Behavioral Health Nursing Exam Questions
Course Introduction
Behavioral Health Nursing explores the role of nurses in caring for individuals with mental health disorders and behavioral challenges in various clinical settings. The course covers foundational concepts in psychiatric nursing, assessment and diagnosis of mental health conditions, therapeutic communication, crisis intervention, and the promotion of mental wellness. Students learn evidence-based interventions, legal and ethical considerations, and the importance of interdisciplinary collaboration in supporting patients and their families. Emphasis is placed on the development of empathy, cultural competence, and self-awareness to effectively manage complex behaviors and provide holistic patient-centered care.
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Psychiatric Mental Health Nursing Concepts of Care in Evidence Based Practice 7th Edition by Mary
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857 Verified Questions
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Chapter 1: The Concept of Stress Adaptation
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Sample Questions
Q1) When an individual's stress response is sustained over a long period of time, which physiological effect of the endocrine system should a nurse anticipate?
A)Decreased resistance to disease
B)Increased libido
C)Decreased blood pressure
D)Increased inflammatory response
Answer: A
Q2) A nurse is working with a client who has recently been under a great deal of stress. Which nursing recommendations would be most helpful when assisting the client in coping with stress? (Select all that apply.)
A)"Enjoy a pet."
B)"Spend time with a loved one."
C)"Listen to music."
D)"Focus on the stressors."
E)"Journal your feelings."
Answer: A, B, C, E
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3
Chapter 2: Mental Healthmental Illness: Historical and Theoretical Concepts
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Q1) A nurse should recognize that the diagnostic and statistical manual of mental disorders (DSM-IV-TR) is based on which model of health-care delivery?
A)The holistic nursing model
B)The eclectic model
C)Freud's psychoanalytic model
D)The medical model
Answer: D
Q2) Which should the nurse recognize as an example of the defense mechanism of repression?
A)A student aware of the need to study for tomorrow's test goes to a movie instead.
B)A woman whose son was killed in Iraq does not believe the military report.
C)A man who is unhappily married goes to school to become a marriage counselor.
D)A woman was raped when she was 12 and no longer remembers the incident.
Answer: D
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4
Chapter 3: Theoretical Models of Personality Development
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Q1) A 29-year-old client living with parents has few interpersonal relationships. The client states, "I have trouble trusting people." Based on Erikson's developmental theory, which should the nurse recognize as a true statement about this client?
A)The client has not progressed beyond the trust versus mistrust developmental stage.
B)Developmental deficits in earlier life stages have impaired the client's adult functioning.
C)The client cannot move to the next developmental stage until mastering all earlier stages.
D)The client's developmental problems began in the intimacy versus isolation stage.
Answer: B
Q2) Which statement describes achievement of Erikson's generativity versus stagnation developmental stage?
A)"I've been a girl scout leader for troop 259 for 7 years."
B)"I feel great that I could pay for my bike with my paper route money."
C)"My parents are so pleased that John and I are going to be married."
D)"I've had a very full life.I'm not afraid to leave this world."
Answer: A
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Page 5
Chapter 4: Concepts of Psychobiology
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Q1) Which of the following symptoms should a nurse expect to assess in a client experiencing elevated levels of thyroid hormone? (Select all that apply.)
A)Emotional lability
B)Depression
C)Insomnia
D)Restlessness
E)Apathy
Q2) A client's wife of 34 years dies unexpectedly. The client cries often and becomes socially isolated. The client's therapist encourages open discussion of feelings, proper nutrition, and exercise. What is the best rationale for the therapist's advice?
A)The therapist is using an interpersonal approach.
B)The client has an alteration in neurotransmitters.
C)It is routine practice to remind clients about nutrition, exercise, and rest.
D)The client is susceptible to illness due to effects of stress on the immune system.
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Chapter 5: Ethical and Legal Issues in Psychiatricmental
Health Nursing
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Q1) Which is an accurate description of a common law?
A)A common law would be invoked to deal with a nurse who, without justification, threatens a client with restraints.
B)A common law would be invoked to deal with a nurse who touches a client without the client's consent.
C)A common law would be invoked to deal with a hospital employee who steals drugs, hospital equipment, or both.
D)A common law would be invoked to deal with a nurse's refusal to provide care for a specific client.
Q2) Which situation exemplifies both assault and battery?
A)The nurse becomes angry, calls the client offensive names, and withholds treatment.
