Behavioral Health Nursing
Midterm Exam
Course Introduction
Behavioral Health Nursing focuses on the specialized care of individuals experiencing mental health disorders, emotional challenges, and behavioral issues across the lifespan. This course explores various mental health conditions, therapeutic communication techniques, evidence-based interventions, and the nurses role within interdisciplinary teams. Emphasis is placed on patient-centered care, crisis intervention, stigma reduction, ethical considerations, and cultural competency. Students will gain the skills necessary to assess, plan, implement, and evaluate effective nursing care strategies that promote mental wellness, resilience, and recovery in diverse populations.
Recommended Textbook
Psychiatric Mental Health Nursing Concepts of Care in Evidence Based Practice 7th Edition by Mary
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Chapter 1: The Concept of Stress Adaptation
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Q1) A client has experienced the death of a close family member and at the same time becomes unemployed. This situation has resulted in a 6-month score of 110 on the Miller and Rahe Recent Life Changes Questionnaire. How should the nurse evaluate this client data?
A)The client is experiencing severe distress and is at risk for physical and psychological illness.
B)A score of 110 on the Miller and Rahe Recent Life Changes Questionnaire indicates no significant threat of stress-related illness.
C)Susceptibility to stress-related physical or psychological illness cannot be estimated without knowledge of coping resources and available supports.
D)The client may view these losses as challenges and perceive them as opportunities. Answer: C
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Chapter 2: Mental Healthmental Illness: Historical and Theoretical Concepts
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Q1) A husband accuses his wife of infidelity. Which situation would indicate to the nurse the husband's use of the ego defense mechanism of projection?
A)The husband cries and stamps his feet, demanding that his wife be true to her marriage vows.
B)The husband ignores the wife's continued absence from the home.
C)The husband has already admitted to having an affair with a coworker.
D)The husband takes out his marital frustrations through employee abuse.
Answer: C
Q2) When under stress, a client routinely uses an excessive amount of alcohol. Finding her drunk, her husband yells at the client about the chronic alcohol abuse. Which reaction should the nurse recognize as the use of the defense mechanism of denial?
A)Hiding liquor bottles in a closet
B)Yelling at their son for slouching in his chair
C)Burning dinner on purpose
D)Saying to the spouse, "I don't drink too much!"
Answer: D
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4
Chapter 3: Theoretical Models of Personality Development
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Q1) 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
Q2) A psychiatric nurse uses Sullivan's theories in group and individual therapy. According to Sullivan and other theorists like him, how are client symptoms viewed?
A)Client symptoms are viewed as learned behaviors that are maintained because they are reinforced.
B)Client symptoms are viewed as responses to anxiety arising from interpersonal relationships.
C)Client symptoms are viewed as internal conflicts arising from early childhood trauma.
D)Client symptoms are viewed as the misinterpretations of experiences.
Answer: B
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Chapter 4: Concepts of Psychobiology
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Q1) Which cerebral structure should a nursing instructor describe to students as the "emotional brain"?
A)The cerebellum
B)The limbic system
C)The cortex
D)The left temporal lobe
Q2) Which part of the nervous system should a nurse identify as playing a major role during stressful situations?
A)Peripheral nervous system
B)Somatic nervous system
C)Sympathetic nervous system
D)Parasympathetic nervous system
Q3) A nurse understands that the abnormal secretion of growth hormone may play a role in which illness?
A)Acute mania
B)Schizophrenia
C)Anorexia nervosa
D)Alzheimer's disease
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Chapter 5: Ethical and Legal Issues in Psychiatricmental
Health Nursing
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Q1) Without authorization, a nurse administers an extra dose of narcotic tranquilizer to an agitated client. The nurse's coworker observes this action but does nothing for fear of repercussion. What is the ethical interpretation of the coworker's lack of involvement?
A)Taking no action is still considered an unethical action by the coworker.
B)Taking no action releases the coworker from ethical responsibility.
