Psychiatric Nursing Reviewer

The psychiatric nurse documents that a client is expressing nihilistic delusions when the client makes which statement? A. "I can't eat; I have no mouth or stomach." B. "I need to leave now; I'm expecting a visit from my sister, the queen." C. "I'll just telephone the president; he always answers my calls." D. "I'm dying; I'm the first to have this form of cancer."

A. "I can't eat; I have no mouth or stomach."

One morning, a client was seen tilting his head as if he was listening to someone. An appropriate nursing intervention would be A. Address him by name to ask if he is hearing voices again B. Involve him in group activities C. Request for an order of antipsychotic medicine D. Tell him to socialize with other patient to divert his attention

A. Address him by name to ask if he is hearing voices again

Which is the key to understanding if a child or adolescent is experiencing an underlying depressive disorder? A. A change in behaviors over a 2-week period. B. Being uninterested in school. C. Feeling insecure at a social gathering. D. Irritability with authority.

A. A change in behaviors over a 2-week period.

A client is diagnosed with male orgasmic disorder. Which assessed behavior supports this diagnosis? A. A delay in or absence of ejaculation following normal sexual excitement B. Dyspareunia C. Inability to maintain an erection D. Premature ejaculation

A. A delay in or absence of ejaculation following normal sexual excitement

Which neurotransmitter has been implicated in the development of Alzheimer's disease? A. Acetylcholine B. Dopamine C. Epinephrine D. Serotonin

A. Acetylcholine

A client was hospitalized following a suicide attempt. His history reveals a previous diagnosis of schizoid personality disorder. Which of the following behaviors would be atypical of a client with this disorder? A. Actions designed to please the nurse B. Limited expressions of feelings and emotions C. Odd ideas and mannerisms D. Reluctance to join group activities

A. Actions designed to please the nurse

A 10-year-old client diagnosed with nightmare disorder is admitted to an in-patient psychiatric unit. Which of the following interventions would be appropriate for this client's problem? Select all that apply. A. Administering medications such as tricyclic antidepressants or low-dose benzodiazepines or both. B. Giving central nervous system stimulants, such as amphetamines. C. Involving the family in therapy to decrease stress within the family. D. Using phototherapy to assist the client to adapt to changes in sleep. E. Using relaxation therapy, such as meditation and deep breathing techniques, to assist the client in falling asleep.

A. Administering medications such as tricyclic antidepressants or low-dose benzodiazepines or both. C. Involving the family in therapy to decrease stress within the family. E. Using relaxation therapy, such as meditation and deep breathing techniques, to assist the client in falling asleep.

Which symptoms would the nurse expect to assess in a client suspected to have a serotonin syndrome? A. Alterations in mental status, restlessness, tachycardia, labile blood pressure, and diaphoresis. B. Dizziness, lethargy, headache, and nausea. C. Hypomania, akathisia, cardiac arrhythmias, and panic attacks. D. Orthostatic hypotension, urinary retention, constipation, and blurred vision.

A. Alterations in mental status, restlessness, tachycardia, labile blood pressure, and diaphoresis.

The nurse assesses a young woman with anorexia nervosa and compared the client's wight with norms for age and height. Which of the following assessment findings would be expected in this client? Select all that apply. A. Amenorrhea B. Bradycardia C. Diarrhea D. Hypertension E. Lanugo F. Tachycardia

A. Amenorrhea B. Bradycardia

A client hospitalized with a diagnosis of schizophrenia recently started talking oral trifluoperazine (Stelazine), 2 mg three times daily. The client complains of progressive stiff, painful and tense neck muscles. Given this data, the nurse suspects that the client is experiencing. A. An acute dystonic reaction B. Increased tension related to the illness C. Neuroleptic malignant syndrome D. Symptoms of pseudoparkinsonism

A. An acute dystonic reaction

An adolescent hospitalized in a psychiatric unit initiates frequent flights with peers. Which implementation is most appropriate? A. Anticipate and neutralize potentially explosive situations. B. Ignore minor infractions of rules against fighting. C. Isolate the adolescent from contact with peers. D. Talk to the adolescent each time fighting occurs.

A. Anticipate and neutralize potentially explosive situations.

When assessing a client who abuses barbiturates and benzodiazepine, the nurse would observe for evidence of which withdrawal symptoms? A. Anxiety, tremors, and tachycardia B. Muscle aches, cramps, and lacrimation C. Paranoia, depression, and agitation D. Respiratory depression, stupor, and bradycardia

A. Anxiety, tremors, and tachycardia

A client is about to be discharged with a prescription for the antipsychotic agent haloperidol (Haldol), 10mg by mouth twice per day. During a discharge teaching session, the nurse should provide which instruction to the client? A. Apply a sunscreen before being exposed to the sun. B. Decrease the dosage if signs of illness decrease. C. Increase the dosage up to 50 mg twice per day if signs of illness D. Take the medication 1 hour before a meal.