B)The nurse threatens to "tie down" the client and then does so against the client's wishes.
C)The nurse hides the client's clothes and medicates the client to prevent elopement.
D)The nurse restrains the client without just cause and communicates this to family.
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Chapter 6: Cultural and Spiritual Concepts Relevant to Psychiatricmental Health Nursing
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Q1) When working with clients of a particular culture, which action should a nurse avoid?
A)Maintaining eye contact based on cultural norms
B)Assuming that all individuals who share a culture or ethnic group are similar
C)Supporting the client in participating in cultural and spiritual rituals
D)Using an interpreter to clarify communication
Q2) An African American youth, growing up in an impoverished neighborhood, seeks affiliation with a black gang. Soon he is engaging in theft and assault. What cultural consideration should a nurse identify as playing a role in this youth's choices?
A)Most African American homes are headed by strong, dominant father figures.
B)Most African Americans choose to remain within their own social organization.
C)Most African Americans are uncomfortable expressing emotions and need group affiliations.
D)Most African Americans have limited religious beliefs which contribute to criminal activity.
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Chapter 7: Relationship Development
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Q1) A hungry, homeless client, diagnosed with schizophrenia, refuses to participate in an admission interview. A nurse streamlines the assessment, verbally assures safety, and provides a warm meal. What is the nurse promoting by these actions?
A)Sympathy
B)Trust
C)Veracity
D)Manipulation
Q2) Which is the best nursing action when a client demonstrates transference toward a nurse?
A)Promoting safety and immediately terminating the relationship with the client
B)Encouraging the client to ignore these thoughts and feelings
C)Immediately reassigning the client to another staff member
D)Helping the client to clarify the meaning of the current nurse-client relationship
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Chapter 8: Therapeutic Communication
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Q1) Which therapeutic communication technique is being used in this nurse-client interaction? Client: "When I am anxious, the only thing that calms me down is alcohol."
Nurse: "Other than drinking, what alternatives have you explored to decrease anxiety?"
A)Reflecting
B)Making observations
C)Formulating a plan of action
D)Giving recognition
Q2) A nurse is assessing a client diagnosed with schizophrenia for the presence of hallucinations. Which therapeutic communication technique used by the nurse is an example of making observations?
A)"You appear to be talking to someone I do not see."
B)"Please describe what you are seeing."
C)"Why do you continually look in the corner of this room?"
D)"If you hum a tune, the voices may not be so distracting."
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Chapter 9: The Nursing Process in Psychiatricmental Health
Nursing
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Q1) A nurse on an inpatient psychiatric unit implements care by scheduling client activities, interacting with clients, and maintaining a safe therapeutic environment. These actions reflect which role of the nurse?
A)Health teacher
B)Case manager
C)Milieu manager
D)Psychotherapist
Q2) Which data gathering technique is employed during the assessment phase of the nursing process?
A)Asking the client to rate mood after administering an antidepressant
B)Asking the client to verbalize understanding of previously explained unit rules
C)Asking the client to describe any thoughts of self-harm
D)Asking the client if the group on assertiveness skills was helpful
Q3) How should a nurse prioritize nursing diagnoses?
A)By the established goal of care
B)By the life-threatening potential
C)By the physician's priority of care
D)By the client's preference
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Chapter 10: Therapeutic Groups
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Q1) When planning group therapy, a nurse should identify which configuration as most optimal for a therapeutic group?
A)Open-ended membership; circle of chairs; group size of 5 to 10 members
B)Open-ended membership; chairs around a table; group size of 10 to 15 members
C)Closed membership; circle of chairs; group size of 5 to 10 members
D)Closed membership; chairs around a table; group size of 10 to 15 members
Q2) An experienced psychiatric registered nurse has taken a new position leading groups in a day treatment program. Without further education, which group is this nurse most qualified to lead?
A)A psychodrama group
B)A psychotherapy group
C)A parenting group
D)A family therapy group
Q3) During a therapeutic group, a client talks about personal accomplishments in an effort to gain attention. Which group role, assumed by this client, should the nurse identify?
A)The task role of gatekeeper
B)The individual role of recognition seeker
C)The maintenance role of dominator
D)The task role of elaborator
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Chapter 11: Intervention With Families
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Q1) In defiance of parental wishes, a Japanese teenager succumbs to peer pressure and gets a tattoo. According to Bowen's family systems theory, how should the community health nurse interpret the teenager's action?
