Psych Quiz 2

Joanne presents in the emergency department with complaints of suicidal ideation. The following data is collected by the nurse. Which of these assessment findings suggests that bulimia nervosa might be a health problem? Select all that apply. a. Joanne's parotid glands appear enlarged. b. Joanne's teeth have a "moth eaten" pattern of tooth decay. c. Joanne reports that she takes laxatives daily. d. Joanne's weight is within the expected range.

a,b,c,d

A client admitted to the emergency department smells strongly of alcohol, and his wife reports he has been a heavy drinker for the last 25 years. Which of the following assessment findings are consistent with long-term chronic alcohol abuse? Select all that apply. a. The client reports weak leg muscles, and his gait is unsteady. b. The client's abdomen is distended. c. The client reports he was coughing up some blood. d. The client reports he has double vision. e. Blood tests reveal a low white blood cell count.

a,b,c,d,e

Which of the following medications have been indicated for improvement in cognitive functioning in mild to moderate Alzheimer's disease? Select all that apply. a. Donepezil (Aricept) b. Rivastigmine (Exelon) c. Risperidone (Risperdal) d. Sertraline (Zoloft) e. Galantamine (Razadyne)

a,b,e Donepezil (Aricept) Rivastigmine (Exelon) Galantamine (Razadyne)

In addition to disturbances in cognition and orientation, individuals with Alzheimer's disease may also show changes in which of the following? Select all that apply. a. Personality b. Vision c. Speech d. Hearing e. Mobility

a,c,e Personality Speech Mobility

Dan begins attendance at AA meetings. Which of the statements by Dan reflects the purpose of this organization? a. "They claim they will help me stay sober." b. "I'll dry out in AA, then I can have a social drink now and then." c. "AA is only for people who have reached the bottom." d. "If I lose my job, AA will help me find another."

a. "They claim they will help me stay sober."

Amanda's mobile home was destroyed by a tornado. Amanda received only minor injuries but is experiencing disabling anxiety in the aftermath of the event. What is this type of crisis called? a. Crisis resulting from traumatic stress b. Maturational or developmental crisis c. Dispositional crisis d. Crisis of anticipated life transitions

a. Crisis resulting from traumatic stress

Dan, who has been admitted to the alcohol rehabilitation unit after being fired for drinking on the job, states to the nurse, "I don't have a problem with alcohol. I can handle my booze better than anyone I know. My boss is a jerk! I haven't missed any more days than my coworkers." What defense mechanism is Dan using? a. Denial b. Projection c. Displacement d. Rationalization

a. Denial

The Maudsley approach to treatment of adolescents with anorexia nervosa advances which of the following fundamental concepts? a. Family should be actively involved in each phase of treatment. b. Parents should be prohibited from involvement in helping their child eat more because there are often control issues. c. Adolescents need to work on developing healthy self-identities before they can begin to gain weight. d. Individual psychotherapy is the most effective treatment for adolescents with anorexia nervosa.

a. Family should be actively involved in each phase of treatment.

Jack is a new client on the psychiatric unit with a diagnosis of Antisocial Personality Disorder. Which of the following characteristics would you expect to assess in Jack? a. Lack of guilt for wrongdoing b. Insight into his own behavior c. Ability to learn from past experiences d. Compliance with authority

a. Lack of guilt for wrongdoing

The most appropriate nursing intervention with Jenny (from question 5) would be to a. Make arrangements for her to start attending Alateen meetings. b. Help her identify the positive things in her life and recognize that her situation could be a lot worse than it is. c. Teach her about the effects of alcohol on the body and that it can be hereditary. d. Refer her to a psychiatrist for private therapy to learn to deal with her home situation.

a. Make arrangements for her to start attending Alateen meetings.

Which of the following factors is not associated with increased incidence of NCD due to Alzheimer's disease? a. Multiple small strokes b. Family history of Alzheimer's disease c. Head trauma d. Advanced age

a. Multiple small strokes

Which of the following behavioral patterns is characteristic of individuals with narcissistic personality disorder? a. Overly self-centered and exploitative of others b. Suspicious and mistrustful of others c. Rule conscious and disapproving of change d. Anxious and socially isolated

a. Overly self-centered and exploitative of others

Kim, a client diagnosed with BPD, manipulates the staff in an effort to fulfill her own desires. All of the following may be examples of manipulative behaviors in the borderline client except: a. Refusal to stay in room alone, stating, "It's so lonely." b. Asking Nurse Jones for cigarettes after 30 minutes, knowing the assigned nurse has explained she must wait 1 hour. c. Stating to Nurse Jones, "I really like having you for my nurse. You're the best one around here." d. Cutting arms with razor blade after discussing dismissal plans with physician.

a. Refusal to stay in room alone, stating, "It's so lonely."

