Nursing Care of Patients with Mental Disorders
Mock Exam
Course Introduction
This course explores the principles and practices of nursing care for individuals experiencing mental health disorders. It emphasizes the assessment, diagnosis, planning, and implementation of evidence-based interventions tailored to the needs of patients with various psychiatric conditions. Students will examine the biological, psychological, and social factors influencing mental health, as well as the legal and ethical responsibilities of mental health nurses. Through case studies, simulations, and clinical experiences, students develop essential communication, therapeutic, and advocacy skills to support recovery and promote holistic well-being in diverse patient populations.
Recommended Textbook
Psychiatric Mental Health Nursing Concepts of Care in Evidence Based Practice 7th Edition by Mary
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Chapter 1: The Concept of Stress Adaptation
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Q1) A 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
Q2) 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
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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 should the nurse recognize as a DSM-IV-TR Axis II disorder?
A)Obesity
B)Major depressive disorder
C)Hypertension
D)Borderline personality disorder
Answer: D
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4
Chapter 3: Theoretical Models of Personality Development
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Q1) A 29-year-old client living with parents has few interpersonal relationships. The client states, "I have trouble trusting people." Based on Erikson's developmental theory, which should the nurse recognize as a true statement about this client?
A)The client has not progressed beyond the trust versus mistrust developmental stage.
B)Developmental deficits in earlier life stages have impaired the client's adult functioning.
C)The client cannot move to the next developmental stage until mastering all earlier stages.
D)The client's developmental problems began in the intimacy versus isolation stage.
Answer: B
Q2) According to Peplau, treatment of client symptoms should involve which nursing action?
A)Establishing a therapeutic nurse-client relationship
B)Using the technique of desensitization
C)Challenging clients' negative thoughts
D)Uncovering clients' past experiences
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) A withdrawn client diagnosed with schizophrenia expresses little emotion and refuses to attend group therapy. What altered component of the nervous system should a nurse recognize as being responsible for this behavior?
A)Dendrites
B)Axons
C)Neurotransmitters
D)Synapses
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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Page 6
Chapter 5: Ethical and Legal Issues in Psychiatricmental
Health Nursing
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Q1) What is the legal significance of a nurse's action when the nurse threatens a demanding client with restraints?
A)The nurse can be charged with assault.
B)The nurse can be charged with negligence.
C)The nurse can be charged with malpractice.
D)The nurse can be charged with beneficence.
Q2) An inpatient psychiatric physician refuses to treat clients without insurance and prematurely discharges those whose insurance benefits have expired. Which violation of an ethical principle should a nurse recognize in this situation?
A)Autonomy
B)Beneficence
C)Nonmaleficence
D)Justice
Q3) 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
Page 7
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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) 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
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Chapter 7: Relationship Development
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Q1) What should be the nurse's primary goal during the preinteraction phase of the nurse-client relationship?
A)To evaluate goal attainment and ensure therapeutic closure
B)To establish trust and formulate a contract for intervention
C)To explore self-perceptions
D)To promote client change
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) If an individual is "two-faced," which characteristic essential to the development of a therapeutic relationship should a nurse identify as missing?
A)Respect
B)Genuineness
C)Sympathy
D)Rapport
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9
Chapter 8: Therapeutic Communication
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Q1) Which therapeutic communication technique is being used in this nurse-client interaction? Client: "When I get angry, I get into a fistfight with my wife or I take it out on the kids."
Nurse: "I notice that you are smiling as you talk about this physical violence."
A)Encouraging comparison
B)Exploring
C)Formulating a plan of action
D)Making observations
Q2) Which nursing statement is a good example of the therapeutic communication technique of focusing?
A)"Describe one of the best things that happened to you this week."
B)"I'm having a difficult time understanding what you mean."
C)"Your counseling session is in 30 minutes.I'll stay with you until then."
D)"You mentioned your relationship with your father.Let's discuss that further."
Q3) During a nurse-client interaction, which nursing statement may belittle the client's feelings and concerns?
A)"Don't worry.Everything will be alright."
B)"You appear uptight."
C)"I notice you have bitten your nails to the quick."
D)"You are jumping to conclusions."
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Chapter 9: The Nursing Process in Psychiatricmental Health
Nursing
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Q1) Which nursing response would be appropriately used in the evaluation phase of the nursing process?
