Psychiatry MCQ PART I Electroconvulsive Therapy 1.

The nurse understands that ECT treatments are thought to alleviate symptoms of depression by which action? A. Altering serotonin levels B. Enhancing the efficacy of psychotropic drugs C. Causing memory loss D. Stimulating the thyroid gland Answer. A Electroconvulsive therapy is thought to correct the biochemical abnormalities of serotonin and dopamine during the transmission of nerve impulses between synapses. It can result in transient memory disturbances but this is an adverse effect of the treatment, not the reason for its use. It does not enhance drug therapy; rather it is commonly used in clients who have not responded to drug therapy. It does not affect the thyroid gland. 2. The nurse in the outpatient ECT clinic reviews the client's history for which of the following that might increase the client's risk during ECT? A. Degenerative joint disease B. Insulin-dependent diabetes mellitus C. Recent myocardial infarction D. Use of multiple medications Answer.C The client's risk for injury or complications with ECT is increased with a history of a recent myocardial infarction or other cardiac disease. Degenerative joint disease, diabetes, and multiple medication use are not conditions associated with an increased risk to the client. 3. The nurse teaches the client scheduled for ECT treatment that preparation includes which of the following? A. Eating a light breakfast at least 3 hours before treatment B. Limiting intake of carbohydrates at least 3 days before treatment C. Refraining from food and fluids for at least 8 hours before treatment D. Washing hair the morning of treatment Answer. C Prior to ECT, food and fluids are withheld from the client for at least 8 hours. Hair does not need to be washed before treatment. 4. Which intervention would be the priority during the ECT procedure? A. Assessing EEG B. Assisting the physician C. Monitoring seizure actions D. Protecting the client Answer. D During the ECT procedure, the priority is protecting the client from injury that may result from the motor seizures secondary to the procedure. Assessing the EEG and seizure activity is the responsibility of the anesthesiologist and physician. Assisting the client, not the physician, is the priority. 5. In the post-ECT recovery period, which finding would alert the nurse to a possible problem? A. Sleepiness B. Lack of seizure activity C. Urinary incontinence D. Vital sign alterations Answer. D Vital sign alterations should be reported to the physician immediately. Like any other procedure performed under general anesthesia, vital sign changes indicate a problem. Typically after ECT, the client is sleepy. Seizure activity is not evident and urinary incontinence may have occurred during the ECT procedure. 6 A client scheduled for electroconvulsive therapy asks the nurse how the therapy helps relieve her depression. The nurse’s response is based on an understanding that ECT: A. Eliminates the neurotransmitter acetylcholine. B. Increases the perception of external stimuli. C. Decreases levels of cortisol from the adrenal cortex. D. Produces a seizure that temporarily alters brain chemicals.
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Answer. D is correct. Electroconvulsive therapy produces a tonic-clonic seizure that temporarily increases brain chemicals, serotonin, dopamine, and norepinephrine. 7. Which is the highest priority in the post ECT care? A. Observe for confusion B. Monitor respiratory status C. Reorient to time, place and person D. Document the client’s response to the treatment Answer. (B) Monitor respiratory status A side effect of ECT which is life threatening is respiratory arrest. A and C. Confusion and disorientation are side effects of ECT but these are not the highest priority. 8. A 23-year-old woman is experiencing an acute phase of catatonic schizophrenia that is not responding to psychopharmacological treatment. She is scheduled for ECT in the morning. A preoperative drug that the nurse would most likely administer prior to the treatment would be: A. Atropine B. Inderal (propranolol) C. Lithium D. Dalmane (flurazepam) Answer. (A) Atropine is given prior to ECT because it acts to prevent airway complications from excessive secretions during the treatment. (B) Propranolol is a -blocker not used in conjunction with ECT. (C) Lithium is used in the treatment of bipolar disorders. (D) Flurazepam is used for insomnia. Pharma 9. When administering the neuroleptic haloperidol (Haldol) to a client, the nurse understands that it is decreasing the amounts of which neurotransmitter? a. Acetylcholine b. Dopamine c. Serotonin d. Histamine Answer.. B Haloperidol acts on dopamine, blocking its action. It does not affect other neurotransmitters such as acetylcholine, serotonin, or histamine. 10. For the client receiving the antipsychotic medication clozapine (Clozaril), which laboratory study would be most important for the nurse to monitor? a. Complete blood count b. Liver function study c. Thyroid profile d. Renal function study Answer.. A Clozapine is specifically associated with agranulocytosis. Therefore, the nurse would monitor the complete blood cell count for changes in white blood cell count. Other laboratory studies may be indicated based on the client's condition. Liver and renal functions studies are commonly done for many drugs because most drugs are metabolized by the liver and excreted by the kidneys. 11. A client receiving the neuroleptic medication chlorpromazine (Thorazine) exhibits excessive drooling and fine hand tremors. Which medication would the nurse expect the physician to order? a. Benztropine (Cogentin) b. Acetaminophen (Tylenol) c. Lorazepam (Ativan) d. Naproxen (Aleve) Answer.. A The client is exhibiting signs and symptoms of parkinsonism, an adverse effect of typical antipsychotic agents. This condition can be treated with administration of an anticholinergic agent such as benztropine (Cogentin). Acetaminophen and naproxen are nonnarcotic analgesics. Lorazepam is an antianxiety agent not associated with the development of parkinsonism. 12. The nurse instructs a client receiving the MAOI agent phenelzine (Nardil) about dietary restrictions for foods high in tyramine to prevent which adverse effect? a. Gastrointestinal upset b. Hypertensive crisis c. Neuromuscular effects d. Urinary retention
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Answer.. B Ingestion of foods high in tyramine while receiving MAOI therapy can lead to hypertensive crisis. Gastrointestinal upset is an adverse effect commonly seen with many pharmacologic agents. Neuromuscular adverse effects are associated with antipsychotic agents. Urinary retention is associated with anticholinergic agents. 13. The nurse advises the client taking lithium carbonate to do which of the following to prevent toxic effects of lithium? a. Maintain adequate sodium and water intake. b. Avoid foods high in tyramine. c. Establish a schedule for regular sleep. d. Monitor for increased temperature. Answer. A To prevent the possibility of lithium toxicity, the nurse would instruct the client to maintain an adequate intake of sodium and water. Foods high in tyramine are to be avoided when a client is receiving MAOI therapy. Establishing a regular sleep schedule would be helpful for clients receiving hypnotic agents. Monitoring for an increased temperature suggestive of infection would be important for clients receiving clozapine (due to possible agranulocytosis). 14. The client on Haldol has pill rolling tremors and muscle rigidity. He is likely manifesting: A. tardive dyskinesia B. Pseudoparkinsonism C. akinesia D. dystonia Answer. (B) Pseudoparkinsonism is a side effect of antipsychotic drugs characterized by masklike facies, pill rolling tremors, muscle rigidity A. Tardive dyskinesia is manifested by lip smacking, wormlike movement of the tongue C. Akinesia is characterized by feeling of weakness and muscle fatigue D. Dystonia is manifested by torticollis and rolling back of the eyes 15. Which of the following is included in the health teachings among clients receiving Valium?: A. Avoid foods rich in tyramine. B. Take the medication after meals. C. It is safe to stop it anytime after long term use. D. Double up the dose if the client forgets her medication. Answer. (B) Antianxiety medications cause G.I. upset so it should be taken after meals. A. This is specific for antidepressant MAOI. Taking tyramine rich food can cause hypertensive crisis. C. Valium causes dependency. In which case, the medication should be gradually withdrawn to prevent the occurrence of convulsion. D The dose of Valium should not be doubled if the previous dose was not taken. It can intensify the CNS depressant effects. 16. During the mental status examination a patient may be asked to explain several proverbs, such as "Don't cry over spilled milk." The purpose is to evaluate the pat's ability to think: a) rationally b) concretely c) abstractly d) tangentially Answer. C - Abstract thinking is the ability to conceptualize and interpret meaning. It is a higher level of intellectual functioning than a concrete thinking, in which the patient would explain the proverb by its literal meaning. Rational thinking involves the ability to think logically, make judgments, and be goal directed. Tangential thinking is scattered, non-goal-directed, and difficult to swallow. 17. The nurse expects to assess which of the following in a client with the diagnosis of schizophrenia, paranoid type? a. Anger, auditory hallucinations, persecutory delusions b. Abnormal motor activity, frequent posturing, autism c. Flat affect, anhedonia, alogia d. Silly behavior, poor personal hygiene, incoherent speech
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Answer. A Clients with schizophrenia, paranoid type, tend to experience persecutory or grandiose delusions and auditory hallucinations in addition to behavioral changes such as anger, hostility, or violent behavior. Abnormal motor activity, posturing, autism, stupor, and echolalia are associated with schizophrenia, catatonic type. Flat affect, anhedonia, and alogia are negative symptoms associated with schizophrenia in general. Schizophrenia, disorganized type, is characterized by withdrawal, incoherent speech, and lack of attention to personal hygiene. 18. The nurse would assess a client diagnosed with cyclothymic disorder for which behaviors? a. Feelings of grandiosity and increased spending b. Feelings of depression and decreased sleep c. Periods of hypomania and depressive symptoms d. Periods of depression accompanied by anxiety Answer. C A client with a cyclothymic disorder displays numerous periods of hypomania and depression that do not meet the criteria for a major depressive episode. Feelings of grandiosity with increased spending may be associated with manic episodes of bipolar disorder. Feelings of depression and decreased sleep are associated with a major depressive disorder. Periods of depression accompanied by anxiety may be associated with depressive disorder not otherwise specified. 19. Which symptom would the nurse expect to assess related to anger expression in a client diagnosed with borderline personality disorder? a. Controlled, subtle anger b. Inappropriate, intense anger c. Inability to recognize anger d. Substitution of physical symptoms for anger Answer. B A client with borderline personality disorder would most likely exhibit impulsive, unpredictable behavior related to gambling, shoplifting, sex, and substance abuse. Contributing to unstable, intense interpersonal relationships are inappropriate, intense anger; unstable affect reflecting depression, dysphoria, or anxiety; disturbance in self-concept, including gender identity; and the inability to control one's emotions. A client with a somatoform disorder develops physical symptoms in response to anxiety, not anger. 20. An adolescent client tells the nurse that she frequently feels compelled to eat a large amount of food in a small amount of time. The nurse identifies this problem as characteristic of which condition? a. Anorexia b. Bulimia c. Overeating d. Compulsiveness Answer. B Bulimia is characterized as the ingestion of a large amount of food over a short amount of time or less than the usual time it would take to consume that amount of food. Anorexia refers to the refusal to maintain weight at or above minimally normal weight through restricting food intake or engaging in binge-eating or purging. Overeating refers to the ingestion of large amounts of food. Compulsiveness refers to an insistent, repetitive urge to engage in an activity. 21. Which nursing intervention would be the priority for a client with suicidal intent? a. Encouraging verbalization of negative feelings b. Pointing out the positive aspects of living c. Providing activities to keep the client busy d. Reassuring the client that thoughts of suicide will decrease Answer. A The priority intervention for a client with suicidal intent is to encourage the client to verbalize negative feelings. Doing so helps clients to explore the reasons underlying the suicidal ideation and provides them with support. Pointing out the positive aspects of living is nappropriate and non-therapeutic. Providing activities to keep the client busy ignores the client's needs. Telling the client that thoughts of suicide will decrease is false reassurance.
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A Interaction with the staff. b. The nursing staff and treatment team participate in a process of reviewing the client's behaviors and the completed suicide despite all precautions implemented on the unit. Introspection d. who can provide you with guidance as to how to proceed. then you. This process also provides staff members with an opportunity to self-assess their behavior and responses and discuss their concerns with peers. Prejudice c. were missed so that staff members can learn from the evaluation of a particular situation. Treatment analysis d. 23. Treatment analysis and team discussion are general terms related to client care. Asking if the client is happy or sad or asking if the client is upset labels the emotion and does not allow the client to verbalize the emotion or feeling. or emotions. Answer. together with your instructor. Ask a peer to introduce you to the client. are you? d. 24. can discuss the client's care with the staff member caring for the client. You look upset. Prejudice refers to feelings of intolerance for another. The staff is engaging in which of the following? a. Your friends are exhibiting which of the following? a. Discuss your feelings with your instructor before approaching the client. They agree that mentally ill persons are not capable of living alone or working. A client has committed suicide while hospitalized on an inpatient psychiatric unit. it is always best to discuss your client care concerns with your instructor.22. Your instructor is knowledgeable about the clinical area as well as aware of your nursing program's policies and procedures. d. A :Stereotyping refers to categorizing persons based on generalized beliefs about a group. Postvention process c. an attempt to 25. is referred to as a psychological autopsy. You overhear two of your friends talking about mental illness. Team discussion Answer. a process used to examine what clues. Stereotyping b.What brought you to the hospital? ‌ Answer. in which the staff reviews the client's behaviors and suicidal act. Ask a staff member what approach is usually effective with the client. 26. Which of the following outcomes is most appropriate for the client with a nursing diagnosis of Social Isolation related to inability to trust as evidenced by withdrawal from others? 5 . If additional information is needed. Asking a peer to introduce you to the client is inappropriate and could lead to client confusion about who will be providing care. Waiting for the client to approach the nurse is inappropriate because the client is verbalizing feelings of hopelessness. Are you happy or sad?‌ c. Introspection refers to selfreflection. Your first assignment in the psychiatric–mental health clinical setting is to provide care for a female client who appears sad and verbalizes hopelessness to the staff. Which of the following questions would be most appropriate to use during the psychiatric admission assessment to obtain data about the client's affect? a. You are uncertain how to approach the client. What are you feeling?‌ b. and thus would not seek out contact with others. Which of the following actions would be the most effective? a. Wait for the client to approach you to avoid bothering the client. D: When in doubt in any situation in the clinical area. c. A Asking the client a general lead-in question such as “What are you feeling?â€‌ provides information about the client's affect or feelings. Censorship Answer. Psychological autopsy b. Rather it focuses on the client's chief complaint or problem. Postvention is a therapeutic program for bereaved survivors of a suicide. if any. Asking the client about what brought him to the hospital does not address the client's emotion or affect.

b. Axis III d. Virtual reality is to be used to treat a client's phobic response. therefore refusing client request d. c. Aversion therapy uses unpleasant or noxious stimuli to change inappropriate 6 . The nurse reviews the psychiatric history of a client with the DSM-IV-TR diagnosis of Borderline Personality Disorder. Encourages client to express feelings about staff disagreement on this issue c. This diagnosis is coded on which of the following diagnostic axes? a. Assertiveness training involves measures to appropriately relate to others using frank. Exercising 2 hours before bedtime d. the nurse is consistent with the limits that are set. Axis I identifies clinical disorders and other conditions that may be a focus of attention. In addition. The client will identify positive qualities in self and others. C Virtual reality is an example of implosive therapy or flooding in which the individual is exposed to intense forms of anxiety producers either in real life or in imagination. The client will spend time with peers and staff members in unit activities. Allows the client to stay up late to promote staff unity b. Aversion therapy c. though also important. An attitude of overall acceptance and optimism is conveyed with any conflicts in staff about issues being handled and resolved to ensure the milieu. Answer. honest. Borderline personality disorder is coded on Axis II of the DSM-IV-TR. 28. Implosive therapy d. The ability to identify positive qualities in oneself and others is important but unrelated to the problem of social isolation. Assertiveness training b. this participation helps to foster a beginning sense of trust. Axis IV Answer. and direct expressions. d. Drinking coffee before midday b. Axis I b. However. Stating that the level of trust is improved. the client is no longer socially isolated. Maintains the same rules for all clients. 29. By participating in unit activities with others. Exercise stimulates body functions and is not considered relaxing. Going to bed at the same time each night c. Behavior modification Answer. The nurse assesses all of the following factors in a client complaining of insomnia. The client will ask the nurse for permission to be excused from activities. C Measures to help promote sleep include avoiding exercising before bedtime. Reducing noise at bedtime Answer. Reducing noise also has been shown to facilitate sleep. The nurse interprets this type of treatment as an example of which of the following? a. Axis IV addresses psychosocial and environmental problems. Drinking coffee before midday would be allowed because the caffeine at this time would not affect the client's ability to sleep. Going to bed at the same time each night provides a routine that promotes sleep. B Axis II addresses personality disorders and mental retardation. Uses staying up late as a reward for this client's good behaviors Answer. An adolescent client tells the evening-shift nurse that the day-shift nurse promised that she could stay up late to watch a special television program. does not indicate that the client's social isolation is being addressed. thus maintaining the same rules for all clients. ingestion of caffeine after midday would be problematic. Axis II c. The evening nurse does which of the following to maintain the therapeutic milieu? a. 27. Axis III involves general medical conditions. Asking for permission to be excused from activities would only serve to reinforce the client's isolation. Allowing the client to stay up or using this as a reward interferes with the foundation of the milieu. C To maintain the therapeutic milieu. 30. Which of the following does the nurse encourage the client to modify? a. The client will state that his or her level of trust in others is improved.a. D The most appropriate outcome would be the client spending time with peers and staff members in unit activities.

