VP Test 1 EAQs

b

which feeling would the nurse anticipate a manic client with bipolar 1 disorder is likely experiencing? a) guilt b) grandeur c) worthlessness d) self-deprecation

d

a client with bipolar disorder, depressed episode, displays an increase in depression over the past month. which behavior is expected? a) elated affect b) loose associations c) physical exhaustion d) slowed thought processes

d

to determine the effectiveness of therapy, which behavior would the nurse assess for in a client with generalized anxiety disorder? a) participating in activities b) learning how to avoid anxiety c) taking meds as prescribed d) recognizing when anxiety is developing

b

which finding would the nurse observe in a client with conversion disorder who is unable to move the right arm? a) feeling depressed b) appearing composed c) demonstrating free-floating anxiety d) exhibiting tension when discussing symptoms

c

a young female client has an argument with her boyfriend. which defense mechanism is the client using when she complains that the hospital meals are always late and the food is terrible? a) projection b) dissociation c) displacement d) intellectualization

1,2,3,4,5,6

which side effect would the nurse monitor for when administering a SSRI? 1. anxiety 2. nausea 3. sedation 4. restlessness 5. suicidal ideation 6. increased energy level

d

to prevent or minimize client outbursts during group therapy, the nurse would understand that which emotion precedes anger and aggression? a) elation b) isolation c) depression d) vulnerability

3,5

a client with depression presents with feelings of sadness and is having difficulty sleeping. which additional S&S would the nurse monitor for? select all that apply. 1. rigidity with a narrowing of perception 2. alternating episodes of fatigue and high energy 3. diminished pleasure in activities 4. excessive socialization 5. alteration in appetite

a

a client has delusions and hallucinations and refers to himself as 'the man'. he tells the nurse, 'the man is bad.' which defense mechanism if the client demonstrating? a) dissociation b) splitting c) displacement d) identification

d

a client reports decreased appetite, insomnia, anhedonia, and feelings of worthlessness. his job performance and relationships have been affected. which question is the most important to assist the HCP in determining the diagnosis of this mood disorder? a) are you taking any prescribed meds? b) is there any family history of mental illness? c) are you having suicidal thoughts? d) when did the symptoms first start?

d

a client who was sexually assaulted decides to seek prosecution of the rapist. which action is a nursing responsibility? a) file the physical evidence b) contact the prosecutor c) testify against the rapist d) document client statements

b

a client with major depressive disorder is most likely to experience which feeling? a) hedonia b) isolation c) paranoia d) ambivalence

1,3,5

a depressed, suicidal client is most likely to verbalize which feelings? select all that apply. 1. helplessness 2. hypervigilance 3. isolation 4. indecisiveness 5. hopelessness 6. dominance

b

a primary HCP writes a prescription of 'restraints PRN' for a client who has a history of violent behavior. which action would the nurse take? a) ask the HCP to specify the type of restrain in the prescription b) notify the provider that PRN prescription for restraints are unacceptable c) implement the restraint prescription when the client begins to act out d) ensure that the entire staff is aware of the prescription for the restraints

a

a woman who gave birth to a second child 3 weeks age is depressed, crying, and having extreme difficulty caring for her children. which approach would the nurse take when the husband calls the women's health clinic and asks what he should do? a) telling him that his wife may be suffering from depression and needs emergency care b) letting him know that fatigue is expected and that his wife needs to take rest periods during the day c) reassuring him that his wife is experiencing postpartum blues that will lessen in several days d) advising him to make an appointment for his wife to see her HCP if the problem continues

d

a woman who is frequently physically abused says, 'It's my fault that my husband beats me.' which response would the nurse use? a) 'maybe, but it's likely that your husband is also at fault' b) 'I can't agree with that- no one should be beaten.' c)'tell me why you believe that you deserve to be beaten' d)'you say that it was your fault- help me understand that.'

d

a woman with bipolar disorder, manic episode, spent thousands of dollars on clothing and makeup; then she started going to bars every night and rarely sleeps or eats. which concept is the priority in planning care for this patient? a) mood and affect b) fatigue c) nutrition d) safety

