NUR 2212 PSYCH EAQ Questions and Answers
A team approach is used to help a 6-year-old boy with attention deficit-hyperactivity
disorder (ADHD). What
... [Show More] behaviors indicate that the interventions have been
effective? Select all that apply.
1
Is not inhibited by rules or routines
2
Has fun playing with toys by himself
Incorrect3
Is no longer enuretic during the night
Correct4
Has an increased attention span in school
Correct5
Is able to wait his turn when in line with others
A nurse is assigned to lead a relaxation group. Which techniques should the nurse
incorporate? Select all that apply.
Correct1
Meditation
Correct2
Mental imagery
3
Token economy
4
Operant conditioning
Correct5
Deep-breathing exercises
NUR 2212 PSYCH EAQ Questions and
Answers
How should a nurse characterize a sudden terrorist act that causes the deaths of
thousands of adults and children and negatively affects their families, friends,
communities, and the nation?
1
Recurring
2
Situational
Incorrect3
Maturational
Correct4
Adventitious
A nurse has just completed a mental status examination on a newly admitted
psychiatric client and returns to the nurses’ station to document the results. The
nurse reflects on the client’s drawn-out explanation of the reason for the admission
and concludes that excessive detail was given before the client eventually answered
the questions. What mental process does the nurse identify?
1
Flight of ideas
Correct2
Circumstantiality
When talking with a client who has alcoholism, the nurse notes that the client
becomes irritable, makes excuses, and blames family and friends for the drinking
problem. Which defense mechanisms does the nurse conclude that the client is
using? Select all that apply.
Correct1
Projection
Incorrect2
Suppression
3
Sublimation
4
Identification
Correct5
Rationalization
The registered nurse managing the care of four clients is determining individual
priorities. Place the following clients in order of priority, with 1 as the highest
priority.
Incorrect
1.
A client whose auditory hallucinations are saying, “They’re going to get you.”
Correct
2.
A manic client who has spent the last 8 hours refusing liquids and pacing around the unit.
Incorrect
3.
A depressed client who shares with the roommate that the client is “very happy today.”
Correct
4.
A cognitively impaired older adult who believes that the deceased spouse will visit today.
A newly admitted client with schizophrenia has a treatment plan that includes
participation in a physical activity group for several days before assignment to an
analytical group. The basis for this decision is that the client will do what?
Incorrect1
Develop skills in managing leisure time
2
Have time to develop insight into personal problems
3
Be too disruptive to benefit from group therapy at this time
Correct4
Cultivate trust before moving into a potentially anxiety-producing group
The mother of an 18-year-old man comes to the local mental health center. She is
extremely upset because of her son’s behavior since the young man returned from
his freshman year at college. He takes his brother’s clothing, comes in at all hours,
and refuses to get a job. Sometimes he is happy and outgoing, but at other times he
is withdrawn. The mother asks why her son is like this. While contemplating this
situation, the nurse considers that which adjectives usually apply to adolescents?
1
Anxious and unhappy
2
Angry and irresponsible
Correct3
Impulsive and self-centered
A young adult is being treated in the emergency department for injuries sustained
as a result of physical battering by her partner. On learning that there is a history of
such abuse, the nurse plans which tertiary nursing interventions? Select all that
apply.
Incorrect1
Contacting family members to provide support
2
Discussing the legal ramifications of not pressing charges
Incorrect3
Offering to discuss the abusive behavior with the woman's partner
Correct4
Identifying the benefits of attending a support group for battered women
Correct5
Providing her with information regarding local domestic violence shelters
Certain questions are applicable in determining nursing negligence. Select all that
apply.
Correct1
"Was reasonable care provided?"
Correct2
"Was there a breach of nursing duty?"
Correct3
"Was there an act of omission that resulted in harm?"
Correct4
"Except for the nurse’s action, would the injury have occurred?"
The parents of a toddler with recently diagnosed moderate cognitive impairment
state, "Our child should be able to attend college with help and medication." What
should the nurse conclude?
1
They accept the child’s diagnosis.
Correct2
Denial is being used as a defense mechanism.
A nurse is caring for a 20-year-old client. According to Erikson’s developmental
psychosocial theory, what is expected by 20 years of age?
1
Having the capacity for love and a commitment to work
Incorrect2
Being creative and productive and having concern for others
Correct3
Having a coherent sense of self and plans for self-actualization
A small fire has been set in the dayroom garbage can by a client who is currently
demonstrating manic behavior. Place the following nursing interventions in the
appropriate order to best ensure client and milieu safety.
Incorrect
1.
Administer appropriate medications as prescribed if indicated.
Incorrect
2.
Move all clients to a safe, controlled area.
Incorrect
3.
Activate the unit's fire alarm system.
Incorrect
4.
Place the manic client in a quiet environment with low stimulation.
Ensuring the safety of the milieu is the priority. The fire alarm is activated immediately after
all clients and staff have been removed from the area of the fire. The next intervention is
providing the manic client with a quiet, low-stimulation environment. If the nursing
assessment indicates a need for medication to manage the client's behavior, it should then
be administered.
After an electroconvulsive therapy treatment, a client complains of loss of memory.
What is the nurse's best response?
Correct1
"This is temporary; your memory will return after the therapy is done."
A nurse facilitating a support group of widows and widowers recalls that research
indicates that the probability of a spouse having a pathological or morbid grief
response will be greater in what case?
Incorrect1
The couple had an ambivalent relationship.
Correct2
The cause of the spouse's death was suicide.