A. Apply a sunscreen before being exposed to the sun.

A client has been diagnosed with schizophrenia. Assessment reveals that the client lives alone. His clothing is disheveled, his hair is uncombed and matted and his body has a strange odor. During an interview the client's family voices a desire for the client to live with them when he is discharged. Based on the assessment findings, which nursing diagnosis would be a priority. A. Bathing self-care deficit related to symptoms of schizophrenia B. Dysfunctional family process rt psychosis C. Ineffective role performance rt symptoms of schizophrenia D. Social isolation rt auditory hallucinations

A. Bathing self-care deficit related to symptoms of schizophrenia

1The daughter of a client with Alzheimer's disease reports feeling chronic fatigue and mild depression. Further assessment reveals that this daughter has been responsible for feeding, cleaning, and doing laundry for her parent while maintaining a full-time job and caring for two teenagers. Which nursing diagnosis would the nurse establish for the client's daughter? A. Caregiver role strain B. Disabled family coping C. Interrupted family coping D. Social isolation

A. Caregiver role strain

A client newly admitted to an inpatient psychiatric unit is experiencing a manic episode. The client's nursing diagnosis is imbalanced nutrition, less than body requirements. Which meal is most appropriate for this client? A. Chicken fingers and French fries B. Chili and crackers C. Grilled chicken and a baked potato D. Spaghetti and meatballs

A. Chicken fingers and French fries

The school nurses assesses a child newly diagnosed with attention deficit hyperactivity disorder (ADHD). Which of the following symptoms are characteristic of the disorder? Select all that apply. A. Constant fidgeting and squirming B. Difficulty paying attention to details C. Easily distracted D. Excessive fatigue and somatic complaints E. Running away F. Talking constantly, even when inappropriate

A. Constant fidgeting and squirming B. Difficulty paying attention to details C. Easily distracted F. Talking constantly, even when inappropriate

The most commonly supported neuroanatomic theory of schizophrenia suggests which etiology? A. Decreased brain tissue in the frontal and temporal regions of the brain. B. Excessive amounts of dopamine and serotonin in the brain C. Ineffective ability of the brain to use dopamine and serotonin D. Insufficient amounts of dopamine in the brain

A. Decreased brain tissue in the frontal and temporal regions of the brain.

A client who recently retired is admitted to the psychiatric inpatient unit with a diagnosis of major depression. The initial nursing care plan includes the goal "Assist client to express feelings of guilt." What is true about the goal statement referring to the client's depression? A. Depressed clients may be unaware of guilt feelings and should be encouraged to increase self-awareness. B. Implementation of the goal should be deferred until further data can be gathered. C. Nursing goals should be approved by the treatment team before they are initiated. D. The depression will dissipate once the client becomes accustomed to retirement.

A. Depressed clients may be unaware of guilt feelings and should be encouraged to increase self-awareness.

A client has been taking haloperidol (Haldol), 5 mg three times daily, to treat schizophrenia. The nurse routinely assessed for extrapyramidal side effects, which include all of the following, except: A. Dry mouth and urine retention B. Excessive motor restlessness C. Eyes rolling upward uncontrollably D. Tremors and shuffling gait

A. Dry mouth and urine retention

1. The nurse is assessing a client with schizophrenia who has a history of successfully managing the symptoms. The client has few social activities and speaks in a flat tone when interacting with others. Currently the client is experiencing acute psychosis with active hallucinations and social withdrawal. The nurse identifies improved social skills as an important therapeutic goal. How should the nurse implement this plan? A. Enter the client in a social skills training program when acute psychosis subsides. B. Enter the client in the ongoing social skills training program on the unit. Have the client begin on the following day. C. Refer the client to a social skills training program after discharge. D. Wait a few days to enter the client in the social skills training program.

A. Enter the client in a social skills training program when acute psychosis subsides.

When evaluating care of a client with schizophrenia, the nurse should keep which point in mind? A. Frequent reassessment is needed and is based on the client's response to treatment. B. Relapse is not an issue for a client with schizophrenia. C. The client is too ill to learn about his illness. D. The family does not need to be included in the care because the client is an adult.

A. Frequent reassessment is needed and is based on the client's response to treatment.

Various biological and psychological theories have been proposed regarding homosexuality. Which etiological factor has emerged consistently? A. Homosexual behavior has no definitive etiological evidence supporting either biologic or psychosocial theories B. Homosexual behavior is an individual preference C. Homosexual behavior is based on orientation of the individual D. Homosexual behavior is the result of negative Oedipal position

A. Homosexual behavior has no definitive etiological evidence supporting either biologic or psychosocial theories

A client describes himself as "very religious with strong opinions about what is right and what is wrong." The client is quite judgmental about beliefs and lifestyles that are "unacceptable." Which statement supports the nurse's analysis that this client's behavior is typical of someone with a personality disorder? A. Inflexible behaviors, along with the use of rigid defense mechanisms, are characteristic. B. Judgmental behavior, including self-insight, is common. C. Religious fanatics often have personality disorders. D. Strong belief systems are common and can help identify evidence of instability.

