Psychiatric Nursing Practice
Final Exam
Course Introduction
Psychiatric Nursing Practice explores the principles, theories, and therapeutic approaches used in caring for individuals with mental health disorders across the lifespan. The course emphasizes the development of clinical skills needed for assessment, diagnosis, intervention, and evaluation of patients experiencing psychological distress. Students gain knowledge of psychopathology, psychopharmacology, crisis intervention, therapeutic communication, and legal and ethical considerations within psychiatric nursing. Through a combination of classroom instruction and clinical experiences, learners develop competency in working collaboratively with interdisciplinary teams to promote mental health, recovery, and wellness in diverse patient populations.
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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Sample Questions
Q1) Which client statement should alert a nurse that a client may be responding maladaptively to stress?
A)"I've found that avoiding contact with others helps me cope."
B)"I really enjoy journaling; it's my private time."
C)"I signed up for a yoga class this week."
D)"I made an appointment to meet with a therapist."
Answer: A
Q2) An unemployed college graduate is experiencing severe anxiety over not finding a teaching position and has difficulty with independent problem solving. During a routine physical examination, the graduate confides in the clinic nurse. Which is the most appropriate nursing intervention?
A)Encourage the student to use the alternative coping mechanism of relaxation exercises.
B)Complete the problem-solving process for the client.
C)Work through the problem-solving process with the client.
D)Encourage the client to keep a journal.
Answer: C
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3
Chapter 2: Mental Healthmental Illness: Historical and Theoretical Concepts
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31 Flashcards
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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) A nurse is assessing a client who is experiencing occasional feelings of sadness because of the recent death of a beloved pet. The client's appetite, sleep patterns, and daily routine have not changed. How should the nurse interpret the client's behaviors?
A)The client's behaviors demonstrate mental illness in the form of depression.
B)The client's behaviors are extensive which indicates the presence of mental illness.
C)The client's behaviors are not congruent with cultural norms.
D)The client's behaviors demonstrate no functional impairment, indicating no mental illness.
Answer: D
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Chapter 3: Theoretical Models of Personality Development
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30 Flashcards
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Sample Questions
Q1) According to Freud, which statement should a nurse associate with predominance of the superego?
A)"No one is looking, so I will take three cigarettes from Mom's pack."
B)"I don't ever cheat on tests.It is wrong."
C)"If I skip school I will get in trouble and fail my test."
D)"Dad won't miss this little bit of vodka."
Answer: B
Q2) A 6-year-old boy uses his father's flashlight to explore his 3-year-old sister's genitalia. According to Freud, in which stage of psychosocial development should a nurse identify this behavior as normal?
A)Oral
B)Anal
C)Phallic
D)Latency
Answer: C
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Chapter 4: Concepts of Psychobiology
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Sample Questions
Q1) A depressed client states, "I have a chemical imbalance in my brain. I have no control over my behavior. Medications are my only hope to feel normal again." Which nursing response is appropriate?
A)"Medications only address biological factors.Environmental and interpersonal factors must also be considered."
B)"Because biological factors are the sole cause of depression, medications will improve your mood."
C)"Environmental factors have been shown to exert the most influence in the development of depression."
D)"Researchers have been unable to demonstrate a link between nature (biology and genetics) and nurture (environment)."
Q2) Which of the following symptoms should a nurse associate with increased levels of thyroid-stimulating hormone (TSH) in a newly admitted client? (Select all that apply.)
A)Depression
B)Fatigue
C)Increased libido
D)Mania
E)Hyperexcitability
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6
Chapter 5: Ethical and Legal Issues in Psychiatricmental
Health Nursing
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28 Verified Questions
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Sample Questions
Q1) Which client should a nurse identify as a potential candidate for involuntary commitment?
A)A client living under a bridge in a cardboard box
B)A client threatening to commit suicide
C)A client who never bathes and wears a wool hat in the summer
D)A client who eats waste out of a garbage can
Q2) The experience of being physically restrained can be traumatic. Which nursing intervention would best help the client deal with this experience?
