Evidence-Based Practice in Psychiatric Nursing Practice Questions
Course Introduction
This course explores the principles and application of evidence-based practice within the field of psychiatric nursing. Students will learn to critically appraise and integrate current research findings, clinical expertise, and patient preferences to enhance mental health care delivery. Emphasis is placed on identifying credible sources of scientific evidence, implementing evidence-based interventions, and evaluating outcomes for individuals with psychiatric and mental health needs. The course also addresses ethical and cultural considerations, promoting an informed and holistic approach to psychiatric nursing practice.
Recommended Textbook
Psychiatric Mental Health Nursing Concepts of Care in Evidence Based Practice 7th Edition by Mary
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39 Chapters
857 Verified Questions
857 Flashcards
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Page 2
Chapter 1: The Concept of Stress Adaptation
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18 Verified Questions
18 Flashcards
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Sample Questions
Q1) A bright student confides in the school nurse about conflicts related to attending college, or working to add needed financial support to the family. Which coping strategy is most appropriate for the nurse to recommend to the student at this time?
A)Meditation
B)Problem-solving training
C)Relaxation
D)Journaling
Answer: B
Q2) A nursing instructor is teaching about diseases of adaptation and when they are likely to occur. When questioned about situations that precipitate these diseases, which student statement indicates that learning has occurred?
A)"When an individual has limited experience dealing with stress"
B)"When an individual inherits maladaptive genes"
C)"When an individual experiences existing conditions that exacerbate stress"
D)"When an individual's physiological and psychological resources have become depleted"
Answer: D
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3
Chapter 2: Mental Healthmental Illness: Historical and Theoretical Concepts
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31 Verified Questions
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Sample Questions
Q1) An employee uses the defense mechanism of displacement when the boss openly disagrees with suggestions. What behavior would be expected from this employee?
A)The employee assertively confronts the boss
B)The employee leaves the staff meeting to work out in the gym
C)The employee criticizes a coworker
D)The employee takes the boss out to lunch
Answer: C
Q2) A nurse is assessing a client who is experiencing occasional feelings of sadness because of the recent death of a beloved pet. The client's appetite, sleep patterns, and daily routine have not changed. How should the nurse interpret the client's behaviors?
A)The client's behaviors demonstrate mental illness in the form of depression.
B)The client's behaviors are extensive which indicates the presence of mental illness.
C)The client's behaviors are not congruent with cultural norms.
D)The client's behaviors demonstrate no functional impairment, indicating no mental illness.
Answer: D
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Chapter 3: Theoretical Models of Personality Development
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30 Verified Questions
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Sample Questions
Q1) A client has flashbacks of sexual abuse by her uncle. She had not been aware of these memories until recently, when she became sexually active with her boyfriend. A nurse should identify this experience as which part of Sullivan's concept of the self-system?
A)The "good me"
B)The "bad me"
C)The "not me"
D)The "bad you"
Answer: C
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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5
Chapter 4: Concepts of Psychobiology
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Sample Questions
Q1) Which types of adoption studies should a nurse recognize as providing useful information for the psychiatric community?
A)Studies in which children with mentally ill biological parents are raised by adoptive parents who were mentally healthy
B)Studies in which children with mentally healthy biological parents are raised by adoptive parents who were mentally ill
C)Studies in which monozygotic twins from mentally ill parents were raised separately by different adoptive parents
D)Studies in which monozygotic twins were raised together by mentally ill biological parents
E)All of the above
Q2) A client is admitted to an emergency department experiencing memory deficits and decreased motor function. What alteration in brain chemistry should a nurse correlate with the presentation of these symptoms?
A)Abnormal levels of serotonin
B)Decreased levels of dopamine
C)Increased levels of norepinephrine
D)Decreased levels of acetylcholine
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6
Chapter 5: Ethical and Legal Issues in Psychiatricmental
Health Nursing
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Sample Questions
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) There is one bed available on an inpatient psychiatric unit. For which client should a nurse advocate emergency commitment?
