Mental Health Nursing
Midterm Exam
Course Introduction
Mental Health Nursing focuses on equipping students with the knowledge, skills, and attitudes necessary to provide holistic, compassionate care to individuals experiencing mental health challenges. The course explores the theoretical foundations of mental health and illness, assessment techniques, communication strategies, and evidence-based interventions in various healthcare settings. Emphasis is placed on developing therapeutic relationships, promoting recovery, advocating for mental health awareness, and working collaboratively within interdisciplinary teams. Students also examine ethical considerations, legal responsibilities, and the impact of social and cultural factors on mental health, preparing them to support clients and their families effectively throughout the continuum of care.
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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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 school nurse is assessing a female high school student who is overly concerned about her appearance. The client's mother states, "That's not something to be stressed about!" Which is the most appropriate nursing response?
A)"Teenagers! They don't know a thing about real stress."
B)"Stress occurs only when there is a loss."
C)"When you are in poor physical condition, you can't experience psychological well-being."
D)"Stress can be psychological.A threat to self-esteem may result in high stress levels."
Answer: D
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3
Chapter 2: Mental Healthmental Illness: Historical and Theoretical Concepts
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Sample Questions
Q1) Which statement reflects a student nurse's accurate understanding of the concepts of mental health and mental illness?
A)"The concepts are rigid and religiously based."
B)"The concepts are multidimensional and culturally defined."
C)"The concepts are universal and unchanging."
D)"The concepts are unidimensional and fixed."
Answer: B
Q2) Which nursing statement about the concept of neuroses is most accurate?
A)"An individual experiencing neurosis is unaware that he or she is experiencing distress."
B)"An individual experiencing neurosis feels helpless to change his or her situation."
C)"An individual experiencing neurosis is aware of psychological causes of his or her behavior."
D)"An individual experiencing neurosis has a loss of contact with reality."
Answer: B
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4
Chapter 3: Theoretical Models of Personality Development
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Sample Questions
Q1) A 10-year-old child wins the science fair competition and is chosen as a cheerleader for the basketball team. A nurse should recognize that this child is in the process of 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: A
Q2) Which underlying concept should a nurse associate with interpersonal theory when assessing clients?
A)The effects of social processes on personality development
B)The effects of unconscious processes and personality structures
C)The effects on thoughts and perceptual processes
D)The effects of chemical and genetic influences
Answer: A
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5
Chapter 4: Concepts of Psychobiology
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Q1) Which of the following symptoms should a nurse associate with increased levels of thyroid-stimulating hormone (TSH) in a newly admitted client? (Select all that apply.)
A)Depression
B)Fatigue
C)Increased libido
D)Mania
E)Hyperexcitability
Q2) 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
Q3) Which client statement reflects an understanding of the effect of circadian rhythms on psychopathology?
A)"When I dream about my mother's horrible train accident, I become hysterical."
B)"I get really irritable during my menstrual cycle."
C)"I'm a morning person.I get my best work done in the a.m."
D)"Every February, I tend to experience periods of sadness."
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Page 6
Chapter 5: Ethical and Legal Issues in Psychiatricmental
Health Nursing
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Sample Questions
Q1) Which client should a nurse identify as a potential candidate for involuntary commitment?
A)A client living under a bridge in a cardboard box
B)A client threatening to commit suicide
C)A client who never bathes and wears a wool hat in the summer
D)A client who eats waste out of a garbage can
Q2) Which situation exemplifies both assault and battery?
A)The nurse becomes angry, calls the client offensive names, and withholds treatment. B)The nurse threatens to "tie down" the client and then does so against the client's wishes.
C)The nurse hides the client's clothes and medicates the client to prevent elopement. D)The nurse restrains the client without just cause and communicates this to family.
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Chapter 6: Cultural and Spiritual Concepts Relevant to Psychiatricmental Health Nursing
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Q1) Because of cultural characteristics, in which of the following cultural groups would a nurse's assessment of mood and affect be most challenging? (Select all that apply.)
A)Arab Americans
B)Native Americans
C)Latino Americans
D)Western European Americans
E)Asian Americans
Q2) Northern European Americans value punctuality, hard work, and the acquisition of material possessions and status. A nurse should recognize that these values may contribute to which form of psychopathology?
A)Dissociative disorders
B)Alzheimer's dementia
C)Stress-related disorders
D)Schizophrenia-spectrum disorders
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Chapter 7: Relationship Development
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Q1) 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
Q2) On which task should a nurse place priority during the working phase of relationship development?