A)Administering a tranquilizing medication before applying the restraints
B)Talking to the client at brief but regular intervals while the client is restrained
C)Decreasing stimuli by leaving the client alone most of the time
D)Checking on the client infrequently, in order to meet documentation requirements
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Chapter 6: Cultural and Spiritual Concepts Relevant to Psychiatricmental Health Nursing
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Sample Questions
Q1) A Latin American man refuses to acknowledge responsibility for hitting his wife, stating instead, "It's the man's job to keep his wife in line." Which cultural belief should a nurse associate with this client's behavior?
A)Families are male dominated with clear male-female role distinctions.
B)Religious tenets support the use of violence in a marital context.
C)The nuclear family is female dominated and the mother possesses ultimate authority.
D)Marriage dynamics are controlled by dominant females in the family.
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.
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8
Chapter 7: Relationship Development
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Sample Questions
Q1) 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.
Q2) A client diagnosed with paranoid schizophrenia becomes agitated when asked to play a game. The client responds, "Do you want to be my girlfriend?" Which nursing response is most appropriate?
A)"You are upset now.It would be best if you go to your room until you feel better."
B)"Remember, we have a professional relationship.Are you feeling uncomfortable?"
C)"We have discussed this before.I am not allowed to date clients."
D)"I think you should discuss your fantasies with your therapist."
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Chapter 8: Therapeutic Communication
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Sample Questions
Q1) Which therapeutic communication technique is being used in this nurse-client interaction? Client: "When I am anxious, the only thing that calms me down is alcohol."
Nurse: "Other than drinking, what alternatives have you explored to decrease anxiety?"
A)Reflecting
B)Making observations
C)Formulating a plan of action
D)Giving recognition
Q2) The nurse is interviewing a newly admitted psychiatric client. Which nursing statement is an example of offering a "general lead"?
A)"Do you know why you are here?"
B)"Are you feeling depressed or anxious?"
C)"Yes, I see.Go on."
D)"Can you chronologically order the events that led to your admission?"
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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Chapter 9: The Nursing Process in Psychiatricmental Health
Nursing
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Sample Questions
Q1) Which statement regarding nursing interventions should a nurse identify as accurate?
A)Nursing interventions are independent from the treatment team's goals.
B)Nursing interventions are solely directed by written physician orders.
C)Nursing interventions occur independently but in concert with overall treatment team goals.
D)Nursing interventions are standardized by policies and procedures.
Q2) What is the purpose when a nurse gathers client information?
A)It enables the nurse to modify client behaviors related to personality disorders.
B)It enables the nurse to make sound clinical judgments and plan appropriate client care.
C)It enables the nurse to prescribe the appropriate medications.
D)It enables the nurse to assign the appropriate Axis I diagnosis.
Q3) Which nursing diagnosis should a nurse identify as being correctly formulated?
A)Schizophrenia R/T biochemical alterations AEB altered thought
B)Self-care deficit: hygiene R/T altered thought as AEB disheveled appearance
C)Depressed mood R/T multiple life stressors
D)Developmental disability R/T early-onset schizophrenia AEB hallucinations
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Chapter 10: Therapeutic Groups
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22 Flashcards
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Sample Questions
Q1) A nursing instructor is teaching about psychodrama, a specialized type of therapeutic group. Which student statement indicates that further teaching is necessary?
A)"Psychodrama provides a safe setting in which to discuss painful issues."
B)"In psychodrama, the client is the protagonist."
C)"In psychodrama, the client observes actor interactions from the audience."
D)"Psychodrama facilitates resolution of interpersonal conflicts."
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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12
Chapter 11: Intervention With Families
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Sample Questions
Q1) During family counseling a husband states, "Every time my wife and I discuss child discipline, we get into shouting matches." The nurse instructs the couple to shout at each other for 2 weeks on Tuesdays and Thursdays for 30 minutes. What intervention is the nurse using?
A)Reframing
B)Restructuring the family
C)Expressive psychotherapy
D)Paradoxical intervention
Q2) A couple has been married for 20 years. They argue constantly, belittle feelings, and continuously contradict each other. During a therapy session, the nurse documents "Marital schism." What does the nurse mean by this documentation?
A)The couple has a compatible marriage relationship.
B)The husband has a dominant relationship over the wife.
C)The couple has an enmeshed relationship.
D)The couple has an incompatible marriage relationship.
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13
Chapter 12: Milieu Therapy - the Therapeutic Community
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12 Verified Questions
12 Flashcards
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Sample Questions
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 on an inpatient unit angrily states to a nurse, "Peter is not cleaning up after himself in the community bathroom. You need to address this problem." Which is the appropriate nursing response?