A)"If I were in your situation, I would not repeat a behavior that has caused problems."
B)"What do you think needs changing, and what do you want to do differently?"
C)"What exactly will it take to carry out your plan, and what else do you need to do?"
D)"This new approach seems to work for you."
Q2) A client is recovering from abdominal surgery. In order to maximize the learning process prior to discharge teaching, which assessment should be performed by the nurse?
A)Assessing the client's level of pain
B)Assessing and documenting the client's vital signs
C)Assessing skin turgor and hydration status
D)Assessing incisional site for serosanguineous drainage
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) The nurse should utilize which group function to help an extremely withdrawn, paranoid client increase feelings of security?
A)Socialization
B)Support
C)Empowerment
D)Governance
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12
Chapter 11: Intervention With Families
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Q1) During family counseling, a husband tells his wife to spend more time with the family, and she responds by stating, "Okay, I'll turn in my resignation tomorrow." The husband replies, "I knew it! You've always been a quitter!" How should the nurse interpret the husband's statement?
A)The husband is expressing an emotional cutoff.
B)The husband is expressing double-bind communication.
C)The husband is expressing indirect messages.
D)The husband is expressing avoidance behaviors.
Q2) A couple has been married for 20 years. They argue constantly, belittle feelings, and continuously contradict each other. During a therapy session, the nurse documents "Marital schism." What does the nurse mean by this documentation?
A)The couple has a compatible marriage relationship.
B)The husband has a dominant relationship over the wife.
C)The couple has an enmeshed relationship.
D)The couple has an incompatible marriage relationship.
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Chapter 12: Milieu Therapy - the Therapeutic Community
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Q1) A client diagnosed with schizophrenia functions well and is bright, spontaneous, and interactive during hospitalization but then decompensates after discharge. What does the milieu provide that may be missing in the home environment?
A)Peer pressure
B)Structured programming
C)Visitor restrictions
D)Mandated activities
Q2) A nurse working on an inpatient psychiatric unit is assigned to conduct a 45-minute education group. What should the nurse identify as an appropriate group topic?
A)Dream analysis
B)Creative cooking
C)Paint by number
D)Stress management
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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14
Chapter 13: Crisis Intervention
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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) A wife brings her husband to an emergency department after an attempt to hang himself. He is a full-time student and works 8 hours at night to support his family. He states, "I can't function any longer under all this stress." Which type of crisis is the client experiencing?
A)Maturational/developmental crisis
B)Psychiatric emergency crisis
C)Anticipated life transition crisis
D)Traumatic stress crisis
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15
Chapter 14: Relaxation Therapy
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Q1) A client who has been referred for stress management asks the nurse, "Which one of these relaxation techniques requires reimbursement from my health insurance?" Which is the appropriate nursing reply?
A)"Meditation requires reimbursement from health insurance."
B)"Biofeedback requires reimbursement from health insurance."
C)"Physical exercise requires reimbursement from health insurance."
D)"Deep breathing requires reimbursement from health insurance."
Q2) Which response is known to be a physiological manifestation of relaxation?
A)Increased levels of norepinephrine
B)Pupil dilation
C)Reduced metabolic rate
D)Increased levels of blood sugar
Q3) 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.
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Chapter 15: Assertiveness Training
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Q1) During an assertiveness training group, a nurse suggests using "I statements." The group questions the usefulness of this communication technique. Which explanation by the nurse is most appropriate?
A)"When 'I statements' are used, opinions are communicated without blaming others."
B)"When 'I statements' are used, anger is displaced by using indirect means."
C)"When 'I statements' are used, responsibility for one's behavior is attributed to another."
D)"When 'I statements' are used, eye contact is promoted."
Q2) A nurse should assign which nursing diagnosis to a client needing assistance with assertiveness?
A)Disturbed personal identity
B)Disturbed thought processes
C)Defensive coping
D)Impaired verbal communication
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17
Chapter 16: Promoting Self Esteem
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Sample Questions
Q1) A home health nurse visits an 18-year-old client who lives with his mother. The client has been assessed as having low self-esteem. The nurse refers the client for individual counseling. During the next home visit, which assessed client behavior clearly indicates treatment success?
A)The client wants to buy a dog but has not yet asked his mother's permission.