1,4,5

according to Peplau's model of the nurse-client relationship, which behaviors would the nurse expect the client to do during the working phase of a therapeutic relationship? select all that apply. 1. initiate topics of discussion 2. focus the convo on the nurse 3. repress emotionally charged material 4. accept limits on unacceptable behavior 5. express emotions related to transference

d

an older client describes the current situation and then offers information that goes further and further off topic. which pattern of communication is the client using? a) perseveration b) thought blocking c) pressured speech d) tangential thinking

a

during an admission interview, a client is expansive and distractible and demonstrates a fragmented, pressured, non sequential pattern of speech. which communication technique would the nurse use? a) closed question b) active listening c) paraphrasing d) open-ended questions

c

for a client who has many self-inflicted nonlethal injuries over the preceding month, which level of suicidal behavior is demonstrated? a) threats b) ideation c) gestures d) attempts

b

during a mugging and robbery, a client sustained minor abrasions and contusions. based on the assessment findings, which action would the nurse do first? a) monitor the client for occult injury by performing serial assessments b) validate that anxiety is normal and have a family member stay with the client c) keep the auditory and visual stimuli in the client's environment to a minimum d) assign unlicensed assistive personnel to remain with the client to prevent falls

3,5

for a client who recently left her husband because of physical abuse, which behaviors indicate that the crisis intervention therapy has been successful? select all that apply. 1. cries frequently throughout the day 2. sleeps more than half the day 3. utilizes healthier coping skills 4. declines a referral to support services 5. describes the current situation realistically

1,2,3

for a client with bipolar disorder in the manic phase, which S&S are expected? select all that apply 1. irritability 2. grandiosity 3. pressured speech 4. thought blocking 5. psychomotor retardation

c

for a client with the diagnosis of major depression, which problem is the most common? a) loss of faith in God b) visual hallucinations c) decreased social interaction d) loss of family support

b

for a female sexual assault victim, which info is the most important to document? a) observations about the client's reaction to male staff members b) statements by the client about the sexual assault and the rapist c) info about the client's previous knowledge of the rapist d) summary of the client's description of the assault and the raptist

b

in the acute phase of bipolar disorder, manic episode, which biopsychosocial need is the priority? a) psychological b) physical c) intellectual d) relational

d

the nurse receives a telephone call from an adolescent who expresses suicidal ideations. which client response indicates that the nurse can safely terminate the call? a) the adolescent verbalizes a desire to terminate the convo b) the nurse's initial assessment of suicide risk is complete c) the adolescent repeats info that has already been discussed d) the adolescent formulates an action plan to control self-harm behaviors

c

the nurse says, 'let's see whether we both mean the same thing.' which communication technique is the nurse using? a) reflecting feelings b) making observations c) seeking consensual validation d) placing events in sequence

a

when managing the care of an acutely depressed client, which approach would demonstrate that the nurse recognizes the client's fundamental mental health need? a) role modeling a hopeful attitude regarding life and the future b) sharing that life has presented depressing situations for all of us at times c) devoting time with the client while focusing on happy, positive memories d) identifying the client's personal weaknesses to design interventions to strengthen them

1,4,5

which S&S would the nurse find in a client who is in the depressive phase of bipolar I disorder? select all that apply 1. apathy 2. hyperactivity 3. flight of ideas 4. loss of appetite 5. sleep disturbances

d

which S&S would the nurse observe in a client with bipolar disorder, depressed episode? a) elated affect related to reaction formation b) loose associations related to a thought disorder c) physical exhaustion related to decreased physical activity d) paucity of verbal expression related to slowed thought processes

d

which action is most essential for the nurse to effectively respond to victims who call the rape crisis center for help? a) get full contact info from the caller b) assess what took place during the assault c) know myths and facts about sexual assault d) be aware of personal bias about sexual assault

b

which action would the nurse take for a client who is admitted with conversion disorder? a) talk about the physical problems b) explore ways to verbalize feelings c) explain how stress caused the physical symptoms d) focus on the client's concerns regarding the symptoms

a

which action would the nurse take when a newly admitted client with an OCD disorder frequently performs a hand-washing ritual? a) allow the client sufficient time to carry out the ritual b) promote reality by showing that the ritual serves little purpose c) try to ascertain the meaning of the ritual by discussing it with the client d) interrupt the ritual to demonstrate that the ritual does not control what happens

c

which action would the nurse take when the language of a client in the manic phase of a bipolar disorder becomes vulgar and profane? a) state, "We don't like that kind of talk around here." b) ignore it because the client is using it to gain attention c) recognize that the behavior is part of the illness, but set limits on it d) respond, "We'll talk with you when you can speak in an acceptable way"

2,3,4,6

which actions would the nurse take to assist an aggressive client in deescalating the agitated behavior? select all that apply. 1. offer physical touch to show caring 2. encourage the client to express perceived needs 3. avoid verbal struggles in an attempt to demonstrate authority 4. provide the client with clear options to the unacceptable behavior 5. refer to the client in an authoritarian manner to demonstrate control of the situation 6. explain the expected outcomes if the client is unable to control the unacceptable behavior

a

which approach would the nurse take for a client who was involved in a near-fatal automobile collision and arrives at the crisis center with reports of anxiety and flashbacks? a) focusing on the present b) identifying past stressors c) discussing a referral for psychotherapy d) exploring the client's history of mental health problems

