Psych Test 4
The 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.
"Have you been experiencing an increase in stress lately?"
The family members of a client with somatic symptom illness report to the nurse that eery 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?
"I know this is difficult, but exercise is important. It will be a short walk."
The nurse is assessing a 2 year old child during a wellness checkup. Which statements bu the parent indicate that the child needs to be screened for autism spectrum disorder? select all that apply
- "I notice that my child has very few expressions to situations." - There is no spontaneous play at all and will only plays with one object." - "My child rarely makes eye contact with me or siblings."
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?
"Parents that engage in risky behaviors are more likely to have children that engage in these behaviors."
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?
"You are obligated to attend class. Missing class is against the rules."
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 wash cloth without knowing what to do with it. Which is the best response by the nurse?
"this is a washcloth so you can wash your face and hands."
The nurse is education parents of a child with ADHD. Which statement by the parents would indicate the need for further teaching?
"we'll have the child do homework at the kitchen table with the Childs siblings"
The nurse is educating parents of a child with ADHD about the prescription of atomoxetine. Which client statement indicate that the education is effective? Select all that apply
- " We will need to bring our child in for routine liver function testing." - "If our child reports dry mouth, we can give sugar free candy or gum." - "We need to monitor appetites since the medication may suppress appetite." - "It is better to give the medication with food."
An adolescent is displaying behaviors associated with conduct disorder such as stealing, fighting, skipping school, and not adhering to the rules at home. Which factors stated by the client does the nurse correlate with the behaviors exhibited by the adolescent? Select all that apply
- "My parents are into drugs and alcohol." - " If I don't do what my parents say, I get beaten." - " Our family s dysfunctional and no one gets along." - " We live in a rundown apartment on a bad side of town."
The nurse is talking with an adolescent client who has been externalizing behaviors indicating a conduct disorder. Which client statements indicate that externalizing behaviors are being experienced?
- "when I get dropped off at school, I skip and go drink with my friends." -"set fire to a trash can on school property when I threw my cigarette in it." -"I got caught cheating on an exam. I cheat all of the time. why should I study?"
The nurse is working with a school aged child who is being evaluated for a mental health disorder. The parents of the child as 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
- Children are constantly changing and developing and unable to discriminate unusual symptoms from normal feelings - children usually lack the abstract cognitive abilities and verbal skills to describe what is happening - behaviors that are appropriate for a child of one developmental level may be inappropriate for a child of a different developmental level
The nurse is admitting an adolescent client with 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
- Inform the client about the rules or limits - state the expected behavior of the client in the facility - Explain the consequences if the clients exceed the limit
The nurse is creating a plan of care for a client with somatic symptom disorder. Which long-term treatment outcomes for this client will be most achievable and measurable? select all that apply
- The client will identify the relationship between stress and physical symptoms - The client will assume responsibility for self- care activities - The client will verbally express emotional feelings - The client will demonstrate alternative ways to deal with stress, anxiety, and other feelings
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 actions 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
- The parents engage in yelling at, hitting, or simply ignoring the behavior of the child - the parents may not behave appropriately because of a lack of knowledge - the parents blame the school when the child causes a disturbance in school
The adolescent client is exhibiting "bullying behaviors." Which may be concern that a nurse has when caring for clients who have conduct disorders? select all that apply.
- having conflicted feelings regarding holding clients accountable for their behaviors without having a punitive attitude - believing that the client should be able to refrain from hostility and aggression through the use of will power - having anxiety and fears for the nurses personal safety
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 ways for the nurse to assess the child for ADHD? Select all that apply
- interviewing the clients parents - assessing the client in a group of peers - directly observing the child - interviewing the clients teachers
The nurse is working with clients who have disruptive behavior disorders. Which are important points for the nurse to consider when working with these clients and their families? select all that apply
- remember to focus on the clients strengths and assets, as well as their problems - avoid a "blaming" attitude toward clients and/or families - focus on positive actions to improve situations and/or behaviors
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 these questions being asked. Which is the best actions for the nurse to take to obtain the data needed? Select all that apply
- take frequent breaks during the interview process - provide simple explanations to the client as often as required - ask simple questions instead of compound questions - give the client ample time to answer the question asked
A nurse is providing education to a group of parents who have children with ADHD. Which information will the nurse include in the education? select all that apply
- take the time to learn how to rebuild a Childs self esteem - ADHD is not the fault of the parents or the child - Support groups can provide information and encouragement from others
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 reasons the client is experiencing the confusion or delirium? select all that apply
- the client has broken out in hives and using diphenhydramine - the family reports the client has been drinking alcohol to excess - the client is only sleeping approximately 2 to 3 hours a night and up several times. - the client is drinking very little fluids and has to be encouraged to drink water - the client just had the inside of the house painted
The parents of a child with 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
- use a point system for positive and negative behavior - use appropriate time out strategies for behavior control - give verbal reprimands for negative behavior
The nurse is performing an assessment for a 14 year old client whose parents are concerned with recent behaviors exhibited by the adolescent. Which statements by the client in the interview portion of the assessment does the nurse identify as typical adolescent behaviors? select all that apply
- verbally aggressive with parents - critical of self and others
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?
Acknowledge the clients frustrations without fostering continued focus on physical illness
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 ADHD. The. child is having difficulty paying attention, listening, and completing tasks. Which suggestion can the nurse give for improvement to the parent?
Request that the child be seated in front of the teacher in the classroom
A young adolescent client arrives in the outpatient clinic and demonstrates various motor and vial tics. The client is emotional and states that the other linden avoid them and call them horrible names. Which prescription by the health care provider will the nurse educate the client and the parent about?
Risperdone
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?
Ruling out a physical cause of pain
The nurse 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 the most concern?
The child is having decreased urinary output and difficulty urinating
The nurse is caring for an assigned group of clients. Which client does the nurse identify at the highest risk for the development of delirium and will be closely monitored?
an older adult with sepsis from a UTI
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?
conduct disorder
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?
conduct disorder
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?
consider another area of nursing since this is likely to continue to happen
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 on over 20 years. which is the best guidance that the nurse could offer?
go along with the clients thought of it having been a busy day, but do not refer to the clients work
The nurse manager in a 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?
plan for the same staff to provide care to individuals as much as possible
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 clients abilities, which will the nurse document on the electronic health record?
the client is experiencing agnosia
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?
the client will verbally express their emotions
The nurse has been working with clients with Alzheimers disease for almost 6 months. The nurse expresses frustration to the nurse manager because the same instructions have to be given to the clients several times a day. Which suggestion would be most appropriate for the manager to make?
try to stay supportive and meet the clients needs at the current moment
