Tony, age 21, has been diagnosed with schizophrenia. He has been socially isolated and hearing voices telling him to kill his parents. He has been
... [Show More] admitted to the psychiatric unit from the emergency department. The INITIAL nursing intervention for Tony is to
A) Give him an injection of Thorazine
B) Ensure a safe environment for him and others
C) Place him in restraints
D) Order him a nutritious diet - correct answer B) Ensure a safe environment for him and others
The primary goal in working with an actively psychotic, suspicious client would be to:
A) Promote interaction with others
B) Decrease his anxiety and increase trust
C) Improve his relationship with his parents
D) Encourage participation in therapy activities - correct answer B) Decrease his anxiety and increase trust
The nurse is caring for a client with schizophrenia. Orders from the physician include 100mg chlorpromazine IM STAT and then 50mg PO bid; 2 mg benztropine PO bid prn. Why is chlorpromazine ordered?
A) To reduce EPS
B) To prevent neuroleptic malignant syndrome
C) To decrease psychotic symptoms
D) To induce sleep - correct answer C) To decrease psychotic symptoms
The nurse is caring for a client with schizophrenia. Orders from the physician include 100mg chlorpromazine IM STAT and then 50mg PO bid; 2mg benztropine PO bid prn. Because benztropine was ordered on a prn basis, which of the following assessments by the nurse would convey a need for this medication?
A) The client's level of agitation increases
B) The client complains of a sore throat
C) The client's skin has a yellowish cast
D) The client develops tremors and a shuffling gait - correct answer D) The client develops tremors and a shuffling gait
Clint, a client on the psychiatric unit, has been diagnosed with schizophrenia. He begins to tell the nurse about how the CIA is looking for him and will kill him if they find him. The most appropriate response by the nurse is:
A) That's ridiculous, Clint. No one is going to hurt you.
B) The CIA isn't interested in people like you, Clint
C) Why do you think the CIA wants to kill you?
D)I know you believe that, Clint, but it's really hard for me to believe - correct answer D) I know you believe that, Clint, but it's really hard for me to believe
Clint, a client on the psychiatric unit, has been diagnosed with schizophrenia. He begins to tell the nurse about how the CIA is looking for him and will kill him if they find him. Clint's belief is an example of:
A) Delusion of persecution
B) Delusion of reference
C) Delusion of control or influence
D) Delusion of grandeur - correct answer A) Delusion of persecution
The nurse is interviewing a client on the psychiatric unit. The client tilts his head to the side, stops talking in midsentence, and listens intently. The nurse recognizes from these signs that the client is likely experiencing:
A) Somatic delusions
B) Catatonic stupor
C) Auditory hallucinations
D) Pseudoparkinsonism - correct answer C) Auditory hallucinations
The nurse is interviewing a client on the psychiatric unit. The client tilts his head to the side, stops talking in midsentence, and listens intently. The nurse recognizes these behaviors as a symptom of the client's illness. The most appropriate nursing intervention for this symptom is to:
A) Ask the client to describe his physical symptoms
B) Ask the client to describe what he is hearing
C) Administer a dose of benztropine
D) Call the physician for additional orders - correct answer B) Ask the client to describe what he is hearing
When a client suddenly becomes aggressive and violent on the unit, which of the following approaches would be best for the nurse to use first?
A) Provide large motor activities to relieve the client's pent-up tension
B) Administer a dose of prn chlorpromazine to keep the client calm
C) Call for sufficient help to control the situation safely
D) Convey to the client that his behavior is unacceptable and will not be permitted - correct answer C) Call for sufficient help to control the situation safely
The primary focus of family therapy for clients with schizophrenia and their families is:
A) To discuss concrete problem solving and adaptive behaviors for coping with stress
B) To introduce the family to others with the same problem
C) To keep the client and family in touch with the health care system
D) To promote family interaction and increase understanding of the illness - correct answer D) To promote family interaction and increase understanding of the illness
Which of the following is a true statement about mental health recovery? (select all that apply)
a. mental health recovery applies only to severe and persistent mental illnesses
b. mental health recovery serves to provide empowerment to the client
c. mental health recovery is based on the medical model
d. mental health recovery is a collaborative process - correct answer b, d
A nurse is assisting an individual with mental illness recovery using the Tidal Model. Which of the following is a component of this model?
a. the wellness toolbox
b. the daily maintenance list
c. the individual's personal story
d. triggers - correct answer c
A nurse is assisting an individual with mental illness recovery using the Psychological Recovery Model. The client says to the nurse, "I have schizophrenia. Nothing can be done. I might as well die." In which stage of the Psychological Recovery Model would the nurse assess the individual to be?
a. the awareness stage
b. the preparation stage
c. the rebuilding stage
d. the moratorium stage - correct answer d
A nurse who is helping a client in the preparation stage of the Psychological Recovery Model might include which of the following interventions?
