Psychiatric Nursing Practice Test 3 (Practice Mode)- Rnpedia

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Psychiatric Nursing Quizzes & Trivia

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Questions and Answers
  • 1. 

    Francis who is addicted to cocaine withdraws from the drug. Nurse Ron should expect to observe:

    • A.

      Hyperactivity

    • B.

      Depression

    • C.

      Suspicion

    • D.

      Delirium

    Correct Answer
    B. Depression
    Explanation
    There is no set of symptoms associated with cocaine withdrawal, only the depression that follows the high caused by the drug.

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  • 2. 

    Nurse John is aware that a serious effect of inhaling cocaine is?

    • A.

      Deterioration of nasal septum

    • B.

      Acute fluid and electrolyte imbalances

    • C.

      Extra pyramidal tract symptoms

    • D.

      Esophageal varices

    Correct Answer
    A. Deterioration of nasal septum
    Explanation
    Cocaine is a chemical that when inhaled, causes destruction of the mucous membranes of the nose.

    Rate this question:

  • 3. 

    A tentative diagnosis of opiate addiction, Nurse Candy should assess a recently hospitalized client for signs of opiate withdrawal. These signs would include:

    • A.

      Rhinorrhea, convulsions, subnormal temperature

    • B.

      Nausea, dilated pupils, constipation

    • C.

      Lacrimation, vomiting, drowsiness

    • D.

      Muscle aches, papillary constriction, yawning

    Correct Answer
    D. Muscle aches, papillary constriction, yawning
    Explanation
    These adaptations are associated with opiate withdrawal which occurs after cessation or reduction of prolonged moderate or heavy use of opiates.

    Rate this question:

  • 4. 

    A 48 year old male client is brought to the psychiatric emergency room after attempting to jump off a bridge. The client’s wife states that he lost his job several months ago and has been unable to find another job. The primary nursing intervention at this time would be to assess for:

    • A.

      A past history of depression

    • B.

      Current plans to commit suicide

    • C.

      The presence of marital difficulties

    • D.

      Feelings of excessive failure

    Correct Answer
    B. Current plans to commit suicide
    Explanation
    Whether there is a suicide plan is a criterion when assessing the client’s determination to make another attempt.

    Rate this question:

  • 5. 

    Before helping a male client who has been sexually assaulted, nurse Maureen should recognize that the rapist is motivated by feelings of:

    • A.

      Hostility

    • B.

      Inadequacy

    • C.

      Incompetence

    • D.

      Passion

    Correct Answer
    A. Hostility
    Explanation
    Rapists are believed to harbor and act out hostile feelings toward all women through the act of rape.

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  • 6. 

    When working with children who have been sexually abused by a family member it is important for the nurse to understand that these victims usually are overwhelmed with feelings of:

    • A.

      Humiliation

    • B.

      Confusion

    • C.

      Self blame

    • D.

      Hatred

    Correct Answer
    C. Self blame
    Explanation
    hese children often have nonsexual needs met by individual and are powerless to refuse.Ambivalence results in self-blame and also guilt.

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  • 7. 

    Joy who has just experienced her second spontaneous abortion expresses anger towards her physician, the hospital and the “rotten nursing care”. When assessing the situation, the nurse recognizes that the client may be using the coping mechanism of:

    • A.

      Projection

    • B.

      Displacement

    • C.

      Denial

    • D.

      Reaction formation

    Correct Answer
    B. Displacement
    Explanation
    The client’s anger over the abortion is shifted to the staff and the hospital because she is unable to deal with the abortion at this time.

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  • 8. 

    The most critical factor for nurse Linda to determine during crisis intervention would be the client’s:

    • A.

      Available situational supports

    • B.

      Willingness to restructure the personality

    • C.

      Developmental theory

    • D.

      Underlying unconscious conflict

    Correct Answer
    A. Available situational supports
    Explanation
    Personal internal strength and supportive individuals are critical factors that can be employed to assist the individual to cope with a crisis.

    Rate this question:

  • 9. 

     Nurse Trish suggests a crisis intervention group to a client experiencing a developmental crisis.These groups are successful because the:

    • A.

      Crisis intervention worker is a psychologist and understands behavior patterns

    • B.

      Crisis group supplies a workable solution to the client’s problem

    • C.

      Client is encouraged to talk about personal problems

    • D.