Day hall supervision B. When assessing the risk of suicide for a depressed client. B. Splitting Answer. the nurse knows that: A. B The priority is to encourage the client to verbalize feelings and thoughts about the current situation. The client admitted with suicidal thoughts or suicidal gestures is best cared for by constant supervision. C. An overdose of pills is never as lethal as injury by firearms.” What defense mechanism is the client using? A.behavior. they are incorrect. Selecting a book from the hospital library 7 . therefore. Which intervention would be the priority? a. Constant supervision C. and D are not reflected by the client’s statement. 36. therefore. Answers A and C are not true statements. Checks every 15 minutes D. Allow her access to the kitchen between meals B. The nurse should provide the client with high-calorie foods that she can eat as she moves about. Provide small attractively arranged trays D. To help her maintain sufficient nourishment the nurse should: A. 31. 32. therefore. C. Teaching the client about various community supports available Answer. B is correct. Teaching about community supports would be appropriate later on in the care of the client. Allow her to order meals outside the hospital Answer. B is correct. Which of the following interventions provides best for the client’s safety? A. Serve high-calorie foods she can carry with her C. 33. A is correct. therefore. Answer D is incorrect. The availability of means is essential to even the simplest suicide plan. The client is using the defense mechanism of rationalization to justify his behavior. Clients who survive unsuccessful suicide attempts are not likely to try again. C. they are incorrect. The nurse is formulating a plan of care for a client with schizophrenia. Rationalization B. The client is fearful that she will not be able to return to her previous independent lifestyle. they are incorrect. Collaborating with the physical therapist to motivate the client b. Answer. A client with depression and suicidal ideation is admitted to the behavioral health unit for observation. C. This information would be helpful in determining the most appropriate actions for the nurse. Encouraging the client to verbalize feelings and thoughts about the current situation c. Providing reassurance is never appropriate because it can lead to mistrust should the client be unable to achieve her previous level of functioning. 34. A client with mania is unable to complete her meals because of her elevated level of activity. and D do not provide for continual observations to ensure the client’s safety. A client admitted to the chemical dependency unit states “My wife is making too much of this. Projection C. they are incorrect. Which activity is best for increasing the client’s social interaction? A. Answers B. Participating in a game of volleyball B. Answers A. Collaboration with the physical therapist may be appropriate but later in the course of the client's care. 35. Dissociation D. I don’t drink any more than the next guy. and D do not ensure proper nutrition. Providing reassurance that the situation will work out okay d. An older adult client is admitted to the nursing home for rehabilitation after surgery to repair a fractured hip. One-on-one night supervision Answer. Even the simplest plan for suicide requires that the means be available. D. therefore. B is correct. Behavior modification uses Pavlov's theory of conditioning and Skinner's theory of operant conditions involving the use of reinforcers in response to behavior. People who talk about suicide are not likely to harm themselves. Answers A. Overdose by pills is sometimes as fatal as injury by firearms.

Administering prescribed anti-Parkinson medication C. Applying an oxygen saturation monitor to detect hypoxia B. Answers A. 38. The client’s symptoms are an adverse reaction to antipsychotic medication. nausea. and D do not effective ways of decreasing the client’s ritualistic behavior. B is correct. Give the client Cogentin C. The nurse recognizes that binge episodes are associated with: A. Answers B and D are incorrect. 40. 37. therefore. A. Hyponatremia places the client at risk for the development of lithium toxicity. Help the client explore the dynamics of his behavior C. The common side effects of Lithium are fine hand tremors. Feelings of self-loathing and low self-esteem are associated with binge episodes. C. Severe weight loss Answer. Allowing the client to complete his ritualistic behavior will help reduce the client’s anxiety level. Feelings of self-loathing D. are not associated with an increased risk for lithium toxicity. B. and D do not take priority over Answer B. Answer A is incorrect because the client is depressed rather than euphoric. therefore. Applying a heating pad to the neck and shoulders D. 8 . During morning assessments. Recognize this as a drug interaction B. which are within normal limits. A client on Lithium has diarrhea and vomiting. and C. Sodium level of 120 mEq/L Answer. A client with bulimia nervosa reports that she binges at least two times a week. Lithium carbonate (Lithobid) has been ordered for a client with mania. Cogentin is used to manage the extra pyramidal symptom side effects of antipsychotics. Which finding increases the likelihood of the client developing lithium toxicity? A. rather than bulimia nervosa. Answers A. therefore. The nurse should give priority to: A. Participating in a game of volleyball can be overwhelming for a client with schizophrenia. A sense of euphoria B. polyuria and polydipsia. B.C. Allow the client to complete his ritualistic behavior D. C. Answer B is incorrect because the client’s weight is normal or near normal. 39. Administering anti-Parkinson medication will alleviate the client’s dystonia and torticollis. B. Hold the next dose and obtain an order for a stat serum lithium level Answer. C is correct. Answer A is incorrect. The next dose of lithium should be withheld and test is done to validate the observation. Potassium level of 4. Answer D is incorrect because it refers to the client with anorexia nervosa. Calcium level of 8. Participating in a card game D. Answers A. The manifestations are not due to drug interaction. they are incorrect. 41. C is correct. D is correct. Substantial weight gain C. What should the nurse do first: A. Which action is best for the nurse to take when he observes a client engaging in ritualistic behavior? A. Magnesium level of 1.2 mg/Dl B. Reassure the client that these are common side effects of lithium therapy D.8 mg/dL D.0 mEq/L C. Administer sedative medication when the client begins his use of rituals Answer. the nurse finds that a client who has been taking chlorpromazine (Thorazine) has signs of dystonia and torticollis. therefore. Watching TV in the unit dayroom Answer. Participating in a card game allows the client to socially interact with a limited number of others. C is correct. they are incorrect. (D) Hold the next dose and obtain an order for a stat serum lithium level Diarrhea and vomiting are manifestations of Lithium toxicity. Reading and watching TV do not encourage social interaction. Offering additional fluids to reduce dry mouth Answer. Ask the client to carry out his rituals in his room B.

Which observation requires immediate nursing intervention? A. and C are incorrect because they do not take priority over the risk of violence. A.42. D is correct. intoxication D. The nurse is formulating a nursing care plan for a client with paranoid schizophrenia who is experiencing command hallucinations. Answer D is incorrect because it refers to tardive dyskinesia. The client’s morning temperature was 104° F. 44. withdrawal B. 46. Withdrawal refers to the physical signs and symptoms that occur when the addictive substance is reduced or withheld. Assisting with identification of maladaptive behaviors D. they are incorrect. Answer B is incorrect because it refers to echolalia. psychological dependence Answer. Answer B is correct. Psychological dependence refers to the intake of the substance 9 . is characterized by motor restlessness such as pacing and rocking. B. C. which is reflected by extreme elevations in temperature. Involuntary repetition of words spoken by others C. The nurse is caring for a client who is receiving olanzapine (Zyprexa). Answer C is incorrect because it refers to clang association. and D are side effects associated with antipsychotic medication that require the nurse’s attention. Answer D is incorrect because tube feedings are a last resort in the treatment of a client with anorexia nervosa. Answers A and C are not specific to the client’s behavioral program for weight gain. Intoxication refers to the behavioral changes that occur upon recent ingestion of a substance. The client’s skin is red after sitting in the sunlight. Use of words by sound rather than meaning D. B. 43. The use of antipsychotic medications such as Zyprexa can result in neuroleptic malignant syndrome. Giving positive rewards for weight gain C. 45. Pacing and generalized restlessness B. Initiating tube feedings with high-calorie supplements Answer. Answers A. Akathisia. A client who has been taking chlorpromazine (Thorazine) has developed akathisia. Which nursing intervention is most specific to goal attainment? A. C. Ineffective individual coping related to inadequate support systems D. Answers A. A behavioral program for weight gain is started for a client with anorexia nervosa. therefore. B. A client with paranoid schizophrenia who is experiencing command hallucinations represents a risk of violence to himself and others. Slow. rhythmical movements Answer. a side effect of antipsychotic drug therapy. Risk for violence directed at self or others related to disturbed thinking Answer. Answer. D. (B) tolerance refers to the increase in the amount of the substance to achieve the same effects. however. Situation : The nurse assigned in the detoxification unit attends to various patients with substance-related disorders. Social isolation related to mistrust of others C. Providing emotional support and active listening B. The client asks for additional water. Which behavior should the nurse expect the client to exhibit? A. B is correct. D. Altered thought process related to impaired judgment B. they are not as severe as elevations in temperature. A is correct. The client complains of dizziness when he stands. Which nursing diagnosis should receive priority? A. Giving positive rewards for weight gain is most specific to the client’s behavioral program. tolerance C.A 45 years old male revealed that he experienced a marked increase in his intake of alcohol to achieve the desired effect This indicates: A.

A and D are psychosocial needs of a client with anorexia nervosa but they are not the priority.” The individual does not acknowledge that the loss has occurred to protect self from the psychological pain of the loss.. Methadone (Dolophine) Answer. Disulfiram (Antabuse) D. Naltrexone (Revia) B. anger D. The condition occurs unconsciously. The client will experience high level of anxiety in response to the paralysis. A. (C) the client uses body symptoms to relieve anxiety. A. Depression is a painful stage where the individual mourns for what was lost. will reminisce to decrease isolation C. (B) Fluid volume deficit is the priority over altered nutrition (A) since the situation indicates that the client is dehydrated.to prevent the onset of withdrawal symptoms. The symptoms are conscious effort to control anxiety B. remains in a safe and secure environment D. Disulfiram is used as a deterrent in the use of alcohol. (C) Anger is experienced as reality sets in. This is an opiate receptor blocker used to relieve the craving for heroine C. independently performs self care Answer. The client should not be confronted by the underlying cause of his condition because this can aggravate the client’s anxiety. but it is not the priority B. A client is admitted with needle tracts on his arm. This may either be directed to God. Situation: A 17 year old gymnast is admitted to the hospital due to weight loss and dehydration secondary to starvation. altered family process D. Which of the following nursing diagnoses will be given priority for the client? A. fluid volume deficit C. Situation: A 20 year old college student is admitted to the medical ward because of sudden onset of paralysis of both legs. has just been told that she has AIDS. A. altered nutrition less than body requirements Answer. 51. The client is not distressed by the lost or altered body function. Pamela says to the nurse. Patient is allowed to reminisce but it is not the priority. Methadone is used as a substitute in the withdrawal from heroine 48.Why me? How could God do this to me? This reaction is one of: A. (C) Safety is a priority consideration as the client’s cognitive ability deteriorates. it can’t be true. A is appropriate interventions because the client’s cognitive impairment can affect the client’s ability to attend to his nutritional needs. D. Narcan (Naloxone) C. stuporous and with pin point pupil will likely be managed with: A. Denial C. In bargaining the individual holds out hope for 10 . receives adequate nutrition and hydration B. B. The client in the moderate stage of Alzheimer’s disease will have difficulty in performing activities independently 49. the deceased or displaced on others. The primary nursing intervention in working with a client with moderate stage dementia is ensuring that the client: A. Answer.The nurse plans intervention based on which correct statement about conversion disorder? A. Denial is the first stage of the grieving process evidenced by the statement “No. 50. altered self-image B. B. D. (B) Narcan is a narcotic antagonist used to manage the CNS depression due to overdose with heroin. A confrontational approach will be beneficial for the client. bargaining Answer. C. The conversion symptom has symbolic meaning to the client D. D. Depression B. whose husband died one year ago due to AIDS. D. Situation: A widow age 28. Extensive examination revealed no physical basis for the complaint. 47.

56. suicidal ideation C. (A) Accessibility of the means of suicide increases the lethality. This is not congruent with therapeutic milieu. D. anxiety B. (C) “. Which is the most therapeutic approach by the nurse? A. (D) Broad opening technique allows the client to take the initiative in introducing the topic. pacing up and 11 . (C) A therapeutic milieu refers to a broad conceptual approach in which all aspects of the environment are channeled to provide a therapeutic environment for the client. validating C. Behavioral approach in psychiatric care is based on the premise that behavior can be learned or unlearned through the use of reward and punishment. D. The six environmental elements include structure. Answer. Remove all potentially harmful items from the client’s room. The client says to the nurse ” Pray for me” and entrusts her wedding ring to the nurse. A living.. 55. the statement and non verbal cue of the client indicate suicide. reflecting D. A.additional alternatives to forestall the loss. (B) The client’s statement is a verbal cue of suicidal ideation not anxiety. A therapy that rewards adaptive behavior B. The nurse asks her “What are you thinking about?” This communication technique is: A. this occurs when their depression starts to lift. “You seem to have concerns about going home. “You are much better than when you were admitted so there’s no reason to worry. The client is concerned about his coming discharge. limit setting.” D. 54. This close ended question does not encourage verbalization of feelings. Allowing patient to express feelings and setting a no suicide contract are interventions for suicidal client but blocking the means of suicide is priority. A permissive and congenial environment Answer. evidenced by the statement “If only…” 52. The nurse knows that this may signal which of the following: A.B and C are all therapeutic techniques but these are not exemplified by the nurse’s statement. Hopelessness indicates no alternatives available and may lead to suicide. Situation: Knowledge and skills in the care of violent clients is vital in the psychiatric unit. 53. One morning the nurse sees the client in a depressed mood. Cognitive approach to change behavior is done by correcting distorted perceptions and irrational beliefs to correct maladaptive behaviors. Major depression D. focusing B. Which of the following interventions should be prioritized in the care of the suicidal client? A. C. A. B. B. 57. learning or working environment. While this technique explores plans after discharge. Hopelessness Answer. Increasing self esteem is an intervention for depressed clients bur not specifically for suicide. safety. balance and unit modification. D. it does not focus on expression of feelings. While suicide is common among clients with major depression. Showing empathy can encourage the client to talk which is important as an alternative more adaptive way of coping with stressors. A nurse observes that a client with a potential for violence is agitated. Which of the following best describes a therapeutic milieu? A. Note the client’s capabilities to increase self esteem. Giving false reassurance is not therapeutic. The nurse ensures a therapeutic environment for the client. giving broad opening Answer. This statement reflects how the client feels. D.” B. A. manifested by being unusually sad. A cognitive approach to change behavior C. Allow the client to express feelings of hopelessness. B. “Aren’t you glad that you’re going home soon?” Answer. “What would you like to do now that you’re about to go home?” C. norms. Set a “no suicide” contract with the client.

