Mental Health Nursing Exam
Answer Key
Course Introduction
Mental Health Nursing focuses on the principles and practices of caring for individuals experiencing mental health conditions across the lifespan. The course covers the assessment, planning, implementation, and evaluation of nursing care for clients with psychiatric disorders, emphasizing therapeutic communication, crisis intervention, and culturally sensitive approaches. Students learn about common mental illnesses, pharmacological and non-pharmacological interventions, legal and ethical considerations, and strategies to support families and communities. The course prepares future nurses to advocate for mental health awareness, reduce stigma, and deliver holistic, person-centered care in diverse healthcare settings.
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 nurse is working with a client who has recently been under a great deal of stress. Which nursing recommendations would be most helpful when assisting the client in coping with stress? (Select all that apply.)
A)"Enjoy a pet."
B)"Spend time with a loved one."
C)"Listen to music."
D)"Focus on the stressors."
E)"Journal your feelings."
Answer: A, B, C, E
Q2) A nurse is evaluating a client's response to stress. What would indicate to the nurse that the client is experiencing a secondary appraisal of the stressful event?
A)When the individual judges the event to be benign
B)When the individual judges the event to be irrelevant
C)When the individual judges the resources and skills needed to deal with the event
D)When the individual judges the event to be pleasurable
Answer: C
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Chapter 2: Mental Healthmental Illness: Historical and Theoretical Concepts
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Q1) Which should the nurse recognize as an example of the defense mechanism of repression?
A)A student aware of the need to study for tomorrow's test goes to a movie instead.
B)A woman whose son was killed in Iraq does not believe the military report.
C)A man who is unhappily married goes to school to become a marriage counselor.
D)A woman was raped when she was 12 and no longer remembers the incident.
Answer: D
Q2) How is the DSM-IV-TR useful in the practice of psychiatric nursing? (Select all that apply.)
A)It considers level of functioning as well as problems.
B)It represents progress toward a more holistic view of mind-body.
C)It provides a framework for interdisciplinary communication.
D)It provides a template for nursing care plans.
E)It provides a framework for communication with the client.
Answer: A, B, C
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Page 4
Chapter 3: Theoretical Models of Personality Development
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Sample Questions
Q1) A nursing instructor is teaching about the application of Peplau's theory to nursing care. Which student statement indicates that learning has occurred?
A)"The nurse assumes the role of a parenting figure instructing the client in good health practices."
B)"The nurse is concerned more about psychosocial functioning than physiological functioning."
C)"The nurse bases the client care plan on standardized nursing approaches and physician orders."
D)"The nurse applies principles of human relations to the problems that arise at all levels of experience."
Answer: D
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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Chapter 4: Concepts of Psychobiology
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Q1) 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
Q2) 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
Q3) 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
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Chapter 5: Ethical and Legal Issues in Psychiatricmental
Health Nursing
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Q1) A client diagnosed with schizophrenia receives fluphenazine decanoate (Prolixin Decanoate) from a home health nurse. The client refuses medication at one regularly scheduled home visit. Which nursing intervention is ethically appropriate?
A)Allow the client to decline the medication and document.
B)Tell the client that if the medication is refused, hospitalization will occur.
C)Arrange with a relative to add medication to the client's morning orange juice.
D)Call for help to hold the client down while the injection is administered.
Q2) The nursing staff is discussing the concept of competency. Which information about competency should a nurse recognize as true?
A)Competency is determined with a client's compliance with treatment.
B)Refusal of medication can initiate an incompetency hearing leading to forced medications.
C)A competent client has the ability to make reasonable judgments and decisions.
D)Competency is a medical determination made by the client's physician.
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Chapter 6: Cultural and Spiritual Concepts Relevant to Psychiatricmental Health Nursing
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Q1) A Native American client is admitted to an emergency department (ED) with an ulcerated toe secondary to uncontrolled diabetes mellitus. The client refuses to talk to a physician unless a shaman is present. Which nursing intervention is most appropriate?
A)Try to locate a shaman that will agree to come to the ED.
B)Explain to the client that "voodoo" medicine will not heal the ulcerated toe.