A)Establishing a contract for intervention
B)Examining feelings about working with a particular client
C)Establishing a plan for continuing aftercare
D)Promoting the client's insight and perception of reality
Q3) Which phase of the nurse-client relationship begins when the individuals first meet and is characterized by an agreement to continue to meet and work on setting client-centered goals?
A)Preinteraction
B)Orientation
C)Working
D)Termination
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Chapter 8: Therapeutic Communication
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Sample Questions
Q1) The nurse is interviewing a newly admitted psychiatric client. Which nursing statement is an example of offering a "general lead"?
A)"Do you know why you are here?"
B)"Are you feeling depressed or anxious?"
C)"Yes, I see.Go on."
D)"Can you chronologically order the events that led to your admission?"
Q2) A client slammed a door on the unit several times. The nurse responds, "You seem angry." The client states, "I'm not angry." What therapeutic communication technique has the nurse employed and what defense mechanism is the client unconsciously demonstrating?
A)Making observations and the defense mechanism of suppression
B)Verbalizing the implied and the defense mechanism of denial
C)Reflection and the defense mechanism of projection
D)Encouraging descriptions of perceptions and the defense mechanism of displacement
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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Chapter 9: The Nursing Process in Psychiatricmental Health
Nursing
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Q1) A client diagnosed with schizophrenia is exhibiting nonverbal behaviors indicating that the client is hearing things that others do not. Which nursing diagnosis accurately reflects this client's problem?
A)Altered thought processes
B)Altered sensory perception
C)Anxiety
D)Chronic confusion
Q2) The nurse should recognize which acronym as representing problem-oriented charting?
A)SOAPIE
B)APIE
C)DAR
D)PQRST
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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Sample Questions
Q1) When planning group therapy, a nurse should identify which configuration as most optimal for a therapeutic group?
A)Open-ended membership; circle of chairs; group size of 5 to 10 members
B)Open-ended membership; chairs around a table; group size of 10 to 15 members
C)Closed membership; circle of chairs; group size of 5 to 10 members
D)Closed membership; chairs around a table; group size of 10 to 15 members
Q2) 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
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12
Chapter 11: Intervention With Families
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Sample Questions
Q1) A depressed 21-year-old client has lived with his mother ever since the death of his father 3 years ago. After the client received a college acceptance, the mother repeatedly states, "That's wonderful. I'll be fine all alone." How would the nurse interpret the mother's statements?
A)The mother is withholding supportive messages.
B)The mother is expressing denigrating remarks.
C)The mother is communicating indirectly.
D)The mother is using double-bind communication.
Q2) During family counseling a child states, "I just want to surf like other kids. Mom says it's okay, but Dad says I'm too young." The mother allows surfing when the father is absent. In the structural model of family therapy, what family interactional pattern should the nurse recognize?
A)Multigenerational transmission
B)Disengagement
C)Mother-child subsystem
D)Emotional cutoff
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Chapter 12: Milieu Therapy - the Therapeutic Community
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Q1) To promote self-reliance, how should a psychiatric nurse best conduct medication administration?
A)Encourage clients to request their medications at the appropriate times.
B)Refuse to administer medications unless clients request them at the appropriate times.
C)Allow the clients to determine appropriate medication times.
D)Take medications to the clients' bedside at the appropriate times.
Q2) An angry client on an inpatient unit approaches a nurse stating, "Someone took my lunch! People need to respect others, and you need to do something about this now!"
The nurse's response should be guided by which basic assumption of milieu therapy?
A)Conflict should be avoided at all costs on inpatient psychiatric units.
B)Conflict should be resolved by the nursing staff.
C)Every interaction is an opportunity for therapeutic intervention.
D)Conflict resolution should only be addressed during group therapy.
Q3) In the role of milieu manager, which activity should the nurse prioritize?
A)Setting the schedule for the daily unit activities
B)Evaluating clients for medication effectiveness
C)Conducting therapeutic group sessions
D)Searching newly admitted clients for hazardous objects
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Page 14
Chapter 13: Crisis Intervention
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Sample Questions
Q1) A mother is concerned about her ability to perform in her new role. She is quite anxious and refuses to leave the postpartum unit. To offer effective client care, a nurse should recognize which information about this type of crisis?
A)This type of crisis is precipitated by unexpected external stressors.
B)This type of crisis is precipitated by preexisting psychopathology.
