Foundations of Psychiatric Nursing Exam Review
Course Introduction
Foundations of Psychiatric Nursing introduces students to the core concepts and principles underlying mental health nursing. The course explores the biological, psychological, and social factors influencing mental health and illness, emphasizes the therapeutic nurse-patient relationship, and examines common psychiatric disorders across the lifespan. Students learn effective communication skills, assessment techniques, and evidence-based interventions, along with ethical and legal considerations in psychiatric care. Through theoretical learning and practical case studies, the course prepares students to provide holistic, compassionate, and culturally sensitive care for individuals experiencing mental health challenges.
Recommended Textbook
Psychiatric Mental Health Nursing Concepts of Care in Evidence Based Practice 7th Edition by Mary
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857 Flashcards
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Page 2
Chapter 1: The Concept of Stress Adaptation
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Sample Questions
Q1) A distraught, single, first-time mother cries and says to a nurse, "How can I go to work if I can't afford childcare!" What is the nurse's initial action in assisting the client with the problem-solving process?
A)Determine the risks and benefits for each alternative
B)Formulate goals for resolution of the problem
C)Evaluate the outcome of the implemented alternative
D)Assess the facts of the situation
Answer: D
Q2) Which symptom should a nurse identify as typical of the "fight-or-flight" response?
A)Pupil constriction
B)Increased heart rate
C)Increased salivation
D)Increased peristalsis
Answer: B
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Chapter 2: Mental Healthmental Illness: Historical and Theoretical Concepts
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Q1) Devastated by a divorce from an abusive husband, a wife completes grief counseling. Which statement by the wife should indicate to a nurse that the client is in the acceptance stage of grief?
A)"If only we could have tried again, things might have worked out."
B)"I am so mad that the children and I had to put up with him as long as we did."
C)"Yes, it was a difficult relationship, but I think I have learned from the experience."
D)"I still don't have any appetite and continue to lose weight."
Answer: C
Q2) Which is an example of the ego defense mechanism of regression?
A)A mother blames the teacher for her child's failure in school.
B)A teenager becomes hysterical after seeing a friend killed in a car accident.
C)A woman wants to marry a man exactly like her beloved father.
D)An adult throws a temper tantrum when he does not get his own way.
Answer: D
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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 married, 26-year-old client works as a schoolteacher. She and her husband have just had their first child. A nurse should recognize that this client is successfully accomplishing which stage of Erikson's developmental theory?
A)Industry versus inferiority
B)Identity versus role confusion
C)Intimacy versus isolation
D)Generativity versus stagnation
Answer: C
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Chapter 4: Concepts of Psychobiology
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Q1) 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
Q2) Which client diagnosis should a nurse associate with a decrease in gamma-aminobutyric acid (GABA)?
A)Alzheimer's disease
B)Schizophrenia
C)Panic disorder
D)Depression
Q3) A nurse should recognize that a decrease in norepinephrine levels would play a significant role in which mental illness?
A)Mania
B)Schizophrenia
C)Anxiety
D)Depression
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Chapter 5: Ethical and Legal Issues in Psychiatricmental
Health Nursing
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Q1) Which statement should a nurse identify as correct regarding a client's right to refuse treatment?
A)Clients can refuse pharmacological but not psychological treatment.
B)Clients can refuse any treatment at any time.
C)Clients can refuse only electroconvulsive therapy (ECT).
D)Professionals can override treatment refusal if the client is actively suicidal or homicidal.
Q2) After disturbing the peace, an aggressive, disoriented, unkempt, homeless individual is escorted to an emergency department by police. The client threatens suicide. Which criteria would enable a physician to consider involuntary commitment? (Select all that apply.)
A)Being dangerous to others
B)Being homeless
C)Being disruptive to the community
D)Being gravely disabled and unable to meet basic needs
E)Being suicidal
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Chapter 6: Cultural and Spiritual Concepts Relevant to Psychiatricmental Health Nursing
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Q1) A female nurse is caring for an Arab American male client. When planning effective care for this client, the nurse should be aware of which of the following cultural considerations? (Select all that apply.)