C)Ask the client to explain what the shaman can do that the physician cannot.
D)Inform the client that refusing treatment is a client's right.
Q2) A Latin American man refuses to acknowledge responsibility for hitting his wife, stating instead, "It's the man's job to keep his wife in line." Which cultural belief should a nurse associate with this client's behavior?
A)Families are male dominated with clear male-female role distinctions.
B)Religious tenets support the use of violence in a marital context.
C)The nuclear family is female dominated and the mother possesses ultimate authority.
D)Marriage dynamics are controlled by dominant females in the family.
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Chapter 7: Relationship Development
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Q1) A client has made the decision to leave her alcoholic husband. She is feeling very depressed. Which nontherapeutic statement by the nurse conveys sympathy?
A)"You are feeling very depressed.I felt the same way when I decided to leave my husband."
B)"I can understand you are feeling depressed.It was a difficult decision.I'll sit with you."
C)"You seem depressed.It was a difficult decision to make.Would you like to talk about it?"
D)"I know this is a difficult time for you.Would you like a prn medication for anxiety?"
Q2) Which client statement should a nurse identify as a typical response to stress most often experienced in the working phase of the nurse-client relationship?
A)"I can't bear the thought of leaving here and failing."
B)"I might have a hard time working with you.You remind me of my mother."
C)"I really don't want to talk any more about my childhood abuse."
D)"I'm not sure that I can count on you to protect my confidentiality."
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9
Chapter 8: Therapeutic Communication
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Sample Questions
Q1) A nurse maintains an uncrossed arm and leg posture. This nonverbal behavior is reflective of which letter of the SOLER acronym for active listening? A)S
B)O
C)L
D)E
E)R
Q2) A mother rescues two of her four children from a house fire. In the emergency department, she cries, "I should have gone back in to get them. I should have died, not them." What is the nurse's best response?
A)"The smoke was too thick.You couldn't have gone back in."
B)"You're feeling guilty because you weren't able to save your children."
C)"Focus on the fact that you could have lost all four of your children."
D)"It's best if you try not to think about what happened.Try to move on."
Q3) What is the purpose of a nurse providing appropriate feedback?
A)To give the client good advice
B)To advise the client on appropriate behaviors
C)To evaluate the client's behavior
D)To give the client critical information
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Page 10
Chapter 9: The Nursing Process in Psychiatricmental Health
Nursing
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Q1) During the implementation phase of the nursing process, a nurse is teaching an adult with a cochlear implant about medications. Which modification in the teaching plan would be the most appropriate for this client?
A)Using repetition
B)Speaking directly face-to-face
C)Employing the use of sign language
D)Providing large-print materials
Q2) Which of the following characteristics of accurately developed client outcomes should a nurse identify? (Select all that apply.)
A)Client outcomes are specifically formulated by nurses.
B)Client outcomes are not restricted by time frames.
C)Client outcomes are specific and measurable.
D)Client outcomes are realistically based on client capability.
E)Client outcomes are formally approved by the psychiatrist.
Q3) Which nursing diagnosis should a nurse identify as being correctly formulated?
A)Schizophrenia R/T biochemical alterations AEB altered thought
B)Self-care deficit: hygiene R/T altered thought as AEB disheveled appearance
C)Depressed mood R/T multiple life stressors
D)Developmental disability R/T early-onset schizophrenia AEB hallucinations
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Chapter 10: Therapeutic Groups
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Q1) During a group discussion, members freely interact with each other. Which member statement is an example of Yalom's curative group factor of imparting information?
A)"I found a Web site explaining the different types of brain tumors and their treatment."
B)"My brother also had a brain tumor and now is completely cured."
C)"I understand your fear and will be by your side during this time."
D)"My mother was also diagnosed with cancer of the brain."
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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12
Chapter 11: Intervention With Families
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Q1) A client is angry because her husband has forgotten their anniversary. The following week, the client is still unwilling to discuss this with her husband because she is afraid she will lose control. How should the nurse interpret this client's means of coping with anger?
A)Coping by attacking
B)Coping by surrendering
C)Coping by avoiding
D)Coping by belittling
Q2) Which task should the nurse recognize as appropriate to stage IV of the family life cycle?