A)The teenager is attempting to differentiate self.
B)The teenager is triangulating self.
C)The teenager is cutting self off emotionally.
D)The teenager is exhibiting antisocial traits.
Q2) A client is angry because her husband has forgotten their anniversary. The following week, the client is still unwilling to discuss this with her husband because she is afraid she will lose control. How should the nurse interpret this client's means of coping with anger?
A)Coping by attacking
B)Coping by surrendering
C)Coping by avoiding
D)Coping by belittling
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Chapter 12: Milieu Therapy - the Therapeutic Community
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Q1) To promote self-reliance, how should a psychiatric nurse best conduct medication administration?
A)Encourage clients to request their medications at the appropriate times.
B)Refuse to administer medications unless clients request them at the appropriate times.
C)Allow the clients to determine appropriate medication times.
D)Take medications to the clients' bedside at the appropriate times.
Q2) How does a democratic form of self-government in the milieu contribute to client therapy?
A)By setting punishments for clients who violate the community rules
B)By dealing with inappropriate behaviors as they occur
C)By setting community expectations wherein all clients are treated on an equal basis
D)By interacting with professional staff members to learn about therapeutic interventions
Q3) In the role of milieu manager, which activity should the nurse prioritize?
A)Setting the schedule for the daily unit activities
B)Evaluating clients for medication effectiveness
C)Conducting therapeutic group sessions
D)Searching newly admitted clients for hazardous objects
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Page 14
Chapter 13: Crisis Intervention
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Sample Questions
Q1) A client comes to a psychiatric clinic experiencing sudden extreme fatigue and decreased sleep and appetite. The client works 12 hours a day and rates anxiety as 8/10 on a numeric scale. What correctly written long-term outcome is realistic in addressing this client's crisis?
A)The client will change his or her type A personality traits to more adaptive ones by week 1.
B)The client will list five positive self-attributes.
C)The client will examine how childhood events led to an overachieving orientation. D)The client will return to previous adaptive levels of functioning by week 6.
Q2) A wife brings her husband to an emergency department after an attempt to hang himself. He is a full-time student and works 8 hours at night to support his family. He states, "I can't function any longer under all this stress." Which type of crisis is the client experiencing?
A)Maturational/developmental crisis
B)Psychiatric emergency crisis
C)Anticipated life transition crisis
D)Traumatic stress crisis
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Page 15
Chapter 14: Relaxation Therapy
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Q1) Which response is known to be a physiological manifestation of relaxation?
A)Increased levels of norepinephrine
B)Pupil dilation
C)Reduced metabolic rate
D)Increased levels of blood sugar
Q2) A nurse is teaching a client deep breathing exercises. The client asks, "Why do I need to make that funny shape with my lips when I breathe out?" What is the most appropriate nursing reply?
A)"You can actually exhale anyway you like; the lip shape is not important."
B)"Pursed lip breathing helps you control the exhalation and helps to keep your airways open."
C)"Don't worry about the lip shape; concentrate instead on the pace of your breathing."
D)"The shape of the lip decreases the cough and choking reflex."
Q3) Which should a nurse recognize as the reason that physical exercise is an effective relaxation technique?
A)Physical exercise stresses and strengthens the cardiovascular system.
B)Physical exercise decreases the metabolic rate.
C)Physical exercise decreases levels of norepinephrine in the brain.
D)Physical exercise provides a natural outlet for releasing muscle tension.
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Page 16
Chapter 15: Assertiveness Training
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Sample Questions
Q1) What type of intervention would be most beneficial for clients diagnosed with cluster C personality disorders?
A)Training that includes the control of emotional tone of the voice
B)Training that includes incremental exposure to feared objects
C)Training that includes appropriate limit setting
D)Training that includes appropriate coping strategies
Q2) A nurse has identified the following nursing diagnosis: "ineffective communication
R/T lack of assertiveness skills AEB inability to state needs." Which statement encourages the client to acknowledge the priority of this problem?
A)"Are you having thoughts of harming yourself or others?"
B)"With whom are you least assertive?"
C)"On a scale of 1 to 10, rank the importance of being assertive."
D)"When are you available to attend the assertiveness training class?"
Q3) A nurse should assign which nursing diagnosis to a client needing assistance with assertiveness?
