NURS 312 Final (questions)

Which did Carl Rogers advocate that the therapist treating the client should do? Select one:

a. provide validation of the terminology used during the session

b. recognize an understanding of the client's basic needs

c. focus on the client's instinctual drives

d. develop unconditional positive regard for the client

d. develop unconditional positive regard for the client

A nurse performs behaviors the treatment team wishes the client to develop. The client internalizes these behaviors through pervasive imitation. The treatment team is integrating which cognitive theory in the client's treatment?

a. Freud's psychoanalytic model

b. Skinner's operant conditions

c. Erikson's model of psychosocial development

d. Albert Bandura's social cognitive theory

d. Albert Bandura's social cognitive theory

Who proposed a gender differentiation developmental theory that female development does not follow a progression of stages but based on experiences within relationships?

a. Anna Freud

b. Carol Gilligan

c. Carl Rogers

d. Abraham Maslow

b. Carol Gilligan

A PMH nurse is reviewing different nursing theories. What do these theories form?

a. the conceptual basis for nursing practice

b. the basis for understanding the client

c. the spiritual basis for nursing practice

d. the context for nursing practice

a. the conceptual basis for nursing practice

Which domain includes cultural forces?

a. spiritual domain

b. biologic domain

c. psychological domain

d. social domain

d. social domain

A nurse is integrating Peplau's model when proving care to a client with mental illness. Which would the nurse identify as a key component?

a. self-care

b. nonverbal behaviours

c. anxiety

d. Suffering

c. anxiety

Which nursing theorist made a major contribution to psychiatric-mental health nursing introducing the conceptualization of the nurse-client relationship and its phases? Select one:

a. Dorothea Orem

b. Sigmund Freud

c. Hildegard Peplau

d. Margaret Newman

c. Hildegard Peplau

Which nursing intervention would focus on a client's spiritual distress related to a newly diagnosed psychiatric disorder?

a. supporting the clients to find meaning in their circumstances

b. ensuring medication adherence

c. developing a treatment plan that connects the client with the community

d. motivating the client to participate in learning activities

a. supporting the clients to find meaning in their circumstances

Which key psychodynamic concept is recognized as the core of PMH nursing intervention?

a. transference and countertransference

b. needs

c. the therapeutic relationship

d. defence mechanisms

c. the therapeutic relationship

The structures within the limbic system are integrally involved with which functions? Select all that apply.

a. hearing

b. tactile sensations

c. memory

d. speech

e. emotional behaviour

c. memory

e. emotional behaviour

A client with schizophrenia has been prescribed an antipsychotic medication. This medication likely affects metabolism of what neurotransmitter?

a. dopamine

b. seratonin

c. GABA

d. Acetylcholine

a. dopamine

Which statements regarding biologic rhythms and psychiatric illness are accurate? Select all that apply

a. Dysfunctions in biologic rhythms can contribute to the development of psychiatric illness

b. Biologic rhythms are unrelated to psychiatric illness

c. The only association between biologic rhythms and psychiatric illness is that individuals under stress have compromised immune systems

d. New information has come as biologic rhythms are more fully understood and defined

e. Dysfunction in biologic rhythms can result from psychiatric illness

a. Dysfunctions in biologic rhythms can contribute to the development of psychiatric illness

d. New information has come as biologic rhythms are more fully understood and defined

e. Dysfunction in biologic rhythms can result from psychiatric illness

Which statements about genetics and psychiatric disorders are accurate? Select all that apply.

a. One gene alteration may cause different symptoms in different people

b. One gene is likely responsible for the majority of psychiatric disorders

c. Diagnosis of psychiatric disorders in ancestors is a reliable method to predict psychiatric disorders

d. Psychiatric-mental health nurses increasingly will need greater understanding of the role of genetics in mental illness

e. Environmental influences alter the body's functioning and often mediate or worsen genetic risk factors.

a. One gene alteration may cause different symptoms in different people

d. Psychiatric-mental health nurses increasingly will need greater understanding of the role of genetics in mental illness

e. Environmental influences alter the body's functioning and often mediate or worsen genetic risk factors.

How can the nurse best apply neurobiologic theories of mental disorders

a. referring a client for cognitive-behavioural therapy

b. administering antipsychotic medications

c. organizing family therapy sessions

d. applying the principles of therapeutic communication

b. administering antipsychotic medications

Which of the following are key components of PMH nursing practice? Select all that apply.

a. clinical pathways in care planning

b. recovery as a framework for mental health care

c. collaborative care

d. autonomy

e. clinical decision-making

a. clinical pathways in care planning

b. recovery as a framework for mental health care

c. collaborative care

e. clinical decision-making

The client states, "who is confused? He said I should go, but I did not. Is that weird?" Which response by the nurse would be best to clarify the client's statement?

a. "When did you first notice yourself feeling confused?"

b. "How did you feel before you talked with him?"

c. "I do not understand. Please explain in another way".

d. "Did he indicate to you exactly what he meant?"

c. "I do not understand. Please explain in another way".

