PSYCHIATRIC NURSING - POST TEST
Gelyn, a schizophrenic client with delusions tells the nurse, "There is a man wearing a red coat who's out to get me." The client exhibits increasing anxiety when focusing on the delusions. Which of the following would be the best response? a. "This subject seems to be troubling you. Let's walk to the activity room." b. "Describe the man who's out to get you. What does he look like?" c. "There is no reason to be afraid of that man. This hospital is very secure." d "There is no need to be concerned with a man who isn't even real "
Answer: A
Krisha, diagnosed with bulimia tells the nurse that she eats excessively when she is upset and then vomits so she won't gain a lot of weight. Which of the following nursing diagnostic categories would be most appropriate for her? a. Ineffective coping. b. Imbalanced nutrition: more than body requirements. c. Anxiety. d. Disabled family coping.
Answer: A
Ofel, a client with paranoid type schizophrenia becomes angry and tells the nurse to leave her alone. The nurse should: a. tell her that she'll leave for now but will return soon. b. ask her if it's okay if she sits quietly with him c. ask her why he wants to be left alone. d. tell her that she won't let anything happen to him.
Answer: A
Propranolol (Inderal) is used in the mental health setting to manage which of the following conditions? a. Antipsychotic-induced akathisia and anxiety b. The manic phase of bipolar illness as a mood stabilizer c. Delusions for clients suffering from schizophrenia d. Obsessive-compulsive disorder (OCD) to reduce ritualistic behavior
Answer: A
The nurse is planning care for Chester, a client admitted to the psychiatric unit with a diagnosis of paranoid schizophrenia. Which nursing diagnosis should receive the highest priority? a. Risk for violence toward self or others b. Imbalanced nutrition: Less than body requirements c. Ineffective family coping d. Impaired verbal communication
Answer: A
The nurse knows that the physician has ordered the liquid form of the drug chlorpromazine (Thorazine) rather than the tablet form because the liquid: a. has a more predictable onset of action. b. produces fewer anticholinergic effects. c. produces fewer drug interactions. d. has a longer duration of action.
Answer: A
Tic-tic, a client is admitted to a psychiatric facility with a diagnosis of chronic schizophrenia. The history indicates that the client has been taking neuroleptic medication for many years. Assessment reveals unusual movements of the tongue, neck, and arms. Which condition should the nurse suspect? a. Tardive dyskinesia b. Dystonia c. Neuroleptic malignant syndrome d. Akathisia
Answer: A
Violet, a client with catatonic schizophrenia is mute, can't perform activities of daily living, and stares out the window for hours. What is the nurse's first priority? a. Assist the client with feeding. b. Assist the client with showering. c. Reassure the client about safety. d. Encourage socialization with peers.
Answer: A
When assessing Edna, a patient with anorexia nervosa, the nurse would expect to find which of the following? a. Lanugo, hypothermia, and hypotension. b. Constipation, dysmenorrheal, and hypertension. c. Diarrhea, dry skin and menorrhagia. d. Hyperthermia, oliguria and bradycardia.
Answer: A
When assessing Toni, a 17-year-old male patient with depression for suicide risk, which of the following questions would be best? a. "Are you thinking about killing yourself?" b. "What movies about death have you watched lately?" c. "Can you tell me what you think about suicide?" d. "Has anyone in your family ever committed suicide?"
Answer: A
When developing a teaching plan for a high school health class about anorexia nervosa, which of the following would the nurse include as the primary group affected by this disease? a. Women, age at onset between 12 to 20 years. b. Men, onset during the college years. c. Women, onset typically after 30 years of age. d. Men, onset before 20 years of age.
Answer: A
When planning the care for Gerly who is abused, which of the following measures would be most important to include? a. Helping the patient develop a safety plan. b. Explaining to the patient her personal and legal rights. c. Teaching her about abuse and the cycle of violence. d. Being compassionate and empathetic.
Answer: A
Aida, a client is admitted to the inpatient unit of the mental health center with a diagnosis of paranoid schizophrenia. She's shouting that the government of France is trying to assassinate her. Which of the following responses is most appropriate? a. "I think you're wrong. France is a friendly country and an ally of the United States. Their government wouldn't try to kill you." b. "I find it hard to believe that a foreign government or anyone else is trying to hurt you. You must feel frightened by this. c. "You're wrong. Nobody is trying to kill you." d. "A foreign government is trying to kill you? Please tell me more about it."