A)An individual who is persistently mentally ill and evicted from an apartment
B)An individual treated in the emergency department (ED) for generalized anxiety disorder
C)An individual who is delusional and has a plan to kill his wife
D)An individual who rates mood 4/10 and is participating in a no-harm safety plan
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Chapter 6: Cultural and Spiritual Concepts Relevant to Psychiatricmental Health Nursing
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20 Verified Questions
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Sample Questions
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) 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.
Q3) A nursing instructor is teaching about cultural characteristics. Which statement by the student indicates the need for further instruction?
A)"All cultures communicate freely within their group."
B)"All cultures embrace light therapeutic touch."
C)"All cultures view the importance of timeliness differently."
D)"All cultures display biological variations."
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Page 8
Chapter 7: Relationship Development
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Sample Questions
Q1) What is the most essential task for a nurse to accomplish prior to forming a therapeutic relationship with a client?
A)To clarify personal attitudes, values, and beliefs
B)To obtain thorough assessment data
C)To determine the client's length of stay
D)To establish personal goals for the interaction
Q2) The nurse-client therapeutic relationship includes which of the following characteristics? (Select all that apply.)
A)Meeting the psychological needs of the nurse and the client
B)Ensuring therapeutic termination
C)Promoting client insight into problematic behavior
D)Collaborating to set appropriate goals
E)Meeting both the physical and psychological needs of the client
Q3) If an individual is "two-faced," which characteristic essential to the development of a therapeutic relationship should a nurse identify as missing?
A)Respect
B)Genuineness
C)Sympathy
D)Rapport
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Page 9
Chapter 8: Therapeutic Communication
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Sample Questions
Q1) Which therapeutic communication technique is being used in this nurse-client interaction? Client: "When I get angry, I get into a fistfight with my wife or I take it out on the kids."
Nurse: "I notice that you are smiling as you talk about this physical violence."
A)Encouraging comparison
B)Exploring
C)Formulating a plan of action
D)Making observations
Q2) A student nurse tells the instructor, "I'm concerned that when a client asks me for advice I won't have a good solution." Which should be the nursing instructor's best response?
A)"It's scary to feel put on the spot by a client.Nurses don't always have the answer."
B)"Remember, clients, not nurses, are responsible for their own choices and decisions."
C)"Just keep the client's best interests in mind and do the best that you can."
D)"Set a goal to continue to work on this aspect of your practice."
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10
Chapter 9: The Nursing Process in Psychiatricmental Health
Nursing
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Sample Questions
Q1) 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."
Q2) The following North American Nursing Diagnosis Association (NANDA) nursing diagnostic stem was developed for a client on an inpatient unit: Risk for injury. What assessment data most likely led to the development of this problem statement?
A)The client is receiving electroconvulsive therapy (ECT) and is diagnosed with Parkinsonism.
B)The client has a history of four suicide attempts in adolescence.
C)The client expresses hopelessness and helplessness and isolates self.
D)The client has disorganized thought processes and delusional thinking.
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Page 11
Chapter 10: Therapeutic Groups
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Sample Questions
Q1) A man diagnosed with alcohol dependence experiences his first relapse. During his AA meeting, another group member states, "I relapsed three times, but now have been sober for 15 years." Which of Yalom's curative group factors does this illustrate?
A)Imparting of information
B)Instillation of hope
C)Catharsis
D)Universality
Q2) A single, pregnant teenager in a parenting class discloses her ambivalence toward the pregnancy and the subsequent guilt that these thoughts generate. A mother of three admits to having felt that way herself. Which of Yalom's curative group factors does this illustrate?
A)Imparting of information
B)Instillation of hope
C)Altruism
D)Universality
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Chapter 11: Intervention With Families
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Sample Questions
Q1) After hearing parents discuss divorce, a 5-year-old develops behavioral problems. Upon dealing with the child's behavioral issues, the marital relationship conflict decreases. The pediatric clinic nurse should recognize that this is an example of which family system concept?
A)Differentiation of self
B)Triangulation
C)Fusion
D)Emotional cutoff
Q2) A home health nurse is visiting an Asian family. A married couple, their three children, and the maternal grandparents all live in the home. How should the nurse interpret the presence of the grandparents in the home?
A)The parents have diffuse boundaries and have allowed the grandparental subsystem to be present.
