Exam Review

A nurse is discharging a client who was admitted for the treatment of alcohol withdrawal. Which of the following resources should the nurse recommend to the client?
A)
Reach to Recovery.
B)
A 12-step program.
C)
Al-Anon.
D)
Light therapy.
A nurse is caring for a client who has dementia and insists that a doll is their infant child. Which of the following behavioral management techniques should the nurse use when interacting with the client?
A)
Cognitive reframing.
B)
Thought stopping.
C)
Validation therapy.
D)
Operant conditioning.
A nurse in an acute care facility is assessing a client who has schizophrenia. The client states, "Walk tall broom short dog bell." The nurse should document the client's speech as which of the following speech patterns?
A)
Flight of ideas.
B)
Word salad.
C)
Neologisms.
D)
Clang associations.
A nurse in an urgent care clinic is caring for a school-age child who has several visible bruises. The child's parent states, "My partner got fired today and came home angry. I don't think this will happen again." Which of the following responses should the nurse make?
A)
"I agree with you. I'm sure this will never happen again."
B)
"This is awful. You should file charges against your partner."
C)
"This is clearly child endangerment. I will have to call the police."
D)
"I'd like to know more about what happened. Let's sit and talk."

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Exam Review

A nurse is conducting an admission assessment for a client who is experiencing a manic episode of bipolar disorder. Which of the following behaviors should the nurse expect? (Select all that apply)
(SATA)
A)
Grandiosity.
B)
Flight of ideas.
C)
Splitting.
D)
Hyperactivity.
E)
Withdrawal.
A nurse is preparing to teach a client who has major depressive disorder and is scheduled to undergo electroconvulsive therapy (ECT). Which of the following statements should the nurse include in the teaching?
A)
"ECT is contraindicated in clients who have psychotic symptoms."
B)
"ECT is delivered through electrodes attached to the head."
C)
"ECT cannot be administered to clients who have suicidal ideation."
D)
"ECT is conducted under regional anesthesia."
A nurse is creating a plan of care for a client who has panic disorder. Which of the following interventions should the nurse include?
A)
Encourage the client to attend group therapy sessions.
B)
Allow the client to choose scheduled daily activities.
C)
Use simple words to describe procedures to the client.
D)
Avoid discussing topics that can trigger a panic attack.
A nurse on a medical-surgical unit is caring for a client who tells the nurse about their intentions to harm an ex-partner. Which of the following actions is a legal duty of the nurse?
A)
Keep the client hospitalized until there is no longer a threat.
B)
Ensure the client's ex-partner is notified of the threat.
C)
Ask a friend or family member to monitor the client.
D)
Transfer the client to a mental health facility.

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Exam Review

A nurse on a mental health unit is planning a group therapy session about assertiveness training. For which of the following clients should the nurse recommend the training?
A)
A client who has new-onset depression.
B)
A client who is experiencing auditory hallucinations.
C)
A client who is experiencing mania.
D)
A client who has somatic symptom disorder.
A nurse is conducting a child maltreatment screening of a family who has a toddler. Which of the following findings should the nurse identify as an indicator of possible child neglect?
A)
The child has a history of jaw fractures.
B)
The child seems frightened of their parent.
C)
The child has had no immunization since birth.
D)
The child rocks back and forth continually.
A nurse is caring for a client who has bipolar disorder. The client says to the nurse, "Give me your pen to cut the pain out of my chest." The nurse should identify that the client is at risk for which of the following?
A)
Delusion.
B)
Hallucination.
C)
Attention-seeking behavior.
D)
Self-mutilation.
A nurse is creating a plan of care for a newly admitted client who has obsessive-compulsive disorder (OCD). Which of the following interventions should the nurse include?
A)
Use detailed explanations when providing education to the client.
B)
Maintain a stimulating environment for the client.
C)
Provide the client with a structured schedule of daily activities.
D)
Limit time for rituals to 30 minutes each day.