A)Making adjustments within the marital system to meet the responsibilities of parenthood
B)Establishing a new identity as a couple by realigning relationships with extended family
C)Redefining the level of dependence so that adolescents are provided with greater autonomy
D)Reestablishing the bond of the dyadic marital relationship
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Chapter 12: Milieu Therapy - the Therapeutic Community
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Sample Questions
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) 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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Chapter 13: Crisis Intervention
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Sample Questions
Q1) An inpatient client with a known history of violence suddenly begins to pace. Which client behavior should alert a nurse to escalating anger and aggression?
A)The client requests prn medications.
B)The client has a tense facial expression and body language.
C)The client refuses to eat lunch.
D)The client sits in group therapy with back to peers.
Q2) What is the best nursing rationale for holding a debriefing session with clients and staff after clients have witnessed a peer being "taken-down" after a violent outburst?
A)To reinforce unit rules with the client population
B)To create protocols for the future release of tensions associated with anger
C)To process feelings and concerns related to the witnessed intervention
D)To discuss the client problems that led to inappropriate expressions of anger
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15
Chapter 14: Relaxation Therapy
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Q1) Which response is known to be a physiological manifestation of relaxation?
A)Increased levels of norepinephrine
B)Pupil dilation
C)Reduced metabolic rate
D)Increased levels of blood sugar
Q2) Which should a nurse recognize as the reason that physical exercise is an effective relaxation technique?
A)Physical exercise stresses and strengthens the cardiovascular system.
B)Physical exercise decreases the metabolic rate.
C)Physical exercise decreases levels of norepinephrine in the brain.
D)Physical exercise provides a natural outlet for releasing muscle tension.
Q3) A nurse is teaching a client deep breathing exercises. The client asks, "Why do I need to make that funny shape with my lips when I breathe out?" What is the most appropriate nursing reply?
A)"You can actually exhale anyway you like; the lip shape is not important."
B)"Pursed lip breathing helps you control the exhalation and helps to keep your airways open."
C)"Don't worry about the lip shape; concentrate instead on the pace of your breathing."
D)"The shape of the lip decreases the cough and choking reflex."
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Page 16
Chapter 15: Assertiveness Training
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Sample Questions
Q1) A client continually waits more than an hour before being seen at the mental health clinic. The client approaches the nurse and states, "When I have to wait for more than an hour to be seen, I feel like my time is not important." The nurse recognizes this as what type of behavior?
A)Aggressive behavior
B)Assertive behavior
C)Passive-aggressive behavior
D)Passive behavior
Q2) A client on an inpatient unit is angry with a peer. During lunch, when the peer is not looking, the client spits into his soup. How would the nurse document this interaction?
A)"Client is displaying assertive behaviors."
B)"Client is displaying aggressive behaviors."
C)"Client is displaying passive behaviors."
D)"Client is displaying passive-aggressive behaviors."
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17
Chapter 16: Promoting Self Esteem
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Sample Questions
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 nursing instructor is teaching about self-concept. Which student statement indicates a need for further instruction?
A)Self-concept is the thinking component of the self.
B)Self-concept is a system of learned beliefs about self.
C)Self-concept is the degree of regard that individuals have for themselves.
D)Self-concept is the attitudes and opinions held true about personal existence.
Q3) Which is an appropriate initial nursing intervention for a client with chronic low self-esteem?
A)Assessing the content of negative self-talk
B)Administering anxiolytic medications
C)Using reassurance and physical touch
D)Using distraction techniques
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Page 18
Chapter 17: Angeraggression Management
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Q1) The nurse observes a client's escalating anger. The client begins to pace the hall and shouts, "You all better watch out. I'm going to hurt anyone who gets in my way." Which should be the priority nursing intervention?
A)Calmly tell the client, "Staff will help you to control your impulse to hurt others."
B)Remove other clients from the area and maintain milieu safety.
C)Gather a show of force by contacting security for assistance.
D)Calmly tell the client, "You will need to be medicated and secluded."