Answer: B
Alvin, a client with paranoid schizophrenia has been experiencing auditory hallucinations for many years. One approach that has proven to be effective for hallucinating clients is to: a. take an as-needed dose of psychotropic medication whenever they hear voices. b. practice saying "Go away" or "Stop" when they hear voices. c. sing loudly to drown out the voices and provide a distraction. d. go to their room until the voices go away.
Answer: B
Benztropine (Cogentin) is used to treat the extrapyramidal effects induced by antipsychotics. This drug exerts its effect by: a. decreasing the anxiety causing muscle rigidity. b. blocking the cholinergic activity in the central nervous system (CNS). c. increasing the level of acetylcholine in the CNS. d. increasing norepinephrine in the CNS.
Answer: B
During the assessment stage, Sweet, a client with schizophrenia leaves his arm in the air after the nurse has taken his blood pressure. His action shows evidence of: a. somatic delusions. b. waxy flexibility. c. neologisms. d. nihilistic delusions.
Answer: B
During the initial interview, Kriszel who has a compulsive eating disorder remarks, "I can't stand myself and the way I look." Which of the following statements by the nurse would be most therapeutic? a. "Don't worry, you'll soon be back in shape." b. "Tell me more about your feelings." c. "Everyone who has the same problem feels like you do." d. "I don't think you look bad at all."
Answer: B
For several years, a client with chronic schizophrenia has received 10 mg of fluphenazine hydrochloride (Prolixin) by mouth four times per day. Now the client has a temperature of 102° F (38.9° C), a heart rate of 120 beats/minute, a respiratory rate of 20 breaths/minute, and a blood pressure of 210/140 mm Hg. Because the client also is confused and incontinent, the nurse suspects malignant neuroleptic syndrome. What steps should the nurse take? a. Give the next dose of fluphenazine, call the physician, and monitor vital signs. b. Withhold the next dose of fluphenazine, call the physician, and monitor vital signs. c. Give the next dose of fluphenazine and restrict the client to the room to decrease stimulation. d. Withhold the next dose of fluphenazine, administer an antipyretic agent, and increase the client's fluid intake.
Answer: B
Jiffery, a client with a diagnosis of paranoid schizophrenia comments to the nurse, "How do I know what is really in those pills?" Which of the following is the best response? A. Say, "You know it's your medicine." B. Allow him to open the individual wrappers of the medication. C. Say, "Don't worry about what is in the pills. It's what is ordered." D. Ignore the comment because it's probably a joke.
Answer: B
Lhoy, a client receiving haloperidol (Haldol) complains of a stiff jaw and difficulty swallowing. The nurse's first action is to: A. reassure the client and administer as needed lorazepam (Ativan) I.M. B. administer as needed dose of benztropine (Cogentin) I.M. as ordered. C. administer as needed dose of benztropine (Cogentin) by mouth as ordered. D. administer as needed dose of haloperidol (Haldol) by mouth.
Answer: B
One of the myths about sexual abuse of young children is that it usually involves physically violent acts. Which of the following behaviors is more likely to be used by the abusers? a. Asking for the child's consent for sex. b. Coercion as a result of the trusting relationship. c. Tying the child down. d. Bribery with money.
Answer: B
Prometheus is admitted to the inpatient unit of the mental health center with a diagnosis of paranoid schizophrenia. He's shouting that the government of France is trying to assassinate him. Which of the following responses is most appropriate? a. "I think you're wrong. France is a friendly country and an ally of the United States. Their government wouldn't try to kill you." b. "I find it hard to believe that a foreign government or anyone else is trying to hurt you. You must feel frightened by this." c. "You're wrong. Nobody is trying to kill you." d. "A foreign government is trying to kill you? Please tell me more about it."
Answer: B
Salty, a client in the manic phase of bipolar disorder constantly belittles other clients and demands special favors from the nurses. Which nursing intervention would be most appropriate for this client? a. Ask other clients and staff members to ignore the client's behavior. b. Set limits with consequences for belittling or demanding behavior. c. Offer the client an antianxiety drug when belittling or demanding behavior occurs. d. Offer the client a variety of stimulating activities to distract him from belittling or making demands of
Answer: B
Seng, a 24-year-old client is experiencing an acute schizophrenic episode. She has vivid hallucinations that are making him agitated. The nurse's best response at this time would be to: a. take the client's vital signs. b. explore the content of the hallucinations. c. tell him his fear is unrealistic. d. engage the client in reality-oriented activities.