Ensuring she adheres to certain restrictions Answer. You need to stop that behavior now. Restricting her from other clients D. C. (D) This documentation indicates that the client has been placed on restraints after the least restrictive measures failed in containing the client’s violent behavior. Answer. C. A and D. The plan of care for clients with borderline personality should include: A. 59. social withdrawal. Suspicious. This describes the obsessive compulsive personality 61. expectations. rules and regulation upon admission. hypervigilance and coldness D. This is not part of the care 12 . recover with therapeutic intervention B. manifest enduring patterns of inflexible behaviors D. Answer. The client with this disorder will not likely present himself for treatment unless something has gone wrong in his life so he may not recover from therapeutic intervention. Situation: Clients with personality disorders have difficulties in their social and occupational functions. C. help the client identify the stressor or the true object of hostility. Flexibility and bargaining are not therapeutic in dealing with a manipulative client. Giving medications to prevent acting out C. B. sensitivity to rejection and criticism C. He was restrained after his behavior can no longer be controlled by the staff. Seek treatment willingly from some personally distressing symptoms Answer. D. There is no specific medication prescribed for this condition. Which of the following statements is most appropriate to make to this patient? A. The staff carried out less restrictive measures but were unsuccessful. The client must be informed about the policies. B. C. A teenage girl is diagnosed to have borderline personality disorder. These are the characteristics of a client with paranoid personality D.down the hallway and making aggressive remarks. Lack of self esteem. This disorder is manifested by life-long patterns of behavior. There was a doctor’s order for restraints/seclusion B. Which of these documentations indicates the safeguarding of the patient’s rights? A. You will need to be placed in seclusion.Clients with personality disorder will most likely: A. inadequacy. (C) Personality disorders are characterized by inflexible traits and characteristics that are lifelong. The staff observed confidentiality D. Limit setting and flexibility in schedule B. This is a threatening statement that can heighten the client’s tension. 58. C. orderliness and need for control Answer. A. Seclusion is used when less restrictive measures have failed. This describes the avoidant personality. (A) These are the characteristics of client with borderline personality. Preoccupation with perfectionism. (D) The client is manipulative. B. 60. Medications are generally not recommended for personality disorders. D. The client jumps up and throws a chair out of the window. You will need to be restrained if you do not change your behavior. respond to antianxiety medication C. Which manifestations support the diagnosis? A. What is causing you to become agitated? B. The patient’s rights were explained to him. B. Limits should be firmly and consistently implemented. This helps reveal unresolved issues so that they may be confronted. (A) In a non-violent aggressive behavior. strong dependency needs and impulsive behavior B. Pacing is a tension relieving measure for an agitated client.

anorexia. Conversion involves the transformation of anxiety into a physical symptom. This option cannot be considered correct because the slamming of the cupboard doors cannot be considered a constructive activity. The nurse then went to the utility room and slammed several cupboard doors while looking for Kleenex. Two staff nurses were considered for promotion to head nurse. are not therapeutic responses because these disagree with the client’s false belief and makes the client feel challenged D. This behavior is an example of: A. B.” B. Reaction formation keeps unacceptable feelings or behaviors out of awareness by using the opposite feeling or behavior. object. and diaphoresis C) Persistent hallucinations D) Aggressive behavior and difficulty with balance Answer. When the nurse who was not promoted first read the memo and learned the that the other nurse had received the promotion. conversion. (C) This presents reality and acknowledges the clients feeling A and B. Refusing admission. (A) Displacement unconsciously transfers emotions associated with a person. 66. Answer. comforting. rationalization. sublimation C. object.” D.” Answer. is admitted in the morning for treatment of gastritis. Sublimation is the unconscious process of substituting constructive activity for unacceptable impulses. Introjection involves intense unconscious identification with another person. 65. Rationalization involves the unconscious process of developing acceptable explanations to justify unacceptable ideas. This behavior exemplifies: A. Answer.. Scenario: Questions 8–13. or situation to another less threatening person. or feelings. Client who has threatened suicide c. “I don’t believe that. she left the room in tears. actions. Client whose family has requested admission Answer. a successful teacher. The ego returned to an earlier. Conversion involves unconsciously transforming anxiety into a physical symptom. (B) Crying is a regressive behavior.plan. Interaction with other clients are allowed but the client should be observed and given limits in her attempt to manipulate and dominate others 62. The signs of alcohol withdrawal. are tremors. reaction formation. Client who has a long history of mental illness d. introjections. which appear within the first 8–12 hours. and less mature way of behaving in the face of disappointment. (B). and a family's request for admission are not considered appropriate criteria. Client who is competent but refuses admission b. C. D. regression.” The nurse’s best response is: A. “ What made you think of that. “I don’t know anything about that.” C. The client says “ the police is out to get me. 13 . D. B. or situation. You are afraid of being harmed. Which of the following represents appropriate criteria for the involuntary admission of a client into a psychiatric facility? a. a long history of mental illness. “The police is not out to catch you. She slammed doors instead of striking the other nurse or the administrator who made the promotion decision. displacement. 64. and diaphoresis. anorexia. Near the end of a 12-hour shift. B The key element or criteria for involuntary admission is that the client is considered to be a threat to himself or others. the nurse notices which of the following symptoms that would which suggest(s) alcohol withdrawal? A) Delirium tremens B) Tremors. unnecessary exploration of the false 63. conversion. Lucy J. The promotion is announced via a memo on the unit bulletin board.

Answer. The nurse who was not promoted tells another friend. she suddenly found she had lost her voice and was unable to offer her congratulations. D. Compensation would result in the nurse unconsciously attempting to make up for a perceived weakness by emphasizing a strong point. she would probably be demonstrating: A. B. (C) Conversion unconsciously transforms anxiety into a physical symptom that has no organic basis. Journaling is effective in identifying feelings. Answer. if one cannot speak. discuss the repetitive action. An effective intervention for a client diagnosed with an obsessive compulsive disorder would be: A. C. projection. C. Providing literature and journaling are not effective in reducing stress.” If she actually believes this of the administrator. well. encourage daily exercise. The symptom resolves a conflict. providing literature on stress reduction B.or cost-effective. “Oh. compensation. (D) Obsessive compulsive disorder is an anxiety disorder. C. Rationalization is an unconscious form of self-deception in which we make excuses. rationalization. who. In this case. B. denial. requiring each nurse to write out feelings in a journal each week Answer. limit time for the maladaptive behavior and direct the client’s attention outward. Projection operates unconsciously and would result in blaming behavior. Answer.” The nurse replies that she isn’t the least bit angry. five clients have died in the intensive care unit. nurses should not interfere with performance of the repetitive act. projection. 70. “I knew I’d never get the job. denial. 72. suppression. Answer. 69. “You seem pretty angry. (C) A “debriefing” session will allow nurses to ventilate feelings and gain support from each other. denial. (C) Projection results in unconsciously adopting blaming behavior. 71. conversion. denial. Compensation requires unconsciously making up for perceived deficits 68. In this instance the nurse in probably utilizing: A. If. try reasoning the client out of the behavior or ridicule the behavior. The hospital administrator hates me. Exercise will release emotional energy. in this case the nurse is unable to acknowledge her true feelings. reaction formation. B. inform the client the act is not necessary.67 An aide comes into the utility room and remarks. Repression would operate unconsciously to exclude the event from awareness. Individual counseling sessions are not time. D. (D) Denial involves an unconscious process of escaping an unpleasant reality by ignoring its existence. insist the client not perform the repetitive act. knows little of her. C. In the last week. Initially. (A) This is called the “sour grapes” form of rationalization. D. D. compensation. It allows us to attribute our own unacceptable attributes to other people. The nurse who was not promoted tells a friend. in reality. 14 . B. reaction formation. repression. when the nurse who was not promoted met the newly promoted nurse in the hall. D. Reaction formation is an unconscious process that would call for her to display a feeling that is the opposite of anger. C. B. Denial is an unconscious process that would call for her to ignore the existence of the situation. I really didn’t want the job anyway.” This is an example of: A. Which intervention would be most helpful to reduce the nurse’s stress? A. a “debriefing” session lead by a mental health nurse C individual counseling sessions with a mental health nurse D. one cannot be expected to offer congratulations. repression. she is demonstrating: A. Answer. compensation.

and extensive hand washing is an attempt to: A. Disorganized schizophrenia B. (D) The fear of fire is called pyrophobia. (B) Clients with obsessive-compulsive disorder often recognize that they have little control over their obsessions and compulsions and that they are interfering with their ability to function. The nurse knows that ECT is most commonly prescribed for: A. One nursing goal in the care plan for a client with a paranoid personality disorder is promoting consensual validation of reality. Major depression C. D. (B) Clients with agoraphobia are afraid to leave their homes for fear of being trapped without the ability to escape. (A) The client with obsessive-compulsive disorder uses the rituals to cope with intense anxiety related to aggressive impulses and guilt. Increase her self-esteem D. Crisis intervention Answer. Relieve underlying anxiety B. In implementing treatment for a client with a phobic disorder. (C) Interventions include assisting these clients to clarify thoughts and feelings. (B) These clients often interpret the use of humor in others as a personal assault—that they are the intended focus of the joke. In providing care to a client with an obsessive-compulsive disorder. By gradually exposing these clients to the phobic stimulus. 76. who have medical problems that contraindicate the use of 15 . Which of the following nursing actions would be most appropriate to achieve this goal? A. the nurse recognizes that the client’s frequent. The client is afraid of pain. C. The nurse is caring for a 35-year-old woman with agoraphobia. A 55-year-old woman is scheduled for ECT the next morning. B. Use humor to challenge his perceptions. such as leaving their homes or the hospital unit. Reduce the possibility of infection Answer. Which of the following behaviors would the nurse expect to observe in the client? A. Answer. Administering lithium C. The client is afraid of talking to other people. and the clients can begin to function more effectively. (D) Antidepressant medications are used frequently for clients with depressive disorder. D. Answer. Arguing about his suspicions will reinforce them. They need opportunities to discuss their perceptions. (C) Desensitization treatment is an appropriate part of the nursing care plan for phobic clients. but the nurse should avoid arguing with the client about his perceptions. Discourage him from verbalizing his perceptions. The client is afraid to leave her home. (D) The excessive hand washing contributes to the risk of infection because it threatens skin integrity. (C) The rituals do not contribute to a sense of self-esteem for clients with this disorder. Insight-oriented psychotherapy B. Dissociative disorder Answer. nursing actions include: A. Give herself a sense of control over her life C. (B) ECT is commonly used for treatment of major depression in clients who have not responded to antidepressants. The client is afraid of fire. (C) The fear of pain is called algophobia.73. B. 75. Antisocial personality disorder D. Desensitization treatment D. 74. (A) An effective implementation for promoting consensual validation of reality is to reinforce reality. Reinforce reality but avoid arguing with the client about his perceptions. intensive. C. not paranoid personality disorder 77. They often recognize that the rituals are unreasonable and excessive. Administer antidepressant drugs to decrease his depression. anxiety can gradually be decreased.

(C) Neuroleptics such as haloperidol are effective in decreasing psychotic symptoms so that clients with psychotic disorders may interact more functionally with their environment. 80. The nurse is collecting data to plan the care of a 21-year old woman with a diagnosis of catatonic schizophrenia. (B) This client would most likely exhibit symptoms of dehydration secondary to poor fluid intake. Skin rash.antidepressants. The most serious symptoms include nystagmus. The symptoms the nurse would expect to observe in clients experiencing lithium toxicity would be: A. The nurse explains that haloperidol is given to: A. sits. potentially fatal complication of treatment with neuroleptic drugs. Behaviors must be closely monitored to maintain safety because these clients often experience poor impulse control with their labile mood. The nurse would likely observe that this client: A. labile mood C. Bizarre thoughts B. (C) Extreme suspiciousness is more characteristic of clients with paranoid personality disorder or paranoid schizophrenia. She had discontinued her medication as an outpatient and has experienced a significant increase in dysfunctional behavior. He was estranged from his father for several years. Prevent neuroleptic malignant syndrome C. (D) The client with catatonic schizophrenia can be observed standing. severe diarrhea Answer. (D) Early symptoms of lithium toxicity include ataxia. Has excessive weight gain B. Decrease psychotic symptoms D. Is hyperreactive to stimuli D. delirium. Major ranquilizers are most commonly used. Stands. A 42-year-old woman has been admitted to the psychiatric unit with a diagnosis of bipolar disorder. (B) Neuroleptic malignant syndrome is a rare. Dystonia. tinnitus. sitting. Recently he has been spending some time with his father. it is not given to promote sleep. (A) Bizarre thoughts are more characteristic of clients with schizophrenia. 79. A 22-year-old client with a diagnosis of undifferentiated schizophrenia is being treated with haloperidol 5 mg bid. Appears overhydrated C. Auditory hallucinations Answer. or lies immobile Answer. severe diarrhea. orthostatic hypotension C. then suddenly become very irritable and hostile. The immobility can last for minutes. the nurse would anticipate assessing which behavior in the client? A. hours. (D) Although neuroleptic drugs such as haloperidol may make a client drowsy. akathesia D. Ataxia. On admission. 78. Assist with sleep Answer. or days. Urinary retention. and blurred vision. Intense. (C) The client with catatonic schizophrenia has diminished ability to deal with environmental stimuli and withdraws. His father comes with him to an appointment at the mental health clinic and asks the nurse what the haloperidol is for. (C) ECT is not commonly used in treatment of personality disorders. (B) Intense. persistent nausea and vomiting. More serious symptoms include increasing muscle tremors and mental confusion. Reduce extrapyramidal symptoms B. (D) Auditory hallucinations are not a common characteristic of clients with bipolar disorder. manic phase. During the manic phase. photosensitivity B. or lying immobile. labile mood is characteristic of clients in the manic phase of bipolar disorder. persistent nausea and vomiting. 16 . These clients may be euphoric and elated. (D) ECT is not the treatment of choice for clients with dissociative disorders. the client is dressed in very colorful clothes with heavy makeup. (A) ECT is not commonly used for treatment of schizophrenia. (A) Side effects of neuroleptic drugs are extrapyramidal symptoms. (A) A client with catatonic schizophrenia tends to lose weight because of inability or unwillingness to eat secondary to symptoms of stuporous withdrawal and distorted perceptions. Extreme suspiciousness D. 81.

(A) Skin rash and photosensitivity can be side effects of antipsychotic medications. Before responding to W. but they are not symptoms of lithium toxicity. is known as: A. Situation: W. C. Identification is a defense mechanism in which the patient adopts the characteristics of the nurse. In the client.displaying an accepting attitude of the patient's negative response helps foster trust. and remain nearby b) say. the nurse implies that the patient's feelings are erroneous. this promotes a feeling of being connected to others in a meaningful way. 83. 85. The nurse enters W. denying the patient's feelings. I don't like you. but they are not symptoms of lithium toxicity. I'm E. "W. Let me help you put your things away. a 27 year old secretary. Why do you think I'm mean?" c) say.arrhythmias. and cardiovascular collapse. "W. An accurate assessment of the distance needed between the nurse patient is possibly only if the nurse assesses her own response first. or leaving the patient alone. (A) Trust involves a sense of confidence that another person is interested in one’s welfare and has a desire to be of assistance. In interacting with clients on the psychiatric inpatient unit. is brought to the hospital in an agitated state. challenging her will only increase her anxiety and make her feel more vulnerable. Regression is a retreat to behaviors manifested during an earlier developmental level 84. This characteristic. Genuineness D. (B) Respect involves the unconditional acceptance of another person as a worthwhile and unique person. but they are not symptoms of lithium toxicity. If the nurse has similar unwarranted responses to the patient. "I want another nurse.'s response in an example of: a) identification b) regression c) countertransference d) transference Answer. (D) Empathy is the ability to accurately perceive and understand what another person is feeling or experiencing. Respect C. You're mean. responds. which is important in establishing a therapeutic relationship. transference of feelings from another relationship is probably occurring.. The nurse's recognition hat trust takes time to develop may be useful in planning an appropriate response. (C) When a nurse is aware of internal experiences while interacting with a client and responds to the client with honesty and openness. the nurse should: a) make sure she is a safe distance from the patient b) move closer to the patient to show that she is not afraid c) assess her own feelings and responses to the patient's behavior d) recognize that it takes time for relationships to develop and not feel hurt Answer.'s room for the first time and says. the nurse is demonstrating genuineness. (C) Dystonia and akathesia are extrapyramidal symptoms that can occur with antipsychotic medications. "I'll be back in half an hour... the nurse demonstrates congruence between what she feels and what she expresses.the nurse must first identify her feelings toward the patient and use them as a guide to determine an appropriate response." then leave the patient's room Answer. (B) Urinary retention and orthostatic hypotension can be side effects of antidepressant medications. "I'm only trying to be helpful. Trust B. 82." W. we've just met.'s initial outburst. the nurse should identify her feelings about the patient before formulating a response. It also demonstrates the nurse's interest in and concern for the patient without challenging the patient.." d) say. Leaving the room serves no purpose and may exacerbate the patient's anxiety by increasing her feelings of aloneness and introducing a feeling of 17 . I'll help you get settled. She is admitted to the psychiatric unit for observation and treatment.when a patient's response to the nurse is extremely negative or extremely positive with no apparent basis. accept what the patient has said. By emphasizing that she is only being helpful. A. Empathy Answer. the nurse. however. What would be the most therapeutic initial response by the nurse? a) say nothing." The nurse recognizes that W. The patient probably cannot verbalize why she feels the way she does. D. countertransference is taking place.