      Client is assisted to investigate alternative approaches to solving the identified problem

    Correct Answer
    D. Client is assisted to investigate alternative approaches to solving the identified problem
    Explanation
    Crisis intervention group helps client reestablish psychologic equilibrium by assisting them to explore new alternatives for coping. It considers realistic
    situations using rational and flexible problem solving methods.

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  • 10. 

    Nurse Ronald could evaluate that the staff’s approach to setting limits for a demanding, angry client was effective if the client:

    • A.

      Apologizes for disrupting the unit’s routine when something is needed

    • B.

      Understands the reason why frequent calls to the staff were made

    • C.

      Discuss concerns regarding the emotional condition that required hospitalizations

    • D.

      No longer calls the nursing staff for assistance

    Correct Answer
    C. Discuss concerns regarding the emotional condition that required hospitalizations
    Explanation
    This would document that the client feels comfortable enough to discuss the problems that have motivated the behavior.

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  • 11. 

    Nurse John is aware that the therapy that has the highest success rate for people with phobias would be:

    • A.

      Psychotherapy aimed at rearranging maladaptive thought process

    • B.

      Psychoanalytical exploration of repressed conflicts of an earlier development phase

    • C.

      Systematic desensitization using relaxation technique

    • D.

      Insight therapy to determine the origin of the anxiety and fear

    Correct Answer
    C. Systematic desensitization using relaxation technique
    Explanation
    The most successful therapy for people with phobias involves behavior modification techniques using desensitization.

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  • 12. 

    When nurse Hazel considers a client’s placement on the continuum of anxiety, a key in determining the degree of anxiety being experienced is the client’s:

    • A.

      Perceptual field

    • B.

      Delusional system

    • C.

      Memory state

    • D.

      Creativity level

    Correct Answer
    A. Perceptual field
    Explanation
    Perceptual field is a key indicator of anxiety level because the perceptual fields narrow as anxiety increases.

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  • 13. 

    In the diagnosis of a possible pervasive developmental autistic disorder. The nurse would find it most unusual for a 3 year old child to demonstrate:

    • A.

      An interest in music

    • B.

      An attachment to odd objects

    • C.

      Ritualistic behavior

    • D.

      Responsiveness to the parents

    Correct Answer
    D. Responsiveness to the parents
    Explanation
    One of the symptoms of autistic child displays a lack of responsiveness to others. There is little or no extension to the external environment.

    Rate this question:

  • 14. 

    Malou with schizophrenia tells Nurse Melinda, “My intestines are rotted from worms chewing on them.” This statement indicates a:

    • A.

      Jealous delusion

    • B.

      Somatic delusion

    • C.

      Delusion of grandeur

    • D.

      Delusion of persecution

    Correct Answer
    B. Somatic delusion
    Explanation
    Somatic delusions focus on bodily functions or systems and commonly include delusion about foul odor emissions, insect manifestations, internal
    parasites and misshapen parts.

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  • 15. 

    Andy is admitted to the psychiatric unit with a diagnosis of borderline personality disorder. Nurse Hilary should expects the assessment to reveal:

    • A.

      Coldness, detachment and lack of tender feelings

    • B.

      Somatic symptoms

    • C.

      Inability to function as responsible parent

    • D.

      Unpredictable behavior and intense interpersonal relationships

    Correct Answer
    D. Unpredictable behavior and intense interpersonal relationships
    Explanation
    A client with borderline personality displays a pervasive pattern of unpredictable behavior, mood and self image. Interpersonal relationships may be
    intense and unstable and behavior may be inappropriate and impulsive.

    Rate this question:

  • 16. 

     PROPRANOLOL (Inderal) is used in the mental health setting to manage which of the following conditions?

    • A.

      Antipsychotic – induced akathisia and anxiety

    • B.

      Obsessive – compulsive disorder (OCD) to reduce ritualistic behavior

    • C.

      Delusions for clients suffering from schizophrenia

    • D.

      The manic phase of bipolar illness as a mood stabilizer

    Correct Answer
    A. Antipsychotic – induced akathisia and anxiety
    Explanation
    Propranolol is a potent beta adrenergic blocker and producing a sedating effect, therefore it is used to treat antipsychotic induced akathisia and anxiety.

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  • 17. 

    Which medication can control the extra pyramidal effects associated with antipsychotic agents?

    • A.

      Clorazepate (Tranxene)

    • B.

      Amantadine (Symmetrel)

    • C.

      Doxepin (Sinequan)

    • D.