A)Limited touch is acceptable only between members of the same sex.
B)Conversing individuals of this culture stand far apart and do not make eye contact.
C)Devout Muslim men may not shake hands with women.
D)The man is the head of the household and women take on a subordinate role.
E)Men of this culture are responsible for the education of their children.
Q2) Which cultural considerations should a nurse identify with Western European Americans?
A)They are present-time oriented and perceive the future as God's will.
B)They value youth, and older adults are commonly placed in nursing homes.
C)They are at high risk for alcoholism due to a genetic predisposition.
D)They are future oriented and practice preventive health care.
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8
Chapter 7: Relationship Development
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Q1) Which client statement indicates that termination of the therapeutic nurse-client relationship has been handled successfully?
A)"I know I can count on you for continued support."
B)"I am looking forward to discharge, but I am surprised that we will no longer work together."
C)"Reviewing the changes that have happened during our time together has helped me put things in perspective."
D)"I don't know how comfortable I will feel when talking to someone else."
Q2) A nurse moving out of state speaks to a client about the need to work with a new nurse. The client states, "You're the only one who can make me well." What does this client response indicate to the nurse?
A)The client is using manipulation to receive secondary gain.
B)The client is using the defense mechanism of denial.
C)The client is having trouble terminating the relationship.
D)The client is using "splitting" as a way to remain dependent on the nurse.
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Chapter 8: Therapeutic Communication
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Sample Questions
Q1) A nurse states to a client, "Things will look better tomorrow after a good night's sleep." This is an example of which communication technique?
A)The therapeutic technique of "giving advice"
B)The therapeutic technique of "defending"
C)The nontherapeutic technique of "presenting reality"
D)The nontherapeutic technique of "giving false reassurance"
Q2) Which nursing statement is a good example of the therapeutic communication technique of offering self?
A)"I think it would be great if you talked about that problem during our next group session."
B)"Would you like me to accompany you to your electroconvulsive therapy treatment?"
C)"I notice that you are offering help to other peers in the milieu."
D)"After discharge, would you like to meet me for lunch to review your outpatient progress?"
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Chapter 9: The Nursing Process in Psychiatricmental Health
Nursing
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Q1) After a comprehensive assessment, correctly written nursing diagnoses developed for psychiatric clients may include which of the following components? (Select all that apply.)
A)Medical judgments related to the psychiatric disorder
B)Unmet client needs present at the moment
C)Supporting data that validate the diagnosis
D)Outcomes that will be targets for nursing interventions
E)Statements of client problems of a functional nature
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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Chapter 10: Therapeutic Groups
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Q1) Which of the following behavioral skills should a nurse implement when leading a group that is functioning in the orientation phase of group development? (Select all that apply.)
A)Encouraging members to provide feedback to each other about individual progress
B)Ensuring that group rules do not interfere with goal fulfillment
C)Working with group members to establish rules that will govern the group
D)Emphasizing the need for and importance of confidentiality within the group
E)Helping the members to resolve conflicts and foster cohesiveness within the group
Q2) 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
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Chapter 11: Intervention With Families
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Sample Questions
Q1) A fatherless, 11-year-old African American girl lives with her grandmother after the death of her mother. Her older stepbrother is very involved in her life. How should the community health nurse view this family constellation, and why?
A)Abnormal; the grandmother should be concerned with issues other than childrearing.
B)Abnormal; a two-parent household is the most advantageous arrangement for parenting.
C)Normal; cultural variations exist in the family life cycle.
D)Normal; because of their wisdom, older adults make better parenting figures.
Q2) A nursing instructor is teaching about the importance of healthy family member expectations for newly blended families. Which student statement indicates a need for further instruction?
A)"Healthy family member expectations should be flexible."
B)"Healthy family member expectations should be conforming."
C)"Healthy family member expectations should be individual."
D)"Healthy family member expectations should be realistic."
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Chapter 12: Milieu Therapy - the Therapeutic Community
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Q1) A client has undergone psychological testing. With which member of the interdisciplinary team should a nurse collaborate to review these results?
A)The psychiatrist
B)The psychiatric social worker
C)The clinical psychologist
D)The clinical nurse specialist
Q2) 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.