Mr. White is admitted to the hospital after an extended period of binge alcohol drinking. His wife reports that he has been a heavy drinker for a number of years. Laboratory reports reveal he has a blood alcohol level of 250 mg/dL. He is placed on the chemical addiction unit for detoxification. When would the first signs of alcohol withdrawal symptoms be expected to occur? a. Several hours after the last drink b. 2 to 3 days after the last drink c. 4 to 5 days after the last drink d. 6 to 7 days after the last drink

a. Several hours after the last drink

A polysubstance abuser makes the statement, "The green and whites do me good after speed." How might the nurse interpret the statement? a. The client abuses amphetamines and anxiolytics. b. The client abuses alcohol and cocaine. c. The client is psychotic. d. The client abuses narcotics and marijuana.

a. The client abuses amphetamines and anxiolytics.

Nurse Jones is caring for a client who has been hospitalized with anorexia nervosa and is severely malnourished. The client continues to refuse to eat. What is the most appropriate response by the nurse? a. "You know that if you don't eat, you will die." "b. If you continue to refuse to take food orally, you will be fed through a nasogastric tube." c. "You might as well leave if you are not going to follow your therapy regimen." d. "You don't have to eat if you don't want to. It is your choice."

b. "If you continue to refuse to take food orally, you will be fed through a nasogastric tube."

John has sought help for his concern that he is binge eating, and he feels it has "gotten out of control." He asks the nurse what can be done to help him. Which of the following is the most accurate response? a. "There is nothing that can be done." b. "There are some medications and psychological treatments that have demonstrated effectiveness in reducing binge eating behaviors." c. "The primary problem is obesity. I can help you set up a calorie-restricted diet." d. 'There are medications that can help with weight loss, but there are no medications effective for reducing binge eating."

b. "There are some medications and psychological treatments that have demonstrated effectiveness in reducing binge eating behaviors."

Mrs. G, who has NCD due to Alzheimer's disease, says to the nurse, "I have a date tonight. I always have a date on Christmas." Which of the following is the most appropriate response? a. "Don't be silly. It's not Christmas, Mrs. G." b. "Today is Tuesday, October 21, Mrs. G. We will have supper soon, and then your daughter will come to visit." c. "Who is your date with, Mrs. G?" d. "I think you need some more medication, Mrs. G I'll bring it to you now."

b. "Today is Tuesday, October 21, Mrs. G. We will have supper soon, and then your daughter will come to visit."

Mr. Stone is a client in the hospital with a diagnosis of vascular NCD. In explaining this disorder to Mr. Stone's family, which of the following statements by the nurse is correct? a. "He will probably live longer than if his disorder was of the Alzheimer's type." b. "Vascular NCD shows stepwise progression. This is why he sometimes seems okay." c. "Vascular NCD is caused by plaques and tangles that form in the brain." d. "The cause of vascular NCD is unknown."

b. "Vascular NCD shows stepwise progression. This is why he sometimes seems okay."

Dan, who has been admitted to the alcohol rehabilitation unit after being fired for drinking on the job, states to the nurse, "I don't have a problem with alcohol. I can handle my booze better than anyone I know. My boss is a jerk! I haven't missed any more days than my coworkers." What is the nurse's best response? a. "Maybe your boss is mistaken, Dan." b. "You are here because your drinking was interfering with your work, Dan." c. "Get real, Dan! You're a boozer and you know it!" d. "Why do you think your boss is a jerk, Dan?"

b. "You are here because your drinking was interfering with your work, Dan."