Based on the following documentation, to best address the client's needs, what is
the nurse's initial intervention?
Incorrect1
Having male staff interact with the client only in public areas of the unit
Correct2
Offering the client a high-protein drink every hour in a quiet area of the unit
A client who had to be cut out of a car after a motor vehicle collision
has no visible physical effects from the ordeal. The client responds to
the emergency department nurse's questions factually in a soft voice
with a composed manner. What may this behavior indicate about the
client?
Correct1
The client is controlling the expression of feelings.
An older woman comes to the mental health clinic and reports, "I've not been
feeling right and haven't been able to sleep or eat since my husband died 8 months
ago." The nurse determines that the client is experiencing grief associated with the
loss of the husband. What supports this conclusion?
1
Inability to talk about her loss
2
Difficulty in expressing her loss
Correct3
Lack of sleep and the presence of symptoms of depression
A primary nurse notes that a client has become jaundiced after 2 weeks of
antipsychotic drug therapy. The nurse continues to administer the antipsychotic
until the primary healthcare provider can be consulted. What does the nurse
manager conclude about this situation?
Correct1
Jaundice is sufficient reason to discontinue the antipsychotic.
Which individual is coping with issues concerning dependence versus
independence?
1
Infant
Correct2
Toddler
A nurse is teaching a group of recently hired staff members about
defense mechanisms. An example given is Scarlett O'Hara, in the
movie Gone with the Wind, who said, "I'll think about that tomorrow."
What defense mechanism does this statement reflect?
Incorrect1
Denial
2
Splitting
3
Repression
A client's hands are raw and bloody from a ritual involving frequent hand washing.
Which defense mechanism does the nurse identify?
Correct1
Undoing
A nurse working in a mental health clinic has a caseload composed of a number of
individuals and families. Which members of the caseload are at the greatest risk
for mental health problems?
Correct1
A family with a new baby, a divorced man, and a recently retired older woman
A parent of four is remanded to the psychiatric unit by the court for observation.
The client was arrested and charged with abusing a 2-year-old child, who is in the
pediatric intensive care unit in critical condition. The nurse approaches the client for
the first time. How should the nurse anticipate that the client will likely
respond? Select all that apply.
Correct1
By denying beating the child
Correct2
By avoiding talking about the situation
Incorrect3
By asking where the other three children are
4
By expressing excessive concern for the child
Correct5
By exhibiting an emotional response that is inconsistent with the degree of injury
According to Erikson, a person’s adjustment to the period of senescence will depend
largely on the adjustment the individual made to which earlier developmental
stage?
1
Trust versus mistrust
Incorrect2
Industry versus inferiority
3
Identity versus role confusion
Correct4
Generativity versus stagnation
During the eighth session of a therapy group, a member who talks frequently is
interrupted by one who doesn't. When the interrupting person is finished talking,
the one who usually contributes says, "I'm so glad that you feel like talking today."
While saying this, the client sits rigidly and looks angry. How should the nurse
respond?
Correct1
Comment on the interrupted client's angry behavior and pleasant words.
A practitioner prescribes routine checks of the client's lithium level to be performed.
How many hours after the last dose of lithium should the nurse plan to obtain the
blood specimen?
Incorrect1
2 to 4
2
4 to 6
3
6 to 8
Correct4
8 to 12
A psychiatric unit uses a behavioral approach to determine a client's level of
privileges. Which factor should a nurse use to determine whether an increase in
privileges is warranted?
1
Stating that the depression is lifting
Correct2
Performing hygiene activities independently
Which client in a psychiatric unit needs immediate therapeutic intervention from
the nurse?
Incorrect1
A 25-year-old man who is mimicking the use of a machine gun in front of the nurse’s station
2
A 45-year-old man who is sitting quietly in the corner, watching the movements of other
clients
Correct3
A 50-year-old woman who is pacing back and forth across the dayroom and picking fights
with other clients
A client who was sexually assaulted and is aware of the possible legal implications
decides to seek prosecution of the rapist. The nurse carefully listens and documents
all assessments. This is done because with a charge of rape the burden of proof has
which implication?
Incorrect1
The burden of proof rests with the health team.
2
It is on the defendant to prove innocence.
3
Burden of proof must be established before the case will be heard.
Correct4
The burden of proof rests with the criminal justice system in collaboration with the victim.
A 17-year-old client is diagnosed with leukemia. Which statements by the teenager
reflect Piaget’s cognitive processes associated with adolescence? Select all that
apply.
1
"My smoking pot probably caused the leukemia."
Correct2
"I’m going to do my best to fight this awful disease."
Correct3
"Now I can’t go to the prom because I have this stupid disease."
Incorrect4
"I know I got sick because I’ve been causing a lot of problems at home."
Correct5
"This illness is serious, but with treatment I think I have a chance to get better."
A young woman is brought to the emergency department by friends after being
sexually assaulted. The client has a small but deep laceration on her chin, as well as
contusions on her arms and legs. The client appears withdrawn but calm. Place the
following nursing interventions in the appropriate order to best address the client’s
immediate needs.
Incorrect
1.
Advise her of the potential related health risks and the treatments that are available.
Incorrect
2.
Talk to her in a calm, nonjudgmental manner.
Incorrect
3.
Encourage her to express her feelings concerning the assault.
Incorrect
4.
Provide care for her laceration and contusions.
Incorrect
5.
Provide her with clear, concise explanations of care that will be provided.