Answer: B
The nurse is with the parents of Kevin, a 16-year-old boy who recently attempted suicide. The nurse cautions the parents to be especially alert for which of the following in their son? a. Decision to try out for an extracurricular activity. b. Giving away valued personal items. c. Desire to spend more time with friends. d. Expression of a desire to date.
Answer: B
Which of the following medications would the nurse anticipate administering as a treatment for tic disorders, including Tourette disorder? a. Lithium. b. Clonidine. c. Chlorpromazine. d. Imipramine.
Answer: B
Which of the following medications would the nurse expect the physician to order to reverse a dystonic reaction? a. prochlorperazine (Compazine) b. diphenhydramine (Benadryl) c. haloperidol (Haldol) d. midazolam (Versed)
Answer: B
15. Mai-mai, a client tells the nurse that the television newscaster is sending a secret message to her. The nurse suspects the client is experiencing: a. a delusion. b. flight of ideas. c. ideas of reference. d. a hallucination
Answer: C
Aura is suspected of being sexually abused because she demonstrates the self-destructive behaviors of head banging and self-mutilation. Which of the following behaviors would the nurse also commonly expect to assess? a. Substance abuse. b. Overcontrol of anger. c. Truancy and running away. d. Inability to play.
Answer: C
Bitter, a client diagnosed with depression tells the nurse, "I won't allow myself to cry because it upsets the whole family when I cry." This is an example of: a. manipulation. b. insight. c. rationalization. d. repression.
Answer: C
Daryl, a client has been receiving chlorpromazine (Thorazine), an antipsychotic, to treat his psychosis. Which findings should alert the nurse that the client is experiencing pseudoparkinsonism? a. Restlessness, difficulty sitting still, and pacing b. Involuntary rolling of the eyes c. Tremors, shuffling gait, and masklike face d. Extremity and neck spasms, facial grimacing, and jerky movements
Answer: C
Desiree who has been sexually abused has difficulty putting feelings into words. Which of the following would the nurse employ with the child? a. Role-playing. b. Giving the patient's drawings to the abuser. c. Engaging in play therapy. d. Reporting the abuse to a prosecutor.
Answer: C
Ed, a psychotic client reports to the evening nurse that the day nurse put something suspicious in his water with his medication. The nurse replies, "You're worried about your medication?" The nurse's communication is: a. an example of presenting reality. b. reinforcing the client's delusions. c. focusing on emotional content. d. a nontherapeutic technique called mind reading.
Answer: C
Gay-gay, a client who has been hospitalized with disorganized type schizophrenia for 8 years can't complete activities of daily living (ADLs) without staff direction and assistance. The nurse formulates a nursing diagnosis of Self-care deficient: Dressing/grooming related to inability to function without assistance. What is an appropriate goal for this client? a. "Client will be able to complete ADLs independently within 1 month." b. "Client will be able to complete ADLs with only verbal encouragement within 1 month." c. "Client will be able to complete ADLs with assistance in organizing grooming items and clothing within 1 month." d. "Client will be able to complete ADLs with complete assistance within 1 month."
Answer: C
Important teaching for women in their childbearing years who are receiving antipsychotic medications includes which of the following? a. Occurrence of increased libido due to medication adverse effects b. Increased incidence of dysmenorrhea while taking the drug c. Continuing previous use of contraception during periods of amenorrhea d. Instruction that amenorrhea is irreversible
Answer: C
Most antipsychotic medications exert which of following effects on the central nervous system (CNS)? a. Stimulate the CNS by blocking postsynaptic dopamine, norepinephrine, and serotonin receptors. b. Sedate the CNS by stimulating serotonin at the synaptic cleft. c. Depress the CNS by blocking the postsynaptic transmission of dopamine, serotonin, and norepinephrine. d. Depress the CNS by stimulating the release of acetylcholine.
Answer: C
Orly, a client with borderline personality disorder becomes angry when he is told that today's psychotherapy session with the nurse will be delayed 30 minutes because of an emergency. When the session finally begins, the client expresses anger. Which response by the nurse would be most helpful in dealing with the client's anger? A. "If it had been your emergency, I would have made the other client wait." B. "I know it's frustrating to wait. I'm sorry this happened." C. "You had to wait. Can we talk about how this is making you feel right now?" D. "I really care about you and I'll never let this happen again."
