Evidence-Based Practice in Psychiatric Nursing Exam Solutions
Course Introduction
This course explores the principles and application of evidence-based practice within the field of psychiatric nursing. Students will learn to critically evaluate and integrate current research findings, clinical expertise, and patient values to inform decision-making and enhance patient outcomes in mental health settings. The curriculum covers methodologies for appraising evidence, implementing best practices, and measuring the impact of interventions. Ethical, cultural, and legal considerations specific to psychiatric care are also examined, equipping students with the knowledge and skills to deliver safe, effective, and compassionate care grounded in the latest scientific evidence.
Recommended Textbook
Psychiatric Mental Health Nursing Concepts of Care in Evidence Based Practice 7th Edition by Mary
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39 Chapters
857 Verified Questions
857 Flashcards
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Chapter 1: The Concept of Stress Adaptation
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18 Verified Questions
18 Flashcards
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Sample Questions
Q1) A distraught, single, first-time mother cries and says to a nurse, "How can I go to work if I can't afford childcare!" What is the nurse's initial action in assisting the client with the problem-solving process?
A)Determine the risks and benefits for each alternative
B)Formulate goals for resolution of the problem
C)Evaluate the outcome of the implemented alternative
D)Assess the facts of the situation
Answer: D
Q2) 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
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3
Chapter 2: Mental Healthmental Illness: Historical and Theoretical Concepts
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Sample Questions
Q1) 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
Q2) How is the DSM-IV-TR useful in the practice of psychiatric nursing? (Select all that apply.)
A)It considers level of functioning as well as problems.
B)It represents progress toward a more holistic view of mind-body.
C)It provides a framework for interdisciplinary communication.
D)It provides a template for nursing care plans.
E)It provides a framework for communication with the client.
Answer: A, B, C
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Page 4
Chapter 3: Theoretical Models of Personality Development
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Sample Questions
Q1) 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
Q2) A nurse observes a 3-year-old client willingly sharing candy with a sibling. According to Peplau, which psychological stage of development should the nurse determine that this child has completed?
A)"Learning to count on others"
B)"Learning to delay satisfaction"
C)"Identifying oneself"
D)"Developing skills in participation"
Answer: B
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5
Chapter 4: Concepts of Psychobiology
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Sample Questions
Q1) Which client statement reflects an understanding of the effect of circadian rhythms on psychopathology?
A)"When I dream about my mother's horrible train accident, I become hysterical."
B)"I get really irritable during my menstrual cycle."
C)"I'm a morning person.I get my best work done in the a.m."
D)"Every February, I tend to experience periods of sadness."
Q2) A nurse should recognize that a decrease in norepinephrine levels would play a significant role in which mental illness?
A)Mania
B)Schizophrenia
C)Anxiety
D)Depression
Q3) Which part of the nervous system should a nurse identify as playing a major role during stressful situations?
A)Peripheral nervous system
B)Somatic nervous system
C)Sympathetic nervous system
D)Parasympathetic nervous system
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Chapter 5: Ethical and Legal Issues in Psychiatricmental
Health Nursing
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Sample Questions
Q1) Which situation reflects the ethical principle of veracity?
A)A nurse provides a client with outpatient resources to benefit recovery.
B)A nurse refuses to give information to a physician who is not responsible for the client's care.
C)A nurse tricks a client into seclusion by asking the client to carry linen to the seclusion room.
D)A nurse treats all of the clients equally regardless of illness severity.
Q2) A client who will be receiving electroconvulsive therapy (ECT) must provide informed consent. Which situation should cause a nurse to question the validity of the informed consent?
A)The client is paranoid.
B)The client is 87 years old.
C)The client incorrectly reports his or her spouse's name, date, and time of day.
D)The client relies on his or her spouse to interpret the information.
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7
Chapter 6: Cultural and Spiritual Concepts Relevant to Psychiatricmental Health Nursing
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Sample Questions
Q1) 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.
Q2) Which cultural group is correctly matched with the disease process for which this group is most susceptible?
A)African Americans are susceptible to lactose intolerance.
B)Western European Americans are susceptible to malaria.
C)Arab Americans are susceptible to sickle cell disease.
D)Jewish Americans are susceptible to thalassemia.