Q2) After restraints are removed from a client, the staff discusses the incident and establishes guidelines for the client's return to the therapeutic milieu. Which unit procedure is the staff implementing?
A)Postrestraint intervention
B)Treatment planning
C)Crisis intervention
D)Debriefing
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19
Chapter 18: Intervention With a Suicidal Client
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Q1) A client is newly admitted to an inpatient psychiatric unit. Which assessment data are critical in determining an increased risk for suicide?
A)Monitoring the client continually for 1 hour after admission
B)Encouraging the client to discuss feelings
C)Asking the client about any history of suicide attempts
D)Removing hazardous materials from the environment
Q2) After a teenager reveals that he is gay, the father responds by beating him. The next morning, the teenager is found hanging in his closet. Which paternal emotions should a nurse anticipate? (Select all that apply.)
A)Shock and disbelief
B)Guilt and remorse
C)Anger and resentment
D)Bargaining and depression
E)Denial and rationalization
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Chapter 19: Behavior Therapy
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Q1) 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."
Q2) During a smoking cessation group, the community health nurse explains that in their effort to quit smoking, a reciprocal inhibition approach will be used. The nurse should give the group which example of this technique?
A)"Before you can smoke, you must first take a half-hour walk."
B)"When you have the urge to smoke, imagine being short of breath."
C)"You'll receive $1 for each cigarette not smoked and forfeit $2 for each cigarette smoked."
D)"When you have the urge to smoke, hold your breath, then rhythmically breathe."
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Chapter 20: Cognitive Therapy
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Q1) A nursing instructor is teaching about the didactic aspects of cognitive therapy. Which student statement indicates a deficit in meeting the learning objectives of this content?
A)"The therapist provides information about the process of cognitive therapy."
B)"The therapist uses guided imagery in an effort to elicit automatic thoughts."
C)"The therapist provides information about how cognitive therapy works."
D)"The therapist uses reading assignments to reinforce learning."
Q2) A client is experiencing auditory hallucinations. Using a cognitive strategy, which should the nurse encourage the client to do?
A)"Try singing Happy Birthday until the voices are gone."
B)"Document what the voices are saying to note cause and effect."
C)"Try listening to music using headphones for distraction."
D)"Remind yourself that the voices are symptoms of your disease."
Q3) Which client statement would exemplify the cognitive changes that you would expect to see in mild anxiety?
A)"Right now I feel as sharp as a tack."
B)"I'm having a tough time focusing."
C)"Sometimes I feel like I'm having an out-of-body experience."
D)"All I seem to focus on is my anger."
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Chapter 21: Electroconvolusive Therapy
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Sample Questions
Q1) When scheduling electroconvulsive therapy (ECT), which client should the nurse prioritize?
A)A client in bed in a fetal position who is experiencing active suicidal ideations
B)A client with an irritable mood and exhibiting angry outbursts
C)A client experiencing command hallucinations and delusions of reference
D)A client experiencing manic episodes of bipolar disorder
Q2) A client scheduled for electroconvulsive therapy (ECT) at 9:00 a.m. is discovered eating breakfast at 8:00 a.m. Based on this observation, which is the most appropriate nursing action?
A)The nurse notifies the client's physician of the situation and cancels the ECT.
B)The nurse removes the breakfast tray and assists the client to the ECT treatment room.
C)The nurse allows the client to finish breakfast and reschedules ECT for 10:00 a.m.
D)The nurse increases the client's fluid intake to facilitate the digestive process.
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Chapter 22: Complementary Therapies
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Q1) A client has been taking 1,200 mg/day of St. John's wort during the past year for symptoms of depression. Recently, the client complains of side effects from this herbal remedy. What symptom should the nurse expect the client to report?
A)Photosensitivity
B)Insomnia
C)Hirsutism
D)Restlessness
Q2) A client diagnosed with chronic migraine headaches is considering acupuncture. The client asks a clinic nurse, "How does this treatment work?" Which is the best response by the nurse?
A)"Western medicine believes that acupuncture stimulates the body's release of pain-fighting chemicals called endorphins."
B)"I'm not sure why he suggested acupuncture.There are a lot of risks, including HIV."
