Psych Midterm NCLEX Q's
A client admitted voluntarily for treatment of an anxiety problem demands to be released from the hospital. Which action should the nurse take initially? A. Contact the client's healthcare provider B. Call the client's family to arrange for transportation C. Attempt to persuade the client to stay "for only a few more days" D. Tell the client that leaving would likely result in an involuntary commitment
A
A client diagnosed with schizophrenia exhibits a flat affect, apathy, and avolition. Which mediation should the nurse expect the physician to order to address these symptoms? A. Olanzapine (Zyprexa) to address these negative symptoms B. Haloperidol (Haldol) to address these negative symptoms C. Risperidone (Risperdal) to address these negative symptoms D. Chlorpromazine (Thorazine) to address these negative symptoms
A
A client diagnosed with schizophrenia experiences identity confusion and communicates with the nurse using echolalia. What is the client attempting to do by using this form of speech? A. Identify with the person speaking B. Imitate the nurse's movements C. Alleviate alogia D. Alleviate avolition
A
A client is experiencing a panic attack. The client states, "I'm losing control. I feel like I'm going crazy." Which nursing intervention takes priority? A. Stay with the client and offer support B. Distract the client by redirecting physical activities C. Teach the etiology and management of panic disorders D. Encourage the client to express feelings
A
A client is experiencing disturbed thought process and believes that his food is being poisoned. Which communication technique should the nurse use to encourage the client to eat? A. Using open ended questions and silence B. Sharing personal preference regarding food choices C. Documenting reasons why the client does not want to eat D. Offering opinions about the necessity of adequate nutrition
A
A client states, "My husband says I'm cold but actually I think I am hot." In an attempt to clarify the meaning of the client's statement, which nursing response is the most appropriate? A. In what context are you using the word hot? B. Tell me more about that sensation C. I find that hard to believe D. Are you feeling rejected by your husband?
A
A client who is prescribed lithium carbonate is being discharged from inpatient care. Which medication information should the nurse teach this client? A. Do not skimp on dietary sodium intake B. Have serum lithium levels checked every 6 months C. Limit fluid intake to 1000mL of fluid per day D. Adjust the medication dose if you feel out of control
A
A nurse is assessing a client diagnosed with paranoid schizophrenia for the presence of hallucinations. Which therapeutic communication technique used by the nurse is an example of making observations? A. "I notice that you are talking to someone who I do not see" B. "Please tell me what they are telling you" C. "Why do you continually look up at the ceiling?" D. I understand that you see someone in the hall, but I do not see anyone"
A
A nursing instructor is teaching about the use of therapeutic techniques and non-therapeutic blocks to communication. Which student statement indicates that learning has occurred? A. Making an approval statements such as "That was a great decision" is considered non-therapeutic B. The technique of verbalizing the implied is considered non-therapeutic because the nurse is making an assumption C. The technique of suggesting collaboration is non-therapeutic because it implies that there is collusion between the nurse and the client D. Silence is a non therapeutic technique that should be avoided
A
A war veteran describes having his legs blown off during an attack. His affect is flat and he shows no emotion during this disclosure. This veteran is using which defense mechanism? A. Isolation B. Identification C. Introjection D. Displacement
A
Clearly depressed about a transfer to Hawaii because of the High Cost of living, an Air Force Major does research and convinces his family of the great surfing Hawaii offers. A nurse would recognize that the major is using which defense mechanism? A. Intellectualization B. Denial C. Rationalization D. Suppression
A
What is the rationale for a nurse to perform a psychosocial assessment on a client with a family history of cardiovascular disease? A. Unresolved anxiety can contribute to physiological disorders. B. Cardiovascular disease has been associated with mental illness C. It is important to rule out the diagnosis of personality disorder D. Psychosocial assessment can always predict pathophysiology
A
What should the nurse's primary goal be during the termination phase of the nurse-client relationship? A. To evaluate goal attainment and ensure therapeutic closure B. To establish trust and formulate a contract for intervention C. To explore self perceptions D. To promote client change
A
When reviewing the admission assessment, the nurse notes that the client was admitted to the mental health unit voluntarily. Based on this type of admission, the nurse should provide which intervention for this client? A. Monitor closely for harm to self or others B. Assist in completing an application for admission C. Supply the client with written in information about his or her mental health problem D. Provide an opportunity for the family to discuss why they felt the admission was needed
A
Which interaction is an example of dialogue that would be used in the context of behavioral therapy? A. Cl: I can't stop pulling out my eyelashes when I'm stressed/ N: when you get this urge, try locking your arms to make eyelash pulling impossible B. Cl: I was punished frequently by my mother, and now I can't do anything right/ N: Tell me about your feelings of anger C. Cl: I see no benefit in going to my group therapy/ N: group therapy offers you can opportunity to appropriately interact with others D. Cl: My stupid doctor hates me, so he revoked my pass/ N: What makes you think the doctor hates you?