A)"I'll talk to Peter and present your concerns."
B)"Why are you overreacting to this issue?"
C)"You should bring this to the attention of your treatment team."
D)"I can see that you are angry.Let's discuss ways to approach Peter with your concerns."
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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Sample Questions
Q1) A despondent client who has recently lost her husband of 30 years tearfully states, "I'll feel a lot better if I sell my house and move away." Which nursing reply is most appropriate?
A)"I'm confident you know what's best for you."
B)"This may not be the best time for you to make such an important decision."
C)"Your children will be terribly disappointed."
D)"Tell me why you want to make this change."
Q2) A high school student has learned that she cannot graduate. Her boyfriend will be attending a college out of state that she planned to also attend. She is admitted to a psychiatric unit after overdosing on Tylenol. Which is the correctly written priority nursing diagnosis for this client?
A)Ineffective coping R/T situational crisis AEB powerlessness
B)Anxiety R/T fear of failure
C)Risk for self-directed violence R/T hopelessness
D)Risk for low self-esteem R/T loss events AEB suicidal ideations
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15
Chapter 14: Relaxation Therapy
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Sample Questions
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 positive physical benefit would relaxation provide for a client who has experienced stress-related asthma?
A)Decreased neurotransmitters
B)Decreased blood pressure
C)Increased oxygen saturation levels
D)Decreased alpha brain waves
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16
Chapter 15: Assertiveness Training
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23 Flashcards
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Sample Questions
Q1) A client is experiencing high stress. The client states, "My boss treats me like a doormat and thinks nothing of demanding frequent overtime." Which nursing intervention would be appropriate?
A)To incorporate the family support system into the clients plan of care
B)To teach thought reframing techniques
C)To encourage the client to seek other employment
D)To hold a group in which clients are encouraged to use "I" statements
Q2) Which is the most appropriate nursing reply when a client asks what is the goal and benefit of assertive skills training?
A)"It protects the client from others who express aggressive feelings."
B)"It gives reliable, expert information so that clients may correct faulty behaviors."
C)"It clarifies misperceptions that have caused clients to distort reality."
D)"It improves communication skills in order to improve interpersonal relationships."
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Chapter 16: Promoting Self Esteem
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Sample Questions
Q1) 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"
Q2) 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
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Chapter 17: Angeraggression Management
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Sample Questions
Q1) A nursing instructor is teaching about violence-intervention protocols. Which student statement would indicate the need for further instruction?
A)"Administering psychotropic medications can be a part of violence-intervention protocols."
B)"Soothing the client by stroking an arm or shoulder can be a part of violence-intervention protocols."
C)"Applying leather restraints can be a part of violence-intervention protocols."
D)"Calling for assistance is a part of violence-intervention protocols."
Q2) The client states, "I get into trouble because I respond violently without thinking. That usually gets me into a mess." Which nursing reply would be most therapeutic to address this client's problem?
A)"Everybody loses their temper.It's good that you know that about yourself."
B)"I'll bet you have some interesting stories to share about overreacting."
C)"Let's explore methods to help you stop and think before taking action."
D)"It's good that you are showing readiness for behavioral change."
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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) Which client data indicate that a suicidal client is participating in a plan for safety?
A)Compliance with antidepressant therapy
B)A mood rating of 9/10
C)Disclosing a plan for suicide to staff
D)Expressing feelings of hopelessness to nurse
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Chapter 19: Behavior Therapy
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Sample Questions
Q1) A nursing instructor is teaching about the behavior technique of modeling. When asked to give an example of this behavioral intervention, which student statement meets the learning objective?
A)"A child is first rewarded for using a spoon to eat and then rewarded for using a fork, and finally rewarded for cutting food with a knife."
B)"An adolescent imitates Dad by using and caring for tools appropriately."
C)"A client and therapist agree to conditions of therapy stating explicitly in writing the behavior change that is desired."
D)"A mother tells her child that television can be watched only after homework is completed."
Q2) A mother states, "You are old enough to clean your own bedroom." Later inspection finds the floor clear, but with everything stacked in a chair. The mother praises the child for clearing the floor. This is consistent with which technique of behavior modification?
