Psych C487 Psych OA Review Questions and Answers- Western Governors University
The daughter of a female client with stage-1 Alzheimer’s disease (AD)
... [Show More] asks the nurse what
changes should she expect her mother to demonstrate in this stage. What finding should the
nurse tell the daughter is common?
A. Personality changes and agitation.
B. Alterations in communication.
C. Inability to recognize one’s location.
D. Depression and emotional lability.
*C
Physical examination of a school-aged child reveals several bite marks in various locations
on the body. X-ray examination reveals healed fractures of the ribs. The mother tells the
nurse that the child is always having accidents. Which initial response is best for the nurse
to make?
A. I need to inform the healthcare provider about your child’s tendency to be accident
prone.
B. Boys this age always seem to require more supervision and can be quite accident
prone.
C. Tell me more specifically about your child’s accidents.
D. I must report these injuries to the authorities because they do not seem accidental.
*C
A client who is being treated with lithium carbonate for bipolar disorder develops diarrhea,
vomiting, and drowsiness. What action should the nurse take?
A. Record the symptoms as normal side effects and continue administration of the
prescribed dosage.
B. Notify the health care provider of the symptoms prior to the next administration of the
drug.
C. Hold the medication and refuse to administer additional amounts of the drug.
D. Notify the health care provider immediately and prepare for administration of an
antidote.
*B
On admission to a residential care facility, an older female client tells the nurse that she
enjoys cooking, quilting, and watching television. 24 hours after admission, the nurse notes
that the client is withdrawn and isolated. Which activity should the nurse encourage the
client to become involved and participate?
A. Bake a cake for a resident's birthday.
B. Participate in a group quilting project.
C. Clean the unit kitchen cabinets.
D. Watch television in the activity room.
*B
The nurse is caring for a client who received the first-time electroconvulsive therapy (ECT)
a half hour ago. Which action should the nurse implement first?
A. Encourage group participation.
B. Offer oral fluids.
C. Evaluate ECT effectiveness.
D. Monitor vital signs.
*D
Within several days of hospitalization, a client is repeatedly washing the top of the same
table. Which initial intervention is best for the nurse to implement to help the client cope
with anxiety related to this behavior?
A. Administer a prescribed PRN anti-anxiety medication.
B. Assist the client to identify stimuli that precipitates the ritualistic activity.
C. Teach the client relaxation and thought stopping techniques.
D. Allow time for the ritualistic behavior, then redirect the client to other activities.
*D
the charge nurse is collaborating with the nursing staff about the plan of care for a client
who is very depressed. What is the most important intervention to implement during the
first 48 hours after the client's admission to the unit?
A. Encourage participation in activities.
B. Monitor appetite and observe intake at meals.
C. Provide ongoing, supportive contact.
D. Maintain safety in the client’s milieu.
*D
A female client comes to an outpatient therapy appointment intoxicated. The spouse tells
the nurse, “There wasn't anything I could do to stop her drinking this morning.” What
intervention should the nurse take at this time?
A. Tell the client that therapy cannot take place while she is intoxicated.
B. Have the client admitted to the inpatient psychiatric unit.
C. Arrange for emergency admission to a detoxification unit.
D. Talk to this spouse about strategies to limit the client’s drinking.
*A
The nurse is conducting discharge teaching for a client with schizophrenia who plans to live
in a group home. Which statement is most indicative of the need for careful follow-up after
discharge?
A. Crickets are a good source of protein.
B. I have not heard any voices for a week.
C. Sometimes I have a hard time sitting still.
D. Only my belief in God can help me.
*D
A client with bipolar disorder on the mental health unit becomes loud, and shouts at one of
the nurses, “You fat tub of lard! Get something done around here!” What is the best initial
action for the nurse to take?
A. Tell the client his health care provider will be notified if he continues to be verbally
abusive.
B. Redirect the client's energy by asking him to tidy the recreation room.
C. Call the health care provider to obtain a prescription for a sedative.
D. Have the orderly escort the client to his room.
*B
The wife of a male client recently diagnosed with schizophrenia asks the nurse, “What
exactly is schizophrenia? Is my husband alright?” Which response is best for the nurse to
provide to this family member?
A. It is a chemical imbalance in the brain that causes disorganized thinking.
B. I think you should talk to your husband psychologist about this question.
C. It sounds like you're worried about your husband. Let's sit down and talk.
D. Your husband will be just fine if he takes his medications regularly.
*A
A male client with mental illness and substance dependency tells the mental health nurse
that he has started using illegal drugs again and wants to seek treatment. Since he has a
dual diagnosis, which person is best for the nurse to refer this client to first?