C)"Acupuncture works by encouraging the body to increase its development of serotonin and norepinephrine."
D)"Your acupuncturist is your best resource for answering your specific questions."
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Chapter 23: Disorders Usually First Diagnosed in Infancy,
Childhood, or Adolescence
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Q1) 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.
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."
Q3) In planning care for a child diagnosed with autistic disorder, which would be a realistic client outcome?
A)The client will communicate all needs verbally by discharge.
B)The client will participate with peers in a team sport by day 4.
C)The client will establish trust with at least one caregiver by day 5.
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D)The client will perform most self-care tasks independently.
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Chapter 24: Delirium, Dementia, and Amnestic Disorders
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Q1) 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
Q2) 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
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26
Chapter 25: Substance-Related Disorders
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Q1) Upon admission for symptoms of alcohol withdrawal a client states, "I haven't eaten in 3 days." Assessment reveals BP 170/100 mm Hg, P 110, R 28, and T 97S1U1P1\(\circ\)S1S1P0F (36S1U1P1\(\circ\)S1S1P0C) with dry skin, dry mucous membranes, and poor skin turgor. What should be the priority nursing diagnosis?
A)Knowledge deficit
B)Fluid volume excess
C)Imbalanced nutrition: less than body requirements
D)Ineffective individual coping
Q2) A client diagnosed with alcohol abuse joins a community 12-step program and states, "My life is unmanageable." How should the nurse interpret this client's statement?
A)The client is using minimization as an ego defense.
B)The client is ready to sign an Alcoholics Anonymous contract for sobriety.
C)The client has accomplished the first of 12 steps advocated by Alcoholics Anonymous.
D)The client has met the requirements to be designated as an Alcoholics Anonymous sponsor.
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Chapter 26: Schizophrenia and Other Psychotic Disorders
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Q1) A client is diagnosed with schizophrenia. A physician orders haloperidol (Haldol) 50 mg bid, benztropine (Cogentin) 1 mg prn, and zolpidem (Ambien) 10 mg HS. Which client behavior would warrant the nurse to administer benztropine?
A)Tactile hallucinations
B)Tardive dyskinesia
C)Restlessness and muscle rigidity
D)Reports of hearing disturbing voices
Q2) 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."
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Chapter 27: Mood Diorders: Depression
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Q1) 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."
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.
Q3) 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
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Chapter 28: Mood Disorders: Bipolar Disorder
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Sample Questions
Q1) A nursing instructor is discussing various challenges in the treatment of clients diagnosed with bipolar disorder. Which student statement demonstrates an understanding of the most critical challenge in the care of these clients?
A)"Treatment is compromised when clients can't sleep."
B)"Treatment is compromised when irritability interferes with social interactions."
C)"Treatment is compromised when clients have no insight into their problems."
D)"Treatment is compromised when clients choose not to take their medications."
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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Q1) A nurse has been caring for a client diagnosed with post-traumatic stress disorder. What short-term, realistic, correctly written outcome should be included in this client's plan of care?
A)The client will have no flashbacks.
B)The client will be able to feel a full range of emotions by discharge.
C)The client will not require zolpidem (Ambien) to obtain adequate sleep by discharge.
D)The client will refrain from discussing the traumatic event.
Q2) A client is newly diagnosed with obsessive-compulsive disorder and spends 45 minutes folding clothes and rearranging them in drawers. Which nursing intervention would best address this client's problem?
A)Distract the client with other activities whenever ritual behaviors begin.
B)Report the behavior to the psychiatrist to obtain an order for medication dosage increase.
C)Lock the room to discourage ritualistic behavior.
D)Discuss the anxiety-provoking triggers that precipitate the ritualistic behaviors.
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Chapter 30: Somatoform and Disassociative Disorders
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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 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.
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Chapter 31: Issues Related to Human Sexuality and Gender
Identity
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Q1) A nurse is working with a client diagnosed with pedophilia. Which client outcome is appropriate for the nurse to expect during the first week of hospitalization?
A)The client will verbalize an understanding of the importance of follow-up care.
B)The client will implement several relapse-prevention strategies.
C)The client will identify triggers that lead to inappropriate behaviors.