Which of the following behavioral patterns is characteristic of individuals with schizotypal personality disorder? a. Belittling themselves and their abilities b. A lifelong pattern of social withdrawal c. Suspiciousness and mistrust of others d. Overreacting inappropriately to minor stimuli

b. A lifelong pattern of social withdrawal

"Splitting" by the client with BPD denotes which of the following? a. Evidence of precocious development b. A primitive defense mechanism in which the client sees objects as all good or all bad c. A brief psychotic episode in which the client loses contact with reality d. Two distinct personalities within the borderline client

b. A primitive defense mechanism in which the client sees objects as all good or all bad

Jane is hospitalized on the psychiatric unit. She has a history and current diagnosis of bulimia nervosa. Which of the following symptoms would be congruent with Jane's diagnosis? a. Binging, purging, obesity, hyperkalemia b. Binging, purging, normal weight, hypokalemia c. Binging, laxative abuse, amenorrhea, severe weight loss d. Binging, purging, severe weight loss, hyperkalemia

b. Binging, purging, normal weight, hypokalemia

Which of the following medications is the physician most likely to order for a client experiencing alcohol withdrawal syndrome? a. Haloperidol (Haldol) b. Chlordiazepoxide (Librium) c. Methadone (Dolophine) d. Phenytoin (Dilantin)

b. Chlordiazepoxide (Librium)

Marie, age 56, is the mother of five children. Her youngest child, who had been living at home and attending the local college, recently graduated and accepted a job in another state. Marie has never worked outside the home and has devoted her life to satisfying the needs of her husband and children. Since the departure of her last child from home, Marie has become increasingly despondent. Her husband is very concerned and takes her to the local mental health center. What is this type of crisis called? a. Dispositional crisis b. Crisis of anticipated life transitions c. Psychiatric emergency d. Crisis resulting from traumatic stress

b. Crisis of anticipated life transitions

The most appropriate crisis intervention with Amanda (from question 3) would be to a. Encourage her to recognize how lucky she is to be alive. b. Discuss stages of grief and feelings associated with each. c. Identify community resources that can help Amanda. d. Suggest that she find a place to live that provides a storm shelter.

b. Discuss stages of grief and feelings associated with each.

Milieu therapy is a good choice for clients with antisocial personality disorder because it: a. Provides a system of punishment and rewards for behavior modification. b. Emulates a social community in which the client may learn to live harmoniously with others. c. Provides mostly one-to-one interaction between the client and therapist. d. Provides a structured setting in which the clients have very little input into the planning of their care.

b. Emulates a social community in which the client may learn to live harmoniously with others.

Mrs. G has been diagnosed with NCD due to Alzheimer's disease. The primary nursing intervention in working with Mrs. G is which of the following? a. Ensuring that she receives food she likes to prevent hunger b. Ensuring that the environment is safe to prevent injury c. Ensuring that she meets the other patients to prevent social isolation d. Ensuring that she takes care of her own ADLs to prevent dependence

b. Ensuring that the environment is safe to prevent injury

Nancy, age 14, has just been admitted to the psychiatric unit for anorexia nervosa. She is emaciated and refuses to eat. What is the primary nursing diagnosis for Nancy? a. Complicated grieving b. Imbalanced nutrition: Less than body requirements. c. Interrupted family processes d. Anxiety (severe)

b. Imbalanced nutrition: Less than body requirements.

From which of the following symptoms might the nurse identify a chronic cocaine user? a. Clear, constricted pupils b. Red, irritated nostrils c. Muscle aches d. Conjunctival redness

b. Red, irritated nostrils

The most appropriate nursing intervention with Ginger (from question 7) would be to a. Suggest she move to a college closer to home. b. Work with Ginger on unresolved dependency issues. c. Help her find someone in the college town from whom she could seek assistance rather than calling her mother regularly. d. Recommend that the college physician prescribe an antianxiety medication for Ginger.

b. Work with Ginger on unresolved dependency issues.

An example of a treatable (reversible) form of NCD is one that is caused by which of the following? Select all that apply. a. Multiple sclerosis b. Multiple small brain infarcts c. Electrolyte imbalances d. HIV disease e. Folate deficiency

c, e

Which of the following interventions is most appropriate in helping a client with Alzheimer's disease with her ADLs? Select all that apply. a. Perform ADLs for her while she is in the hospital. b. Provide her with a written list of activities she is expected to perform. c. Assist her with step-by-step instructions. d. Tell her that if her morning care is not completed by 9:00 a.m., it will be performed for her by the nurse's aide so that she can attend group therapy. e. Encourage her and give her plenty of time to perform as many of her ADLs as possible independently.

c,e -Assist her with step-by-step instructions. -Encourage her and give her plenty of time to perform as many of her ADLs as possible independently.