C)Taking no action is advised when potential adverse consequences are foreseen.
D)Taking no action is acceptable because the coworker is only a bystander.
Q2) An involuntarily committed client is verbally abusive to the staff and repeatedly threatening to sue. The client records the full names and phone numbers of the staff. Which nursing action is most appropriate to decrease the possibility of a lawsuit?
A)Verbally redirect the client, and then limit one-on-one interaction.
B)Involve the hospital's security division as soon as possible.
C)Notify the client that documenting personal staff information is against hospital policy.
D)Continue professional attempts to establish a positive working relationship with the client.
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Page 7
Chapter 6: Cultural and Spiritual Concepts Relevant to Psychiatricmental Health Nursing
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Q1) Which rationale by a nursing instructor best explains why it is challenging to globally classify the Asian American culture?
A)Extremes of emotional expression prevent accurate assessment of this culture.
B)Suspicion of Western civilization has resulted in minimal cultural research.
C)The small size of this subpopulation makes research virtually impossible.
D)The Asian American culture includes individuals from many different countries.
Q2) A nurse is preparing to establish a therapeutic relationship with a grieving family from China. Which nursing intervention would be considered most appropriate?
A)Touch each member lightly as this enhances the communication process.
B)Direct questions to the young males of the family as they maintain positions of authority.
C)Avoid direct eye contact as it implies rudeness.
D)Remain objective and empathetic as Asians express feelings freely.
Q3) 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
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Chapter 7: Relationship Development
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Q1) What is the main goal of the working phase of the nurse-client therapeutic relationship?
A)Role modeling to improve interaction with others
B)Resolution of the client's problems
C)Using therapeutic communication to clarify perceptions
D)Helping the client access outpatient treatment
Q2) A mother notified that her child was killed in a tragic car accident states, "I can't bear to go on with my life." Which nursing statement conveys empathy?
A)"This situation is very sad, but time is a great healer."
B)"You are sad, but you must be strong for your other children."
C)"Once you cry it all out, things will seem so much better."
D)"It must be horrible to lose a child; I'll stay with you until your husband arrives."
Q3) What should be the nurse's primary goal during the preinteraction phase of the nurse-client relationship?
A)To evaluate goal attainment and ensure therapeutic closure
B)To establish trust and formulate a contract for intervention
C)To explore self-perceptions
D)To promote client change
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9
Chapter 8: Therapeutic Communication
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Q1) Which nursing response is an example of the nontherapeutic communication block of requesting an explanation?
A)"Can you tell me why you said that?"
B)"Keep your chin up.I'll explain the procedure to you."
C)"There is always an explanation for both good and bad behaviors."
D)"Are you not understanding the explanation I provided?"
Q2) Which example of a therapeutic communication technique would be effective in the planning phase of the nursing process?
A)"We've discussed past coping skills.Let's see if these coping skills can be effective now."
B)"Please tell me in your own words what brought you to the hospital."
C)"This new approach worked for you.Keep it up."
D)"I notice that you seem to be responding to voices that I do not hear."
Q3) Which nursing statement is a good example of the therapeutic communication technique of giving recognition?
A)"You did not attend group today.Can we talk about that?"
B)"I'll sit with you until it is time for your family session."
C)"I notice you are wearing a new dress and you have washed your hair."
D)"I'm happy that you are now taking your medications.They will really help."
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10
Chapter 9: The Nursing Process in Psychiatricmental Health
Nursing
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Q1) Which nursing response would be appropriately used in the evaluation phase of the nursing process?
A)"If I were in your situation, I would not repeat a behavior that has caused problems."
B)"What do you think needs changing, and what do you want to do differently?"
C)"What exactly will it take to carry out your plan, and what else do you need to do?"
D)"This new approach seems to work for you."
Q2) The nurse interviewed a client who was uncooperative, answered questions with minimal responses, and rarely made eye contact. Which is the most complete documentation of baseline data obtained during the interview?
