Nursing Practice V- care Of Clients With Physio And Psychosocial (Exam Mode)
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- 1.Mr. Marquez reports of losing his job, not being able to sleep at night, and feeling upset with his wife. Nurse John responds to the client, “You may want to talk about your employment situation in group today.” The Nurse is using which therapeutic technique?
- A.
Observations
- B.
Restating
- C.
Exploring
- D.
Focusing
- 2.Tony refuses his evening dose of Haloperidol (Haldol), then becomes extremely agitated in the dayroom while other clients are watching television. He begins cursing and throwing furniture. Nurse Oliver first action is to:
- A.
Check the client’s medical record for an order for an as-needed I.M. dose of medication for agitation.
- B.
Place the client in full leather restraints.
- C.
Call the attending physician and report the behavior.
- D.
Remove all other clients from the dayroom.
- 3.Tina who is manic, but not yet on medication, comes to the drug treatment center. The nurse would not let this client join the group session because:
- A.
The client is disruptive.
- B.
The client is harmful to self.
- C.
The client is harmful to others.
- D.
The client needs to be on medication first.
- 4.Dervid, an adolescent boy was admitted for substance abuse and hallucinations. The client’s mother asks Nurse Armando to talk with his husband when he arrives at the hospital. The mother says that she is afraid of what the father might say to the boy. The most appropriate nursing intervention would be to:
- A.
Inform the mother that she and the father can work through this problem themselves.
- B.
Refer the mother to the hospital social worker.
- C.
Agree to talk with the mother and the father together.
- D.
Suggest that the father and son work things out.
- 5.What is Nurse John likely to note in a male client being admitted for alcohol withdrawal?
- A.
Perceptual disorders.
- B.
Impending coma.
- C.
Recent alcohol intake.
- D.
Depression with mutism.
- 6.Aira has taken amitriptyline HCL (Elavil) for 3 days, but now complains that it “doesn’t help” and refuses to take it. What should the nurse say or do?
- A.
Withhold the drug.
- B.
Record the client’s response.
- C.
Encourage the client to tell the doctor.
- D.
Suggest that it takes awhile before seeing the results.
- 7.Dervid, an adolescent has a history of truancy from school, running away from home and “barrowing” other people’s things without their permission. The adolescent denies stealing, rationalizing instead that as long as no one was using the items, it was all right to borrow them. It is important for the nurse to understand the psychodynamically, this behavior may be largely attributed to a developmental defect related to the:
- A.
Id
- B.
Ego
- C.
Superego
- D.
Oedipal complex
- 8.In preparing a female client for electroconvulsive therapy (ECT), Nurse Michelle knows that succinylcoline (Anectine) will be administered for which therapeutic effect?
- A.
Short-acting anesthesia
- B.
Decreased oral and respiratory secretions.
- C.
Skeletal muscle paralysis.
- D.
Analgesia.
- 9.Nurse Gina is aware that the dietary implications for a client in manic phase of bipolar disorder is:
- A.
Serve the client a bowl of soup, buttered French bread, and apple slices.
- B.
Increase calories, decrease fat, and decrease protein.
- C.
Give the client pieces of cut-up steak, carrots, and an apple.
- D.
Increase calories, carbohydrates, and protein.
- 10.What parental behavior toward a child during an admission procedure should cause Nurse Ron to suspect child abuse?
- A.
Flat affect
- B.
Expressing guilt
- C.
Acting overly solicitous toward the child.
- D.
Ignoring the child.
- 11.Nurse Lynnette notices that a female client with obsessive-compulsive disorder washes her hands for long periods each day. How should the nurse respond to this compulsive behavior?
- A.
By designating times during which the client can focus on the behavior.
- B.
By urging the client to reduce the frequency of the behavior as rapidly as possible.
- C.
By calling attention to or attempting to prevent the behavior.
- D.
By discouraging the client from verbalizing anxieties.
- 12.After seeking help at an outpatient mental health clinic, Ruby who was raped while walking her dog is diagnosed with posttraumatic stress disorder (PTSD). Three months later, Ruby returns to the clinic, complaining of fear, loss of control, and helpless feelings. Which nursing intervention is most appropriate for Ruby?
- A.
Recommending a high-protein, low-fat diet.
- B.
Giving sleep medication, as prescribed, to restore a normal sleepwake cycle.
- C.
Allowing the client time to heal.
- D.
Exploring the meaning of the traumatic event with the client.