A. Inflexible behaviors, along with the use of rigid defense mechanisms, are characteristic.

The nurse reinforces the behavioral contract for a child having difficulty controlling aggressive behaviors on psychiatric unit. Which of the following is the best rationale for this method of treatment? A. It will assist the child to develop more adaptive coping methods. B. It will avoid having the nurse be responsible for setting the rules. C. It will maintain the nurse's role in controlling the child's behavior. D. It will prevent the child from manipulating the nurse.

A. It will assist the child to develop more adaptive coping methods.

Which of the following would the nurse expect to assess in a client suspected to have sleep terror disorder? A. The client experiences an abrupt arousal from sleep with a piercing scream or cry. B. The client is easily awakened after the night terror. C. The client, on awakening, is able to explain the nightmare in vivid detail. D. The client, when awakening during the night terror, is alert and oriented.

A. The client experiences an abrupt arousal from sleep with a piercing scream or cry.

The nurse evaluates the effectiveness of the neuroleptic drug olanzapine (Zyprexa) by noting which expected client outcome? A. The client has a decreased level of anxiety and normal sleep patterns B. The client has decreased excitement and fewer episodes of panic C. The client has increased motivation and improved social interaction A. The client has increased withdrawal and decreased interest in activities

A. The client has a decreased level of anxiety and normal sleep patterns

Which of the following outcome criteria is appropriate for the client with dementia? A. The client will follow an established schedule for activities of daily living. B. The client will learn new coping mechanisms to handle anxiety. C. The client will return to an adequate level of self-functioning. D. The client will seek out resources in the community for support.

A. The client will follow an established schedule for activities of daily living.

The nurse is interviewing a client who states, "The dentist put a filling in my tooth; I now receive transmissions that control what I think and do." The nurse accurately documents this symptom with which charting entry? A. "Client is experiencing a delusion of grandeur." B. "Client is experiencing a delusion of influence." C. "Client is experiencing a delusion of persecution." D. "Client is experiencing a somatic delusion."

B. "Client is experiencing a delusion of influence."

On discharge, a client diagnosed with dementia is prescribed donepezil hydrochloride (Aricept). Which would the nurse include in a teaching plan for the client's family? A. "Donepezil is a sedative/hypnotic used for short-term treatment of insomnia." B. "Donepezil is an Alzheimer's treatment used for mild-to-moderate dementia." C. "Donepezil is an antianxiety agent used for clients diagnosed with dementia." D. "Donepezil is an antipsychotic used for clients diagnosed with dementia."

B. "Donepezil is an Alzheimer's treatment used for mild-to-moderate dementia."

During an intake assessment, which client statement is evidence of the etiology of major depressive disorder from an object-loss theory perspective? A. "I am so angry all the time and seem to take it out on myself." B. "I don't know about my biological family; I was in foster care as an infant." C. "I just don't think my life is ever going to get better. I can't do anything right." D. "My grandmother and great-grandfather also had depression."

B. "I don't know about my biological family; I was in foster care as an infant."

Which nursing charting entry is documentation of a behavioral symptom of mania? A. "Thoughts fragmented, flight of ideas noted." B. "Pacing halls throughout the day. Exhibits poor impulse control." C. "Easily distracted, unable to focus on goals." D. "Mood euphoric and expansive. Rates mood a 10/10."

B. "Pacing halls throughout the day. Exhibits poor impulse control."

A hospitalized client with antisocial personality disorder stole money from an elderly client on the unit. Which of the following is the most appropriate for the nurse to say to this client? A. "Let's talk about how you felt when you took the money." B. "The consequences of stealing are a loss of privileges." C. "This client is defenseless against you." D. "Why did you take the money?"

B. "The consequences of stealing are a loss of privileges."

During an admission assessment with a psychiatric-mental health nurse, a client states that the client hears the voice of God in the client's head and the voice is telling the client that the client is worthless. How should the nurse document this symptom? A. A delusion B. A hallucination C. Thought broadcasting D. Thought insertion

B. A hallucination

From a biochemical influence perspective, which accurately describes the etiology of schizophrenia? A. A higher incidence of schizophrenia occurs after prenatal exposure to influenza. B. An excess of dopamine-dependent neuronal activity in the brain. C. Children born of non-schizophrenic parents and raised by parents diagnosed with schizophrenia have a higher incidence of diagnosis. D. Poor parent-child interaction and dysfunctional family systems.

B. An excess of dopamine-dependent neuronal activity in the brain.

A child with separation anxiety disorder has not attended school for three weeks and cries and exhibits clinging behavior when her mother encourages attendance. The priority nursing action by the home-care psychiatric nurse would be to: A. Arrange for a home-school teacher to visit for two (2) weeks B. Assist the child in returning to school immediately with family support. C. Encourage family discussion of various problem areas. D. Use play therapy to help the child express her feelings.

B. Assist the child in returning to school immediately with family support.

When assessing a client with a delusional disorder who is experiencing somatic delusions, which would the nurse expect as within normal parameters? Select all that apply. A. Appearance B. Attention C. Orientation D. Self-care patterns Thinking

B. Attention C. Orientation E. Thinking

After a routine dental examination on an adolescent, the dentist reports to the parents that bulimia nervosa is suspected. On which of the following assessment data would the dentist base this determination? Select all that apply. A. Amenorrhea. B. Bruises of the palate and posterior pharynx. C. Dental enamel dysplasia D. Discoloration of dental enamel. E. Extreme weight loss.