Q3) A nurse should recognize that clients who have a history of missed or late medical appointments are most likely to come from which cultural group?
A)African Americans
B)Asian Americans
C)Native Americans
D)Jewish Americans
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Chapter 7: Relationship Development
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Sample Questions
Q1) According to Peplau, which nursing intervention is most appropriate when the nurse is functioning in the role of a surrogate?
A)The nurse functions as a nurturing parent in order to build a trusting relationship.
B)The nurse plays cards with a small group of clients.
C)The nurse discusses childhood events that may affect personality development.
D)The nurse provides a safe social environment.
Q2) Which client statement indicates that termination of the therapeutic nurse-client relationship has been handled successfully?
A)"I know I can count on you for continued support."
B)"I am looking forward to discharge, but I am surprised that we will no longer work together."
C)"Reviewing the changes that have happened during our time together has helped me put things in perspective."
D)"I don't know how comfortable I will feel when talking to someone else."
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9
Chapter 8: Therapeutic Communication
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Sample Questions
Q1) A client's younger daughter is ignoring curfew. The client states, "I'm afraid she will get pregnant." The nurse responds, "Hang in there. Don't you think she has a lot to learn about life?" This is an example of which communication block?
A)Requesting an explanation
B)Belittling the client
C)Making stereotyped comments
D)Probing
Q2) A client diagnosed with dependant personality disorder states, "Do you think I should move from my parent's house and get a job?" Which nursing response is most appropriate?
A)"It would be best to do that in order to increase independence."
B)"Why would you want to leave a secure home?"
C)"Let's discuss and explore all of your options."
D)"I'm afraid you would feel very guilty leaving your parents."
Q3) When interviewing a client, which nonverbal behavior should a nurse employ?
A)Maintaining indirect eye contact with the client
B)Providing space by leaning back away from the client
C)Sitting squarely, facing the client
D)Maintaining open posture with arms and legs crossed
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Page 10
Chapter 9: The Nursing Process in Psychiatricmental Health
Nursing
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Sample Questions
Q1) A nurse charts "Verbalizes understanding of the side effects of Prozac." This is an example of which category of focused charting?
A)Data
B)Problem
C)Action
D)Response
Q2) The following clients are seen in the emergency department. The psychiatric unit has one remaining bed. The triage nurse should expect which client to be admitted?
A)The client who is experiencing tremors and has a need for medication adjustment
B)The client who is experiencing anxiety and a sad mood after separation from spouse
C)The client who is a single parent and hears voices stating, "Kill your infant son"
D)The client who argued with her boyfriend and inflicted a superficial cut on her arm
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11
Chapter 10: Therapeutic Groups
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Sample Questions
Q1) During a group session, which client statement demonstrates that the group has progressed to the middle, or working, phase of group development?
A)"It's hard for me to tell my story when I'm not sure about the reactions of others."
B)"I think Joe's Antabuse suggestion is a good one and might work for me."
C)"My situation is very complex, and I need professional, not peer, advice."
D)"I am really upset that you expect me to solve my own problems."
Q2) During a community meeting, a nurse encourages clients to present unit problems and discuss possible solutions. Which type of leadership style is the nurse demonstrating?
A)Democratic
B)Autocratic
C)Laissez-faire
D)Bureaucratic
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12
Chapter 11: Intervention With Families
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Sample Questions
Q1) 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."
Q2) A client is angry because her husband has forgotten their anniversary. The following week, the client is still unwilling to discuss this with her husband because she is afraid she will lose control. How should the nurse interpret this client's means of coping with anger?
A)Coping by attacking
B)Coping by surrendering
C)Coping by avoiding
D)Coping by belittling
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13
Chapter 12: Milieu Therapy - the Therapeutic Community
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Sample Questions
Q1) A nurse attends an interdisciplinary team meeting on an inpatient unit. Which of the following individuals are typically included as members of the interdisciplinary treatment team in psychiatry? (Select all that apply.)
A)Respiratory therapist and psychiatrist
B)Occupational therapist and psychologist
C)Recreational therapist and art therapist
D)Social worker and hospital volunteer
E)Mental health technician and chaplain
Q2) To promote self-reliance, how should a psychiatric nurse best conduct medication administration?