B)The grandparental subsystem is not successfully managing separation from the parental subsystem.
C)Extended family living arrangements are common in some cultures.
D)The nuclear family living arrangement is the preferred environment for childrearing.
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13
Chapter 12: Milieu Therapy - the Therapeutic Community
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Sample Questions
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) A client on an inpatient unit angrily states to a nurse, "Peter is not cleaning up after himself in the community bathroom. You need to address this problem." Which is the appropriate nursing response?
A)"I'll talk to Peter and present your concerns."
B)"Why are you overreacting to this issue?"
C)"You should bring this to the attention of your treatment team."
D)"I can see that you are angry.Let's discuss ways to approach Peter with your concerns."
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) An involuntarily committed client, when offered a dinner tray, pushes it off the bedside table onto the floor. Which intervention should a nurse prioritize to address this behavior?
A)Initiate forced medication protocol.
B)Help the client to explore the source of anger.
C)Ignore the act to avoid reinforcing the behavior.
D)With staff support and a show of solidarity, set firm limits on the behavior.
Q2) After threatening to jump off a bridge, a client is brought to an emergency department by police. To assess for suicide potential, which question should a nurse ask first?
A)"Are you currently thinking about harming yourself?"
B)"Why do you want to harm yourself?"
C)"Have you thought about the consequences of your actions?"
D)"Who is your emergency contact person?"
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15
Chapter 14: Relaxation Therapy
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Sample Questions
Q1) A nurse working for a large corporation is teaching relaxation therapy to employees. Which relaxation technique should the nurse initially teach?
A)Deep-breathing exercises
B)Mental imagery
C)Biofeedback
D)Meditation
Q2) During a psychoeducational group on stress management, a client asks about meditation. Which nursing statement is most accurate regarding meditation?
A)"It is a procedure whereby various muscle groups are contracted and relaxed, bringing about an overall sense of relaxation."
B)"The procedure is one whereby you use your imagination to relax and reduce the tension in your body."
C)"The purpose is to become aware of one's bodily processes and to bring them under conscious control."
D)"The goal is to gain mastery and control over one's attention, bringing about a special state of consciousness."
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16
Chapter 15: Assertiveness Training
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Sample Questions
Q1) Which best describes a nurse's use of assertive behavior?
A)When a nurse attempts to please others and apologizes for awkwardness in a new role
B)When a nurse becomes defensive and angry when peers offer suggestions for improvement
C)When a nurse has problems making decisions and has a tendency to procrastinate
D)When a nurse is open and direct when asked by the nurse manager to complete assignments
Q2) An emergency department nurse, who has worked 10 straight days, is pulled to the psychiatric unit. Which represents a passive-aggressive statement by the emergency department nurse?
A)"Get someone else to work 3 to 11! I've been working 10 days straight, and I need a break!"
B)"Okay.I'll do it." Then purposefully leaves paperwork undone when leaving the unit at 11 p.m.
C)"I have worked 10 days straight, and I cannot work tonight.I will work for you tomorrow if you need me."
D)"Yes, I'll do it.Anything to keep peace with the hospital administration is a good thing."
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Page 17
Chapter 16: Promoting Self Esteem
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Sample Questions
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 47-year-old mother of two has recently undergone a radical mastectomy. She refuses to see anyone and remains isolated and withdrawn. Which of the following may be relevant nursing diagnoses for this client? (Select all that apply.)
A)Disturbed body image
B)Situational low self-esteem
C)Ineffective coping
D)Altered thought processes
E)Altered sensory perception
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18
Chapter 17: Angeraggression Management
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Sample Questions
Q1) Which client statement demonstrates improvement in terms of anger/aggression management?
A)"I realize I have a problem expressing my anger appropriately."
B)"I know I can't use physical force anymore, but I intimidate someone with my words."
C)"It's bad to feel as angry as I feel.I'm working on eliminating this poisonous emotion entirely."
D)"Because my wife seems to be the one to set me off, I've decided to remain separated from her."
Q2) A nurse is caring for four clients. Which client should the nurse identify as least prone to developing problems with anger and aggression?