B. Bruises of the palate and posterior pharynx. C. Dental enamel dysplasia D. Discoloration of dental enamel.

The nurse is teaching a client and her family about the causes of depression. Which of the following causative factors should the nurse emphasize as the most significant? A. Brain structure abnormalities B. Chemical imbalance C. Recessive gene transmission D. Social environment

B. Chemical imbalance

Which etiology for anorexia nervosa is from a neuroendocrine perspective? A. Anorexia nervosa is more common among sisters and mothers of clients with the disorder than among the general population. B. Clients diagnosed with anorexia nervosa have elevated cerebrospinal fluid cortisol levels and possible alterations in the regulation of dopamine. C. Dysfunction of the thalamus is implicated in the diagnosis of anorexia nervosa. D. There is a higher than expected frequency of mood disorders among first-degree relatives of clients diagnosed with anorexia nervosa.

B. Clients diagnosed with anorexia nervosa have elevated cerebrospinal fluid cortisol levels and possible alterations in the regulation of dopamine.

A client with depressive symptoms is given prescribed medications and talks with his therapist about his belief that he is worthless and unable to cope with life. Psychiatric care in this treatment plan is based on which framework? A. Behavioral framework B. Cognitive framework C. Interpersonal framework D. Psychodynamic framework

B. Cognitive framework

A nurse with a history of narcotic abuse is found unconscious in the hospital locker room after overdosing. The nurse is transferred to an inpatient substance abuse unit for care. Which attitudes or behaviors by nursing staff may be enabling? A. Conveying empathy when the nurse discusses fears of disciplinary action by the state board of nursing. B. Conveying understanding that pressures associated with nursing practice underlie substance abuse. C. Pointing out that work problems are the result, but not the cause, of substance abuse. D. Providing health teaching about stress management.

B. Conveying understanding that pressures associated with nursing practice underlie substance abuse.

The nurse is teaching the parents of a child with pervasive developmental disorder about how to deal with the child when his behavioral escalates, and he begins throwing things and screaming. Which guideline would be most helpful for the parents to deal with the situation? A. Accept the child's limitations, and ignore this behavior. B. Decrease stimulation in the environment, and provide a time-out. C. Seek help when feeling overwhelmed by the child's behavior. D. Tell the child to calm down, and encourage quiet activity.

B. Decrease stimulation in the environment, and provide a time-out.

A client notifies a staff member of current suicidal ideations. Which intervention by the nurse would take priority? A. Assess for past history of suicide attempts. B. Determine if the client has a specific plan to commit suicide. C. Notify all staff members and place the client on suicide precautions. D. Place the client on a one-to-one observation.

B. Determine if the client has a specific plan to commit suicide.

A hospitalized client with schizophrenia is receiving antipsychotic medications. While assessing the client, a nurse identifies signs and symptoms of a dystonic reaction. Which agent would the nurse expect to administer? A. Aripiprazole B. Diphenhydramine C. Propranolol D. Risperidone

B. Diphenhydramine

Haloperidol 5 mg TID is ordered for client with schizophrenia. Two days later, the client complains of "tight jaws and a stiff neck." The nurse should recognize that these complaints are which of the following? A. Common side-effects of antipsychotic medications that will diminish over time. B. Early symptoms of extrapyramidal reactions to the medications. C. Permanent side effects of Haldol. D. Psychosomatic complaints resulting from a delusional system.

B. Early symptoms of extrapyramidal reactions to the medications.

A child diagnosed with autistic disorder has a nursing diagnosis of impaired interaction R/T shyness and withdrawal into self. Which of the following nursing interventions would be most appropriate to address this problem? select all that apply. A. Allow the client to behave spontaneously, and shelter the client form peers B. Establish a procedure for behavior modification with rewards to the client for appropriate behaviors C. Explain to other clients the meaning behind some of the client's nonverbal gestures and signals D. Prevent physical aggression by recognizing signs of agitation E. Remain with the client during initial interaction with others on the unit

B. Establish a procedure for behavior modification with rewards to the client for appropriate behaviors C. Explain to other clients the meaning behind some of the client's nonverbal gestures and signals E. Remain with the client during initial interaction with others on the unit

The theory of family dynamics has been implicated as contributing to the etiology of conduct disorders. Which of the following are factors related to this theory? Select all that apply. A. Birth temperament. B. Father absenteeism. C. Fixation in the separation individuation phase of development. D. Frequent shifting of parental figures. E. Large family size.

B. Father absenteeism. D. Frequent shifting of parental figures. E. Large family size.

A client diagnosed with major depressive disorder has a nursing diagnosis of low self-esteem R/T negative view of self. Which cognitive intervention by the nurse would be appropriate to deal with this client's problem? A. Encourage the client to journal to uncover underlying feelings. B. Focus on strengths and accomplishments to minimize failures. C. Promote attendance in group therapy to assist client to socialize. D. Teach assertiveness skills by role-playing situations.