C)This type of crisis is precipitated by an acute response to an external situational stressor.
D)This type of crisis is precipitated by normal life-cycle transitions that overwhelm the client.
Q2) A college student who was nearly raped while jogging completes a series of appointments with a rape crisis nurse. At the final session, which client statement most clearly suggests that the goals of crisis intervention have been met?
A)"You've really been helpful.Can I count on you for continued support?"
B)"I work out in the college gym rather than jogging outdoors."
C)"I'm really glad I didn't go home.It would have been hard to come back."
D)"I carry mace when I jog.It makes me feel safe and secure."
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Chapter 14: Relaxation Therapy
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Sample Questions
Q1) 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."
Q2) Which positive physical benefit would relaxation provide for a client who has experienced stress-related asthma?
A)Decreased neurotransmitters
B)Decreased blood pressure
C)Increased oxygen saturation levels
D)Decreased alpha brain waves
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16
Chapter 15: Assertiveness Training
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Sample Questions
Q1) While trying to control aggressive behavior, a client asks an assertiveness training nurse to give an example of an "I statement." Which is an example of this assertive communication technique?
A)"I would like to know why you came home late without calling me."
B)"I hate it when you think you can just come home late without calling anyone to let them know where you are."
C)"I feel angry when you come home late without calling."
D)"I think you don't care about me, because if you did, you'd call me if you were planning on coming home late."
Q2) During an assertiveness training group, a nurse suggests using "I statements." The group questions the usefulness of this communication technique. Which explanation by the nurse is most appropriate?
A)"When 'I statements' are used, opinions are communicated without blaming others."
B)"When 'I statements' are used, anger is displaced by using indirect means."
C)"When 'I statements' are used, responsibility for one's behavior is attributed to another."
D)"When 'I statements' are used, eye contact is promoted."
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Page 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 nurse is working in a nursing home. How best can this nurse foster self-esteem in the residents of this facility?
A)Allowing them to remain in their rooms as much as they desire to maintain privacy
B)Administering anti-anxiety medications as ordered
C)Providing a sense of mastery over their environment by giving choices when appropriate
D)Teaching assertiveness skills and self-esteem principles
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Chapter 17: Angeraggression Management
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Q1) A client diagnosed with paranoid schizophrenia has a history of aggravated assault. A nurse assigns "Risk for other-directed violence" as the client's priority nursing diagnosis. Based on this diagnosis, which would be an appropriate outcome for this client?
A)The client will not verbalize anger or hit anyone.
B)The client will verbalize anger rather than hit others.
C)The client will not inflict harm on others during this shift.
D)The client will be restrained if verbal or physical abuse is observed during this shift.
Q2) An adult client assaults another client and is placed in restraints at 1345 hours. While the client is in restraints, which client statement should alert a nurse that further assessment is necessary?
A)"I hate all of you!"
B)"My fingers are tingly."
C)"You wait until I tell my lawyer."
D)"I have a sinus headache."
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19
Chapter 18: Intervention With a Suicidal Client
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Q1) A suicidal client says to a nurse, "There's nothing to live for anymore." Which is the most appropriate nursing reply?
A)"Why don't you consider doing volunteer work in a homeless shelter."
B)"Let's discuss the negative aspects of your life."
C)"Things will look better in the morning."
D)"It sounds like you are feeling pretty hopeless."
Q2) In planning care for a suicidal client, which correctly written outcome should be a nurse's first priority?
A)The client will not physically harm self.
B)The client will express hope for the future by day 3.
C)The client will establish a trusting relationship with the nurse.
D)The client will remain safe during the hospital stay.
Q3) A client is newly committed to an inpatient psychiatric unit. Which nursing intervention best lowers this client's risk for suicide?
A)Encouraging participation in the milieu to promote hope
B)Developing a strong personal relationship with the client
C)Observing the client at intervals determined by assessed data
D)Encouraging and redirecting the client to concentrate on happier times
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Page 20
Chapter 19: Behavior Therapy
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Sample Questions
Q1) 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
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.
Q3) A 2-year-old engages in frequent temper tantrums that usually result in the parents giving in to demands. During family therapy, how should a nurse counsel the parents?
A)"You are shaping your child's behavior."
B)"Your child has modeled your behavior."
C)"You are positively reinforcing your child's behavior."
D)"You are negatively reinforcing your child's behavior."