Q3) What is the best rationale for including the client's family in therapy within the inpatient milieu?
A)To structure a program of social and work-related activities
B)To facilitate discharge from the hospital
C)To provide a concrete demonstration of caring
D)To encourage the family to model positive behaviors
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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) Which of the following are effective interventions that a nurse should utilize when caring for an inpatient client who expresses anger inappropriately? (Select all that apply.)
A)Maintain a calm demeanor.
B)Clearly delineate the consequences of the behavior.
C)Use therapeutic touch to convey empathy.
D)Set limits on the behavior.
E)Teach the client to avoid "I" statements related to expression of feelings.
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15
Chapter 14: Relaxation Therapy
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Sample Questions
Q1) 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
Q2) A client diagnosed with major depressive disorder refuses to get out of bed. Which nursing statement appropriately educates the client about the benefits of physical activity?
A)"Depression is caused by the lack of certain brain chemicals that can increase with exercise."
B)"Physical activity is good for everyone regardless of their diagnosis."
C)"Low-intensity exercise is more beneficial than high-impact exercise."
D)"When you are physically active, it helps to lower your beta endorphins."
Q3) 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
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Page 16
Chapter 15: Assertiveness Training
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Sample Questions
Q1) A teenager gets a "C" in algebra. The mother angrily states, "All you ever do is listen to music and text your friends." The teenager replies, "What is it that you're really upset about mom?" Which response pattern is the teenager expressing?
A)Clouding and fogging
B)Shifting from content to process
C)Delaying assertively
D)Assuming responsibility for one's own statements
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 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
Q2) Based on Erikson's psychosocial developmental stages, what way should a nurse expect a school-aged child to most likely gain positive self-esteem?
A)Through basic need fulfillment and environmental predictability
B)Through exploration and experimentation resulting in self-confidence in ability to perform
C)Through positive reinforcement of creativity and recognition of performance
D)Through receiving recognition when learning, competing, and performing successfully
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Chapter 17: Angeraggression Management
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Sample Questions
Q1) On an inpatient psychiatric unit, a restrained 16-year-old client continues to verbally lash out, and threatens to abuse staff and kill self when released. To meet Joint Commission standards, at what time should a nurse expect the physician to renew the client's restraint order?
A)Within 1 hour of the original restraint order
B)Within 2 hours of the original restraint order
C)Within 3 hours of the original restraint order
D)Within 4 hours of the original restraint order
Q2) 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.
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) A new nursing graduate asks the psychiatric nurse manager how to best classify suicide. Which is the nurse manager's best reply?
A)"Suicide is a DSM-IV-TR diagnosis."
B)"Suicide is a mental disorder."
C)"Suicide is a behavior."
D)"Suicide is an antisocial affliction."
Q2) 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.
Q3) Which client data indicate that a suicidal client is participating in a plan for safety?
A)Compliance with antidepressant therapy
B)A mood rating of 9/10
C)Disclosing a plan for suicide to staff
D)Expressing feelings of hopelessness to nurse
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Chapter 19: Behavior Therapy
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Q1) A client is diagnosed with an anxiety disorder. The nurse counselor recommends intervention with the behavioral technique of reciprocal inhibition. The client asks, "What's that?" Which is the most appropriate nursing reply?
A)"At the beginning of this intervention, a contract will be drawn up explicitly stating the behavior change agreed upon."
B)"By introducing an adaptive behavior that is mutually exclusive to your maladaptive behavior, we will expect subsequent behavior to improve."
C)"Through a series of increasingly anxiety-provoking steps, we will gradually increase your tolerance to anxiety."
D)"In one intense session, you will be exposed to a maximum level of anxiety that you will learn to tolerate."
Q2) 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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Chapter 20: Cognitive Therapy
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Q1) A successful business executive continually thinks that job accomplishments are not adequate. A nurse recognizes that the client's thinking is reflective of which cognitive error?
A)Minimization
B)Dichotomous thinking
C)Arbitrary inference
D)Personalization
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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Page 22
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) 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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Page 23
Chapter 22: Complementary Therapies
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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) A client inquires about the practice of therapeutic touch. Which nursing reply best explains the goal of this therapy?