D)The client will attend aversion therapy groups.
Q2) A newly married woman comes to a gynecology clinic reporting anorexia, insomnia, and extreme dyspareunia that have affected her intimate relationship. What initial intervention should the nurse expect a physician to implement?
A)A thorough physical to include gynecological examination
B)Referral to a sex therapist
C)Assessment of sexual history and previous satisfaction with sexual relationships
D)Referral to the recreational therapist for relaxation therapy
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33
Chapter 32: Eating Disorders
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Q1) A client who is 5 foot 6 inches tall and weighs 98 pounds is admitted with a medical diagnosis of anorexia nervosa. Which nursing diagnosis would take priority at this time?
A)Ineffective coping R/T food obsession
B)Altered nutrition: less than body requirements R/T inadequate food intake
C)Risk for injury R/T suicidal tendencies
D)Altered body image R/T perceived obesity
Q2) A client's altered body image is evidenced by claims of "feeling fat" even though the client is emaciated. Which is the appropriate outcome criterion for this client's problem?
A)The client will consume adequate calories to sustain normal weight.
B)The client will cease strenuous exercise programs.
C)The client will perceive an ideal body weight and shape as normal.
D)The client will not express a preoccupation with food.
Q3) Why are behavior modification programs the treatment of choice for clients diagnosed with eating disorders?
A)These programs help clients correct distorted body image.
B)These programs address underlying client anger.
C)These programs help clients manage uncontrollable behaviors.
D)These programs allow clients to maintain control.
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Chapter 33: Adjustment and Impulse Control Disorders
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Q1) A client diagnosed with an adjustment disorder asks the nurse, "Tell me about medications that will cure this problem." Which of the following are appropriate nursing replies? (Select all that apply.)
A)"Medications can interfere with your ability to find a more permanent problem solution."
B)"Medications may mask the real problem at the root of this diagnosis."
C)"Adjustment disorders are not commonly treated with medications."
D)"Psychoactive drugs carry the potential for physiological and psychological dependence."
E)"Psychoactive drugs will be prescribed only if your problems persist for more than 3 months."
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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Q1) Which adult client should a nurse identify as exhibiting the characteristics of a dependent personality disorder?
A)A physically healthy client who is dependent on meeting social needs by contact with 15 cats
B)A physically healthy client who has a history of depending on intense relationships to meet basic needs
C)A physically healthy client who lives with parents and relies on public transportation
D)A physically healthy client who is serious, inflexible, perfectionistic, and depends on rules to provide security
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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Q1) A nurse is conducting a class on fall prevention at a local senior center. In relationship to the slowed cognitive processing of advanced age, which teaching modification would be most appropriate for the nurse to implement?
A)Encouraging the clients to use hearing aids if needed
B)Avoiding overarticulation
C)Minimizing distractive stimuli
D)Providing more time for client feedback
Q2) 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
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 questioned about bruises, a woman states, "It was an accident. My husband just had a bad day at work. He's being so gentle now and even brought me flowers. He's going to get a new job, so it won't happen again." This client is in which phase of the cycle of battering?
A)Phase I: The tension-building phase
B)Phase II: The acute battering incident phase
C)Phase III: The honeymoon phase
D)Phase IV: The resolution and reorganization phase
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 client diagnosed with schizophrenia was released from a state mental hospital after 20 years of institutionalization. A nurse should recognize which characteristic that is likely to be exhibited by this client?
A)The client is likely to be compliant with treatment because of institutional dependency.
B)The client is likely to find a variety of community support services to aid in the transition.
C)The client is likely to adjust to the community environment if given sufficient support.
D)The client is likely to be admitted at some time to an acute care unit for psychiatric treatment.
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.
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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 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.
Q3) A forensic nurse assesses patterned injuries on a 3-year-old child. What assessment data led to this conclusion?
A)Multiple minute cuts and abrasions
B)Generalized bruising of the buttock
C)Circular burn marks, the size of a lit cigarette
D)Stab wounds resulting from sharp object penetration
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Page 40
Chapter 39: The Bereaved Individual
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Q1) 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.
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 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
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