B. Focus on strengths and accomplishments to minimize failures.

From a sociocultural perspective, which accurately describes the etiology of schizophrenia? A. Disordering of pyramidal cells in the hippocampus contributes to the cause of schizophrenia. B. Greater numbers of individuals from lower socioeconomic backgrounds are diagnosed with schizophrenia. C. Relatives of individuals diagnosed with schizophrenia have a much higher probability of developing the disease. D. Structural brain abnormalities, such as enlarged ventricles, cause schizophrenia.

B. Greater numbers of individuals from lower socioeconomic backgrounds are diagnosed with schizophrenia.

A client diagnosed with anorexia nervosa has a nursing diagnosis of disturbed body image. Which nursing intervention addresses this problem? A. Explain to client that privileges and restrictions will be based on weight gain. B. Help client to realize that perfection is unrealistic. C. Help the client to identify and set weight loss goals. D. Stay with client during mealtime and for at least 1 hour after meals.

B. Help client to realize that perfection is unrealistic.

Which nursing intervention is most appropriate for a client with anorexia nervosa during initial hospitalization on a behavioral therapy unit? A. Emphasize the importance of good nutrition to establish normal weight. B. Help establish a plan using privileges and restrictions based on compliance with refeeding. C. Ignore the client's mealtime behavior and focus instead on issues of dependence and independence. D. Teach the client information about the long-term physical consequence of anorexia.

B. Help establish a plan using privileges and restrictions based on compliance with refeeding.

A 9-year-old child is admitted to a psychiatric treatment unit accompanied by both parents. To establish trust and a position of neutrality, which action would the nurse take? A. Encourage the parents to leave while interviewing the child alone. B. Interview the child and parents together, observing their interaction. C. Provide diversion for the child, and interview the parents alone. D. Review the clinical record prior to interviewing the parents.

B. Interview the child and parents together, observing their interaction.

Which ability should a nurse expect from a client in the mild stage of dementia of the Alzheimer's type? A. Coping with anxiety B. Recalling past events C. Remembering the daily schedule D. Solving problems of daily living

B. Recalling past events

A client on the psychiatric unit, diagnosed with bipolar disorder, becomes loud and shouts at one of the nurses, "You fat tub of lard, get something done around here!" What is the best initial action for the nurse to take? A. Have the staff escort the client to his room. B. Redirect the client by offering an activity such as playing card games. C. Review the medication record for an antipsychotic drug D. Tell the client that his behavior will be documented in his record.

B. Redirect the client by offering an activity such as playing card games.

The student nurse correctly recognizes that which one of the following findings is best supported by genetic studies in the etiology of schizophrenia? A. If a person has schizophrenia, distant relatives are also at risk. B. That schizophrenia is at least partially inherited. C. That there is a weak correlation between genetics and schizophrenia. D. That there is no relationship at all between schizophrenia and genetics.

B. That schizophrenia is at least partially inherited.

The nurse is evaluating the plan of care for a client with schizophrenia. Which observation best suggests that the plan has been effective? A. The client has been engaging in more conversation with the staff. B. The client has resumed employment and has been attending social functions. C. The client no longer believes that the client has special powers. D. The client reports that the client no longer has hallucinations.

B. The client has resumed employment and has been attending social functions.

Which goal is a priority for a client with a diagnosis of delirium and the nursing diagnosis - Acute confusion related to recent surgery secondary to traumatic hip fracture? A. The client will complete activities of daily living. B. The client will maintain safety. C. The client will remain oriented. D. The client will understand communication.

B. The client will maintain safety.

A depressed patient is threatening to harm himself. Which nursing action indicates an understanding of the appropriate care of the suicidal patient? A. The nurse administers a sedative. B. The nurse asks the patient if he has a plan. C. The nurse calls the family and asks them to visit the patient. D. The nurse places the patient in seclusion.

B. The nurse asks the patient if he has a plan.

A client with schizophrenia is seen sitting alone and talking out load. Suddenly, the client stops and turns as if listening to someone. The nurse approaches and sits down beside the client. Which of the following is the best initial response by the nurse? A. "How long have you known the person you are talking to?" B. "I can tell you are hearing voices, but they are not real." C. "I don't hear or see anyone else; what are you hearing and seeing?" D. "You must be pretty bored to be sitting here talking to an invisible person."

C. "I don't hear or see anyone else; what are you hearing and seeing?"

A client is telling the nurse about his perception of his thought patterns. Which of the following statements by the client would validate the diagnosis of schizophrenia? A. "I can't get the same thoughts out of my head." B. "I know I sometimes feel on top of the world, then suddenly down." C. "It's clear that this is an alien laboratory, and I am in charge." D. "Sometimes I look up and wonder where I am."