A)Shaping
B)Extinction
C)Stimulus generalization
D)Reciprocal inhibition
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Chapter 20: Cognitive Therapy
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Sample Questions
Q1) A client is experiencing auditory hallucinations. Using a cognitive strategy, which should the nurse encourage the client to do?
A)"Try singing Happy Birthday until the voices are gone."
B)"Document what the voices are saying to note cause and effect."
C)"Try listening to music using headphones for distraction."
D)"Remind yourself that the voices are symptoms of your disease."
Q2) The director of nursing (DON) sets up a meeting with the newly appointed nurse manager who, to this point, has done an excellent job. The nurse manager anticipates job termination. What is the best description of the cognitive error being employed by the nurse manager?
A)Thinking from an "all-or-nothing" perspective
B)Always thinking the worst will occur without considering positive outcomes
C)Viewing only selected negative evidence while editing out positive aspects
D)Undervaluing the positive significance of an event
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22
Chapter 21: Electroconvolusive Therapy
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Sample Questions
Q1) 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."
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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23
Chapter 22: Complementary Therapies
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Sample Questions
Q1) A client who prefers to use St. John's wort and psychotherapy in lieu of antidepressant therapy asks for tips on using herbal remedies. Which teaching points should a nurse provide? (Select all that apply.)
A)Select a reputable brand.
B)Increasing dosage does not lead to improved effectiveness.
C)Monitor for adverse reactions.
D)Gradually increase dosage to gain maximum effect.
E)Most herbal remedies are best absorbed on an empty stomach.
Q2) A client inquires about the practice of therapeutic touch. Which nursing reply best explains the goal of this therapy?
A)"The goal is to improve circulation to the body by deep, circular massage."
B)"The goal is to re-pattern the body's energy field by the use of rhythmic hand motions."
C)"The goal is to improve breathing by increasing oxygen to the brain and body tissues."
D)"The goal is to decrease blood pressure by body toxin release."
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Chapter 23: Disorders Usually First Diagnosed in Infancy,
Childhood, or Adolescence
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Sample Questions
Q1) A child diagnosed with severe autistic disorder has the nursing diagnosis of disturbed personal identity. Which outcome would best address this client's diagnosis?
A)The client will name own body parts as separate from others by day 5.
B)The client will establish a means of communicating personal needs by discharge.
C)The client will initiate social interactions with caregivers by day 4.
D)The client will not harm self or others by discharge.
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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Sample Questions
Q1) 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
Q2) A geriatric nurse is teaching student nurses about the risk factors for the development of delirium in older adults. Which student statement indicates that learning has occurred?
A)"Taking multiple medications may lead to adverse interactions or toxicity."
B)"Age-related cognitive changes may lead to alterations in mental status."
C)"Lack of rigorous exercise may lead to decreased cerebral blood flow."
D)"Decreased social interaction may lead to profound isolation and psychosis."
Q3) Which symptom should a nurse identify that would differentiate clients diagnosed with dementia from clients diagnosed with mood disorders?
A)Altered sleep
B)Altered concentration
C)Impaired memory
D)Impaired psychomotor activity
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Page 26
Chapter 25: Substance-Related Disorders
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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 nurse holds the hand of a client who is withdrawing from alcohol. What is the nurse's rationale for this intervention?
A)To assess for emotional strength
B)To assess for Wernicke-Korsakoff syndrome
C)To assess for tachycardia
D)To assess for fine tremors
Q3) 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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Page 27
Chapter 26: Schizophrenia and Other Psychotic Disorders
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Sample Questions
Q1) During an admission assessment, a nurse notes that a client diagnosed with schizophrenia has allergies to penicillin, prochlorperazine (Compazine), and bee stings. Based on this assessment data, which antipsychotic medication would be contraindicated?
A)Haloperidol (Haldol), because it is used only in elderly patients
B)Clozapine (Clozaril), because of a cross-sensitivity to penicillin
C)Risperidone (Risperdal), because it exacerbates symptoms of depression
D)Thioridazine (Mellaril), because of cross-sensitivity among phenothiazines
Q2) A client has been recently admitted to an inpatient psychiatric unit. Which intervention should the nurse plan to use to reduce the client's focus on delusional thinking?