Answer: C
The nurse at the mental health clinic is meeting a new patient who is Kezia, a 7-year-old girl with Tourette syndrome. Which of the following would the nurse expect to assess? a. Isolated verbal tics. b. Alternating simple and complex motor tics. c. Multiple motor and verbal tics. d. Primarily motor tics.
Answer: C
The nurse is assessing Renee's methods of coping. A patient who is being abused would be least likely to demonstrate which of the following? a. Self-blame. b. Alcohol abuse. c. Assertiveness. d. Suicidal thoughts
Answer: C
The nurse is caring for Guy, a client with schizophrenia who experiences auditory hallucinations. The client appears to be listening to someone who isn't visible. He gestures, shouts angrily, and stops shouting in mid-sentence. Which nursing intervention is the most appropriate? a. Approach the client and touch him to get his attention. b. Encourage the client to go to his room where he'll experience fewer distractions. c. Acknowledge that the client is hearing voices but make it clear that the nurse doesn't hear these voices. d. Ask the client to describe what the voices are saying.
Answer: C
The nurse is preparing for the discharge of Charlie, a client who has been hospitalized for paranoid schizophrenia. The client's husband expresses concern over whether his wife will continue to take her daily prescribed medication. The nurse should inform him that: a. his concern is valid but his wife is an adult and has the right to make her own decisions. b. he can easily mix the medication in his wife's food if she stops taking it. c. his wife can be given a long-acting medication that is administered every 1 to 4 weeks. d. his wife knows she must take her medication as prescribed to avoid future hospitalizations.
Answer: C
Yesterday, James, a client with schizophrenia began treatment with haloperidol (Haldol). Today, the nurse notices that the client is holding his head to one side and complaining of neck and jaw spasms. a. Assume that the client is posturing. b. Tell the client to lie down and relax. c. Evaluate the client for adverse reactions to haloperidol. d. Put the client on the list for the physician to see tomorrow
Answer: C
A dopamine receptor agonist such as bromocriptine (Parlodel) relieves muscle rigidity caused by antipsychotic medication by: a. blocking dopamine receptors in the central nervous system (CNS). b. blocking acetylcholine in the CNS. c. activating norepinephrine in the CNS. d. activating dopamine receptors in the CNS.
Answer: D
Frowline, a client is admitted to the psychiatric unit of a local hospital with chronic undifferentiated schizophrenia. During the next several days, the client is seen laughing, yelling, and talking to herself. This behavior is characteristic of: a. delusion. b. looseness of association. c. illusion. d. hallucination.
Answer: D
How soon after chlorpromazine (Thorazine) administration should the nurse expect to see a client's delusional thoughts and hallucinations eliminated? a. Several minutes b. Several hours c. Several days d. Several weeks
Answer: D
Josh, a 3-year-old child is brought into the physician's office by her parents who are concerned by his behavior. They state that he resists their affection, twirls around frequently, and refuses to respond to other children and adults. Based on the analysis of these behaviors, which of the following would the nurse suspect? a. Tourette syndrome. b. Schizophrenia. c. ADHD. d. Autism.
Answer: D
Ruth, a client begins taking haloperidol (Haldol). After a few days, she experiences severe tonic contractures of muscles in the neck, mouth, and tongue. The nurse should recognize this as: a. psychotic symptoms. b. parkinsonism. c. akathisia. d. dystonia.
Answer: D
When monitoring Howard, a male client recently admitted for treatment of cocaine addiction, the nurse notes sudden increase in the arterial blood pressure and heart rate. To correct these problems, the nurse expects the physician to prescribe: a. Norepinephrine (Levophed) and lidocaine (Xylocaine) b. Nifedipine (Procardia) and lidocaine c. Nitroglycerin (Nitro-Bid IV) and esmolol (Brevibloc) d. Nifedipine and nitroglycerin
Answer: D
Which of the following would the nurse expect to include in the teaching plan for the parents of Kyle who is receiving methylphenidate (Ritalin)? a. Allowing concurrent use of any over-the-counter medications with this drug. b. Giving the medication at the same time every evening. c. Having the child take two doses at the same time if the last dose was missed. d. Giving the single-dose form of the medication early in the day.
Answer: D
A schizophrenic client states, "I hear the voice of King Tut." Which response by the nurse would be most therapeutic? a. "I don't hear the voice, but I know you hear what sounds like a voice." b. "You shouldn't focus on that voice." c. "Don't worry about the voice as long as it doesn't belong to anyone real." d. "King Tut has been dead for years."
Asnwer: A