At the first meeting of a group at a daycare center for older adults, the nurse asks one of the members what kinds of things the client would like to do wi... [Show More] th the group. The older adult shrugs and says, "You tell me. You're the leader." What would be the best response for the nurse to make?
A."Yes, I am the leader today. Would you like to be the leader tomorrow?"
B."Yes, I will be leading this group. What would you like to accomplish?"
C."Yes, I have been assigned to lead this group. I will be here for the next 6 weeks."
D. "Yes, I am the leader. You seem angry about not being the leader yourself." - ANS: B
Anxiety over participation in a group and testing of the leader characteristically occur in the initial phase of group dynamics. (B) provides information and refocuses the group to defining its function. (A) is manipulative bargaining. (C) does not focus the group on its purpose or task. (D) is interpreting the client's feelings and is almost challenging.
A client who is being treated with lithium carbonate for manic depression begins to develop diarrhea, vomiting, and drowsiness. Which action should the nurse take?
A. Notify the health care provider immediately and force fluids.
B. Prior to giving the next dose, notify the health care provider of these symptoms.
C. Record the symptoms and continue with medication as prescribed.
D. Hold the medication and refuse to administer additional doses. - ANS: B
Although these are expected symptoms, the health care provider should be notified prior to the next administration of the drug (B). Early side effects of lithium carbonate (occurring with serum lithium levels below 2 mEq/L) generally follow a progressive pattern, beginning with diarrhea, vomiting, drowsiness, and muscular weakness (C). At higher levels, ataxia, tinnitus, blurred vision, and large dilute urine output may occur. (A) will lower the lithium level. (D) is not warranted.
A woman brings her 48-year-old husband to the outpatient psychiatric unit and tells the nurse that he has been sleepwalking, cannot remember who he is, and exhibits multiple personalities. These behaviors are often associated with which condition?
A. Dissociative disorder
B. Obsessive-compulsive disorder
C. Panic disorder
D. Posttraumatic stress syndrome - ANS: A
Sleepwalking, amnesia, and multiple personalities are examples of detaching emotional conflict from one's consciousness (A). (B) is characterized by persistent, recurrent intrusive thoughts or urges (obsessions) that are unwilled and cannot be ignored and provoke impulsive acts (compulsions), such as constant and repeated hand washing. (C) is an acute attack of anxiety characterized by personality disorganization. (D) is reexperiencing a psychologically terrifying or distressing event that is outside the usual range of human experience such as war or rape.
During a home visit, a client with schizophrenia reports hearing voices that tell the client to walk in the middle of the street. The nurse records several statements made by the client. Based on which statement should the nurse determine that the client needs hospitalization?
A."Sometimes I take an extra one of my pills when I hear the voices."
B."The voices are louder when I forget to take my medication. "
C."No matter what I do, I cannot make the voices go away. "
D."I just try to tell the voices to stop when they bother me. " - ANS: C
Hospitalization is needed if the client continues to hear voices telling the client to do things that can cause self-harm (C). (A or B) do not require hospitalization unless symptoms become severe. The client should continue symptom management strategies (D) to prevent hospitalization.
An adult client who lives in a residential facility is mentally retarded and has a history of bipolar disorder. During the past week, the client has refused to wear clothes and frequently exposes their body to other residents. Which intervention should the nurse implement?
A. Establish a one-to-one relationship to discuss the behavior.
B. Redirect the client to physically demanding activities.
C. Encourage the client to verbalize thoughts when acting out.
D. Restrict social interactions with other residents in the facility. - ANS: B
The client is exhibiting manic behavior related to bipolar disorder, and the nurse should redirect the client to activities that are physically demanding (B) so that energy can be expended in a socially acceptable manner. Psychotic clients are not capable of (A). When exhibiting acting-out behavior, the client is distracted and (C) is difficult. (D) is likely to increase manic behaviors, such as mood swings and acting-out behaviors.
A client on the psychiatric unit seeks out a particular nurse and imitates her mannerisms. Which defense mechanism does the nurse recognize in this client?
A.Sublimation
B.Identification
C.Introjection
D.Repression - ANS: B
Identification (B) is an attempt to be like someone or emulate the personality traits of another. [Show Less]