A
Which is an example of the therapeutic communication technique of offering a general lead? A: Cl: My wife is threatening to take sole custody of our children/ N: I see B. Cl: I need to talk to you about my divorce/ N: Where would you like to begin? C: Cl: Since the divorce I feel hollow inside/ N: help me understand what you mean by hollow D: Cl: I don't think I will ever be able to marry again/ N: You won't ever be able to marry again?
A
Which medication would be a first line consideration in the treatment of anxiety for a client actively abusing alcohol? A. Buspirone (Buspar) B. Alprazolam (Xanex) C. Chlordiazepoxide (Librium) D. Clonazepam (Klonopin)
A
Which symptom is an example of an affective alteration exhibited by clients diagnosed with severe depression? A. Apathy B. Somatic delusion C. Difficulty falling asleep D. Social isolation
A
A suicidal client has not been responding to prescribed antianxiety medication. Which of the following should the nurse functioning in the role of medication manager consider when assessing this client? Select all that apply. A. The client may be cheeking the medication B. The client may be trying to accumulate medications for a suicide attempt C. The nurse may need to to check the client's mouth after drug administration D. The nurse may need to advocate for an alternative way to administer the drug E. The client may be allergic to the medication
A, B, C, D
Which action should the clinician take when there is reasonable certainty that a client is going to harm someone? Select all that apply. A. Assess the threat of violence toward another B. Identify the person being threatened C. Notify the identified victim D. Notify only law enforcement authorities to protect confidentiality E. Consider petitioning the court for continued commitment
A, B, C, E
Which data gathering technique can be employed during the evaluation step of the nursing process? Select all that apply. A. Asking the client to rate anxiety after administering an anxiolytic B. Asking the client to verbalize understanding of the explained unit rules C. Asking the client to describe any thoughts of self-harm D. Asking the client if the group on assertiveness skills was helpful E. Asking the client if a prn medication would be helpful
A, B, D
Which nonverbal behavior should a nurse avoid when gathering assessment data on a newly admitted client? Select all that apply. A. Maintain indirect eye contact with the client B. Provide space by leaning back away from the patient C. Sitting squarely, facing the patient D. Sitting with arms and legs in an open posture E. Standing while the client sits
A, B, E
A home health nurse has been assigned a client diagnosed with agoraphobia. Which of the following symptoms would the nurse expect to assess? Select all that apply. A. Fear of standing in a line B. Fear of authoritative figures C. Fear of being outside of the home alone D. Fear of traveling in a car E. Fear of loud noises
A, C, D
A psychiatrist ordered habit reversal therapy (HRT) for a client diagnosed with hair pulling behavior. After several weeks of treatment, which of the following client behaviors would the nurse expect? Select all that apply. A. The client is attempting to extinguish unwanted behavior B. The client is becoming less aware of the behavior C. The client can identify times of hair-pulling occurrence D. The client has substituted a more adaptive coping strategy E. The client understands that hair pulling behaviors are genetic in nature
A, C, D
A client diagnosed with an anxiety disorder tells the nurse, "I'm not sleeping much. I hurt all over and feel sad and irritable". Which of the following is subjective assessment data? Select all the apply. A. I'm not sleeping much B. My mood is a 4 on that 10 point scale C. I hurt all over D. I'm feeling sad E. I'm feeling irritable
A, C, D, E
An instructor is listing the symptoms that a client could experience during a hypomanic episode. Which of the following should be included in this list? Select all that apply. A. Perceptions of the self are grandiose B. Decrease in goal directed activities C. Decreased need for sleep D. Flight of ideas E. Distractibility
A, C, D, E