A)Encourage clients to request their medications at the appropriate times.
B)Refuse to administer medications unless clients request them at the appropriate times.
C)Allow the clients to determine appropriate medication times.
D)Take medications to the clients' bedside at the appropriate times.
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14
Chapter 13: Crisis Intervention
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Sample Questions
Q1) A wife brings her husband to an emergency department after an attempt to hang himself. He is a full-time student and works 8 hours at night to support his family. He states, "I can't function any longer under all this stress." Which type of crisis is the client experiencing?
A)Maturational/developmental crisis
B)Psychiatric emergency crisis
C)Anticipated life transition crisis
D)Traumatic stress crisis
Q2) A mother is concerned about her ability to perform in her new role. She is quite anxious and refuses to leave the postpartum unit. To offer effective client care, a nurse should recognize which information about this type of crisis?
A)This type of crisis is precipitated by unexpected external stressors.
B)This type of crisis is precipitated by preexisting psychopathology.
C)This type of crisis is precipitated by an acute response to an external situational stressor.
D)This type of crisis is precipitated by normal life-cycle transitions that overwhelm the client.
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Page 15
Chapter 14: Relaxation Therapy
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Sample Questions
Q1) 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
Q2) A client who has been undergoing stress management training asks a nurse how long practicing stress reduction should last. Which is the most appropriate nursing reply?
A)"Until this stressor has resolved."
B)"Usually it takes several months before stress is eliminated."
C)"Whenever you feel better, you can stop."
D)"Managing stress is a lifelong function."
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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16
Chapter 15: Assertiveness Training
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Sample Questions
Q1) Which best describes a nurse's use of assertive behavior?
A)When a nurse attempts to please others and apologizes for awkwardness in a new role
B)When a nurse becomes defensive and angry when peers offer suggestions for improvement
C)When a nurse has problems making decisions and has a tendency to procrastinate
D)When a nurse is open and direct when asked by the nurse manager to complete assignments
Q2) A nurse is caring for four clients. Which of the following clients should the nurse identify as most likely to experience difficulty in being assertive? (Select all that apply.)
A)A 20-year-old woman who was recently raped
B)A 69-year-old widow who is socially isolated
C)A 17-year-old boy with conduct disorder
D)A 45-year-old successful executive
E)A 50-year-old diagnosed with narcissistic personality disorder
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17
Chapter 16: Promoting Self Esteem
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Sample Questions
Q1) A home health nurse visits an 18-year-old client who lives with his mother. The client has been assessed as having low self-esteem. The nurse refers the client for individual counseling. During the next home visit, which assessed client behavior clearly indicates treatment success?
A)The client wants to buy a dog but has not yet asked his mother's permission.
B)The client asks his mother for permission to buy a dog.
C)The client tells his mother he plans to buy a dog.
D)The client buys a dog and hides it in the garage.
Q2) A 47-year-old mother of two has recently undergone a radical mastectomy. She refuses to see anyone and remains isolated and withdrawn. Which of the following may be relevant nursing diagnoses for this client? (Select all that apply.)
A)Disturbed body image
B)Situational low self-esteem
C)Ineffective coping
D)Altered thought processes
E)Altered sensory perception
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18
Chapter 17: Angeraggression Management
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Sample Questions
Q1) Which nursing approach is likely to be most therapeutic when dealing with a newly admitted, hostile, suspicious client?
A)Places hand on the client's shoulder and states, "I will help you to your room."
B)Slowly and matter-of-factly state, "I am your nurse and I will show you to your room."
C)Firmly set limits by stating, "If your behavior does not improve you will be secluded."
D)Smiles and states, "I am your nurse.When do you want to go to your room?"
Q2) How often should a nurse plan to observe a client who is in restraints?
A)At least every 5 minutes
B)Continually for the first hour
C)At least every 15 minutes
D)Every 2 hours
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Chapter 18: Intervention With a Suicidal Client
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Sample Questions
Q1) A nurse discovers a client's suicide note that details the time, place, and means to commit suicide. What should be the priority nursing intervention, and the rationale for this action?