B)The client asks his mother for permission to buy a dog.
C)The client tells his mother he plans to buy a dog.
D)The client buys a dog and hides it in the garage.
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.
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18
Chapter 17: Angeraggression Management
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Q1) A student nurse has just entered a psychiatric rotation. The student asks a nursing instructor, "How will we know if someone may get violent?" Which is the most appropriate reply by the nursing instructor?
A)"You can't really say for sure.There are limited indicators of potential violence."
B)"Certain behaviors indicate a potential for violence.They are labeled as a 'prodromal syndrome' and include rigid posture, clenched fists, and raised voice."
C)"Any client can become violent, so it is best to be aware of your surroundings at all times."
D)"When a client suddenly becomes quiet, withdrawn, and maintains a flat affect, this is an indicator of potential violence."
Q2) Which risk factor should a nurse recognize as the most reliable indicator of potential client violence?
A)A diagnosis of schizotypal personality disorder
B)History of assaultive behavior
C)Family history of violence
D)Recent eviction from a homeless shelter
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Chapter 18: Intervention With a Suicidal Client
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Q1) The treatment team is making a discharge decision regarding a previously suicidal client. Which client assessment information should a nurse recognize as contributing to the team's decision?
A)No previous admissions for major depressive disorder
B)Vital signs stable; no psychosis noted
C)Able to comply with medication regimen; able to problem-solve life issues
D)Able to participate in a plan for safety; family agrees to constant observation
Q2) A nursing instructor is teaching about suicide in the elderly population. Which information should the instructor include?
A)Elderly people use less lethal means to commit suicide.
B)While the elderly make up less than 13% of the population, they account for 16% of all suicides.
C)Suicide is the second leading cause of death in the elderly.
D)It is normal for elderly individuals to express a desire to die because they have come to terms with their mortality.
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Chapter 19: Behavior Therapy
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Q1) An adolescent comes from a dysfunctional family where physical and verbal abuse prevail. At school this adolescent bullies and fights with classmates. Based on principles of behavior therapy, what is the probable source of this behavior?
A)Shaping
B)Modeling
C)Premack principle
D)Reciprocal inhibition
Q2) A nursing instructor is teaching about the behavior technique of modeling. When asked to give an example of this behavioral intervention, which student statement meets the learning objective?
A)"A child is first rewarded for using a spoon to eat and then rewarded for using a fork, and finally rewarded for cutting food with a knife."
B)"An adolescent imitates Dad by using and caring for tools appropriately."
C)"A client and therapist agree to conditions of therapy stating explicitly in writing the behavior change that is desired."
D)"A mother tells her child that television can be watched only after homework is completed."
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21
Chapter 20: Cognitive Therapy
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Q1) When a client's husband comes home late from work, the wife immediately fears infidelity. The advanced practice nurse therapist encourages the wife to consider other explanations for her husband's tardiness. What technique is the nurse using?
A)Examination of the evidence
B)Decatastrophizing
C)Generating alternatives
D)Reattribution
Q2) A nurse practitioner uses cognitive therapy with depressed clients. The nurse asks clients to keep a daily record of dysfunctional thoughts. Which of the following are appropriate nursing replies to a client questioning the purpose of this exercise? (Select all that apply.)
A)"The purpose of this exercise is to identify automatic thoughts."
B)"The purpose of this exercise is to identify rational alternatives."
C)"The purpose of this exercise is to modify cognitive errors."
D)"The purpose of this exercise is to eliminate irrational beliefs."
E)"The purpose of this exercise is to monitor thoughts related to self-esteem."
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Chapter 21: Electroconvolusive Therapy
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Q1) A client is scheduled for an initial treatment of electroconvulsive therapy (ECT). Which information should a nurse include when teaching about the potential side effects of this procedure?
A)"You may experience transient tangential thinking."
B)"You may experience some memory deficit surrounding the ECT."
C)"You may experience avolution for the remainder of the day."
D)"You may experience a higher risk for subsequent seizures."
Q2) A client with cognitive deficits is extremely suicidal. The client has not responded to antidepressants and the treatment team is considering electroconvulsive therapy (ECT).
What client information would determine the feasibility of this treatment option?
A)Because the client is extremely suicidal, ECT is an appropriate option.
B)Because antidepressant medications have been ineffective, ECT is a good alternative.