The establishment of a trusting, mutually respectful nurse-client relationship is the initial
focus in this particular scenario. To best minimize further trauma, the nurse will provide the
client with an explanation of all care (physical contact) that will tak
What action should the nurse manager take when it becomes apparent that
communication between the nurse and the client is consistently superficial?
1
Assessing the client’s ability to understand the nurse’s questions
Correct2
Evaluating how actively the nurse has been listening to the client
A female adolescent in group therapy tells the other group members that while out
on a pass she used marijuana because her boyfriend made her smoke it. What
defense mechanism is the client using?
1
Denial
Incorrect2
Undoing
Correct3
Projection
An older adult with a chronic degenerative disease progresses to the stage at which
self-care is no longer possible, and admission to a long-term care facility becomes
necessary. What is the major developmental conflict for this client, according to
Erikson?
Incorrect1
Intimacy versus isolation
Correct2
Ego integrity versus despair
The nurse’s role in maintaining or promoting the health of the older adult should be
based on which principle?
1
Some physiologic changes that occur as a result of aging are reversible.
Incorrect2
Thoughts of impending death are common and depressing to most older adults.
3
Older adults can better accept the dependent state that chronic illness often causes.
Correct4
There is a strong correlation between successful retirement and maintaining health.
A client with bipolar disorder has been admitted for alcohol detoxification, and
laboratory tests are performed. Which results should prompt the nurse to notify the
admitting health care provider? Select all that apply.
1
Hemocrit: 47%
Correct2
Prothrombin time: 13.9 seconds
Correct3
Serum albumin: 2.9 g/dL (29 g/L)
Incorrect4
Lithium level: 1.2 mEq/L (1.2 mmol/L)
5
Serum sodium: 140 mEq/L (140 mmol/L)
Correct6
Blood urea nitrogen: 25 mg/dL (9.0 mmol/L
A nurse begins terminating the consistent one-to-one relationship with a client who
is soon to be discharged. How might the nurse expect the client to respond to the
termination of their relationship?
Correct1
Grief
The home care nurse visits a child in whom failure to thrive has been diagnosed and
makes observations that lead the nurse to suspect that the house is being used as a
methamphetamine laboratory. Which observations support this conclusion? Select
all that apply.
Correct1
Many small plastic bags
Correct2
A strong odor of acetone
Correct3
Many empty cold medicine bottles
4
A pot of tall plants with broad leaves
Correct5
Jars containing bright-yellow crystals
The parents of an autistic child begin family therapy with a nurse therapist. The
father states that the family members wish to share their religious beliefs with the
therapist. What should the nurse do?
Incorrect1
Limit the father's discussion of religion.
2
Include the mutual discussion of religious beliefs.
3
Invite the family's religious leader to a therapy session.
Correct4
Encourage family discussion of their religion in the sessions.
What is the best initial approach to take with a self-accusatory, guilt-ridden client?
1
Contradict the client's persecutory delusions.
Correct2
Accept the client's statements as the client's beliefs
A nurse in the mental health clinic is counseling a client with the diagnosis of
depression. During the counseling session the client says, "Things always seem the
same. They never change." The nurse suspects that the client is feeling hopeless.
For what indication of hopelessness should the nurse assess the client?
Correct1
Outbursts of ange
An 8-year-old child is found to have oppositional defiant disorder. What behavior
noted by the nurse supports this diagnosis?
Incorrect1
Easily distracted
Correct2
Argues with adults
Which client assessment does the nurse determine is inconsistent with the
diagnosis of anorexia nervosa, restricting type?
Correct1
Engages in episodes of purging
What should the nurse teach parents about childhood depression?
Correct1
May appear as acting-out behavior
The nurse is interviewing a female adolescent with anorexia nervosa who is
malnourished and severely underweight. Which statement leads the nurse to
conclude that the client is experiencing secondary gains from her behavior?
1
"I'm as big as a house."
2
"I get straight A's in school."
Correct3
"My mother keeps trying to get me to eat."
A client with a long history of alcohol abuse who has been hospitalized for 1 week
tells the nurse, "I feel much better and probably won't need any more treatment."
What does the nurse conclude when evaluating the client's progress?
1
The client has accepted the illness and now must use willpower to resist alcohol.
Incorrect2
The client will probably not use alcohol again as long as the client's family remains
supportive.
Correct3
The client's lack of insight into the emotional aspects of the illness indicates the need for
continued supervision.
A nurse in a mental health unit of the emergency department of a hospital
frequently cares for adolescents who attempt suicide. What is important for the
nurse to remember about adolescent suicide behavior?
1
Boys account for more attempts than do girls.
2
Girls use more dramatic methods than do boys.
Incorrect3
Girls talk more about suicide before attempting it.
Correct4
Boys are more likely to use lethal methods than are girls.
A 42-year-old adult with a long history of alcohol abuse seeks help in one of the
local hospitals. What does the nurse consider to be the major underlying factor for
success in a client’s alcohol treatment program?
1
Family
Correct2
Motivation
A nurse is working with clients with a variety of eating disorders. Which
characteristic unique to bulimia nervosa differentiates this disorder from anorexia
nervosa?
1
The client is obese and attempting to lose weight.
Correct2
The client behaves appropriately and looks normal.
A nurse is discussing plans with a client who has decided to withdraw from alcohol.
What should the nurse recommend as one of the mosteffective treatments for
alcoholism?
Incorrect1
Daily administration of disulfiram
2
Individual or group psychotherapy
3
Admission to an alcoholic unit in a hospital
Correct4
Active membership in Alcoholics Anonymous
A severely depressed male client responds to therapy and with the help of the staff
begins to set some daily objectives. Which behavior mostindicates improvement in
this client?
