Exam Review
- A nurse is admitting a client into an inpatient mental health facility.
Opioid Intoxication Stimulant Intoxication Hallucinogen Intoxication Speech ✓ Heart rate ✓ ✓ ✓ Pupils ✓ ✓ ✓ Blood pressure ✓ ✓ ✓ Tremors ✓ ✓ - A nurse in an emergency department is creating a plan of care for a client who reports experiencing intimate partner violence. Which of the following interventions should the nurse include as the priority?A)Refer the client to a support group.B)Teach the client stress-reduction techniques.C)Follow the facility’s protocol for reporting the abuse.D)Place the client in a private area to ensure safety.
- A nurse is providing teaching to the caregiver of an older adult client who has Alzheimer's disease and is being cared for at home. The client wanders at night and has a history of previous falls. Which of the following instructions should the nurse include in the teaching? (Select all that apply).(SATA)A)Place the client in a reclining chair.B)Put locks at the top of doors.C)Install sensor devices on outside doors.D)Position the mattress on the floor.E)Encourage physical activity prior to bedtime.
- A nurse is assessing a client who has alcohol use disorder and is experiencing withdrawal. Which of the following findings should the nurse expect?A)RhinorrheaB)HypotensionC)SeizuresD)Hyperglycemia
Exam Review
- A nurse is caring for an adolescent whose family has a very rigid system of rules. Which of the following characteristics should the nurse expect when observing the family?A)The family members make decisions based on compromise.B)The family members exhibit psychosomatic manifestations.C)The older children in the family take over parenting roles for younger children.D)The communication between family members is minimal.
- A nurse in an inpatient mental health facility observes a client who is becoming increasingly angry. Which of the following actions should the nurse take first?A)Administer a tranquilizing medication to calm the client down.B)Place the client in seclusion to prevent them from harming other clients.C)Walk with the client to help release energy.D)Ensure enough staff are available to assist if the client becomes violent.
- A nurse is caring for a client who has been receiving treatment for antisocial personality disorder. The nurse should identify that which of the following findings indicates the treatment is effective?A)The client verbalizes anger in an acceptable manner.B)The client displays dependent behaviors.C)The client manipulates others to increase self-worth.D)The client verbalizes a sense of personal identity.
- A nurse is caring for a client who is experiencing a crisis. Which of the following actions should the nurse take first?A)Teach the client about relaxation techniques.B)Advise the client to maintain their usual routines.C)Encourage the client to be transparent when communicating.D)Ask the client if they are experiencing thoughts of self-harm.
Exam Review
- A nurse is caring for a client in an inpatient mental health facility who has anorexia nervosa. The client declines treatment and reports wanting to be discharged. After notifying the provider, which of the following actions should the nurse take?A)Have the client sign a form to acknowledge they are leaving against medical advice.B)Tell the client that requests are not granted until case management approves.C)Place the client in restraints.D)Notify the client’s family members.
- A nurse is assessing a newly admitted client who has schizophrenia and takes thioridazine. Which of the following findings should the nurse document as an adverse effect of this medication?A)Waxy flexibilityB)Incongruent affectC)Contractions of the jawD)Anhedonia
- A nurse is preparing to administer methylphenidate 25 mg PO to a school-age child who has ADHD. Available is methylphenidate 10 mg/5 mL liquid. How many mL should the nurse administer? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)
- A nurse is providing teaching for a client who has alcohol use disorder. Which of the following statements should the nurse include in the teaching?A)You should take disulfiram to help with withdrawal symptoms.B)An early manifestation of alcohol withdrawal is tremors.C)There is not a known genetic predisposition for this disorder.D)Self-help groups are not effective for maintaining long-term sobriety.
Exam Review
- A nurse is caring for a client who is experiencing manifestations of alcohol withdrawal. Which of the following medications should the nurse plan to administer?A)MethadoneB)ClozapineC)LorazepamD)Bupropion
- A nurse is caring for a client who reports feelings of hopelessness after being diagnosed with a serious illness. Which of the following actions should the nurse take first?A)Document the client's concerns.B)Ask the client if they are having thoughts of self-harm.C)Assist the client in identifying their support system.D)Inform the client about ways to manage their feelings.
- A nurse on an inpatient mental health unit is teaching an adolescent client who has anorexia nervosa about relaxation techniques. Which of the following statements should the nurse make?A)"Imagine things that make you feel good."B)"Avoid writing down your feelings when you are experiencing stress."C)"Take shallow breaths to reduce feelings of stress."D)"Continue your previous exercise routine while on the unit."
- A case manager in a mental health facility is reviewing the medical records of a group of clients. Which of the following clients should the case manager identify as having the greatest risk of accident and injury?A)A client who has obsessive compulsive disorderB)A school-age child who has a tic disorderC)A client who has a gambling disorderD)An adolescent who has delirium
Exam Review
- A home care nurse is speaking with the adult child of a client who has Alzheimer’s disease and is having difficulty managing their parent’s wandering behavior at night. The nurse should instruct the client’s child to take which of the following actions?A)Install locks at the tops of doors.B)Administer phenobarbital 120 mg at bedtime.C)Encourage physical activity in the evening.D)Restrain the client at bedtime.
- A nurse is caring for a group of children in a clinic. Which of the following children should the nurse identify as being at an increased risk for child maltreatment?A)A preschooler whose parents report the child often says “no.”B)A school-age child whose parent has generalized anxiety disorder.C)An adolescent who requests contraception.D)A toddler who has cerebral palsy.
- A charge nurse on a mental health unit is preparing an in-service about client rights for staff members. Which of the following information should the nurse include?A)Clients can refuse to attend group therapy.B)Client withdrawal of prior consent must be done in writing.C)Clients who are violent can refuse chemical restraint.D)Clients who have a severe mental illness cannot request a psychiatric advance directive.
- A nurse is caring for a client who reports an inability to pay for their newly prescribed medications to treat bipolar disorder. The nurse should report this information to which member of the interprofessional team?A)Social workerB)Occupational therapistC)PsychologistD)Psychiatrist
Exam Review
- A nurse is preparing to administer medications to a newly admitted client who has bipolar disorder and is experiencing mania. Which of the following medications should the nurse plan to administer?A)Haloperidol 2.5 mg IM every 6 hr PRN agitationB)Lithium 600 mg PO three times per dayC)Aripiprazole 400 mg IM every 4 weeksD)Liraglutide 0.6 mg subcutaneously daily
- A nurse is caring for a group of clients at a mental health facility. Which of the following findings should the nurse identify as requiring completion of an incident report?A)A client who has obsessive-compulsive disorder and has washed their hands 20 times todayB)A client who states the staff is poisoning their foodC)A client who has an eating disorder and refuses to eat breakfast and lunchD)A client who did not receive their antipsychotic medication
- A nurse is caring for a client who is experiencing acute mania related to bipolar disorder. Which of the following actions should the nurse take?A)Provide the client with finger-foods throughout the day.B)Give the client coffee or caffeinated beverages.C)Keep the overhead lights on in the client's room.D)Encourage the client to participate in group activities.
- A nurse is reviewing a medication reference prior to administering fluoxetine to a client for the first time. Which of the following interventions should the nurse plan to implement?A)Monitor for changes in the client's mental status.B)Evaluate therapeutic results within 12 hr of administration.C)Observe the client for Chvostek sign.D)Administer ibuprofen to the client to treat elevated temperature.