A)"Appears uncooperative.Exhibits characteristics of depression."
B)"Maintains poor eye contact throughout interview process.Unable to answer interview questions due to depression."
C)"States, 'I don't need to be here.' when discussing admission status.Maintains minimal eye contact and offers little data related to triggers for admission."
D)"Unwilling to respond openly during interview."
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Page 11
Chapter 10: Therapeutic Groups
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Q1) During a group session, which client statement demonstrates that the group has progressed to the middle, or working, phase of group development?
A)"It's hard for me to tell my story when I'm not sure about the reactions of others."
B)"I think Joe's Antabuse suggestion is a good one and might work for me."
C)"My situation is very complex, and I need professional, not peer, advice."
D)"I am really upset that you expect me to solve my own problems."
Q2) During a therapeutic group, which nursing action demonstrates a laissez-faire leadership style?
A)The nurse mandates that all group members reveal an embarrassing personal situation.
B)The nurse asks for a show of hands to determine group topic preference.
C)The nurse sits silently as the group members stray from the assigned topic.
D)The nurse shuffles through papers to determine the facility policy on length of group.
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Chapter 11: Intervention With Families
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Q1) During family counseling a child states, "I just want to surf like other kids. Mom says it's okay, but Dad says I'm too young." The mother allows surfing when the father is absent. In the structural model of family therapy, what family interactional pattern should the nurse recognize?
A)Multigenerational transmission
B)Disengagement
C)Mother-child subsystem
D)Emotional cutoff
Q2) A couple has been married for 20 years. They argue constantly, belittle feelings, and continuously contradict each other. During a therapy session, the nurse documents "Marital schism." What does the nurse mean by this documentation?
A)The couple has a compatible marriage relationship.
B)The husband has a dominant relationship over the wife.
C)The couple has an enmeshed relationship.
D)The couple has an incompatible marriage relationship.
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13
Chapter 12: Milieu Therapy - the Therapeutic Community
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Q1) A nurse attends an interdisciplinary team meeting on an inpatient unit. Which of the following individuals are typically included as members of the interdisciplinary treatment team in psychiatry? (Select all that apply.)
A)Respiratory therapist and psychiatrist
B)Occupational therapist and psychologist
C)Recreational therapist and art therapist
D)Social worker and hospital volunteer
E)Mental health technician and chaplain
Q2) An angry client on an inpatient unit approaches a nurse stating, "Someone took my lunch! People need to respect others, and you need to do something about this now!" The nurse's response should be guided by which basic assumption of milieu therapy?
A)Conflict should be avoided at all costs on inpatient psychiatric units.
B)Conflict should be resolved by the nursing staff.
C)Every interaction is an opportunity for therapeutic intervention.
D)Conflict resolution should only be addressed during group therapy.
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Chapter 13: Crisis Intervention
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Q1) A college student who was nearly raped while jogging completes a series of appointments with a rape crisis nurse. At the final session, which client statement most clearly suggests that the goals of crisis intervention have been met?
A)"You've really been helpful.Can I count on you for continued support?"
B)"I work out in the college gym rather than jogging outdoors."
C)"I'm really glad I didn't go home.It would have been hard to come back."
D)"I carry mace when I jog.It makes me feel safe and secure."
Q2) Which of the following nursing statements and/or questions represent appropriate communication to assess an individual in crisis? (Select all that apply.)
A)"Tell me what happened."
B)"What coping methods have you used, and did they work?"
C)"Describe to me what your life was like before this happened."
D)"Let's focus on the current problem."
E)"I'll assist you in selecting functional coping strategies."
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Chapter 14: Relaxation Therapy
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Q1) Which action should a nurse take prior to educating clients about relaxation techniques?
A)Assisting the client in identifying triggers or sources of stress
B)Performing a physical examination to qualify the client as a candidate for this therapy
C)Obtaining an order from the physician
D)Educating the client's family so they can be active participants in the therapy
Q2) 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
Q3) The nurse should recognize that improvement in concentration and attention occurs with which relaxation technique?