A hospitalized client with bulimia nervosa has stopped vomiting in the hospital and tells the nurse she is afraid she is going to gain weight. Which is the most appropriate response by the nurse? a. "Don't worry. The dietitian will ensure you don't get too many calories in your diet." b. "Don't worry about your weight. We are going to work on other problems while you are in the hospital." c. "I understand that you are concerned about your weight, and we will talk about the importance of good nutrition; but for now, I want you to tell me about your recent invitation to join the National Honor Society. That's quite an accomplishment." d. "You are not fat, and the staff will ensure that you do not gain weight while you are in the hospital, because we know that is important to you."

c. "I understand that you are concerned about your weight, and we will talk about the importance of good nutrition; but for now, I want you to tell me about your recent invitation to join the National Honor Society. That's quite an accomplishment."

The night nurse finds Mrs. G, a client with Alzheimer's disease, wandering the hallway at 4 a.m. and trying to open the door to the side yard. Which statement by the nurse probably reflects the most accurate assessment of the situation? a. "That door leads out to the patio, Mrs. G. It's nighttime. You don't want to go outside now." b. "You look confused, Mrs. G. What is bothering you?" c. "This is the patio door, Mrs. G. Are you looking for the bathroom?" d. "Are you lonely? Perhaps you'd like to go back to your room and talk for a while."

c. "This is the patio door, Mrs. G. Are you looking for the bathroom?"

Which of the following is a correct assumption regarding the concept of crisis? a. Crises occur only in individuals with psychopathology. b. The stressful event that precipitates crisis is seldom identifiable. c. A crisis situation contains the potential for psychological growth or deterioration. d. Crises are chronic situations that recur many times during an individual's life.

c. A crisis situation contains the potential for psychological growth or deterioration.

Which of the following physical manifestations would you expect to assess in a client suffering from anorexia nervosa? a. Tachycardia, hypertension, hyperthermia b. Bradycardia, hypertension, hyperthermia c. Bradycardia, hypotension, hypothermia d. Tachycardia, hypotension, hypothermia

c. Bradycardia, hypotension, hypothermia

Symptoms of alcohol withdrawal include which of the following? a. Euphoria, hyperactivity, and insomnia b. Depression, suicidal ideation, and hypersomnia c. Diaphoresis, nausea and vomiting, and tremors d. Unsteady gait, nystagmus, and profound disorientation

c. Diaphoresis, nausea and vomiting, and tremors

Jenny reported to the high school nurse that her mother drinks too much. She is drunk every afternoon when Jenny gets home from school. Jenny is afraid to invite friends over because of her mother's behavior. What is this type of crisis called? a. Crisis resulting from traumatic stress b. Maturational or developmental crisis c. Dispositional crisis d. Crisis reflecting psychopathology

c. Dispositional crisis

Which medication has been used with some success in clients with anorexia nervosa? a. Lorcaserin (Belviq) b. Diazepam (Valium) c. Fluoxetine (Prozac) d. Carbamazepine (Tegretol)

c. Fluoxetine (Prozac)

In evaluating the progress of Jack, a client diagnosed with Antisocial Personality Disorder, which of the following behaviors would be considered the most significant indication of positive change? a. Jack got angry only once in group this week. b. Jack was able to wait a whole hour for a cigarette without verbally abusing the staff. c. On his own initiative, Jack sent a note of apology to a man he had injured in a recent fight. d. Jack stated that he would not start any more fights.

c. On his own initiative, Jack sent a note of apology to a man he had injured in a recent fight.

Dan has been admitted to the alcohol rehabilitation unit after being fired for drinking on the job. Dan's drinking buddies come for a visit, and when they leave, the nurse smells alcohol on Dan's breath. Which of the following would be the best intervention with Dan at this time? a. Search his room for evidence. b. Ask, "Have you been drinking alcohol, Dan?" c. Send a urine specimen from Dan to the lab for drug screening. d. Tell Dan, "These guys cannot come to the unit to visit you again."

c. Send a urine specimen from Dan to the lab for drug screening.

Andrew, a New York City firefighter, and his entire unit responded to the terrorist attacks at the World Trade Center. Working as a team, he and his best friend, Carlo, entered the area together. Carlo was killed when the building collapsed. Andrew was injured but survived. Since that time, Andrew has had frequent nightmares and anxiety attacks. He says to the mental health worker, "I don't know why Carlo had to die and I didn't!" This statement by Andrew suggests that he is experiencing a. Spiritual distress. b. Night terrors. c. Survivor's guilt. d. Suicidal ideation.

c. Survivor's guilt.

