BSTRANDABLE NCLEX MENTAL HEALTH 1 OF 2
QUESTIONS AND ANSWERS LATEST UPDATE
2022/2023
A client is diagnosed with intermittent explosive disorder. The
... [Show More] clinic nurse should
anticipate teaching about which medication?
A. Citalopram (Celexa)
B. Risperidone (Risperdal)
C. Fluvoxamine (Luvox)
D. Isocarboxazid (Marplan) - ANS-ANS: B
An antipsychotic like Risperdal can be prescribed for intermittent explosive disorder.
An antidepressant is not the usual drug of choice for this disorder.
A nurse is caring for a client who is suspected of having the diagnosis of
trichotillomania. What condition must be ruled out prior to a definitive diagnosis of
this disorder?
A. Bipolar disorder
B. Alopecia areata
C. Post-traumatic stress disorder
D. Body dysmorphic disorder - ANS-ANS: B
Alopecia areata is a dermatological condition that, according to the DSM-IV
diagnostic criteria for trichotillomania, must be ruled out to establish this diagnosis.
A nursing instructor is teaching about the correlation between pathological gambling
and abnormalities in the neurotransmitter system. What statement by the nursing
student indicates that learning has occurred?
A. "Pathological gamblers present with decreased serotonin, increased
norepinephrine, and increased dopamine."
B. "Pathological gamblers present with increased serotonin, increased
norepinephrine, and increased dopamine."
C. "Pathological gamblers present with decreased serotonin, decreased
norepinephrine, and decreased dopamine."
D. "Pathological gamblers present with increased serotonin, decreased
norepinephrine, and decreased dopamine." - ANS-ANS: A
Serotonergic function is linked to behavioral initiation, inhibition, and aggression.
Noradrenergic function mediates arousal and detects novel and aversive stimuli.
Dopaminergic function is associated with reward and reinforcement mechanisms.
Thus, pathological gamblers present with decreased serotonin, increased
norepinephrine, and increased dopamine.
A 13-year-old client's father has recently been deployed to Afghanistan. Since
deployment, the client has begun to participate in isolative behaviors, truancy,
vandalism, and fighting. The pediatric nurse practitioner should identify this behavior
with which adjustment disorder?
A. An adjustment disorder with anxiety
B. An adjustment disorder with disturbance of conduct
C. An adjustment disorder with mixed disturbance of emotions and conduct
D. An adjustment disorder unspecified - ANS-ANS: C
The predominant features of an adjustment disorder with mixed disturbance of
emotions and conduct include symptoms of anxiety or depression as well as
behaviors to include violations of rights of others, truancy, vandalism, and fighting.
A client, who recently delivered a stillborn baby, has a diagnosis of adjustment
disorder unspecified. The nurse case manager should expect which client
presentation that is characteristic of this diagnosis?
A. The client worries continually and appears nervous and jittery.
B. The client complains of a depressed mood, is tearful, and feels hopeless.
C. The client is belligerent, violates the rights of others, and defaults on legal
responsibilities.
D. The client complains of many physical ailments, refuses to socialize, and quits her
job. - ANS-ANS: D
The diagnosis of adjustment disorder unspecified is assigned when the maladaptive
reaction is not consistent with any of the other categories. Manifestations may
include physical complaints, social withdrawal, or work or academic inhibition,
without significant depressed or anxious mood.
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. - ANS-ANS: B
According to the DSM-IV diagnostic criteria for adjustment disorders, the
development of emotional or behavioral symptoms in response to an identifiable
stressor occurs within 3 months of the onset of the stressor.
A 15-year-old who is angry about not being chosen as the basketball team's captain,
spray paints obscene words on the newly chosen captain's car. What information
would cause a school nurse to consider a diagnosis of intermittent explosive
disorder?
A. The destruction of property is grossly out of proportion to the precipitating factor.
B. The destruction of property is not a pattern of failure to resist aggressive impulses.
C. The teenager has a diagnosis of conduct disorder.
D. The teenager has previously been diagnosed with Tourette's syndrome. - ANSANS: A
The DSM-IV-TR criteria for the diagnosis of intermittent explosive disorder state that
several discrete episodes of destruction of property must occur, and the aggressive
episode can not be better accounted for by another mental disorder such as conduct
disorder or Tourette's syndrome. The degree of aggressiveness must be grossly out
of proportion to the precipitating factor.
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. - ANS-ANS: C
The DSM-IV-TR criteria for the diagnosis of kleptomania state that an individual
diagnosed with this disorder experiences a sense of tension before committing theft
and relief at the time of the theft. The theft cannot be committed as an act of anger or
vengeance, and the object stolen cannot be needed for personal use.
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