      Perphenazine (Trilafon)

    Correct Answer
    B. Amantadine (Symmetrel)
    Explanation
    Amantadine is an anticholinergic drug used to relive drug-induced extra pyramidal adverse effects such as muscle weakness, involuntary muscle
    movements, pseudoparkinsonism and tar dive dyskinesia.

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  • 18. 

     Which of the following statements should be included when teaching clients about monoamine oxidase inhibitor (MAOI) antidepressants?

    • A.

      Don’t take aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs)

    • B.

      Have blood levels screened weekly for leucopenia

    • C.

      Avoid strenuous activity because of the cardiac effects of the drug

    • D.

      Don’t take prescribed or over the counter medications without consulting the physician

    Correct Answer
    D. Don’t take prescribed or over the counter medications without consulting the physician
    Explanation
    MAOI antidepressants when combined with a number of drugs can cause life-threatening hypertensive crisis. It’s imperative that a client checks with his physician and pharmacist before taking any other medications.

    Rate this question:

  • 19. 

    Kris periodically has acute panic attacks. These attacks are unpredictable and have no apparent association with a specific object or situation. During an acute panic attack, Kris may experience:

    • A.

      Heightened concentration

    • B.

      Decreased perceptual field

    • C.

      Decreased cardiac rate

    • D.

      Decreased respiratory rate

    Correct Answer
    B. Decreased perceptual field
    Explanation
    Panic is the most severe level of anxiety. During panic attack, the client experiences a decrease in the perceptual field, becoming more focused on self,
    less aware of surroundings and unable to process information from the environment. The decreased perceptual field contributes to impaired attention
    andinability to concentrate.

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  • 20. 

    Initial interventions for Marco with acute anxiety include all except which of the following?

    • A.

      Touching the client in an attempt to comfort him

    • B.

      Approaching the client in calm, confident manner

    • C.

      Encouraging the client to verbalize feelings and concerns

    • D.

      Providing the client with a safe, quiet and private place

    Correct Answer
    A. Touching the client in an attempt to comfort him
    Explanation
    The emergency nurse must establish rapport and trust with the anxious client before using therapeutic touch. Touching an anxious client may actually
    increase anxiety.

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  • 21. 

    Nurse Jessie is assessing a client suffering from stress and anxiety. A common physiological response to stress and anxiety is:

    • A.

      Uticaria

    • B.

      Vertigo

    • C.

      Sedation

    • D.

      Diarrhea

    Correct Answer
    D. Diarrhea
    Explanation
    Diarrhea is a common physiological response to stress and anxiety.

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  • 22. 

     When performing a physicalexamination on a female anxious client, nurse Nelli would expect to find which of the following effects produced by the parasympathetic system?

    • A.

      Muscle tension

    • B.

      Hyperactive bowel sounds

    • C.

      Decreased urine output

    • D.

      Constipation

    Correct Answer
    B. Hyperactive bowel sounds
    Explanation
    The parasympathetic nervous system would produce incomplete G.I. motility resulting in hyperactive bowel sounds, possibly leading to diarrhea.

    Rate this question:

  • 23. 

    Which of the following drugs have been known to be effective in treating obsessive-compulsive disorder (OCD)?

    • A.

      Divalproex (depakote) and Lithium (lithobid)

    • B.

      Chlordiazepoxide (Librium) and diazepam (valium)

    • C.

      Fluvoxamine (Luvox) and clomipramine (anafranil)

    • D.

      Benztropine (Cogentin) and diphenhydramine (benadryl)

    Correct Answer
    C. Fluvoxamine (Luvox) and clomipramine (anafranil)
    Explanation
    The antidepressants fluvoxamine and clomipramine have been effective in the treatment of OCD.

    Rate this question:

  • 24. 

    Tony with agoraphobia has been symptom-free for 4 months. Classicsigns and symptoms of phobia include:

    • A.

      Severe anxiety and fear

    • B.

      Withdrawal and failure to distinguish reality from fantasy

    • C.

      Depression and weight loss

    • D.

      Insomnia and inability to concentrate

    Correct Answer
    A. Severe anxiety and fear
    Explanation
    Phobias cause severe anxiety (such as panic attack) that is out of proportion to the threat of the feared object or situation. Physical signs and
    symptoms of phobias include profuse sweating, poor motor control, tachycardia and elevated B.P.

    Rate this question:

  • 25. 

     Which nursing action is most appropriate when trying to diffuse a client’s impending violent behavior?

