Psych PrepU Quizzes (5-7)
A 74-year-old is being seen in the mental health clinic. The client has never fully regained the level of activity the client had prior to the death of the client's spouse. The client continues to have symptoms of depression and has not been able to work or volunteer. In addition, the client complains of "anxiety attacks" that occur nearly every night. What type of grief reaction is this client exhibiting?
The client is experiencing complicated grieving reaction. The client needs to have a comprehensive mental health assessment.
A client who has suspicion has been placed in a room with a roommate. The night nurse assesses the situation and reports that this client has been awake for the past 3 nights. The likely explanation for the client's wakefulness is what?
The client is fearful of what the roommate might do to the client while sleeping.
Which stages of grieving, according to Kubler-Ross (1969), occurs when the person asks God or fate for more time to delay the inevitable loss?
bargaining
When working with the family of a client with anorexia nervosa, which issue must be addressed?
control
Which can correctly be identified as a behavioral response to grief?
crying uncontrollably
The nurse is assessing a client with an eating disorder. Which personality characteristic would the nurse expect to detect when interacting with the client?
eager to please
A nurse is assessing a child with a diagnosis of autism spectrum disorder. The child has severe uncontrollable temper outbursts and repeatedly bangs the head on the wall or door. When considering medication for treatment, the nurse knows which will be the most effective?
haloperidol
Several medications are prescribed for a client who has anorexia. Which medication may be prescribed to help treat the client's distorted body image?
olanzapine
A client comes to the clinic for an evaluation. During the interview, the client states that the client feels insects crawling all over the skin on the client's arms and legs. The nurse interprets this as which type of sensorium or processing deficit?
tactile hallucination
The nurse observes a client with schizophrenia sitting alone, laughing occasionally, and turning their head as if listening to another person. The nurse assesses this behavior as indicating that the client is experiencing auditory hallucinations. What statement by the nurse is most appropriate?
"Are you hearing something?"
A client diagnosed with schizophrenia tells the nurse, "I hear the voice of Elvis." Which is the most therapeutic response by the nurse?
"I don't hear the voice, but I know you hear what sounds like a voice."
A family member is the primary caregiver to a client with dementia. Which statement by the nurse would be most appropriate?
"Spending some time relaxing and doing what you like to do will help you manage the demands of caregiving."
The nurse is using limit setting with a child diagnosed with conduct disorder. Which statement reflects the most effective way for the nurse to set limits with the child?
"That is not allowed here. You will lose a privilege. You need to stop."
An 80-year-old client with Alzheimer's disease is prescribed donepezil. Which teaching points should the nurse provide to the client's spouse about the new medication?
"The drug won't cure the client's Alzheimer's, but it has the potential to slow down the progression of the disease."
A client with schizophrenia is reluctant to take prescribed oral medication. Which is the most therapeutic response by the nurse to this refusal?
"What is it about the medicine that you don't like?"
A client with a persecutory delusion has been explaining to the nurse the specifics of the conspiracy against the client. The client pauses and says, "I get the feeling that you don't actually believe that what I'm telling you is true." How should the nurse respond?
"What you're telling me is difficult for me to believe. This may be real for you, but not me."
In which ways can anticipatory grief be helpful for the client and family?
Acceptance of impending death
A 15-year-old is admitted for treatment of anorexia nervosa. Which is characteristic of anorexia nervosa?
Body weight less than normal for age, height, and overall physical health
Which is a term used to describe grief over a loss that is not or cannot be acknowledged openly, mourned publicly, or supported socially?
Disenfranchised grief
Which of the following disorders involves the emergence of varying personalities in a person that is associated with stress and conflict?
Dissociative identity disorder
The nurse is preparing to perform the initial interview of a client who has been diagnosed with posttraumatic stress disorder (PTSD). What action should the nurse prioritize during this interaction?
Establishing therapeutic rapport with the client
Which intervention would be appropriate for a client with anorexia nervosa?
Having the client in view of staff for 90 minutes after each meal
All of the following nursing diagnoses are appropriate for the care of a client with anorexia nervosa. Which nursing diagnosis has the priority?
Imbalanced nutrition: less than body requirements
The traumatized client has suddenly changed demeanor and voice pitch. Which is true about the use of touch with a client with dissociative identity disorder?
It is best not to touch the client without his or her permission.
A client is exhibiting signs of mild delirium such as occasional confusion about why the client is in the hospital and what day of the week it is. When developing a care plan, the nurse identifies several strategies to improve the client's cognitive function. Which intervention will be helpful to the client?
Make up a daily calendar with the date and the times of scheduled activities.
Which nursing intervention would be most likely to help the client with anorexia to establish healthy eating patterns?
Offer liquid protein supplements if the client is unable to complete a meal.
A client is brought to the emergency department stating, "I'm scared because the Federal Bureau of Investigation is now tapping my home phone, and I can hear them talking between my two telephones during the night." The client's eyes dart around the room while the nurse is trying to interview the client, and the client is tapping the client's fingers on the table. The nursing priority with this client is what?
Reassure the client that the client is in a safe place where the client will be helped.