1
Staying clear of people who make him anxious
Correct2
Talking with at least one person on the unit daily
A client with recurrent episodes of depression comes to the mental health clinic for
a routine follow-up visit. The nurse suspects that the client is at increased risk for
suicide. What is a contributing factor to the client's risk for suicide?
Incorrect1
Psychomotor retardation
2
Decreased physical activity
3
Deliberate thoughtful behavior
Correct4
Overwhelming feelings of guilt
A client who is to begin a physical therapy regimen after orthopedic surgery
expresses anxiety about starting this new therapy. Why does the nurse respond that
some of this apprehension can be an asset?
1
Slow physiological function
Correct2
Increase alertness to the environment
Many clients who call a crisis hotline are extremely anxious. The nurse answering
the hotline phone remembers what characteristic as distinguishing posttraumatic
stress disorders from other anxiety disorders?
1
Lack of interest in family and others
Correct2
Reexperiencing the trauma in dreams and flashbacks
A nurse knows that individuals who are alcoholics use alcohol for what reason?
Correct1
Blunt reality
A nurse is assessing a client with the diagnosis of schizophrenia, undifferentiated
type. What defense mechanisms should the nurse anticipate that this client might
use?
Incorrect1
Projection
2
Repression
Correct3
Regression
4
Conversion
When the nurse is managing the care of an acutely depressed client, which
intervention demonstrates that the nurse recognizes the client's fundamental
mental health need?
Correct1
Role modeling a hopeful attitude regarding life and the future
Anorexia nervosa follows a cyclical pattern. Place the following statements in order
of progression through this cycle, with 1 as the first step and 4 as the last step.
Incorrect
1.
Dieting is an attempt to maintain control.
Incorrect
2.
Secondary gains reinforce the anorectic client's behaviors.
Incorrect
3.
Sociocultural attitudes exert pressure to attain an idolized body.
Incorrect
4.
Self-esteem increases as weight is lost.
Sociocultural (fashion, "superwoman" issues, and the diet and fitness industry), biological,
psychological, and familial factors all influence the development of anorexia
nervosa [1] [2]. Dieting, exercise, purging, and laxatives are used to lose weight, with the
resulting primary gain of a feeling of control over one's life. As weight is lost, the individual
feels a sense of accomplishment, and self-esteem increases. Finally, secondary gains such
as attention from parents and peers reinforce the behaviors associated with anorexia
nervosa.
In what situation should a nurse anticipate that a client will experience a phobic
reaction?
Incorrect1
When seeking attention from others
2
When thinking about the feared object
Correct3
When coming into contact with the feared object
During the intake interview at a mental health clinic, a client in withdrawal reveals
to the nurse long-term, high-dose cocaine use. Which signs and symptoms support
the conclusion that the client has been abusing cocaine for a prolonged
time? Select all that apply.
Correct1
Sadness
Incorrect2
Euphoria
3
Loss of appetite
4
Impaired judgment
Correct5
Psychomotor retardation
A client with a history of methamphetamine use is admitted to the mental health
unit because of aggressive, violent behavior. For what clinical manifestations of
methamphetamine use should the nurse assess this client? Select all that apply.
1
Bradypnea
Correct2
Tachycardia
Correct3
Hyperthermia
A 6-year-old child has been wetting the bed at night since the birth of a baby
brother. What defense mechanism is the child using to cope with the stress of
accepting a new family member?
Correct1
Regression
A nurse is teaching a client and family about the characteristics of dementia of the
Alzheimer type. What physiologic characteristic should the nurse include?
Incorrect1
Periodic exacerbations
2
Aggressive acting-out behavior
3
Hypoxia of selected areas of brain tissue
Correct4
Areas of brain destruction called senile plaques
Clients with eating disorders often exhibit similar symptoms. What should the nurse
expect an adolescent with anorexia nervosa to exhibit?
Correct1
Affective instability
A student is anxious about an upcoming examination but is able to study intently
and does not become distracted by a roommate's talking and loud music. What
level of anxiety is demonstrated by the student's ability to shut out the distractions?
Correct1
Mild
A nurse is caring for several clients with the diagnosis of bulimia nervosa. What
primary feeling does the nurse anticipate that these clients experience after an
episode of bingeing?
Correct1
Guilt
A nurse is caring for several clients with the diagnosis of bulimia nervosa. What
primary feeling does the nurse anticipate that these clients experience after an
episode of bingeing?
Correct1
Guilt
A woman with bipolar disorder, manic episode, has been spending thousands of
dollars on clothing and makeup. She has been partying in bars every night and
rarely sleeps or eats. The nurse in the outpatient clinic knows that this client rarely
eats. What does the nurse recognize as the mostlikely cause of her eating
problems?
1
Feelings of guilt
Incorrect2
Need to control others
3
Desire for punishment
Correct4
Excessive physical activity
A nurse is counseling the spouse of a client who has a history of alcohol abuse.
What does the nurse explain is the main reason for drinking alcohol in people with a
long history of alcohol abuse?
Correct1
They are dependent on it.
During a home visit to an older adult, the nurse observes a change in behavior and
suspects delirium. The nurse assesses the client for one of several conditions that
may have precipitated the delirium. Select all that apply.
Correct1
Infection
Incorrect2
Dementia
Correct3
Dehydration
Correct4
Urine retention
5
Restricted mobilit
A nurse is caring for a client with the diagnosis of schizophrenia. What is a common
problem for clients with this diagnosis?