C)Because informed consent is required for ECT, cognitive deficits preclude this option.
D)Because of the client's cognitive deficits, a signed consent is waived.
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Chapter 22: Complementary Therapies
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Q1) A lethargic client is diagnosed with major depressive disorder. After taking antidepressant therapy for 6 weeks, the symptoms have not resolved. Which nutritional deficiency should a nurse identify as potentially contributing to the client's symptoms?
A)Vitamin A deficiency
B)Vitamin C deficiency
C)Iron deficiency
D)Folic acid deficiency
Q2) A client reports taking St. John's wort for depression. The client states, "I'm taking the recommended dose, but it seems like if two capsules are good, four would be better!"
Which is an appropriate nursing reply?
A)"Herbal medicines are more likely to cause adverse reactions than prescription medications."
B)"Increasing the amount of herbal preparations can lead to overdose and toxicity."
C)"The FDA does not regulate herbal remedies, therefore ingredients are often unknown."
D)"Certain companies are better than others.Always buy a reputable brand."
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Chapter 23: Disorders Usually First Diagnosed in Infancy,
Childhood, or Adolescence
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Q1) An adolescent client who was diagnosed with conduct disorder at the age of 8 is sentenced to juvenile detention after bringing a gun to school. How should the nurse apply knowledge of conduct disorder to this client's situation?
A)Childhood-onset conduct disorder is more severe than the adolescent-onset type, and these individuals likely develop antisocial personality disorder in adulthood.
B)Childhood-onset conduct disorder is caused by a difficult temperament, and the child is likely to outgrow these behaviors by adulthood.
C)Childhood-onset conduct disorder is diagnosed only when behaviors emerge before the age of 5, and therefore improvement is likely.
D)Childhood-onset conduct disorder has no treatment or cure, and children diagnosed with this disorder are likely to develop progressive oppositional defiant disorder.
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Chapter 24: Delirium, Dementia, and Amnestic Disorders
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Q1) A nursing instructor is teaching about donepezil (Aricept). A student asks, "How does this work? Will this cure Alzheimer's dementia?" Which is the appropriate instructor reply?
A)"This medication delays the destruction of acetylcholine, a chemical in the brain necessary for memory processes.Although most effective in the early stages, it serves to delay, but not stop, the progression of the dementia."
B)"This medication encourages production of acetylcholine, a chemical in the brain necessary for memory processes.It delays the progression of the disease."
C)"This medication delays the destruction of dopamine, a chemical in the brain necessary for memory processes.Although most effective in the early stages, it serves to delay, but not stop, the progression of the dementia."
D)"This medication encourages production of dopamine, a chemical in the brain necessary for memory processes.It delays the progression of the disease."
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Chapter 25: Substance-Related Disorders
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Q1) A nurse is interviewing a client in an outpatient substance-abuse clinic. To promote success in the recovery process, which outcome should the nurse expect the client to initially accomplish?
A)The client will identify one person to turn to for support.
B)The client will give up all old drinking buddies.
C)The client will be able to verbalize the effects of alcohol on the body.
D)The client will correlate life problems with alcohol use.
Q2) On the first day of a client's alcohol detoxification, which nursing intervention should take priority?
A)Strongly encourage the client to attend 90 Alcoholics Anonymous meetings in 90 days.
B)Educate the client about the biopsychosocial consequences of alcohol abuse.
C)Administer ordered chlordiazepoxide (Librium) in a dosage according to protocol.
D)Administer vitamin B<sub>1</sub> to prevent Wernicke-Korsakoff syndrome.
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Chapter 26: Schizophrenia and Other Psychotic Disorders
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Q1) Which statement should indicate to a nurse that an individual is experiencing a delusion?
A)"There's an alien growing in my liver."
B)"I see my dead husband everywhere I go."
C)"The IRS may audit my taxes."
D)"I'm not going to eat my food.It smells like brimstone."
Q2) A nurse is caring for a client who is experiencing a flat affect, paranoid delusions, anhedonia, anergia, neologisms, and echolalia. Which statement correctly differentiates the client's positive and negative symptoms of schizophrenia?
A)Paranoid delusions, anhedonia, and anergia are positive symptoms of schizophrenia.
B)Paranoid delusions, neologisms, and echolalia are positive symptoms of schizophrenia.