The legal duty to warn for protection of a third-party refers to which of the following nursing obligations? Select all that apply. A. The nurse is obligated to assess a client's threat of violence toward another individual B. The nurse is obligated to inform family members of the client's intent to do harm C. The nurse is obligated to find out the identity of the intended victim D. The nurse is obligated to report the client's intention to harm another to the psychiatrist or to other team members E. The nurse is obligated to protect an unintended victim in a feasible meaningful way
A, C, D, E
A client scheduled for ECT asks the nurse to explain procedures and medications that will be administered. Which of the following should the nurse include? Select all that apply. A. Atropine sulfate or glycopyrrolate (Robinul) is administered intramuscularly before treatment to reduce secretions B. Glycopyrrolate (Robinul) paralyzes respiratory muscles making the administration of oxygen necessary before treatment C. Succinylcholine chloride (Anectine) is given IV to prevent muscle contractions and and bone fractures during the seizure D. Ventilation with pure oxygen will be initiated before, during, and after the treatment E. The anesthesiologist will administer a short acting anesthetic, such as propofol (Diprivan) or etomidate (Amidate)
A, C, E
Which of the following are negative symptoms of schizophrenia that are categorized as psychomotor behavior? Select all that apply. A. Anergia B. Apathy C. Waxy flexibility D. Emotional ambivalence E. Posturing
A, C, E
An instructor is teaching about phobias and the different treatments used to decrease fear driven anxiety. Which of the following student statements about implosion therapy (flooding) indicates that learning has occurred? Select all that apply. A. A client must imagine of participate in an extremely frightening situation for a long period of time B. A client must participate in relaxation training to decrease the onset of a panic attack C. A client is flooded with soothing music and images of cloud formations when triggers to anxiety are presented D. The client continues implosion therapy until the stimulus no longer elicits anxiety E. The client learns to be anxious and relaxed at the same time while being exposed to anxiety provoking triggers
A, D
It has been determined that a newly admitted client is gravely disabled. Which of the following statutes that specifically defined the "gravely disabled" client would have led to the determination? Select all that apply. A. The client who, because of mental illness, cannot fulfill his or her activities of daily living B. The client who, because of mental illness, is unable to provide resources to meet their basic needs C. The client who, because of mental illness, has been deemed a danger to self and/or others D. The client who, because of mental illness, lacks the ability to make use of available resources that are needed to meet daily living requirements E. The client who, because of mental illness, is having paranoid delusions about being on the FBI's most wanted list.
A, D
Which of the following best exemplifies a client's use of the defense mechanism of displacement. Select all that apply. A. A student fails a dosage calculation test then arbitrarily picks a fight with a roommate. B. An adolescent who feels angry and hostile towards others decides to become a therapist C. A woman is unhappy about being a mother, although others know her as an attentive parent D. A client is drinking 6 to 8 beers a day while still attending AA as a group leading E. After a heated argument with his wife, a husband berates a restaurant waiter for slow service
A, E
How would the nurse determine whether a child or adolescent is experiencing manic symptoms? Select all that apply. A. Symptoms must exceed the FIND (frequency, intensity, number, and duration) threshold. B. Symptoms must occur in concert with other manic symptoms because no one symptom is diagnostic of mania C. Symptoms must include an increased need for sleep D. Symptoms must include suicidality E. Symptoms must occur on a monthly basis
A,B
A client who is being treated for an anxiety disorder with clonazepam( Klonopin) complains that the medication seems ineffective. To correctly assess the client, which of the following questions should the nurse ask? Select all that apply. A. Are you a smoker? B. How long have you been taking the drug? C. How much coffee do you drink? D. Do you have any kidney problems? E. Do you take the herbal supplement valerian?