the client experiences noxious and uncomfortable symptoms. Answer. The client receiving disulfiram must be taught to read ingredient labels carefully to avoid products containing alcohol such as aftershave lotions. b. barbiturates. Opiate withdrawal causes severe physical discomfort and can be life-threatening. C. To try to prevent alcohol withdrawal symptoms. 89. toothpaste. 86. Instituting seizure precautions. A-a Physical comfort is the priority nursing care of a terminally ill client. Aftershave lotion C. Even alcohol rubbed onto the skin can produce a reaction. the nurse teaches the client that he must read labels carefully on which of the following products? A. what is the first priority? A. B. 87. and recording fluid intake and output B. and benzodiazepines are highly addictive and would require detoxification treatment. thiothixene (Navane) C. This is the global response. Restricting fluids and leaving the client alone to "sleep off" the episode Answer. clozapine (Clozaril) B. obtaining frequent vital signs. D. Cheese Answer. heroin. and rambling. lorazepam (Ativan) D. as needed. modify the plan of care. amphetamines. Before initiating therapy with disulfiram (Antabuse). No other information about the client is available. inhibiting the conversion of acetaldehyde to acetate. Checking the client's medical records for health history information C. Disulfiram works by blocking the oxidation of alcohol. A A nurse who lacks adequate information to determine which level of care a client requires must take all possible precautions to ensure the client's physical safety and prevent complications. Answer. 90. The nurse is providing care for a client undergoing opiate withdrawal. Physical comfort. c. Other assessment findings include an enlarged liver. the nurse can begin seeking health history information and. As acetaldehyde builds up in the blood. After taking all possible precautions. Encouraging unlimited visits from family members. Disulfiram may be given to clients with chronic alcohol abuse who wish to curb impulse drinking. and cheese don't contain alcohol and don't need to be avoided by the client. lithium carbonate (Eskalith) Answer. Medications to reduce pain. Clozapine and thiothixene are antipsychotic agents. Carbonated beverages B. and morphine. B. The nurse is caring for a client being treated for alcoholism. Toothpaste D. A client is admitted to the psychiatric unit with a diagnosis of alcohol intoxication and suspected alcohol dependence. and lithium carbonate is an antimanic agent. such as cocaine. d. What is the most important priority in providing nursing care for a patient with a terminal illness? a. Carbonated beverages. opiate users are commonly detoxified with: A. To minimize these effects. Fluids are typically increased unless contraindicated by a preexisting medical condition. After the nurse completes the initial assessment. Attempting to contact the client's family to obtain more information about the client D. it includes b&c. C The best choice for preventing or treating alcohol withdrawal symptoms is lorazepam.desertion. incoherent speech. lethargy. 88. the physician is most likely to prescribe which drug? A. A client who reportedly consumes 1 qt of vodka daily is admitted for alcohol detoxification. a benzodiazepine. methadone. 18 . Prevention of pressure sores. To do otherwise could place the client at risk for potential complications. C Methadone is used to detoxify opiate users because it binds with opioid receptors at many sites in the central nervous system but doesn't have the same deleterious effects as other opiates. Barbiturates. these drugs aren't used to manage alcohol withdrawal syndrome. amphetamines. jaundice. benzodiazepines.

Answer A. PRESENT REALITY by telling the patient that you do not hear anything. Answer D is a reflex abnormal in anyone older than two years of age. As a counsellor . I understand that god’s voice are real to you. Don’t think of anything right now. asking the client what do you think can help you right now is INAPPROPRIATE for the nurse to ask. The client is in the hospital because she needs help. B is unrelated to coping strategies. 92." The nurse's best response is: a. Clonus B. Answer A is a steroid. Answer C is a neurotransmitter not missing in Parkinson’s disease. The client states "God is telling me to kill myself right now. WBC count is important to assess if the clients immune function is severely impaired. The student asks the client to stand with arms at sides and feet and knees close together. Romberg’s sign tests balance and is performed in this manner. I will stay with you. The neurotransmitter dopamine is missing in clients with Parkinson’s disease. 94. Anti-diuretic hormone Answer B is correct. The third part of 19 . Clozaril c. infection and sore throat. so they are incorrect. Letter A can only be answered by FINE and close further communication. think of something else and itll go away d. What does the nurse deduce that the student is testing? A. 93. Clozaril : Clozapine is a dreaded aypical antipsychotic because it causes severe bone marrow depression. what do you think will help you right now? d. and Answer D is secreted by the pituitary gland not related to the stated diagnosis. Answers A and B are muscular actions often seen in seizure activity. it will stop if you take medication c. Tonicity C. the nurse performs which of the ff: task? a.91. how are you feeling right now? b. The voices are part of your illness. the nurse assess the ff: to determine the patients coping strategy a. help the client prepare in group activities d. I will stay with you. The student instructs the client to first stand with the eyes open and then with eyes closed. The nurse on a neurological unit is observing a student performing an assessment. encourage client to express feelings and concerns : A counselor is much more of a listener than a speaker . so it is wrong. disappointments and frustrations. Romberg’s sign D. Lithane b. Most of the treatment involves replacement of this drug. Tofranil d. The first presenting sign of agranulocytosis is SORE THROAT. assist the client in setting limits on her behaviour Answer A. client with a history of schizophrenia has been admitted for suicidal ideation. I understand that god’s voice are real to you. just go and relax. Dopamine C. Letter C. During the nurse patient interaction. Parkinson’s disease has been diagnosed in a client exhibiting tremors. Serotonin D. 95. encourage client to express feelings and concerns b. and D are incorrect. She encourage the client to express feelings and concerns as to formulate necessary response and facilitate a channel to express anger . therefore Answers A. Babinski reflex Answer C is correct. The voices are all in your imagination. How does your problem affect your life? Answer d: this is the only question that determines the effects of the problem on the client and the ways she is dealing with it. Which of the following drugs needs a WBC level checked regularly? a. Celestone B. But I don’t hear anything. If she knows something that can help her with her problem she shouldn’t be there. agranulocytosis. : The nurse should first ACKNOWLEDGE that the voices are real to the patient and then. C. But I don’t hear anything. 96. Which of the following is lacking in this disorder? A. b. do you have anyone to take you home? c. Diazepam Answer b. helps client to learn a dance or song to enable her to participate in activities c.

Relate to his peers. the one that probably most influenced the decision not to hospitalize him is his ability to: a. 98. 100. The nurse would develop a plan of care based on: a. therefore. 101. People with schizophrenia do not think that they are ILL. Milieu therapy is best employed to do which of the following? 20 . which is not desired. I’d like to go to sleep and not wake up c. not therapeutic. c. Hold a job. which statement by the client would give the nurse the HIGHEST cause for concern? a. dykinesia b. anxiety disorder c. A nurse is caring for a client with Parkinson's disease who has been taking carbidopa/ levodopa (Sinemet) for a year . dizziness and lethargy are side effects of anti parkinson drugs like levodopa and carbidopa. A. The only feasible diagnosis a doctor can make is among the choices is schizophrenia. I’ve thought about taking pills and alcohol till I pass out d. borderline personality disorder b. respiratory depression Answer C. Complains of dry mouth b. glaucoma c. schizophrenia : When disorders of perception and thoughts came in. Which of the following would indicate to the nurse that the medication is having the desired effect? a. Of the following abilities the client has demonstrated. Schizophrenia is characterized by disorders of thoughts. Perform activities of daily living. hypotension : Hypotension.D are all indicative of suicidal ideation but it contains no specific plans to carry out the objective. I’d like to be free from all these worries Answer C. A client who was wandering aimlessly around the streets acting inappropriately and appeared disheveled and unkempt was admitted to a psychiatric unit and is experiencing auditory and visual hallucinations. In assessing a client's suicide potential. delusion. Telling the client that the voices is part of his illness is not therapeutic. hypotension d. He has been given a PRN dose of Thorazine IM. d. B and D indicates that the drug is not effective in controlling the client’s agitation. my thoughts of hurting myself are scary to me b. A decision is made to not hospitalize a client with obsessive-compulsive disorder . I’ve thought about taking pills and alcohol till I pass out : This is the only statement of the client that contains a specific and technical plan. depression Answer C. schizophrenia d. 102.B and D can occur in normal individuals without altering their perceptions. 97. Behave in an outwardly normal Answer c. hallucination. Perform activities of daily living : If a client can do ADLs . Which of the following adverse reactions will the nurse monitor the client for? a. 99. Letter A is the side effect of the drug.the nursing intervention in hallucination is LESSENING THE STIMULI by either staying with the patient or removing the patient from a highly stimulating place. Letter C and D disregards the client’s concern and therefore. Stops pacing and sits with the nurse : Thorazine is a neuroleptic. Letter A admits the client thinks of hurting himself. Exhibits increase activity and speech Answer C. there is no reason for that client to be hospitalized. it is not indicative of suicidal ideation. Desired effect evolve on controlling the client’s psychoses. Stops pacing and sits with the nurse d. A client with paranoid schizophrenia has persecutory delusions and auditory hallucinations and is extremely agitated. B. illusion and disorganization. but not doing it because it scares him. restlessness and disorders of perception. b. State he feels restless in his body c.

The way a person perceives and responds to stress is most affected by which of these predisposing factors? 1. 3. aimed at maintaining the individual’s integrity. exhaustion stage 4. Focus on inappropriate behavior. Answer (4) Milieu therapy provides repetitive ordinary experiences on a daily basis. and decreases disruptive behavior by keeping tasks simple. It disrupts the integrity of a person. which one is thought to cause illnesses? 1. Age 2. This theory was developed by: 1. a specialized area of nursing practice that assists the therapist to relieve the symptoms of the patient 3. aimed at disrupting the individual’s integrity. a specialized area of nursing practice in which the patient is committed to long-term therapy with the nurse Answer (1) The ANA sets standards of practice on psychiatric and mental health nursing roles: the quality of care. play therapy. alarm stage 2. education. Investigate the patient’s view of the world. 104. 2. Dixs. 4. family history Answer (3) Past experiences result in learned patterns that can influence an individual’s adaptive responses. and mental disorders. collaboration. gets resolved. ulcers. 4. Promote socialization skills. 106. intensifies. 107. performance appraisal. Coping strategies are considered maladaptive when the conflict being experienced: 1. Sullivan. Selye. Provide repetitive ordinary experiences on a daily basis. behavior modification. colitis. 2. directed at stabilizing internal biological processes. 109. a specialized area of nursing practice that involves solving the patient’s problems and giving him the answers 4. Maladaptation is said to be present when the person’s responses are: 1. 21 . physical changes. 108. 103. ethics.1. In the General Adaptive Syndrome (GAS) phases. 4. directed toward the preserving of self-esteem. Gender 3. 4. Freud. Answer (2) Behavior modification gives positive feedback and rewards for appropriate behavior. Behavior modification requires negative behavior if its not destructive or life threatening. 3. a specialized area of nursing practice that employs theories of human behavior as its “science” and the powerful use of self as its “art” 2. 3. 3. controls the environment by minimizing change as much as possible. The general adaptation syndrome is based on the concept of stressor and response to stressors over time. Past experiences 4. 2. How does the American Nurses’ Association (ANA) define the psychiatric nursing role? 1. CAD. 2. and research through the use of the nursing process. milieu therapy. 105. recuperative stage Answer (3) Exhaustion stage occurs when the patient’s adaptive energy is depleted and the patient has no other resources for adaptation: disease of adaptation of HA. (3) Hans Selye published his research concerning the physiologic response of a biological system to stress or change imposed upon it. resistance stage 3. 2. The “token economy” is a type of therapy that focuses on: 1. Answer (4) Maladaption is viewed as negative or unhealthy.

When the client is able. 4. You are seeing things again. increases energy sources. An essential topic to include would be: 1. maintains vital signs in normal parameters. Support groups are useful to the caregivers. 2. 3. support groups that can help the parents release their feelings of frustration. ask the client to describe what is happening. The hospital said she was better. 2. 2. “I do not see anyone. need to take extra medication when feeling stressed. A nurse observes a client sitting alone and talking.” 4. tell the client there are no voices. 4. Initially.” 3. 3. 113. “I told you before there is no one there. A nurse is teaching a group of clients with a diagnosis of schizophrenia who are nearing discharge from a residential care facility. motivational techniques that are effective in clients with schizophrenia. 4. Answer (3) The nurse conducting discharge teaching must stress the lengthy recuperation process with emphasis on the sedative qualities of the medication used to prevent relapse. 110. They will go away. the pathophysiology and acting out behaviors of schizophrenia. The emphasis on recuperation is to maintain nutrition and hygiene. Talking about the hallucinations is reassuring and validating to the client. We cannot get her to go to the vocational training you arranged. Answer (2) Coping strategies are maladaptive when conflict being experienced goes unresolved or intensifies. “I do not understand what is going on. how to recognize and manage symptoms of relapse. 4. an appropriate intervention is to assist the client to identify triggers for the hallucination. Nurses need to determine whether a command hallucination is occurring that tells the client to harm himself or others.” The nurse recognizes more teaching is needed about: 1. leave the client alone until reality returns. The nurse’s next action would be: 1. This increases vulnerability to physical and psychological illnesses. Answer (3) Nurses frequently observe behavioral cues that indicate the presence of hallucinations. but all she does is sit around all day and smoke. contact with follow-up care daily.3. 3. Answer (2) Clients are usually aware of the symptoms that indicate relapse is occurring. the client feels anxious and overwhelmed and may proceed to becoming 22 . 112. “Who are those two people by the door?” The nurse recognizes the client is having a hallucination. Can you tell me more about what you are seeing?” 2. pathophysiology of the disease and expected symptoms. The client had a prolonged recovery from relapse. Energy sources are depleted. and the best response would be: 1. When asked. touch the client to help return to reality. The first two stages of relapse are more difficult to recognize because they do not present symptoms that indicate psychosis. A client with a diagnosis of schizophrenia has been released from an acute care setting. The parents discuss the situation with the nurse. Focusing on the symptoms and asking about the hallucinations empowers the client to gain control. Why do you keep bothering me?” Answer (1) Nurses need to inform clients that there is a difference in perceptions and pay attention to the content of the hallucination. 111. the client reports he is talking to the voices. A client in an acute care psychiatric hospital asks. “There is no one there. “Just ignore them. the prolonged recovery time and depressive effects of medicines to prevent relapse. The client needs to know how to find a safe environment and to seek help.

Answer (2) Tricyclic antidepressants may cause orthostatic hypotension. Second generation antidepressants (Maprotiline. Tricyclic antidepressants improve ventricular dysrhythmias. Fetal alcohol syndrome is a combination of mental and physical abnormalities present in infants born to mothers who have consumed alcohol during pregnancy. Multiple drug use complicates assessment and intervention because the client may be demonstrating effects or withdrawal from several drugs. 118. tachycardia.” 4. A client is admitted with a diagnosis of multiple drug use. 2.” Answer (1) The best recommendation is that no alcohol be consumed during pregnancy. 114. 119. or benzodiazepines. Trazodone. A woman asks. 117. Clients receiving antidepressants require serial blood pressure and electrocardiogram monitoring. the nurse uses the knowledge that: 23 .” 3.withdrawn. in addicted populations. 4. undetected substance problems have no real effect on treatment of psychiatric disorders. renal disease. lessen. and an inappropriate referral may also occur. Answer (2) Simultaneous or sequential use of more than one substance is very common. cardiac disease. “How much alcohol can I safely drink while pregnant?” The nurse’s best response would be: 1. “Consuming one or two beers or glasses of wine a day is considered safe for a healthy pregnant woman. there is greater prevalence of psychiatric illness. Antidepressants are considered the treatment of choice for major depression. alcohol and barbiturates used together are not dangerous because one is a stimulant and the other a depressant. 115. and conduction defects. Heroin users often also use alcohol. 3. respiratory disease. avoid negative people. While admitting a client to an acute care psychiatric unit. “You can have a drink to help you relax and get to sleep at night. 4. When planning care of a client who has been diagnosed with amphetamine abuse. people with psychiatric disorders are more prone to substance abuse. neglect of appropriate interventions. and decrease stimuli and stress. is the only harmful type of drinking during pregnancy. suboptimal pharmacological treatment. or change the nature of the intoxication or relieve withdrawal symptoms. they should be used with caution in clients with: 1. Multiple drug use may enhance. 3. Answer (2) The failure to address substance abuse among clients with psychiatric disorders interferes with treatment effectiveness and contributes to relapse. Fluoxetine) cause decreased heart rate and orthostatic hypotension. The amount of alcohol needed to cause fetal alcohol syndrome has not been determined. The client needs to go to a safe environment with someone that is trusted. however. liver disease. “Drinking three or more drinks on any given occasion. 3. multiple drug use is very uncommon. “No amount of alcohol is safe during pregnancy. marijuana. This is the crucial period to intervene. assessment and intervention are easier with multiple drug use because of the synergistic effect. people may use more than one drug to enhance the effect or relieve withdrawal symptoms. substance disorders are easily detected and diagnosed in acute care psychiatric settings. Multiple drug use is especially dangerous if synergistic drugs are combined. Amitriptyline has been shown to cause sudden cardiac death in clients with pre-existing heart disease.” 2. The nurse plans care base upon knowledge that: 1. the nurse asks about substance use based upon knowledge that: 1. binging. 2. 4. 2. Misdiagnosis of psychiatric disorder.