During the initial interview with a client, the nurse begins to feel uncomfortable and realizes the client's behaviors and mannerisms remind the nurse of the nurse's abusive parent. The nurse concludes that the current situation represents which phenomenon?

a. reaction formation

b. countertransference

c. denial

d. transference

b. countertransference

A client asks the nurse what to do about leaving the spouse. The nurse replies, "Why are you having trouble deciding? It is easy to see that you should file for a divorce." The nurse manager overhearing the conversation would counsel the nurse because of which inappropriate element of the nurse's response? Select all that apply.

a. It belittles the client and the client's indecisiveness

b. It assumes that the client is incapable of reaching an independent decision

c. It restricts the client's opportunity for self- exploration and problem solving

d. It challenges the client's belief system

e. It positively reinforces the client's indecision.

a. It belittles the client and the client's indecisiveness

b. It assumes that the client is incapable of reaching an independent decision

c. It restricts the client's opportunity for self- exploration and problem solving

While communicating with a client, the nurse provides feedback to the client. What is the primary reason for the nurse to give appropriate feedback?

a. explain behaviour

b. explore feelings

c. present advice

d. provide information

d. provide information

A client has purposefully attempted to embarrass a nurse by making a sexually explicit comment. What is the best response by the nurse?

a. refuse to talk with the client any further

b. clarify the intention of the client

c. continue to interact as if the comments did not cause embarrassment.

d. leave the situation altogether

b. clarify the intention of the client

Which of the following statements of a therapeutic interaction is false?

a. A therapeutic interaction facilitates growth, developmental maturity, impowered functioning, and improved coping

b. The receiver may have to restate the message to the sender to ensure understanding.

c. A therapeutic interaction requires that there be a sender, message, and receiver

d. It is unnecessary to validate the receiver's perception of the message for a therapeutic interaction to occur

d. It is unnecessary to validate the receiver's perception of the message for a therapeutic interaction to occur

Which of the following comments by the nurse indicates that the nurse is being empathetic?

a. "Oh, I feel so sorry for you".

b. "It must be very hard to lose someone you love. Would you like to talk about it?"

c. "How can you tolerate your roommate?"

d. "I can't understand how you can handle so much pain and still be cheerful".

b. "It must be very hard to lose someone you love. Would you like to talk about it?"

Which of the following statements about active listening is false?

a. Active listening requires practice

b. It is difficult to listen actively when you do not value what the other person is saying

c. It is possible to listen actively and still plan what you will say in response

d. You can let the "sender" know you are listening by nodding your head and maintaining eye contact.

c. It is possible to listen actively and still plan what you will say in response

Which of the following is a true statement about nonverbal communication?

a. Touch is not always associated with comforting and caring by all clients

b. A client who avoids eye contact with you has something to hide

c. The hands are the most expressive part of the body.

d. Nonverbal communication is interpreted the same by all observers

a. Touch is not always associated with comforting and caring by all clients

A client is experiencing the biologic action of a drug. The action will depend on how the drug's structure interacts with a specific:

a. ion

b. organ

c. enzyme

d. receptor

d. receptor

A client is taking a psychotropic medication. Receptors for neurochemicals other than those in specific brain regions are being affected. What will the client experience?

a. intrinsic affinity

b. antagonist

c. agonists

d. side effects

d. side effects

A medication is known to have a high ability to produce a desired response. This drug is known to have a high degree of:

a. receptivity

b. efficacy

c. selectivity

d. intrinsic activity

b. efficacy

A client with a history of depression has been prescribed sertraline? Levels of which neurotransmitter will be most affected?

a. norepinephrine

b. serotonin

c. acetycholine

d. Melatonin

b. serotonin

A client's medication has a powerful bond between the drug molecules and its receptor. What characteristic does this drug possess?

a. response

b. affinity

c. selectivity

d. Efficacy

b. affinity

Which is the term for a drug that only interacts with its specific receptors in the areas of the body where these receptors occur?

a. covalent

b. intrinsic

c. particular

d. selective

d. selective

Which is the advantage of the newer antidepressants that are selective to both serotonin and norepinephrine?

a. There is an increased degree of receptor occupancy

b. Clients do not develop tolerance.

c. they take longer for affinity to occur.

d. They have fewer side effects.

d. They have fewer side effects.

