Behavioral Health Nursing Practice Exam
Course Introduction
Behavioral Health Nursing explores the principles and practices involved in caring for individuals experiencing mental health challenges, emotional disorders, and behavioral issues across the lifespan. This course emphasizes the assessment, diagnosis, and evidence-based interventions for a range of psychiatric conditions, integrating therapeutic communication, crisis intervention, and psychosocial strategies. Students will develop skills to support patients and their families in diverse healthcare settings, understand the legal and ethical considerations in behavioral health, and collaborate effectively within interdisciplinary teams to promote mental wellness and recovery.
Recommended Textbook
Psychiatric Mental Health Nursing Concepts of Care in Evidence Based Practice 7th Edition by Mary
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Page 2
Chapter 1: The Concept of Stress Adaptation
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Q1) A nursing instructor is teaching about diseases of adaptation and when they are likely to occur. When questioned about situations that precipitate these diseases, which student statement indicates that learning has occurred?
A)"When an individual has limited experience dealing with stress"
B)"When an individual inherits maladaptive genes"
C)"When an individual experiences existing conditions that exacerbate stress"
D)"When an individual's physiological and psychological resources have become depleted"
Answer: D
Q2) Which symptom should a nurse identify as typical of the "fight-or-flight" response?
A)Pupil constriction
B)Increased heart rate
C)Increased salivation
D)Increased peristalsis
Answer: B
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3
Chapter 2: Mental Healthmental Illness: Historical and Theoretical Concepts
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Q1) Which should the nurse recognize as a DSM-IV-TR Axis II disorder?
A)Obesity
B)Major depressive disorder
C)Hypertension
D)Borderline personality disorder
Answer: D
Q2) Which should the nurse recognize as an example of the defense mechanism of repression?
A)A student aware of the need to study for tomorrow's test goes to a movie instead.
B)A woman whose son was killed in Iraq does not believe the military report.
C)A man who is unhappily married goes to school to become a marriage counselor.
D)A woman was raped when she was 12 and no longer remembers the incident.
Answer: D
Q3) Which is an example of the ego defense mechanism of regression?
A)A mother blames the teacher for her child's failure in school.
B)A teenager becomes hysterical after seeing a friend killed in a car accident.
C)A woman wants to marry a man exactly like her beloved father.
D)An adult throws a temper tantrum when he does not get his own way.
Answer: D
Page 4
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Chapter 3: Theoretical Models of Personality Development
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Q1) When assessing clients, a psychiatric nurse should understand that psychoanalytic theory is based on which underlying concept?
A)A possible genetic basis for the client problems
B)The structure and dynamics of the personality
C)Behavioral responses to stressors
D)Maladaptive cognitions
Answer: B
Q2) According to Peplau, treatment of client symptoms should involve which nursing action?
A)Establishing a therapeutic nurse-client relationship
B)Using the technique of desensitization
C)Challenging clients' negative thoughts
D)Uncovering clients' past experiences
Answer: A
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Chapter 4: Concepts of Psychobiology
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Q1) Which mental illness should a nurse identify as being associated with a decrease in prolactin hormone level?
A)Major depression
B)Schizophrenia
C)Anorexia nervosa
D)Alzheimer's disease
Q2) Which of the following information should a nurse include when explaining causes of anorexia nervosa to a client? (Select all that apply.)
A)There is a possible correlation between abnormal secretion of growth hormone and anorexia nervosa.
B)There is a possible correlation between antidiuretic hormone levels and anorexia nervosa.
C)There is a possible correlation between low levels of gonadotropin and anorexia nervosa.
D)There is a possible correlation between increased levels of prolactin and anorexia nervosa.
E)There is a possible correlation between altered levels of oxytocin and anorexia nervosa.
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6
Chapter 5: Ethical and Legal Issues in Psychiatricmental
Health Nursing
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Q1) In response to a student's question regarding choosing a psychiatric specialty, a charge nurse states, "Mentally ill clients need special care. If I were in that position, I'd want a caring nurse also." From which ethical framework is the charge nurse operating?
A)Kantianism
B)Christian ethics
C)Ethical egoism
D)Utilitarianism
Q2) An inpatient psychiatric physician refuses to treat clients without insurance and prematurely discharges those whose insurance benefits have expired. Which violation of an ethical principle should a nurse recognize in this situation?