A)A child raised by a physically abusive parent
B)An adult with a history of epilepsy
C)A young adult living in the ghetto of an inner city
D)An adolescent raised by Scandinavian immigrant parents
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19
Chapter 18: Intervention With a Suicidal Client
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Sample Questions
Q1) During a one-to-one session with a client, the client states, "Nothing will ever get better," and "Nobody can help me." Which nursing diagnosis is most appropriate for a nurse to assign to this client at this time?
A)Powerlessness R/T altered mood AEB client statements
B)Risk for injury R/T altered mood AEB client statements
C)Risk for suicide R/T altered mood AEB client statements
D)Hopelessness R/T altered mood AEB client statements
Q2) A nursing student is developing a plan of care for a suicidal client. Which documented intervention should the student implement first?
A)Communicate therapeutically.
B)Observe the client.
C)Provide a hazard-free environment.
D)Assess suicide risk.
Q3) Which nursing intervention strategy is most appropriate to implement initially with a suicidal client?
A)Ask a direct question such as, "Do you ever think about killing yourself?"
B)Ask client, "Please rate your mood on a scale from 1 to 10."
C)Establish a trusting nurse-client relationship.
D)Apply the nursing process to the planning of client care.
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Page 20
Chapter 19: Behavior Therapy
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Sample Questions
Q1) A client is in therapy with a nurse practitioner for the treatment of arachnophobia. The nurse practitioner decides to use the technique of "flooding." Which intervention best exemplifies this technique?
A)Giving rewards for demonstrating a decrease in fear of spiders
B)Encouraging the client to sit through the movie "Spiderman"
C)Accompanying the client to a 1-hour visit to the local zoo's spider room
D)Offering a computer program that progressively presents anxiety-producing spider scenarios
Q2) A child always chooses to ask mother over father when seeking special privileges. The father is more apt to disagree than agree with the child's requests while the mother usually consents. The child's choice is the result of which component of operant conditioning?
A)Conditioned stimuli
B)Unconditioned stimuli
C)Aversive stimuli
D)Discriminative stimuli
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Chapter 20: Cognitive Therapy
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Sample Questions
Q1) An advanced practice nurse recommends that a client participate in cognitive therapy. The client asks, "What's cognitive therapy and how can it help me?" Which is the nurse's most appropriate reply?
A)"It is a system of techniques in which you use positive thinking to improve your mood."
B)"It is a long-term interpersonal approach that emphasizes the role of early childhood experiences."
C)"It is a interpersonal treatment approach that specifically targets magical thinking."
D)"It is a type of psychotherapy that focuses treatment on the modification of distorted thinking and maladaptive behaviors."
Q2) The director of nursing (DON) sets up a meeting with the newly appointed nurse manager who, to this point, has done an excellent job. The nurse manager anticipates job termination. What is the best description of the cognitive error being employed by the nurse manager?
A)Thinking from an "all-or-nothing" perspective
B)Always thinking the worst will occur without considering positive outcomes
C)Viewing only selected negative evidence while editing out positive aspects
D)Undervaluing the positive significance of an event
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Chapter 21: Electroconvolusive Therapy
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Sample Questions
Q1) A nurse administers ordered preoperative glycopyrrolate (Robinul) 30 minutes prior to a client's electroconvulsive therapy (ECT) treatment. What is the rationale for administering this medication?
A)Robinul decreases anxiety during the ECT procedure.
B)Robinul induces an unconscious state to prevent pain during the ECT procedure.
C)Robinul prevents severe muscle contractions during the ECT procedure.
D)Robinul decreases secretions to prevent aspiration during the ECT procedure.
Q2) A chronically depressed and suicidal client is admitted to a psychiatric unit. The client is scheduled for electroconvulsive therapy (ECT). During the course of ECT treatments, a nurse should recognize the continued need for which critical intervention?
A)Suicide assessment must continue throughout the ECT course of treatment.
B)Antidepressant medications are contraindicated throughout the ECT course of treatment.
C)Discourage expressions of hopelessness throughout the ECT course of treatment.
D)Encourage high-caloric diet throughout the ECT course of treatment.