A)Administering lorazepam (Ativan) prn because the client is angry about the discovery of the note
B)Establishing room restrictions because the client's threat is an attempt to manipulate the staff
C)Placing this client on one-to-one suicide precautions because the more specific the plan, the more likely the client will attempt suicide
D)Calling an emergency treatment team meeting because the client's threat must be addressed
Q2) After years of dialysis, an 84-year-old states, "I'm exhausted, depressed, and so over these attempts to keep me alive." Which question should the nurse ask the spouse when preparing a discharge plan of care?
A)"Has there been had any appetite or sleep changes?"
B)"How often is your spouse left alone?"
C)"Has your spouse been following a diet and exercise program consistently?"
D)"How would you characterize your relationship with your spouse?"
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Page 20
Chapter 19: Behavior Therapy
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Sample Questions
Q1) A client reports, "My friend panicked at the site of spiders. Her therapist used gradual exposure to spiders that initially made her increasingly more anxious." Which technique was the friend's therapist most likely using?
A)Extinction
B)Covert sensitization
C)Systematic desensitization
D)Reciprocal inhibition
Q2) A child always chooses to ask mother over father when seeking special privileges. The father is more apt to disagree than agree with the child's requests while the mother usually consents. The child's choice is the result of which component of operant conditioning?
A)Conditioned stimuli
B)Unconditioned stimuli
C)Aversive stimuli
D)Discriminative stimuli
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21
Chapter 20: Cognitive Therapy
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Sample Questions
Q1) An advanced practice nurse is counseling a client diagnosed with generalized anxiety disorder. The nurse plans to use activity scheduling to address this client's concerns. What is the purpose of this nursing intervention?
A)To identify important areas needing concentration during therapy
B)To increase self-esteem and decrease feelings of helplessness
C)To modify maladaptive behaviors by the use of role-play
D)To divert away from intrusive thoughts and depressive ruminations
Q2) A client states, "I keep having horrible nightmares about the car accident that killed my daughter. I shouldn't have taken her with me to the store." Using a cognitive approach, which nursing reply would be most therapeutic?
A)"Are other issues from your past affecting your ability to move on?"
B)"Describe your current feelings about your loss."
C)"Let's talk about something that will help you move on."
D)"Can anyone predict when a car accident will happen?"
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Chapter 21: Electroconvolusive Therapy
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Sample Questions
Q1) A client is scheduled for an initial treatment of electroconvulsive therapy (ECT). Which information should a nurse include when teaching about the potential side effects of this procedure?
A)"You may experience transient tangential thinking."
B)"You may experience some memory deficit surrounding the ECT."
C)"You may experience avolution for the remainder of the day."
D)"You may experience a higher risk for subsequent seizures."
Q2) A client who is learning about electroconvulsive therapy (ECT) treatment asks a nurse "Isn't this treatment dangerous?" Which is the most appropriate nursing reply?
A)"No, this treatment is side-effect free."
B)"There can be temporary paralysis but full functioning returns within 3 hours of treatment."
C)"There are some risks, but a thorough examination will determine your candidacy for ECT."
D)"Transient ischemic attacks (TIA) can occur but are rare."
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Chapter 22: Complementary Therapies
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Sample Questions
Q1) A client reports taking St. John's wort for depression. The client states, "I'm taking the recommended dose, but it seems like if two capsules are good, four would be better!" Which is an appropriate nursing reply?
A)"Herbal medicines are more likely to cause adverse reactions than prescription medications."
B)"Increasing the amount of herbal preparations can lead to overdose and toxicity."
C)"The FDA does not regulate herbal remedies, therefore ingredients are often unknown."
D)"Certain companies are better than others.Always buy a reputable brand."
Q2) A client is exhibiting short-term memory loss and has a slow capillary refill. Which herbal remedy would address this client's symptoms?
A)Ginkgo
B)Fennel
C)Passion flower
D)Black cohosh
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24
Chapter 23: Disorders Usually First Diagnosed in Infancy,
Childhood, or Adolescence
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Q1) Which nursing intervention related to self-care would be most appropriate for a teenager diagnosed with moderate mental retardation?
A)Meeting all of the client's self-care needs to avoid injury
B)Providing simple directions and praising client's independent self-care efforts
C)Avoiding interference with the client's self-care efforts in order to promote autonomy
D)Encouraging family to meet the client's self-care needs to promote bonding
Q2) Which behavioral approach should a nurse utilize when caring for children diagnosed with disruptive behavior disorders?