A)Autonomy
B)Beneficence
C)Nonmaleficence
D)Justice
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Chapter 6: Cultural and Spiritual Concepts Relevant to Psychiatricmental Health Nursing
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Q1) To effectively care for Asian American clients, a nurse should be aware of which cultural norm?
A)Obesity and alcoholism are common problems.
B)Older people maintain positions of authority within the culture.
C)"Tai" and "chi" are the fundamental concepts of Asian health practices.
D)Asian Americans are likely to seek psychiatric help.
Q2) Which cultural considerations should a nurse identify with Western European Americans?
A)They are present-time oriented and perceive the future as God's will.
B)They value youth, and older adults are commonly placed in nursing homes.
C)They are at high risk for alcoholism due to a genetic predisposition.
D)They are future oriented and practice preventive health care.
Q3) A nurse is preparing to establish a therapeutic relationship with a grieving family from China. Which nursing intervention would be considered most appropriate?
A)Touch each member lightly as this enhances the communication process.
B)Direct questions to the young males of the family as they maintain positions of authority.
C)Avoid direct eye contact as it implies rudeness.
D)Remain objective and empathetic as Asians express feelings freely.
Page 8
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Chapter 7: Relationship Development
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Q1) On which task should a nurse place priority during the working phase of relationship development?
A)Establishing a contract for intervention
B)Examining feelings about working with a particular client
C)Establishing a plan for continuing aftercare
D)Promoting the client's insight and perception of reality
Q2) A nurse moving out of state speaks to a client about the need to work with a new nurse. The client states, "You're the only one who can make me well." What does this client response indicate to the nurse?
A)The client is using manipulation to receive secondary gain.
B)The client is using the defense mechanism of denial.
C)The client is having trouble terminating the relationship.
D)The client is using "splitting" as a way to remain dependent on the nurse.
Q3) What is the most essential task for a nurse to accomplish prior to forming a therapeutic relationship with a client?
A)To clarify personal attitudes, values, and beliefs
B)To obtain thorough assessment data
C)To determine the client's length of stay
D)To establish personal goals for the interaction
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Page 9
Chapter 8: Therapeutic Communication
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Q1) A student nurse is learning about the appropriate use of touch when communicating with clients diagnosed with psychiatric disorders. Which statement by the instructor best provides information about this aspect of therapeutic communication?
A)"Touch carries a different meaning for different individuals."
B)"Touch is often used when deescalating volatile client situations."
C)"Touch is used to convey interest and warmth."
D)"Touch is best combined with empathy when dealing with anxious clients."
Q2) During a nurse-client interaction, which nursing statement may belittle the client's feelings and concerns?
A)"Don't worry.Everything will be alright."
B)"You appear uptight."
C)"I notice you have bitten your nails to the quick."
D)"You are jumping to conclusions."
Q3) Which nursing response is an example of the nontherapeutic communication block of requesting an explanation?
A)"Can you tell me why you said that?"
B)"Keep your chin up.I'll explain the procedure to you."
C)"There is always an explanation for both good and bad behaviors."
D)"Are you not understanding the explanation I provided?"
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Page 10
Chapter 9: The Nursing Process in Psychiatricmental Health
Nursing
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Q1) During the implementation phase of the nursing process, a nurse is teaching an adult with a cochlear implant about medications. Which modification in the teaching plan would be the most appropriate for this client?
A)Using repetition
B)Speaking directly face-to-face
C)Employing the use of sign language
D)Providing large-print materials
Q2) Which data gathering technique is employed during the assessment phase of the nursing process?
A)Asking the client to rate mood after administering an antidepressant
B)Asking the client to verbalize understanding of previously explained unit rules
C)Asking the client to describe any thoughts of self-harm
D)Asking the client if the group on assertiveness skills was helpful
Q3) The nurse should recognize which acronym as representing problem-oriented charting?
A)SOAPIE
B)APIE
C)DAR
D)PQRST
11
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Chapter 10: Therapeutic Groups
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Q1) During an inpatient educational group, a client shouts out, "This information is worthless. Nothing you have said can help me." These statements indicate to the nurse leader that the client is assuming which group role?
A)The group role of aggressor
B)The group role of initiator
C)The group role of gatekeeper
D)The group role of blocker
Q2) During a therapeutic group, which nursing action demonstrates a laissez-faire leadership style?