A)Disturbed personal identity
B)Disturbed thought processes
C)Defensive coping
D)Impaired verbal communication
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Page 17
Chapter 16: Promoting Self Esteem
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Q1) A client shows a nurse a piece of artwork that took 3 days to create. How will this achievement improve the client's self-esteem?
A)By providing a framework for assertive behavior
B)By providing an expression of feelings and a sense of competence and pride
C)By providing a positive perception of body image
D)By providing appropriate boundaries for relationship establishment
Q2) A 40-year-old client lives with her parents. She has a high school diploma and works at a low-paying job. Her parents give her a weekly allowance to supplement her income. How should the nurse classify their client-parent boundaries?
A)As loose
B)As rigid
C)As flexible
D)As enmeshed
Q3) Which is an appropriate initial nursing intervention for a client with chronic low self-esteem?
A)Assessing the content of negative self-talk
B)Administering anxiolytic medications
C)Using reassurance and physical touch
D)Using distraction techniques
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Page 18
Chapter 17: Angeraggression Management
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Q1) A client diagnosed with psychotic disorder NOS is pacing the milieu and occasionally punches the wall. Which should be the initial nursing action?
A)Assertively instruct the client to stop punching the wall.
B)Encourage the client to write down feelings in a journal.
C)With the help of staff, initiate seclusion protocol.
D)Ensure adequate physical space between the nurse and the client.
Q2) At 3 a.m., when less restrictive methods fail, a physician orders restraints for an angry, aggressive client. To meet Joint Commission standards, at what time and by whom should a nurse expect an in-person client evaluation?
A)At 8 a.m., by a licensed independent practitioner or a clinical nurse specialist
B)At 4 a.m., by a physician or a licensed independent practitioner (LIP)
C)At 3:30 a.m.by a physician or the client's case manager
D)At 6 a.m.by the psychiatrist or a clinical nurse specialist
Q3) How often should a nurse plan to observe a client who is in restraints?
A)At least every 5 minutes
B)Continually for the first hour
C)At least every 15 minutes
D)Every 2 hours
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Chapter 18: Intervention With a Suicidal Client
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Q1) A nursing student is developing a study guide related to historical facts about suicide. Which of the following facts should the student include? (Select all that apply.)
A)In the Middle Ages, suicide was viewed as a selfish and criminal act.
B)During the Roman Empire, suicide was treated by incineration of the body.
C)Suicide was an offense in ancient Greece, and a common site burial was denied.
D)During the Renaissance, suicide was discussed and viewed more philosophically.
E)Old Norse traditionally set a person who committed suicide adrift in the North Sea.
Q2) Which statement indicates that the nurse is acting as an advocate for a client who has recently made a suicide attempt?
A)"I must observe you continually for 1 hour in order to keep you safe."
B)"Let's confer with the treatment team about the triggers to your attempt that we discussed."
C)"You must have been very upset to do what you did today."
D)"Are you currently thinking about harming yourself?"
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Chapter 19: Behavior Therapy
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Q1) Parents of a 3-year-old have noticed an improvement in behavior because of using a "time out" behavioral approach. What aspect of "time out" therapy may be responsible for this child's improved behavior?
A)"Negative reinforcement discourages maladaptive behavior."
B)"Positive reinforcement is removed."
C)"Covert sensitization is being applied.
D)"Reciprocal inhibition is eliminated."
Q2) A client reports, "My friend panicked at the site of spiders. Her therapist used gradual exposure to spiders that initially made her increasingly more anxious." Which technique was the friend's therapist most likely using?
A)Extinction
B)Covert sensitization
C)Systematic desensitization
D)Reciprocal inhibition
Q3) Which assumption is most reflective of a behavioral theory model?
A)Mental illness is characterized by structural and biochemical alterations.
B)Thought processes influence behaviors.
C)All personality development has a social context.
D)There is a basic relationship between stimulus and response.
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Page 21
Chapter 20: Cognitive Therapy
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Q1) A welder has been selected as employee of the year. The welder wants to ask for a promotion but is hampered by poor self-esteem. The employee health nurse provides assistance. Which technique should the nurse use to help the employee request the promotion?
A)Socratic questioning
B)Activity scheduling
C)Distraction
D)Cognitive rehearsal
Q2) A client recovering from alcohol toxicity is using minimization. Which statement reflects this cognitive distortion?
A)"I can't give up alcohol right now because I just gave up smoking."
B)"I just read that red wine has health benefits."
C)"I may have a minor problem, but I can handle it."
