Exam Review
- The nurse is having feelings of judgement regarding a client's contributory behavior to an automobile accident that resulted in deaths. Which action would the nurse take?A)Letting the client know that he or she is now traumatized beyond repairB)Discussing the nurse's personal feelings with a peer or a counselorC)Acknowledging to the client the judgment regarding his or her contributory behaviorD)Sharing the client's horror and encouraging him or her to avoid thinking about it
- A client has just been diagnosed as having major depression. At which time would the nurse expect the client to be at highest risk for self- harm?A)Immediately after a family visitB)Approximately 2 weeks after starting antidepressant medicationC)During the first few days after admissionD)On the anniversary of significant life events in the client's life
- A client being discharged appears angry with the nurse when the nurse attempts to review discharge instructions with the client. The nurse can best assist the client in this stage of the relationship with which response?A)"We have to go over these instructions before you can go. Please try to listen."B)"You should be able to regulate your feelings better by now. Why are you angry?"C)"I can sense you are angry this morning. Tell me how you feel about being discharged today."D)"Would you rather not be discharged today?"
- A client being served in a busy inpatient psychiatric unit becomes very noisy and combative. The other clients are reporting the noise and that they are afraid that they will be hurt by the client. The nurse determines that the best course of action for all involved is to seclude the client until the client is able to regain control of his behavior. On which ethical principle did the nurse base this decision?A)DeontologyB)UtilitarianismC)NonmaleficenceD)Veracity
Exam Review
- Military veterans with mental issues often do not seek treatment. The nurse in a VA hospital knows which disorder is moderately higher in veterans than in the general population?A)Depressive disorderB)Bipolar disorderC)Obsessive-compulsive disorderD)Paranoid disorder
- A client is seen in the clinic with clinical manifestations of an inability to sit still and a rigid posture. As the nurse performs the assessment, which of these side effects would be correctly identified?A)Tardive dyskinesiaB)Neuroleptic malignant syndromeC)AkathisiaD)Dystonia
- A nurse is providing discharge instructions to a client who was hospitalized for a suicide attempt. Which information is included in the instructions?A)Get adequate sleep and eat healthy.B)When stressed, write down the emotions and reflect on them.C)Occasional use of alcohol during the holidays is acceptable.D)Join a local gym and visit the trainer twice per week.
- The nurse is assessing a 30-month-old child during a well-baby checkup. Which behaviors by the child would lead the nurse to suspect that the child has autism spectrum disorder? Select all that apply.(SATA)A)Thrives on changes in routineB)Does not like spontaneous playC)Makes few facial expressions toward othersD)Rarely makes eye contact with othersE)Answers questions verbally
Exam Review
- A pre-teen client has been considered a neighborhood bully for several years. Peers avoid him, and the mother says she cannot believe a thing he tells her. Recently, the client was observed shooting at several dogs with a pellet gun and setting fire to a vacant lot for the first time. A nurse would assess these behaviors as being most consistent with which disorder?A)oppositional defiant disorderB)pyromaniaC)defiance of authorityD)conduct disorder
- The client says to the nurse, "I know I can learn to cope with my family situation. By getting help here at the clinic, I'll be able to deal with them more effectively, and I won't be so stressed out all the time." This client is demonstrating a high level of which personal characteristic?A)ResilienceB)HardinessC)Self-efficacyD)Sense of belonging
- A client is showing no facial expression when engaging in a game with peers during an outing at a park. The nurse uses which term when documenting the client's affect?A)Broad affectB)Absent affectC)Restricted affectD)Flat affect
- The client tells the nurse, "I don't think you can help me. Every time I talk to you, I am reminded of my mother, and I hated her." The nurse should recognize this as:A)incongruence.B)confrontation.C)transference.D)countertransference.
Exam Review
- The client's family is questioning the nurse about bipolar disorder. Which statements about the etiology of bipolar disorder do most psychoanalytical theories subscribe to? Select all that apply.A)Acetylcholine seems to be implicated in mania.B)Norepinephrine levels may be increased in mania.C)The id takes over the ego and acts as an undisciplined hedonistic being (child).D)Manic episodes are a "defense" against underlying depression.
- The nurse is assisting a child with attention deficit hyperactivity disorder (ADHD) to complete the child's activities of daily living. Which is the best approach for nurse to use with this child?A)Break tasks into small steps.B)Set a time limit to complete all tasks.C)Let the child complete tasks at the child's own pace.D)Offer rewards when all tasks are completed.
- Which client would most likely be mandated outpatient treatment?A)A client with schizophrenia who lives in a single family home with siblingsB)A homeless client who has been arrested for petty theft of groceries from a convenience store.C)A client who is addicted to alcohol who has two driving under the influence offensesD)A client with bipolar disorder who has quit three jobs in the last 6 months
- What is the primary difference between anorexia nervosa and bulimia nervosa?A)Clients who are anorexic are proud of their control over eating, and clients with bulimia are ashamed of their behavior.B)Anorexia has a psychological basis, whereas the cause of bulimia is biologic.C)There is no real difference between these two types of disorders.D)Bulimia can be life threatening, whereas anorexia is seldom so.
Exam Review
- A new graduate nurse has accepted a staff position at an inpatient mental health facility. The graduate nurse can expect to be responsible for basic-level functions, including...A)using effective communication skills.B)directing program development.C)providing clinical supervision.D)adjusting client medications.
- The client tells the nurse, "That new TV anchor is telling the world about me." This is an example of what type of thought processing?A)thought broadcastingB)persecutory delusionsC)ideas of referenceD)thought insertion
- In the psychiatric setting, what is the most effective intervention in preventing the hostile client's behavior from escalating to physical aggression?A)Getting as far away from him or her as possibleB)Engaging the hostile person in dialogueC)Ensuring that the client gets his or her wayD)Yelling at the client to settle down now
- The client states, "I can't go to group today. I have a very upset stomach this morning." Which would be the nurse's most appropriate response?A)"Okay, you can miss this time."B)"You aren't really feeling nauseous. It is part of your illness."C)"I know you don't feel well, but it's important for you to participate in therapy."D)"You have to go to group. The doctor has ordered it."
Exam Review
- A client with bipolar disorder has been taking lithium, and today the client's serum lithium level is 2.0 mEq/L. What effects would the nurse expect to see?A)None; the serum level is in therapeutic rangeB)Nausea, diarrhea, and confusionC)Fever, muscle rigidity, and disorientationD)Constipation and postural hypotension
- Which is the main reason why the periodic team meetings are important when caring for a client with antisocial personality?A)Team consistency is important to prevent manipulation by the client.B)The team needs to consider updating treatment recommendations as the client improves.C)Staff frustrations in caring for the client need to be processed.D)Rotating team members need to be apprised of the care planned for the client.
- A client has not been to work in three days. When she returns to work, she is wearing dark glasses. Facial and body bruises are visible. Her supervisor takes her to the occupational nurse. Which assessment is the priority for the nurse?A)physical injuriesB)coping mechanismsC)emotional distressD)psychological trauma
- Which questions would help the nurse to evaluate the effectiveness of antipsychotic medications for a client who has schizophrenia? Select all that apply.A)"Do you have access to community agencies that will help you to live successfully in this community?"B)"Are you satisfied with your quality of life?"C)"Are you committed to taking the medication as prescribed?"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?"