A)The nurse mandates that all group members reveal an embarrassing personal situation.
B)The nurse asks for a show of hands to determine group topic preference.
C)The nurse sits silently as the group members stray from the assigned topic.
D)The nurse shuffles through papers to determine the facility policy on length of group.
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Chapter 11: Intervention With Families
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Q1) A clinic nurse is caring for a 40-year-old client who lives with his parents. The client's mother continues to do the client's laundry and provides spending money. Based on this situation, which family dynamic does the nurse recognize?
A)Taking over
B)Communicating indirectly
C)Belittling feelings
D)Making assumptions
Q2) A nursing instructor is teaching about the importance of healthy family member expectations for newly blended families. Which student statement indicates a need for further instruction?
A)"Healthy family member expectations should be flexible."
B)"Healthy family member expectations should be conforming."
C)"Healthy family member expectations should be individual."
D)"Healthy family member expectations should be realistic."
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13
Chapter 12: Milieu Therapy - the Therapeutic Community
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Q1) A nurse working on an inpatient psychiatric unit is assigned to conduct a 45-minute education group. What should the nurse identify as an appropriate group topic?
A)Dream analysis
B)Creative cooking
C)Paint by number
D)Stress management
Q2) A client has undergone psychological testing. With which member of the interdisciplinary team should a nurse collaborate to review these results?
A)The psychiatrist
B)The psychiatric social worker
C)The clinical psychologist
D)The clinical nurse specialist
Q3) In the role of milieu manager, which activity should the nurse prioritize?
A)Setting the schedule for the daily unit activities
B)Evaluating clients for medication effectiveness
C)Conducting therapeutic group sessions
D)Searching newly admitted clients for hazardous objects
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14
Chapter 13: Crisis Intervention
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Q1) Which of the following are effective interventions that a nurse should utilize when caring for an inpatient client who expresses anger inappropriately? (Select all that apply.)
A)Maintain a calm demeanor.
B)Clearly delineate the consequences of the behavior.
C)Use therapeutic touch to convey empathy.
D)Set limits on the behavior.
E)Teach the client to avoid "I" statements related to expression of feelings.
Q2) A college student who was nearly raped while jogging completes a series of appointments with a rape crisis nurse. At the final session, which client statement most clearly suggests that the goals of crisis intervention have been met?
A)"You've really been helpful.Can I count on you for continued support?"
B)"I work out in the college gym rather than jogging outdoors."
C)"I'm really glad I didn't go home.It would have been hard to come back."
D)"I carry mace when I jog.It makes me feel safe and secure."
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Chapter 14: Relaxation Therapy
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Q1) A nurse is teaching a client deep breathing exercises. The client asks, "Why do I need to make that funny shape with my lips when I breathe out?" What is the most appropriate nursing reply?
A)"You can actually exhale anyway you like; the lip shape is not important."
B)"Pursed lip breathing helps you control the exhalation and helps to keep your airways open."
C)"Don't worry about the lip shape; concentrate instead on the pace of your breathing."
D)"The shape of the lip decreases the cough and choking reflex."
Q2) Which response is known to be a physiological manifestation of relaxation?
A)Increased levels of norepinephrine
B)Pupil dilation
C)Reduced metabolic rate
D)Increased levels of blood sugar
Q3) Which should a nurse recognize as the reason that physical exercise is an effective relaxation technique?
A)Physical exercise stresses and strengthens the cardiovascular system.
B)Physical exercise decreases the metabolic rate.
C)Physical exercise decreases levels of norepinephrine in the brain.
D)Physical exercise provides a natural outlet for releasing muscle tension.
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Page 16
Chapter 15: Assertiveness Training
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Sample Questions
Q1) A nursing supervisor is scheduling holiday hours. When the supervisor tells the staff nurse that she needs to work Christmas day, the staff nurse calmly repeats, "I worked last Christmas and will not work this Christmas." This is an example of which assertive behavior technique?
A)Shifting from content to process
B)Standing up for one's basic rights
C)Responding as a broken record
D)Defusing
Q2) While trying to control aggressive behavior, a client asks an assertiveness training nurse to give an example of an "I statement." Which is an example of this assertive communication technique?
A)"I would like to know why you came home late without calling me."