C. "It's clear that this is an alien laboratory, and I am in charge."

Which of the following questions would best help the nurse to evaluate the effectiveness of antipsychotic medications for a client who has schizophrenia, except one: A. Are you committed to taking the medication as prescribed? B. Are you satisfied with your quality of life? C. Do you have access to community agencies that will help you to live successfully in this community? D. Have the symptoms you were experiencing disappeared? E. If the symptoms have not disappeared, are you able to carry out your daily life despite the persistence of some psychotic symptoms?

C. Do you have access to community agencies that will help you to live successfully in this community?

A client with the diagnosis of bipolar disorder, single manic episode. Which of the following behaviors would the nurse expect to assess? A. Apathy, poor insight, and poverty of ideas. B. Anxiety, somatic complaints, and insomnia. C. Elation, hyperactivity, and impaired judgment. D. Social isolation, delusional thinking, and clang associations.

C. Elation, hyperactivity, and impaired judgment.

A client diagnosed with exhibitionism is newly admitted to an inpatient psychiatric unit. Which would be an example of a behavioral nursing intervention for this client? A. Administer prescribed medications that block or decrease circulating androgens B. Administer prescribed progestin derivatives to decrease the client's libido C. Encourage the client to pair noxious stimuli with sexually deviant impulses D. Help the client identify unresolved conflicts and traumas from early childhood

C. Encourage the client to pair noxious stimuli with sexually deviant impulses

A patient diagnosed with major depression appears tired and lethargic, but states he will try a group activity. What nursing intervention best assists this patient to integrate into the milieu? A. Arrange for the patient to participate in a structured group activity. B. Do nothing and allow the patient to take the initiative in joining a group. C. Encourage the patient to choose which of several groups he might like to attend. D. Have the patient sit outside of groups until he is ready to fully participate.

C. Encourage the patient to choose which of several groups he might like to attend.

The nurse is caring for a client with delusional schizophrenia. The patient is responding well to the therapy but had had limited social contact with others. Which of the following interventions is most appropriate? A. Discourage the patient from interacting with others because if his efforts fail it will be traumatic for the patient. B. Encourage the patient to attend a party thrown for the residents of the facility. C. Encourage the patient to participate in one-on-one interactions. D. Encourage the patient to place a personal advertisement in the local newspaper but not to reveal his disability.

C. Encourage the patient to participate in one-on-one interactions.

A client experiencing sleepwalking is newly admitted to an in-patient psychiatric unit. Which nursing intervention would take priority? A. Discourage strenuous exercise within 1 hour of bedtime. B. Encourage activities that prepare one for sleep, such as soft music. C. Equip the bed with an alarm that is activated when the bed is exited. D. Limit caffeine-containing substances within 4 hours of bedtime.

C. Equip the bed with an alarm that is activated when the bed is exited.

A client with a diagnosis of histrionic personality disorder behaves in a dramatic fashion and displays intense emotions when having to wait in the clinic for an appointment. How can the nurse best respond to this situation? A. Call the health care provider and urge that the client be seen immediately because the behavior is disruptive to others. B. Directly confront the client about the unreasonable nature of the behavior and point out that other people are also waiting. C. Explain to the client the reason for the delay in a calm, nonthreatening manner, and offer to reschedule the appointment if the client wishes to do so. D. Ignore the client's behavior and avoid confrontation, which can lead to an escalation of the problem.

C. Explain to the client the reason for the delay in a calm, nonthreatening manner, and offer to reschedule the appointment if the client wishes to do so.

The nurse is working with the family of a client with personality disorder. Which of the following should the nurse encourage the family members to work on? A. Avoiding direct expression of problem within the family B. Changing the client's problem behaviors C. Improving self-functioning D. Supporting the client's defenses

C. Improving self-functioning

The school nurse is meeting with the school and health treatment team about the child who has been receiving methylphenidate (Ritalin) for two months. The meeting is to evaluate the results of the child's medication use. Which behavior change noted by the teacher will help determine the medication's effectiveness. A. Decrease repetitive behavior B. Decreased signs of anxiety C. Increased ability to concentrate on tasks D. Increased depressed mood

C. Increased ability to concentrate on tasks

The nurse assesses a client with admitted diagnosis of bipolar affective disorder mania. The symptom presented by the client that requires the nurse's immediate intervention is the client's: A. Constant incessant talking that includes sexual topic and teasing. B. Grandiose delusions of being a royal descendant of King Arthur. C. Nonstop physical activity and poor nutritional intake D. Outlandish behaviors and inappropriate dress

C. Nonstop physical activity and poor nutritional intake

A client who abuses alcohol and cocaine tells the nurse that he only uses substances because of his stressful marriage and difficult job. Which defense mechanisms is this client using? A. Displacement B. Projection C. Rationalization D. Sublimation

C. Rationalization

Which behavior assessment in a child is most consistent with a diagnosis of conduct disorder? A. Arguing with adults B. Gross impairment in communication C. Physical aggression toward others D. Refusal to separate from caretaker

C. Physical aggression toward others

A client who is being treated with lithium carbonate for manic depression begins to develop diarrhea, vomiting, and drowsiness. Which action should the nurse take? A. Hold the medication and refuse to administer additional doses. B. Notify the health care provider immediately and force fluids. C. Prior to giving the next dose, notify the health care provider of these symptoms. D. Record the symptoms and continue with medication as prescribed.