a. teach about effects of the illness and how to recognize, monitor, and manage symptoms
b. help the client identify triggers that cause distress or discomfort
c. help the client establish a daily maintenance list
d. listen actively while the client composes his or her personal story - correct answer a
A nurse who is helping a client with mental illness recovery using the WRAP Model says to the client, "First you must create a wellness toolbox." She explains to the client that a wellness toolbox is which of the following?
a. a list of words that describe how the individual feels when he or she is feeling well
b. a list of things the client needs to do every day to maintain wellness
c. a list of strategies the client has used in the past that help relieve disturbing symptoms
d. a list of the c - correct answer c
N.J. is the nurse leader of a childbirth preparation group. Each week she shows various films and sets out various reading materials. She expects the participants to utilize their time on a topic of their choice on practice skills they have observed on the films. Two couples have dropped out of the group, stating, "This is a big waste of time." Which type of group and style of leadership is described in this situation?
a. task/democratic
b. teaching/laissez-faire
c. self-help/democratic
d. supp - correct answer b
M.K. is a psychiatric nurse who has been selected to lead a group for women who desire to lost weight. The criterion for membership is that they must be at least 20 lb overweight. All have tried to lost weight on their own many times in the past without success. At their first meeting, M.K. provides suggestions as the members determine what their goals will be and how they plan to go about achieving those goals. They decided how often they wanted to meet, and what they planned to do at each meet - correct answer d
J.J is a staff nurse on a surgical unit. He has been selected as leader of a newly established group of staff nurses organized to determine ways to decrease the number of medication errors occurring on the unit. J.J. has definite ideas about how to bring this about. He also applied for the position of Head Nurse on the unit and believes that if he is successful in leading the group toward achievement of his goals, he can also facilitate his chances for promotion. At each meeting he addresses the - correct answer a
The nurse leader is explaining about group "curative factors" to members of the group. She tells the group that group situations are beneficial members can see that they are not alone in their experiences. This is an example of which curative factor?
a. altruism
b. imitative behavior
c. universality
d. imparting of information - correct answer c
Nurse Jones is the leader of a bereavement group for widows. Nancy is a new member. She listens to the group and sees that one member. Jane, has been a widow for 5 years now. Jane has adjusted well and Nancy thinks maybe she can too. This is an example of which curative factor?
a. universality
b. imitative behavior
c. installation of hope
d. imparting of information - correct answer c
Paul is a member of an anger management group. He knew that people did not want to be his friend because of his violent temper. In the group, he has learned to control his temper and form satisfactory interpersonal relationships with others. This is an example of which curative factor?
a. catharsis
b. altruism
c. imparting of information
d. development of socializing techniques - correct answer d
Henry is a member of an AA group. He learned about the effects of alochol on the body when a nurse from the chemical dependency unit spoke to the group. This is an example of which curative factor?
a. catharsis
b. altruism
c. imparting on information
d. universality - correct answer c
Sandra is the nurse leader of a supportive-therapuetic group for individuals with anxiety disorders. In this group, Helen talks incessantly. When someone else tries to make a comment, she refuses to allow him or her speak. What type of member role is Helen assuming in this group?
a. aggressor
b. monopolizer
c. blocker
d. seducer - correct answer b
Sandra is the nurse leader of a supportive-therapuetic group for individuals with anxiety disorders. On the first day the group meets, Valerie speaks and begins by sharing the intimate details of her incestuous relationship with her father. What type of member role is Valerie assuming in this group?
a. aggressor
b. monopolizer
c. blocker
d. seducer - correct answer d
Sandra is the nurse leader of a supportive-therapuetic group for individuals with anxiety disorders. Violet, who is beautiful but lacks self-confidence, states to the group, "Maybe if I became a blond my boyfriend would love me more." Larry responds, "Listen, dummy, you need more than blond hair to keep the guy around. A bit more in the brains department would help!" What type of member role is Larry assuming in this group?
a. aggressor
b. monopolizer
c. blocker
d. seducer - correct answer a
Which of the following are basic assumptions of milieu therapy? (select all that apply)
a. the client owns his or her own environment
b. each client owns his or her behavior
c. peer pressure is a useful and powerful tool
d. inappropriate behaviors are punished immediately - correct answer a, b, c
John tells the nurse, "I think lights out at 10 o' clock on a weekend is stupid. We should be able to watch TV until midnight!" Which of the following is the most appropriate response from the nurse on the milieu unit?
a. "John, you were told the rules when you were admitted."
b. "You may bring it up before the others at the community meeting, John."
c. "Some people want to o to bed early, John."