A. The clinic health care provider.
B. His support group sponsor.
C. His case manager.
D. The emergency room nurse.
*C
Adult female client is admitted to the psychiatric hospital with a diagnosis of bipolar
disorder, manic phase. She is demanding and active. Which intervention should the nurse
include in this client's plan of care?
A. Provide a structured environment with little stimuli.
B. Reinforce her ability to make her own decisions.
C. Encourage her to identify feelings of anger.
D. Schedule her to attend various group activities.
*A
A female client with obsessive-compulsive disorder (OCD) is describing her obsessions and
compulsions and asks the nurse why these make her feel safer. What information should
the nurse include in this client's teaching plan? Select all that apply.
A. Obsessions cause compulsions.
B. Obsessive thoughts are linked to levels of neurochemicals.
C. Antidepressant medications increase serotonin levels.
D. Compulsions relieve anxiety.
E. Anxiety is the key reason for OCD.
*B, C, D, and E
A client who has been admitted to the psychiatric unit tells the nurse, “My problems are so
bad that no one can help me.” Which response is best for the nurse to make?
A. Let's talk about what is right with your life.
B. Things probably are not as bad as they seem right now.
C. I hear how miserable you are, but things will get better soon.
D. How can I help?
*D
The nurse plans to help in 18-year-old female intellectually disabled client ambulate the
first post operative day after her appendectomy. When the nurse tells the client it is time to
get out of bed, the client becomes angry and tells the nurse, “Get out of here! I'll get up
when I'm ready!” Which response is best for the nurse to make?
A. Your health care provider has prescribed ambulation on the first postoperative day.
B. I know how you feel. You're angry about having to ambulate, but this will help you
get well.
C. I'll be back in 30 minutes to help you get out of bed and walk around the room.
D. You must ambulate to avoid complications which could cause more discomfort than
ambulating.
*C
An anxious client expressing a fear of people and open places is admitted to the psychiatric
unit. What is the most effective way for the nurse to assist this client?
A. Distract the client whenever discomfort about being with others is expressed.
B. Confront fears and discuss the possible causes of these fears with the client.
C. Accompany the client outside for an increasing amount of time each day.
D. Plan an outing with the peer group within the first week of admission.
*C
Based on non-compliance with the medication regimen, an adult client with a diagnosis of
substance abuse and schizophrenia recently had a change in prescriptions from oral
fluphenazine HCI (Prolixin) to fluphenazine decanoate (Prolixin IM). What is most
important to teach the client and family about this change in medication regimen?
A. The effects of alcohol and drug interaction.
B. Signs and symptoms of extrapyramidal effects (EPS).
C. Information about substance abuse and schizophrenia.
D. The availability of support groups for those with dual diagnosis.
*A
And older female client with Alzheimer's disease is wandering the busy halls of the
extended care facility and ask the nurse, “Where should I stand for the parade?” Which
response should the nurse provide?
A. Remember I told you that this is a nursing home and I am your nurse.
B. Anywhere you want to stand as long as you do not get hurt by those in the parade.
C. Let's go back to the activity room and see what is going on in there.
D. You are confused because of all the activity in the hall. There is no parade.
*C
The nurse is planning care for a 32-year-old male client diagnosed with HIV infection who
has a history of chronic depression. Recently, the client viral load has begun to increase
rather than decrease despite his adherence to the HIV drug regimen. What should the
nurse do first while taking the client history on admission to the hospital?
A. Determine if the client attends a support group weekly.
B. Have the client describe any recent changes in mood.
C. Ask the client if he takes St. John’s Wort routinely.
D. Hold all antidepressant medications until further notice.
*C
A client who reports feeling depressed tells the nurse on admission, “I want to feel normal
again.” How should the nurse respond?
A. What do you think the hospital can do for you?
B. Tell me more about how things are with you.
C. How long have you felt this way?
D. We are all here to help you get better.
*B
A client who abuses alcohol says to the nurse, “I am glad I went in for treatment period
now my problems with alcohol are all behind me.” Which response is best for the nurse to
provide?
A. You are likely to have a difficult time staying sober if you think that your problems
with alcohol are behind you.
B. Yes, the treatment program you attend has an excellent success profile.
C. Do you know what one day at a time means for those who have problems with
alcohol?
D. Can you tell me more about what you mean when you say that your problems with
alcohol are now behind you?
*D
A male client is admitted to a mental health unit on Friday afternoon and is very upset on
Sunday because he has not had the opportunity to talk with the health care provider.
Which response is best for the nurse to provide this client?