C. Prior to giving the next dose, notify the health care provider of these symptoms.

An adult client who lives in a residential facility is mentally retarted and has a history of bipolar disorder. During the past week, the client has refused to wear clothes and frequently exposes their body to other residents. Which intervention should the nurse implement? A. Encourage the client to verbalize thoughts when acting out. B. Establish a one-to-one relationship to discuss the behavior C. Redirect the client to physically demanding activities D. Restrict social interactions with other residents in the facility

C. Redirect the client to physically demanding activities

Which nursing intervention is most appropriate for a client with Alzheimer's disease who has frequent episodes of emotional lability? A. Attempt humor to alter the client mood. B. Explore reasons for the client's altered mood. C. Reduce environmental stimuli to redirect the client's attention. D. Use logic to point out reality aspects.

C. Reduce environmental stimuli to redirect the client's attention.

A client diagnosed with bipolar I disorder is experiencing auditory hallucinations and flight of ideas. Which medication combination would the nurse expect to be prescribed to treat these symptoms? A. Amitriptyline (Elavil) and divalproex sodium (Depakote) B. Lithium carbonate (Eskalith) and clonazepam (Klonopin) C. Risperidone (Risperdal) and lamotrigine (Lamictal) D. Verapamil (Calan) and topiramate (Topamax)

C. Risperidone (Risperdal) and lamotrigine (Lamictal)

A client with schizophrenia is exhibiting positive and negative symptoms. The nurse anticipates that the client would be prescribed what? A. Antidepressant B. First generation antipsychotic C. Second generation antipsychotic D. Stimulant

C. Second generation antipsychotic

Which statement about an individual with personality disorder is true? A. Prognosis for recovery is good with therapeutic intervention. B. Psychotic behavior is common during acute episodes. C. The individual typically remains in the mainstream of society, although he has problems in social and occupational roles. D. The individual usually seeks treatment willingly for symptoms that are personally distressful.

C. The individual typically remains in the mainstream of society, although he has problems in social and occupational roles.

An 82-year-old man is admitted to the medical-surgical unit for diagnostic confirmation and management of probable delirium. Which statement by the client's daughter best supports the diagnosis? A. "Dad has always been so independent. He's lived alone for years since Mom died." B. "Dad just didn't seem to know what he was doing. He would forget what he had for breakfast." C. "Maybe it's just caused by aging. This usually happens by age 82." D. "The changes in his behavior came on so quickly! I wasn't sure what was happening."

D. "The changes in his behavior came on so quickly! I wasn't sure what was happening."

The community nurse visits the home of a child recently diagnosed with autism. The parents express feelings of shame and guilt about having somehow caused this problem. Which statement by the nurse would best help alleviate parental guilt? A. "Although autism is genetically inherited if you didn't have testing you could not have known this would happen." B. "Autism is a rare disorder. Your other children shouldn't be affected." C. "Sometimes a lack of prenatal care can be cause of autism." D. "The specific cause of autism is unknown. However. it is known to be associated with problems in the structure of and chemicals in the brain."

D. "The specific cause of autism is unknown. However. it is known to be associated with problems in the structure of and chemicals in the brain."

Which has not been proposed as a potential mechanism for the etiology of thought disorders? A. Dysregulation of neurotransmitter systems B. Genetic predispositions C. Hemispheric brain dysfunction D. Neglect in childhood

D. Neglect in childhood

A nurse is caring for a client who is experiencing a flat affect, paranoid delusions, anhedonia, anergia, neologisms, and echolalia. Which statement correctly differentiates the client's positive and negative symptoms of schizophrenia? A. Paranoid delusions, anergia, and echolalia are negative symptoms of schizophrenia. B. Paranoid delusions, anhedonia, and anergia are positive symptoms of schizophrenia. C. Paranoid delusions, flat affect, and anhedonia are negative symptoms of schizophrenia. D. Paranoid delusions, neologisms, and echolalia are positive symptoms of schizophrenia.

D. Paranoid delusions, neologisms, and echolalia are positive symptoms of schizophrenia.

Two days ago, a client arrived on the psychiatric unit, exhibiting extreme excitement, disorientation, incoherent speech, agitation, frantic and aimless physical activity, and 1. grandiose delusion. Which nursing diagnosis takes highest priority for the client at this time? A. Hopelessness B. Ineffective individual coping C. Personal identity disturbance D. Potential for injury

D. Potential for injury

Which nursing diagnosis is most appropriate for a client with anorexia nervosa who expresses feelings of guilt about not meeting family expectations? A. Anxiety B. Defensive coping C. Disturbed body image D. Powerlessness

D. Powerlessness

A client states that she can't eat because her body melts when she swallows water. An appropriate nursing diagnosis would be one of the following: A. Altered thought process B. Impaired social interaction C. Ineffective individual coping D. Sensory perceptual disturbances