d. "You are not the only person on this unit, John. You must think of others besides yourself." - correct answer b
In prioritizing care within the therapeutic environment, which of the following nursing interventions would receive the highest priority?
a. ensuring that the physical facilities are conductive to achievement of the goals of therapy
b. scheduling a community meeting for 8:30 each morning
c. attending to the nutritional and comfort needs of all clients
d. establishing contacts with community resources - correct answer c
In the community meeting, which of the following actions is most important for reinforcing the democratic posture of the therapy setting?
a. allowing each person a specific and equal amount of time to talk
b. reviewing group rules and behavior limits that apply to all clients
c. reading the minutes from yesterday's meeting
d. waiting until all clients are present before initiating the meetings - correct answer b
One of the goals of therapeutic community is for clients to become more independent and accept self-responsibility. Which of the following approaches by staff best encourages fulfillment of this goal?
a. including client input and decisions into the treatment plan
b. insisting that each client take a turn as "president" of the community meeting
c. making decisions for the client regarding plans for treatment
d. requiring that the client be bathed, dressed, and attend breakfast on time each morn - correct answer a
Client teaching is an important nursing function in milieu therapy. Which of the following statements by the client indicates the need for knowledge and a readiness to learn?
a. "Get away from me with that medicine! I'm not sick!"
b. "I don't need psychiatric treatment. It's my migraine headaches that I need help with."
c. "I've taken Valium every day of my life for the last 20 years. I'll stop when I'm good and ready!"
d. "The doctor says I have bipolar disorder. What does that really mean?" - correct answer d
Which of the following activities would be a responsibility of the clinical psychologist member of the IDT?
a. locates halfway house and arranges living conditions for client being discharged from the hospital
b. manages the therapeutic milieu on a 24 hour basis
c. administers and evaluates psychological tests that assist in diagnosis
d. conducts psychotherapy and administers electroconvulsive therapy treatments - correct answer c
Which of the following activities would be a responsibility of the psychiatric clinical nurse specialist on the IDT team?
a. manages the therapeutic milieu on a 24 hour basis
b. conducts group therapies and provides consultation and education to staff nurses
c. directs a group of clients in acting out a situation that is otherwise too painful for a client to discuss openly
d. locates halfway house and arranges living conditions for client being discharged from the hospital - correct answer b
On the milieu unit, duties of the staff psychiatric nurse include which of the following? (select all that apply)
a. medication administration
b. client teaching
c. medical diagnosis
d. reality orientation
e. relationship development
f. group therapy - correct answer a, b, d, e
Sally was sexually abused as a child. She is a client on the milieu unit with a diagnosis of borderline personality disorder. She has refused to talk to anyone. Which of the following therapies might the IDT team choose for Sally? (select all that apply)
a. music therapy
b. art therapy
c. psychodrama
d. electroconvulsive therapy - correct answer a, b, c
A client states: "I refuse to shower in this room. I must be very cautious. The FBI has placed a camera in here to monitor my every move." Which of the following is the therapeutic response?
a. "That's not true."
b. "I have a hard time believing that is true."
c. "Surely you don't really believe that."
d. "I will help you search this room so that you can see there is no camera." - correct answer b
Nancy, a depressed client who has been unkept and untidy for weeks, today comes to group therapy wearing makeup and a clean dress and having washed and combed her hair. Which of the following responses by the nurse is most appropriate?
a. "Nancy, I see you have put on a clean dress and combed your hair."
b. "Nancy, you look wonderful today."
c. "Nancy, I'm sure everyone will appreciate that you have cleaned up for the group today."
d. "Now that you see how important it is, I hope you will do th - correct answer a
Dorothy was involved in an automobile accident while under the influence of alcohol. She served her car into a tree and narrowly missed hitting a child on a bicycle. She is in the hospital with multiple abrasions and contusions. She is talking about the accident with the nurse. Which of the following statements by the nurse is most appropriate?
a. "Now that you know what can happen when you drink and drive, I'm sure you won't let it happen again."
b. "You know that was a terrible thing you did. - correct answer d
Judy has been in the hospital for 3 weeks. She has used Valium "to settle my nerves" for the past 15 years. She was admitted by her psychiatrist for safe withdrawal from the drug. She has passed the physical symptoms of withdrawal at this time, but states to the nurse, "I don't know if I will be able to make it without Valium after I go home. I'm already starting to feel nervous. I have so many personal problems." Which is the most appropriate response by the nurse?
a. "Why do you think you hav - correct answer c
Mrs. S asks the nurse, "Do you think I should tell my husband about my affair with my boss?" Which is the most appropriate response by the nurse?
a. "What do you think would be best for you to do?"
b. "Of course you should. Marriage has to be based on truth."
c. "Of course not. That would only make things worse."
d. "I can't tell you what to do. You have to decide for yourself." - correct answer a [Show Less]