A)Biofeedback
B)Physical exercise
C)Meditation
D)Mental imagery
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16
Chapter 15: Assertiveness Training
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Sample Questions
Q1) During an assertiveness training group, a nurse suggests using "I statements." The group questions the usefulness of this communication technique. Which explanation by the nurse is most appropriate?
A)"When 'I statements' are used, opinions are communicated without blaming others."
B)"When 'I statements' are used, anger is displaced by using indirect means."
C)"When 'I statements' are used, responsibility for one's behavior is attributed to another."
D)"When 'I statements' are used, eye contact is promoted."
Q2) An aggressive nurse manager tells a staff nurse she has no business rallying staff to change the schedule. What would be an example of a technique that the staff nurse could use to stand up for her basic human rights?
A)"What is the real reason that you don't want the schedule changed?"
B)"Sounds to me like you're threatened by this change."
C)"Are you upset because you don't want to redo the schedule?"
D)"I have the right to express my opinion about the schedule."
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17
Chapter 16: Promoting Self Esteem
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Q1) A client has continual problematic relationships and rejects others before possibly being rejected. Client states, "I am afraid of failing in my job responsibilities." Which correctly written nursing diagnosis should be prioritized for this client?
A)Poor self-esteem R/T negative self-image AEB fear of failure
B)Altered thought processes R/T anxiety AEB delusions
C)Role confusion R/T rejection and poor job productivity
D)High risk for violence: self-directed R/T rejection of others
Q2) A nurse is running a group on self-esteem. A client asks, "Where does self-esteem come from?" Which is the most appropriate nursing reply?
A)"Many factors, over the life span, influence development and maintenance of self-esteem."
B)"Self-esteem is determined by factors outside of an individual's control."
C)"Self-esteem is established in childhood and remains relatively fixed throughout life."
D)"Genetics are the single largest contributor to an individual's self-esteem."
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18
Chapter 17: Angeraggression Management
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Q1) A client is served divorce papers while on the inpatient psychiatric unit. When a nurse tells the client the unit telephone cannot be used after hours, the client raises fists, swears, and spits at the nurse. Which negative coping mechanism has the client exhibited?
A)The defense mechanism of projection
B)The defense mechanism of reaction formation
C)The defense mechanism of sublimation
D)The defense mechanism of displacement
Q2) A client begins to smash furniture, cannot be "talked down," and refuses medications. Which is the most appropriate nursing intervention?
A)Call a violence code.
B)Ask the ward clerk to put in a call for the physician.
C)Place the client in seclusion.
D)Place the client in four-point restraints.
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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Page 19
Chapter 18: Intervention With a Suicidal Client
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Q1) In planning care for a suicidal client, which correctly written outcome should be a nurse's first priority?
A)The client will not physically harm self.
B)The client will express hope for the future by day 3.
C)The client will establish a trusting relationship with the nurse.
D)The client will remain safe during the hospital stay.
Q2) A nursing instructor is teaching about suicide. Which student statement indicates that learning has occurred?
A)"Suicidal threats and gestures should be considered manipulative and/or attention-seeking."
B)"Suicide is the act of a psychotic person."
C)"All suicidal individuals are mentally ill."
D)"50% to 80% of all people who kill themselves have a history of a previous attempt."
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Chapter 19: Behavior Therapy
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Q1) A kindergarten rule states that if unacceptable behavior occurs, a child's personalized fish will be moved to the sea grass. Children who behave keep their fish out of the sea grass. The school nurse should identify this intervention as based on which principle of behavior therapy?
A)Classical conditioning
B)Conditioned response
C)Positive reinforcement
D)Negative reinforcement
Q2) Parents decide to try the nurse practitioner's suggestion of time out when their child misbehaves. What teaching should the nurse practitioner provide the parents?
A)"Correct your child's behavior by using social isolation."