A,C
Which of the following is an example of normal anxiety? Select all that apply. A. A mother experiences dread when she discovers evidence that her teenage daughter has missed two menstrual periods B. Long after a minor car incident, the man continues to experience tachycardia on revisiting the scene of the accident C. To help decrease her fear, an elderly woman attends daily mass and prays the rosary for her grandson who is on active duty in the army D. A police officer has to apply for a leave of absence because of the feelings experienced after a near fatal car crash E. An individual who recently lost a parent due to a long chronic illness now cannot leave home
A,C
A nursing student is writing a paper about the various types of depressive disorders. Which symptoms would the student include that characterize major depressive disorder (MDD)? Select all that apply. A. Depressed mood or loss of interest or pleasure in usual activities B. Impaired social or occupational functioning for at least a 1 week duration C. History of no more than two manic episodes during the past year D. Symptoms cannot be attributed to substances or other medical condition E. Fatigue or loss of energy nearly every day
A,D,E
Which correct statements related to the following nurse-client communication exchange? Client: "My mother neglected me" Nurse: I see. Go on..." Select all that apply. A. The communication technique is classified as therapeutic B. The communication technique is described as a broad opening C. The communication technique is described as giving recognition D. The communication technique is used to clarify revealed information E. The communication technique is used to communicate that the nurse is listening
A,E
The nurse should plan which goals of the termination stage of group development? Select all that apply. A. The group evaluates the experience B. The real work of the group is accomplished C. Group interaction involves superficial conversation D. Group members become acquainted with one another E. Some structuring of group norms, roles, and responsibilities takes place F. The group explores members' feelings about the group and impending separation
A,F
A client from India states, "My uncle sinned when he slaughtered his cow for profit." Which data should the nurse consider when assessing this client's mental health? A. Delusions are false personal beliefs B. The concepts of mental health and mental illness are defined and influenced by culture and religious beliefs C. Hallucinations are false sensory perceptions not associated with any real external stimuli and may involve the senses D. This client is employing the defense mechanism of projection
B
A client has been adherent with olanzipine (Zyprexa) 4mg QHS for the past year. On assessment, the nurse notes that the client has bizarre facial and tongue movements. Which is a priority nursing intervention? A. With the next dose of olanzapine (Zyprexa), give the ordered prn dose of benztropine (Cogentin) B. Notify the physician of the observed side effects, place a hold on the Zyprexa, and request discontinuation of the medication C. Ask the physician to increase the dose of Zyprexa to assist with the bizarre behaviors D. Explain to the client that these side effects are temporary and should should subside in 2 to 3 weeks
B
A client has been deemed a danger to self by an emergency commitment court ruling. Which might the court mandate for this client? A. Voluntary commitment in a locked psychiatric facility B. Involuntary commitment to an outpatient mental health clinic C. Delaration of incompetence with mandatory medication administration D. Declaration of emergency seclusion
B
A client has recently experienced a second trimester miscarriage and is feeling very depressed. Which therapeutic statement by the nurse conveys empathy? A. You are feeling very depressed. I know how you feel. I felt the same way when I lost my first baby B. I can understand you are feeling depressed. It is difficult to lose a baby. I'll sit with you C. You seem depressed. I think it would be helpful if I explained to you the five stages of grief D. I know this is a difficult time for you. Would you like a prn medication to help you feel better?
B
A client notifies a staff member of current suicidal ideations. Which nursing intervention would take priority? A. Place the client on a one to one observation B. Determine whether the client has a specific plan to commit suicide C. Assess for past history of suicide attempts D. Notify all staff members and place the client on suicide precautions
B
A husband yells at his wife because of her self-indulgent extravagances. Later in the day he buys her a $1,000 gift certificate. The husband is using which defense mechanism? A. Denial B. Undoing C. Compensation D. Repression
B
A nurse believes that the members of a parenting group are in the termination phase of group development. Which group behaviors would support this assumption? A. The group members manage conflict within the group B. The group members use denial as part of a grief response C. The group members compliment the leader and compete for various position roles D. The group members trust one another and the leader
B
A nurse has received a client's white blood cell count (WBC) result. Which client was most likely to have this blood work ordered? A. A client diagnosed with schizophrenia prescribed aripiprazole (Abilify) B. A client diagnosed with schizophrenia prescribed clozapine (Clozaril) C. A client diagnosed with schizophrenia prescribed haloperidol (Haldol) D. A client diagnosed with schizophrenia prescribed risperdal (Risperidone)
B
A nurse is attempting to administer anti-anxiety medication to an involuntarily committed client. The client refuses the medication, curses and states, "I'm going to kill you." Which nursing action is most appropriate at this time? A. The nurse decides to not administer medication B. The nurse initiated the ordered, forced medication protocol C. The nurse initiates legal action to get the client declared competent D. The nurse teaches the client the pros and cons of medication compliance
B
A nurse is caring for an adolescent who has a diagnosis of both ADHD and bipolar disorder. When administering medication for ADHD,, which should the nurse consider? A. Medication for bipolar disorder should be initiated only after ADHD symptoms have been controlled B. Medications for ADHD should be initiated only after bipolar bipolar symptoms have been controlled with a mood stabilizer C. Stimulants work to calm the adolescent experiencing mania D. Nonstimulant medications indicated for ADHD rarely precipitate mania
B
A nursing instructor is teaching about ego defense mechanisms. Which statement indicates a need for further instruction? A. Defense mechanisms are used during periods of increased anxiety and when the strength of the ego is tested B. All individuals who use defense mechanisms to adapt to stress exhibit healthy egos C. At times of mild to moderate anxiety, defense mechanisms can be used adaptively to deal with stress D. Some ego defenses are more adaptive than others but all are used either consciously or unconsciously for ego protection.