D)"I don't drink as much as my wife and nobody thinks she has a problem."
Q3) Which client statement would exemplify the cognitive changes that you would expect to see in mild anxiety?
A)"Right now I feel as sharp as a tack."
B)"I'm having a tough time focusing."
C)"Sometimes I feel like I'm having an out-of-body experience."
D)"All I seem to focus on is my anger."
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Chapter 21: Electroconvolusive Therapy
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Q1) A nursing instructor is teaching about the medications given prior to and during electroconvulsive therapy (ECT) treatments. Which student statement indicates that learning has occurred?
A)"Atropine (Atro-Pen) is administered to paralyze skeletal muscles during ECT."
B)"Succinylcholine chloride (Anectine) decreases secretions to prevent aspiration."
C)"Thiopental sodium (Pentothal) is a short-acting anesthesia to render the client unconscious."
D)"Glycopyrrolate (Robinul) is given to prevent severe muscle contractions during seizure."
Q2) Immediately after an initial electroconvulsive therapy (ECT) treatment a client states, "I'm not hungry and just want to stay in bed and sleep." Based on this information, which is the most appropriate nursing intervention?
A)Allow the client to remain in bed.
B)Encourage the client to join the milieu to promote socialization.
C)Obtain a physician's order for parenteral nutrition.
D)Involve the client in physical activities to stimulate circulation.
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Chapter 22: Complementary Therapies
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Q1) Herbs and plants can be useful in treating a variety of conditions. Which herbal treatment should a nurse determine as appropriate for a client experiencing frequent migraine headaches?
A)Saint John's wort combined with an antidepressant
B)Ginger root combined with a beta-blocker
C)Feverfew, used according to directions
D)Kava-kava added to a regular diet
Q2) A client reports taking St. John's wort for depression. The client states, "I'm taking the recommended dose, but it seems like if two capsules are good, four would be better!" Which is an appropriate nursing reply?
A)"Herbal medicines are more likely to cause adverse reactions than prescription medications."
B)"Increasing the amount of herbal preparations can lead to overdose and toxicity."
C)"The FDA does not regulate herbal remedies, therefore ingredients are often unknown."
D)"Certain companies are better than others.Always buy a reputable brand."
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Chapter 23: Disorders Usually First Diagnosed in Infancy,
Childhood, or Adolescence
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Q1) A nursing instructor is teaching about pharmacological treatments for attention deficit-hyperactivity disorder (ADHD). Which information about atomoxetine (Strattera) should be included in the lesson plan?
A)Strattera, unlike methylphenidate (Ritalin), is a central nervous system depressant.
B)When taking Strattera, a client should eliminate all red food coloring from the diet.
C)Strattera will be a life-long intervention for clients diagnosed with this disorder.
D)Strattera, unlike methylphenidate (Ritalin), is a selective norepinephrine reuptake inhibitor.
Q2) A preschool child diagnosed with autistic disorder has been engaging in constant head-banging behavior. Which nursing intervention is appropriate?
A)Place client in restraints until the aggression subsides.
B)Sedate the client with neuroleptic medications.
C)Hold client's head steady and apply a helmet.
D)Distract the client with a variety of games and puzzles.
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25
Chapter 24: Delirium, Dementia, and Amnestic Disorders
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Q1) A client diagnosed with dementia is exhibiting behavioral problems on a daily basis. At change of shift, the client's behavior escalates from pacing to screaming and flailing. Initially, which action should a nurse implement in this situation?
A)Consult the psychologist regarding behavior-modification techniques.
B)Medicate the client with prn antianxiety medications.
C)Assess environmental triggers and potential unmet needs.
D)Anticipate the behavior and restrain when pacing begins.
Q2) A client is diagnosed with late-stage Alzheimer's dementia. To address the client's symptoms, which nursing intervention should take priority?
A)Improve cognitive status by encouraging involvement in social activities.
B)Decrease social isolation by providing group therapies.
C)Promote dignity by providing comfort, safety, and self-care measures.
D)Facilitate communication by providing assistive devices.
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Chapter 25: Substance-Related Disorders
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Q1) A client has a history of daily bourbon drinking for the past 6 months. He is brought to an emergency department by family who report that his last drink was 1 hour ago. It is now 12 midnight. When should a nurse expect this client to exhibit withdrawal symptoms?
A)Between 3 a.m.and 11 a.m.
