Quiz 4: Nursing care Of The Client With Anxiety And Depression
This is a multiple choice, multiple response and True/False answer quiz. Avoid memorizing answers as questions on future exams will be worded differently.
- 1.A client who was recently paroled as a sex offender is in therapy for pedophilia. The client says, "I’ve served my sentence and I’m still in therapy, so why does this group have posters of me all over the neighborhood? It has my picture on it and tells all about me." Which of the following would be the therapeutic response by the nurse?
- A.
"Try to realize how fortunate you are that our society doesn't let the group escalate to more punitive measures after your crimes against children."
- B.
"Are you saying that you understand people are afraid for their children but that you feel you are being unfairly treated?"
- C.
"It's sad for you, but when children are hurt as you hurt them, people want you identified and isolated"
- D.
"You seem angry, but you must understand that your neighbors are frightened because of your serious crimes against children."
- 2.A nurse is having a conversation with a depressed client in an inpatient psychiatric unit. The client says to the nurse, “Things would be so much better for everyone if I just weren’t around.” Which response by the nurse would be appropriate at this time?
- A.
“Those feelings will go away once your medication really takes effect.”
- B.
“I know what you mean; everyone gets that way when they are depressed.”
- C.
“Have you talked to anyone specifically about what is bothering you?”
- D.
“You sound very unhappy. Are you thinking of harming yourself?”
- 3.A nurse is caring for an elderly client whose husband died approximately 6 weeks ago. The client says, "There’s no one left to care about me. Everyone that I have loved is now gone." The nurse would make which appropriate response?
- A.
“I don't believe that, and I really don’t think you do either.”
- B.
“I’m sure you have someone if you think hard enough.”
- C.
“It sounds as though you are feeling all alone right now.”
- D.
“That doesn’t sound like the real you talking!”
- 4.A client who attempted suicide by overdosing with a very large number of antidepressant pills has been admitted to the psychiatric unit. The nurse, being most concerned with the client’s safety, would take which immediate action?
- A.
Have the client put on a hospital gown and remove the client’s clothing from the room.
- B.
Request that a friend of the client remain with the client at all times.
- C.
Suggest placing the client in a seclusion room where all potentially dangerous articles are removed.
- D.
Stay with the client at all times.
- 5.A client has been brought to the emergency department after attempting to commit suicide by hanging. The nurse should take which nursing action first?
- A.
Examine the neck area and assess the airway
- B.
Encourage the client to talk about the experience
- C.
Administer an anxiolytic medication as prescribed at once.
- D.
Obtain a detailed history of events leading to the attempt
- 6.A nurse working in an urgent care center is interviewing a woman with vague somatic complaints. When the nurse is alone with the client, the client states that she was raped a few weeks ago but still feels “as if it just happened to me.” The nurse should make which therapeutic response to the client?
- A.
"It is very, very hard to get over these types of feelings after being raped."
- B.
"It’s hard, but try to keep a sense of perspective. After all, it’s been a while since the rape occurred.”
- C.
"What do you think you should do to reduce the likelihood that you will be raped again?"
- D.
"Tell me more about what happened, which causes you to feel like the rape just occurred."
- 7.An anxious client reports to the nurse that she feels weak and dizzy. The nurse should respond by:
- A.
Helping the client relax
- B.
Giving the client something to drink
- C.
Giving the client oxygen by nasal cannula
- D.
Taking the client's vital signs
- 8.A client is preoccupied with persistent intrusive thoughts and ideas and uses ritualistic behavior to decrease anxiety associated with the unwelcome thoughts. The most therapeutic treatment options for this client would include:
- A.
Identifying situations that precipitate compulsive behavior and encourage the client to verbalize his concerns and feelings.
- B.
Allow the client to perform the ritualistic behavior, but set limits on behaviors that might interfere with the client's physical well-being.
- C.
Recognize and reinforce positive, nonritualistic behaviors
- D.
Administer tranquilizers such as diazepam to sedate the client when the client's actions jeopardize the safety of others.
- 9.A 52-yr old male is brought by ambulance to the emergency department. His general appearance is unkempt and he smells of urine. He complains of inability to sleep, loss of appetite, and lack of energy. He also expresses a lack of confidence in the ability of the staff to help him with his problems and he refuses to answer questions, asking to be left alone so he can get some sleep. Which interpretation of the client's behavior is most likely?
- A.
He is unhappy about his family's request for emergency medical care. The nurse should tell the client his family only wants what's best for him.
- B.
He needs encouragement and the nurse should provide reassurance that the client has been brought to a very good health care facility and that the doctors will soon be able to make him feel better.
- C.
The client is depressed and at risk for suicide, the nurse should stay with him.
- D.
The client has the right to refuse medical treatment and the nurse should leave the room.
- 10.A nurse enters the room of a middle-aged executive who is on the telephone arguing with his business partner. He abruptly hangs up the phone and becomes angry with the nurse. This client is using which coping mechanism?