B
A nursing instructor is teaching about the reasons clients are admitted to an inpatient psychiatric unit. Which student statement indicates that more instruction is needed? A. This client should be admitted because he is threatening to kill his mother B. This client should be admitted because he is convinced that all clergy go first to purgatory and then hell C. This client should be admitted because of an attempted jump from a bridge D. The client should be admitted because voices tell him to eliminate all people who look like terrorists
B
A pacing, agitated client diagnosed with bipolar mania is unable to concentrate during an interaction with the nurse. The nurse uses closed-ended questions, offers finger foods, and reassures the client. What is the nurse promoting by these actions? A. Sympathy B. Trust C. Veracity D. Congruency
B
During an admission assessment, a nurse asks a client diagnosed with schizophrenia, "Have you ever felt that certain objects or persons have control over your behavior?". The nurse is assessing for which type of thought disruption? A. Delusions of persecution B. Delusions of influence C. Delusions of reference D. Delusions of grandeur
B
The client diagnosed with obsessive-compulsive disorder has an obsession with dirt and germs and has a continual compulsion to spray all surfaces with disinfectant. How would the nurse explain this client's action? A. The compulsion to spray disinfectant reduces bacterial growth B. The compulsion to spray disinfectant relieves the client's anxiety C. The compulsion to spray disinfectant encourages ego integrity D. The compulsion to spray disinfectant increases the client's self esteem.
B
The mother abuses her children and tells the caseworker that it's her husband who abuses the children even though it has been proven that he's a dutiful Father. Which defense mechanism is the mother using? A. Compensation B. Projection C. Displacement D. Denial
B
Which exhibited symptoms would cause a nurse to determine that a client is experiencing a panic level of anxiety? A. The client has difficulty concentrating B. The client, without evidence, is convinced his son is planning his murder C. The client requires assistance in decision making D. The client is restless and complains of muscle tension
B
Which is a realistic expectation of clients participating in milieu therapy? A. To control or set limits on threats and aggressive acts B. To learn adaptive coping, interaction, and relationship skills C. That all maladaptive behaviors are eliminated and adaptive behaviors substituted D. That trust and rapport are quickly established in the context of the of the nurse-client relationship
B
Which of the following situations exemplify the use of the ego defense mechanism of compensation? Select all that apply. A. With a flat affect and displaying no emotion, a daughter describes her mother's recent suicide. B. Failing the college entrance examination due to an inability to comprehend math, the student and embarks on a Master Gardener certification C. A woman recently disbarred from the legal profession takes to her bed and finds comfort in sucking her thumb D. A teacher's aide is reprimanded during school then later criticizes the librarian for a lack of reading materials. E. A woman who is unable to Bear children apply as a foster parent through the Department of Social Services
B,E
A client diagnosed with terminal cancer says to the nurse, "I'm going to die! I wish my family would stop hoping for a cure! I get so angry when they carry on like this. After all, I'm the one who's dying." Which response by the nurse is therapeutic? A. Have you shared your feelings with your family? B. I think we should talk more about your anger with your family C. You're feeling angry that your family continues to hope for you to be cured? D. You're probably very depressed, which is understandable with such a diagnosis
C
A client on an inpatient psychiatric unit has been prescribed tranylcypromine (Parnate) 30mg daily. Which client statement indicates that the discharge teaching has been successful? A. I can't wait to order liver and fava beans with a nice Chianti B. Chicken teriyaki with soy sauce, apple sauce, and tea sounds great C. I'm craving a hamburger with lettuce, onion, potato chips, and milk D. For lunch tomorrow, I'm having bologna and cheese, a banana, and a cola
C
A client states, "I'm worried about my potential disability." The nurse responds, "You're worried about your disability?" Which communication technique is exemplified by this exchange? A. Broad opening B. Verbalizing the implied C. Restating D. Formulating a plan of action
C
A client with a history of generalized anxiety disorder (GAD) presents with restlessness, irritability, BP of 140/90, HR 96, and RR 20. On the basis of these assessed data, which assumption would be correct? A. The client is exhibiting signs of an exacerbation of GAD B. The client's symptoms are due to an underlying medical condition C. A physical examination is needed to determine the etiology of the client's symptoms D. The client's anxiolytic dosage needs to be increased
C