    • A.

      Place the client in seclusion

    • B.

      Leaving the client alone until he can talk about his feelings

    • C.

      Involving the client in a quiet activity to divert attention

    • D.

      Helping the client identify and express feelings of anxiety and anger

    Correct Answer
    D. Helping the client identify and express feelings of anxiety and anger
    Explanation
    In many instances, the nurse can diffuse impending violence by helping the client identify and express feelings of anger and anxiety. Such statement as
    “What happened to get you this angry?” may help the client verbalizes feelings rather than act on them.

    Rate this question:

  • 26. 

     Rosana is in the second stage of Alzheimer’s disease who appears to be in pain. Which question by Nurse Jenny would best elicit information about the pain?

    • A.

      “Where is your pain located?”

    • B.

      “Do you hurt? (pause) “Do you hurt?”

    • C.

      “Can you describe your pain?”

    • D.

      “Where do you hurt?”

    Correct Answer
    B. “Do you hurt? (pause) “Do you hurt?”
    Explanation
    When speaking to a client with Alzheimer’s disease, the nurse should use close-ended questions.Those that the client can answer with “yes” or “no”
    whenever possible and avoid questions that require the client to make choices. Repeating the question aids comprehension.

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  • 27. 

    Nursing preparation for a client undergoing electroconvulsive therapy (ECT) resemble those used for:

    • A.

      General anesthesia

    • B.

      Cardiac stress testing

    • C.

      Neurologic examination

    • D.

      Physical therapy

    Correct Answer
    A. General anesthesia
    Explanation
    The nurse should prepare a client for ECT in a manner similar to that for general anesthesia.

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  • 28. 

    Jose who is receiving monoamine oxidase inhibitor antidepressant should avoid tyramine, a compound found in which of the following foods?

    • A.

      Figs and cream cheese

    • B.

      Fruits and yellow vegetables

    • C.

      Aged cheese and Chianti wine

    • D.

      Green leafy vegetables

    Correct Answer
    C. Aged cheese and Chianti wine
    Explanation
    Aged cheese and Chianti wine contain high concentrations of tyramine.

    Rate this question:

  • 29. 

    Erlinda, age 85, with major depression undergoes a sixth electroconvulsive therapy (ECT) treatment. When assessing the client immediately after ECT, the nurse expects to find:

    • A.

      Permanent short-term memory loss and hypertension

    • B.

      Permanent long-term memory loss and hypomania

    • C.

      Transitory short-term memory loss and permanent long-term memory loss

    • D.

      Transitory short and long term memory loss and confusion

    Correct Answer
    D. Transitory short and long term memory loss and confusion
    Explanation
    ECT commonly causes transitory short and long term memory loss and confusion, especially in geriatric clients. It rarely results in permanent short and
    long term memory loss.

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  • 30. 

    Barbara with bipolar disorder is being treated with lithium for the first time. Nurse Clint should observe the client for which common adverse effect of lithium?

    • A.

      Polyuria

    • B.

      Seizures

    • C.

      Constipation

    • D.

      Sexual dysfunction

    Correct Answer
    A. Polyuria
    Explanation
    Polyuria commonly occurs early in the treatment with lithium and could result in fluid volume deficit.

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  • 31. 

     Nurse Fred is assessing a client who has just been admitted to the ER department.Which signs would suggest an overdose of an antianxiety agent?

    • A.

      Suspiciousness, dilated pupils and incomplete BP

    • B.

      Agitation, hyperactivity and grandiose ideation

    • C.

      Combativeness, sweating and confusion

    • D.

      Emotional lability, euphoria and impaired memory

    Correct Answer
    D. Emotional lability, euphoria and impaired memory
    Explanation
    Signs of anxiety agent overdose include emotional lability, euphoria and impaired memory.

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  • 32. 

    Discharge instructions for a male client receiving tricyclic antidepressants include which of the following information?

    • A.

      Restrict fluids and sodium intake

    • B.

      Don’t consume alcohol

    • C.

      Discontinue if dry mouth and blurred vision occur

    • D.

      Restrict fluid and sodium intake

    Correct Answer
    B. Don’t consume alcohol
    Explanation
    Drinking alcohol can potentiate the sedating action of tricyclic antidepressants. Dry mouth and blurred vision are normal adverse effects of
    tricyclic antidepressants.

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  • 33. 

    Important teaching for women in their childbearing years who are receiving antipsychotic medications includes which of the following?