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Page 21
Chapter 20: Cognitive Therapy
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Q1) A client states, "I keep having horrible nightmares about the car accident that killed my daughter. I shouldn't have taken her with me to the store." Using a cognitive approach, which nursing reply would be most therapeutic?
A)"Are other issues from your past affecting your ability to move on?"
B)"Describe your current feelings about your loss."
C)"Let's talk about something that will help you move on."
D)"Can anyone predict when a car accident will happen?"
Q2) A welder has been selected as employee of the year. The welder wants to ask for a promotion but is hampered by poor self-esteem. The employee health nurse provides assistance. Which technique should the nurse use to help the employee request the promotion?
A)Socratic questioning
B)Activity scheduling
C)Distraction
D)Cognitive rehearsal
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Chapter 21: Electroconvolusive Therapy
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Q1) A nursing instructor is teaching about the medications given prior to and during electroconvulsive therapy (ECT) treatments. Which student statement indicates that learning has occurred?
A)"Atropine (Atro-Pen) is administered to paralyze skeletal muscles during ECT."
B)"Succinylcholine chloride (Anectine) decreases secretions to prevent aspiration."
C)"Thiopental sodium (Pentothal) is a short-acting anesthesia to render the client unconscious."
D)"Glycopyrrolate (Robinul) is given to prevent severe muscle contractions during seizure."
Q2) After receiving two of nine electroconvulsive therapy (ECT) treatments, a client states, "I can't even remember eating breakfast, so I want to stop the ECT treatments." Which is the most appropriate nursing reply?
A)"After you begin the course of treatments, you must complete all of them."
B)"You'll need to talk with your doctor about what you're thinking."
C)"It is within your right to discontinue the treatments, but let's talk about your concerns."
D)"Memory loss is a rare side effect of the treatment.I don't think it should be a concern."
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Chapter 22: Complementary Therapies
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Q1) A nursing student having no knowledge of alternative treatments states, "Aren't these therapies 'bogus' and, like a fad, will eventually fade away?" Which is an accurate nursing reply?
A)"Like nursing, complementary therapies take a holistic approach to healing."
B)"The American Nurses Association is researching the effectiveness of these therapies."
C)"It is important to remain nonjudgmental about these therapies."
D)"Alternative therapy concepts are rooted in psychoanalysis."
Q2) A client is exhibiting short-term memory loss and has a slow capillary refill. Which herbal remedy would address this client's symptoms?
A)Ginkgo
B)Fennel
C)Passion flower
D)Black cohosh
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24
Chapter 23: Disorders Usually First Diagnosed in Infancy,
Childhood, or Adolescence
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Q1) A nursing instructor presents a case study in which a 3-year-old child is in constant motion and is unable to sit still during story time. The instructor asks a student to evaluate this child's behavior. Which student response indicates an appropriate evaluation of the situation?
A)"This child's behavior must be evaluated according to developmental norms."
B)"This child has symptoms of attention deficit hyperactivity disorder."
C)"This child has symptoms of the early stages of autistic disorder."
D)"This child's behavior indicates possible symptoms of oppositional defiant disorder."
Q2) 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.
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) 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) A geriatric nurse is teaching student nurses about the risk factors for the development of delirium in older adults. Which student statement indicates that learning has occurred?
A)"Taking multiple medications may lead to adverse interactions or toxicity."
B)"Age-related cognitive changes may lead to alterations in mental status."
C)"Lack of rigorous exercise may lead to decreased cerebral blood flow."
D)"Decreased social interaction may lead to profound isolation and psychosis."
Q3) Which symptom should a nurse identify that would differentiate clients diagnosed with dementia from clients diagnosed with mood disorders?
A)Altered sleep
B)Altered concentration
C)Impaired memory
D)Impaired psychomotor activity
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Page 26
Chapter 25: Substance-Related Disorders
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Q1) The nurse believes that a client being admitted for a surgical procedure may have a drinking problem. How should the nurse further evaluate this possibility?
A)By asking directly if the client has ever had a problem with alcohol
B)By holistically assessing the client using the CIWA scale
C)By using a screening tool such as the CAGE questionnaire
D)By referring the client for physician evaluation
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
Q3) 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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Page 27
Chapter 26: Schizophrenia and Other Psychotic Disorders
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Q1) Laboratory results reveal decreased levels of prolactin in a client diagnosed with schizophrenia. When assessing the client, which symptoms should a nurse expect to observe?(Select all that apply.)