A client with no history of complicated withdrawal syndrome presents in the ED exhibiting signs of alcohol withdrawal, including complaints of RUQ pain. Which medication would be most appropriate to treat this client's immediate problem? A. Valproic acid (Depakene) B. Thiamine (Vitamine B1) C. Chlordiazepoxide (Librium) D. Lorazepam (Ativan)
C
A family describes a client diagnosed with bipolar disorder as being "on the move". The client sleeps 3 to 4 hours nightly, spends excessively, and has recently lost 10 pounds. During the initial client assessment, which client response would the nurse expect? A. Short, polite responses to interview questions B. Introspection related to present situation C. Disorganized thinking and the inability to to remain seated D. Feelings of helplessness and hopelessness
C
A group of inpatient psychiatric clients on a public elevator begin discussing an out-of-control client who is now in seclusion. Which is the appropriate nursing response? A. I know you are upset by the conflict on the unit. I'm glad you can talk about it B. Now you know what happens when you can't control your anger C. It is inappropriate to to discuss another client's situation in public D. Let's just not talk about this now
C
A nurse is planning to teach a client diagnosed with agoraphobia about this disorder. Which fact should the nurse include in the teaching plan? A. The origin of agoraphobia is the lack of control over life situations B. The origin of agoraphobia is a change in body functioning resulting from inner conflict C. The origin of agoraphobia os the true fear of being separated from a source of security D. The origin of agoraphobia is the direct physiologic effect of a substance
C
A nursing student experiencing acute test anxiety is prescribed propranolol (Inderal). What is the rationale for this treatment? A. Inderal is a mood stabilizer that will decrease situational anxiety B. Inderal is an antihypertensive medication. Question this order. C. Inderal has potent effects on the somatic manifestations of anxiety D. Inderal is an anxiolytic used specifically for generalized anxiety
C
A parent tells the nurse, "The doctor said that my son who has ADHD may also have bipolar disorder, but this diagnosis is still uncertain." Which is the nurse's most appropriate response? A. Children diagnosed with bipolar disorder are rarely diagnosed with ADHD B. Having ADHD rules out the diagnosis of bipolar disorder C. Symptoms of ADHD and bipolar disorder can be so similar that a diagnosis is hard to assign D. Symptoms of bipolar disorder must be present for 6 months to assign this diagnosis
C
A physician orders clonazepam (Klonopin) 50mg/day for a client diagnosed with bipolar disorder. How would a nurse evaluate this medication order? A. This dosage is within the recommended dosage range. B. This dosage is lower than the recommended dosage range C.This dosage is more than twice the recommended dosage range D. This dosage is four times higher than the recommended dosage range
C
In which phase of the nurse-client relationship would a nurse role-play with a client to practice appropriate ways to deal with anger? A. Preinteraction B. Orientation C. Working D. Termination
C
The basic assumptions of a therapeutic community guide a nurse's actions when functioning in the role of milieu manager. Which nursing action is correctly matched with the appropriate assumption? A. The nurse encourages clients to take personal responsibility for personal behaviors (Assumption: peer pressure is a useful and powerful tool) B. The nurse takes immediate action when maladaptive behavior is demonstrated (Assumption: Restrictions and punishments are to be avoided) C. The nurse encourages client participation in environmental decision making. (Assumption: The client owns his or her own environment) D. The nurse uses least restrictive measures to subdue client anger (Assumption: every interaction is an opportunity for therapeutic intervention)
C
The client on an inpatient psychiatric unit states, " I don't think I will ever be able to get into a decent relationship". The nurse responds, "You are feeling powerless about establishing relationships?" Which communication technique has the nurse employed? A. Restating B. Focusing C. Reflection D. Exploring
C
The nurse visits a client at home. The client states, "I haven't slept at all the last couple of nights." Which response by the nurse demonstrates therapeutic communication? A. "I see" B. Really?" C. You're having difficulty sleeping?" D. Sometimes I have trouble sleeping too"
C
The nursing instructor is grading on a matching test related to various types of therapy used for anxiety disorders. Which fact has the student correctly match with the appropriate therapy? A. Relaxation training is not part of this technique: systematic desensitization with reciprocal inhibition B. Progressive exposure to a hierarchy of fear stimuli while in a relaxed state: habit reversal therapy C. Client must participate in real life situations that he or she finds extremely frightening, for a prolonged period of time: implosion therapy D. Attempts to extinguish unwanted behavior by a system of positive and negative reinforcements: flooding
C