    • A.

      Increased incidence of dysmenorrhea while taking the drug

    • B.

      Occurrence of incomplete libido due to medication adverse effects

    • C.

      Continuing previous use of contraception during periods of amenorrhea

    • D.

      Instruction that amenorrhea is irreversible

    Correct Answer
    C. Continuing previous use of contraception during periods of amenorrhea
    Explanation
    Women may experience amenorrhea, which is reversible, while taking antipsychotics. Amenorrhea doesn’t indicate cessation of ovulation thus, the client
    can still be pregnant.

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  • 34. 

    A client refuses to remain on psychotropic medications after discharge from an inpatient psychiatric unit. Which information should the community health nurse assess first during the initial follow-up with this client?

    • A.

      Income level and living arrangements

    • B.

      Involvement of family and support systems

    • C.

      Reason for inpatient admission

    • D.

      Reason for refusal to take medications

    Correct Answer
    D. Reason for refusal to take medications
    Explanation
    The first are for assessment would be the client’s reason for refusing medication. The client may not understand the purpose for the medication, may be experiencing distressing side effects, or may be concerned about the cost of medicine. In any case, the nurse cannot provide appropriate intervention before assessing the client’s problem with the medication. The patient’s income level, living arrangements, and involvement of family and support systems are relevant issues following determination of the client’s reason for refusing medication. The nurse providing follow-up care would have access to the client’s medical record and should already know the reason for inpatient admission.

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  • 35. 

    The nurse understands that the therapeutic effects of typical antipsychotic medications are associated with which neurotransmitter change?

    • A.

      Decreased dopamine level

    • B.

      Increased acetylcholine level

    • C.

      Stabilization of serotonin

    • D.

      Stimulation of GABA

    Correct Answer
    A. Decreased dopamine level
    Explanation
    Excess dopamine is thought to be the chemical cause for psychotic thinking. The typical antipsychotics act to block dopamine receptors and therefore
    decrease the amount of neurotransmitter at the synapses. The typical antipsychotics do not increase acetylcholine, stabilize serotonin, stimulate GABA.

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  • 36. 

    Which of the following best explains why tricyclic antidepressants are used with caution in elderly patients?

    • A.

      Central Nervous System effects

    • B.

      Cardiovascular system effects

    • C.

      Gastrointestinal system effects

    • D.

      Serotonin syndrome effects

    Correct Answer
    B. Cardiovascular system effects
    Explanation
    The TCAs affect norepinephrine as well as other neurotransmitters, and thus have significant cardiovascular side effects. Therefore, they are used with
    caution in elderly clients who may have increased risk factors for cardiac problems because of their age and other medical conditions. The remaining side effects would apply to any client taking a TCA and are not particular to an elderly person.

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  • 37. 

    A client with depressive symptoms is given prescribed medications and talks with his therapist about his belief that he is worthless and unable to cope with life. Psychiatric care in this treatment plan is based on which framework?

    • A.

      Behavioral framework

    • B.

      Cognitive framework

    • C.

      Interpersonal framework

    • D.

      Psychodynamic framework

    Correct Answer
    B. Cognitive framework
    Explanation
    Cognitive thinking therapy focuses on the client’s misperceptions about self, others and the world that impact functioning and contribute to symptoms.
    Using medications to alter neurotransmitter activity is a psychobiologic approachto treatment. The other answer choices are frameworks for care, but hey are not applicable to this situation.

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  • 38. 

    A nurse who explains that a client’s psychotic behavior is unconsciously motivated understands that the client’s disordered behavior arises from which of the following?

    • A.

      Abnormal thinking

    • B.

      Altered neurotransmitters

    • C.

      Internal needs

    • D.

      Response to stimuli

    Correct Answer
    C. Internal needs
    Explanation
    The concept that behavior is motivated and has meaning comes from the psychodynamic framework. According to this perspective, behavior arises from internal wishes or needs. Much of what motivates behavior comes from the unconscious. The remaining responses do not address the internal forces thought to motivate behavior.

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  • 39. 

    A client with depression has been hospitalized for treatment after taking a leave of absence from work. The client’s employer expects the client to return to work following inpatient treatment. The client tells the nurse, “I’m no good. I’m a failure”. According to cognitive theory, these statements reflect:

    • A.

      Learned behavior

    • B.

      Punitive superego and decreased self-esteem

    • C.

      Faulty thought processes that govern behavior

    • D.