3. 3. ascertaining that the client receives the full dose. 122. the behavior is due to the physical dependence on the drug. inhalants may result in permanent cognitive impairment. A client diagnosed with bipolar disease has begun a regimen of lithium. depression. 4. The withdrawal symptoms include headache. produce feelings of lethargy. relief from fatigue. Prolonged or excessive use of amphetamines can lead to psychosis. hypertension. 3. 4. Drug cravings are common and may lead to relapse. lack of energy. Parents of a 14-year-old child who is being treated for marijuana use discuss the child’s apathy and lack of desire to achieve. amphetamines increase energy by increasing dopamine levels at neural synapses. cardiac arrhythmias. Inhalants are popular among preteens because of the low cost and easy availability. LAAM is a longer acting opiate antagonist. and apathy. the person remains productive. The most critical issue for the first two weeks is: 1. A client states that she is codependent. this is typical teenage behavior and not related to the marijuana use. cause death due to cardiac arrhythmias or suicide. addiction to barbiturates and amphetamines is rare because they have opposite effects. however. The nurse explains that: 1. chills. The client will be tested periodically to ensure that the blood level of the drug is at a therapeutic level. 4. Answer (1) Amphetamines cause the release of norepinephrine and dopamine from storage vesicles into the synapse.1. 3. Overdose may cause seizures. and energy and alertness. 2. enhances euphoria by increasing neurotransmitters of enkaphalens. Methadone is used to aid withdrawal and provide maintenance for persons with opiate addiction because methadone: 1. 123. 3. amphetamines produce a 10–20 second rush followed by a 2–4 hour high. Methadone will produce addiction. The increased catecholamines at the receptors causes increased stimulation. ensuring blood levels reach a therapeutic level. replaces endorphins so craving is diminished. and irritability lasting for several weeks. and reduced inhibitions. When abstaining the client may experience fatigue. does not interfere with the ability to function productively. People use amphetamines for the feelings of euphoria. 120. Undesirable effects of marijuana use include tachycardia and panic. 2. Answer (2) People use marijuana for the effects of relaxation. A school nurse is counseling students after a fellow student died following inhalant use. Prolonged use has been associated with decreased motivation. and hyperthermia. The nurse includes the information that inhalants: 1. prolonged marijuana use causes amotivational syndrome. monitoring the blood pressure. Answer (4) Maintenance programs for long-term opiate addiction may last for years using substitute narcotics. have no withdrawal symptoms. amphetamines have low risk of tolerance or addiction. 4. this behavior is a precursor to a psychotic stage. 2. Clear patterns of tolerance and withdrawal have not been described. produces dramatic negative symptoms if opiates are used. Answer (3) Lithium may take 2 weeks to reach therapeutic levels. are costly and produce a prolonged effect without dependence or tolerance. 124. The nurse explains that this means the client: 24 . and abdominal cramps. and loss of desire to be productive. Answer (4) In addition to causing death. educating about side effects of the medicine. 4. 2. 121. poor hygiene. vulnerability. 2. mild euphoria.

notify the prescriber that the client is showing signs of toxicity.The client needs to be monitored closely for adherence and side effects of the medication. A client has been receiving lithium for a diagnosis of bipolar disorder. time. 3. Side effects that may be temporary include nausea. vomiting. using community and family support available to the client. fatigue. 2. muscle twitching. the client needs to recognize when the desire to use the substance is experienced and contact a support person. and stumbling. 2. 127. An elderly client is being placed on a psychotropic medication. require a higher dose because the medicine is not absorbed. The client reports new onset of hand trembling. forms close personal relationships. and place at all times. often do not have an effective response to psychotropic medicines. social relationship with the client. attend two support group meetings per day. have no withdrawal symptoms. The nurse would: 1. Answer (2) Codependency implies a person is only satisfied in caring for others at the expense of personal health and welfare. reassure the client these are temporary side effects. informing the client that side effects are temporary. and cardiac dysrhythmias. discourages the spouse to continue using drugs. diarrhea. The nurse recognizes that older adults: 1. 3. the nurse would assist the client to adhere to the medical regime by: 1. make a daily commitment to abstain. correctly interpret environmental stimuli and discuss feelings about stimuli. The desired outcome for a client withdrawing from a mood-altering substance would be for the client to: 1. requesting the client make an appointment in four weeks. never be tempted to use the substance again. confusion. blurred vision. 4. it is unrealistic to assume a client will have no withdrawal symptoms. are reluctant to take medicine because of the stigma attached to mental illness. slurred speech. 2. and drowsiness. attempts to take responsibility for own behavior. A desired outcome for the client abstaining from using a mood-altering substance would be for the client to: 1. and problems of others. 3. feelings. 3. 4. 3. Answer (2) Involving the family and increasing support through community resources will help the client adhere to the regimen. is preoccupied with the lives. 129. 3. maintaining a casual. thirst. recognize and talk about hallucinations or illusions. 25 . hand tremors. 4. muscle weakness. Answer (1) During abstinence. remain oriented to person. Clients with codependency problems usually have low self-esteem and enable others to use drugs. 2. dizziness. The other choices are outcomes for the withdrawal period. Answer (4) Although desirable. 4. Answer (3) Lithium has a very narrow window of effectiveness. 2. 2. 128. monitor these effects to make sure they do not worsen. The second and third choices are desired outcomes for the client who is abstaining from substance use after the withdrawal period. 125. When working with a client who has been started on a psychotropic medication. drowsiness. 126. Signs of lithium toxicity include nausea.1. contact a support person when the urge to use the substance is experienced. request the client return in three days when the prescriber is present. 4.

Dry mouth and red eyes are signs of marijuana use. 2. documents the medication has the desired effect. The nurse recognizes his comments as: 1. consults the psychiatrist for an anticholinergic drug. Dry mouth and nose are common symptoms during marijuana withdrawal. 3. 1.” 3. denial. A client agrees to stop using marijuana. Tobacco and marijuana are considered gateway drugs. Marijuana is not associated with withdrawal symptoms. Answer (4) Hepatic and renal function declines with age. 3.” 4. “The average age to start smoking is 12 and drinking alcohol is 16. (3) Although all of the answers are true about schizophrenia. Although there is no cure. avoidance. Select the best information for the nurse to teach the client about marijuana withdrawal. is a chronic deteriorating disease with periods of remission. medications are often metabolized more slowly in older adults. records the physical symptoms and client statements. 135. Seizures may occur with alcohol and other depressant withdrawal. (4) Tardive dyskinesia is a neurologic disorder caused by long-term use of neuroleptic drugs. The nurse should limit rationalization and direct the client’s focus to the substance abuse problem. 134. The nurse’s response is based upon the knowledge that schizophrenia: 1. Seizures often occur during marijuana withdrawal. Prevention programs are targeted at students before they begin experimenting with drugs.” 2. Therefore. In recent surveys. 2. rationalization. The client might have flashbacks for months after abstaining from marijuana. “Children at this age have already started experimenting with drugs. A family member of a client with a diagnosis of schizophrenia asks about the prognosis. The nurse repeatedly tries to refocus the client 26 . 4. identification. about half of all high school students had consumed alcohol in the past month. withholds the next dose of the medication. Flashbacks can occur for years after hallucinogen use. 131. “The children are at an age where they can put pressure on their parents to stop using drugs. only option 3 answers the question asked. 3. Gateway drugs are drugs that lead to other drug use. dopamine agonists. 2. Answer (3) Clients who abuse substances frequently use blame-placing and rationalization to explain their behavior. A parent asks the school nurse why they are teaching the third grade class about substance abuse. 4. 132. affects women more often than men. The dose needs to either be decreased or the time between medication dose increased. and benzodiazepines. is diagnosed later in women due to a protective hormone effect. 4. many of the symptoms can be managed with anticholinergics. Answer (1) Marijuana usually has no withdrawal symptoms.” Answer (2) The age that children start smoking and drinking dropped in the late 1990s. 4. 2. 130. “Gateway drugs lead the child to smoking and drinking. 133. usually require a lower dose of medicine due to decreased metabolism. usually is diagnosed between the ages of 15 and 45. The nurse determines that a client has symptoms of tardive dyskinesia and: 1. A client reports that he drinks because of his stressful job and wife’s inability to care for the house and children. 3. resulting in a longer half-life. A client receiving pre-operative instructions asks questions repetitively about when to stop eating the night before the procedure. The nurse’s best response would be: 1.4.

and elevated blood pressure. Depression and/or hypomania may result from sustained crisis situations and ineffective resolutions. A man becomes restless and anxious following retirement. instruct the client to express feelings. and other reminders of the deceased Answer (1) All of the behaviors can be expected during acute loss and bereavement. 3. the client focuses upon small or scattered details. medical intervention and/or counseling are necessary. moderate anxiety. when symptoms such as sleep disturbances become protracted. maturational 2. challenge the client each time denial is used. What is the correct term for the situation characterized by a person or group of persons experiencing a stressful event(s) that results in failure of usual coping mechanisms and/or the utilization of problem-solving resources? 1. tachypnea. but defenses are encouraged or discouraged. Stressor 3. “I do not know what is wrong with me. He states. preoccupation with memories. Returning the client to a prior level of functioning is the goal. Assessment reveals rapid speech. crisis 2. In severe anxiety. The nurse notes the client is frequently startled by noises in the hall. transitional 27 . I was looking forward to having the time to do my favorite hobbies. the nurse documents the client has: 1. (3) With mild anxiety. The client admits to feeling nervous and having trouble sleeping.on other aspects. 2. Which of the following behaviors indicates the need for mental health referral? 1. In order to do this the nurse would: 1. A young child experiences the death of an older sibling. Situational 4. positively reinforce each expression of feelings. There is not enough time in crisis intervention to replace attacked defenses with new ones. 138. sayings of the deceased. mild anxiety. 3. tachycardia. 139. Moderate anxiety narrows the perceptual field. 4. but the client will notice things brought to his attention. trembling hands. the ability to learn and problem solve is enhanced. During a panic attack. Based upon the assessment. hypomania Answer (1) A crisis is characterized by severe disorganization precipitated by failure of customary coping mechanisms or lack of or failure of usual resources. 2. severe anxiety. Now I cannot concentrate on anything. Depression 4. A stressor may be an event or event(s) extrinsic or intrinsic that combines with other factors to bring about the crisis situation. Adventitious 3. and redecoration of the bedroom with photos. 4. crying 4. the person is disorganized and may be unable to speak or act or may be hyperactive. initial weight loss and eating disturbance 3. defenses are not attacked. 136. not restructuring of defenses. a panic attack. however. tell the client to stop using the defense mechanism of denial.” The nurse suspects the client is developing which type of crisis? 1. (2) In crisis intervention. 137. sleep disturbances beyond six months 2. The nurse wishes to decrease the client’s use of denial and increase the client’s expression of feelings during a crisis intervention. The person is unable to problem solve. stimuli are readily perceived and processed. drawings.

Honeymoon 3. Maturational crisis occurs during transitional periods that require a change in roles. reconstruction (1) Five stages of crisis resolution have been identified. A nurse is talking to a client who was diagnosed with diabetes mellitus two days ago. impulse control 4. marriage. A client with anorexia nervosa weighs 80 percent of normal body weight and states “I am so fat I cannot get into my clothes. and medical illness. loss of loved one. dysmenorrhea 3. client will use constructive coping mechanisms. Disillusionment 4. How can you say you are fat?’ 3. client will explore deep psychological problems. hyperkalemia 2. client protection 2. and it is causing you medical problems. A client is transferred to an inpatient psychiatric unit after treatment for self-inflicted burns. “Why do you perceive yourself to be fat?” 28 . panic. the client will rebuild his life. parenthood. The other interventions are desirable after the client’s safety is ensured. and retirement. impact 2. dehydration 4. but the focus is on short-term resolution of the current problem. What is the nurse’s highest priority? 1. client will identify needs that are threatened by the event. and fear. A female with a body weight of less than 90 pounds may have amenorrhea. The honeymoon stage occurs when the client exhibits a desire to help others. 2. Adventitious crises occur during disasters with multiple losses 140. 141. My sister has been overweight all her life. “You only weigh 100 pounds. Which of the following assessment findings is likely for a client with anorexia nervosa? 1. the highest priority is to ensure the client does not harm self or others. 143. Previous psychological issues may recur during crisis. During reconstruction. such as adolescence. At the end. Disillusionment occurs next with the client comparing his plight with that of others.” The nurse identifies the client is in which stage of crisis? 1. How else can you describe your body?” 4. Constructive activity occurs during the heroism phase. 4. denial. Hypokalemia also results from loss of electrolytes in gastric fluid. Initially the client feels the impact of the situation and experiences shock. the nurse would have a desired outcome to be: 1. dental erosion (4) Dental erosion occurs due to the gastric acid with frequent vomiting. suicidal assessment 3. “You need to stop thinking like that. I want the tests rerun. unwanted pregnancy. the nurse credits the client for positive changes and helps the client understand what was learned.” The nurse’s best response would be: 1. 142. client will express positive feeling about event. 145. The client states.Answer (1) There are three types of crises. (4) The primary goal of crisis intervention is to relieve the symptoms of anxiety and foster constructive coping.” 2. This allows the client to use the learned coping mechanisms when new problems arise. When planning intervention for a client during a crisis. 3. self esteem (1) With self-inflicted injuries. Situational crises occur during acute events such as job loss. “No one in my family has diabetes. I cannot manage the diet and testing. “You are under your ideal body weight. she should be the one with diabetes.

Situational 3. the nurse notices the mother is unkempt and tearful. Combinations of crises events can occur. you will need to stay in your room. “I am going to get you some Valium now.(1) The best response is to provide a factual nonjudgmental answer. 150. Adventitious crises occur during disasters with multiple losses. “Please try to concentrate on what I am saying. 2.” 4. This answer provides the client with information about the acceptable behaviors. Adventitious 4. “If you cannot stay in the living area. During the 6-month well child visit. hydration by forcing fluids. The priority for the first 24 hours is: 1. Assisting the client with hydration and showering are less important. maturational 2. 3. 2. disorganized. A nurse is planning care of a client admitted for attempted suicide. and is due to hormonal changes and fatigue. 146. 370. The nurse determines that this is which type of crisis? 1. loss of loved one. What is the best nursing intervention when a client is experiencing a panic attack? 1. “Why are you running in the halls?” (3) The nurse needs to consistently set and enforce limits on undesirable behavior for the client experiencing the manic phase of bipolar disease. blues. and retirement.” 2.” 3. rapid speech. 1. and medical illness. 149. 3. “Let’s go for a short walk until you are calmer. psychosis. Situational crises occur during acute events such as job loss.” 2. The client is unable to use relaxation techniques or other anxiety-reducing activities. The client is disheveled. protecting client from self. “You need to stay out of other peoples rooms. and dehydrated.” 4. The nurse would document the mother may be experiencing postpartum: 1. but often is seen about 6 months. marriage. and mood swings. lasts 1–2 weeks. The mother reports extreme fatigue and feelings of inadequacy. A client is admitted following a suicide attempt. 3. assessing factors that contributed to suicide attempt. assisting with showering and clean clothes. Select the nurse’s best response. as is determining the reasons for the attempt. melancholia. parenthood. depression. 147. (4) Clients at risk for self-inflicted harm need to be protected. An adolescent is brought to the mental health center after witnessing the death of a friend in a car crash.” Answer (4) Panic results in disorganized thinking and loss of the ability to concentrate. 4. confusion. A client diagnosed with bipolar disease is running in the halls and entering other client’s rooms. Frequently situational crises occur at transitional periods. 4. Postpartum depression can occur from 2 weeks to 1 year after delivery. Which intervention will the nurse include in the plan of care? 29 . such as adolescence. Postpartum psychosis usually occurs within the first week after delivery and is associated with hallucinations. situational and maturational Answer (4) Maturational crisis occurs during transitional periods that require a change in roles. paranoia. “Just sit back in your chair and take a few deep breaths. 148. “You need to walk with me to get some medicine to help you calm down. Answer (2) Postpartum blues occurs within five days of delivery. The client is not able to explain why they have a distorted perception. unwanted pregnancy.