A client with a mental health disorder has been prescribed a typical antipsychotic. What is the likely mechanism of action?

a. decreasing the sensitization of affected cells, making them less easy to stimulate

b. reuptake inhibition at serotonin and norepinephrine transporters

c. decreasing positive target symptoms as potent postsynaptic dopamine antagonists

d. blocking serotonin receptors that reside on dopamine neurons as well as dopamine receptors

c. decreasing positive target symptoms as potent postsynaptic dopamine antagonists

Which are mechanisms of action for tricyclic antidepressants? Select all that apply.

a. down-regulating specific serotonin and noradrenergic receptors

b. inhibiting reuptake at serotonin and norepinephrine transporters

c. inhibiting MAO, an enzyme that breaks down biogenic amines, such as serotonin, thereby increasing synaptic neurotransmission

d. increasing the amount of neurotransmitter in the synaptic space available for action on the receptors

e. blocking cholinergic, adrenergic, and histamine receptors

a. down-regulating specific serotonin and noradrenergic receptors

b. inhibiting reuptake at serotonin and norepinephrine transporters

e. blocking cholinergic, adrenergic, and histamine receptors

Which is the most important nursing intervention during the stabilization phase for a hospitalized client when medications are being increased rapidly?

a. continuing to assess target symptoms

b. closely monitoring vital signs and adverse reactions

c. providing verbal and written educational materials

d. changing medications when the client develops side effects

b. closely monitoring vital signs and adverse reactions

The client has started a new antipsychotic medication. When the nurse observes that the client has a thick tongue, tight jaw, or stiff neck muscles, which should the nurse document?

a. tardive dyskinesia

b. dystonia

c. kindling

d. Akathisia

b. dystonia

After educating a client who is receiving phenelzine, an MAOI, the nurse determines that the education was successful when the client states the need to avoid

a. fresh cottage cheese

b. cooked sliced ham

c. tap beers

d. milk

c. tap beers

A nurse observes an older adult client who has been taking antipsychotic medications for 8 months. The nurse sees the client's lips smacking and eyes blinking rapidly. The nurse also observes a protruding tongue. Which action by the nurse would be most appropriate?

a. Ask whether the client has been experiencing side effects.

b. Instruct the client to begin tapering the medication.

c. Contact the client's health care provider for a different medication order

d. Document the client's symptoms of tardive dyskinesia

d. Document the client's symptoms of tardive dyskinesia

An older adult reports anxiety and is prescribed diazepam by a family health care provider. The health care provider asks the office nurse to explain to the client the problematic side effects of this medication. Which instruction about this drug would be most important for the nurse to emphasize?

a. "You may find that you have temporary memory disturbances."

b. "You may experience minor urine incontinence from time to time."

c. "You may feel dizzy and be prone to falls after taking this medication."

d. "You need to use this medication cautiously because it can cause dependence"

c. "You may feel dizzy and be prone to falls after taking this medication."

While talking with an individual client diagnosed with schizophrenia, the nurse notices the client look away from the nurse and stare at the wall while making facial grimaces. What is the most appropriate intervention by the nurse?

a. Administer the ordered prn trihexphenidyl (Artane)

b. End the conversation because the client is not listening

c. Redirect the conversation to a neutral topic

d. Ask the client if they see something on the wall

d. Ask the client if they see something on the wall

A client taking antipsychotic medications for treatment of schizophrenia reports feeling nervous. The nurse notices that the client is pacing the long hallway and is unable to remain still, even when in conversation with other clients. What term should the nurse use to document this occurrence?

a. Akathisia

b. Akinesia

c. Dystonia

d. Tardive dyskinesia

a. Akathisia

The client who has been diagnosed with schizoaffective disorder takes both haloperidol (Haldol) and valporic acid (Depakote). When the client asks the nurse to explain what this particular combination of drugs is expected to do, what would be the best response by the nurse?

a. "Halperidol (Haldol) makes your moods calmer and valproic acid prevents tight muscles"

b. "This combination is good for people who have problems like yours"

c. "This is an old combination of drugs that helps people to keep thinking and feeling in balance"

d. "Halperidol improves your thinking and valproic acid stabilizes your moods"

d. "Halperidol improves your thinking and valproic acid stabilizes your moods"

A client admitted to an inpatient unit has been diagnosed with paranoid-type schizophrenia. The new mental health care worker on the unit asks about the best way to work with this client. How should the nurse respond?

a. "When possible, remains at arm's length from this client"

b. "Offer the client a hand-shake before beginning conversations"

c. "This client is anxious. Offer back rubs at bed time"

d. "To get the client's attention, place your hand gently on the arm or the hand"

a. "When possible, remains at arm's length from this client"

The client has been diagnosed with schizophrenia, residual type. A nursing care plan should give priority to which nursing diagnosis?