B)"Ignore the child's negative behavior."
C)"Add positive reinforcement for acceptable behavior."
D)"Temporarily move your child to an area where behavior is not being reinforced."
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Chapter 20: Cognitive Therapy
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Q1) A nurse practitioner uses cognitive therapy with depressed clients. The nurse asks clients to keep a daily record of dysfunctional thoughts. Which of the following are appropriate nursing replies to a client questioning the purpose of this exercise? (Select all that apply.)
A)"The purpose of this exercise is to identify automatic thoughts."
B)"The purpose of this exercise is to identify rational alternatives."
C)"The purpose of this exercise is to modify cognitive errors."
D)"The purpose of this exercise is to eliminate irrational beliefs."
E)"The purpose of this exercise is to monitor thoughts related to self-esteem."
Q2) A client diagnosed with borderline personality disorder states, "Get out of here. No one cares about me or my situation!" Which nursing reply is an example of a cognitive intervention?
A)"You have an anti-anxiety medication ordered.It may make you feel better."
B)"It sounds like you are feeling really frustrated."
C)"Can you explain further your thinking about your situation?"
D)"No one cares about you?"
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Chapter 21: Electroconvolusive Therapy
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Q1) Which of the following conditions would place a client at risk for injury during electroconvulsive therapy (ECT) treatments? (Select all that apply.)
A)Severe osteoporosis
B)Acute and chronic pulmonary disorders
C)Hypothyroidism
D)Recent cardiovascular accident
E)Prostatic hypertrophy
Q2) A nursing instructor is teaching about electroconvulsive therapy (ECT). Which student statement indicates that learning has occurred?
A)"During ECT a state of euphoria is induced."
B)"ECT induces a grand mal seizure."
C)"During ECT a state of catatonia is induced."
D)"ECT induces a petit mal seizure."
Q3) Immediately after electroconvulsive therapy, in which position should a nurse place the client?
A)On his or her side to prevent aspiration
B)In semi-Fowler's position to promote oxygenation
C)In Trendelenburg's position to promote blood flow to vital organs
D)In prone position to prevent airway blockage
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Page 23
Chapter 22: Complementary Therapies
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Q1) A lethargic client is diagnosed with major depressive disorder. After taking antidepressant therapy for 6 weeks, the symptoms have not resolved. Which nutritional deficiency should a nurse identify as potentially contributing to the client's symptoms?
A)Vitamin A deficiency
B)Vitamin C deficiency
C)Iron deficiency
D)Folic acid deficiency
Q2) Which of the following nursing statements best explains to the client the benefits of pet therapy? (Select all that apply.)
A)"Pet therapy allows the therapist to assess the client's social relationships."
B)"Pet therapy decreases blood pressure."
C)"Pet therapy enhances client mood."
D)"Pet therapy improves sensory functioning."
E)"Pet therapy mitigates the effects of loneliness."
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24
Chapter 23: Disorders Usually First Diagnosed in Infancy,
Childhood, or Adolescence
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Q1) A preschool child is admitted to a psychiatric unit with a diagnosis of autistic disorder. To help the child feel more secure on the unit, which intervention should a nurse include in this client's plan of care?
A)Encourage and reward peer contact.
B)Provide consistent caregivers.
C)Provide a variety of safe daily activities.
D)Maintain close physical contact throughout the day.
Q2) A nursing instructor is teaching about the developmental characteristics of clients diagnosed with moderate mental retardation (MR). Which student statement indicates that further instruction is needed?
A)"These clients can work in a sheltered workshop setting."
B)"These clients can perform some personal care activities."
C)"These clients may have difficulties relating to peers."
D)"These clients can successfully complete elementary school."
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25
Chapter 24: Delirium, Dementia, and Amnestic Disorders
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Q1) A nursing instructor is teaching about donepezil (Aricept). A student asks, "How does this work? Will this cure Alzheimer's dementia?" Which is the appropriate instructor reply?