3. have decreased anxiety. limit time for the maladaptive behavior and direct the client’s attention outward. Exercise will release emotional energy. 2. An effective intervention for a client diagnosed with an obsessive compulsive disorder would be: 1. A client reports that someone is in the room and trying to kill him. 4. 3. 152. and realistic. try reasoning the client out of the behavior or ridicule the behavior. (2) Outcome criteria need to be specific. discuss the repetitive action. (3) His wife is exhibiting obsessive compulsive behavior.” 3.” 4. inform the client the act is not necessary. Talking for 10 minutes meets all of these conditions. telling his wife to stop cleaning whenever he notices her actions.1. Within 4 days the client will: 1. 153. decreasing the stimuli in the home. Based on Maslow’s hierarchy. “There is no one in your room. (2) A serious threat of suicide requires constant one-to-one observation.” 2. 4. He states he has awakened in the middle of the night and found her cleaning. 154. helping his wife with cleaning. but you seem to be very frightened. 2. A man reports his wife is constantly cleaning. The nurse consults with the couple and recommends the husband can help with therapy by: 1. Friends have stopped visiting because she makes them uncomfortable. Initially. Since this is an anxiety disorder. (4) Obsessive compulsive disorder is an anxiety disorder. nurses should not interfere with performance of the repetitive act. The other actions deny the client’s perceptions. 3. 4. measurable.” (2) It is important to acknowledge the client’s fear. 4. The activity has interfered with the family life. 3. The nurse is developing a care plan for the client with severe anxiety. safety is the priority when physiological needs are met. “Just tell the person to go away. it is desirable to maintain an 30 . 2. The nurse’s best response would be: 1. It is not realistic to expect a severely anxious client to sit quietly for 30 minutes. talk to the nurse for 10 minutes. encourage daily exercise. One-to-one suicide precautions. Teach the client to report any suicidal thoughts. making a baseline record of the time the wife spends cleaning. Check the client every 15 minutes. 151. The other statements are vague and not measurable. Let’s get you more medicine. 2. Place the client on bedrest with bilateral wrist restraints. “I do not see anyone. develop an adaptive coping mechanism. “No one can hurt you here. insist the client not perform the repetitive act. sit quietly for 30 minutes.

constantly observe the client to prevent self-harm. causes withdrawal symptoms including agitation. ask the client to describe events that precede increased anxiety.” 4. ask the staff member to talk in private and reinforce how antisocial clients try to divide staff. Here is what is left of my last prescription. help relate anxiety to specific behaviors. the dose needs to be raised again until symptoms are gone and tapering resumed at a slower rate. “I will not take another Xanax pill. check on the client every 15 minutes to ensure she is not engaging in harmful behavior. the repetitive behavior. The client reports taking 0. hypertension. therefore. the nurse would: 1. 3. 3. bring up the incident during the weekly conference so this staff will not be assigned to work with antisocial persons again. enlist client in defining and describing harmful behaviors. 4. Talking with the staff member in private will allow the person to develop skills to work with this client population. (3) It is essential that the treatment program be followed exactly for clients with antisocial personality disorder because they are very manipulative and will attempt to divide staff.” 2. The best intervention to facilitate behavior change would be: 1. 2. The drug needs to be slowly decreased to prevent these side effects. instruct the client to practice relaxation techniques. insomnia. 31 . (2) To gain insight. write an incident report so there is a “paper trail” of the staff’s failure to follow the planned program. seizures. The nurse would: 1. confronting the staff member in front of the client will enhance the division of staff.” (3) Xanax. and abdominal pain. When helping the client gain insight into anxiety. 4. A client has been taking alprazolam (Xanax) for four years to manage anxiety. 156. “I can expect be sleepy for several days after stopping the medicine. The nurse observes a staff member not following the plan of care for a client with an antisocial personality disorder.” 3. The drug must be tapered slowly to minimize rebound symptoms of insomnia and anxiety. 4. “I will take three pills per day next week. If symptoms occur. 3. The other activities focus on recognition of when anxiety is occurring and how to manage the anxiety. 157.” 2. confront the client’s resistive behavior. 155. A client diagnosed with a borderline personality disorder frequently attempts to burn herself. then two pills for one week. like other benzodiazepines. 158. 2. the client needs to recognize causal events. then one pill for one week.environment that is calm and as stress free as possible. Attempting to stop or focusing on the behavior can increase the wife’s anxiety and. “I can drink alcohol now that I will be decreasing my Xanax. However. confront the staff member immediately and say “You know that is not the treatment plan.5 mg four times a day. remove all items from the environment that the client could use to harm self. Which statement indicates the client has learned the nurse’s teaching about discontinuing the medication? 1.

4. 162. The doctor will see you in 5 minutes. Doctors always make you wait. 2. therefore. Which of the following would be a good positive reinforcer of desired behavior? 1. 3. That is not too long. accumulated points need short-term rewards. The nurse can apologize for delays and problems with the system.” 2. A nurse is developing a treatment plan for a client with a diagnosis of antisocial personality disorder. Accumulate points for daily trip to canteen. even when you have an appointment. 3. (3) Reinforcers for clients with antisocial behavior disorder need to be concrete and readily available. during the admission assessment the nurse would: 1. To provide the client some control.” The nurse believes the family member is becoming aggressive and says: 1.” 4. 159. It must be difficult to see your sister in pain. 3. 2. 4. In past admissions. (2) Involving the client in identification of triggers and methods to decrease agitation and aggression empowers the 32 .” 3. We want to see the doctor now. This group of client’s required immediate gratification. We have been waiting for four hours. The most important intervention is to listen to the person. Client does not manipulate other residents into giving him their belongings. Threatening the person or making promises you cannot keep will escalate the anger. A client is admitted to an acute care unit with a diagnosis of bipolar disorder. Client participates in a mutually satisfying interpersonal relationship. Client uses interpersonal relationships as alternative to self-mutilation. nonprovocative manner. A family member of a client in the emergency department is pacing the floor. Client describes interpersonal strengths and weaknesses. Enlisting the client to identify the triggers for self-harm will make the client an active participant in treatment. Nurses are less judgmental when they understand the source of the behavior and can be sensitive to client feelings. Which of the following statements indicates that a client diagnosed with antisocial personality disorder is meeting a desired short-term outcome? 1. Place the client in isolation when undesirable behavior occurs. The family member stops between the nurse and the door and loudly states “You said the doctor would see my sister soon. place the client in isolation until it was determined whether he was aggressive. You need to calm down. “You are next in line. A short-term objective would be to not engage in manipulation of other residents. Have the client save tokens for an outing once a month. ask the client what methods worked in the past to decrease aggressive behavior. 161.(2) The challenge when intervening with clients who may harm themselves is to maintain client safety while facilitating behavior change. Removing the client from contact with others may be necessary when the client cannot control behavior. the nurse should remain calm and speak in a soft. or I will call security. “I am sorry you have had to wait. 2. inform the client when agitated that the client would be taken to the gym to work off energy. 4. instruct the client that he would receive one token per hour he was not aggressive. 160. “There are sick people here. “I know how you feel. the client had assaulted others when stressed. Praise the client for desired behavior.” (4) When communicating with someone who is becoming aggressive. (2) Goals for clients with antisocial personality disorder include developing close interpersonal relationships and tolerating distress.

the client will gain 2 pounds each week. A patient who has suffered a right hemisphere cardiovascular accident (CVA) will be expected to exhibit: 1. slurred speech. (1) A realistic initial goal for a client with anorexia nervosa is to refrain from activities that cause weight loss: binging. Which area of the brain is associated with perception? 1. the client will attain a realistic view of her body.client. This precedes slurred speech or changed pupillary responses. 4. highly distractible and left visual field loss. 4. 3. occipital area cardiovascular accident (CVA). 2. Long-term goals include identifying triggers for the eating. For some clients. slow and cautious behavior. poor judgment. Change in locus of control. overestimates of one’s ability. (3) Change in locus of control (LOC) is the most sensitive indicator of changes in perception/sensation. nonfluent aphasia is associated with left hemisphere cardiovascular accident (CVA). exercise decreases agitation. 2. purging. 3. 165. nonfluent aphasia. 164. purging. for others. parietal lobe 3. the client will identify irrational thoughts about her weight. (2) Right hemisphere CVA behaviors include motor deficit on the left side. occipital lobe (2) The right side of the brain. recognizing faulty thinking. left hemisphere cardiovascular accident (CVA). denial or unawareness of deficit. and acquiring adaptive coping responses. temporal area cardiovascular accident (CVA). highly distractible. Token programs may be effective if the reward is something the client is willing to work toward. Temporal lobe makes memories 33 . A nurse is developing a contract with a client with anorexia nervosa. impulsivity. spatial perceptual loss. exercise increases it. impulsivity. laxative use. especially the parietal lobe. The most sensitive indicator of changes in level or orientation of perception is: 1. pupillary responses. 166. frontal lobe 4. 163. motor deficit on the right side. 163. and exercising behaviors. temporal lobe 2. 2. Expressive aphasia is associated with: 1. 2. 3. the client will not lose any weight for the first 2 weeks. 4. Unless the client is aggressive at time of admission. is important in perception. right hemisphere cardiovascular accident (CVA). 4. and exercise. 3. change in level of consciousness. he should not be placed in isolation. A realistic goal for the first 2 weeks would be: 1. (1) Expressive.

169. which restores dopamine to the brain. read and write. Parkinson’s disease is a chronic. Levodopa crosses the blood brain barrier and is converted to dopamine. 4. 2. 2. Agnasia is a sequelae of cardiovascular accident (CVA). Demonstrate or pantomime ideas 34 . acetylcholine 3. The medication most commonly used in the management of Parkinson’s disease is: 1. 171. Occipital lobe is for vision. serotonin (2) Acetylocholine. GABA 4. recognize relationships of various body parts. This drug is a combination of Carbidopa and Levodopa. decreases the number of acetylcholine reception postsynaptic membrane. (1) Destruction of the dopaminergic neurons in substantia regia reduces the amount of neurotransmitter dopamine. Clients with special needs require specific communication techniques. 3. recognize and use familiar objects correctly. dopamine 2. 172. progressive motor disorder caused by the loss of: 1. tremors. fatigue. 168. muscarinic receptors in the muscles. (4) Tremor of Parkinson’s disease is known as pill rolling (nonintentional) tremors. This involves the loss of ability to: 1. Myasthemia Gravis is a rare. 4. 2. 3. Sinemet. chronic disease that affects the deficit of which neurotransmitter? 1. sporadic muscle jerkiness. Rigidity causes the loss of facial expression and forward tilt of the body for posture. Carbidopa blocks peripheral conversion of the Levodopa making more dopamine available in the brain. altered gait. 167. (2) The drug of choice in managing Parkinson’s disease is Sinemet. Keep communication simple and concrete c. personality. Allopurinol. 170. Frontal lobe is reasoning. Which specific communication techniques should a nurse utilize when caring for a client who is cognitively impaired? Select all that apply. ptosis. 3. rigidity. Mestinon. Select all that apply. paresthesias. and paralysis. dysphagia. bradykinesia. (1) Agnasia involves the inability to recognize familiar objects. dopamine from substantia nigra. and mathematical. 4. altered gait. The four classic manifestations of Parkinson’s disease are: 1. myelenation of the motor nerves. and urinary overflow. 4. decrease of temperature. muscle movement is slowed and stiff. a neurotransmitter. acetylcholine from the basal ganglia.and stores them. Use open-ended questions d. 3. a. Crestor. carry out a learned sequence. salivation. Maintain eye contact b. and postural inability. and postural inability. 2.

The client’s gender b. A commonly-used behavioral management technique is the use of contracts made with the client. A contract may be used to hold a client accountable for his/her actions c. c. A contract serves as a constant reminder of client tasks and goals d. keep communication simple and concrete. Providing a comfortable environment b. all of which aid the client in establishing a sense of trust with the nurs 174. Cognitive restructuring gives a client greater control over negative thinking by correcting the distortions. Clients are independent and self-sufficient d. and c. Group therapy promotes self-expression and the exchange of ideas. Using open-ended questions is a therapeutic communication technique. take ownership of their behavior and environment. Enhancing client privacy d. ensuring client confidentiality. and d. b. b. Trust-building is an important nursing activity when establishing a nurse–client relationship. and giving advice. length of stay. Clients are responsible for safety and trust development Correct answers: a. and d. Room assignments on a psychiatric unit are based on which factors? a. Which statements are true regarding clients in a therapeutic environment? a. Which statements are accurate regarding client contracts? a. The client’s length of stay Correct answers: a. and be client when communicating with a client who is cognitively impaired. Focusing on the diagnosis instead of the client b. When a nurse draws the curtains around a client’s bed.The nurse should maintain eye contact. A contract promotes self-expression and the exchange of ideas Correct answers: b and c. and function independently and selfsufficiently. Ensuring client confidentiality c. The client’s race d. 176. The client’s fragility c. The nurse assists the mental health client in achieving and maintaining self-control of behavior. Clients take ownership of their behavior and environment c. Providing a personal space Correct answers: a. Which actions by the nurse are barriers to therapeutic nurse—client communication? a. using slang terminology. The nurse is responsible for facilitating safety development and trust development within the therapeutic environment. age.Barriers to therapeutic communication include: focusing on the diagnosis instead of the client. b. which trust builders are the nurse utilizing? a. and level of personal distress.By performing the simple act of drawing the curtains around a client’s bed. A contract gives a client greater control over negaive thinking b. 173. 35 . Using open-ended questions d.Correct answers: a and b.Room assignments on a psychiatric unit are based upon numerous factors which include: gender. the nurse is providing a more comfortable environment.Clients in a therapeutic environment are active participants in their lives. The goal of the therapeutic environment is to promote health and healing. Demonstration or pantomiming ideas are not effective techniques for communicating with those who are cognitively impaired. avoid open-ended questions. and d. Giving advice Correct answers: a. Clients are active participants in their own lives b. fragility. 177. and providing a personal space. Using slang terminology c. overall behavior. 175. b. enhancing client privacy. A contract may be used to hold a client accountable for his/her own actions and serves as a constant reminder of client tasks and goals.