A. What concerns do you have at this time?
B. How can I help answer your questions?
C. Let me call and leave a message for your health care provider.
D. The health care provider should be here on Monday morning.
*C
The nurse is assessing a client who is admitted with a diagnosis of depression. Which
findings is characteristic of depression?
A. Grandiose ideations.
B. Self-destructive thoughts.
C. Suspiciousness of others.
D. A negative view of self in the future.
*D
When preparing a teaching plan for a client who is to be discharged with a prescription for
lithium carbonate (Lithonate), which instruction is most important for the nurse to
include?
A. Eat foods high in fiber such as whole grain breads.
B. Keep your dietary salt intake consistent.
C. It may take three to four weeks to achieve therapeutic effects.
D. Avoid eating aged cheese and chicken liver.
*B
The nurse observes a female client with schizophrenia watching the news on television. She
begins to laugh softly and says, “Yes, my love, I'll do it.” When the nurse questions the
client about her comment she states, “The news commentator is my lover and he speaks to
me each evening. Only I can understand what he says.” What is the best response for the
nurse to make?
A. The news commentator is not talking to you.
B. What do you believe the news commentator said to you?
C. Does the news commentator have plans to harm you or others?
D. Let's watch news on a different television channel.
*B
A male adolescent is admitted with bipolar disorder after being released from jail for
assault with a deadly weapon. When the nurse asks the teen to identify his reason for the
assault, he replies, “Because he made me mad!” Which goal is best for the nurse to include
in the client's plan of care?
A. Discuss recognizing consequences for behaviors exhibited.
B. Encourage client to verbalize feelings when anger occurs.
C. Teach the client to outline methods for managing anger.
D. Suggest actions to control impulsive responses towards self and others.
*D
The nurse is caring for a client who was admitted for alcohol detoxification 2 days ago.
Which finding is most critical for the nurse to report to the health care provider?
A. Restlessness, anxiety, and difficulty sleeping.
B. Agitation, vomiting, and visual and auditory hallucinations.
C. Global confusion and inability to recognize family members.
D. Low-grade fever, diaphoresis, hypertension, and tachycardia.
*C
A female client refuses to take an oral hypoglycemic agent because she believes that the
drug is being administered as part of an elaborate plan by the Mafia to harm her. Which
nursing intervention is most important to include in this client's plan of care?
A. Ask the health care provider to give the client the medication.
B. Explain that the diabetic medication is important to take.
C. Reassure the client that no one will harm her while she is in the hospital.
D. Reassess client's mental status for thought processes and content.
*D
The parents of a 14-year-old boy bring their son to the hospital. He is lethargic, but
responsive. The mother states, “I think he took some of my pain pills.” During initial
assessment of the adolescent, what information is most important for the nurse to obtain
from the parents?
A. If he might have taken any other drugs.
B. If he has seemed depressed recently.
C. If he has a desire to quit taking drugs.
D. If a drug overdose has ever occurred before.
*A
A female client with depression attends group and states that she sometimes misses her
medication appointment because she feels very anxious about riding the bus. Which
statement is the nurses best response?
A. Let's talk about what happens when you feel very anxious.
B. Take your medication for anxiety before you ride the bus.
C. What are some ways that you can cope with your anxiety?
D. Can your case manager take you to your appointments?
*C
A client is responding to auditory hallucination and shakes a fist at a nurse and says, “Back
off, witch!” The nurse follows the client to the unit dayroom. What action should the nurse
implement?
A. Sit down in a chair near the client.
B. Move to a position that allows the client to be closest to the room's door.
C. Position self within an arm’s length of the client.
D. Ensure that there is physical space between the nurse and client.
*D
A male client is admitted to the mental health unit because he was feeling depressed about
the loss of his wife and job. The client has a history of alcohol dependency and admits that
he was drinking alcohol 12 hours ago. Vital signs are: temperature 100 degrees Fahrenheit,
100 beats per minute, and blood pressure 142/100. The nurse plans to give the client
lorazepam (Ativan) based on which priority client problem?
A. Knowledge deficit related to ineffective coping.
B. Risk for injury related to alcohol detoxification.
C. Health seeking behaviors related to personal crisis.
D. Risk for injury related to suicidal ideations.
*B
Which statement about contemporary mental health nursing practice is accurate?
A. There is one approved theoretical framework for psychiatric nursing practice.
B. The psychiatric nursing client may be an individual, family, group, organization, or
community.
C. Contemporary practice of psychiatric nursing is primarily focused on inpatient care.
D. Psychiatric nursing has yet to be recognized as a core mental health discipline.
*B
The nurse should withhold the next scheduled dose of a client haloperidol (Haldol) based
on which assessment finding?