B)"I hate it when you think you can just come home late without calling anyone to let them know where you are."
C)"I feel angry when you come home late without calling."
D)"I think you don't care about me, because if you did, you'd call me if you were planning on coming home late."
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Page 17
Chapter 16: Promoting Self Esteem
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Q1) A nurse is working in a nursing home. How best can this nurse foster self-esteem in the residents of this facility?
A)Allowing them to remain in their rooms as much as they desire to maintain privacy
B)Administering anti-anxiety medications as ordered
C)Providing a sense of mastery over their environment by giving choices when appropriate
D)Teaching assertiveness skills and self-esteem principles
Q2) The nurse is working with a 15-year-old client suffering from low self-esteem. Based on Erikson's psychosocial developmental theory, which factor has most probably influenced this client's self-esteem?
A)Regret over life choices
B)Lack of personal concern for others
C)Inconsistent, overly harsh, or absent parental discipline
D)Parental labeling of the child as "good" or "bad"
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Chapter 17: Angeraggression Management
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Q1) A student nurse has just entered a psychiatric rotation. The student asks a nursing instructor, "How will we know if someone may get violent?" Which is the most appropriate reply by the nursing instructor?
A)"You can't really say for sure.There are limited indicators of potential violence."
B)"Certain behaviors indicate a potential for violence.They are labeled as a 'prodromal syndrome' and include rigid posture, clenched fists, and raised voice."
C)"Any client can become violent, so it is best to be aware of your surroundings at all times."
D)"When a client suddenly becomes quiet, withdrawn, and maintains a flat affect, this is an indicator of potential violence."
Q2) Which risk factor should a nurse recognize as the most reliable indicator of potential client violence?
A)A diagnosis of schizotypal personality disorder
B)History of assaultive behavior
C)Family history of violence
D)Recent eviction from a homeless shelter
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Chapter 18: Intervention With a Suicidal Client
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Q1) A nursing student is developing a plan of care for a suicidal client. Which documented intervention should the student implement first?
A)Communicate therapeutically.
B)Observe the client.
C)Provide a hazard-free environment.
D)Assess suicide risk.
Q2) The treatment team is making a discharge decision regarding a previously suicidal client. Which client assessment information should a nurse recognize as contributing to the team's decision?
A)No previous admissions for major depressive disorder
B)Vital signs stable; no psychosis noted
C)Able to comply with medication regimen; able to problem-solve life issues
D)Able to participate in a plan for safety; family agrees to constant observation
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20
Chapter 19: Behavior Therapy
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Q1) A kindergarten rule states that if unacceptable behavior occurs, a child's personalized fish will be moved to the sea grass. Children who behave keep their fish out of the sea grass. The school nurse should identify this intervention as based on which principle of behavior therapy?
A)Classical conditioning
B)Conditioned response
C)Positive reinforcement
D)Negative reinforcement
Q2) An adolescent client was recently admitted to the psychiatric unit because of impulsivity and acting-out behavior at school. The nurse should initially implement which nursing action?
A)Redirect the client to activities to decrease stress.
B)Explain the unit rules and consequences of breaking the rules.
C)Place the client on close observation to insure a trusting relationship.
D)Administer an anti-anxiety medication.
Q3) Which assumption is most reflective of a behavioral theory model?
A)Mental illness is characterized by structural and biochemical alterations.
B)Thought processes influence behaviors.
C)All personality development has a social context.
D)There is a basic relationship between stimulus and response.
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Chapter 20: Cognitive Therapy
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Q1) When a client's husband comes home late from work, the wife immediately fears infidelity. The advanced practice nurse therapist encourages the wife to consider other explanations for her husband's tardiness. What technique is the nurse using?
A)Examination of the evidence
B)Decatastrophizing
C)Generating alternatives
D)Reattribution
Q2) A nurse practitioner uses cognitive therapy with depressed clients. The nurse asks clients to keep a daily record of dysfunctional thoughts. Which of the following are appropriate nursing replies to a client questioning the purpose of this exercise? (Select all that apply.)
A)"The purpose of this exercise is to identify automatic thoughts."
B)"The purpose of this exercise is to identify rational alternatives."
C)"The purpose of this exercise is to modify cognitive errors."
D)"The purpose of this exercise is to eliminate irrational beliefs."
