b.“I don’t know” answer to questionsc.Shallow of labile effectd.Neglect of personal hygiene
13.Nurse Trish is working in a mental healthfacility; the nurse priority nursing interventionfor a newly admitted client with bulimianervosa would be to?
a.Teach client to measure I & Ob.Involve client in planning daily mealc.Observe client during mealsd.Monitor client continuously
14.Nurse Patricia is aware that the major healthcomplication associated with intractableanorexia nervosa would be?
a.Cardiac dysrhythmias resulting to cardiac arrestb.Glucose intolerance resulting in protractedhypoglycemiac.Endocrine imbalance causing cold amenorrhead.Decreased metabolism causing cold intolerance
15.Nurse Anna can minimize agitation in adisturbed client by?
a.Increasing stimulationb.limiting unnecessary interactionc.increasing appropriate sensory perceptiond.ensuring constant client and staff contact
16.A 39 year old mother with obsessive-compulsive disorder has become immobilizedby her elaborate hand washing and walkingrituals. Nurse Trish recognizes that the basisof O.C. disorder is often:
a.Problems with being too conscientiousb.Problems with anger and remorsec.Feelings of guilt and inadequacyd.Feeling of unworthiness and hopelessness
17.Mario is complaining to other clients about notbeing allowed by staff to keep food in hisroom. Which of the following interventionswould be most appropriate?
a.Allowing a snack to be kept in his roomb.Reprimanding the clientc.Ignoring the clients behaviord.Setting limits on the behavior
18.Conney with borderline personality disorderwho is to be discharge soon threatens to “dosomething” to herself if discharged. Which of the following actions by the nurse would bemost important?
a.Ask a family member to stay with the client athome temporarilyb.Discuss the meaning of the client’s statementwith herc.Request an immediate extension for the clientd.Ignore the clients statement because it’s a signof manipulation
Joey a client with
belches loudly. A staff member asksJoey, “Do you know why people find yourepulsive?” this statement most likely wouldelicit which of the following client reaction?
20.Which of the following approaches would bemost appropriate to use with a client sufferingfrom narcissistic personality disorder whendiscrepancies exist between what the clientstates and what actually exist?
a.Rationalizationb.Supportive confrontationc.Limit settingd.Consistency
21.Cely is experiencing alcohol withdrawalexhibits tremors, diaphoresis andhyperactivity. Blood pressure is 190/87 mmhgand pulse is 92 bpm. Which of themedications would the nurse expect toadminister?
a.Naloxone (Narcan)b.Benzlropine (Cogentin)c.Lorazepam (Ativan)d.Haloperidol (Haldol)
22.Which of the following foods would the nurseTrish eliminate from the diet of a client inalcohol withdrawal?
a.Milkb.Orange Juicec.Sodad.Regular Coffee
23.Which of the following would Nurse Hazelexpect to assess for a client who is exhibitinglate signs of heroin withdrawal?
a.Yawning & diaphoresisb.Restlessness & Irritabilityc.Constipation & steatorrhea