A client with Alzheimer's disease has a nursing diagnosis of risk for injury related to memory loss, wandering, and disorientation. Which nursing intervention should appear in this client's care plan to prevent injury?
Remove hazards from the environment
Which is the primary objective of nursing interventions in the care of a client with anorexia nervosa?
Restoring nutritional status to normal
The nurse is assessing a client with bulimia nervosa. Which symptoms would the nurse expect to find? Select all that apply.
-Normal weight for height -Dental erosion -Metabolic alkalosis
A nurse is assessing a client who has experienced trauma. The nurse determines that the client is experiencing physiologic hyperarousal based on which finding? Select all that apply.
-Overreacts to others -Startles easily
Which drug classification is the primary medication treatment for schizophrenia?
antipsychotics
A client diagnosed with delusional disorder is telling everyone that the client is the president of the United States. This client is exhibiting which type of delusion?
grandiose
A child has been displaying behaviors associated with conduct disorder. As the nurse evaluates these behaviors, the nurse will further assess for which common risk factors seen in children with conduct disorder? Select all that apply.
-Poor family functioning -Family history of substance abuse -Possible child abuse -Poverty conditions
A nurse is interviewing a client who is suffering from posttraumatic stress disorder (PTSD). Which intervention would help the nurse ensure the client's comfort during the interview?
Keep environmental noises to a minimum.
When preparing to educate a client regarding a newly prescribed antipsychotic medication, which action would be most appropriate for the nurse to do? Select all that apply.
-Identify lifestyle adjustments that the resulting lethargy may require -Suggest methods to minimize the potential for weight gain -Encourage the use of sugar-free gum to help manage dry mouth -Advise the client to discuss any concerns regarding sexual dysfunction
The nurse documents that the client is exhibiting negative symptoms of schizophrenia when observing the client doing what? Select all that apply.
-Inability to maintain to complete a goal-directed activity -Repeatedly turning down invitations to join in unit activities
A nurse is preparing a presentation for a local middle school health class about eating disorders as a means for prevention and early detection. Which would the nurse incorporate into the presentation as being common to both anorexia nervosa and bulimia nervosa? Select all that apply.
-Body dissatisfaction -Obsessiveness -Cognitive distortions
A nurse is counseling a client who lost family members in a cyclone but has never had therapy related to the trauma. Which statement by the client suggests that the client is likely to develop posttraumatic stress disorder (PTSD)?
"I am fine, I am going to move on."
The nurse is working with a client who is experiencing a crisis due to a divorce. Which statement would alert the nurse to the client's need for referral for further mental health counseling?
"I am trying to work through this but have had to cut myself a few times."
A nurse is assessing a 13-year-old client with intermittent explosive disorder (IED). The nurse suspects that the client has other psychiatric disorders. What findings would lead the nurse to conclude this? Select all that apply.
-Depression -Drug abuse -Hyperactivity
A client with schizophrenia is attending a follow-up appointment at the community mental health clinic. The client reports to the nurse, "I stopped taking the antipsychotic medication because I can't get an erection with my girlfriend anymore." Which should the nurse recommend to enhance the client's well-being?
"It is important for you to take an antipsychotic medication, but perhaps a different type will be less likely to affect your sexual functioning. I would like to call your health care provider about this.
A client states, "I am dead. I have come back from the dead." What is the most appropriate response by the nurse?
"Show me what you did in art therapy this morning."
A nurse is assessing a child diagnosed with autism spectrum disorder. When assessing the child's communication, which of the following would the nurse expect to find? Select all that apply.
-Echolalia -Delayed language skills
A client comes to the health care provider's office for an annual checkup. During the interview, the nurse learns that the client's spouse died unexpectedly of a heart attack 2 months ago. Which would be the most appropriate response by the nurse?
"The loss of your spouse must be very painful for you."
A client suffers from drug-induced parkinsonism. The nurse notices this client walking with a shuffling gait. What other symptoms might this client show? Select all that apply.
-Akinesia -Masklike facies -Drooling -Cogwheel rigidity
A client is diagnosed with intermittent explosive disorder (IED). What drugs are likely to be prescribed for the client? Select all that apply.
-Antidepressant drugs -Mood-stabilizing drugs
Assessment of a child with autism spectrum disorder reveals stereotypic behavior. Which behavior would the nurse most likely document being demonstrated by the child?
-Hand flapping -Rocking -Head banging
Which steps are involved in limit setting? Select all that apply.
-State the expected behavior. -Inform clients of the rule or limit. -Explain the consequences if clients exceed the limit.
A nurse is assessing a client with posttraumatic stress disorder (PTSD). Which symptoms in the client would indicate a need for hospitalization? Select all that apply.
-The client has suicidal tendencies. -The client is overwhelmed with flashbacks of the traumatic event.
A nurse observes a middle school student having an angry outburst in the hallway. The nurse is aware that the student has these outbursts frequently. The nurse suspects that the student has intermittent explosive disorder (IED). What other assessment findings would support this conclusion? Select all that apply.
-The student has experienced anger episodes over very minor events. -The student has caused extensive damage to school property. -The student has had outbursts of anger without any warning.