When being confronted for engaging in dysfunctional behavior during group therapy, a client uses the defense mechanism of projection. Which short term outcome is appropriate for this client? A. The client will not injure himself or herself or someone else B. The client will covertly express feelings of anger in group therapy C. The client will take responsibility for the dysfunctional behavior by the end of the shift D. The client will participate in outpatient therapy within 2 weeks of discharge
C
When developing a therapeutic relationship with a client, which characteristic is the most essential? A. Catharsis B. Confrontation C. Genuineness D. Giving advice
C
When teaching a client diagnosed with alcohol use disorder about nutritional needs, which nutritional concept should the nurse emphasize? A. Eat a high protein, low carbohydrate diet to promote lean body mass B. Increase sodium rich foods to increase iodine levels C. Take a multivitamin supplement that includes thiamin and folic acid D. Restrict fluid intake to decrease renal load
C
Which example of a therapeutic communication technique should the nurse use when trying to obtain general information? A. You seem upset. Why do you feel this way? B. Are you feeling okay today? C. Let's talk about your family situation D. I hope that you are packed and ready to leave
C
Which psychiatric therapy, in relationship to the others presented, is considered least restrictive? A. ECT B. Chemical interventions C. Verbal Rehabilitative techniques D. Mechanical restraints
C
Which situation exemplifies the use of the ego defense mechanism of identification? A. A veterinarian who dislikes cats begins with specialty in feline medicine B. A self admitted homosexual tells his parents he has noted homosexual tendencies in his younger brother C. A 10 year old is rescued from a house fire and later in life decides to become a firefighter D. A singer tells her agent that her heavy smoking will not harm her voice
C
Which symptoms should a nurse recognize that differentiate a client diagnosed with body dysmorphic disorder from a client diagnosed with a delusional disorder somatic type? A. Client diagnosed with bdd experience the delusional belief that the body is deformed or defective in some specific way, and claim diagnosed with delusional disorder do not B. Clients diagnosed with delusional disorder experience the exaggerated belief that the body is deformed or defective in some specific way, and clients diagnosed with BDD do not C. Clients diagnosed with bdd are able to acknowledge that their concerns are exaggerated and client diagnosed with delusional disorder cannot D. Client diagnosed with delusional disorder are able to acknowledge that their concerns are exaggerated, and clients diagnosed with bdd cannot
C
A nurse should recognize which of the following statements as being a misconception about suicide? Select all that apply. A. 8 out of 10 people who commit suicide give warnings about their intentions B. Most suicidal people are very ambivalent about their feelings about suicide C. Most individuals commit suicide by taking an overdose of drugs D. initial mood improvement can precipitate suicide E. All suicidal individuals are mentally ill and psychotic
C,E
A client diagnosed with schizophrenia states, "Look, color, hate me, get away, yes, yes". Which is an appropriate charting entry to describe this client's statement? A. The client is experiencing command hallucinations B. The client is verbalizing a neologism C. The client is experiencing a delusion of control D. The client is verbalizing a word salad
D
A client has a history of excessive fear of lightning. What is the term that a nurse would chart to document this specific phobia? A. Cynophobia B. Murophobia C. Pyrophobia D. Astraphobia
D
A client is being treated with sertraline (Zoloft) for a major depressive episode. The client tells the nurse, "I've only been taking this drug for 2 weeks, but I'm sleeping better, and my appetite has improved". Which is the correct response by the nurse? A. It will take a minimum of 8 weeks for any mood elevation to occur B. Sleep disturbances and appetite problems are not affected by Zoloft C. A change in your environment and activity is the reason for this improvement D. Zoloft therapy can improve insomnias and appetite by the second week
D
A client is experiencing paranoid delusions. What behaviors could the nurse expect to assess? A. Altered speech and extreme suspiciousness B. Psychomotor retardation C. Regressive and primitive behaviors D. Anger and aggressive acts
D
A client prescribed lithium carbonate (Lithobid) 300mg twice daily 3 months ago comes to the ED with mental confusion, excessive diluted urine output, and consistent tremors. Which lithium level would the nurse expect? A. 1.2 mEq/L B. 1.5 mEq/L C. 1.7 mEq/L D. 2.2 mEq/L
D
A client with a diagnosis of depression who has attempted suicide says to the nurse, "I should have died. I've always been a failure. Nothing ever goes right for me." Which response by the nurse demonstrates therapeutic communication? A. "You have everything to live for" B. "Why do you see yourself as a failure?" C. "Feeling like this is all part of being depressed" D. "You've been feeling like a failure for awhile?"