A)Present evidence that supports the reality of the situation
B)Focus on feelings suggested by the delusion
C)Address the delusion with logical explanations
D)Explore reasons why the client has the delusion
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28
Chapter 27: Mood Diorders: Depression
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Sample Questions
Q1) A newly admitted client diagnosed with major depressive disorder states, "I have never considered suicide." Later the client confides to the nurse about plans to end it all by medication overdose. What is the most helpful nursing reply?
A)"I'm glad you shared this.There is nothing to worry about.We will handle it together."
B)"Bringing this up is a very positive action on your part."
C)"We need to talk about the things you have to live for."
D)"I think you should consider all your options prior to taking this action."
Q2) A client diagnosed with major depressive disorder was raised in an excessively religiously based household. Which nursing intervention would be most appropriate to address this client's underlying problem?
A)Encourage the client to bring into awareness underlying sources of guilt.
B)Teach the client that religious beliefs should be put into perspective throughout the life span.
C)Confront the client with the irrational nature of the belief system.
D)Assist the client to modify his or her belief system in order to improve coping skills.
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29
Chapter 28: Mood Disorders: Bipolar Disorder
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Q1) 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
Q2) Which of the following instructions regarding lithium therapy should be included in a nurse's discharge teaching? (Select all that apply.)
A)Avoid excessive use of beverages containing caffeine.
B)Maintain a consistent sodium intake.
C)Consume at least 2,500 to 3,000 mL of fluid per day.
D)Restrict sodium content.
E)Restrict fluids to 1,500 mL per day.
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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 nurse has been caring for a client diagnosed with post-traumatic stress disorder. What short-term, realistic, correctly written outcome should be included in this client's plan of care?
A)The client will have no flashbacks.
B)The client will be able to feel a full range of emotions by discharge.
C)The client will not require zolpidem (Ambien) to obtain adequate sleep by discharge.
D)The client will refrain from discussing the traumatic event.
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Chapter 30: Somatoform and Disassociative Disorders
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Q1) A nurse is working with a client diagnosed with somatoform pain disorder. What predominant symptoms should a nurse expect to assess?
A)The client's predominant symptom focuses on discomfort in one or more anatomical sites.
B)The client's predominant symptom affects voluntary motor or sensory functioning.
C)The client's predominant symptom is the belief that the body is deformed or defective.
D)The client's predominant symptom is the preoccupation and fear of having a serious disease.
Q2) A client is exhibiting symptoms of generalized amnesia. Which of the following questions should the nurse ask to confirm this diagnosis? (Select all that apply.)
A)"Have you taken any new medications recently?"
B)"Have you recently traveled away from home?"
C)"Have you recently experienced any traumatic event?"
D)"Have you ever felt detached from your environment?"
E)"Have you had any history of memory problems?"
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Chapter 31: Issues Related to Human Sexuality and Gender
Identity
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Q1) A female client on an inpatient unit enters the day area for visiting hours dressed in a see-through blouse and wearing no undergarments. Which intervention should be a nurse's first priority?
A)Discuss with the client the inappropriateness of her attire.
B)Avoid addressing her attention-seeking behavior.
C)Lead the client back to her room and assist her to choose appropriate clothing.
D)Restrict client to room until visiting hours are over.
Q2) A client is diagnosed with female sexual aversion disorder. In addition to systematic desensitization techniques, which medication therapy could accompany this intervention?
A)Quetiapine (Seroquel)
B)Phenelzine (Nardil)
C)Amoxapine (Asendin)
D)Carbamazepine (Tegretol)
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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 group of nurses are discussing how food is used in their families and the effects this might have on their ability to work with clients diagnosed with eating disorders. Which of these nurses will probably be most effective with these clients?
A)The nurse who understands the importance of three balanced meals a day
B)The nurse who permits children to have dessert only after finishing the food on their plate
C)The nurse who refuses to engage in power struggles related to food consumption
D)The nurse who grew up poor and frequently did not have enough food to eat
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Chapter 33: Adjustment and Impulse Control Disorders
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Q1) 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.
Q2) Which individual would most likely be diagnosed with intermittent explosive disorder?