1,5

which approaches would the nurse use during a crisis intervention interview. select all that apply. 1) active 2) passive 3) reflective 4) interpretive 5) goal directed

d

which aspect would nurses have difficulty dealing with when caring for a client with major depressive disorder? a) the client's lack of energy b) the negative nonverbal responses c) the client's psychomotor retardation d) the pervasive quality of the depression

a

which assessment finding would the nurse observe in a client with bipolar disorder, manic phase? a) constant singing b) ritualistic behavior c) flat affect d) apathetic demeanor

a

which behavior by the client would best indicate to the nurse a trusting relationship is beginning to develop with a client who has major depressive disorder? a) establishes eye contact with the nurse b) accompanies the nurse to the dining room c) responds to the nurse when asked a question d) permits the nurse to assist with dressing in the morning

b

which behavior indicates that a client who has bipolar disorder with episodes of mania has entered the working stage of the therapeutic nurse-client relationship? a) client identifies goals for the client-nurse interaction b) client explores the effect of bipolar behavior on the family c) client expresses ambivalence about meeting with the nurse d) client informs the nurse that other family members are bipolar

c

which behavior is anticipated for a client with a somatoform disorder? a) writes down conversations to retain info b) monopolizes convos to describe anxiety c) redirects conversations to physical symptoms d) starts conversations to learn about palliative care

d

which cause would the nurse conclude is the underlying reason a client with conversion disorder is unable to walk? a) nondisabling illness b) enjoyment of being sick c) loss of contact with reality d) result of intrapsychic conflict

1,5

which characteristics of affect are expected for a client with the diagnosis of somatoform disorder, conversion type? select all that apply. 1. calm 2. cheerful 3. depressed 4. frightened 5. matter-of-fact

b

which client education info would the nurse give to a client who has suicidal ideations and is recently prescribed a tricyclic antidepressant med to ease depression? a) aged cheese may cause a hypertensive crisis that could result in a stroke b) there may not be an noticeable improvement for 2-3 weeks or longer c) med must be taken with milk to avoid GI irritation d) blood specimens are required weekly for 3 months to monitor med levels

c

which client has the greatest risk for a completed suicide? a) young adult who is acutely psychotic b) adolescent who was recently sexually abused c) older single man diagnosed with pancreatic cancer d) middle-aged woman experiencing dysfunctional grieving

a

which client is displaying the use of cognitive distortion? a) a client with major depression says, "no matter what i do, everything turns out bad" b) a client with somatic disorder says, "can you feel my forehead? i think i have a fever" c) a school-aged child says, "I wet the bed last night. can you call my mom to come and get me?" d) an adolescent client says, "I might have tried drugs and drunk some alcohol, so what?"

1,3,4,5

which clinical findings are seen in anxiety disorders? select all that apply. 1. worrying about a variety of issues 2. acting out with antisocial behavior 3. converting the anxiety into a physical symptom 4. displacing the anxiety onto a less threatening object 5. decreased concentration and impaired problem-solving

2,3,4,5

which clinical manifestations would the nurse observe in an older client with major depressive disorder? select all that apply. 1. loss of memory 2. decreased appetite 3. neglect of personal hygiene 4. 'I don't know' answers to questions 5. 'I can't remember' answers to questions

b

which comorbid disorder is most commonly associated with GAD? a) PTSD b) major depressive disorder c) histrionic personality disorder d) primary hyperinsomnia

c

which defense mechanism is a client displaying when the client can no longer remember why an event was stressful, even though it happened just 3 days ago? a) denial b) regression c) repression d) dissociation

1,2,6

which descriptors would the nurse expect to hear from a client describing experiences of panic? select all that apply. 1. severe withdrawal 2. hallucinations or delusions 3. a decreased need for sleep 4. being more talkative than usual or feelings pressure to keep talking 5. flight of ideas or the subjective experience that thoughts are racing 6. feeling unreal (depersonalization) or that the world is unreal (derealization)

d

which factor is most important in predicting a person's reaction to imminent loss and grief? a) family interactions b) social support systems c) emotional relationships d) earlier experiences with grief

d

which factor would likely be the reason a woman with bipolar disorder, manic episode, rarely eats? a) feelings of guilt b) need to control others c) desire for punishment d) excessive physical activity

b

which feeling would be difficult for a client with major depression to express? a) need for comforting b) anger toward others c) remorse for past behaviors d) feelings of low self-esteem