B)Shortly after a 24-hour period
C)At the beginning of the third day
D)Withdrawal is individualized and cannot be predicted.
Q2) A client diagnosed with alcohol abuse joins a community 12-step program and states, "My life is unmanageable." How should the nurse interpret this client's statement?
A)The client is using minimization as an ego defense.
B)The client is ready to sign an Alcoholics Anonymous contract for sobriety.
C)The client has accomplished the first of 12 steps advocated by Alcoholics Anonymous.
D)The client has met the requirements to be designated as an Alcoholics Anonymous sponsor.
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Chapter 26: Schizophrenia and Other Psychotic Disorders
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Q1) A client has been recently admitted to an inpatient psychiatric unit. Which intervention should the nurse plan to use to reduce the client's focus on delusional thinking?
A)Present evidence that supports the reality of the situation
B)Focus on feelings suggested by the delusion
C)Address the delusion with logical explanations
D)Explore reasons why the client has the delusion
Q2) A client diagnosed with schizophrenia is slow to respond and appears to be listening to unseen others. Which medication should a nurse expect a physician to order to address this type of symptom?
A)Haloperidol (Haldol) to address the negative symptom
B)Clonazepam (Klonopin) to address the positive symptom
C)Risperidone (Risperdal) to address the positive symptom
D)Clozapine (Clozaril) to address the negative symptom
Q3) Which statement should indicate to a nurse that an individual is experiencing a delusion?
A)"There's an alien growing in my liver."
B)"I see my dead husband everywhere I go."
C)"The IRS may audit my taxes."
D)"I'm not going to eat my food.It smells like brimstone."
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Chapter 27: Mood Diorders: Depression
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Q1) A client diagnosed with seasonal affective disorder (SAD) states, "I've been feeling 'down' for 3 months. Will I ever feel like myself again?" Which reply by the nurse will best assess this client's symptoms.
A)"Have you been diagnosed with any physical disorder within the last 3 months?"
B)"Have you experienced any traumatic events that triggered this mood change?"
C)"People who have seasonal mood changes often feel better when spring comes."
D)"Help me understand what you mean when you say, 'feeling down'?"
Q2) What is the rationale for a nurse to perform a full physical health assessment on a client admitted with a diagnosis of major depressive disorder?
A)The attention during the assessment is beneficial in decreasing social isolation.
B)Depression can generate somatic symptoms that can mask actual physical disorders.
C)Physical health complications are likely to arise from antidepressant therapy.
D)Depressed clients avoid addressing physical health and ignore medical problems.
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Chapter 28: Mood Disorders: Bipolar Disorder
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Sample Questions
Q1) A client has been taking lithium for several years with good symptom control. The client presents in the emergency department with blurred vision, tinnitus, and severe diarrhea. The nurse should correlate these symptoms with which lithium level?
A)1.3 mEq/L
B)1.7 mEq/L
C)2.3 mEq/L
D)3.7 mEq/L
Q2) Which of the following explanations should a nurse include when teaching parents why is it difficult to diagnose a child or adolescent exhibiting symptoms of bipolar disorder? (Select all that apply.)
A)Bipolar symptoms are similar to attention deficit-hyperactivity disorder symptoms.
B)Children are naturally active, energetic, and spontaneous.
C)Neurotransmitter levels vary considerably in accordance with age.
D)The diagnosis of bipolar disorder cannot be assigned prior to the age of 18.
E)Genetic predisposition is not a reliable diagnostic determinant.
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Chapter 29: Anxiety Disorders
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Sample Questions
Q1) A client diagnosed with panic disorder states, "When an attack happens, I feel like I am going to die." Which is the most appropriate nursing reply?
A)"I know it's frightening, but try to remind yourself that this will only last a short time."
B)"Death from a panic attack happens so infrequently that there is no need to worry."
C)"Most people who experience panic attacks have feelings of impending doom."
D)"Tell me why you think you are going to die every time you have a panic attack."
Q2) A client diagnosed with generalized anxiety states, "I know the best thing for me to do now is to just forget my worries." How should the nurse evaluate this statement?
A)The client is developing insight.
B)The client's coping skills are improving.
C)The client has a distorted perception of problem resolution.
D)The client is meeting outcomes and moving toward discharge.
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Chapter 30: Somatoform and Disassociative Disorders
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Q1) A client is exhibiting symptoms of generalized amnesia. Which of the following questions should the nurse ask to confirm this diagnosis? (Select all that apply.)