A)Involving parents in designing and implementing the treatment process
B)Reinforcing positive actions to encourage repetition of desired behaviors
C)Providing opportunities to learn appropriate peer interactions
D)Administering psychotropic medications to improve quality of life
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Chapter 24: Delirium, Dementia, and Amnestic Disorders
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Q1) A client is diagnosed with late-stage Alzheimer's dementia. To address the client's symptoms, which nursing intervention should take priority?
A)Improve cognitive status by encouraging involvement in social activities.
B)Decrease social isolation by providing group therapies.
C)Promote dignity by providing comfort, safety, and self-care measures.
D)Facilitate communication by providing assistive devices.
Q2) Which symptom should a nurse identify that would differentiate clients diagnosed with dementia disorders from clients diagnosed with amnesic disorders?
A)Dementia disorders involve disorientation that develops suddenly, whereas amnestic disorders develop more slowly.
B)Dementia disorders involve impairment of abstract thinking and judgment, whereas amnestic disorders do not.
C)Dementia disorders include the symptom of confabulation, whereas amnestic disorders do not include these symptoms.
D)Both dementia disorders and profound amnesia typically share the symptom of disorientation to place, time, and self.
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Chapter 25: Substance-Related Disorders
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Sample Questions
Q1) A client with a history of heavy alcohol use is brought to an emergency department (ED) by family members who state that the client has had nothing to drink in the last 24 hours. Which client symptom should the nurse immediate report to the ED physician?
A)Tactile hallucinations
B)Blood pressure of 180/100 mm Hg
C)Mood rating of 2/10 on numeric scale
D)Dehydration
Q2) A lonely, depressed divorcée has been self-medicating with cocaine for the past year. Which term should a nurse use to best describe this individual's situation?
A)The individual is experiencing psychological dependency.
B)The individual is experiencing physical dependency.
C)The individual is experiencing substance dependency.
D)The individual is experiencing social dependency.
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Chapter 26: Schizophrenia and Other Psychotic Disorders
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Q1) A client diagnosed with chronic schizophrenia presents in an emergency department (ED) with uncontrollable tongue movements, stiff neck, and difficulty swallowing. The nurse would expect the physician to recognize which condition and implement which treatment?
A)Neuroleptic malignant syndrome and treat by discontinuing antipsychotic medications
B)Agranulocytosis and treat by administration of clozapine (Clozaril)
C)Extrapyramidal symptoms and treat by administration of benztropine (Cogentin)
D)Tardive dyskinesia and treat by discontinuing antipsychotic medications
Q2) A client diagnosed with schizophrenia takes an antipsychotic agent daily. Which assessment finding should a nurse immediately report to the client's attending psychiatrist?
A)Respirations of 22 beats/minute
B)Weight gain of 8 pounds in 2 months
C)Temperature of 104S1U1P1\(\circ\)S1S1P0F (40S1U1P1\(\circ\)S1S1P0C)
D)Excessive salivation
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Chapter 27: Mood Diorders: Depression
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Q1) A client who has been taking fluvoxamine (Luvox) without significant improvement asks a nurse, "I heard about something called a monoamine oxidase inhibitor (MAOI). Can't my doctor add that to my medications?" Which is an appropriate nursing reply?
A)"This combination of drugs can lead to delirium tremens."
B)"A combination of an MAOI and Luvox can lead to a life-threatening hypertensive crisis."
C)"That's a good idea.There have been good results with the combination of these two drugs."
D)"The only disadvantage would be the exorbitant cost of the MAOI."
Q2) A client who has been taking buspirone (BuSpar) as prescribed for 2 days is close to discharge. Which statement indicates to the nurse that the client has an understanding of important discharge teaching?
A)"I cannot drink any alcohol with this medication."
B)"It is going to take 2 to 3 weeks in order for me to begin to feel better."
C)"This drug causes physical dependence and I need to strictly follow doctor's orders."
D)"I can't take this medication with food.It needs to be taken on an empty stomach."
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Chapter 28: Mood Disorders: Bipolar Disorder
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Q1) A newly admitted client is diagnosed with bipolar disorder: manic episode. Which symptom related to altered thought is the nurse most likely to assess?