C)Paranoid delusions, anergia, and echolalia are negative symptoms of schizophrenia.
D)Paranoid delusions, flat affect, and anhedonia are negative symptoms of schizophrenia.
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28
Chapter 27: Mood Diorders: Depression
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Q1) Sertraline (Zoloft) has been prescribed for a client complaining of poor appetite, fatigue, and anhedonia. Which consideration should the nurse recognize as influencing this prescriptive choice?
A)Zoloft is less expensive for the client.
B)Zoloft is extremely sedating and will help with sleep disturbances.
C)Zoloft has less adverse side effects than other antidepressants.
D)Zoloft begins to improve depressive symptoms quickly.
Q2) What is the rationale for a nurse to perform a full physical health assessment on a client admitted with a diagnosis of major depressive disorder?
A)The attention during the assessment is beneficial in decreasing social isolation.
B)Depression can generate somatic symptoms that can mask actual physical disorders.
C)Physical health complications are likely to arise from antidepressant therapy.
D)Depressed clients avoid addressing physical health and ignore medical problems.
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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 client is diagnosed with cyclothymic disorder. What client behaviors should the nurse expect to assess?
A)The client expresses "feeling blue most of the time."
B)The client has endured periods of elation and dysphoria lasting for more than 2 years.
C)The client fixates on hopelessness and thoughts of suicide continually.
D)The client has labile moods with periods of acute mania.
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Chapter 29: Anxiety Disorders
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Sample Questions
Q1) A client diagnosed with panic disorder states, "When an attack happens, I feel like I am going to die." Which is the most appropriate nursing reply?
A)"I know it's frightening, but try to remind yourself that this will only last a short time."
B)"Death from a panic attack happens so infrequently that there is no need to worry."
C)"Most people who experience panic attacks have feelings of impending doom."
D)"Tell me why you think you are going to die every time you have a panic attack."
Q2) A nursing instructor is teaching about specific phobias. Which student statement should indicate that learning has occurred?
A)"These clients do not recognize that their fear is excessive and rarely seek treatment."
B)"These clients have a panic level of fear that is overwhelming and unreasonable."
C)"These clients experience symptoms that mirror a cerebrovascular accident (CVA)."
D)"These clients experience the symptoms of tachycardia, dysphagia, and diaphoresis."
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Chapter 30: Somatoform and Disassociative Disorders
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Sample Questions
Q1) Which symptom exhibited by a client diagnosed with a conversion disorder would predict the poorest prognosis?
A)Seizures
B)Blindness
C)Aphonia
D)Paralysis
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) 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 client is diagnosed with sexual aversion disorder. Which symptom of this disorder should the nurse correctly pair with an appropriate therapeutic intervention?
A)Avoidance of all genital sexual contact treated by systematic desensitization
B)Avoidance of all genital sexual contact treated by medicating with tadalafil (Cialis)
C)Anorgasmia treated by vardenafil (Levitra)
D)Anorgasmia treated by sensate focus exercises
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Chapter 32: Eating Disorders
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Q1) A nurse is seeing a client in an outpatient clinic for treatment of anorexia nervosa. Which is the most appropriate, correctly written short-term outcome for this client?
A)The client will use stress-reducing techniques to avoid purging.
B)The client will discuss chaos in personal life and be able to verbalize a link to purging.
C)The client will gain 2 pounds prior to the next weekly appointment.
D)The client will remain free of signs and symptoms of malnutrition and dehydration.
Q2) A nurse responsible for conducting group therapy on an eating disorder unit schedules the sessions immediately after meals. Which is the rationale for scheduling group therapy at this time?
A)To shift the clients' focus from food to psychotherapy
B)To prevent the use of maladaptive defense mechanisms
C)To promote the processing of anxiety associated with eating
D)To focus on weight control mechanisms and food preparation
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Chapter 33: Adjustment and Impulse Control Disorders
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Q1) Which individual would most likely be diagnosed with intermittent explosive disorder?
A)A client diagnosed with antisocial personality disorder who attacks the nursing staff
B)A client diagnosed with diabetes mellitus who has a history of multiple severe assaultive acts
C)A client diagnosed with schizophrenia who sets fires because of command hallucinations
D)A client diagnosed with alcohol dependence who severely beats wife while intoxicated
Q2) In evaluating nursing interventions, which of the following types of questions would a nurse use to gather information from a client diagnosed with an impulse control disorder? (Select all that apply.)
