a different developmental level. D.Sometimes, children "outgrow" psychiatric disorders at different stages of life. E.Children are constantly changing and developing and unable to discriminate unusual symptoms from normal feelings.
B,C,E
The nurse is performing an assessment for a 14-year-old client whose parents are concerned with recent behaviors exhibited by the adolescent. Which statement(s) by the client in the interview portion of the assessment does the nurse identify as typical adolescent behaviors? Select all that apply. A.Lacks caring about peer approval B.Critical of self and others C.Consistent and predictable behaviors D.Verbally aggressive with parentsE.Inability to postpone gratification
B,D
A client diagnosed with somatic symptom disorder reports to the nurse that others doubt the seriousness of their illness. The client is angry, frustrated, and anxious. Which nursing intervention takes priority? A.Document the client's unwillingness to accept anxiety as the source of the illness. B.Discuss with the family ways to avoid secondary gains associated with physical concerns. C.Acknowledge the client's frustrations without fostering continued focus on physical illness. D.Remind the client that lab tests showed no evidence of physiological problems.
C
After being arrested for prostitution, an adolescent client has been referred to a mental health clinic by a juvenile officer. The client has a history of truancy and being physically abusive to siblings. From the history gathered during assessment, the nurse identifies that these behaviors correlate with which disorder? A.Oppositional disorder B.Childhood depressive disorder C.Conduct disorder D.Intermittent explosive disorder
C
The nurse is educating parents of a child with attention-deficit/hyperactivity disorder (ADHD). Which statement by the parents would indicate the need for further teaching? A."We'll set up rules with specific times for eating, sleeping, and playing." B."We'll use simple, clear directions and instructions." C."We'll have the child do homework at the kitchen table with the child's siblings." D."We'll make sure the child completes one task before going on to another."
C
The nurse is assessing an adolescent client. The parent is in the room and answers most of the questions, even though the questions are directed at the client. Which action(s) from the parents of a child with conduct disorders does the nurse identify may be a contributing factor to the behaviors? Select all that apply. A.The parents establish household responsibilities that are age appropriate. B.The parents make reasonable curfews that are age appropriate. C.The parents blame the school when the child causes a disturbance in school. D.The parents may not behave appropriately because of a lack of knowledge. E.The parents engage in yelling at, hitting, or simply ignoring the behavior of the child.
C,D,E
The nurse is caring for an assigned group of clients. Which client does the nurse identify is at the highest risk for the development of delirium and will be closely monitored? A.A client who sustained a fractured femur in a motor vehicle crash B.A client with a blood glucose level of 110 mg/dL (6.1 mmol/L) C.An adult client being prepared for a laparoscopic cholecystectomy. D.An older adult client with sepsis from a urinary tract infection
D
The nurse is preparing to set a client with dementia up for breakfast and gives the client a washcloth to clean their face and hands. The client looks at the washcloth without knowing what to do with it. Which is the best response by the nurse? A."Go ahead and wash your face and hands so that you can eat your breakfast." B."Did you forget about what that item is? Do you want me to tell you?" C."Do you know what to do with the washcloth?" D."This is a washcloth so you can wash your face and hands."
D
The school nurse is talking with the parent of a 7-year-old child who is having difficulty in the classroom due to a diagnosis of attention-deficit/hyperactivitydisorder (ADHD). The child is having difficulty paying attention, listening, and completing tasks. Which suggestion can the nurse give for improvement to the parent? A.Allow the child to listen to music with headphones while completing class work. B.Encourage the parent to increase the dosage of medication the child is taking. C.Have the child do the majority of school work on a computer in the classroom. D.Request that the child be seated in front of the teacher in the classroom.
D