- A.
Diffusion
- B.
Displacement
- C.
Denial
- D.
Decompensation
- 11.A nurse is caring for a client with a diagnosis of depression. The nurse monitors for signs of constipation and urinary retention, knowing that these problems are likely caused by:
- A.
Poor dietary choices
- B.
Lack of exercise and poor diet
- C.
Inadequate dietary intake and dehydration
- D.
Psychomotor retardation and side effects of medication
- 12.A mother of a teenage daughter with an anxiety disorder is concerned about her daughter's progress on discharge. She states that her daughter "stashes food, eats all the wrong things that make her hyperactive," and "hangs out with the wrong crowd." In helping the mother prepare for her daughter's discharge, the nurse suggests that the mother:
- A.
Restrict the daughter's socializing time with her friends
- B.
Restrict the amount of chocolate and caffeine products in the home
- C.
Keep her daughter out of school until she can adjust to the school environment
- D.
Consider taking time from work to help her daughter readjust to being at home
- 13.A client is unwilling to go out of the house for fear of "doing something crazy in public." Because of this, the client remains homebound, except when accompanied outside by a trusted adult. The nurse determines that the client has:
- A.
Agoraphobia
- B.
Hematophobia
- C.
Claustrophobia
- D.
Hypochondriasis
- 14.A nurse collects data on a client with a diagnosis of bipolar affective disorder mania. The finding that requires the nurse's immediate intervention is:
- A.
The client's outlandish behavior and inappropriate dress
- B.
The client's grandiose delusions of being a royal descendent of King Arthur
- C.
The client's constant incessant talking that includes sexual innuendoes and teasing the staff
- D.
The client's nonstop activity and poor nutritional intake
- 15.A client in a manic state emerges from her room. She is topless and is making sexual remarks and gestures toward staff and peers. The appropriate nursing action is to:
- A.
Approach the client in the hallway and insist that she go into the room
- B.
Confront the client on the inappropriateness of her behavior and offer her a time out.
- C.
Quietly approach the client, escort her to her room and assist her in getting dressed
- D.
Ask the other clients to ignore her behavior: she will eventually return to her room.
- 16.A nurse reviews the activity schedule for the day and determines that the best activity that the manic client could participate in is:
- A.
A paint-by-number activity
- B.
A brown bag lunch and book review
- C.
Deep breathing and progressive relaxation exercises
- D.
Ping-pong
- 17.A woman comes into the emergency department in a severe state of anxiety following a car accident. The most important nursing intervention is to:
- A.
Put the client in a quiet room
- B.
Remain with the client
- C.
Teach the client deep breathing
- D.
Encourage the client to talk about her feelings and concerns.
- 18.Choose all nursing interventions for a hospitalized client with mania who is exhibiting manipulative behavior (Select all that apply)
- A.
Communicate expected behaviors to the client
- B.
Ensure that the client knows that he or she is not in charge of the nursing unit.
- C.
Assist the client in developing means of setting limits on personal behaviors.
- D.
Follow through about the consequences of behavior in a nonpunitive manner.
- E.
Be clear with the client about the consequences of exceeding limits set regarding behavior.
- 19.Nursing diagnoses for the client with bipolar disorder include all of the following, except:
- A.
Disturbed sleep pattern related to inability to sleep and sensitivity to environmental noise
- B.
Noncompliance with medication and treatment regimen related to health beliefs
- C.
Imbalanced nutrition: Less than body requirements related to constant activity and increased metabolic demand
- D.
Risk for Electrolyte Imbalance related to inadequate fluid intake and lithium therapy for bipolar disorder
- E.
Hopelessness related to feelings of loss of control and need for lifelong treatment with mood stabilizing medications
- F.
Anxiety related to inability to recall important information
- 20.The best way for a nurse to determine whether domestic violence abuse is occurring is:
- A.
Notice unusual behavior patterns, such as a father bringing children in for medical care without the mother being present.
- B.
Assess all members of the family unit, especially the children, for signs of physical injury.
- C.
The nurse should ask directly if abuse is occurring
- D.
The nurse should schedule a follow-up appointment to validate concerns
- 21.A nurse answering a hotline at a rape crisis center should instruct a victim to bathe and shower before going to the Emergency department of the local hospital.
- A.
True
- B.
False
- 22.If a client admits that domestic violence and abuse are occurring, the most beneficial nursing intervention would be to identify resources for shelter and safety of the victim.
- A.
True
- B.
False
- 23.A depressed client who is scheduled for a series of ECT treatments is most likely to experience headache and short-term memory loss in the immediate post-procedure period.
- A.
True
- B.
False
- 24.A client with a specific phobia like claustrophobia typically uses avoidance as a coping mechanism to deal with fear.
- A.
True
- B.
False
- 25.Frequent panic attacks should be treated as soon as possible to decrease likelihood that the client may fear venturing from home and become reclusive.
- A.
True
- B.
False
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