A)Can the client demonstrate the ability to delay gratification?
B)Does the client demonstrate evidence of progression along the grief response?
C)Can the client accomplish activities of daily living independently?
D)Does the client verbalize symptoms of tension preceding unacceptable behavior?
E)Does the client verbalize the unacceptability of maladaptive behaviors?
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Chapter 34: Personality Disorders
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Q1) A nurse would expect a client diagnosed with schizotypal personality disorder to exhibit which characteristic?
A)The client keeps to self and has few, if any relationships.
B)The client has many brief but intense relationships.
C)The client experiences incorrect interpretations of external events.
D)The client exhibits lack of tender feelings toward others.
Q2) Which client situation should a nurse identify as reflective of the impulsive behavior that is commonly associated with borderline personality disorder?
A)As the day shift nurse leaves the unit, the client suddenly hugs the nurse's arm and whispers, "The night nurse is evil.You have to stay."
B)As the day shift nurse leaves the unit, the client suddenly hugs the nurse's arm and states, "I will be up all night if you don't stay with me."
C)As the day shift nurse leaves the unit, the client suddenly hugs the nurse's arm, yelling, "Please don't go! I can't sleep without you being here."
D)As the day shift nurse leaves the unit, the client suddenly shows the nurse a bloody arm and states, "I cut myself because you are leaving me."
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Chapter 35: The Aging Individual
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Q1) A nursing instructor is teaching about reminiscence therapy. What student statement indicates that learning has occurred?
A)"Reminiscence therapy is a group in which participants create collages representing significant aspects of their lives."
B)"Reminiscence therapy encourages members to share both positive and negative significant life memories to promote resolution."
C)"Reminiscence therapy is a social group where members chat about past events and future plans."
D)"Reminiscence therapy encourages members to share positive memories of significant life transitions."
Q2) An elderly client who lives with a caregiver is admitted to an emergency department for a fractured arm. The client is soaked in urine and has dried fecal matter on lower extremities. The client is 6 feet tall and weighs 120 pounds. Which condition should the nurse suspect?
A)Inability for the client to meet self-care needs
B)Alzheimer's dementia
C)Abuse, neglect, or both
D)Caregiver role strain
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Chapter 36: Victims of Abuse or Neglect
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Q1) A client who has been raped is crying, pacing, and cursing her attacker in an emergency department. Which behavioral defense should a nurse recognize?
A)Controlled response pattern
B)Compounded rape reaction
C)Expressed response pattern
D)Silent rape reaction
Q2) 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.
Q3) Which assessment data should a school nurse recognize as signs of physical neglect?
A)The child is often absent from school and seems apathetic and tired.
B)The child is very insecure and has poor self-esteem.
C)The child has multiple bruises on various body parts.
D)The child has sophisticated knowledge of sexual behaviors.
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Page 38
Chapter 37: Community Mental Health Nursing
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Q1) A client diagnosed with schizophrenia is hospitalized due to an exacerbation of psychosis related to antipsychotic medication noncompliance. Which level of care does the client's hospitalization reflect?
A)Primary prevention level of care
B)Secondary prevention level of care
C)Tertiary prevention level of care
D)Case management level of care
Q2) 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
Q3) 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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Page 39
Chapter 38: Forensic Nursing
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Sample Questions
Q1) 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
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) Which factor impedes the establishment of a therapeutic relationship between a nurse and a prison inmate?
A)The misinterpretation of relationships as sexual, based on sexual activity deprivation
B)The inmate's suspicion of the nurse's attempt to establish rapport
C)The wide socioeconomic gap between the nurse and inmate
D)The limited inmate freedom that might generate resentments
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Chapter 39: The Bereaved Individual
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Q1) 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
Q2) A nurse is leading a bereavement group. Which of the following group members should the nurse identify as being at high risk for complicated grieving? (Select all that apply.)
A)A widower who has recently experienced the death of two good friends
B)A man whose wife died suddenly after a cerebrovascular accident
C)A widow who, after a year, allowed removal of life support from her terminally ill husband
D)A woman who had a competitive relationship with her recently deceased brother
E)A young couple whose child recently died of a genetic disorder
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