a. Anxiety

b. Social isolation

c. Impaired verbal communication

d. Self-care deficit

b. Social isolation

The nurse observes that the client diagnosed with paranoid schizophrenia appears very preoccupied. The client is pacing back and forth in the hall, periodically looking to the side, clenching the fist, and saying "I told you to go away". At this time, the nurse should plan to do which of the following? Select all that apply.

a. Refrain from using non-verbal hand gestures

b. Reduce proximity to others

c. Offer frequent orienting stimuli

d. Avoid touching the client during conversations

a. Refrain from using non-verbal hand gestures

b. Reduce proximity to others

d. Avoid touching the client during conversations

The nurse is to complete an AIMS assessment of the client. When explaining this test to the client, the nurse should say that this test will help to identify of the client is beginning to have which of the following?

a. Weak muscles

b. Uncontrollable motions in the body

c. Shaking hands and feed

d. Slowed body movement

b. Uncontrollable motions in the body

A client is having blurred vision that began after beginning drug therapy with a traditional anti-psychotic. What would be the best response by the nurse?

a. "You need to schedule an appointment with your eye doctor to get anew prescription for your eyeglasses"

b. "Blurred vision is a temporary side effect of your medication that usually resolves within a few weeks"

c. "You need to stop taking your antipsychotic medication and notify your doctor immediately" d. "Blurred vision is a permanent condition as a result of your medication"

b. "Blurred vision is a temporary side effect of your medication that usually resolves within a few weeks"

A Client is planning to be discharged from the hospital. It is the nurse's responsibility to educate this client regarding prescribed medication. This client is taking clozapine (Clozaril). The nurse makes it a priority to teach the client to notify the physician immediately for which of the following?

a. Unusual reactions to exposure to the sun

b. Interferences with the normal sleep pattern

c. Indications of any sort of infection.

d. Feelings of increased energy and interest in the environment

c. Indications of any sort of infection.

A client diagnosed with chronic schizophrenia has been receiving an atypical antipsychotic for three months. The nurse concludes that the client is experiencing a reduction in negative symptoms of schizophrenia if a family member says which of the following? Select all that apply.

a. "We walked together for 15 minutes, and I could see no evidence he was 'hearing voices'".

b. "It has been more than a month since he said that he is a Martian prince".

c. "I've noticed that his thoughts are better organized".

d. "For the past week, he has gotten up, dressed, and taken a walk early each morning"

e. "We went to a musical concert, and he smiled and applauded the musicians"

d. "For the past week, he has gotten up, dressed, and taken a walk early each morning"

e. "We went to a musical concert, and he smiled and applauded the musicians"

While the nurse is meeting with the family of a client diagnosed with schizophrenia, a family member asks the nurse to explain what causes the disorder. What is the nurse's best response?

a. "It is clear that early-age psychological traumas cause schizophrenia".

b. "It is likely that poor parenting skills cause schizophrenia to occur"

c. "The exact cause of schizophrenia is unclear at this time"

d. "Research indicates that schizophrenia is caused by a genetic predisposition"

c. "The exact cause of schizophrenia is unclear at this time"

Which statement about ethics are true? Select all that apply.

a. Ethics is defined as the practical application of law

b. Ethics is about learning how to reach our potential as human beings

c. Ethics needs to be an everyday part of our lives and build into our society.

d. Ethics is about values, relationships, principles, duties, rights, and responsibilities

e. Ethics and law belong to the same domain

b. Ethics is about learning how to reach our potential as human beings

c. Ethics needs to be an everyday part of our lives and build into our society.

d. Ethics is about values, relationships, principles, duties, rights, and responsibilities

Which is the basis for the nurse's decision-making process to determine if the client is making a rational choice?

a. diagnosis

b. capacity

c. history

d. Age

b. capacity

A nurse is upset because their heavy workload does not allow them to provide the level of care that they believe their clients deserve. What is this nurse experiencing?

a. reactive distress

b. moral residue

c. moral distress

d. moral dilemma

c. moral distress

Psychiatric mental health (PMH) nurses are responsible for understanding the Mental health Act of their province and territory and to

a. support the provisions of the Mental health Act and implement changes to the legislation

b. consider issues that affect individuals with medical problems

c. explain the Act's basic provisions to people with mental illness and their families

d. advocate on behalf of the health profession the importance of the Act

c. explain the Act's basic provisions to people with mental illness and their families

Which are criteria for involuntary admission required by the Provincial and Territorial Mental Health Acts for all provinces and territories in Canada? Select all that apply.

a. meets the definition of a mental disorder

b. is not suitable as a voluntary patient

c. meets the criteria for harm

d. likely to suffer substantial mental or physical deterioration

e. refusal of treatment by the person after admission

a. meets the definition of a mental disorder

b. is not suitable as a voluntary patient

c. meets the criteria for harm

d. likely to suffer substantial mental or physical deterioration

During the client assessment, the nurse finds that the client is trembling and restless, blood pressure and pulse are elevated, and the client reports dry mouth, shortness of breath, inability to relax, loss of appetite, and an upset stomach. The nurse should include that this client is experiencing which level of anxiety?

