Mental Health

Front 1

The nurse is working with an adolescent client with social anxiety disorder who will be attending college in 6 months. The parent tells the nurse that this anticipated change is already causing increased anxiety for the client. Which action reported by the client does the nurse evaluate as indicating the greatest amount of progress? The client:

Back 1

arranges an overnight visit at a college with a current student

Front 2

A hospitalized client is dying and is very weak, tired and short of breath. The appropriate nursing care plan for this client and the client’s family will include:

Back 2

allowing family members to spend as much time as possible with the client

Front 3

The community health nurse notes several suspicious bruises and old burns on an infant. Which is the nurse’s priority action?

Back 3

call the child protection hotline and report possible abuse

Front 4

The nurse understands that the best explanation for involuntary admission for psychiatric treatment is that:

Back 4

the client exhibits behavior that is a threat to either the client or to society

Front 5

A client diagnosed with borderline personality disorder purposely cuts his arm with a piece of broken glass when his favorite nurse calls in sick. When the client’s favorite nurse returns to the unit, they meet to discuss the cutting incident. How can the nurse best prevent future incidents of self mutilating behavior in this client?

Back 5

emphasize that self destructive behavior is unacceptable and obtain a written contract from the client stating, “I will not harm myself.”

Front 6

The nurse is interviewing an elderly client who may have been abused by the neighbor who provides much of the client’s care. The nurse’s interview questions should:

Back 6

be nonthreatening and nonjudgemental

Front 7

The nurse realizes that a typical characteristic of clients with anorexia nervosa is they:

Back 7

exercise relentlessly

Front 8

In planning the initial care for a client with an acute schizophrenic illness, the nurse will appropriately emphasize:

Back 8

assign the same staff members of the nursing staff to work with the client each day.

Front 9

. A client is admitted to the psychiatric unit on a temporary detention order. The nurse observes that the client is staring out the 4th floor window and replying to voices that the nurse is unable to see. The initial therapeutic statement that the nurse makes to the client is:

Back 9

are you thinking about jumping out the window?

Front 10

The client is admitted to the hospital with injuries sustained in an automobile accident. The client, who has a history of previous arrests for driving under the influence (DUI) has an admission blood alcohol level of 0.25. When the nurse asks the client how much alcohol the client consumes daily, the nurse knows the most likely response by the client is:

Back 10

not much, I don’t even get drunk

Front 11

Which behavior would best indicate that the antisocial client is making the most progress in treatment?

Back 11

assisting a depressed roommate to fill out a menu

Front 12

The client tells the nurse that the television set in the room is really a two way radio. The client states that “voices are coming from the TV and everything we say in this room is being recorded.” The appropriate nursing response would be:

Back 12

That must be very frightening

Front 13

The nurse approaches the triage window to see a client who is well known to the emergency room staff as being a frequent visitor who demonstrates drug seeking behavior. When asked what the problem is, the client states, “I want to see the doctor. I am having chest pains.” What is the most appropriate action for the nurse to take?

Back 13

bring the client to a treatment room and obtain a STAT electrocardiogram

Front 14

Which treatment approach would be most therapeutic for a hospitalized client with antisocial behavior?

Back 14

participation in group therapy

Front 15

After one week in a behavior modification program, a bulimic client has gained three pounds. The nurse learns that the client still has the urge to vomit after eating. How can the nurse best deal with this behavior?

Back 15

establish a contract with the client to seek out a staff member if they feel the urge to vomit

Front 16

The nursing staff decides to develop a behavioral modification program to help a young anorexic client gain weight. Which intervention is contraindicated for this client?

Back 16

permitting the client to spend some quiet time alone after each meal

Front 17

A client with paranoid delusions believes the hospital food is being poisoned by the staff. The nurse knows the meal presentation that is the most effective method of encouraging nutritional intake is to serve:

Back 17

individual items that are pre-packaged and sealed

Front 18

The nurse enters an anorexic client’s room and finds the client doing vigorous push-ups on the floor. What is the most therapeutic nursing action?

Back 18

tell the client to stop doing the push-ups and suggest a less strenuous activity

Front 19

The nurse would question the order if the physician prescribed a benzodiazepine for the treatment of:

Back 19

chronic pain syndrome

Front 20

The nurse knows which medication may be safely prescribed for a client already taking lithium (Lithane)?

Back 20

Valproic Acid (Depakane)

Front 21

In caring for abused children, the nurse understands that sexual abuse of children is:

Back 21

often repeated from generation to generation

Front 22

A client is admitted through the emergency department with a diagnosis of depression. During the initial phase of the relationship with this client, the nurse would expect which reaction to interpersonal communication?

Back 22

silence

Front 23

Which will the nurse expect to be ordered to manage a client’s withdrawal from alcohol?

Back 23

Chlordiazepoxide (Librium)

Front 24

The nursing care plan for the antisocial client should stress:

Back 24

setting clear rules and expectations about the client’s behavior

Front 25

Thirty minutes after receiving diazepam (valium), an emergency room client reports feeling much calmer. “I can’t believe how scared I was when I came in. I will do anything to avoid having another panic attack.” The nurse realizes the most important action at this time is:

Back 25

make an appointment for outpatient psychotherapy

Front 26

A client was admitted recently with a diagnosis of schizophrenia, paranoid type. Since admission, the client has had several verbal outbursts of anger but has not been violent. A staff member tells the nurse the client is pacing up and down the hallway very rapidly and muttering in an angry manner. What would the nurse do first?