A)"This medication delays the destruction of acetylcholine, a chemical in the brain necessary for memory processes.Although most effective in the early stages, it serves to delay, but not stop, the progression of the dementia."
B)"This medication encourages production of acetylcholine, a chemical in the brain necessary for memory processes.It delays the progression of the disease."
C)"This medication delays the destruction of dopamine, a chemical in the brain necessary for memory processes.Although most effective in the early stages, it serves to delay, but not stop, the progression of the dementia."
D)"This medication encourages production of dopamine, a chemical in the brain necessary for memory processes.It delays the progression of the disease."
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Chapter 25: Substance-Related Disorders
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Q1) Which client statement demonstrates positive progress toward recovery from substance abuse?
A)"I have completed detox and therefore am in control of my drug use."
B)"I will faithfully attend Narcotic Anonymous (NA) when I can't control my carvings."
C)"As a church deacon, my focus will now be on spiritual renewal."
D)"Taking those pills got out of control.It cost me my job, marriage, and children."
Q2) What should be the priority nursing diagnosis for a client experiencing alcohol withdrawal?
A)Risk for injury R/T central nervous system stimulation
B)Disturbed thought processes R/T tactile hallucinations
C)Ineffective coping R/T powerlessness over alcohol use
D)Ineffective denial R/T continued alcohol use despite negative consequences
Q3) A nurse holds the hand of a client who is withdrawing from alcohol. What is the nurse's rationale for this intervention?
A)To assess for emotional strength
B)To assess for Wernicke-Korsakoff syndrome
C)To assess for tachycardia
D)To assess for fine tremors
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Chapter 26: Schizophrenia and Other Psychotic Disorders
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Q1) A 16-year-old-client diagnosed with paranoid schizophrenia experiences command hallucinations to harm others. The client's parents ask a nurse, "Where do the voices come from?" Which is the appropriate nursing reply?
A)"Your child has a chemical imbalance of the brain which leads to altered thoughts."
B)"Your child's hallucinations are caused by medication interactions."
C)"Your child has too little serotonin in the brain causing delusions and hallucinations."
D)"Your child's abnormal hormonal changes have precipitated auditory hallucinations."
Q2) An aging client diagnosed with chronic schizophrenia takes an antipsychotic and a beta-adrenergic blocking agent (propranolol) for hypertension. Understanding the combined side effects of these drugs, which statement by a nurse is most appropriate?
A)"Make sure you concentrate on taking slow, deep, cleansing breaths."
B)"Watch your diet and try to engage in some regular physical activity."
C)"Rise slowly when you change position from lying to sitting or sitting to standing."
D)"Wear sunscreen and try to avoid midday sun exposure."
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28
Chapter 27: Mood Diorders: Depression
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Q1) A newly admitted client is diagnosed with major depressive disorder with suicidal ideations. Which would be the priority nursing intervention for this client?
A)Teach about the effective of suicide on family dynamics.
B)Carefully and unobtrusively observe based on assessed data, at varied intervals around the clock.
C)Encourage the client to spend a portion of each day interacting within the milieu.
D)Set realistic achievable goals to increase self esteem.
Q2) A client is admitted with a diagnosis of depression NOS (not otherwise specified). Which client statement would describe a somatic symptom that can occur with this diagnosis?
A)"I am extremely sad, but I don't know why."
B)"Sometimes I just don't want to eat because I ache all over."
C)"I feel like I can't ever make the right decision."
D)"I can't seem to leave the house without someone with me."
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Chapter 28: Mood Disorders: Bipolar Disorder
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Q1) A client is diagnosed with cyclothymic disorder. What client behaviors should the nurse expect to assess?
A)The client expresses "feeling blue most of the time."
B)The client has endured periods of elation and dysphoria lasting for more than 2 years.
C)The client fixates on hopelessness and thoughts of suicide continually.
D)The client has labile moods with periods of acute mania.