The parents of a child with attention deficit hyperactivity disorder (ADHD) express to the nurse, "We get so frustrated when our child never minds us." Which parenting strategies should the nurse discuss with the parents? Select all that apply.
-Use a point system for positive and negative behavior. -Give verbal reprimands for negative behavior. -Use time-out for behavior control.
Which client is most at risk for experiencing anticipatory grief?
61-year-old spouse of a client experiencing symptomology of moderate-stage Alzheimer disease
The dentist of a client noticed that the client's teeth were losing enamel and that the client looked extremely thin. The dentist refers the client for follow up based on the understanding that eating disorder is most often associated with dental caries and enamel loss?
Anorexia nervosa, purging type
A client is diagnosed with terminal kidney failure. The client's spouse demonstrates loss and grief behaviors. Which term accurately describes the spouse's experience?
Anticipatory grief
During the nursing assessment, a client describes constantly hearing voices mumbling in the background. The client denies that the voices are telling the client to do anything harmful. The nurse documents that the client is experiencing what?
Auditory hallucinations
A nurse works in a psychiatric clinic. A client who lost a spouse during a robbery at their home 1 month ago approaches the nurse for consultation. How would the nurse differentiate posttraumatic stress disorder (PTSD) from acute stress disorder?
The symptoms began 3 months after the trauma.
What is the primary difference between anorexia nervosa and bulimia nervosa?
Clients who are anorexic are proud of their control over eating, and clients with bulimia are ashamed of their behavior.
A client in a psychiatric clinic has a history of two distinct personality states. The client is also unable to remember important personal information. What is the client likely to be suffering from?
Dissociative identity disorder
A married couple arrives at the outpatient clinic. Upon assessment, the nurse finds that the couple believes that the police have been following them and tapping their phones for 2 months. This couple most likely suffers from which disorder?
Folie à deux
A nurse is providing education about trauma and its effects to a community group in a community that has just been hit by a devastating tornado. One of the participants asks about what kind of support a survivor of the tornado will need. Which would be the best response of the nurse?
If a person is reluctant to share his or her feelings, he or she may be denying his or her importance and may be at increased risk for future problems such as posttraumatic stress disorder (PTSD).
The nurse is caring for a 16-year-old client with a history of sexual abuse. What might the nurse expect to assess in this client?
Long-term emotional trauma
A hospice nurse is providing emotional care and support for a family who lost a child. The nurse will provide care on the basis of what knowledge?
Stages of grief reactions may overlap and are individualized
A nurse is assessing a young client who has recently witnessed a murder. Despite directly witnessing the crime, the client has been unable to provide proper information about the event to the police. The client tells the nurse that the client does not remember anything related to the crime scene. What is the most likely cause for the inability to remember the events related to the scene?
The client may have dissociative amnesia.
The nurse is working with a 17-year-old client with a complex and dysfunctional family background. What aspect of this client's history should the nurse identify as the most significant risk factor for posttraumatic stress disorder (PTSD)?
The client was sexually abused by the mother's boyfriend at a young age
A nurse is conducting a visit to a client who is receiving palliative care at home for dying. The client's husband tells the nurse, "I know she needs to be with God. This is not a good place for her now." The client is experiencing which stage of Kubler-Ross' stages of grieving?
acceptance
A child is expelled from school for repeated fighting and vandalizing school property. The school nurse and counselor meet with the parents to explain that the child may benefit from counseling and are formulating a collaborative plan. The child is experiencing signs of which disorder?
conduct disorder
A pre-teen client has been considered a neighborhood bully for several years. Peers avoid him, and the mother says she cannot believe a thing he tells her. 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?
conduct disorder
A nurse is seeing a female client who has been mandated to counseling sessions after shoplifting numerous times. Which disruptive behavior disorder is the client most likely experiencing?
kleptomania
A nursing student is preparing to care for a client diagnosed with schizophrenia. When interacting with the client, the student notices that the client is highly suspicious and guarded, stating, "They're out to get me." The student identifies this as what?
paranoia
While conducting a mental status examination, the client accuses the nurse of recording the interview so that it can be sent to the Federal Bureau of Investigation. What type of delusion is this client experiencing?
paranoid
The client says to the nurse that the client is having trouble keeping up with things. The nurse is assessing a client with early signs of dementia. What is the nurse trying to determine when asking what the client ate for breakfast that morning?
recent memory
A client was admitted to the intensive care unit after a motor vehicle accident. The client sustained a right parietal injury, resulting in an acute confusional state or delirium. The client reports that there are "bugs crawling around" on the arms. The nurse understands this as:
tactile hallucinations from delirium.
The nurse is assessing a client who has been diagnosed with leukemia. Which behavior of the client would indicate that the client is experiencing the anger stage of Kubler-Ross's stages of grieving?
the client is verbally abusive
A nurse is caring for a client who has been taking clozapine for 2 weeks. The client tells the nurse, "My throat is sore, and I feel weak." The nurse assesses the client's vital signs and finds that the client has a fever. The nurse notifies the physician, expecting an order to obtain which laboratory test?
white blood cell count