E)"The purpose of this exercise is to monitor thoughts related to self-esteem."
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Chapter 21: Electroconvolusive Therapy
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Q1) A nurse should recognize that electroconvulsive therapy (ECT) would potentially improve the symptoms of clients with which of the following Axis I diagnoses? (Select all that apply.)
A)Major depressive disorder
B)Bipolar disorder: manic phase
C)Schizoaffective disorder
D)Obsessive-compulsive anxiety disorder
E)Body dysmorphic disorder
Q2) A client experienced bradycardia during electroconvulsive therapy (ECT) treatment. A nurse assigns a nursing diagnosis of decreased cardiac output R/T vagal stimulation occurring during ECT. Which outcome would the nurse expect the client to achieve?
A)The client will verbalize an understanding of the need for moving slowly after treatment.
B)The client will maintain an oxygen saturation level of 88% 1 hour after treatment.
C)The client will continue adequate tissue perfusion 1 hour after treatment.
D)The client will verbalize an understanding of common side effects of ECT.
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Chapter 22: Complementary Therapies
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Q1) A nursing student having no knowledge of alternative treatments states, "Aren't these therapies 'bogus' and, like a fad, will eventually fade away?" Which is an accurate nursing reply?
A)"Like nursing, complementary therapies take a holistic approach to healing."
B)"The American Nurses Association is researching the effectiveness of these therapies."
C)"It is important to remain nonjudgmental about these therapies."
D)"Alternative therapy concepts are rooted in psychoanalysis."
Q2) A client has been taking 1,200 mg/day of St. John's wort during the past year for symptoms of depression. Recently, the client complains of side effects from this herbal remedy. What symptom should the nurse expect the client to report?
A)Photosensitivity
B)Insomnia
C)Hirsutism
D)Restlessness
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24
Chapter 23: Disorders Usually First Diagnosed in Infancy,
Childhood, or Adolescence
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Q1) A preschool child diagnosed with autistic disorder has been engaging in constant head-banging behavior. Which nursing intervention is appropriate?
A)Place client in restraints until the aggression subsides.
B)Sedate the client with neuroleptic medications.
C)Hold client's head steady and apply a helmet.
D)Distract the client with a variety of games and puzzles.
Q2) A nurse has taken report for the evening shift on an adolescent inpatient unit. Which client should the nurse address first?
A)A client diagnosed with oppositional defiant disorder being sexually inappropriate with staff
B)A client diagnosed with conduct disorder who is verbally abusing a peer in the milieu
C)A client diagnosed with conduct disorder who is demanding special attention from staff
D)A client diagnosed with attention deficit disorder who has a history of self-mutilation
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Chapter 24: Delirium, Dementia, and Amnestic Disorders
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Q1) After 1 week of continuous mental confusion, an elderly African American client is admitted with a preliminary diagnosis of Alzheimer's dementia. What should cause the nurse to question this diagnosis?
A)Alzheimer's dementia does not typically occur in African American clients.
B)The symptoms presented are more indicative of Parkinsonism.
C)Alzheimer's dementia does not develop suddenly.
D)There has been no T3 or T4 level evaluation ordered.
Q2) A client diagnosed with vascular dementia is discharged to home under the care of his wife. Which information should cause the nurse to question the client's safety?
A)His wife works from home in telecommunication.
B)The client has worked the night shift his entire career.
C)His wife has minimal family support.
D)The client smokes one pack of cigarettes per day.
Q3) A client diagnosed with dementia is disoriented, ataxic, and wanders. Which is the priority nursing diagnosis?
A)Disturbed thought processes
B)Self-care deficit
C)Risk for injury
D)Altered health-care maintenance
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Page 26
Chapter 25: Substance-Related Disorders
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Q1) Which is the priority nursing intervention for a client admitted for acute alcohol intoxication?
A)Darken the room to reduce stimuli in order to prevent seizures.
B)Assess aggressive behaviors in order to intervene to prevent injury to self or others.
C)Administer lorazepam (Ativan) to reduce the rebound effects on the central nervous system.
D)Teach the negative effects of alcohol on the body.
Q2) What should be the priority nursing diagnosis for a client experiencing alcohol withdrawal?