A)Apathy
B)Social withdrawal
C)Anhedonia
D)Auditory hallucinations
E)Delusions
Q2) A client diagnosed with chronic schizophrenia presents in an emergency department (ED) with uncontrollable tongue movements, stiff neck, and difficulty swallowing. The nurse would expect the physician to recognize which condition and implement which treatment?
A)Neuroleptic malignant syndrome and treat by discontinuing antipsychotic medications
B)Agranulocytosis and treat by administration of clozapine (Clozaril)
C)Extrapyramidal symptoms and treat by administration of benztropine (Cogentin)
D)Tardive dyskinesia and treat by discontinuing antipsychotic medications
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Chapter 27: Mood Diorders: Depression
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Q1) A newly admitted client is diagnosed with major depressive disorder with suicidal ideations. Which would be the priority nursing intervention for this client?
A)Teach about the effective of suicide on family dynamics.
B)Carefully and unobtrusively observe based on assessed data, at varied intervals around the clock.
C)Encourage the client to spend a portion of each day interacting within the milieu.
D)Set realistic achievable goals to increase self esteem.
Q2) A nurse is implementing a one-on-one suicide observation level with a client diagnosed with major depressive disorder. The client states, "I'm feeling a lot better so you can stop watching me. I have taken up too much of your time already." Which is the best nursing reply?
A)"I really appreciate your concern but I have been ordered to continue to watch you."
B)"Because we are concerned about your safety, we will continue to observe you."
C)"I am glad you are feeling better.The treatment team will consider your request."
D)"I will forward you request to your psychiatrist because it is his decision."
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Chapter 28: Mood Disorders: Bipolar Disorder
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Sample Questions
Q1) A client's spouse asks, "What evidence supports the possibility of genetic transmission of bipolar disorder?" Which is the best nursing reply?
A)"Clients diagnosed with bipolar disorders have alterations in neurochemicals which affect behaviors."
B)"Higher rates of relatives diagnosed with bipolar disorder are found in families of client's diagnosed with this disorder."
C)"Higher rates of relatives of clients diagnosed with bipolar disorder respond in an exaggerated way to daily stress."
D)"More individuals diagnosed with bipolar disorder come from higher socioeconomic and educational backgrounds."
Q2) 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."
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Chapter 29: Anxiety Disorders
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Sample Questions
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 nurse is providing discharge teaching to a client taking a benzodiazepine. Which client statement would indicate a need for further follow-up instructions?
A)"I will need scheduled blood work in order to monitor for toxic levels of this drug."
B)"I won't stop taking this medication abruptly because there could be serious complications."
C)"I will not drink alcohol while taking this medication."
D)"I won't take extra doses of this drug because I can become addicted."
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Chapter 30: Somatoform and Disassociative Disorders
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Q1) Which would be considered an appropriate outcome when planning care for an inpatient client diagnosed with somatization disorder?
A)The client will admit to fabricating physical symptoms to gain benefits by day 3.
B)The client will list three potential adaptive coping strategies to deal with stress by day 2.
C)The client will comply with medical treatments for physical symptoms by day 3.
D)The client will openly discuss physical symptoms with staff by day 4.
Q2) Which are examples of primary and secondary gains that clients diagnosed with somatoform pain disorders may experience?
A)Primary: chooses to seek a new doctor; secondary: euphoric feeling from new medications
B)Primary: euphoric feeling from new medications; secondary: chooses to seek a new doctor
C)Primary: receives get-well messages; secondary: pain prevents attendance at family reunion
D)Primary: pain prevents attendance at family reunion; secondary: receives get-well messages
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Chapter 31: Issues Related to Human Sexuality and Gender
Identity
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Q1) Which of the following characteristics should a nurse identify as "normal" in the development of human sexuality for an 11-year-old child? (Select all that apply.)
A)The child experiments with masturbation.
B)The child may experience homosexual play.
C)The child shows little interest in the opposite sex.
D)The child shows little concern about physical attractiveness.
E)The child is unlikely to want to undress in front of others.
Q2) A psychiatric nursing instructor is teaching about the psychological effects of the diagnosis of a sexually transmitted disease (STD). Which student statement indicates that further instruction is needed?
A)"STDs carry strong connotations of illicit sex and considerable social stigma."
B)"STDs can cause insanity."
C)"The diagnosis of HIV can generate hopelessness and helplessness."
D)"Antibiotics administered in the early stages can cure all STDs."
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Chapter 32: Eating Disorders
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Q1) A nursing instructor is teaching students about the differences between the symptoms of anorexia nervosa and the symptoms of bulimia nervosa. Which student statement indicates that learning has occurred?