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23
Chapter 22: Complementary Therapies
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Sample Questions
Q1) A nurse understands that when a practitioner corrects subluxation by manipulating the vertebrae of the spinal column the practitioner is employing which therapy?
A)Allopathic therapy
B)Therapeutic touch therapy
C)Massage therapy
D)Chiropractic therapy
Q2) 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
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24
Chapter 23: Disorders Usually First Diagnosed in Infancy,
Childhood, or Adolescence
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Q1) An adolescent client who was diagnosed with conduct disorder at the age of 8 is sentenced to juvenile detention after bringing a gun to school. How should the nurse apply knowledge of conduct disorder to this client's situation?
A)Childhood-onset conduct disorder is more severe than the adolescent-onset type, and these individuals likely develop antisocial personality disorder in adulthood.
B)Childhood-onset conduct disorder is caused by a difficult temperament, and the child is likely to outgrow these behaviors by adulthood.
C)Childhood-onset conduct disorder is diagnosed only when behaviors emerge before the age of 5, and therefore improvement is likely.
D)Childhood-onset conduct disorder has no treatment or cure, and children diagnosed with this disorder are likely to develop progressive oppositional defiant disorder.
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Chapter 24: Delirium, Dementia, and Amnestic Disorders
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Sample Questions
Q1) A client with a history of cerebrovascular accident (CVA) is brought to an emergency department experiencing memory problems, confusion, and disorientation. Based on this client's assessment data, which diagnosis would the nurse expect the physician to assign?
A)Delirium due to adverse effects of cardiac medications
B)Vascular dementia
C)Altered thought processes
D)Alzheimer's dementia
Q2) At what time during a 24-hour period should a nurse expect clients diagnosed with Alzheimer's dementia to exhibit more pronounced symptoms?
A)When they first awaken
B)In the middle of the night
C)At twilight
D)After taking medications
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26
Chapter 25: Substance-Related Disorders
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Q1) Which is the priority nursing intervention for a client admitted for acute alcohol intoxication?
A)Darken the room to reduce stimuli in order to prevent seizures.
B)Assess aggressive behaviors in order to intervene to prevent injury to self or others.
C)Administer lorazepam (Ativan) to reduce the rebound effects on the central nervous system.
D)Teach the negative effects of alcohol on the body.
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
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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 nurse is administering risperidone (Risperdal) to a client diagnosed with schizophrenia. The therapeutic effect of this medication would most effectively address which of the following symptoms? (Select all that apply.)
A)Somatic delusions
B)Social isolation
C)Gustatory hallucinations
D)Flat affect
E)Clang associations
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28
Chapter 27: Mood Diorders: Depression
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Sample Questions
Q1) A client is admitted to the psychiatric unit with a diagnosis of major depression. The client is unable to concentrate, has no appetite, and is experiencing insomnia. Which should be included in this client's plan of care?
A)A simple, structured daily schedule with limited choices of activities
B)A daily schedule filled with activities to promote socialization
C)A flexible schedule that allows the client opportunities for decision making
D)A schedule that includes mandatory activities to decrease social isolation
Q2) What client information does a nurse need to assess prior to initiating medication therapy with phenelzine (Nardil)?
A)The client's understanding of the need for regular blood work
B)The client's mood and affect score, using the facility's mood scale
C)The client's cognitive ability to understand information about the medication
D)The client's access to a support network willing to participate in treatment
Q3) A nurse assesses a client suspected of having major depressive disorder. Which client symptom would eliminate this diagnosis?
A)The client is disheveled and malodorous.
B)The client refuses to interact with others.
C)The client is unable to feel any pleasure.
D)The client has maxed-out charge cards and exhibits promiscuous behaviors.
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Page 29
Chapter 28: Mood Disorders: Bipolar Disorder
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Q1) A nurse learns at report that a newly admitted client experiencing mania is demonstrating grandiose delusions. The nurse should recognize that which client statement would provide supportive evidence of this symptom?
A)"I can't stop my sexual urges.They have led me to numerous affairs."
B)"I'm the world's most perceptive attorney."
C)"My wife is distraught about my overspending."
D)"The FBI has tapped my room and are out to get me."