1,2,4

which findings would support the nurse's conclusion that the depressed client is experiencing hopelessness? select all that apply. 1. bouts of crying 2. self-destructive acts 3. presence of delusions 4. feelings of worthlessness 5. intense interpersonal relationships

3,4,5

which info would support the nurse's decision to arrange for a staff member to remain with a depressed client continuously? 1. refusal to eat any food 2. inability to concentrate 3. agitated pacing in the hall 4. history of suicide attempts 5. statements that life is not worth living

a

which initial action would the nurse take for a depressed, suicidal client whose energy is returning and has been taking a mood-elevating med for several weeks? a) keep the client under close observation b) arrange for the client to have more visitors c) engage the client in preliminary discharge planning d) observe the client for side effects of the med

a

which initial behavior would the nurse help a client with major depressive disorder complete? a) develop rapport with the nurse b) investigate new leisure activities c) participate in small-group activities d) initiate conversations about feelings

1,2,3,5

which instructions would the nurse include regarding how to help prevent or identify impending relapse for a group of clients who experience bipolar disorder, manic episodes? select all that apply 1. watch for changes in libido 2. keep dietary changes to a minimum 3. maintain a regular sleeping schedule 4. plan multiple varied activities every day 5. monitor yourself for increased irritability or mood instability

c

which intervention is most important when helping clients resolve a crisis situation? a) encouraging socialization b) meeting dependency needs c) supporting coping behaviors d) suggesting a therapy group

2,3

which intervention would be included in the plan of care for a client with bipolar disorder? select all that apply 1. touch the client to provide reassurance 2. provide a structured environment for the client 3. ensure that the client's nutritional needs are met 4. engage the client in conversation about current affairs 5. design activities that require the client to maintain short-term memory

d

which intervention would the nurse add to the plan of care for a client who engages in ritualistic behavior? a) redirect the client's energy into activities to help others b) teach the client that the behavior is not serving a realistic purpose c) administer antianxiety meds that block out the memory of internal fears d) help the client understand that the behavior is caused by maladaptive coping with increased anxiety

c

which intervention would the nurse include in the plan of care for a client with PTSD who verbalizes a desire to have control over personal feelings related to being the only survivor? a) work on self-forgiveness b) explore specific feelings related to survivor guilt c) discuss life situations that the client is able to manage d) focus on the client's inability to limit escalating anxiety

d

which intervention would the nurse include when developing a plan of care for a client in the manic phase of bipolar disorder? a) focus the client's interest in reminiscing b) encourage the client to talk as much as needed c) persuade the client to complete any task that has been started d) redirect the client's excess energy to more constructive activities

d

which legal ramification would be indicated when a newly admitted male client with bipolar disorder who has a history of hyperactivity and combativeness is found later in the evening beating another client? a) the client should have been placed in restraints of admission b) keeping the client sedated is necessary for a client who is known to have been combative c) a client with bipolar disorder who is in contact with reality does not require supervision d) because it was known that the client was frequently combative, close observation by the nursing staff was indicated

b

which question is most important to ask a depressed client when assessing current risk of attempting suicide? a) "have you ever wanted to die?" b) "do you have a plan to end your life?" c) "do you have family or friends you can talk to?" d) "when was the last time you felt depressed?"

d

which response would the nurse make to a depressed client who asks, 'do you think they'll ever let me out of here'? a) we should ask your primary HCP b) everyone says you're doing fine c) do you think you're ready to leave? d) how do you feel about leaving here?

3,4

which safety intervention would the nurse include in a plan of care for a client with somatic disorder who reports loss of vision? select all that apply. 1. apply restrains 2. administer sedatives 3. put the call light within reach 4. orient the client to surroundings 5. use therapeutic communication

b

which strategy would the nurse use to help a depressed, withdrawn client who exhibits sadness through nonverbal behavior? a) increase structured physical activity b) cope with painful feelings by sharing them c) decide which unit activities the client can perform d) improve the ability to communicate with significant others

c

which supervised activity would be therapeutic for a client with bipolar disorder, manic episode, during the early phase of treatment? a) doing a needlepoint project b) joining a brief swimming competition c) walking around the facility with a nurse d) playing a board game with another client

c

which verbalization from a client with a dissociative identity disorder, who is to be discharged after a 2-week hospitalization, would indicate effectiveness of the short-term therapy? a) the ability to deal openly with feelings b) that many of the personalities can be ignored c) the need for long-term outpatient psychotherapy d) that the personalities serve no protective purpose