a. Panic

b. Mild

c. Severe

d. Moderate

c. Severe

During an assessment interview the client tells the nurse, "I can't stop worrying about my makeup. I can't go anywhere nor do anything unless my makeup is fresh and perfect. I wash my face and put on fresh makeup at least once and sometimes twice an hour." The nurse's priority should be to adjust the client's plan of care so that which of the following will happen?

a. The client will be given advance notice of approaching time for all group therapy sessions

b. The client will be allowed to use own cosmetics and grooming products

c. The client will be required to spend daytime hours out of own room.

d. The client will be asked to keep a diary of feelings experienced if unable to groom self at will

a. The client will be given advance notice of approaching time for all group therapy sessions

When assessing an apparently anxious client, the nurse ensures that questions related to the client's anxiety are which of the following?

a. Avoided until anxiety disappears

b. Avoided until the client brings up the topic

c. Abstract and nonthreatening

d. Specific and direct

d. Specific and direct

The nurse is caring for a client who is anxious . Which nursing diagnosis has the highest priority at this time?

a. Risk for self-directed violence

b. Defensive coping

c. Risk of loneliness

d. Ineffective denial

a. Risk for self-directed violence

The nurse have taught an anxious client a relaxation technique. The nurse would evaluate the effect of the instruction on which client goal? Select all that apply.

a. The client will experience anxiety without feeling overwhelmed

b. The client will keep a journal of times anxiety is experienced

c. The client will confront the source of the anxiety

d. The client will suppress anxious feelings

e. The client will work through problems without being devastated.

a. The client will experience anxiety without feeling overwhelmed

e. The client will work through problems without being devastated.

The nurse has established the following long-term goal: "The client will learn new ways of coping with anxiety". For which level of anxiety is this goal most appropriate?"

a. Mild

b. Panic

c. Moderate

d. Severe

c. Moderate

Which of the following will be the best nursing intervention for a client who is having a panic attack?

a. Teach the client to recognize signs of a panic attack

b. Instruct the client to remain alone until the symptoms subside

c. As the client to describe what was happening before the anxiety began.

d. Remain with the client

d. Remain with the client

A client asks why a beta blocker-medication has been prescribed for anxiety. When answering this question, the nurse should explain that this medication class is effective for treatment of which symptoms associated with anxiety? Select all that apply.

a. Palpitations

b. Insomnia

c. Confusion

d. Rapid heart rate

e. Suicidal ideations

a. Palpitations

d. Rapid heart rate

A client who has refused to take the regular prescribed dose of clonazepam (Klonopin or Rivotril) reports irritability, insomnia, and sweating. The nurse concludes that the client is most likely experiencing symptoms associated with which of the following?

a. Withdrawal

b. Overdose

c. Manipulation

d. Anxiety

a. Withdrawal

The nurse is caring for a client with posttraumantic stress disorder (PTSD). Which statement by the client would indicate the most improvement?

a. "I am responsible for what happened with me"

b. "I like to stay awake all night"

c. "I can't relax. I stay alert all the time"

d. "I enjoy being back at work with my friends"

d. "I enjoy being back at work with my friends"

Before the newly admitted anxious client begin treatment with benzodiazepines, it is most important for the nurse to assess which of the following?

a. Recent use of alcohol or other depressants

b. Stressors and use of coping mechanisms

c. Level of motivation for treatment

d. Situational and social support

a. Recent use of alcohol or other depressants

The nursing assessment indicates that a client is experiencing a panic attack. The client is unable to understand directions and is preoccupied with thoughts of danger. Which of the following would be the most appropriate nursing diagnosis?

a. Impaired communication

b. Risk for noncompliance

c. Ineffective health maintenance

d. Impaired thought processes

d. Impaired thought processes

The nurse would formulate which goal as most appropriate for a client who has been diagnosed as having generalized anxiety disorder (GAD)?

a. The nurse will describe dissociative experiences

b. The client will relive the traumatic event

c. The client will verbalize a sense of control over ritualistic behaviors

d. The client will display the ability to cope with mild anxiety

d. The client will display the ability to cope with mild anxiety

A client who is receiving an anxiolytic medication is reluctant to participate in group therapy. The client states "The pills I am taking will take care of my stress. I don't need to talk about my problems". In response to the client's statement which of the following should the nurse explain?