D
A client with a history of a suicide attempt has been discharged and is being followed in an outpatient clinic. At this time, what is the most appropriate nursing intervention? A. Provide the client with a safe and structured environment B. Isolate the client from all stressful situations that may precipitate a suicide attempt C. Observe the client continuously to prevent self harm D. Assist the client to develop more effective coping mechanisms
D
A mentally ill client has the right to refuse treatment to the extent permitted by the law. It is important for the psychiatric nurse to be aware of this ethical / legal issue. Which situation would the nurse recognize as an example of this client right of refusal? A. The client has expressed a desire to harm a spouse and refuses to take all medications B. A client is benefitting from psychotropic medications but refuses drugs because of command hallucinations C. A client who has been deemed incompetent will not take ordered medications D. A client diagnosed with depression decides to not take his or her antidepressant medication
D
A nurse would recognize which medication as most effective in providing a client immediate relief from neuroleptic induced EPS? A. Lorazepam (Ativan) 1mg PO B. Diazepam (Valium) 5mg PO C. Haloperidol (Haldol) 2mg IM D. Benztropine (Cogentin) 2mg PO
D
A nursing instructor is teaching about anxiety issues in the elderly. Which student statement indicates that learning has occurred? A. Anxiety disorders do not manifest themselves after age 50 B. There are fewer sleep disturbances noted in the elderly population C. The response to a major stressor in the elderly is diminished D. In the elderly, anxiety and depression symptoms often accompany each other
D
A nursing instructor is teaching about bipolar disorders. Which statement differentiates the symptoms of a manic episode from a hypomanic episode? A. During a manic episode, clients are more talkative than usual and experience pressure to keep talking. These symptoms are absent in hypomania B. During a manic episode, there may be an increase in goal directed activity or psychomotor agitation. These symptoms are absent in hypomania C. During a manic episode, clients may have excessive involvement in pleasurable but risky activities. This symptom is absent in hypomania. D. During a manic episode, there is a marked impairment in social or occupational functioning. This symptom is absent in hypomania.
D
A nursing instructor is teaching about the dimensional assessment tools included in Section 3 of the diagnostic and statistical Manual of mental disorders fifth edition. Which student statement indicates a need for further instruction? A. The dimensional assessment tool may be specific to a given disorder B. The dimensional assessment tool can be used initially to establish a baseline C. The dimensional assessment tool provides additional data needed for treatment D. The dimensional assessment tool relies heavily on physician assessment data
D
A severely depressed, sullen adolescent has been taking fluoxetine (Prozac) for 10 days. During a follow up visit , the client smiles euphorically and states, "I feel so much better now". How might the nurse interpret this behavioral change? A. The prozac has potentiated serotonin syndrome B. The medication dosage should be decreased C. The client's behavioral change is normal and expected D. The client may have decided to carry out a suicide plan
D
On review of the client's record, the nurse notes that the admission was voluntary. Based on this information, the nurse plans care anticipating which client behavior? A. Fearfulness regarding treatment measures B. Anger and aggressiveness directed toward others C. An understanding of the pathology and symptoms of the diagnosis D. A willingness to participate in the planning of the care and treatment plan
D
The nurse's ability to have unconditional positive regard for the client and also to maintain a non judgemental attitude is described as which characteristic that enhances the nurse-client relationship? A. Genuineness B. Empathy C. Objectivity D. Respect
D
To deal with a client's hallucinations therapeutically, which nursing intervention should be implemented? A. Reinforce the perceptual distortions until the client develops new defenses B. Provide an unstructured environment C. Avoid making connections between anxious situations and hallucinations D. Distract the client's attention
D
Which is an example of an open ended question? A. Did you say that your wife has a miscarriage last summer? B. Has your appetite improved since you have been admitted? C. Are you happy about being discharged today? D. How do you feel about your girlfriend's affair?
D
Which situation exemplifies rapport, a condition essential to the development of a therapeutic relationship? A. The nurse communicates regard for the client as a person of worth who is valued and accepted without qualification B. The nurse communicates an understanding of the client's world from the client's internal frame of reference, with sensitivity to the client's feelings C. The nurse communicates openness, self congruency, authenticity, and transparency when dealing with the client D. The nurse communicates acceptance, warmth, friendliness, common interests, a sense of trust, and a non judgemental attitude when dealing with the client
D