Q2) A client diagnosed with bipolar disorder weighs 220 lb. A physician orders lamotrigine (Lamictal) 10 mg/kg/day to a maximum of 400 mg/day for mood stabilization. Which is a true statement about this medication order?
A)This calculated dosage is within the recommended dosage range.
B)This calculated dosage is lower than the recommended dosage range.
C)This calculated dosage is more than twice the recommended dosage range.
D)This calculated dosage is four times higher than the recommended dosage range.
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Chapter 29: Anxiety Disorders
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Q1) A college student has been diagnosed with generalized anxiety disorder (GAD). Which of the following symptoms should a campus nurse expect this client to exhibit? (Select all that apply.)
A)Fatigue
B)Anorexia
C)Hyperventilation
D)Insomnia
E)Irritability
Q2) Which nursing diagnosis would best describe the problems evidenced by the following client symptoms: avoidance, poor concentration, nightmares, hypervigilance, exaggerated startle response, detachment, emotional numbing, and flashbacks?
A)Ineffective coping
B)Post-trauma syndrome
C)Complicated grieving
D)Panic anxiety
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Chapter 30: Somatoform and Disassociative Disorders
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Q1) Which are examples of primary and secondary gains that clients diagnosed with somatoform pain disorders may experience?
A)Primary: chooses to seek a new doctor; secondary: euphoric feeling from new medications
B)Primary: euphoric feeling from new medications; secondary: chooses to seek a new doctor
C)Primary: receives get-well messages; secondary: pain prevents attendance at family reunion
D)Primary: pain prevents attendance at family reunion; secondary: receives get-well messages
Q2) 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?"
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Chapter 31: Issues Related to Human Sexuality and Gender
Identity
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Q1) A psychiatric nursing instructor is teaching about the psychological effects of the diagnosis of a sexually transmitted disease (STD). Which student statement indicates that further instruction is needed?
A)"STDs carry strong connotations of illicit sex and considerable social stigma."
B)"STDs can cause insanity."
C)"The diagnosis of HIV can generate hopelessness and helplessness."
D)"Antibiotics administered in the early stages can cure all STDs."
Q2) A client is diagnosed with female sexual aversion disorder. In addition to systematic desensitization techniques, which medication therapy could accompany this intervention?
A)Quetiapine (Seroquel)
B)Phenelzine (Nardil)
C)Amoxapine (Asendin)
D)Carbamazepine (Tegretol)
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Chapter 32: Eating Disorders
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Q1) A nurse should identify topiramate (Topamax) as the drug of choice for which of the following conditions? (Select all that apply.)
A)Binge eating with obesity
B)Bingeing and purging with a diagnosis of bulimia nervosa
C)Weight loss with a diagnosis of anorexia nervosa
D)Amenorrhea with a diagnosis of anorexia nervosa
E)Emaciation with a diagnosis of bulimia nervosa
Q2) A client diagnosed with bulimia nervosa has been attending a mental health clinic for several months. Which factor should a nurse identify as an appropriate indicator of a positive client behavioral change?
A)The client gains 2 pounds in 1 week.
B)The client focuses conversations on nutritious food.
C)The client demonstrates healthy coping mechanisms that decrease anxiety.
D)The client verbalizes an understanding of the etiology of the disorder.
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Chapter 33: Adjustment and Impulse Control Disorders
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Q1) Which individual would most likely be diagnosed with intermittent explosive disorder?
A)A client diagnosed with antisocial personality disorder who attacks the nursing staff
B)A client diagnosed with diabetes mellitus who has a history of multiple severe assaultive acts
C)A client diagnosed with schizophrenia who sets fires because of command hallucinations
D)A client diagnosed with alcohol dependence who severely beats wife while intoxicated
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) 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
Q2) Which nursing diagnosis should be prioritized when providing care to a client diagnosed with paranoid personality disorder?