A)Pacing
B)Flight of ideas
C)Liability of mood
D)Irritability
Q2) A client on an inpatient unit is diagnosed with bipolar disorder: manic phase. During a discussion in the dayroom about weekend activities, the client raises voice, becomes irritable, and insists that plans change. What should be the nurse's initial intervention?
A)Ask the group to take a vote on alternative weekend events.
B)Remind the client to quiet down or leave the dayroom.
C)Assist the client to move to a calmer location.
D)Discuss with the client impulse control problems.
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Chapter 29: Anxiety Disorders
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Sample
Questions
Q1) A client refuses to go on a cruise to the Bahamas with his spouse due to fearing that the cruise ship will sink and all will drown. Using a cognitive theory perspective, how should a nurse explain to the spouse the etiology of this fear?
A)"Your spouse may be unable to resolve internal conflicts which result in projected anxiety."
B)"Your spouse may be experiencing a distorted and unrealistic appraisal of the situation."
C)"Your spouse may have a genetic predisposition to overreacting to potential danger."
D)"Your spouse may have high levels of brain chemicals that may distort thinking."
Q2) How should a nurse best describe the major maladaptive client response to panic disorder?
A)Clients overuse medical care due to physical symptoms.
B)Clients use illegal drugs to ease symptoms.
C)Clients perceive having no control over life situations.
D)Clients develop compulsions to deal with anxiety.
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Chapter 30: Somatoform and Disassociative Disorders
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Sample Questions
Q1) An inpatient client is newly diagnosed with dissociative identity disorder (DID) stemming for severe childhood sexual abuse. Which nursing intervention takes priority?
A)Encourage exploration of sexual abuse
B)Encourage guided imagery
C)Establish trust and rapport
D)Administer antianxiety medications
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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Source URL: https://quizplus.com/quiz/79532
Sample Questions
Q1) A psychiatric nursing instructor is teaching about the psychological effects of the diagnosis of a sexually transmitted disease (STD). Which student statement indicates that further instruction is needed?
A)"STDs carry strong connotations of illicit sex and considerable social stigma."
B)"STDs can cause insanity."
C)"The diagnosis of HIV can generate hopelessness and helplessness."
D)"Antibiotics administered in the early stages can cure all STDs."
Q2) In the course of an assessment interview, a female client reveals a history of bisexual orientation. Which action should the nurse initially implement when working with this client?
A)Self-assess personal attitudes toward homosexuality.
B)Review client's possible childhood sexual abuse history.
C)Encourage discussion of aversion to heterosexual relationships.
D)Explore client's family history of homosexuality.
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33
Chapter 32: Eating Disorders
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Sample Questions
Q1) A client diagnosed with bulimia nervosa has been attending a mental health clinic for several months. Which factor should a nurse identify as an appropriate indicator of a positive client behavioral change?
A)The client gains 2 pounds in 1 week.
B)The client focuses conversations on nutritious food.
C)The client demonstrates healthy coping mechanisms that decrease anxiety.
D)The client verbalizes an understanding of the etiology of the disorder.
Q2) A nurse is seeing a client in an outpatient clinic for treatment of anorexia nervosa. Which is the most appropriate, correctly written short-term outcome for this client?
A)The client will use stress-reducing techniques to avoid purging.
B)The client will discuss chaos in personal life and be able to verbalize a link to purging.
C)The client will gain 2 pounds prior to the next weekly appointment.
D)The client will remain free of signs and symptoms of malnutrition and dehydration.
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Chapter 33: Adjustment and Impulse Control Disorders
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Sample Questions
Q1) During her aunt's wake, before a mother can stop her 4-year-old child, the child runs up to the casket. An appointment is made with a nurse practitioner when the child starts twisting and pulling out hair. Which nursing diagnosis should the nurse practitioner assign to this child?
A)Complicated grieving
B)Altered family processes
C)Ineffective coping
D)Body image disturbance
Q2) A client has discovered that her husband is having an affair with a neighbor. During a visit to the neighbor's home, the wife steals the neighbor's diamond ring from the kitchen windowsill. What information would cause a nurse to rule out a diagnosis of kleptomania?