Q2) A client on an inpatient unit is diagnosed with bipolar disorder: manic phase. During a discussion in the dayroom about weekend activities, the client raises voice, becomes irritable, and insists that plans change. What should be the nurse's initial intervention?
A)Ask the group to take a vote on alternative weekend events.
B)Remind the client to quiet down or leave the dayroom.
C)Assist the client to move to a calmer location.
D)Discuss with the client impulse control problems.
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Chapter 29: Anxiety Disorders
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Sample Questions
Q1) A nursing student questions an instructor regarding the order for fluvoxamine (Luvox) 300 mg daily for a client diagnosed with obsessive-compulsive disorder (OCD). Which instructor reply is most accurate?
A)"High doses of tricyclic medications will be required for effective treatment of OCD."
B)"Selective serotonin reuptake inhibitor (SSRI) doses, in excess of what is effective for treating depression, may be required for OCD."
C)"The dose of Luvox is low due to the side effect of daytime drowsiness and nighttime insomnia."
D)"The dosage of Luvox is outside the therapeutic range and needs to be questioned."
Q2) A client is experiencing a severe panic attack. Which nursing intervention would meet this client's immediate need?
A)Teach deep breathing relaxation exercises
B)Place the client in a Trendelenburg position
C)Stay with the client and offer reassurance of safety
D)Administer the ordered prn buspirone (BuSpar)
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Chapter 30: Somatoform and Disassociative Disorders
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Sample Questions
Q1) A nursing instructor is teaching about the etiology of hypochondriasis from a psychoanalytical perspective. What student statement about clients diagnosed with this disorder indicates that learning has occurred?
A)"They express personal worthlessness through physical symptoms because physical problems are more acceptable than psychological problems."
B)"When the sick role relieves them from stressful situations, their physical symptoms are reinforced."
C)"They misinterpret and cognitively distort their physical symptoms."
D)"They tend to have a familial predisposition to this disorder."
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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Sample Questions
Q1) A nurse is counseling a client diagnosed with transgenderism. Which characteristic would differentiate this disorder from transvestic fetishism?
A)Clients diagnosed with transvestic fetishism are dissatisfied with their gender, whereas clients diagnosed with transgenderism are not.
B)Clients diagnosed with transgenderism are dissatisfied with their gender, whereas clients diagnosed with transvestic fetishism are not.
C)Clients diagnosed with transgenderism never engage in cross-dressing, whereas clients diagnosed with transvestic fetishism do.
D)Clients diagnosed with transvestic fetishism never engage in cross-dressing, whereas clients diagnosed with transgenderism do.
Q2) In the course of an assessment interview, a female client reveals a history of bisexual orientation. Which action should the nurse initially implement when working with this client?
A)Self-assess personal attitudes toward homosexuality.
B)Review client's possible childhood sexual abuse history.
C)Encourage discussion of aversion to heterosexual relationships.
D)Explore client's family history of homosexuality.
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Page 33
Chapter 32: Eating Disorders
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Sample Questions
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 nurse is seeing a client in an outpatient clinic for treatment of anorexia nervosa. Which is the most appropriate, correctly written short-term outcome for this client?
A)The client will use stress-reducing techniques to avoid purging.
B)The client will discuss chaos in personal life and be able to verbalize a link to purging.
C)The client will gain 2 pounds prior to the next weekly appointment.
D)The client will remain free of signs and symptoms of malnutrition and dehydration.
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34
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 client is diagnosed with intermittent explosive disorder. The clinic nurse should anticipate teaching about which medication?
A)Citalopram (Celexa)
B)Risperidone (Risperdal)
C)Fluvoxamine (Luvox)
D)Isocarboxazid (Marplan)
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Chapter 34: Personality Disorders
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Q1) A nurse would expect a client diagnosed with schizotypal personality disorder to exhibit which characteristic?
A)The client keeps to self and has few, if any relationships.
B)The client has many brief but intense relationships.
C)The client experiences incorrect interpretations of external events.
D)The client exhibits lack of tender feelings toward others.
Q2) During an interview, which client statement indicates to a nurse that a potential diagnosis of schizotypal personality disorder should be considered?
A)"I really don't have a problem.My family is inflexible, and every relative is out to get me."