Incorrect1
Chronic confusion
Correct2
Disordered thinking
During an assessment interview the client reports overwhelming, irresistible attacks
of sleep. Which sleep disorder does the nurse conclude that the client is
experiencing?
1
Insomnia
Correct2
Narcolepsy
A nurse in an outpatient mental health setting has been assigned to care for a new
client who has been found to have an antisocial personality disorder. What does the
nurse expect to observe in the client during the assessment?
1
Pays great attention to detail and demonstrates a high level of anxiety
Incorrect2
Has scars from self-mutilation and a history of many negative relationships
Correct3
Displays charm, has an above-average intelligence, and tends to manipulate others
A nurse working on a substance abuse unit knows that the individual uses
opioids most commonly for what reason?
1
Desires independence
Correct2
Is trying to reduce stress
A nurse interviews a young female client with anorexia nervosa to obtain
information for the nursing history. What will the client's history most likely reveal?
Correct1
Strong desire to improve her body image
A client proclaims that he is "the second son of God." What type of delusion does
the nurse identify?
1
Influence
Correct2
Religious
A nurse assesses a client recently admitted to an alcohol detoxification unit. What
common clinical manifestation should the nurse expect during the initial stage of
alcohol detoxification?
Correct1
Nausea
When visiting hours are over, a nurse approaches a client with paranoid
schizophrenia, who shouts, "You're the one that made my lover leave me." What
conclusion does the nurse make about the client?
Incorrect1
The patient is disoriented.
2
The patient is actively hallucinating.
Correct3
The patient feels a sense of vulnerability
A client arrives at the mental health clinic disheveled, agitated, and demanding that
the nurse "do something to make these feelings stop." What clinical manifestation is
evident?
Correct1
Feelings of panic
The nurse is caring for a client with dementia whose expression of emotions is
altered. Which behavior is unexpected with this client?
1
Lability
2
Passivity
Correct3
Curiosity
An obviously upset client comes to the mental health clinic and, after pushing
ahead of the other clients, states, "I had an argument with my daughter, and now
I'm tense, and worried, and angry." What level of anxiety does the nurse determine
that the client is experiencing?
1
Mild
2
Panic
Incorrect3
Severe
Correct4
Moderate
A young adolescent is found to have anorexia nervosa. What does the nurse
understand probably precipitated the anorexia nervosa?
1
The acting out of aggressive impulses, resulting in feelings of hopelessness
2
An unconscious wish to punish a parent who tries to dominate the adolescent's life
Incorrect3
The inability to deal with being the center of attention in the family and a desire for
independence
Correct4
An inaccurate perception of hunger stimuli and a struggle between depende
A mental health nurse is working on a unit where many clients have the diagnosis of
alcoholism. Which defense mechanism does the nurse identify as most commonly
used by clients who are alcoholics?
Correct1
Denial
A client being admitted for alcoholism reports having had alcoholic blackouts. What
is the best description of an alcoholic blackout?
Incorrect1
A fugue state resembling absence seizures
2
Fainting spells followed by loss of memory
3
Loss of consciousness lasting less than 10 minutes
Correct4
Absence of memory in relation to drinking episodes
The nurse is working with a client who has a diagnosis of borderline personality
disorder. What personality traits should the nurse expect the client to
exhibit? Select all that apply.
Correct1
Engaging
2
Indecisive
Incorrect3
Withdrawn
Correct4
Manipulative
5
Perfectionisti
A nurse is assessing a client with a diagnosis of primary insomnia. Which findings
from the client's history may be the cause of this disorder? Select all that apply.
Correct1
Significant life stress
2
Severe anxiety
3
Generalized pain
Correct4
Excessive caffeine
5
Chronic depression
Correct6
Environmental noise/distracto
The nurse can identify the mostcommonly demonstrated comorbid disorders
associated with generalized anxiety disorder (GAD) by assessing the client for which
of the following? Select all that apply.
1
Obesity
Correct2
Phobias
Correct3
Suicidal ideations
4
Impaired cognitive function
Correct5
Signs of alcohol withdrawa
A recovering alcoholic joins Alcoholics Anonymous (AA) to help maintain sobriety.
What type of group is AA?
1
Social group
Correct2
Self-help group
The nurse is interviewing the family about the onset of problems in a young client
with the diagnosis of schizophrenia. In what stage of development does the nurse
expect that the client's difficulties with reality testing began?
1
Puberty
Correct2
Adolescenc
An assistant to a dean at a local university is admitted to the psychiatric inpatient
unit for assessment and treatment. The client claims to be president of the
university. What type of delusion does the nurse identify?
1
Somatic
Correct2
Grandiose
A client with a recent history of binge eating and purging is admitted to the eating
disorder unit with a diagnosis of bulimia nervosa. How does the nurse explain
bulimia nervosa to the family?
1
Uncontrollable pilfering and hoarding of food for later consumption
Incorrect2
Refusal to eat in public accompanied by excessive private overeating
3
Mood swings, ranging from euphoria to depression, associated with food
Correct4
Uncontrollable ingestion of large quantities of food in a short period with subsequent purging
A nurse is caring for a client with a diagnosis of catatonic schizophrenia. What
clinical finding does the nurse expect the client to exhibit?
1
Crying
2
Self-mutilation
Correct3
Immobile posturing
A nurse who plans to care for a client with an obsessive-compulsive disorder should
understand that the client’s personality can usually be characterized in what way?