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Exam Review

A nurse is reviewing the medical records of a group of clients. For which of the following clients should the nurse implement seizure precautions?
A)
A client who is experiencing withdrawal from oxycodone.
B)
A client who is experiencing withdrawal from diazepam.
C)
A client who has a low lithium level.
D)
A client who has a low imipramine level.
A nurse is assessing a client who has delirium as a result of sepsis. Which of the following manifestations should the nurse expect? (Select all that apply.)
A)
Slow speech.
B)
Rapid mood changes.
C)
Hallucinations.
D)
Unaltered level of consciousness.
E)
Restlessness.
A home health nurse is caring for a client who reports feeling tired and being unable to grocery shop. Which of the following responses by the nurse is an example of therapeutic communication?
A)
"Have you thought about taking a sleeping pill?"
B)
"Your fatigue will pass, and everything will be just fine."
C)
"Do you have a family member who can assist you?"
D)
"Let's discuss how to get you the help you need."
A nurse is discussing discipline techniques with the parent of a preschooler. Which of the following statements by the parent indicates an understanding of time-out as a form of discipline?
A)
"I place my child in time-out for ten minutes when they misbehave."
B)
"I send my child to their room for the time-out period."
C)
"I make use of time-out."
D)
"I use a kitchen timer to mark the end of the time-out period."

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Exam Review

A nurse is administering an antidepressant medication to a client. The nurse should understand that which of the following is the major difference between selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs)?
A)
SSRIs are more effective in relieving manifestations.
B)
SSRIs produce a more sedative effect.
C)
TCAs are lethal in overdose.
D)
TCAs have fewer cardiovascular effects.
A nurse is admitting a client who has posttraumatic stress disorder (PTSD) to a community mental health facility. Which of the following manifestations should the nurse expect when completing the admission assessment?
A)
Decreased startle response to loud noises.
B)
Reports uninterrupted sleep of 10 to 12 hours each night.
C)
Reluctance to discuss the event that precipitated the distress.
D)
Reports feelings of acute distress that began 1 to 2 weeks ago.
A mental health nurse is providing preventive care for a group of clients in the community. Which of the following actions by the nurse demonstrates a secondary prevention strategy?
A)
Leading a group discussion with several clients who have schizophrenia and are dealing with tardive dyskinesia.
B)
Screening college students who demonstrate manifestations of depressive disorder.
C)
Training volunteers in an adult day care facility to communicate effectively with clients who have cognitive impairments.
D)
Teaching personal coping skills to a group of adults whose parents have Alzheimer's disease.
A nurse is caring for a client who has posttraumatic stress disorder (PTSD) after being physically assaulted. The client is unable to recall any details of the event. Which of the following defense mechanisms should the nurse recognize that the client is displaying?
A)
Dissociation.
B)
Rationalization.
C)
Undoing.
D)
Reaction formation.

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Exam Review

A nurse is caring for a 4-year-old child who has autism spectrum disorder. Which of the following behaviors should the nurse expect?
A)
Lack of eye contact.
B)
Inability to play quietly.
C)
Constant spinning of a toy.
D)
Withdrawal from physical contact.
E)
Repeated voicing in clothes.
A nurse is caring for a client who has a history of suicide attempts. Which of the following findings places the client at risk for another suicide attempt?
A)
Hallucinations.
B)
Depression.
C)
Delusions.
D)
Catatonia.
E)
Tinnitus.
A charge nurse is planning an in-service for newly licensed nurses on tort law in mental health care. Which of the following scenarios should the charge nurse provide as an example of an unintentional tort?
A)
A nurse did not clarify a client's prescription that was difficult to read, resulting in a medication error.
B)
A nurse posted private information on social media about a client who has a substance use disorder.
C)
A nurse placed a client in mechanical restraints without obtaining a prescription, resulting in injury.
D)
A nurse threatened a client with physical harm after the client became verbally abusive to staff members.
A nurse is assessing a client who reports using cocaine 1 hour ago. Which of the following findings should the nurse expect?
A)
Polyphagia.
B)
Fever.
C)
Bradycardia.
D)
Oliguria.

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