A)"The goal is to improve circulation to the body by deep, circular massage."
B)"The goal is to re-pattern the body's energy field by the use of rhythmic hand motions."
C)"The goal is to improve breathing by increasing oxygen to the brain and body tissues."
D)"The goal is to decrease blood pressure by body toxin release."
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24
Chapter 23: Disorders Usually First Diagnosed in Infancy,
Childhood, or Adolescence
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Q1) A child diagnosed with attention deficit-hyperactivity disorder (ADHD) is having difficulty completing homework assignments. What information should the nurse include when teaching the parents about task performance improvement?
A)The parents should isolate the child when completing homework to improve focus.
B)The parents should withhold privileges if homework is not completed within a 2-hour period.
C)The parents should divide the homework task into smaller steps and provide an activity break.
D)The parents should administer an extra dose of methylphenidate (Ritalin) prior to homework.
Q2) A child has been recently diagnosed with mild mental retardation (MR). What information about this diagnosis should the nurse include when teaching the child's mother?
A)Children with mild MR need constant supervision.
B)Children with mild MR develop academic skills up to a sixth-grade level.
C)Children with mild MR appear different from their peers.
D)Children with mild MR have significant sensory-motor impairment.
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Page 25
Chapter 24: Delirium, Dementia, and Amnestic Disorders
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Q1) A client diagnosed with dementia is disoriented, ataxic, and wanders. Which is the priority nursing diagnosis?
A)Disturbed thought processes
B)Self-care deficit
C)Risk for injury
D)Altered health-care maintenance
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
Q3) A client diagnosed with Alzheimer's dementia has impairments of memory and judgment and is incapable of performing activities of daily living. Which nursing intervention should take priority?
A)Present evidence of objective reality to improve cognition
B)Design a bulletin board to represent the current season
C)Label the client's room with name and number
D)Assist with bathing and toileting
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26
Chapter 25: Substance-Related Disorders
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Q1) A client diagnosed with depression and substance abuse has an altered sleep pattern and demands that a psychiatrist prescribe a sedative. Which rationale explains why a nurse should encourage the client to first try nonpharmacological interventions?
A)Sedative-hypnotics are potentially addictive and will lose their effectiveness due to tolerance.
B)Sedative-hypnotics are expensive and have numerous side effects.
C)Sedative-hypnotics interfere with necessary REM (rapid eye movement) sleep.
D)Sedative-hypnotics are not as effective to promote sleep as antidepressant medications.
Q2) A client with a history of insomnia has been taking chlordiazepoxide (Librium) 15 mg at night for the past year. The client currently reports getting to sleep. Which nursing diagnosis appropriately documents this problem?
A)Ineffective coping R/T unresolved anxiety AEB substance abuse
B)Anxiety R/T poor sleep AEB difficulty falling asleep
C)Disturbed sleep pattern R/T Librium tolerance AEB difficulty falling asleep
D)Risk for injury R/T addiction to Librium
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Chapter 26: Schizophrenia and Other Psychotic Disorders
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Q1) A client diagnosed with schizophrenia tells a nurse, "The 'Shopatouliens' took my shoes out of my room last night." Which is an appropriate charting entry to describe this client's statement?
A)"The client is experiencing command hallucinations."
B)"The client is expressing a neologism."
C)"The client is experiencing a paranoid delusion."
D)"The client is verbalizing a word salad."
Q2) A college student has quit attending classes, isolates self due to hearing voices, and yells accusations at fellow students. Based on this information, which nursing diagnosis should the nurse prioritize?
A)Altered thought processes R/T hearing voices AEB increased anxiety
B)Risk for other-directed violence R/T yelling accusations
C)Social isolation R/T paranoia AEB absence from classes
D)Risk for self-directed violence R/T depressed mood
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Chapter 27: Mood Diorders: Depression
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Q1) The nurse is providing counseling to clients diagnosed with major depressive disorder. The nurse chooses to assess and attempt to modify the negative thought patterns of these clients. The nurse is functioning under which theoretical framework?