a. The medications will not work unless the client participates in group therapy

b. Many anxiolytics are habituating

c. Medications relieve symptoms but do not change the source of the anxiety

d. The client will need to attend group therapy only until the medication becomes effective

c. Medications relieve symptoms but do not change the source of the anxiety

A client states "I am always late for everything because I can't leave my room without checking every drawer and door to make sure they are locked. If I don't do that, I get so worried that I have to go back. I can't seem to stop by behavior". The nurse should take which action at this time?

a. Explore childhood experiences that may have led to the behavior.

b. Allow the client adequate time to carry out the ritual

c. Remind the client that the staff will not allow others to enter the room

d. Encourage the client to remain in the room until the urge to recheck has decreased

b. Allow the client adequate time to carry out the ritual

The client is experiencing a panic attack. Which of the following actions by the nurse would be appropriate? Select all that apply.

a. Restrict the client's physical activity

b. Use short simple sentences

c. Speak loudly and firmly

d. Remain calm and serene

b. Use short simple sentences

d. Remain calm and serene

A client has obsessive-compulsive disorder (OCD). Which of the following statements made by the client of the nurse would be the best indicator of Improvement?

a. "My friends don't know about my disorder".

b. "I only do my ritual to reward myself when I have been good"

c. "I have more control over my thoughts and behaviours"

d. "I know that my thoughts and behaviours are not normal"

c. "I have more control over my thoughts and behaviours"

A client with generalized anxiety disorder states, "I now know the best thing for me to do is just to try to forget my worries". How should the nurse evaluate this statement?

a. The client needs to be encouraged to verbalize feelings

b. The client's coping skills are improving

c. The nurse-client relationship should be terminated

d. The client is developing insight

a. The client needs to be encouraged to verbalize feelings

The client is taking triazolam (Halicion) to reduce anxiety related symptoms. Which statement indicates that the nurse should provide teaching to the client? Select all that apply

a. "I might not be able to drive while I am taking this medication"

b. "I don't need to go to therapy since the medication is working"

c. "The doctor wants me to take this drug at bedtime because it will help me to sleep better"

d. "I will probably have to take this medication for the rest of my life"

e. "I should stop taking the medication abruptly"

b. "I don't need to go to therapy since the medication is working"

d. "I will probably have to take this medication for the rest of my life"

e. "I should stop taking the medication abruptly"

The client is scheduled for electroconvulsive therapy (ECT) when teaching the client about what to expect in the post-ECT period, which statements should the nurse make? Select all that apply.

a. "It is common for persons who receive ECT to lose all painful memories of early life"

b. "It may hard for you to remember everything that happened during the days and weeks you receive ECT"

c. "You should expect that you will be able to remember recent events more clearly than you did before you started receiving ECT"

d. "Even though modifications have been made in ECT over the years, you may have some disorientation briefly upon awakening from the procedure"

e. "If you notice that you are having changes in your memory, let a staff member know immediately"

b. "It may hard for you to remember everything that happened during the days and weeks you receive ECT"

d. "Even though modifications have been made in ECT over the years, you may have some disorientation briefly upon awakening from the procedure"

The client suffers from bipolar disorder. Lithium carbonate 300mg four times daily has been prescribed. After three days of lithium therapy, the client says "What's wrong? My hands are shaking a little". What is the best response by the nurse?

a. "Just in case your blood level is too high, am not going to give you your next dose of lithium".

b. "I wouldn't worry about it if I were you. It's a small tremor that doesn't interfere with your functioning"

c. "There is no reason to worry about that. We won't unless it lasts longer than a couple of weeks"

d. "Minor hand trembling happens for a few days after lithium is started. It usually stops in one or two weeks".

d. "Minor hand trembling happens for a few days after lithium is started. It usually stops in one or two weeks".

The client is being admitted to the inpatient psychiatric unit with a diagnosis of major depressive disorder. During the initial nursing assessment, the nurse anticipates that the client will acknowledge which of the following? Select all that apply.

a. Presence of hallucinations for at least three days

b. Loss of appetite for approximately three days

c. Loss of interest in previously enjoyed activities

d. Suicidal thoughts or plans of suicide over at least the last two weeks.

e. History of one depressive episode within the last two years

c. Loss of interest in previously enjoyed activities

d. Suicidal thoughts or plans of suicide over at least the last two weeks.

A client hospitalized with bipolar disorder is in a state of mania. The client, who was admitted on a formal voluntary status, demands immediate discharge from the facility. What should the nurse do first?

a. Notify the police of the client's intention

b. Develop a Safety Plan with the client

c. Notify the supervisor on the nursing unit

d. Inform the client's spouse of the request of the client

b. Develop a Safety Plan with the client

The nurse needs to teach a client about newly prescribed sertraline (Zoloft). Which information is essential to include in the teaching? Select all that apply.

a. Sertraline is most often taken as a morning dose.

b. It is possible that sexual side effects will occur.

c. Constipation is a common side effect of sertraline.

d. Fever and flu-like symptoms are bothersome but not dangerous side effects of sertraline.

e. Clients taking sertraline will usually recognize improvement within a week.

a. Sertraline is most often taken as a morning dose

b. It is possible that sexual side effects will occur.