Incorrect1
Marked emotional maturity
2
Rapid, frequent mood swings
3
Elaborate delusional systems
Correct4
Doubts, fears, and indecisiveness
A nurse knows that individuals who are alcoholics use alcohol for what reason?
Correct1
Blunt reality
A nurse is counseling the spouse of a client who has a history of alcohol abuse.
What does the nurse explain is the main reason for drinking alcohol in people with a
long history of alcohol abuse?
Correct1
They are dependent on it.
When caring for clients who are demonstrating manic behavior, the nurse must
constantly reassess these clients' physical needs. What characteristic about these
clients makes this particularly important?
1
Will withdraw to their rooms if left alone
2
Have difficulty making their needs known
Incorrect3
May gain too much weight from overeating
Correct4
May become exhausted from excessive activity
A client tells the nurse, "All my friends experiment with drugs. I like the high I get
when I huff paint. Nothing bad is going to happen to me." What is
the best response by the nurse?
1
"Inhalants can cause a mild state of intoxication."
Correct2
"Huffing paint can damage your lungs, kidneys, and liver
A client who is a regular user of cocaine is admitted to a rehabilitation facility. Which
common side effects of regular cocaine use should the nurse expect when assessing
this client?
1
Nausea, fatigue, and extreme hunger
Correct2
Anxiety, dysphoria, and extreme suspicion
A client is admitted to the hospital with a diagnosis of depression. What clinical
manifestations of depression does the nurse expect when assessing this client?
1
Flight of ideas
2
Suspicion of others
Correct3
Psychomotor retardation
What is the primary concern for a nurse caring for a client who is grossly impaired
by stimulants?
1
Drowsiness
Correct2
Seizure activity
A nurse is interviewing a child with attention deficit disorder. For which major
characteristic should the nurse assess this child?
Correct1
Overreaction to stimuli
A man has completed an alcohol detoxification program and is setting goals for
rehabilitation. When the client sets outcomes, what need is it important for him to
understand?
1
Plan to avoid people who drink.
2
Accept that he is a fragile person.
Incorrect3
Develop new social drinking skills.
Correct4
Restructure his life without alcohol.
A nurse is in the process of developing a therapeutic relationship with a client who
has an addiction problem. What client communication permits the nurse to conclude
that they are making progress in the working stage of the relationship? Select all
that apply.
1
Describes how others have caused the addiction
Correct2
Verbalizes difficulty identifying personal strengths
3
Expresses uncertainty about meeting with the nurse
Correct4
Acknowledges the effects of the addiction on the family
Correct5
Addresses how the addiction has contributed to family distress
Many clients who call a crisis hotline are extremely anxious. The nurse answering
the hotline phone remembers what characteristic as distinguishing posttraumatic
stress disorders from other anxiety disorders?
1
Lack of interest in family and others
Correct2
Reexperiencing the trauma in dreams and flashbacks
A client with recurrent episodes of depression comes to the mental health clinic for
a routine follow-up visit. The nurse suspects that the client is at increased risk for
suicide. What is a contributing factor to the client's risk for suicide?
Incorrect1
Psychomotor retardation
2
Decreased physical activity
3
Deliberate thoughtful behavior
Correct4
Overwhelming feelings of guilt
A client with schizophrenia is admitted to an acute care psychiatric unit. Which
clinical findings indicate positive signs and symptoms of schizophrenia?
1
Withdrawal, poverty of speech, inattentiveness
2
Flat affect, decreased spontaneity, asocial behavior
Incorrect3
Hypomania, labile mood swings, episodes of euphoria
Correct4
Hyperactivity, auditory hallucinations, loose associations
A nurse is caring for several clients with the diagnosis of bulimia nervosa. What
primary feeling does the nurse anticipate that these clients experience after an
episode of bingeing?
Correct1
Guilt
What should a nurse conclude that a client is doing when he makes up stories to fill
in blank spaces of memory?
1
Lying
2
Denying
3
Rationalizing
Correct4
Confabulating
A client with a history of alcohol abuse says to the nurse, "Drinking is a way out of
my depression." Which strategy will probably be most effective for the client at this
time?
Correct1
A self-help group
A person with a history of alcoholism says, "I've been drinking since last Friday to
celebrate my son's graduation from college." What defense mechanism does the
nurse identify?
1
Denial
2
Projection
Incorrect3
Identification
Correct4
Rationalization
hat characteristic of the environment is most therapeutic for clients with the
diagnosis of bulimia nervosa?
1
Controlling
2
Empathetic
Incorrect3
Focused on food
Correct4
Based on realistic limits
A nurse is interviewing a client newly admitted to an outpatient program after
withdrawal from alcohol. What behavior best indicates that the client has accepted
that drinking is a problem?
1
Participates in scheduled counseling sessions
Correct2
Attends Alcoholics Anonymous meetings daily
A client who was admitted to the psychiatric unit because of a major depressive
disorder is exhibiting increasingly withdrawn behavior. The nurse understands that
eventually the client will experience what feelings?
1
Hedonia
Correct2
Isolation
A nurse in a mental health unit of the emergency department of a hospital
frequently cares for adolescents who attempt suicide. What is important for the
nurse to remember about adolescent suicide behavior?
1
Boys account for more attempts than do girls.
Incorrect2
Girls use more dramatic methods than do boys.
3
Girls talk more about suicide before attempting it.
Correct4
Boys are more likely to use lethal methods than are girls.
A recovering alcoholic joins Alcoholics Anonymous (AA) to help maintain sobriety.
What type of group is AA?