A crisis center Correct answers: a. family history of child abuse and altered body image are all risk factors for suicide. Substance abuse b. psychiatric nurse specialists. hospital emergency departments. If the client is not is in a private room. severe pain. b. Clients with histories of which of the following factors are at increased risk for committing suicide? a. which items should the nurse remove from the room? a. nausea. the client and family cannot function normally and require interventions to regain equilibrium. c. delusions. A psychiatrist b. intractable. Domestic violence is rarely a one-time occurrence in a relationship. Anything. MDMA (Ecstasy) is a form of methamphetamine. A nurse in the Emergency Department is caring for a client who has been smoking crack cocaine. these types of items belonging to the other person in the room must also be removed. Risk factors for abuse include: alcoholism. the nurse should facilitate referrals to which health care professionals? a. which side effects should the nurse anticipate? a. Provide a private. Meperidine (Pethidine) c. Which nursing interventions are appropriate for a client experiencing alcohol withdrawal? a.In crisis situations. 181. it is appropriate for the nurse to facilitate referrals to psychiatrists. sharp objects. MDMA (Ecstasy) d. tachycardic. A hospital emergency department d. high stress levels. paranoia. Intractable. Implement seizure precautions 36 . 182. suicidal ideation. hallucinations. When caring for a client on suicide precautions. or items in any way able to inflict injury must be removed from the room. In crisis situations. hypervigilance. aggression. severe pain d. As the client experiences withdrawal from crack cocaine. and d. vomiting. Nail file c. Hallucinations c. and agitated. During a crisis. A psychiatric nurse specialist c. b. fatigue. Lorazepam (Ativan) is a benzodiazepine 184. Matches Correct answer: all of the above. depression. and history of violence. Alcoholism b. hyperthermia and general malaise. Illusions d. Impulsiveness c.Hydromorphone (Dilaudid) and meperidine (Demerol) are opioids. Opioids are often prescribed by physicians for pain control and are commonly-abused substances. This includes alcohol-based solutions and aerosol cans. high emotions. muscle pain.178. Lorazepam (Ativan) Correct answers: a and b. Alcohol based mouth wash e. Family history of child abuse e. Hand mirror b. High stress levels c. Psychosis b. physical. impulsiveness. and crisis centers 179. ideas of persecution. flammable liquids. Substance abuse. emotional. it usually continues and escalates in severity. insomnia. and/or financial dependency. Aerosol deodorant d. lighted environment for recovery b. Financial independency d. Nail polish remover f. glass. Physical dependency Correct answers: a. 183. Which medications are opioids? ( a. Nausea and vomiting Correct answers: a. The client’s pupils are dilated and the client is euphoric. morphone (Dilaudid) b. and d. 180. A client who is undergoing withdrawal from cocaine may experience side effects which include psychosis. Which factors increase the risk of an individual becoming violent? a. and d. b. Altered body image Correct answer: all of the above. tremors.

and d. Provide small. Which statement made by a participant in a seminar on delirium indicates that additional clarification is needed? a. cardiac. 186. orient the client to person. and d. Which assessment finding could be indicative of psychopathology? a. There is nothing to suggest that the client has been emotionally abused or is an emotional abuser. place. poor hygiene. “It is considered a medical emergency. Signs of chemical abuse and dependency d. implement seizure precautions.” c. Antidepressants may cause anticholinergic. monitor vital signs and neurological status. Disorientation c. permanent brain damage can occur. memory loss. Mania d. b. frequent high-carbohydrate feedings. ECT may be used as an effective treatment for depression that does not respond to antidepressant pharmacotherapy. Agitation and hostility are not side effects of antidepressant use. family. Delirium begins with confusion and progresses to disorientation over a brief time span. A nurse is caring for an elderly client who is experiencing dementia. c. provide small. Hallucinations are a sign of delirium—a medical emergency. Calm affect b. Signs of an impending crisis b. particularly when being given to elderly clients.” d. Which assessment findings would the nurse expect? a. It is appropriate for the nurse to teach the client and family about the signs of an impending crisis that could precipitate suicidal thoughts. and c. which is commonlyssociated with suicidal behavior. frequent. Poor hygiene Correct answers: b. b. c. A nurse on a psychiatric unit is performing an initial assessment on the mental health of a client. Memory loss c. b. Inappropriate dress d. Signs of emotional abuse Correct answers: a. Forgetfulness b. 187. if untreated. Hostility Correct answers: a and b. Agitation d.” b. Hostility d. c. mania. Which content would be appropriate for the nurse to teach? (Select all that apply. b. b. The nurse is providing discharge teaching to the client and the family. “It may result in hallucinations. or schizophrenia. Abnormal assessment findings that could be indicative of psychopathology include disorientation. lighted environment to reduce the potential for hallucinations. Anticholinergic effects b. Electroconvulsive therapy (ECT) is used as an effective treatment for which mental disorders? a. “It mostly affects elderly living in institutional settings. and orthostatic side effects as well as interactions with other medications. When caring for a client who is experiencing alcohol withdrawal. A nurse is discharging a client from a psychiatric unit who has been under suicide precautions. Orient the client to person. and hostility are all signs of dementia in the elderly. “If untreated. the signs of suicidal behavior to help the family recognize risk for suicide. It is considered a medical emergency and. Severe catatonia c.” Correct answers: a. Hallucinations Correct answers: a. Forgetfulness. Depression b. absent memory recall. 189. severe catatonia. and provide support to the client. and d. may result in permanent brain 37 . and c. and significant others 185. and time. Cardiac effects c. 190. it is appropriate for the nurse to provide a private. and d. Schizophrenia Correct answers: a. 188. inappropriate dress. high-carbohydrate feedings Correct answers: a. record intake and output. Signs of suicidal behavior c. Antidepressant medications must be prescribed and administered with care. and incoherent or illogical thought processes.c.) a. Which adverse effects should the nurse anticipate when administering antidepressants to elderly clients? a. place. and time d. and signs of chemical abuse and dependency.

or social integrity. He claims his actions were justified since his employer did not treat him fairly. Which behavioral clue would the nurse identify as suggestive of suicide? a. An adventitious crisis (option 1) occurs from an accidental or sporadic event. Her behavior is not characteristic of individuals diagnosed with schizotypal. A social crisis (option 4) is a crisis that occurs within a social context. Joking indicates a coping mechanism. He is displaying characteristics of which personality disorder? A. Seeking help for symptoms of depression Correct answers B Feelings of hopelessness and helplessness are key indicators suggesting suicide. 191. d. Histrionic C. or schizoid personality disorder. His behavior is not characteristic of individuals diagnosed with narcissistic. fears criticism and rejection from others. 192. Maturational crisis C. Schizotypal B. paranoid. the nurse suspects that the client may have which of the following personality disorders? A. He has expressed neither remorse for his actions nor any response to his conviction. Borderline Rationale C. c. and lack of ability to concentrate are all effects of cocaine use. Situational crisis D. Avoidant D. tachypnea. Agitation f. Hypervigilance and tremors are signs of cocaine withdrawal. Paranoid C. and withholds information about her thoughts and feelings because she anticipates a negative reaction. Tachycardia c. Lack of concentration g. Avoidant : The described behavior reflects the DSM-IV diagnostic criteria for avoidant personality disorder. Hypervigilance j. 193. Antisocial: The described behavior reflects DSM-IV diagnostic criteria for antisocial personality disorder. such as in adolescents or older adults. Social crisis Rationale: A situational crisis is one that is often sudden and unavoidable. 194. or borderline personality disorder. Slurred speech and poor coordination are signs of benzodiazepine use. Tremors Correct answers: b. Verbalizing feelings of hopelessness and helplessness about problems c. A maturational crisis (option 2) occurs because of a situation occurring from the maturing process. Hypertension. Dementia mostly affects elderly living in institutional settings. Poor coordination i. and f. Based on the data. The stressful event threatens a person’s physical. The nurse on an alcohol and drug rehabilitation unit teaches a client group about depression and suicide. The client’s history indicates that she has few friends. A client recently released from prison for embezzlement has a history of blaming others for his problems and becoming defensive and angry when criticized. Engaging in weekend drinking episodes d. When assessing a client for cocaine use. Adventitious crisis B. A client who is unable to cope with the sudden loss of a job and who is feeling confused and unable to make decisions is said to be experiencing which of the following? A. Engaging in weekend drinking episodes suggests a 38 . for which signs would the nurse observe? a. Dilated pupils e. agitation. Hallucinations are a sign of delirium.Tachycardia. Antisocial D. Tachypnea d. 195. emotional. Joking about stressful situations b.damage. A 35-year-old client is being interviewed by the nurse. Hypotension b. Narcissistic B. histrionic. e. dilated pupils. is also an effect. not hypotension. Schizoid Rationale C. Slurred speech h.

Psychological autopsy b. A The priority intervention for a client with suicidal intent is to encourage the client to verbalize negative feelings. A Interaction with the staff. Pointing out the positive aspects of living c. if any. During the period of deepest depression c. At this time. When the client continues to ruminate about problems Correct answers. the greatest risk for suicide occurs during the recovery period from depression. including specific details of the plan. Questions related to the specific details of a suicide plan are not therapeutic. Correct answers. Prior to effective onset of action of antidepressants d. Treatment analysis d. Telling the client that thoughts of suicide will decrease is false reassurance. Seeking help for symptoms of depression indicates the client's desire for a positive change. in which the staff reviews the client's behaviors and suicidal act. B A client's degree of suicidality is not a static quality. assessment of suicide risk is an ongoing process. Postvention process c. After a suicidal gesture. The nursing assessment of a client who expresses suicidal intent is made based on which of the following principles about suicide prevention? a.substance abuse problem. Clients expressing suicide intent may or may not follow through with the action. Doing so helps clients to explore the reasons underlying the suicidal ideation and provides them with support. Team discussion Correct answers. 199. d. A Although the client's risk for suicide is ever-present. This process also provides staff members with an opportunity to self-assess their behavior and responses and discuss their concerns with peers. Pointing out the positive aspects of living is inappropriate and non-therapeutic. is essential. c. Providing activities to keep the client busy ignores the client's needs. possibly fluctuating quickly and unpredictably. During the period of recovery from depression b. Therefore. individuals with severe depression experience the energy level to follow through with self-destructive thoughts. Clients expressing intentions of suicide rarely follow through with the action. a process used to examine what clues. The nursing staff and treatment team participate in a process of reviewing the client's behaviors and the completed suicide despite all precautions implemented on the unit. Following a suicidal gesture. b. Direct questioning about suicide intent. 39 . not a single event. The nursing plan of care for a client with depression who has verbalized the wish to die identifies the period of greatest suicide risk as which of the following? a. A client has committed suicide while hospitalized on an inpatient psychiatric unit. The staff is engaging in which of the following? a. Treatment analysis and team discussion are general terms related to client care. 196. Encouraging verbalization of negative feelings b. 197. is referred to as a psychological autopsy. the client may be more depressed about not having been successful. Which nursing intervention would be the priority for a client with suicidal intent? a. were missed so that staff members can learn from the evaluation of a particular situation. the client will be grateful to be alive. Postvention is a therapeutic program for bereaved survivors of a suicide. Reassuring the client that thoughts of suicide will decrease Correct answers. Degree of suicidal intent is not a static quality and may change day-to-day. Providing activities to keep the client busy d. 198.

sex drive B. the autonomic nervous system. D. B.Homeostasis is promoted via interaction between the brain and internal organs mediated by A.altering brain neurochemistry. D.The basic functional unit of the nervous system is called a A.A client receiving a psychotropic drug complains to the nurse that he is drowsy all the time and is having difficulty focusing his attention. C. dry mouth. 3. C. cerebellum C. urinary retention. C. 5.Which organs secrete hormones that are a normal component of the body's general response to stress? A. the nurse would expect that the client would initially demonstrate A. conscious behavior. the nurse can view a client's symptoms of profound depression as at least partially related to A.Treatment of mental illnesses using psychotropic drugs is directed at A. skull x-ray 7. decreased acetylcholine level. skeletal muscle contraction C. B. B. constipation. dendrites. GI disturbances. D.When the nurse knows a client is taking a medication that has anticholinergic properties.PART II 1. increased dopamine level. The nurse will correctly interpret this symptom as related to the drug's effect on the brain's ability to regulate A. blood pressure irregularities. activating the body's normal response to stress. CT scan B. decreased serotonin level. regulate conscious mental activity. PET scan C. D. disequilibrium. alertness. B. C. C. ejaculatory disturbances. the nurse would assess for A. C. drowsiness. C. conduct electrical impulses and release neurotransmitters are called A. pituitary gland. hypotension.A client's communication is marked by loose associations and word salad. brain. receptor. 11. regulate social behavior. pancreas. 2. brain stem D. neurons. 14. impaired social judgment. increased norepinephrine level. neurotransmitter. weight gain. B. receptors. adrenal glands.The behavior of an individual who seems unable to learn right from wrong and who repeatedly violates norms and laws demonstrates problems related to the brain's inability to A. mood. D.When a tumor of the cerebellum is present. memory. Dysfunction of which portion of the brain can the nurse hypothesize is responsible for these symptoms? A. sedation. D. sleep cycle D. brain. MRI scan D. thyroid gland. D. C. adrenal glands C. pancreas B. orthostatic hypotension. retain and recall past experience. 13. synapse. B. weight gain. B.Which imaging technique can provide information about brain function? A. parathyroid glands 9. 8. B. maintenance of a focused stream of consciousness 4. D. the sympathetic nervous system. sedation.A client taking a medication known to block H1 should be carefully observed for A. thought. B. D. 6. cerebrum B. neuron. Cells that respond to stimuli. correcting brain anatomical defects. priapism. the parasympathetic nervous system. thyroid gland D. 40 . hypotension.maintain homeostasis 10. C. pituitary gland. motor abnormalities. synapses. Based on current understanding of neurotransmitters. B.regulation of social behaviors. abnormal eye movement. basal ganglia 12. memory dysfunction.Which of the following is classified as a circadian rhythm? A.

Noncompliance due to side effects B. Who is the head man?" A.The physician mentions to the nurse that the medication prescribed for a client is thought to potentiate the action of GABA. Which substance would be implicated? A.The medication prescribed for a client acts by blocking reuptake of both serotonin and norepinephrine." From this explanation. B.A client is admitted to the hospital with severe depression. D.Selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs) both function by: A.The physician tells a client who demonstrates use of many rituals. Read the communication dialogue and select the appropriate technique from the choices provided. Decreasing levels of epinephrine and serotonin at nerve endings D.clarification B." Nurse-"Have you thought about asking a friend to feed your cat?" A.theme identification D. Patient-"I don't know what to do. Higher costs by decreasing amount of drug used C. normal appetite.sharing perception 22. improved sleep pattern. Read the communication dialogue and select the appropriate technique from the choices provided. mood elevation B. blurred vision.clarification D.reflection D. tachycardia.suggesting 23. reduced aggression 17. ventriculogram.Read the communication dialogue and select the appropriate technique from the choices provided. dry mouth. C.sharing perception C. PET scan. Patient-"My mother hates me." A. The physician mentions the possibility that depression may be related to hormonal imbalances associated with stress. 16. Nurse-"I am wondering from your expression if it is difficult for you to ask. 15. less anxiety. CT scan. My cat is home and no one is there to feed it. We believe the study will help us determine how to treat your symptoms. tremors. the nurse can determine that the physician will order a/an A. 18. Patient-"I need to change my appointment time again" (Said with an expression of dread).focusing B.theme identification C. Increasing the placebo effect 20. buspirone B." Nurse-"Tell me about a time when you thought your mother hated you. improved memory D. Increasing alertness levels in the brain C. Patient-"The head man expects some cash today. constipation. "We want to do an imaging study that will tell us which parts of your brain are particularly active.restating B. Blocking the reuptake of neurotransmitters at nerve endings B. mirtazapine D. Tardive dyskinesia and other extrapyramidal reactions 21. C. D. D.restating 41 . Destructive behaviors by allowing patient to regain control D. ejaculatory dysfunction. Read the communication dialogue and select the appropriate technique from the choices provided.broad opening C. electroencephalogram.reflection 24. reduced auditory hallucinations.C. decreased pain C.” The nurse explains that the purpose of this is to help prevent: A.suggesting C. clomipramine 19. B. The nurse would evaluate treatment as being successful when the client demonstrates A." Nurse-"I am not sure what you mean. What change would cause the nurse to evaluate the treatment as successful? A." A.informing D. Patients taking antipsychotic medications may be periodically prescribed a “drug-free holiday. cortisol C. informing B.

" A.theme identification B.broad opening D. Massage C.000 ml per day 1.sharing perception D." A." Nurse-"Tell me about what has been on your mind recently. Reminding her to perform rituals early in the evening d. Acquires more superego b.Read the communication dialogue and select the appropriate technique from the choices provided.focusing B.compulsive traits." Nurse-"You say your life is going downhill since your son left?" A. Patient-"I don't know where to start. Patient-"I just want to scream when my husband spends all his time at the computer. The treatment plan should include: a.suggesting 29. Biofeedback B.500 ml per day c. Recommending a sedative medication b." A. my life went downhill. What associated behavior does the nurse assess? a. Firm and directive b. The most recent Lithium level on bipolar patient indicates a drop nontherapeutic level.broad opening 28.clarification B. No longer needs them to manage her feelings of anxiety 35.reflection D.25.informing C.restating B." A. Read the communication dialogue and select the appropriate technique from the choices provided. Patient-"I am going to a restaurant on my pass. Modifying the routine to diminish her bedtime anxiety c.focusing C." Nurse-"Let's review the special diet required while you are taking this antidepressant.suggesting 26. Of the following behavior's. The patient will not be able to stop her compulsive washing routines until she: a. Rituals relieve intense anxiety d. which one would you expect the patient to exhibit? a. temperature and muscle tension which she can visualize and assess? A. Hyperactivity d. Adequate fluid intake for a patient on Lithium is: a." Nurse-"You have spoken so often of feeling deserted by your wife. Upon admission to the hospital the patient increases the ritual behavior at bedtime.restating C. Patient-"Since my wife left me nothing matters. 2. Confusion c. Ataxia b. The patient cannot help herself b. Read the communication dialogue and select the appropriate technique from the choices provided. Helpful and advisory d Subjective and non-judgmental 42 .informing D. Insistence that things be done his way 36. Medications cannot help 34.broad opening B. Lethargy 33.theme identification 27. 3. 1. The nursing interventions most effective in working with substance dependent pts are: a. Read the communication dialogue and select the appropriate technique from the choices provided. A patient has been diagnosed with a personality disorder with . She cannot sleep. Instillation of values c. Inability to alter plans d.clarification D.600 ml per day 32. Regains with reality c. Patient-"After my son left home at fourteen. Visualization and Imagery 31. Spontaneous playfulness c. The patient cannot change c. Limit the amount of time she spends washing her hands 35." Nurse-"You are feeling very frustrated about your husband spending time at the computer.sharing perception C.reflection C. To understand the meaning of the cleaning rituals. What type of relaxation technique does Lyza uses if a machine is showing her pulse rate. Autogenic training D. It seems this change has left you feeling empty. Inability to make decisions b. Read the communication dialogue and select the appropriate technique from the choices provided.focusing 30. Recognizes the behavior is unrealistic d. the nurse must realize: a.000 ml per day d.