      Evidence of difficult relationships in the work environment

    Correct Answer
    C. Faulty thought processes that govern behavior
    Explanation
    The client is demonstrating faulty thought processes that are negative and that govern his behavior in his work situation – issues that are typically
    examined using a cognitive theory approach. Issues involving learned behavior are best explored through behavior theory, not cognitive theory. Issues involving ego development are the focus of psychoanalytic theory. Option 4 is incorrect because there is no evidence in this situation that the client has conflictual relationships in the work environment.

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  • 40. 

    The nurse describes a client as anxious. Which of the following statement about anxiety is true?

    • A.

      Anxiety is usually pathological

    • B.

      Anxiety is directly observable

    • C.

      Anxiety is usually harmful

    • D.

      Anxiety is a response to a threat

    Correct Answer
    D. Anxiety is a response to a threat
    Explanation
    Anxiety is a response to a threat arising from internal or external stimuli.

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  • 41. 

    A client with a phobic disorder is treated by systematic desensitization. The nurse understands that this approach will do which of the following?

    • A.

      Help the client execute actions that are feared

    • B.

      Help the client develop insight into irrational fears

    • C.

      Help the client substitutes one fear for another

    • D.

      Help the client decrease anxiety

    Correct Answer
    A. Help the client execute actions that are feared
    Explanation
    Systematic desensitization is a behavioral therapy technique that helps clients with irrational fears and avoidance behavior to face the thing they fear,
    without experiencing anxiety. There is no attempt to promote insight with this procedure, and the client will not be taught to substitute one fear for another.
    Although the client’s anxiety may decrease with successful confrontation of irrational fears, the purpose of the procedure is specifically related to performing
    activities that typically are avoided as part of the phobic response.

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  • 42. 

    Which client outcome would best indicate successful treatment for a client with an antisocial personality disorder?

    • A.

      The client exhibits charming behavior when around authority figures

    • B.

      The client has decreased episodes of impulsive behaviors

    • C.

      The client makes statements of self-satisfaction

    • D.

      The client’s statements indicate no remorse for behaviors

    Correct Answer
    B. The client has decreased episodes of impulsive behaviors
    Explanation
    A client with antisocial personality disorder typically has frequent episodes of acting impulsively with poor ability to delay self-gratification. Therefore,
    decreased frequency of impulsive behaviors would be evidence of improvement. Charming behavior when around authority figures and statements indicating no
    remorse are examples of symptoms typical of someone with this disorder and would not indicate successful treatment. Self-satisfaction would be viewed as a
    positive change if the client expresses low self-esteem; however this is not a characteristic of a client with antisocial personality disorder.

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  • 43. 

    The nurse is caring for a client with an autoimmune disorder at a medical clinic, where alternative medicine is used as an adjunct to traditional therapies. Which information should the nurse teach the client to help foster a sense of control over his symptoms?

    • A.

      Pathophysiology of disease process

    • B.

      Principles of good nutrition

    • C.

      Side effects of medications

    • D.

      Stress management techniques

    Correct Answer
    D. Stress management techniques
    Explanation
    In autoimmune disorders, stress and the response to stress can exacerbate symptoms. Stress management techniques can help the client reduce
    the psychological response to stress, which in turn will help reduce the physiologic stress response. This will afford the client an increased sense of control over his symptoms. The nurse can address the remaining answer choices in her teaching about the client’s disease and treatment; however, knowledge alone will not help the client to manage his stress effectively enough to control symptoms.

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  • 44. 

    Which of the following is the most distinguishing feature of a client with an antisocial personality disorder?

    • A.

      Attention to detail and order

    • B.

      Bizarre mannerisms and thoughts

    • C.

      Submissive and dependent behavior

    • D.

      Disregard for social and legal norms

    Correct Answer
    D. Disregard for social and legal norms
    Explanation
    Disregard for established rules of society is the most common characteristic of a client with antisocial personality disorder. Attention to detail and
    order is characteristic of someone with obsessive compulsive disorder. Bizarre mannerisms and thoughts are characteristics of a client with schizoid or
    schizotypal disorder. Submissive and dependent behaviors are characteristic of someone with a dependent personality.

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  • 45. 

    Which nursing diagnosis is most appropriate for a client with anorexia nervosa who expresses feelings of guilt about not meeting family expectations?

    • A.

      Anxiety

    • B.

      Disturbed body image

    • C.

      Defensive coping

    • D.