1
Social group
Correct2
Self-help grou
A 56-year-old man is admitted to the inpatient unit after family members report that
he seems to be experiencing auditory hallucinations. The man has a history of
schizophrenia and has had several previous admissions. Which statement indicates
to the nurse that the client is experiencing auditory hallucinations?
1
"Get these horrible snakes out of my room!"
Correct2
"I am not the devil! Stop calling me those names!"
A client with a long history of alcohol abuse who has been hospitalized for 1 week
tells the nurse, "I feel much better and probably won't need any more treatment."
What does the nurse conclude when evaluating the client's progress?
Incorrect1
The client has accepted the illness and now must use willpower to resist alcohol.
2
The client will probably not use alcohol again as long as the client's family remains
supportive.
Correct3
The client's lack of insight into the emotional aspects of the illness indicates the need for
continued supervision.
Anorexia nervosa follows a cyclical pattern. Place the following statements in order
of progression through this cycle, with 1 as the first step and 4 as the last step.
Incorrect
1.
Dieting is an attempt to maintain control.
Incorrect
2.
Self-esteem increases as weight is lost.
Incorrect
3.
Sociocultural attitudes exert pressure to attain an idolized body.
Correct
4.
Secondary gains reinforce the anorectic client's behaviors.
A client who is a polysubstance abuser is mandated to seek drug and alcohol
counseling. What is an appropriate initial outcome criterion for this client?
Correct1
Verbalizes that a substance abuse problem exists
While a nurse is assisting with morning care for a client with the diagnosis of
schizophrenia, the client suddenly throws off the covers and starts shouting, "My
body is disintegrating! I'm being pinched." What term best describes the client's
behavior?
Correct1
Somatic delusion
A 5-foot 5-inch (165 cm) 15-year-old girl who weighs 80 lb (36.3 kg) is admitted to a
mental health facility with a diagnosis of anorexia nervosa. The nurse recognizes
what factor as the most likely cause of her problem?
Correct1
A desire to control her life
A client with schizophrenia is admitted to an acute care psychiatric unit. Which
clinical findings indicate positive signs and symptoms of schizophrenia?
1
Withdrawal, poverty of speech, inattentiveness
Incorrect2
Flat affect, decreased spontaneity, asocial behavior
3
Hypomania, labile mood swings, episodes of euphoria
Correct4
Hyperactivity, auditory hallucinations, loose associations
Nursing care for a client with a bipolar mood disorder, manic episode, is sometimes
difficult. What important fact about these clients should the nurse consider when
planning their care?
1
Embarrassed by their behavior
Correct2
Aware of their environment and reality
AWhat characteristic of an adolescent girl suggests to the nurse that she has
bulimia?
1
History of gastritis
2
Positive self-concept
Correct3
Excessively stained teeth
or success in a client’s alcohol treatment program?
Incorrect1
Family
Correct2
Motivatio
What is the greatest difficulty for nurses caring for the severely depressed client?
Incorrect1
Client's lack of energy
2
Negative cognitive processes
3
Client's psychomotor retardation
Correct4
Contagious quality of depression
It is determined that a staff nurse has a drug abuse problem. What approach to the
staff nurse’s addiction should be taken as an initial intervention?
1
Counseled by the staff psychiatrist
2
Dismissed from the job immediately
Correct3
Referred to the employee assistance program
An adolescent with a conduct disorder is undergoing behavioral therapy in an
attempt to limit behaviors that violate societal norms. What specific outcome
criterion is unique to adolescents with this problem?
1
Increased impulse control
2
Identification of two positive personal attributes
Correct3
Demonstration of respect for the rights of others
A severely depressed male client responds to therapy and with the help of the staff
begins to set some daily objectives. Which behavior mostindicates improvement in
this client?
1
Staying clear of people who make him anxious
Correct2
Talking with at least one person on the unit daily
What is a priority nursing intervention in the care of a drug-dependent mother and
infant?
Correct1
Supporting the mother's positive responses toward her infant
When planning care for a client who has just completed withdrawal from multipledrug
abuse, what reality in relation to the client should the nurse take into
consideration?
1
Unable to give up drugs
Incorrect2
Unconcerned with reality
Correct3
Unable to delay gratification
What should a nurse identify as the most important factor in rehabilitation of a
client addicted to alcohol?
Correct1
Motivational readiness
it with the diagnosis of anorexia nervosa. What typical signs and symptoms of
anorexia nervosa does the nurse expect the client to exhibit?
1
Slow pulse, mild weight loss, and alopecia
2
Compulsive behaviors, excessive fears, and nausea
Correct3
Amenorrhea, excessive weight loss, and abdominal distention
An executive assistant experiences an overwhelming impulse to count and arrange
the rubber bands and paper clips in his desk. The client feels that something
dreadful will occur if the ritual is not carried out. Considering the client's symptoms,
what does the nurse conclude about the rituals?
1
They are useful in our society as long as they can be controlled
Correct2
They serve to control anxiety resulting from unconscious impulses
A client who uses ritualistic behavior taps other clients on the shoulders three times
as part of the ritual. What does the nurse infer about this client?
1
A blurred personal identity
Incorrect2
Poor control of sudden urges
3
A disturbance in spatial boundaries
Correct4
A diminished ability to adapt to life's stresses
On the third day of hospitalization, a client with a history of heavy drinking begins
experiencing delirium alcohol withdrawal syndrome. What is the mostappropriate
response by the nurse when the client begins experiencing hallucinations?