Exercising 1 hour before bedtime to promote sleep 43 . Otitis media 42. The nurse is caring for a client who is experiencing auditory hallucination. Paranoia b. Delusion of persecution c. In attempting to control a patient who is suffering panic attack. The nurse is caring for a client whom she suspects is paranoid. Demonstrate ADLs frequently 38. How suicidal the client is c. Disorganized speech c. This statement is an indication of which of the following? a. Increased respirations and decreased heart rate 39. How would the nurse confirm this assessment? a. Encourage. Family history of psychosis c. Direct questioning c. Which of the following teaching topics should be included in the plan? a. Eating unlimited spicy foods. Change lifestyle completely c. indirect questioning b. Catatonic behavior 44. Dyskinesia d. socialization with peers. In teaching stress management. Impaired social skills related to inadequate developed superego 47. heart rate and respirations c. A patient with schizophrenia (catatonic type) is mute and can't perform activities of daily living. Provide safely b. The patient stares out the window for hours. and provide a stimulating environment 45. Social isolation related to impaired ability to trust d. Learn new ways of thinking 40. How the client is behaving 48. Illusion 41. Which nursing diagnosis is most likely to be associated with a person who has a medical diagnosis of schizophrenia. Describe crisis in detail d. Jaundice c.37. What would be most crucial for the nurse to assess? a. The client tells the nurse that he can't eat because his food has been poisoned. Flat affect d. and try to orient him to his surroundings d. Delusions b. What is your first priority in this situation? a. Increasing BP. Hallucination d. Content of the hallucination d. Decreasing BP. Assist the patient with showering and tasks for hygiene c. Agranulocytosis 46. the nursing priority is: a. Les-ad-in-sentences d. Modify responses to stress d. Possible hearing impairment b. Open-ended sentences 43. Reassure the patient about safely. Assist the patient with feeding b. Which of the following would you suspect in a patient receiving Chlorpromazine (Thorazine) who complains of a sore throat and has a fever? a. increasing heart rate and respirations b. How flat the client's affect b. Which assessment would the nurse most likely find in a person who is suffering increased anxiety? a. and limiting caffeine and alcohol b. When writing an assessment of a client with mood disorder. Perceptual disturbance related to delusion of persecution c. Which of the following is an example of a negative symptom of schizophrenia? a. How grandiose the client is d. the goal of therapy is to: a. Increased BP and decreased respirations d. An allergic reaction b. Get rid of the major stressor b. The nurse is preparing a teaching plan for a client diagnosed with primary insomnia. Hold the patient c. Fear of being along b. paranoid type? a. the nurse should specify: a.

maintain the client’s contact with his/her family d. sedation d. The nurse knows the most common side effect of benzodiazepine antianxiety medications is: a. Drinking warm milk before bed to induce sleep 49. A client is admitted with a history of extremely elevated. good problem solving skills d. providing an unstructured environment 51. Ibuprofen (Advil) c.c. recall the events of the distant past 59. silence c. acceptance d. A priority nursing intervention for a client experiencing an acute manic episode? a. a one to one nurse client relationship d. flight of ideas. improvement in judgement b. Succinylcholine (Anectine) d. During the initial phase of the relationship with this client. flatulence 61. insight b. irritable mood for a week. redirect excessive energy to creative tasks 55. 10 to 12 c. insomnia. similar to a seizure disorder d. denial c. dysfunction of the cardiovascular system b. 6 to 8 b. 3 to 5 d. and psychomotor agitation. solve simple mathematical problems c. paint alone for 15 minutes 57. the nurse would expect which reaction to interpersonal communication? a. A client is admitted through the emergency department with a diagnosis of depression. Initially the nurse would expect a client to react to a diagnosis of cancer with: a. cope with stressful experiences b. Hydrochlorothiazide b. elation 53. chair the unit’s self-government meeting d. anger d. The nurse knows which medication may be safely prescribed for a client already taking lithium (Lithane)? a. protect the client from impulsive behavior c. Valproic Acid (Depakane) 52. confusion b. anger b. negotiating the treatment plan with the client c. commitment to long term goals 60. In the early stages of Alzheimer’s disease. involuntary muscle movements c. compete in a unit volley ball game c. discourage the client’s use of vulgar language b. Unlimited 50.An ongoing critically important responsibility of nurses working on an in-patient psychiatric unit is 44 . Importance of steeping whenever the client tires d. The nurse sets as a priority short term goal: the client will demonstrate: a. Which treatment approach would be most therapeutic for a hospitalized client with antisocial behavior? a. headache c. When preparing to conduct group therapy. a toxic reaction of the liver 56. stability of mood c. The nurse understands that EPS is: a. adequate nutrition and rest d. participation in group therapy b. On assessment the nurse notes grandiosity. identify three strengths b. the nurse would anticipate that a client will retain the ability to: a. fear 54. What would the nurse most expect to observe in a client with impulsive behavior? a. A client who is taking chlorpromazine hydrochloride (Thorazine) is experiencing extrapyramidal side effects (EPS). remember a daily schedule d. understanding of medication regimen 58. ability to delay gratification b. the nurse keeps in mind that the optimal number of clients in a group would be: a. The nurse knows an appropriate short term goal for a client exhibiting manic behavior is for the client to: a. low tolerance for frustration c.

D. the intervention is called A. goes into shock. which of the following does he/she NOT have a patient's right to do? A. 72. take unilateral action to make changes in client care plans. 68 karmah is being prepared for discharge. 64. Trust may develop in the nurse -client relationship when the nurse a. The following behaviors indicate recurrence of depression. feeling of hopelessness 69. tell him how he should behave d. B. U. B. Grandiosity b. T goes into cardiopulmonary arrest.In most in-patient psychiatric units it can be expected that administration of medications will involve A. who hears voices telling her to hit others. management by coercion. C. seek legal counsel D. A client is suffering from post-traumatic stress disorder following a rape by an unknown assailant. C. fostering research. One of the primary goals of nursing care for this client would be to. the nurse taking medications to one client at a time. asks for and receives prn medication.A basic nursing student assigned to the psychiatric inpatient unit should A. sympathetic listening. Rules and behavioral limits are inconsistently enforced. D. D. How can I hurt you? b. Ms.When a client is admitted to a behavioral health unit. Tell me more about this d.Which is a characteristic of a therapeutic in-patient milieu? A. I die. B. The best response for the nurse to make to this behavior is: a. managers and instructors. C. Control aggressive behavior c. behavioral contingency. 62 . a. B. retain all possessions brought to the hospital 66. Hallucination b. avoid limit setting b. Mrs. R. psychomotor retardation d.Which would not be considered a crisis on a psychiatric unit? A. B." This is an example of: a. S demonstrates anger that escalates to physical assault. Deal with the client's anxiety d. supportive environment b. milieu management. D. encourage the client to use "testing" behaviors c. Establish safe. Delusion c. less than one-quarter of the clients receiving medication. It provides for client safety. D. Clients are responsible for all decisions about privileges. Except: a. the nurse taking a medication cart from client to client. milieu management. Staff provide frequent and ongoing negative feedback to clients. providing negative feedback. Mr. seek opportunities to inform interdisciplinary staff of less restrictive alternatives. show of force. C. B. 67. I'm the nurse c. 65. Mr. 63. C.A. AS the nurse approaches pt he says"If you come any closer. send and receive mail C. D. view clients as potential threats to personal safety. Uses consistency in approaching the client. That's a silly thing to say 71.When a number of staff gather to provide silent support for a staff member who has given a directive to a client in an attempt to de-escalate a crisis. C. The nurse instructs tier husband to observe signs of depression. Insomnia c. clients coming to a central location to receive medication. illusion d. idea of reference 70. Discuss client's nightmare and reactions. maintain open communication with staff. 45 . refuse treatment B.

Dissociation b. Neologism d. The priority in working with patient a thought disorder is: a." a. A male client who has delusions of persecution and auditory hallucination is admitted for psychiatric evaluation after stabbing a friend. Set limits and restrict client's behavior d. Later a nurse on the unit greets the client by saying. Hypoxia of of brain tissue d. 84. Reality testing d. "I will not eat bananas especially those which are over ripe. Say with the client during the stressful time. During the physical assessment Lizbeth's arms remains outstretched after her pulse and blood pressure were taken and the nurse has to reposition it for her. "MAO inhibitors are considered as effective as other forms of treatment. After surgical repair the nurse notes that the client's pain does not seem to be relieved by the prescribed IM pethidine. rationalization. Ask direct questions about the client's behavior c.73." answers. Lizbeth is showing. Make the client more amenable to psychotherapy 80. The nurse recognizes that the failure to achieve pain relief from indicates that she is probably experiencing the phenomenon of: a. Prevent destructiveness d. "Good evening. Waxy flexibility d." b. Reaction formation 77. denial. "I should avoid milk & milk products 46 ."I will drink beer instead of wine. and distortion by hallucinations and delusions are examples of a disturbance in: a. A disturb client starts to repeat phrase that others have just said. Displacement d. habituation c. Reorient him to reality d. psychologic 75. A mate client on the psychiatric unit becomes upset and breaks a chair when a visitor does not show up. Logic b. a. A patient taking MAOI Is correct when he states: a. Ran with the client on hew he can better handle frustration. "The man is bad. The thought process 79. Echopraxia 78. b. The first nursing intervention should be to" a. Projection. Echopraxia 76. Get him to understand what you're saying b. Autism b." c. restraints c. Periodic remissions and exacerbations c." c. Areas of brain destruction called senile plaques 81. Muscle rigidity c. " Can you manage alone?" 83. 74." d. "Don't waste your time with me. tolerance b. The nurse recognizes that dementia of the Alzheimer's type is characterized by a." b. Association c. Aggressive acting out behavior b. Echolalia c. Ms. The major reasons for treating severe emotional disorders with tranquilizers is to: a. "Just call me when you are okey. “I’ll stay with you for a while. Get him to do his ADLs c. Administer antipsychotic medications 82. physical addiction d. Zepetee is treated for multiple stab wounds to the abdomen. Transference c. Prevent secondary complication c. Frequently reminding patient of things he should not do. Which of the following nursing intervention would be most appropriate for a patient with bipolar disorder in Manic stage? a. How are you?" The client who has been referring to himself as "man. Ensure safety d. Distractability b." This is example of: a. Which of the following is a therapeutic response to a patient in depression when he says. b. This type of speech is known as: a. Do not respond to their enthusiasm. Reduce the neurotic syndrome b. "Why did you say that?" d.

Liver c. dysphagia 90. the same c. Self-care deficit 100. La belle indifference d. everyone is against me. Dissociative disorder 96. a female client loudly announces: “Everyone kneel. Noncompliance b. Which of the following is not a characteristic of a panic disorder? a. expressive aphasia b. A multiple personality disorder 98. A disorder where an individual may manifest a personality that is opposite to a previous identity is: a. An appropriate nursing diagnosis of a client with a major depression is: a. 86. no cure d. “No one cares. Hypersensitive d. Delusional blocking 94. and I am so important in my office that that the other people will not be able to work without me. you are in the presence of the Queen of England. The situation in which individuals have excessive worry or belief that they are suffering from a physical illness despite lack of medical evidence is known as: a. Chocolates b. A histrionic personality disorder b. lungs 88. Which of the following describes a person using words that have no known meaning? a.5 is: a. Excessive perspiration c. Exploitative c. Schizoid personality disorder c. Urination d. Alteration in perceptions c. Nausea b. Which of the following is not a sign of anxiety? a. Seldom occurs and does not last long in normal person.” This type of statement is consistent with what disorder? a. GI symptoms 92. A delusion of grandeur 95. Chest pain 93. Lithium serum of 2. Impaired communication c. above normal b. A delusion of self-belief b. Alteration in activity b. Alteration in affect d.85. Antisocial personality disorder 97. Moist mouth d. Psychogenic amnesia b. Which of the following types of behavior is expected from a client diagnosed with paranoid personality disorder? a. Difficulty in naming previously known objects is: a. normal c. Neologisms b. non therapeutic 89. Paranoid personality disorder b. An antisocial personality disorder c. A newly admitted client states. On arrival for admission to a voluntary unit. Mentally ill is subject to suicidal tendencies b. A client is diagnosed with catatonic schizophrenia. cheese d. Your client states. Verbalism d. Eccentric b. Psychogenic fugue 47 . Alteration in social activity 99. Seductive 91. fresh vegetables 87. Dyspnea b. Which organ functioning should be assessed prior to giving lithium a. global aphasia d. toxic d. heart d. Avocado c. Pain disorder b. Which is the highest priority nursing diagnosis? a. dysplasia c. A narcissistic personality disorder d. Somatoform disorder c. “I work for the government. A client In MAOI (Nardil) therapy can eat which of tie following food? a. What js the difference between a depression of a normal person and that of a mentally ill person? a. A nihilistic delusion d. Hyperventilation c.” This is: a. A delusion of self-appreciation c. Schizotypal personality disorder d. Phobic disorder c. Somatoform disorder d.” This is characteristic of: a. Neolithic c. Kidney b. Ineffective coping d.

Other antidepressant 17. 6. Benzodiazepine antagonist 4.10 . Antipsychotic 9. F . Oxygen f. or not Column A WITH ANSWERS Column B 1. 8. l Lithium carbonate (Eskalith) 18. he or she is suicidal forever. Selective serotonin reuptake inhibitor antidepressant 6. b Phenelzine (Nardil) b.9 9. The only absolute contraindication for ECT 3. i 7. Given prior to ECT to decrease secretions and 4. Administered prior to. Most people give clues and warnings about their suicidal intentions. About Suicide 1. Benzodiazepine antianxiety agent 2. Opiate antagonist 8. b Tranylcypromine (Parnate) f. h Haloperidol (Haldol) m. Most suicidal people have ambivalent feelings abut living and dying. F 1. Anti-Parkinsonism agent 14. 3. Administered as a short-acting anesthetic g .10 48 . Psychedelic 5. Muscle relaxant given to prevent bone fractures Answ Indicate whether each of the following statements is true or false. Alcohol deterrent 12. m Benztropine (Cogentin) 19. o Buspirone (BuSpar) e. If a person has attempted suicide. more than once. e Sertraline (Zoloft) c. a Lorazepam (Ativan) g. h Clozapine (Clozaril) 20. Major depression ECT 8. Gunshot wounds are the leading cause of death among suicide victims. h Risperidone (Risperdal ECT: Match the terms on the left with the descriptions listed on the right. F 4. Thiopental sodium c. Informed consent g. h Olanzapine (Zyprexa) p. Succinylcholine b. k Disulfiram (Antabuse) o. Monoamine oxidase inhibitor(MAOI)antidepressant 3. T 2.10 9. Suicide is the act of a psychotic person. Antimania (mood stabilizing) agent 13. h Chlorpromazine (Thorazine) k. j 2.9 8. he or she will not do it again. T 8. Suicide is an inherited trait. c Flumazenil (Aexate) h. 5.PART III MATCHING ANSWERS Match the following (note that descriptions may be used once. Methamphetamine 7. he or she cannot be stopped. Other antianxiety agent 16. If a suicidal person is intent upon dying. Temporary memory loss and d. Increased intracranial pressure increase heart rate 5. a Diazepam (Valium) a. Anticonvulsant 15. during. Most suicides occur when the severe depression has started to improve. n Valproic acid (Depokene) i. h 5. F 6. f Methylphenidate (Ritalin) d. 7. b 4. Answ Column A Column A 1. F . a confusion e. c 1. f 3.People who talk about suicide don’t commit suicide . Most common side effects of ECT Recent myocardial infarction . Once a person is suicidal. and following ECT 6. Most common cause of mortality associated with 7. Norepinephrine and serotonin h.10 i. j Imipramine HCl (Tofranil) l. Serotonin modulator antidepressant 10 g Naloxone (Narcan) j. Tricyclic antidepressant 11. T 7. Required before treatment can be initiated j. 2. F 5. Atropine sulfate a. Thought to be increased by ECT e . d 6. j Amitriptyline HCl (Elavil) n. T 3. Major indication for ECT 2. 4.

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