- 13.Meryl, age 19, is highly dependent on her parents and fears leaving home to go away to college. Shortly before the semester starts, she complains that her legs are paralyzed and is rushed to the emergency department. When physical examination rules out a physical cause for her paralysis, the physician admits her to the psychiatric unit where she is diagnosed with conversion disorder. Meryl asks the nurse, "Why has this happened to me?" What is the nurse's best response?
- A.
"You've developed this paralysis so you can stay with your parents. You must deal with this conflict if you want to walk again."
- B.
"It must be awful not to be able to move your legs. You may feel better if you realize the problem is psychological, not physical."
- C.
"Your problem is real but there is no physical basis for it. We'll work on what is going on in your life to find out why it's happened."
- D.
"It isn't uncommon for someone with your personality to develop a conversion disorder during times of stress."
- 14.Nurse Krina knows that the following drugs have been known to be effective in treating obsessive-compulsive disorder (OCD):
- A.
Benztropine (Cogentin) and diphenhydramine (Benadryl).
- B.
Chlordiazepoxide (Librium) and diazepam (Valium)
- C.
Fluvoxamine (Luvox) and clomipramine (Anafranil)
- D.
Divalproex (Depakote) and lithium (Lithobid)
- 15.Alfred was newly diagnosed with anxiety disorder. The physician prescribed buspirone (BuSpar). The nurse is aware that the teaching instructions for newly prescribed buspirone should include which of the following?
- A.
A warning about the drugs delayed therapeutic effect, which is from 14 to 30 days.
- B.
A warning about the incidence of neuroleptic malignant syndrome (NMS).
- C.
A reminder of the need to schedule blood work in 1 week to check blood levels of the drug.
- D.
A warning that immediate sedation can occur with a resultant drop in pulse.
- 16.Richard with agoraphobia has been symptom-free for 4 months. Classic signs and symptoms of phobias include:
- A.
Insomnia and an inability to concentrate.
- B.
Severe anxiety and fear.
- C.
Depression and weight loss.
- D.
Withdrawal and failure to distinguish reality from fantasy.
- 17.Which medications have been found to help reduce or eliminate panic attacks?
- A.
Antidepressants
- B.
Anticholinergics
- C.
Antipsychotics
- D.
Mood stabilizers
- 18.A client seeks care because she feels depressed and has gained weight. To treat her atypical depression, the physician prescribes tranylcypromine sulfate (Parnate), 10 mg by mouth twice per day. When this drug is used to treat atypical depression, what is its onset of action?
- A.
1 to 2 days
- B.
3 to 5 days
- C.
6 to 8 days
- D.
10 to 14 days
- 19.A 65 years old client is in the first stage of Alzheimer's disease. Nurse Patricia should plan to focus this client's care on:
- A.
Offering nourishing finger foods to help maintain the client's nutritional status.
- B.
Providing emotional support and individual counseling.
- C.
Monitoring the client to prevent minor illnesses from turning into major problems.
- D.
Suggesting new activities for the client and family to do together.
- 20.The nurse is assessing a client who has just been admitted to the emergency department. Which signs would suggest an overdose of an antianxiety agent?
- A.
Combativeness, sweating, and confusion
- B.
Agitation, hyperactivity, and grandiose ideation
- C.
Emotional lability, euphoria, and impaired memory
- D.
Suspiciousness, dilated pupils, and increased blood pressure
- 21.The nurse is caring for a client diagnosed with antisocial personality disorder. The client has a history of fighting, cruelty to animals, and stealing. Which of the following traits would the nurse be most likely to uncover during assessment?
- A.
History of gainful employment
- B.
Frequent expression of guilt regarding antisocial behavior
- C.
Demonstrated ability to maintain close, stable relationships
- D.
A low tolerance for frustration
- 22.Nurse Amy is providing care for a male 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
- 23.Nurse Cristina is caring for a client who experiences false sensory perceptions with no basis in reality. These perceptions are known as:
- A.
Delusions
- B.
Hallucinations
- C.
Loose associations
- D.
Neologisms
- 24.Nurse Marco is developing a plan of care for a client with anorexia nervosa. Which action should the nurse include in the plan?
- A.
Restricts visits with the family and friends until the client begins to eat.
- B.
Provide privacy during meals.
- C.
Set up a strict eating plan for the client.
- D.
Encourage the client to exercise, which will reduce her anxiety.
- 25.Tim is admitted with a diagnosis of delusions of grandeur. The nurse is aware that this diagnosis reflects a belief that one is:
- A.
Highly important or famous.
- B.
Being persecuted
- C.
Connected to events unrelated to oneself
- D.
Responsible for the evil in the world.
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