A client who had coronary bypass surgery six days ago reports having no appetite and feeling very sad. The client further complains of having difficulty falling asleep. The nurse concludes that it is likely that this client is experiencing which of the following?

a. Depressed mood

b. Disturbed body image

c. Activity intolerance

d. Delayed surgical recovery

a. Depressed mood

The client diagnosed with Dysthymia asks the nurse to explain what the diagnosis means. When responding to the client, the nurse should state that before dysthymia can be diagnosed, depressed mood needs to be present for at least how long?

a. Two years

b. Four weeks

c. Two weeks

d. One year

a. Two years

The hospitalized client is in the acute stage of mania. What is an appropriate client goal for the client to work toward?

a. Spend at least 30 minutes per hour watching TV in the activity room

b. Maintain distance of two to three at all times when interacting with others

c. Lead other clients in group physical exercises each morning

d. Participate actively in the psychodrama group each day

b. Maintain distance of two to three at all times when interacting with others

The family members of a client in an acute state of mania relate that the client has not slept for four nights. They further report that the client climbed up and down the stairs of a nearby sports stadium for at least six hours without stopping. The client now has blisters on the feet and is perspiring profusely. When planning care for the client, the nurse should give priority to which of the following problems?

a. Ineffective Coping

b. Risk for Deficient Fluid Volume

c. Impaired Adjustment

d. Impaired Skin Integrity

b. Risk for Deficient Fluid Volume

The nurse assesses that a client in a state of elevated affect is at risk for self-harm. The nurse then places high priority on including which of the following in the plan of care?

a. A room that is observable from the nurse's station

b. A quiet, non-stimulating private room for the client

c. Constant supervision of the client

d. Administration of all medications intramuscularly rather than orally

c. Constant supervision of the client

The inpatient mental health client is being treated for major depression. The client has psychomotor retardation, speaks very little, and is extremely inactive physically. The client takes an antidepressant that causes anticholinergic side effects. The nurse should conclude that this client is at particular risk for developing which of the following? Select all that apply

a. Weight loss

b. Diarrhea

c. Vomiting

d. Constipation

e. Dry mouth

d. Constipation

e. Dry mouth

The 26-year-old female hospitalized client is being treated for major depressive disorder. The client participated actively in group therapy during the hour before lunchtime. When it is time for lunch, the client tells the nurse "I'm not going. I'm going to my room". What is the nurse's best response?

a. Ask the client if there is a problem with the food

b. Tell the client that there is a unit schedule that must be followed by everyone

c. Ask the client if she is angry

d. Ask the client to sit for a few minutes to discuss this

d. Ask the client to sit for a few minutes to discuss this

The nurse is conducting discharge teaching for a client taking tranylcypromine (Parnate). The nurse determines that the client understands the instructions given if the client says not to eat which food while taking the medication?

a. Baked chicken

b. Salami

c. Potatoes

d. Apples

b. Salami

A nurse is teaching a group of clients about addiction. One client says he can stop drinking whenever he wants. The nurse concludes that this client does not yet understand that addiction is a disease in which individuals primarily loose ability to do which of the following?

a. Think logically about their addictive behaviour

b. Act sober even if they are not

c. Control addictive and impulsive behaviors

d. Recognizes that addictive behaviour is harmful to themselves and others

c. Control addictive and impulsive behaviors

As part of assessment activities to determine if the client is alcohol dependent, the nurse needs to conduct a CAGE assessment with the client. Which question asked by the nurse would be consistent with the structure of CAGE? Select all that apply.

a. "Have you ever counted the number of drinks consumed?"

b. "Have you ever found yourself gulping drinks before going out?"

c. "Have you ever felt that you needed to cut down on your drinking?"

d. "Have you ever been annoyed by comments made about your drinking?"

e. "Have you ever had a morning "eye-opener" to calm your nerves?"

c. "Have you ever felt that you needed to cut down on your drinking?"

d. "Have you ever been annoyed by comments made about your drinking?"

e. "Have you ever had a morning "eye-opener" to calm your nerves?"