A)Psychoanalytic theory
B)Interpersonal theory
C)Cognitive theory
D)Behavioral theory
Q2) 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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29
Chapter 28: Mood Disorders: Bipolar Disorder
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Q1) A client is diagnosed with bipolar disorder: manic phase. Which nursing intervention would be implemented to achieve the outcome of "Client will gain 2 lbs by the end of the week?"
A)Provide client with high-calorie finger foods throughout the day.
B)Accompany client to cafeteria to encourage adequate dietary consumption.
C)Initiate total parenteral nutrition to meet dietary needs.
D)Teach the importance of a varied diet to meet nutritional needs.
Q2) A newly admitted client is experiencing the manic phase of bipolar I disorder. The nurse should assign which priority nursing diagnosis to this client?
A)Ineffective individual coping R/T hospitalization AEB alcohol abuse
B)Altered nutrition: less than body requirements R/T mania AEB 10 lb weight loss
C)Risk for violence: directed toward others R/T agitation and hyperactivity
D)Sleep pattern disturbance R/T flight of ideas AEB sleeps 1 to 2 hours per night
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Chapter 29: Anxiety Disorders
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Sample Questions
Q1) How should a nurse best describe the major maladaptive client response to panic disorder?
A)Clients overuse medical care due to physical symptoms.
B)Clients use illegal drugs to ease symptoms.
C)Clients perceive having no control over life situations.
D)Clients develop compulsions to deal with anxiety.
Q2) Which treatment should a nurse identify as most appropriate for clients diagnosed with generalized anxiety disorder (GAD)?
A)Long-term treatment with diazepam (Valium)
B)Acute symptom control with citalopram (Celexa)
C)Long-term treatment with buspirone (BuSpar)
D)Acute symptom control with ziprasidone (Geodon)
Q3) A college student is unable to take a final examination due to severe test anxiety. Instead of studying, the student relieves stress by attending a movie. Which priority nursing diagnosis should a campus nurse assign for this client?
A)Noncompliance R/T test taking
B)Ineffective role performance R/T helplessness
C)Altered coping R/T anxiety
D)Powerlessness R/T fear
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Page 31
Chapter 30: Somatoform and Disassociative Disorders
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Q1) A client diagnosed with dissociative identity disorder (DID) switches personalities when confronted with destructive behavior. The nurse recognizes that this dissociation serves which function?
A)It is a means to attain secondary gain.
B)It is a means to explore feelings of excessive and inappropriate guilt.
C)It serves to isolate painful events so that the primary self is protected.
D)It serves to establish personality boundaries and limit inappropriate impulses.
Q2) Which symptom exhibited by a client diagnosed with a conversion disorder would predict the poorest prognosis?
A)Seizures
B)Blindness
C)Aphonia
D)Paralysis
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Chapter 31: Issues Related to Human Sexuality and Gender
Identity
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Sample Questions
Q1) 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.
Q2) A nursing instructor is teaching about the various categories of paraphilia. Which of the following categories are correctly matched with expected behaviors? (Select all that apply.)
A)Exhibitionism: Mary models lingerie for a company that specializes in home parties.
B)Voyeurism: John is arrested for peering in a neighbor's bathroom window.
C)Frotteurism: Peter enjoys subway rush-hour female contact that results in arousal.
D)Pedophilia: George can experience an orgasm by holding and feeling shoes.
E)Fetishism: Henry masturbates into his wife's silk panties.
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Chapter 32: Eating Disorders
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Sample Questions
Q1) A morbidly obese client is prescribed an anorexiant medication. The nurse should prepare to teach the client about which medication?
A)Diazepam (Valium)
B)Dexfenfluramine (Redux)
C)Sibutramine (Meridia)
D)Pemoline (Cylert)
Q2) The family of a client diagnosed with anorexia nervosa becomes defensive when the treatment team calls for a family meeting. Which is the appropriate nursing reply?
A)"Tell me why this family meeting is causing you to be defensive.All clients are required to participate in two family sessions."
B)"Eating disorders have been correlated to certain familial patterns; without addressing these, your child's condition will not improve."