A)"Have you taken any new medications recently?"
B)"Have you recently traveled away from home?"
C)"Have you recently experienced any traumatic event?"
D)"Have you ever felt detached from your environment?"
E)"Have you had any history of memory problems?"
Q2) An inpatient client is newly diagnosed with dissociative identity disorder (DID) stemming for severe childhood sexual abuse. Which nursing intervention takes priority?
A)Encourage exploration of sexual abuse
B)Encourage guided imagery
C)Establish trust and rapport
D)Administer antianxiety medications
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Chapter 31: Issues Related to Human Sexuality and Gender
Identity
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Q1) A newly married woman comes to a gynecology clinic reporting anorexia, insomnia, and extreme dyspareunia that have affected her intimate relationship. What initial intervention should the nurse expect a physician to implement?
A)A thorough physical to include gynecological examination
B)Referral to a sex therapist
C)Assessment of sexual history and previous satisfaction with sexual relationships
D)Referral to the recreational therapist for relaxation therapy
Q2) When planning care for a client diagnosed with female sexual arousal disorder, what should a nurse document as an expected outcome of senate focus exercises?
A)To initiate immediate orgasm
B)To reduce anxiety by eliminating physical touch
C)To focus on touching breasts and genitals
D)To reduce goal-oriented demands of intercourse
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Chapter 32: Eating Disorders
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Q1) A nursing diagnosis of ineffective coping R/T feelings of loneliness AEB bingeing then purging when alone, is assigned to a client diagnosed with bulimia nervosa. Which is an appropriate outcome related to this nursing diagnosis?
A)The client will identify two alternative methods of dealing with isolation by day 3.
B)The client will appropriately express angry feelings about lack of control by week 2.
C)The client will verbalize two positive self attributes by day 3.
D)The client will list five ways that the body reacts to bingeing and purging.
Q2) A high school senior is diagnosed with anorexia nervosa and is hospitalized for severe malnutrition. The treatment team is planning to use behavior modification. What rationale should a nurse identify as the reasoning behind this therapy choice?
A)This therapy will increase the client's motivation to gain weight.
B)This therapy will reward the client for perfectionist achievements.
C)This therapy will provide the client with control over behavioral choices.
D)This therapy will protect the client from parental overindulgence.
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34
Chapter 33: Adjustment and Impulse Control Disorders
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Q1) In evaluating nursing interventions, which of the following types of questions would a nurse use to gather information from a client diagnosed with an impulse control disorder? (Select all that apply.)
A)Can the client demonstrate the ability to delay gratification?
B)Does the client demonstrate evidence of progression along the grief response?
C)Can the client accomplish activities of daily living independently?
D)Does the client verbalize symptoms of tension preceding unacceptable behavior?
E)Does the client verbalize the unacceptability of maladaptive behaviors?
Q2) A 13-year-old client's father has recently been deployed to Afghanistan. Since deployment, the client has begun to participate in isolative behaviors, truancy, vandalism, and fighting. The pediatric nurse practitioner should identify this behavior with which adjustment disorder?
A)An adjustment disorder with anxiety
B)An adjustment disorder with disturbance of conduct
C)An adjustment disorder with mixed disturbance of emotions and conduct
D)An adjustment disorder unspecified
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Chapter 34: Personality Disorders
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Q1) A pessimistic client expresses low self-worth, has much difficulty making decisions, avoids positions of responsibility, and has a behavioral pattern of "suffering" in silence. Which underlying cause of this client's personality disorder should a nurse recognize?
A)"Nurturance was provided from many sources, and independent behaviors were encouraged."
B)"Nurturance was provided exclusively from one source, and independent behaviors were discouraged."
C)"Nurturance was provided exclusively from one source, and independent behaviors were encouraged."
D)"Nurturance was provided from many sources, and independent behaviors were discouraged."
Q2) Which reaction to a compliment from another client should a nurse identify as a typical response from a client diagnosed with avoidant personality disorder?
A)Interpreting the compliment as a secret code used to increase personal power
B)Feeling the compliment was well deserved
C)Being grateful for the compliment but fearing later rejection and humiliation
D)Wondering what deep meaning and purpose are attached to the compliment
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Chapter 35: The Aging Individual
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Q1) A nursing instructor is teaching about reminiscence therapy. What student statement indicates that learning has occurred?
