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89 Item Psychiatric Nursing Exam II

89 Item Psychiatric Nursing Exam II

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Published by: shark_tale04 on May 30, 2010
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89 Item Psychiatric Nursing Exam II : Substance Abuse, Eating disorders andImpulse control disorders
 http://www.pinoybsn.tk  1. An unemployed woman, age 24, seeks help because she feels depressed andabandoned and doesn't know what to do with her life. She says she has quit her last five jobs because her coworkers didn't like her and didn't train her adequately. Last week, her  boyfriend broke up with her after she drove his car into a tree after an argument. Theclient's initial diagnosis is borderline personality disorder. Which nursing observationssupport this diagnosis?A. Flat affect, social withdrawal, and unusual dressB. Suspiciousness, hypervigilance, and emotional coldnessC. Lack of self-esteem, strong dependency needs, and impulsive behavior D. Insensitivity to others, sexual acting out, and violence2.In a toddler, which of the following injuries is most likely the result of child abuse?A. A hematoma on the occipital region of the headB. A 1-inch forehead lacerationC. Several small, dime-sized circular burns on the child's back D. A small isolated bruise on the right lower extremity3. A client is admitted to the emergency department after being found unconscious. Her  blood pressure is 82/50 mm Hg. She is 5
4" (1.6 m) tall, weighs 79 lb (35.8 kg), andappears dehydrated and emaciated. After regaining consciousness, she reports that shehas had trouble eating lately and can't remember what she ate in the last 24 hours. Shealso states that she has had amenorrhea for the past year. She is convinced she is fat andrefuses food. The nurse suspects that she has:A. bulimia nervosa.B. anorexia nervosa.C. depression.D. schizophrenia.4. A 15-year-old girl with anorexia has been admitted to a mental health unit. She refusesto eat. Which of the following statements is the best response from the nurse?A. "You don't have to eat. It's your choice."B. "I hope you'll eat your food by mouth. Tube feedings and I.V. lines can beuncomfortable."C. "Why do you think you're fat? You're underweight. Here — look in the mirror."D. "You really look terrible at this weight. I hope you'll eat."5. A client with a history of substance abuse has been attending Alcoholics Anonymousmeetings regularly in the psychiatric unit. One afternoon, the client tells the nurse, "I'mnot going to those meetings anymore. I'm not like the rest of those people. I'm not adrunk. "What is the most appropriate response?
 A. "If you aren't an alcoholic, why do you keep drinking and ending up in the hospital?"B. "It's your decision. If you don't want to go, you don't have to."C. "You seem upset about the meetings."D. "You have to go to the meetings. It's part of your treatment plan."6. A client is admitted to the inpatient adolescent unit after being arrested for attemptingto sell cocaine to an undercover police officer. The nurse plans to write a behavioralcontract. To best promote compliance, the contract should be written:A. abstractly.B. by the client alone.C. jointly by the client and nurse.D. jointly by the physician and nurse.7. During which phase of alcoholism is loss of control and physiologic dependenceevident?A. Prealcoholic phaseB. Early alcoholic phaseC. Crucial phaseD. Chronic phase8. Which of the following is important when restraining a violent client?A. Have three staff members present, one for each side of the body and one for the head.B. Always tie restraints to side rails.C. Have an organized, efficient team approach after the decision is made to restrain theclient.D. Secure restraints to the gurney with knots to prevent escape.9. A client who's actively hallucinating is brought to the hospital by friends. They say thatthe client used either lysergic acid diethylamide (LSD) or angel dust (phencyclidine[PCP]) at a concert. Which of the following common assessment findings indicates thatthe client may have ingested PCP?A. Dilated pupilsB. NystagmusC. ParanoiaD. Altered mood10. A severely dehydrated teenager admitted to the hospital with hypotension andtachycardia undergoes evaluation for electrolyte disturbances. Her history includesanorexia nervosa and a 20-lb (9.1-kg) weight loss in the last month. She is 5
7" (1.7 m)tall and weighs 80 lb (36.3 kg). Which nursing intervention takes highest priority?A. Initiating caloric and nutritional therapy as orderedB. Instituting behavioral modification therapy as ordered
C. Addressing the client's low self-esteemD. Regularly monitoring vital signs and weight11. A client tells the nurse that he is having suicidal thoughts every day. In conferringwith the treatment team, the nurse should make which of the followingrecommendations?A. A no-suicide contractB. Weekly outpatient therapyC. A second psychiatric opinionD. Intensive inpatient treatment12. Which of the following etiologic factors predispose a client to Tourette syndrome?A. No known etiologyB. Abnormalities in brain neurotransmitters, structural changes in basal ganglia andcaudate nucleus, and geneticsC. Abnormalities in the structure and function of the ventriclesD. Environmental factors and birth-related trauma13. A client is admitted for detoxification after a cocaine overdose. The client tells thenurse that he frequently uses cocaine but he can control his use if he chooses. Whichcoping mechanism is he using?A. WithdrawalB. Logical thinkingC. RepressionD. Denial14. An 16-year-old boy is admitted to the facility after acting out his aggressionsinappropriately at school. Predisposing factors to the expression of aggression include:A. violence on television.B. passive parents.C. an internal locus of control.D. a single-parent family15. A client is brought to the emergency department after being beaten by her husband, a prominent attorney. The nurse caring for this client understands that:A. open boundaries are common in violent families.B. violence usually results from a power struggle.C. domestic violence and abuse span all socioeconomic classes.D. violent behavior is a genetic trait passed from one generation to the next.16. On discharge after treatment for alcoholism, a client plans to take disulfiram(Antabuse) as prescribed. When teaching the client about this drug, the nurse emphasizesthe need to:

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