      Powerlessness

    Correct Answer
    D. Powerlessness
    Explanation
    The client with anorexia typically feels powerless, with a sense of having little control over any aspect of life besides eating behavior. Often, parental
    expectations and standards are quite high and lead to the clients’ sense of guilt over not measuring up.

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  • 46. 

    A nurse is evaluating therapy with the family of a client with anorexia nervosa. Which of the following would indicate that the therapy was successful?

    • A.

      The parents reinforced increased decision making by the client

    • B.

      The parents clearly verbalize their expectations for the client

    • C.

      The client verbalizes that family meals are now enjoyable

    • D.

      The client tells her parents about feelings of low-self esteem

    Correct Answer
    A. The parents reinforced increased decision making by the client
    Explanation
    One of the core issues concerning the family of a client with anorexia is control. The family’s acceptance of the client’s ability to make independent
    decisions is key to successful family intervention. Although the remaining options may occur during the process of therapy, they would not necessarily indicate a successful outcome; the central family issues of dependence and independence are not addresses on these responses.

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  • 47. 

    A client with dysthymic disorder reports to a nurse that his life is hopeless and will never improve in the future. How can the nurse best respond using a cognitive approach?

    • A.

      Agree with the client’s painful feelings

    • B.

      Challenge the accuracy of the client’s belief

    • C.

      Deny that the situation is hopeless

    • D.

      Present a cheerful attitude

    Correct Answer
    B. Challenge the accuracy of the client’s belief
    Explanation
    Use of cognitive techniques allows the nurse to help the client recognize that this negative beliefs may be distortions and that, by changing his thinking, he can adopt more positive beliefs that are realistic and hopeful. Agreeing with the client’s feelings and presenting a cheerful attitude are not consistent with a cognitive approach and would not be helpful in this situation. Denying the client’s feelings is belittling and may convey that the nurse does not understand the depth of the client’s distress.

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  • 48. 

     A client with major depression has not verbalized problem areas to staff or peers since admission to a psychiatric unit. Which activity should the nurse recommend to help this client express himself?

    • A.

      Art therapy in a small group

    • B.

      Basketball game with peers on the unit

    • C.

      Reading a self-help book on depression

    • D.

      Watching movie with the peer group

    Correct Answer
    A. Art therapy in a small group
    Explanation
    Art therapy provides a nonthreatening vehicle for the expression of feelings, and use of a small group will help the client become comfortable with
    peers in a group setting. Basketball is a competitive game that requires energy; the client with major depression is not likely to participate in this activity.
    Recommending that the client read a self-help book may increase, not decrease his isolation. Watching movie with a peer group does not guarantee that
    interaction will occur; therefore, the client may remain isolated.

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  • 49. 

    The home health psychiatric nurse visits a client with chronic schizophrenia who was recently discharged after a prolong stay in a state hospital. The client lives in a boarding home, reports no family involvement, and has little social interaction. The nurse plan to refer the client to a day treatment program in order to help him with:

    • A.

      Managing his hallucinations

    • B.

      Medication teaching

    • C.

      Social skills training

    • D.

      Vocational training

    Correct Answer
    C. Social skills training
    Explanation
    Day treatment programs provide clients with chronic, persistent mental illness training in social skills, such as meeting and greeting people, asking
    questions or directions, placing an order in a restaurant, taking turns in a group setting activity. Although management of hallucinations and medication teaching may also be part of the program offered in a day treatment, the nurse is referring the client in this situation because of his need for socialization skills. Vocational training generally takes place in a rehabilitation facility; the client described in this situation would not be a candidate for this service.

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  • 50. 

    Which activity would be most appropriate for a severely withdrawn client?

    • A.

      Art activity with a staff member

    • B.

      Board game with a small group of clients

    • C.

      Team sport in the gym

    • D.

      Watching TV in the dayroom

    Correct Answer
    A. Art activity with a staff member
    Explanation
    The best approach with a withdrawn client is to initiate brief, nondemanding activities on a one-to-one basis. This approach gives the nurse an opportunity to establish a trusting relationship with the client. A board game with a group clients or playing a team sport in the gym may overwhelm a severely withdrawn client. Watching TV is a solitary activity that will reinforce the client’s withdrawal from others.

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  • Current Version
  • Mar 20, 2023
    Quiz Edited by
    ProProfs Editorial Team
  • May 21, 2012
    Quiz Created by
    RNpedia.com
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