A)Risk for violence: directed toward others R/T suspicious thoughts
B)Risk for suicide R/T altered thought
C)Altered sensory perception R/T increased levels of anxiety
D)Social isolation R/T inability to relate to others
Q3) When planning care for a client diagnosed with borderline personality disorder, which self-harm behavior should a nurse expect the client to exhibit?
A)The use of highly lethal methods to commit suicide
B)The use of suicidal gestures to evoke a rescue response from others
C)The use of isolation and starvation as suicidal methods
D)The use of self-mutilation to decrease endorphins in the body
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Chapter 35: The Aging Individual
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Q1) Which psychiatric disorder would a nurse expect to see diagnosed in a client's later life?
A)Schizophrenia
B)Major depressive disorder
C)Phobic disorder
D)Dependent personality disorder
Q2) An elderly client is exhibiting symptoms of major depressive disorder. A physician is considering prescribing an antidepressant. Which physiological problem should make a nurse question this medication regime?
A)Altered cortical and intellectual functioning
B)Altered respiratory and gastrointestinal functioning
C)Altered liver and kidney functioning
D)Altered endocrine and immune system functioning
Q3) According to the U.S. Census Bureau criteria, how would a nurse classify a 70-year-old man?
A)This man would be classified as "older."
B)This man would be classified as "elderly."
C)This man would be classified as "aged."
D)This man would be classified as "very old."
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Chapter 36: Victims of Abuse or Neglect
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Q1) When planning care for women in abusive relationships, which of the following information is important for the nurse to consider? (Select all that apply.)
A)It often takes several attempts before a woman leaves an abusive situation.
B)Substance abuse is a common factor in abusive relationships.
C)Until children reach school age, they are usually not affected by parental discord.
D)Women in abusive relationships usually feel isolated and unsupported.
E)Economic factors rarely play a role in the decision to stay in abusive relationships.
Q2) In the emergency department, a raped client appears calm and exhibits a blunt affect. The client answers a nurse's questions in a monotone using single words. How should the nurse interpret this client's responses?
A)The client may be lying about the incident.
B)The client may be experiencing a silent rape reaction.
C)The client may be demonstrating a controlled response pattern.
D)The client may be having a compounded rape reaction.
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Chapter 37: Community Mental Health Nursing
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Q1) When intervening with a married couple experiencing relationship discord, which reflects a nursing intervention at the secondary level of prevention?
A)Teaching assertiveness skills in order to meet assessed needs
B)Supplying the couple with guidelines related to marital seminar leadership
C)Teaching the couple about various methods of birth control
D)Counseling the couple related to open and honest communication skills
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) Which intervention should the nurse consider as primary prevention for an individual who is on the verge of being homeless due to a job layoff?
A)Referral to primary care provider to improve general health status
B)Encouraging client to recognize reasons for job layoff
C)Job training to increase employment options
D)Encouraging the use of prn medications to control symptoms
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Chapter 38: Forensic Nursing
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Q1) 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
Q2) A nurse providing health teaching to inmates of a correctional facility is most likely to include which of the following topics? (Select all that apply.)
A)Benefits of exercise
B)Ways to achieve optimum wellness
C)Prevention of sexually transmitted diseases (STDs)
D)Prevention of pregnancy
E)Stress management
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Chapter 39: The Bereaved Individual
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Q1) A teenager has recently lost a parent. Which grieving behavior should a school nurse expect when assessing this client?
A)Denial of personal mortality
B)Preoccupation with the loss
C)Clinging behaviors and personal insecurity
D)Acting-out behaviors, exhibited in aggression and defiance
Q2) 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
Q3) A nurse assigns a client the nursing diagnosis of complicated grieving. According to Bowlby, which long-term outcome would be most appropriate for this client's problem?
A)The client will accomplish the recovery stage of grief by year 1.
B)The client will accomplish the acceptance stage of grief by year 1.
C)The client will accomplish the reorganization stage of grief by year 1.
D)The client will accomplish the emotional relocation stage of grief by year 1.
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