B)"I am so excited about working with you.Have you noticed my new nail polish: 'Ruby Red Roses'?"
C)"I spend all my time tending my bees.I know a whole lot of information about bees."
D)"I am getting a message from the beyond that we have been involved with each other in a previous life."
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Chapter 35: The Aging Individual
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Q1) An elderly client has met the criteria for a diagnosis of major depressive disorder. The client does not respond to antidepressant medications. Which treatment should a nurse anticipate that the physician would prescribe for this client?
A)Electroconvulsive therapy (ECT)
B)Neuroleptic therapy
C)An antiparkinsonian agent
D)An anxiolytic agent
Q2) A client diagnosed with middle-stage Alzheimer's dementia has difficulty communicating because of cognitive deterioration. Which nursing intervention is appropriate to improve communication?
A)Discourage attempts at verbal communication due to increased client frustration.
B)Increase the volume of the nurse's communication responses.
C)Verbalize the nurse's perception of the implied communication.
D)Encourage the client to communicate by writing.
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Chapter 36: Victims of Abuse or Neglect
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Q1) A nursing student asks an emergency department nurse, "Why does a rapist use a weapon during the act of rape?" Which nursing reply is most accurate?
A)"A weapon is used to increase the victimizer's security."
B)"A weapon is used to inflict physical harm."
C)"A weapon is used to terrorize and subdue the victim."
D)"A weapon is used to mirror learned family behavior patterns."
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) A client who has been raped is crying, pacing, and cursing her attacker in an emergency department. Which behavioral defense should a nurse recognize?
A)Controlled response pattern
B)Compounded rape reaction
C)Expressed response pattern
D)Silent rape reaction
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Chapter 37: Community Mental Health Nursing
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Sample Questions
Q1) A nursing instructor is teaching students about the differences between partial and inpatient hospitalization. In what way does partial hospitalization differ from traditional inpatient hospitalization?
A)Partial hospitalization does not provide medication administration and monitoring.
B)Partial hospitalization does not use an interdisciplinary team.
C)Partial hospitalization does not offer a comprehensive treatment plan.
D)Partial hospitalization does not provide supervision 24 hours a day.
Q2) A nursing instructor is teaching about case management. What student statement indicates that learning has occurred?
A)"Case management is a method used to achieve independent client care."
B)"Case management provides coordination of services required to meet client needs."
C)"Case management exists to facilitate client admission to needed inpatient services."
D)"Case management is a method to facilitate physician reimbursement."
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Chapter 38: Forensic Nursing
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Sample Questions
Q1) 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
Q2) A prison nurse is reviewing an inmate's health record. Which documentation on Axis I would indicate a dual diagnosis?
A)Bipolar II and antisocial personality disorder
B)Schizophrenia and alcohol dependence
C)Attention deficit disorder and conduct disorder
D)Cocaine addiction and marijuana abuse
Q3) A rape victim is concerned about becoming pregnant. Which is the most appropriate intervention by the nurse practitioner?
A)Refer the client to an abortion clinic.
B)Refer the client to a spiritual counselor.
C)Offer ethinyl estradiol/norgestrel (Ovral).
D)Instruct the client to douche daily for 1 week.
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Page 40
Chapter 39: The Bereaved Individual
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Q1) A nurse is caring for an Irish client who has recently lost a spouse. The client states to the nurse, "I'm planning an elaborate wake and funeral." According to George Engel, what purpose would these rituals serve?
A)To delay the recovery process initiated by the loss of the client's spouse
B)To facilitate the acceptance of the loss of the client's spouse
C)To avoid dealing with grief associated with the loss of the client's spouse
D)To eliminate emotional pain related to the loss of the client's spouse
Q2) A nurse is leading a bereavement group. Which of the following group members should the nurse identify as being at high risk for complicated grieving? (Select all that apply.)
A)A widower who has recently experienced the death of two good friends
B)A man whose wife died suddenly after a cerebrovascular accident
C)A widow who, after a year, allowed removal of life support from her terminally ill husband
D)A woman who had a competitive relationship with her recently deceased brother
E)A young couple whose child recently died of a genetic disorder
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