Take The Psychiatric Nursing NCLEX Practice Paper Quiz!

1. The characteristic manifestation that will differentiate bulimia nervosa from anorexia nervosa is that bulimic individual

Have episodic binge eating and purging

Have repeated attempts to stabilize their weight

Have peculiar food handling patterns

Have threatened self-esteem

Bulimia is characterized by binge eating which is characterized by taking in a large amount of food over a short period of time.Options B and C are characteristics of a client with anorexia nervosa.Option D: Low esteem is noted in both eating disorders

Explanation

Bulimia is characterized by binge eating which is characterized by taking in a large amount of food over a short period of time.Options B and C are characteristics of a client with anorexia nervosa.Option D: Low esteem is noted in both eating disorders

2. The primary nursing intervention in working with a client with moderate stage dementia is ensuring that the client:

Receives adequate nutrition and hydration

Will reminisce to decrease isolation

Remains in a safe and secure environment

Independently performs self-care

Safety is a priority consideration as the client’s cognitive ability deteriorates.Option A is appropriate interventions because the client’s cognitive impairment can affect the client’s ability to attend to his nutritional needs. but it is not the priority.Option B: Patient is allowed to reminisce but it is not the priority.Option D: The client in the moderate stage of Alzheimer’s disease will have difficulty in performing activities independently

Explanation

Safety is a priority consideration as the client’s cognitive ability deteriorates.Option A is appropriate interventions because the client’s cognitive impairment can affect the client’s ability to attend to his nutritional needs. but it is not the priority.Option B: Patient is allowed to reminisce but it is not the priority.Option D: The client in the moderate stage of Alzheimer’s disease will have difficulty in performing activities independently

3. What is the best intervention to teach the client when she feels the need to starve?

Allow her to starve to relieve her anxiety

Do a short term exercise until the urge passes

Approach the nurse and talk out her feelings

Call her mother on the phone and tell her how she feels

The client with anorexia nervosa uses starvation as a way of managing anxiety. Talking out feelings with the nurse is an adaptive coping.Option A: Starvation should not be encouraged. Physical safety is a priority. Without adequate nutrition. a life threatening situation exists.Option B: The client with anorexia nervosa is preoccupied with losing weight due to disturbed body image. Limits should be set on attempts to lose more weight.Option D: The client may have a domineering mother which causes the client to feel ambivalent. The client will not discuss her feelings with her mother.

Explanation

The client with anorexia nervosa uses starvation as a way of managing anxiety. Talking out feelings with the nurse is an adaptive coping.Option A: Starvation should not be encouraged. Physical safety is a priority. Without adequate nutrition. a life threatening situation exists.Option B: The client with anorexia nervosa is preoccupied with losing weight due to disturbed body image. Limits should be set on attempts to lose more weight.Option D: The client may have a domineering mother which causes the client to feel ambivalent. The client will not discuss her feelings with her mother.

4. The client with anorexia nervosa is improving if:

She eats meals in the dining room.

Weight gain

She attends ward activities.

She has a more realistic self-concept.

Weight gain is the best indication of the client’s improvement. The goal is for the client to gain 1-2 pounds per week.Option A: The client may purge after eating.Option C: Attending an activity does not indicate improvement in the nutritional state.Option D: Body image is a factor in anorexia nervosa. but it is not an indicator of improvement.

Explanation

Weight gain is the best indication of the client’s improvement. The goal is for the client to gain 1-2 pounds per week.Option A: The client may purge after eating.Option C: Attending an activity does not indicate improvement in the nutritional state.Option D: Body image is a factor in anorexia nervosa. but it is not an indicator of improvement.

5. She tearfully tells the nurse "I can't take it when she accuses me of stealing her things." Which response by the nurse will be most therapeutic?

”Don’t take it personally. Your mother does not mean it.”

“Have you tried discussing this with your mother?”

“This must be difficult for you and your mother.”

“Next time ask your mother where her things were last seen.”

This reflecting the feeling of the daughter that shows empathy.Options A and D. Giving advice does not encourage verbalization.Option B: This response does not encourage verbalization of feelings.

Explanation

This reflecting the feeling of the daughter that shows empathy.Options A and D. Giving advice does not encourage verbalization.Option B: This response does not encourage verbalization of feelings.

6. Situation: An old woman was brought for evaluation due to the hospital for evaluation due to increasing forgetfulness and limitations in daily function. The daughter revealed that the client used her toothbrush to comb her hair. She is manifesting:

Apraxia

Aphasia

Agnosia

Amnesia

This is the inability to recognize objects.Option A: Apraxia is the inability to execute motor activities despite intact comprehension.Option B: Aphasia is the loss of ability to use or understand words.Option D: Amnesia is loss of memory.

Explanation

This is the inability to recognize objects.Option A: Apraxia is the inability to execute motor activities despite intact comprehension.Option B: Aphasia is the loss of ability to use or understand words.Option D: Amnesia is loss of memory.

7. Situation: A 17-year-old gymnast is admitted to the hospital due to weight loss and dehydration secondary to starvation. Which of the following nursing diagnoses will be given priority for the client?

Altered self-image

Fluid volume deficit

Altered nutrition less than body requirements

Altered family process

Fluid volume deficit is the priority over altered nutrition since the situation indicates that the client is dehydrated.Options A and D are psychosocial needs of a client with anorexia nervosa but they are not the priority.

Explanation

Fluid volume deficit is the priority over altered nutrition since the situation indicates that the client is dehydrated.Options A and D are psychosocial needs of a client with anorexia nervosa but they are not the priority.

8. Dementia. unlike delirium. is characterized by:

Slurred speech

Insidious onset

Clouding of consciousness

Sensory perceptual change

Dementia has a gradual onset and progressive deterioration. It causes pronounced memory and cognitive disturbances.Options A. C. and D are all characteristics of delirium.

Explanation

Dementia has a gradual onset and progressive deterioration. It causes pronounced memory and cognitive disturbances.Options A. C. and D are all characteristics of delirium.

9. She says to the nurse who offers her breakfast. "Oh no. I will wait for my husband. We will eat together" The therapeutic response by the nurse is:

“Your husband is dead. Let me serve you your breakfast.”

“I’ve told you several times that he is dead. It’s time to eat.”

“You’re going to have to wait a long time.”

“What made you say that your husband is alive?

The client should be reoriented to reality and be focused on the here and now.Option B: This is not a helpful approach because of the short term memory of the client.Option C: This indicates a pompous response.Option D: The cognitive limitation of the client makes the client incapable of giving an explanation.

Explanation

The client should be reoriented to reality and be focused on the here and now.Option B: This is not a helpful approach because of the short term memory of the client.Option C: This indicates a pompous response.Option D: The cognitive limitation of the client makes the client incapable of giving an explanation.

10. A nursing diagnosis for bulimia nervosa is powerlessness related to feeling not in control of eating habits. The goal for this problem is:

Patient will learn problem-solving skills

Patient will have decreased symptoms of anxiety.

Patient will perform self-care activities daily.

Patient will verbalize how to set limits on others.

If the client learns problem-solving skills she will gain a sense of control over her life.Option B: Anxiety is caused by powerlessness.Option C: Performing self-care activities will not decrease one’s powerlessness.Option D: Setting limits to control imposed by others is a necessary skill but problem-solving skill is the priority.

Explanation

If the client learns problem-solving skills she will gain a sense of control over her life.Option B: Anxiety is caused by powerlessness.Option C: Performing self-care activities will not decrease one’s powerlessness.Option D: Setting limits to control imposed by others is a necessary skill but problem-solving skill is the priority.