A)Risk for injury R/T central nervous system stimulation
B)Disturbed thought processes R/T tactile hallucinations
C)Ineffective coping R/T powerlessness over alcohol use
D)Ineffective denial R/T continued alcohol use despite negative consequences
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Chapter 26: Schizophrenia and Other Psychotic Disorders
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Q1) A nurse is assessing a client diagnosed with paranoid schizophrenia. The nurse asks the client, "Do you receive special messages from certain sources, such as the television or radio?" Which potential symptom of this disorder is the nurse assessing?
A)Thought insertion
B)Paranoid delusions
C)Magical thinking
D)Delusions of reference
Q2) During an admission assessment, a nurse asks a client diagnosed with schizophrenia, "Have you ever felt that certain objects or persons have control over your behavior?" The nurse is assessing for which type of thought disruption?
A)Delusions of persecution
B)Delusions of influence
C)Delusions of reference
D)Delusions of grandeur
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28
Chapter 27: Mood Diorders: Depression
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Q1) Which client statement expresses a typical underlying feeling of clients diagnosed with major depressive disorder?
A)"It's just a matter of time and I will be well."
B)"If I ignore these feelings, they will go away."
C)"I can fight these feelings and overcome this disorder."
D)"I deserve to feel this way."
Q2) A client is prescribed phenelzine (Nardil). Which of the following client statements should indicate to a nurse that discharge teaching about this medication has been successful? (Select all that apply.)
A)"I'll have to let my surgeon know about this medication before I have my cholecystectomy."
B)"Guess I will have to give up my glass of red wine with dinner."
C)"I'll have to be very careful about reading food and medication labels."
D)"I'm going to miss my caffeinated coffee in the morning."
E)"I'll be sure not to stop this medication abruptly."
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Chapter 28: Mood Disorders: Bipolar Disorder
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Q1) The inpatient psychiatric unit is being redecorated. At a unit meeting, staff discuss bedroom décor for clients experiencing mania. The nurse manager evaluates which suggestion as most appropriate?
A)Rooms should contain extra-large windows with views of the street.
B)Rooms should contain brightly colored walls with printed drapes.
C)Rooms should be painted deep colors and located close to the nurse's station.
D)Rooms should be painted with neutral colors and contain pale-colored accessories.
Q2) A newly admitted client is experiencing the manic phase of bipolar I disorder. The nurse should assign which priority nursing diagnosis to this client?
A)Ineffective individual coping R/T hospitalization AEB alcohol abuse
B)Altered nutrition: less than body requirements R/T mania AEB 10 lb weight loss
C)Risk for violence: directed toward others R/T agitation and hyperactivity
D)Sleep pattern disturbance R/T flight of ideas AEB sleeps 1 to 2 hours per night
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Chapter 29: Anxiety Disorders
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Q1) A college student has been diagnosed with generalized anxiety disorder (GAD). Which of the following symptoms should a campus nurse expect this client to exhibit? (Select all that apply.)
A)Fatigue
B)Anorexia
C)Hyperventilation
D)Insomnia
E)Irritability
Q2) A college student is unable to take a final examination due to severe test anxiety. Instead of studying, the student relieves stress by attending a movie. Which priority nursing diagnosis should a campus nurse assign for this client?
A)Noncompliance R/T test taking
B)Ineffective role performance R/T helplessness
C)Altered coping R/T anxiety
D)Powerlessness R/T fear
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Chapter 30: Somatoform and Disassociative Disorders
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Q1) Which of the following combinations of somatoform disorder diagnoses and appropriate pharmacological treatment are correctly matched? (Select all that apply.)
A)Pain disorder treated with venlafaxine (Effexor)
B)Hypochondriasis treated with cefadroxil (Duricef)
C)Conversion disorder treated with cyclobenzaprine (Flexeril)
D)Body dysmorphic disorder treated with clomipramine (Anafranil)
E)Depersonalization treated with mometasone (Elocom)
Q2) A nursing instructor is teaching about the etiology of hypochondriasis from a psychoanalytical perspective. What student statement about clients diagnosed with this disorder indicates that learning has occurred?
A)"They express personal worthlessness through physical symptoms because physical problems are more acceptable than psychological problems."
B)"When the sick role relieves them from stressful situations, their physical symptoms are reinforced."
C)"They misinterpret and cognitively distort their physical symptoms."
D)"They tend to have a familial predisposition to this disorder."