A)The wife did not experience a sense of relief when she took the ring.
B)The wife did not experience a sense of tension immediately before stealing the ring.
C)The stealing was committed to express the wife's anger.
D)The ring is desired by the wife for her personal use.
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35
Chapter 34: Personality Disorders
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Sample Questions
Q1) During an assessment interview, a client diagnosed with antisocial personality disorder spits, curses, and refuses to answer questions. Which is the most appropriate nursing statement to address this behavior?
A)"You are very disrespectful.You need to learn to control yourself."
B)"I understand that you are angry, but this behavior will not be tolerated."
C)"What behaviors could you modify to improve this situation?"
D)"What anti-personality-disorder medications have helped you in the past?"
Q2) A highly emotional client presents at an outpatient clinic appointment wearing flamboyant attire, spiked heels, and theatrical makeup. Which personality disorder should a nurse associate with this assessment data?
A)Compulsive personality disorder
B)Schizotypal personality disorder
C)Histrionic personality disorder
D)Manic personality disorder
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Chapter 35: The Aging Individual
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Sample Questions
Q1) A couple resides in a long-term care facility. The husband is admitted to the psychiatric unit after physically abusing his wife. He states, "My wife is having an affair with a young man, and I want it investigated." Which is the appropriate nursing reply?
A)"Your wife is not having an affair.What makes you think that?"
B)"Why do you think that your wife is having an affair?"
C)"Your wife has told us that these thoughts have no basis in fact."
D)"I understand that you are upset.Let's talk about it."
Q2) A client diagnosed with middle-stage Alzheimer's dementia has difficulty communicating because of cognitive deterioration. Which nursing intervention is appropriate to improve communication?
A)Discourage attempts at verbal communication due to increased client frustration.
B)Increase the volume of the nurse's communication responses.
C)Verbalize the nurse's perception of the implied communication.
D)Encourage the client to communicate by writing.
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Chapter 36: Victims of Abuse or Neglect
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Sample Questions
Q1) A nursing student asks an emergency department nurse, "Why does a rapist use a weapon during the act of rape?" Which nursing reply is most accurate?
A)"A weapon is used to increase the victimizer's security."
B)"A weapon is used to inflict physical harm."
C)"A weapon is used to terrorize and subdue the victim."
D)"A weapon is used to mirror learned family behavior patterns."
Q2) A woman comes to an emergency department with a broken nose and multiple bruises after being beaten by her husband. She states, "The beatings have been getting worse, and I'm afraid that next time he might kill me." Which is the appropriate nursing reply?
A)"Leopards don't change their spots, and neither will he."
B)"There are things you can do to prevent him from losing control."
C)"Let's talk about your options so that you don't have to go home."
D)"Why don't we call the police so that they can confront your husband with his behavior?"
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38
Chapter 37: Community Mental Health Nursing
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Sample Questions
Q1) A homeless client comes to an emergency department reporting cough, night sweats, weight loss, and blood-tinged sputum. What disease that has recently become more prevalent among the homeless community should a nurse suspect?
A)Meningitis
B)Tuberculosis
C)Encephalopathy
D)Mononucleosis
Q2) Which of the following clients should a nurse recommend for a structured day program? (Select all that apply.)
A)An acutely suicidal teenager who has had three previous suicide attempts
B)A chronically mentally ill woman who has a history of medication noncompliance
C)An elderly individual with end-stage Alzheimer's disease
D)A depressed individual who is able to participate in a safety plan
E)A client who is hearing voices that tell the client to harm others
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Chapter 38: Forensic Nursing
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Sample Questions
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 forensic nurse assesses hesitation wounds on a client diagnosed with borderline personality disorder. What assessment data led to this conclusion?
A)Bruising in various stages of discoloration
B)Deep cuts exposing muscle tissue of the wrist
C)Superficial, sharp-force wounds on the lower part of the client's body
D)Vertical lacerations of the face
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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Sample Questions
Q1) 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
Q2) A teenager has recently lost a parent. Which grieving behavior should a school nurse expect when assessing this client?
A)Denial of personal mortality
B)Preoccupation with the loss
C)Clinging behaviors and personal insecurity
D)Acting-out behaviors, exhibited in aggression and defiance
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