Psychiatric Nursing Practice Test 9 (Exam Mode) By Rnpedia.Com

50 Questions | Total Attempts: 921

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Psychiatric Nursing Practice Test 9 (Exam Mode) By Rnpedia.Com - Quiz

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Questions and Answers
  • 1. 
    An unemployed woman, age 24, seeks help because she feels depressed and abandoned and doesn't know what to do with her life. She says she has quit her last five jobs because her coworkers didn't like her and didn't train her adequately. Last week, her boyfriend broke up with her after she drove his car into a tree after an argument. The client's initial diagnosis is borderline personality disorder. Which nursing observations support this diagnosis?  
    • A. 

      Flat affect, social withdrawal, and unusual dress

    • B. 

      Suspiciousness, hypervigilance, and emotional coldness

    • C. 

      Lack of self-esteem, strong dependency needs, and impulsive behavior

    • D. 

      Insensitivity to others, sexual acting out, and violence

  • 2. 
    A client voluntarily admits himself to the substance abuse unit. He confesses that he drinks 1 qt or more of vodka each day and uses cocaine occasionally. Later that afternoon, he begins to show signs of alcohol withdrawal. What are some early signs of this condition?
    • A. 

      Vomiting, diarrhea, and bradycardia

    • B. 

      Dehydration, temperature above 101° F (38.3° C), and pruritus

    • C. 

      Hypertension, diaphoresis, and seizures

    • D. 

      Diaphoresis, tremors, and nervousness

  • 3. 
    When monitoring a client recently admitted for treatment of cocaine addiction, the nurse notes sudden increases in the arterial blood pressure and heart rate. To correct these problems, the nurse expects the physician to prescribe:
    • A. 

      Norepinephrine (Levophed) and lidocaine (Xylocaine).

    • B. 

      Nifedipine (Procardia) and lidocaine.

    • C. 

      Nitroglycerin (Nitro-Bid IV) and esmolol (Brevibloc).

    • D. 

      Nifedipine and esmolol

  • 4. 
    In a toddler, which of the following injuries is most likely the result of child abuse? 
    • A. 

      A hematoma on the occipital region of the head

    • B. 

      A 1-inch forehead laceration

    • C. 

      Several small, dime-sized circular burns on the child's back

    • D. 

      A small isolated bruise on the right lower extremity

  • 5. 
    A client is admitted to the emergency department after being found unconscious. Her blood pressure is 82/50 mm Hg. She is 5′ 4" (1.6 m) tall, weighs 79 lb (35.8 kg), and appears dehydrated and emaciated. After regaining consciousness, she reports that she has had trouble eating lately and can't remember what she ate in the last 24 hours. She also states that she has had amenorrhea for the past year. She is convinced she is fat and refuses food. The nurse suspects that she has:
    • A. 

      Bulimia nervosa.

    • B. 

      Anorexia nervosa.

    • C. 

      Depression

    • D. 

      Schizophrenia

  • 6. 
    A 15-year-old girl with anorexia has been admitted to a mental health unit. She refuses to eat. Which of the following statements is the best response from the nurse?
    • A. 

      "You don't have to eat. It's your choice."

    • B. 

      "I hope you'll eat your food by mouth. Tube feedings and I.V. lines can be uncomfortable."

    • C. 

      "Why do you think you're fat? You're underweight. Here — look in the mirror."

    • D. 

      "You really look terrible at this weight. I hope you'll eat."

  • 7. 
    A client with a history of substance abuse has been attending Alcoholics Anonymous meetings regularly in the psychiatric unit. One afternoon, the client tells the nurse, "I'm not going to those meetings anymore. I'm not like the rest of those people. I'm not a drunk. "What is the most appropriate response? 
    • A. 

      "If you aren't an alcoholic, why do you keep drinking and ending up in the hospital?"

    • B. 

      "It's your decision. If you don't want to go, you don't have to."

    • C. 

      "You seem upset about the meetings."

    • D. 

      "You have to go to the meetings. It's part of your treatment plan."

  • 8. 
    A client is admitted to the inpatient adolescent unit after being arrested for attempting to sell cocaine to an undercover police officer. The nurse plans to write a behavioral contract. To best promote compliance, the contract should be written:
    • A. 

      Abstractly

    • B. 

      By the client alone.

    • C. 

      Jointly by the client and nurse.

    • D. 

      Jointly by the physician and nurse.

  • 9. 
    During which phase of alcoholism is loss of control and physiologic dependence evident?
    • A. 

      Prealcoholic phase

    • B. 

      Early alcoholic phase

    • C. 

      Crucial phase

    • D. 

      Chronic phase

  • 10. 
    Which of the following is important when restraining a violent client? 
    • A. 

      Have three staff members present, one for each side of the body and one for the head.

    • B. 

      Always tie restraints to side rails

    • C. 

      Have an organized, efficient team approach after the decision is made to restrain the client.

    • D. 

      Secure restraints to the gurney with knots to prevent escape.

  • 11. 
    A client who's actively hallucinating is brought to the hospital by friends. They say that the client used either lysergic acid diethylamide (LSD) or angel dust (phencyclidine [PCP]) at a concert. Which of the following common assessment findings indicates that the client may have ingested PCP?
    • A. 

      Dilated pupils

    • B. 

      Nystagmus

    • C. 

      Paranoia

    • D. 