After orientating the client to the addiction treatment unit, the nurse suggests that the client invite his 13-yeqr old son to family sessions. The client questions why the need for his son to participate, because he has not seen is father drunk. What is the best response by the nurse?

a. "Your son had probably seen changes in you when you were drinking"

b. "Your son probably knows that you are an alcoholic"

c. "It is good that you have concern for you underage son"

d. "Thirteen-year-olds are old enough to start learning about the effects of alcohol".

a. "Your son had probably seen changes in you when you were drinking"

The nurse conducts an in-service session about impaired nursing practice. The nurse evaluates that the teaching was effective when one of the nurses says that the most influential risk for impaired nursing practice is which of the following?

a. Thinking that professionals are not a high risk for substance dependency

b. Having a tendency to involve self in codependent professional and personal relationship

c. Feeling that nurses' knowledge about drugs protects them from drug dependency

d. Having grown up in a dysfunctional family

c. Feeling that nurses' knowledge about drugs protects them from drug dependency

A male client comes to day treatment surrounded by an intense odor of alcohol. The client staggers when walking but insists that he has not consumed any alcohol. The nurse concludes that his behavior constitutes which of the following?

a. Denial

b. Transference

c. Rationalization

d. Countertransference

a. Denial

A female alcohol-dependent client who has cardiomyopathy tells the nurse that she is certain that her family and friends are against her. The client goes on and say, "They stay on my back about my drinking and say I could die from it". What would be the best response by the nurse?

a. "Perhaps they have noticed that your drinking creates consequences for you".

b. "Anyone saying this to you must have a problem with their own drinking"

c. "Do you think they may be jealous that you can drink more than they can?"

d. "Although their intentions are good, they have no right to judge another person's drinking"

a. "Perhaps they have noticed that your drinking creates consequences for you".

A client who is recovering from alcoholism presents in the psychiatric unit and tells the admitting nurse she is very depressed and has a hard time staying sober. The nurse concludes that the most likely treatment sequence for the client will be which of the following?

a. Depression after the sobriety issue has been resolved.

b. Sobriety issue before the depression

c. Sobriety issue and depression at the same time

d. Depression before the sobriety issue

c. Sobriety issue and depression at the same time

A student nurse attends an Alcoholic Anonymous (AA) meeting and write a report about what was learned. What information would the student include in the report about the twelve-step program? Select all that apply.

a. Once an individual has achieved sobriety, they continue to be at risk for relapse into drinking

b. People learn to change negative attitudes and behaviors into positive ones

c. Once an individual learns how to be sober, they can graduate from attending meetings

d. Acceptance of being an alcoholic will prevent urges to drink, since it represents giving up one's denial.

e. A Higher Power will protect individuals if they feel like using.

a. Once an individual has achieved sobriety, they continue to be at risk for relapse into drinking

b. People learn to change negative attitudes and behaviors into positive ones

The nurse working in the maternal care area is reinforcing physician health teaching about the risks of substance use during pregnancy. When questioned by the client, the nurse should reply that which drugs are most likely to lead to significant physical, cognitive, and developmental problems for any infant?

a. Cocaine

b. Hallucinogens

c. Alcohol

d. Benzodiazepines

c. Alcohol

Having requested it as part of a comprehensive treatment program, the client is to receive disulfiram (Antabuse). Which statement should the nurse include when teaching the client about this drug?

a. "Eating inadequately cooked seafood may lead to disulfiram resistance"

b. "Taking disulfiram will reduce your physical craving for alcohol"

c. "If you consume alcohol while taking disulfiram, rapid intoxication will occur".

d. "Inhaling fumes from paints and wood stains may cause a disulfiram reaction"

d. "Inhaling fumes from paints and wood stains may cause a disulfiram reaction"

The nurse instructs the client about addiction. The nurse determines that the client understands the information given when the client makes which statement? Select all that apply.

a. "Addiction is a moral problem"

b. "Addiction is a medical illness"

c. "Addiction is difficult to cure".

d. "Addiction is an emotional attachment"

e. "Addiction is a behavioural habit"

b. "Addiction is a medical illness"

d. "Addiction is an emotional attachment"

e. "Addiction is a behavioural habit"

A client says, "I have a very small drink every morning to calm my nerves and stop my hands from trembling". The nurse concludes that this client is describing which of the following?

a. Withdrawal

b. Alcohol abuse

c. An anxiety disorder

d. Tolerance

a. Withdrawal

During a family therapy session, an alcoholic client tells a family member, "You made it easy for me to use alcohol. You always made excuses for my behavior." What should the nurse encourage the family to do?

a. Give up enabling behaviors

b. Manage the client's self-care

c. Deal with negative behaviors

d. Evaluate the home environment

a. Give up enabling behaviors

The nurse is developing interventions to prevent a client who abused alcohol from relapsing. What is the most important intervention for the client?

a. Avoid taking over-the-counter medications.

b. Limit monthly contact with the family of origin.

c. Refrain from becoming involved in group activities.

d. Avoid people, places, and activities from the former lifestyle.

d. Avoid people, places, and activities from the former lifestyle.