Back 26

observe the client’s behavior and approach the client in a nonthreatening manner

Front 27

A client has been admitted to the emergency department following a rape. The nurse will expect that the client may manifest post-traumatic stress disorder. The nurse is aware that this syndrome can be best described as:

Back 27

re-experiencing the fear and hopelessness of the original trauma

Front 28

The nurse has an order to administer donepezil (aricept) daily to a client with Alzheimer’s disease. The nurse knows that this drug should be administered:

Back 28

at bedtime

Front 29

The nurse is talking to a resident of a long term care facility who has returned from an overnight stay with his son and son’s wife. Which statement by the resident would warrant further investigation by the nurse for elder abuse?

Back 29

Those bruises aren’t anything. I got clumsy at my son’s house

Front 30

Initially the nurse would expect a client to react to a diagnosis of cancer with:

Back 30

denial

Front 31

The nurse would judge that a client might be developing Wernicke-Korsakoff syndrome when the client exhibits:

Back 31

short term memory loss and disorientation

Front 32

A priority nursing intervention for a client experiencing an acute manic episode?

Back 32

protect the client from impulsive behavior

Front 33

The nurse learns that a client with OCD brushes his/her tongue several times a day and has developed ulcerations on it. The priority nursing goal for this client at this time is. The client will:

Back 33

re-establish healthy tissue in the oral cavity

Front 34

A client who is taking chlorpromazine hydrochloride (Thorazine) is experiencing extrapyramidal side effects (EPS). The nurse understands that EPS is:

Back 34

involuntary muscle movements

Front 35

Family therapy is scheduled for an anorexic client and family. The parents ask how the family therapy will help the client’s eating problems. The best nursing response is that the focus of the therapy will primarily be:

Back 35

improving communication between the family members

Front 36

The nurse knows an appropriate short term goal for a client exhibiting manic behavior is for the client to:

Back 36

paint alone for 15 minutes

Front 37

A client is admitted with a history of extremely elevated, irritable mood for a week. On assessment the nurse notes grandiosity, insomnia, flight of ideas, and psychomotor agitation. The nurse sets as a priority short term goal: the client will demonstrate:

Back 37

adequate nutrition and rest

Front 38

In the early stages of Alzheimer’s disease, the nurse would anticipate that a client will retain the ability to:

Back 38

recall the events of the distant past

Front 39

What would the nurse most expect to observe in a client with impulsive behavior?

Back 39

low tolerance for frustration

Front 40

A client is being prepared to receive electroconvulsive therapy (ECT) when the nurse realizes the client has not signed an informed consent. What provides the rationale for the appropriate nursing action needed to address this issue?

Back 40

failure to obtain informed consent can result in a lawsuit

Front 41

The nurse knows the most common side effect of benzodiazepine antianxiety medications is:

Back 41

sedation

Front 42

An elderly client with Alzheimer’s disease has begun to strike out at staff members when they try to assist the client to bed at night. In addition, the staff members report that the client is awake and restless most of the night. After further assessment, the nurse decides to contact the physician for a medication order. The nurse anticipates that the physician will most likely order:

Back 42

haloperidol (haldol) at bedtime

Front 43

A client on the psychiatric unit is unresponsive or mumbles incoherently whenever the nurse asks the client questions. The nurse will best deal with the client’s communication problems by:

Back 43

continuing to speak with the client using short, clear statements or open ended questions

Front 44

A psychiatrist admits a client to an eating disorders program. The admitting nurse learns that the client has lost 25 pounds over the last month and now weighs 85 pounds. In assessing the client, the nurse knows that an early manifestation of anorexia nervosa is:

Back 44

amenorrhea

Front 45

A female client is seen in the emergency room with ecchymosis of the trunk, face and periorbital area. On direct questioning, the client admits to having been struck by her spouse. When offered information about shelters for battered women, the client declines stating, “I could never leave my husband because of my kids.” The nurse’s appropriate response is:

Back 45

I am very concerned about your safety

Front 46

The nurse in the oncology unit provides support to the parents of a child newly diagnosed with glioblastoma tumor of the brain. In planning care, the nurse understands the parents’ initial reaction to a potentially terminal illness in their child is:

Back 46

denial and disbelief

Front 47

A nurse working with a client with agoraphobia recognizes that the most effective technique for treatment of agoraphobia is:

Back 47

. gradual desensitization by controlled exposure to the situation the client fears

Front 48

the nurse is preparing a brochure on marijuana use for adolescent clients. The nurse includes several reasons meant to discourage adolescents from using marijuana. Which reason is least likely to make an impression on adolescents?

Back 48

your parents will not approve

Front 49

After 6 months on lithium (lithane), the physician determines that the client is no longer responding well. After discontinuing the lithium, the physician prescribes valproic acid (depakote), an anticonvulsant that is also effective in bipolar disorders. What special instructions should the nurse give the client about valproic acid?

Back 49

liver function and hematology levels must be monitored regularly

Front 50

A homeless client with a history of alcohol abuse comes to the drop in shelter where the nurse volunteers. The client arrives apparently intoxicated with the smell of alcohol on the breath and admits to have been drinking to the nurse. Once admitted for the night, the client begins to shout obscenities at the other clients and staff and becomes belligerent and threatening. The nurse advises the staff and other volunteers to:

Back 50

evict the client from the shelter until sober