A. Dizziness when standing.
B. Shuffling gait and hand tremors.
C. Fever of 102 F.
D. urinary retention.
*C
Over a period of several weeks, a male participant of a socialization group at a community
daycare Center for the elderly monopolizes most of the groups time and interrupts others
when they are talking. What is the best action for the nurse to take in this situation?
A. Ask the client to join another group.
B. Talked to the client outside the group about his behavior during group meetings.
C. Allow the group to handle the problem.
D. Remind the client to allow others in the Group A chance to talk.
*C
A schooled-aged girl with severe birth defects and mental retardation is brought to the
emergency room because of a possible broken arm. The caregiver reports that the girl
sustained the injury when she fell from her wheelchair. Which intervention should the
nurse involvement?
A. Prepare the child for cast placement.
B. Evaluate the child for other injuries.
C. Evaluate the intellectual functioning of the child.
D. Ask the child to explain the accident.
*B
An adult male who is a sales manager tells the nurse, “I am thinking about a job change
period I do not feel like I am living up to my potential.” Which of Maslow’s developmental
stages is the client attempting to achieve?
A. Basic needs.
B. Safety and security.
C. Loving and belonging.
D. Self-actualization.
*D
The nurse is preparing to administer phenelzine sulfate (Nardil) to a client on the
psychiatric unit. Which side effect reported by the client is related to administration of this
drug?
A. My urine looks pink.
B. This pill gives me diarrhea.
C. My mouth feels like cotton.
D. That stuff gives me indigestion.
*C
An adult female client who has been taking antipsychotic neuroleptic medication for the
past three days has a decrease in psychotic behavior and appears to be responding well to
the medication. On the 4th day, the client's blood pressure increases, she becomes pale and
febrile, and demonstrates muscular rigidity. Which action should the nurse initiate?
A. Immediately transfer the client to the intensive care unit.
B. Describe the symptoms to the charge nurse and record on the client's chart.
C. No action is required at this time as these are known side effects of such drugs.
D. Place the client on seizure precautions and monitor carefully.
*A
An adult female who is married and works full time in a factory has been absent from
work for three days at a time on several occasions. Each time she returns to work, she
wears dark glasses to cover facial bruising. Her supervisor refers her to the occupational
health nurse. What assessment question should the nurse use?
A. What did you do to deserve this?
B. How did this happen to you?
C. Did your husband beat you?
D. Do you drink excessively?
*B
At a support meeting for a parents of a teenager with polysubstance dependency, a parent
states, “Each time my son tries to quit taking drugs, he gets so depressed that I'm afraid he
will commit suicide.” The nurses response should be based on which information?
A. Feelings of depression frequently lead to drug abuse and addiction.
B. Addiction is a chronic incurable disease.
C. Careful monitoring should be provided during withdrawal from the drugs.
D. Tolerance to the effects of drugs causes feelings of depression.
*C
And adult client who has been hospitalized for two weeks for chronic paranoia continues to
state that someone is trying to steal the clients clothing. Which action should the nurse
take?
A. Explain to the client that his suspicions are false.
B. Place a lock on the client's closet.
C. Encourage the client to actively participate in assigned activities on the unit.
D. Ignore the client's paranoid ideations to extinguish these behaviors.
*C
The Nurse is assessing the parents of a nuclear family who are attending a support group
for parents of adolescents. According to Erikson, these parents who are adapting to middle
adulthood should exhibit which characteristic?
A. Increased self-understanding.
B. Loss of independence.
C. Isolation from society.
D. Development of intimate relationships.
*A
And adolescent who attempted suicide with a drug overdose arrives in the emergency
department with an empty 30-tablet bottle of acetaminophen (Tylenol). Which action
should the nurse implement?
A. Administer acetylcysteine (Mucocyst).
B. Monitor cardiac rhythm for flat T waves.
C. Check both serum AST and ALT levels.
D. Prepare to administer syrup of ipecac.
*A
A client on the psychiatric unit appears to imitate a certain nurse on the unit. The client
seeks out this particular nurse and imitates the nurse’s mannerisms. Which mechanism is
the client using?
A. Sublimation
B. Introjection
C. Repression
D. Identification
*D
The nurse is planning the care for a client based on the psychoanalytical model. Which
intervention should the nurse include in the plan of care?
A. Teach the importance of medication compliance.
B. Focus on the client's positive or negative feelings towards the nurse.
C. Emphasize the client’s strengths and assets.
D. Offer the client psycho educational materials to read. [Show Less]