Which of the following is the desired outcome of working with an individual who has witnessed a traumatic event and is now experiencing panic anxiety? a. The individual will experience no anxiety. b. The individual will demonstrate hope for the future. c. The individual will identify that anxiety is at a manageable level. d. The individual will verbalize acceptance of self as worthy.

c. The individual will identify that anxiety is at a manageable level.

Some obese individuals take amphetamines to suppress appetite and help them lose weight. Which of the following is an adverse effect associated with use of amphetamines that makes this practice undesirable? a. Bradycardia b. Amenorrhea c. Tolerance d. Convulsions

c. Tolderance

The most appropriate nursing intervention with Marie (from question 9) would be to a. Refer her to her family physician for a complete physical examination. b. Suggest she seek outside employment now that her children have left home. c. Identify convenient support systems for times when she is feeling particularly despondent. d. Begin grief work and assist her to recognize areas of self-worth separate and apart from her children.

d. Begin grief work and assist her to recognize areas of self-worth separate and apart from her children.

Mrs. G, who has NCD due to Alzheimer's disease, has trouble sleeping and wanders around at night. Which of the following nursing actions would be best to promote sleep in Mrs. G? a. Ask the doctor to prescribe flurazepam (Dalmane). b. Ensure that Mrs. G gets an afternoon nap so she will not be overtired at bedtime. c. Make Mrs. G a cup of tea with honey before bedtime. d. Ensure that Mrs. G gets regular physical exercise during the day.

d. Ensure that Mrs. G gets regular physical exercise during the day.

Crises occur when an individual a. Is exposed to a precipitating stressor. b. Perceives a stressor to be threatening. c. Has no support systems. d. Experiences a stressor and perceives coping strategies to be ineffective

d. Experiences a stressor and perceives coping strategies to be ineffective

Ginger, age 19 and an only child, left 3 months ago to attend a college of her choice 500 miles away from her parents. It is Ginger's first time away from home. She has difficulty making decisions and will not undertake anything new without first consulting her mother. They talk on the phone almost every day. Ginger has recently started having anxiety attacks. She consults the nurse practitioner in the student health center. What is this type of crisis called? a. Crisis resulting from traumatic stress b. Dispositional crisis c. Psychiatric emergency d. Maturational or developmental crisis

d. Maturational or developmental crisis

An individual who is addicted to heroin is likely to experience which of the following symptoms of withdrawal? a. Increased heart rate and blood pressure b. Tremors, insomnia, and seizures c. Incoordination and unsteady gait d. Nausea and vomiting, diarrhea, and diaphoresis

d. Nausea and vomiting, diarrhea, and diaphoresis

According to Margaret Mahler, predisposition to BPD occurs when developmental tasks go unfulfilled in which of the following phases? a. Autistic phase, during which the child's needs for security and comfort go unfulfilled b. Symbiotic phase, during which the child fails to bond with the mother c. Differentiation phase, during which the child fails to recognize a separateness between self and mother d. Rapprochement phase, during which the mother withdraws emotional support in response to the child's increasing independence

d. Rapprochement phase, during which the mother withdraws emotional support in response to the child's increasing independence

Kim has a diagnosis of BPD. She often exhibits alternating clinging and distancing behaviors. Which of the following is the most appropriate nursing intervention with this type of behavior? a. Encourage Kim to establish trust in one staff person with whom all therapeutic interaction should take place. b. Secure a verbal contract from Kim that she will discontinue these behaviors. c. Withdraw attention if these behaviors continue. d. Rotate staff members who work with Kim so that she will learn to relate to more than one person.

d. Rotate staff members who work with Kim so that she will learn to relate to more than one person.

Carol is a nurse who was floated to the psychiatric unit to cover for a staff nurse who called out sick. She encounters a patient who is diagnosed with BPD, and the patient states "Thank goodness they sent you to the unit. No one else here has taken the time to listen to my concerns." This may be an example of which symptom common in BPD? a. Impulsivity b. Self-harming behaviors c. Dissociation d. Splitting

d. Splitting

Mrs. G has been diagnosed with NCD due to Alzheimer's disease. The cause of this disorder is which of the following? a. Multiple small brain infarcts b. Chronic alcohol abuse c. Cerebral abscess d. Unknown

d. Unknown

Intervention with Andrew (from question 12) would include a. Encouraging expression of feelings. b. Antianxiety medications. c. Participation in a support group. d. a and c. e. All of the above.

e. All of the above.