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Chapter 31: Issues Related to Human Sexuality and Gender
Identity
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Q1) A recently widowed client reports a fear of intimacy due to an inability to achieve and sustain an erection. He has become isolative, has difficulty sleeping, and has recently lost weight. Which correctly written nursing diagnosis should be prioritized for this client?
A)Risk for situational low self-esteem AEB inability to achieve an erection
B)Sexual dysfunction R/T dysfunctional grieving AEB inability to experience orgasm
C)Social isolation R/T low self-esteem AEB refusing to engage in dating activities
D)Disturbed body image R/T penile flaccidity AEB client statements
Q2) Which of the following characteristics should a nurse identify as "normal" in the development of human sexuality for an 11-year-old child? (Select all that apply.)
A)The child experiments with masturbation.
B)The child may experience homosexual play.
C)The child shows little interest in the opposite sex.
D)The child shows little concern about physical attractiveness.
E)The child is unlikely to want to undress in front of others.
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Page 33
Chapter 32: Eating Disorders
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Q1) A client's altered body image is evidenced by claims of "feeling fat" even though the client is emaciated. Which is the appropriate outcome criterion for this client's problem?
A)The client will consume adequate calories to sustain normal weight.
B)The client will cease strenuous exercise programs.
C)The client will perceive an ideal body weight and shape as normal.
D)The client will not express a preoccupation with food.
Q2) A nurse working with a client diagnosed with bulimia nervosa asks the client to recall a time in life when food could be consumed without purging. Which is the purpose of this nursing intervention?
A)To gain additional information about the progression of the disease process
B)To emphasize that the client is capable of consuming food without purging
C)To incorporate specific foods into the meal plan to reflect pleasant memories
D)To assist the client to become more compliant with the treatment plan
Q3) Why are behavior modification programs the treatment of choice for clients diagnosed with eating disorders?
A)These programs help clients correct distorted body image.
B)These programs address underlying client anger.
C)These programs help clients manage uncontrollable behaviors.
D)These programs allow clients to maintain control.
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Page 34
Chapter 33: Adjustment and Impulse Control Disorders
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Q1) A client has been extremely nervous ever since a person died as a result of the client's drunk driving. When assessing for the diagnosis of adjustment disorder, within what timeframe should the nurse expect the client to exhibit these symptoms?
A)To meet the DSM-IV criteria for adjustment disorder, the client should exhibit symptoms within 1 year of the accident.
B)To meet the DSM-IV criteria for adjustment disorder, the client should exhibit symptoms within 3 months of the accident.
C)To meet the DSM-IV criteria for adjustment disorder, the client should exhibit symptoms within 6 months of the accident.
D)To meet the DSM-IV criteria for adjustment disorder, the client should exhibit symptoms within 9 months of the accident.
Q2) A client is diagnosed with intermittent explosive disorder. The clinic nurse should anticipate teaching about which medication?
A)Citalopram (Celexa)
B)Risperidone (Risperdal)
C)Fluvoxamine (Luvox)
D)Isocarboxazid (Marplan)
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Chapter 34: Personality Disorders
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Questions
Q1) Which reaction to a compliment from another client should a nurse identify as a typical response from a client diagnosed with avoidant personality disorder?
A)Interpreting the compliment as a secret code used to increase personal power
B)Feeling the compliment was well deserved
C)Being grateful for the compliment but fearing later rejection and humiliation
D)Wondering what deep meaning and purpose are attached to the compliment
Q2) A client diagnosed with paranoid personality disorder becomes violent on a unit. Which nursing intervention is most appropriate?
A)Provide objective evidence, that violence is unwarranted.
B)Initially restrain the client to maintain safety.
C)Use clear, calm statements and a confident physical stance.
D)Empathize with the client's paranoid perceptions.
Q3) Which nursing diagnosis should a nurse identify as appropriate when working with a client diagnosed with schizoid personality disorder?
A)Altered thought processes R/T increased stress
B)Risk for suicide R/T loneliness
C)Risk for violence: directed toward others R/T paranoid thinking
D)Social isolation R/T inability to relate to others
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Chapter 35: The Aging Individual
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Q1) A son who recently brought his extremely confused parent to a nursing home for admission reports feelings of guilt. Which is the appropriate nursing reply?