C)"Family dynamics are not linked to eating disorders.The meeting is to provide your child with family support."
D)"Clients diagnosed with anorexia nervosa are part of the family system, and any alteration in family processes needs to be addressed."
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Chapter 33: Adjustment and Impulse Control Disorders
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Q1) After a spouse dies, a client is diagnosed with adjustment disorder with depressed mood. Client symptoms include chronic migraines, feelings of hopelessness, social isolation, and self-care deficit. Which outcome would be most appropriate to direct the focus of this client's care?
A)The client will not cope with stress by impulsive behaviors by discharge.
B)The client will accomplish activities of daily living independently by discharge.
C)The client will be able to cope effectively by delaying gratification by discharge.
D)The client will verbalize a positive body image by discharge.
Q2) A 20-year-old client and a 60-year-old client have had drunk driving accidents and are both experiencing extreme anxiety. From a psychosocial theory perspective, which of these clients would be predisposed to the diagnosis of adjustment disorder?
A)The 60-year-old because of memory deficits
B)The 60-year-old because of decreased cognitive processing ability
C)The 20-year-old because of limited cognitive experiences
D)The 20-year-old because of lack of developmental maturity
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Chapter 34: Personality Disorders
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Sample Questions
Q1) From a behavioral perspective, which nursing intervention is most appropriate when caring for a client diagnosed with borderline personality disorder?
A)Seclude the client when inappropriate behaviors are exhibited.
B)Contract with the client to reinforce positive behaviors with unit privileges.
C)Teach the purpose of antianxiety medications to improve medication compliance.
D)Encourage the client to journal feelings to improve awareness of abandonment issues.
Q2) 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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Sample Questions
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) An elderly, emaciated client is brought to an emergency department by the client's caregiver. The client has bruises and abrasions on shoulders and back in multiple stages of healing. When directly asked about these symptoms, which type of client response should a nurse anticipate?
A)The client will honestly reveal the nature of the injuries.
B)The client may deny or minimize the injuries.
C)The client may have forgotten what caused the injuries.
D)The client will ask to be placed in a nursing home.
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Chapter 36: Victims of Abuse or Neglect
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Sample Questions
Q1) A kindergarten student is frequently violent toward other children. A school nurse notices bruises and burns on the child's face and arms. What other symptom should indicate to the nurse that the child might have been physically abused?
A)The child shrinks at the approach of adults.
B)The child begs or steals food or money.
C)The child is frequently absent from school.
D)The child is delayed in physical and emotional development.
Q2) A college student was sexually assaulted when out on a date. After several weeks of crisis intervention therapy, which client statement should indicate to a nurse that the student is handling this situation in a healthy manner?
A)"I know that it was not my fault."
B)"My boyfriend has trouble controlling his sexual urges."
C)"If I don't put myself in a dating situation, I won't be at risk."
D)"Next time I will think twice about wearing a sexy dress."
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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) Which nursing statement best describes the current nature of mental health care in the community?
A)"All homeless people have a history of institutionalization and are frequently admitted to acute care settings."
B)"In the United States, the rate of serious mental illness in the prison population is the same as the general population."
C)"The deinstitutionalization movement in the United States was successful in transitioning clients into the community."
D)"Today, the majority of clients admitted to psychiatric hospitals are in a crisis stage, and the treatment goal is stabilization."
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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 prison nurse overhears an inmate state, "Hey man, can I catch a ride?" How should the nurse interpret this prison slang?
A)The inmate wants to get high and asks a friend to provide drugs.
B)The inmate wants to elope and asks a friend to provide transportation.
C)The inmate wants to play basketball and needs a friend for the team.
D)The inmate wants to bum a cigarette.
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Page 40
Chapter 39: The Bereaved Individual
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Q1) Which grieving behaviors should a nurse anticipate when caring for a Southwest Navajo Indian client?
A)Celebrating the life of a deceased person with festivities and revelry
B)Not expressing grief openly with reluctance to touch a dead body
C)Holding a prayerful vigil for a week following the person's death
D)Expressing grief openly and publicly and erecting an altar in the home to honor the dead
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
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