A)"Reminiscence therapy is a group in which participants create collages representing significant aspects of their lives."
B)"Reminiscence therapy encourages members to share both positive and negative significant life memories to promote resolution."
C)"Reminiscence therapy is a social group where members chat about past events and future plans."
D)"Reminiscence therapy encourages members to share positive memories of significant life transitions."
Q2) A couple resides in a long-term care facility. The husband is admitted to the psychiatric unit after physically abusing his wife. He states, "My wife is having an affair with a young man, and I want it investigated." Which is the appropriate nursing reply?
A)"Your wife is not having an affair.What makes you think that?"
B)"Why do you think that your wife is having an affair?"
C)"Your wife has told us that these thoughts have no basis in fact."
D)"I understand that you are upset.Let's talk about it."
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Chapter 36: Victims of Abuse or Neglect
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Q1) A woman describes a history of physical and emotional abuse in intimate relationships. Which additional factor should a nurse suspect?
A)The woman may be exhibiting a controlled response pattern.
B)The woman may have a history of childhood neglect.
C)The woman may be exhibiting codependent characteristics.
D)The woman might be a victim of incest.
Q2) Which assessment data should a school nurse recognize as signs of physical neglect?
A)The child is often absent from school and seems apathetic and tired.
B)The child is very insecure and has poor self-esteem.
C)The child has multiple bruises on various body parts.
D)The child has sophisticated knowledge of sexual behaviors.
Q3) Which of the following nursing diagnoses could be appropriate for an adult survivor of incest? (Select all that apply.)
A)Low self-esteem
B)Powerlessness
C)Disturbed personal identity
D)Knowledge deficit
E)Noncompliance
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Chapter 37: Community Mental Health Nursing
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Q1) A nurse is implementing care within the parameters of tertiary prevention. Which nursing action is an example of this type of care?
A)Teaching an adolescent about pregnancy prevention
B)Teaching a client the reportable side effects of a newly prescribed neuroleptic medication
C)Teaching a client to cook meals, make a grocery list, and establish a budget
D)Teaching a client about his or her new diagnosis of bipolar disorder
Q2) When a nurse attempts to provide health-care services to the homeless, what should be a realistic concern?
A)Most individuals who are homeless reject help.
B)Most individuals who are homeless are suspicious of anyone who offers help.
C)Most individuals who are homeless are proud and will often refuse charity.
D)Most individuals who are homeless relocate frequently.
Q3) A 27-year-old client was diagnosed 5 years ago with schizophrenia. What course of treatment should the nurse expect to be implemented?
A)Eventual admission for long-term care in a psychiatric facility
B)Community-based care with numerous brief hospitalizations
C)Case management in the community with few relapses
D)Occasional contact with outpatient counselors and psychiatrists
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Page 39
Chapter 38: Forensic Nursing
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Q1) A forensic nurse assesses patterned injuries on a 3-year-old child. What assessment data led to this conclusion?
A)Multiple minute cuts and abrasions
B)Generalized bruising of the buttock
C)Circular burn marks, the size of a lit cigarette
D)Stab wounds resulting from sharp object penetration
Q2) Which of following factors would impede an inmate from benefiting from a nurse-led educational program in a correctional facility?
A)Low reading level skills
B)Language barriers
C)Limited financial resources
D)Limited motivation to learn
E)Absent support systems
Q3) Which inmate statement to the prison nurse describes the circumstances that have contributed to recidivism among the prison population?
A)"I was high on crack when I blew him away."
B)"I never finished high school."
C)"My upbringing was nonexistent."
D)"I'm a product of the foster care system."
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Chapter 39: The Bereaved Individual
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Q1) What term should a nurse use when describing a response to grieving that includes a sudden physical collapse and paralysis, and which cultural group would be associated with this behavior?
A)"Falling out" in the African American culture
B)"Body rocking" in the Vietnamese American culture
C)"Conversion disorder" in the Jewish American culture
D)"Spirit possession" in the Native American culture
Q2) A client is diagnosed with terminal cancer. Which situation would the nurse assess as reflecting Kübler-Ross's grief stage of "anger"?
A)The client registers for an iron-man marathon to be held in 9 months.
B)The client is a devoted Catholic but refuses to attend church and states that his faith has failed him.
C)The client promises God to give up smoking if allowed to live long enough to witness a grandchild's birth.
D)The client gathers family in order to plan a funeral and make last wishes known.
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