D. Sensory perceptual disturbances

An individual with depression has a deficiency in which neurotransmitters, based on the biogenic amine theory? A. Cortisone and epinephrine B. Dopamine and thyroxin C. GABA and acetylcholine D. Serotonin and norepinephrine

D. Serotonin and norepinephrine

All of the following are nursing diagnoses identified for a client with schizophrenia. The student nurse correctly anticipates which diagnosis will resolve when the client's negative symptoms improve? A. Disturbed thought processes B. Impaired verbal communication C. Risk for other-directed violence D. Social isolation

D. Social isolation

When teaching an adolescent health class about the dangers of inhalant abuse, the nurse warns about the possibility of: A. Contracting an infectious disease, such as hepatitis or AIDS B. Psychological dependence after initial use C. Recurrent flashback events D. Sudden death from cardiac or respiratory depression

D. Sudden death from cardiac or respiratory depression

A client with borderline personality disorder has a nursing diagnosis of Risk for self-directed violence, which is related to the client's self-mutilation behavior (burning arms with cigarettes). Which client behavior would indicate a positive outcome of intervention? A. The client denies feelings of wanting to harm anyone. B. The client expresses feelings of anger towards others. C. The client requests cigarettes at appropriate times. D. The client tells the nurse about wanting to burn herself.

D. The client tells the nurse about wanting to burn herself.

1A client diagnosed with anorexia nervosa has a nursing diagnosis of imbalanced nutrition: less than body requirements. Which long-term outcome indicates that the client's problem has improved? A. The client will be free of signs and symptoms of malnutrition and dehydration. B. The client will state an understanding of a previous dependency role by the 3-month follow-up appointment. C. The client will use one healthy coping mechanism during a time of stress by discharge. D. The client's body mass index will be 20 by the 6-month follow-up appointment.

D. The client's body mass index will be 20 by the 6-month follow-up appointment.

Which information is most essential in the initial teaching session for the family of a young adult recently diagnosed with schizophrenia? A. Genetic history is an important factor related to the development of schizophrenia. B. Schizophrenia is a serious disease affecting every aspect of a person's functioning. C. Symptoms of this disease imbalance in the brain. D. The distressing symptoms of this disorder can respond to treatment with medications.

D. The distressing symptoms of this disorder can respond to treatment with medications.

A nurse is evaluating therapy with the family of a client with anorexia nervosa. Which of the following would indicate that the therapy was successful? A. The client tells her parents about feelings of low-self-esteem. B. The client verbalizes that family meals are now enjoyable. C. The parents clearly verbalize their expectations for the client D. The parents reinforce increased decision making by the client

D. The parents reinforce increased decision making by the client

When a person first begins drinking alcohol, two drinks produce relaxation and drowsiness. After one year of drinking, four drinks are needed to achieve the same relaxed, drowsy state. Why does this change occur? A. Antagonistic effects occur. B. Hypomagnesemia develops. C. The alcohol is less potent. D. Tolerance develops.

D. Tolerance develops.

A client developed tolerance to CNS depressants. Which of the following is the correct interpretation of tolerance? A. Concurrence abuse of two different substances B. Continued use of a substance despite absence of life problems C. Need to increase the dose to obtain the desired effect D. Occurrence of physiologic symptoms when the drug is discontinued

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A nurse working in out-patient drug and alcohol clinic interviews an 18-year-olf client who was referred by her school guidance counselor. The client's history reveals that her father abandoned her at the age of 4 and she lives with her mother, older sister and sister's husband all of whom abuse alcohol and drugs. At age 16, she was raped at a party, became pregnant and gave the child for adoption. Her school counselor reports frequent failing grades and suspicion of drug use. Which factors in this client's life would the nurse identify as the most significant for increasing the client's vulnerability for substance abuse? A. Abandonment by father at an early stage B. Family history of substance abuse C. Poor school attendance and failing grades D. Trauma of rape and subsequent pregnancy

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The client tells the nurse that he hears the "voices" more frequently at night when it is quiet, and he is about to sleep. The nurse understands that this is because: A. Hallucinations occur more frequently when the client is not busy interacting with others or involved in activities B. Sleep is threatening because of the possibility of having nightmares and not waking up in the morning C. The client feels alone and depressed when he has nothing else to do D. The client is afraid to be alone at night

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The nurse assess a client in substance abuse unit for symptoms of alcohol withdrawal. Which of the following symptoms are common? Select all that apply. A. Agitation B. Bradycardia C. Decreased blood pressure D. Drowsiness C. Increased blood pressure D. Tachycardia

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The nurse understands that evaluating clients with personality disorder is especially difficult because: A. Nurses may reject these clients because of their irritating behaviors B. These clients are often withdrawn even after therapy and may not share results openly C. These clients improve rapidly and wish to move on with their lives D. Typically, few changes in these client's behavior may be identified overtime

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Understands that delirium is a cognitive impairment characterized by which factor? Select all that apply. A. Acute onset of disease B. Dramatic initial symptoms, such as acute confusion C. Gradual onset of disease D. Motor changes from agitation to somnolence E. Pacing and wandering, especially at night F. Subtle initial symptoms such as difficulty planning meals

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