A)"Support groups are held here on Mondays for children of residents in similar situations."
B)"You did what you had to do.I wouldn't feel guilty if I were you."
C)"Support groups are available to low-income families."
D)"Your parent is doing just fine.We'll take very good care of him."
Q2) According to the U.S. Census Bureau criteria, how would a nurse classify a 70-year-old man?
A)This man would be classified as "older."
B)This man would be classified as "elderly."
C)This man would be classified as "aged."
D)This man would be classified as "very old."
Q3) Which psychiatric disorder would a nurse expect to see diagnosed in a client's later life?
A)Schizophrenia
B)Major depressive disorder
C)Phobic disorder
D)Dependent personality disorder
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Page 37
Chapter 36: Victims of Abuse or Neglect
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Q1) A woman describes a history of physical and emotional abuse in intimate relationships. Which additional factor should a nurse suspect?
A)The woman may be exhibiting a controlled response pattern.
B)The woman may have a history of childhood neglect.
C)The woman may be exhibiting codependent characteristics.
D)The woman might be a victim of incest.
Q2) A college student was sexually assaulted when out on a date. After several weeks of crisis intervention therapy, which client statement should indicate to a nurse that the student is handling this situation in a healthy manner?
A)"I know that it was not my fault."
B)"My boyfriend has trouble controlling his sexual urges."
C)"If I don't put myself in a dating situation, I won't be at risk."
D)"Next time I will think twice about wearing a sexy dress."
Q3) Which assessment data should a school nurse recognize as signs of physical neglect?
A)The child is often absent from school and seems apathetic and tired.
B)The child is very insecure and has poor self-esteem.
C)The child has multiple bruises on various body parts.
D)The child has sophisticated knowledge of sexual behaviors.
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Page 38
Chapter 37: Community Mental Health Nursing
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Q1) A 27-year-old client was diagnosed 5 years ago with schizophrenia. What course of treatment should the nurse expect to be implemented?
A)Eventual admission for long-term care in a psychiatric facility
B)Community-based care with numerous brief hospitalizations
C)Case management in the community with few relapses
D)Occasional contact with outpatient counselors and psychiatrists
Q2) A client on the inpatient unit tells a student nurse, "My life has no purpose. I can't think about living another day, but please don't tell anyone about the way I feel. I know you are obligated to protect my confidentiality." Which is the most appropriate reply by the student nurse?
A)"The treatment team is composed of many specialists who are working to improve your ability to function.Sharing this information with the team is critical to your care."
B)"Let's discuss steps that will resolve negative lifestyle choices that may increase your suicidal risk."
C)"You seem to be preoccupied with self.You should concentrate on hope for the future."
D)"This information is secure with me because of client confidentiality."
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Chapter 38: Forensic Nursing
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Q1) Which inmate statement to the prison nurse describes the circumstances that have contributed to recidivism among the prison population?
A)"I was high on crack when I blew him away."
B)"I never finished high school."
C)"My upbringing was nonexistent."
D)"I'm a product of the foster care system."
Q2) A prison nurse is reviewing an inmate's health record. Which documentation on Axis I would indicate a dual diagnosis?
A)Bipolar II and antisocial personality disorder
B)Schizophrenia and alcohol dependence
C)Attention deficit disorder and conduct disorder
D)Cocaine addiction and marijuana abuse
Q3) A sexual assault nurse examiner (SANE) is called to examine a college student who reports a date rape. What should be the priority nursing intervention?
A)Take samples of potential evidence.
B)Ensure medical stabilization.
C)Take pictures of the wounds.
D)Call law enforcement officials to report the rape.
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Chapter 39: The Bereaved Individual
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Q1) An instructor is teaching nursing students about Worden's grief process. According to Worden, which of the following client behaviors would delay or prolong the grieving process? (Select all that apply.)
A)Refusing to allow self to think painful thoughts
B)Indulging in the pain of loss
C)Using alcohol and drugs
D)Idealizing the object of loss
E)Recognizing that time will heal
Q2) Which is the most accurate description of the nursing diagnosis of dysfunctional grieving?
A)Inability to form a valid appraisal of a loss and failure to use available resources
B)The experience of distress, accompanying sadness which fails to follow norms
C)A perceived lack of control over a current situation involving loss
D)Aloneness perceived as imposed by others and as a negative or threatening state
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