      Altered mood

  • 12. 
    A severely dehydrated teenager admitted to the hospital with hypotension and tachycardia undergoes evaluation for electrolyte disturbances. Her history includes anorexia nervosa and a 20-lb (9.1-kg) weight loss in the last month. She is 5′ 7" (1.7 m) tall and weighs 80 lb (36.3 kg). Which nursing intervention takes highest priority?
    • A. 

      Initiating caloric and nutritional therapy as ordered

    • B. 

      Instituting behavioral modification therapy as ordered

    • C. 

      Addressing the client's low self-esteem

    • D. 

      Regularly monitoring vital signs and weight

  • 13. 
    A client tells the nurse that he is having suicidal thoughts every day. In conferring with the treatment team, the nurse should make which of the following recommendations? 
    • A. 

      A no-suicide contract

    • B. 

      Weekly outpatient therapy

    • C. 

      A second psychiatric opinion

    • D. 

      Intensive inpatient treatment

  • 14. 
    Which of the following etiologic factors predispose a client to Tourette syndrome? 
    • A. 

      No known etiology

    • B. 

      Abnormalities in brain neurotransmitters, structural changes in basal ganglia and caudate nucleus, and genetics

    • C. 

      Abnormalities in the structure and function of the ventricles

    • D. 

      Environmental factors and birth-related trauma

  • 15. 
    A client is admitted for detoxification after a cocaine overdose. The client tells the nurse that he frequently uses cocaine but he can control his use if he chooses. Which coping mechanism is he using? 
    • A. 

      Withdrawal

    • B. 

      Logical thinking

    • C. 

      Repression

    • D. 

      Denial

  • 16. 
    An 16-year-old boy is admitted to the facility after acting out his aggressions inappropriately at school. Predisposing factors to the expression of aggression include:
    • A. 

      Violence on television.

    • B. 

      Passive parents.

    • C. 

      An internal locus of control.

    • D. 

      A single-parent family

  • 17. 
    A client is brought to the emergency department after being beaten by her husband, a prominent attorney. The nurse caring for this client understands that: 
    • A. 

      Open boundaries are common in violent families

    • B. 

      Violence usually results from a power struggle.

    • C. 

      Domestic violence and abuse span all socioeconomic classes.

    • D. 

      Violent behavior is a genetic trait passed from one generation to the next.

  • 18. 
    On discharge after treatment for alcoholism, a client plans to take disulfiram (Antabuse) as prescribed. When teaching the client about this drug, the nurse emphasizes the need to: 
    • A. 

      Avoid all products containing alcohol.

    • B. 

      Adhere to concomitant vitamin B therapy.

    • C. 

      Return for monthly blood drug level monitoring.

    • D. 

      Limit alcohol consumption to a moderate level.

  • 19. 
    During a private conversation, a client with borderline personality disorder asks the nurse to keep his secret and then displays multiple, self-inflicted, superficial lacerations on the forearms. What is the nurse's best response? 
    • A. 

      "That's it! You're on suicide precautions."

    • B. 

      "I'm going to tell your physician. Do you want to tell me why you did that?"

    • C. 

      "Tell me what type of instrument you used. I'm concerned about infection."

    • D. 

      "The team needs to know when something important occurs in treatment. I need to tell the others, but let's talk about it first."

  • 20. 
    The nurse is providing care for a client undergoing opiate withdrawal. Opiate withdrawal causes severe physical discomfort and can be life-threatening. To minimize these effects, opiate users are commonly detoxified with: 
    • A. 

      Barbiturates

    • B. 

      Amphetamines

    • C. 

      Methadone

    • D. 

      Benzodiazepines

  • 21. 
    The nurse is caring for a client who she believes has been abusing opiates. Assessment findings in a client abusing opiates such as morphine include:
    • A. 

      Dilated pupils and slurred speech.

    • B. 

      Rapid speech and agitation.

    • C. 

      Dilated pupils and agitation.

    • D. 

      Euphoria and constricted pupils.

  • 22. 
    Which of the following signs should the nurse expect in a client with known amphetamine overdose? 
    • A. 

      Hypotension

    • B. 

      Tachycardia

    • C. 

      Hot, dry skin

    • D. 

      Constricted pupils

  • 23. 
    A client is admitted to the psychiatric unit with a diagnosis of alcohol intoxication and suspected alcohol dependence. Other assessment findings include an enlarged liver, jaundice, lethargy, and rambling, incoherent speech. No other information about the client is available. After the nurse completes the initial assessment, what is the first priority? 
    • A. 

      Instituting seizure precautions, obtaining frequent vital signs, and recording fluid intake and output

    • B. 

      Checking the client's medical records for health history information

    • C. 

      Attempting to contact the client's family to obtain more information about the client

    • D. 

      Restricting fluids and leaving the client alone to "sleep off" the episode

  • 24. 
    Which nursing action is best when trying to diffuse a client's impending violent behavior? 
    • A. 

      Helping the client identify and express feelings of anxiety and anger

    • B. 

      Involving the client in a quiet activity to divert attention

    • C. 

      Leaving the client alone until the client can talk about feelings

    • D. 

      Placing the client in seclusion

  • 25. 
    The nurse is working with a client who abuses alcohol. Which of the following facts should the nurse communicate to the client?
    • A. 

      Abstinence is the basis for successful treatment.

    • B. 

      Attendance at Alcoholics Anonymous meetings every day will cure alcoholism.

    • C. 

      For treatment to be successful, family members must participate.

    • D. 

      An occasional social drink is acceptable behavior for the alcoholic

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