1
Withholding intervention, because the client may be having vivid dreams
2
Asking the client to describe the hallucinations and explaining that they are not real
Correct3
Administering the prescribed medication to the client to subdue the agitated be
A nurse in the mental health unit is working with a group of adolescent girls with the
diagnosis of anorexia nervosa. What does the nurse recall is the major health
complication associated with intractable anorexia nervosa?
1
Endocrine imbalance causing amenorrhea
2
Decreased metabolism causing cold intolerance
Correct3
Cardiac dysrhythmias resulting in cardiac arrest
A client arrives at the mental health clinic complaining about feelings of extreme
terror when attempting to ride in an elevator and feelings of uneasiness in large
crowds. He reports that these fears are interfering with his concentration at work.
What does the nurse identify as the source of these symptoms?
1
Conflict with society, resulting in an obsession
2
Depression about life events, resulting in unreasonable fears
Correct3
Generalized anxiety about conflicts, resulting in unreasonable fear
nurse is caring for a client exhibiting compulsive behaviors. The nurse concludes
that the compulsive behavior usually incorporates the use of which defense
mechanism?
Incorrect1
Projection
2
Regression
Correct3
Displacement
4
Rationalizatio
What is the prognosis for a normal, productive life for a child with autism?
1
Dependent on an early diagnosis
2
Often related to the child's overall temperament
Incorrect3
Ensured as long as the child attends a school tailored to meet needs
Correct4
Unlikely because of interference with so many parameters of function
unit after attempting suicide. The client's history reveals that his first child died of
sudden infant death syndrome 2 years ago, that he has been unable to work since
the death of the child, and that he has attempted suicide before. When talking with
the nurse he says, "I hear my son telling me to come over to the other side." What
should the nurse conclude that the client is experiencing?
1
Fixed delusion
2
Magical thought
Incorrect3
Pathological regression
Correct4
Command hallucinatio
A nurse is making an assessment of a client's hallucinatory behavior. What is
the most common type of hallucination?
Incorrect1
Visual
2
Tactile
Correct3
Auditory
nd grief counselors have been working with fellow students. What behaviors
indicate to the school nurse that another student may be considering
suicide? Select all that apply.
Correct1
Withdrawing from friends
Correct2
Giving away prized possessions
What are the "four As" for which nurses should assess clients with suspected
Alzheimer disease?
Correct1
Amnesia, apraxia, agnosia, aphasia
A newly admitted client is apathetic and exhibits an inappropriate affect. A
diagnosis of schizophrenia is made. In light of the diagnosis, what is one symptom
the nurse expects to identify in the client's communication or behavior?
Incorrect1
Logical deductions
2
Suicidal preoccupation
3
Absence of self-criticism
Correct4
Response to internal stimulation
A client with a history of gambling is experiencing legal difficulties for embezzling
money and has been required to obtain counseling. During an intake interview the
client says, "I never would have done this if I'd been paid what I am worth." What
factor will create the greatest difficulty in helping this client develop insight?
Incorrect1
Feelings of boredom and emptiness
2
Grandiosity related to personal abilities
Correct3
Projection of reasons for difficulties onto others
An anxious client reports experiencing pain in the abdomen and feeling empty and
hollow. A diagnostic workup reveals no physical causes of these clinical findings.
What term best reflects what the client is experiencing?
1
Dissociation
Correct2
Somatization
A client is admitted to the mental health unit with the diagnosis of anorexia
nervosa. What typical signs and symptoms of anorexia nervosa does the nurse
expect the client to exhibit?
1
Slow pulse, mild weight loss, and alopecia
2
Compulsive behaviors, excessive fears, and nausea
Correct3
Amenorrhea, excessive weight loss, and abdominal distention
What is a primary consideration for the nurse caring for a client with a history of
substance abuse?
Correct1
Setting firm, consistent limits and not varying from them
client who has a long history of alcoholism has not worked for the past 10 years.
When the nurse asks about daily activities the client responds, "I currently work in
the office of a local construction company." Which mental mechanism should the
nurse suspect that the client is using?
1
Regression
Incorrect2
Sublimation
3
Compensation
Correct4
Confabulatio
An older client with vascular dementia has difficulty following simple directions for
selecting clothes to be worn for the day. What does the nurse identify as the cause
of these problems?
Correct1
Receptive aphasia
A client with a history of chronic alcoholism was admitted to a surgical unit after
surgery to repair a severely fractured right ankle. The nurse is concerned that the
client is experiencing manifestations of acute alcohol withdrawal when certain
documentation and assessment data from the last 6 hours seem to indicate this
problem. Which data are the cause of the nurse's concern? Select all that apply.
Correct1
Tremors in both hands make it difficult for the client to hold a cup.
A client experiencing nonspecific, excessive, unpleasant feelings of being worried
concerning one's safety likely is experiencing which mental health disorder?
Incorrect1
Phobia
2
Panic disorder
Correct3
Generalized anxiety disorder (GAD
A mother brings her 5-year-old daughter to the children's clinic after teachers report
that the girl is disobedient and hostile. The child has a negative attitude and argues
often with her teachers. At this time she has not violated the rights of other
students. The mother reports that she has also noticed this behavior at home. The
nurse suspects that the behavior described is associated with what disorder?
Incorrect1
Anxiety disorder
2
Conduct disorder
3
Major depressive disorder
Correct4
Oppositional defiant disorder
On the third day of hospitalization, a client with a history of heavy drinking begins
experiencing delirium alcohol withdrawal syndrome. What is the mostappropriate
response by the nurse [Show Less]