A)A client diagnosed with antisocial personality disorder who attacks the nursing staff
B)A client diagnosed with diabetes mellitus who has a history of multiple severe assaultive acts
C)A client diagnosed with schizophrenia who sets fires because of command hallucinations
D)A client diagnosed with alcohol dependence who severely beats wife while intoxicated
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Chapter 34: Personality Disorders
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Q1) The nurse should recognize which factors that distinguish personality disorders from psychosis?
A)Functioning is more limited in personality disorders than in psychosis.
B)Major disturbances of thought are absent in personality disorders.
C)Personality disordered clients require hospitalization more frequently.
D)Personality disorders do not affect family relationships as much as psychosis.
Q2) A nurse would expect a client diagnosed with schizotypal personality disorder to exhibit which characteristic?
A)The client keeps to self and has few, if any relationships.
B)The client has many brief but intense relationships.
C)The client experiences incorrect interpretations of external events.
D)The client exhibits lack of tender feelings toward others.
Q3) When planning care for clients diagnosed with personality disorders, what should be the anticipated treatment outcome?
A)To stabilize pathology with the correct combination of medications
B)To change the characteristics of the dysfunctional personality
C)To reduce inflexibility of personality traits that interfere with functioning and relationships
D)To decrease the prevalence of neurotransmitters at receptor sites
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Page 36
Chapter 35: The Aging Individual
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Q1) An elderly client is exhibiting symptoms of major depressive disorder. A physician is considering prescribing an antidepressant. Which physiological problem should make a nurse question this medication regime?
A)Altered cortical and intellectual functioning
B)Altered respiratory and gastrointestinal functioning
C)Altered liver and kidney functioning
D)Altered endocrine and immune system functioning
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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Q1) 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."
Q2) When planning care for women in abusive relationships, which of the following information is important for the nurse to consider? (Select all that apply.)
A)It often takes several attempts before a woman leaves an abusive situation.
B)Substance abuse is a common factor in abusive relationships.
C)Until children reach school age, they are usually not affected by parental discord.
D)Women in abusive relationships usually feel isolated and unsupported.
E)Economic factors rarely play a role in the decision to stay in abusive relationships.
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Chapter 37: Community Mental Health Nursing
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Q1) When intervening with a married couple experiencing relationship discord, which reflects a nursing intervention at the secondary level of prevention?
A)Teaching assertiveness skills in order to meet assessed needs
B)Supplying the couple with guidelines related to marital seminar leadership
C)Teaching the couple about various methods of birth control
D)Counseling the couple related to open and honest communication skills
Q2) A nurse is implementing care within the parameters of tertiary prevention. Which nursing action is an example of this type of care?
A)Teaching an adolescent about pregnancy prevention
B)Teaching a client the reportable side effects of a newly prescribed neuroleptic medication
C)Teaching a client to cook meals, make a grocery list, and establish a budget
D)Teaching a client about his or her new diagnosis of bipolar disorder
Q3) When a nurse attempts to provide health-care services to the homeless, what should be a realistic concern?
A)Most individuals who are homeless reject help.
B)Most individuals who are homeless are suspicious of anyone who offers help.
C)Most individuals who are homeless are proud and will often refuse charity.
D)Most individuals who are homeless relocate frequently.
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Page 39
Chapter 38: Forensic Nursing
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Q1) A prison nurse overhears an inmate state, "Hey man, can I catch a ride?" How should the nurse interpret this prison slang?
A)The inmate wants to get high and asks a friend to provide drugs.
B)The inmate wants to elope and asks a friend to provide transportation.
C)The inmate wants to play basketball and needs a friend for the team.
D)The inmate wants to bum a cigarette.
Q2) Why is it important for the forensic nurse to maintain a proper chain of evidence?
A)Maintaining a proper chain of evidence will exonerate the perpetrator.
B)Maintaining a proper chain of evidence will assist in gathering enough data for conviction.
C)All evidence, if properly maintained, will convict the assailant.
D)Crime data maintained with a proper chain of evidence can be used in a court of law.
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Chapter 39: The Bereaved Individual
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Q1) Which grieving behaviors should a nurse anticipate when caring for a Southwest Navajo Indian client?
A)Celebrating the life of a deceased person with festivities and revelry
B)Not expressing grief openly with reluctance to touch a dead body
C)Holding a prayerful vigil for a week following the person's death
D)Expressing grief openly and publicly and erecting an altar in the home to honor the dead
Q2) 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
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