A)"Clients diagnosed with anorexia nervosa experience extreme nutritional deficits, whereas clients diagnosed with bulimia nervosa do not."
B)"Clients diagnosed with bulimia nervosa experience amenorrhea, whereas clients diagnosed with anorexia nervosa do not."
C)"Clients diagnosed with bulimia nervosa experience hypotension, edema, and lanugo, whereas clients diagnosed with anorexia nervosa do not."
D)"Clients diagnosed with anorexia nervosa have eroded tooth enamel, whereas clients diagnosed with bulimia nervosa do not."
Q2) Which nursing intervention is appropriate when caring for clients diagnosed with either anorexia nervosa or bulimia nervosa?
A)Provide privacy during meals.
B)Remain with the client for at least 1 hour after the meal.
C)Encourage the client to keep a journal to document types of food consumed.
D)Restrict client privileges when provided food is not completely consumed.
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Page 34
Chapter 33: Adjustment and Impulse Control Disorders
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Q1) 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)
Q2) 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.
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Chapter 34: Personality Disorders
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Q1) Which nursing approach should be used to maintain a therapeutic relationship with a client diagnosed with borderline personality disorder?
A)Being firm, consistent, and empathic, while addressing specific client behaviors
B)Promoting client self-expression by implementing laissez-faire leadership
C)Using authoritative leadership to help clients learn to conform to society norms
D)Overlooking inappropriate behaviors to avoid promoting secondary gains
Q2) During an assessment interview, a client diagnosed with antisocial personality disorder spits, curses, and refuses to answer questions. Which is the most appropriate nursing statement to address this behavior?
A)"You are very disrespectful.You need to learn to control yourself."
B)"I understand that you are angry, but this behavior will not be tolerated."
C)"What behaviors could you modify to improve this situation?"
D)"What anti-personality-disorder medications have helped you in the past?"
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Chapter 35: The Aging Individual
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Q1) 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.
Q2) An elderly client is exhibiting symptoms of major depressive disorder. A physician is considering prescribing an antidepressant. Which physiological problem should make a nurse question this medication regime?
A)Altered cortical and intellectual functioning
B)Altered respiratory and gastrointestinal functioning
C)Altered liver and kidney functioning
D)Altered endocrine and immune system functioning
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Chapter 36: Victims of Abuse or Neglect
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Sample Questions
Q1) 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."
Q2) 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
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Chapter 37: Community Mental Health Nursing
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Q1) Which intervention should the nurse consider as primary prevention for an individual who is on the verge of being homeless due to a job layoff?
A)Referral to primary care provider to improve general health status
B)Encouraging client to recognize reasons for job layoff
C)Job training to increase employment options
D)Encouraging the use of prn medications to control symptoms
Q2) A newly admitted homeless client diagnosed with schizophrenia states, "I have been living in a cardboard box for 2 weeks. Why did the government let me down?" Which is an appropriate nursing reply?
A)"Your discharge from the state hospital was done prematurely.Had you remained in the state hospital longer, you would not be homeless."
B)"Your premature discharge from the state hospital was not intended for patients diagnosed with chronic schizophrenia."
C)"Your discharge from the state hospital was based on firm principles; however, the resources were not available to make the transition a success."
D)"Your discharge from the state hospital was based on presumed family support, and this was not forthcoming."
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Page 39
Chapter 38: Forensic Nursing
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Sample Questions
Q1) 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
Q2) A sexual assault nurse examiner (SANE) is called to examine a college student who reports a date rape. What should be the priority nursing intervention?
A)Take samples of potential evidence.
B)Ensure medical stabilization.
C)Take pictures of the wounds.
D)Call law enforcement officials to report the rape.
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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Chapter 39: The Bereaved Individual
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Q1) A teenager has recently lost a parent. Which grieving behavior should a school nurse expect when assessing this client?
A)Denial of personal mortality
B)Preoccupation with the loss
C)Clinging behaviors and personal insecurity
D)Acting-out behaviors, exhibited in aggression and defiance
Q2) An instructor is teaching nursing students about Worden's grief process. According to Worden, which of the following client behaviors would delay or prolong the grieving process? (Select all that apply.)
A)Refusing to allow self to think painful thoughts
B)Indulging in the pain of loss
C)Using alcohol and drugs
D)Idealizing the object of loss
E)Recognizing that time will heal
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