2. The Department of Health and Human Services estimates that of the 200,000 chronically homeless persons in the United States, the prevalence of mental illness and substance abuse is?

A. 25%

B. 40%

C. 70%

D. 85%

3. Hospitals established by Dorothea Dix were designed to provide which of the following?

A. Asylum

B. Confinement

C. Therapeutic Milieu

D. Public safety

4. Hildegard Peplau is best known for her writing about which of the following?

A. Community-based care

B. Human treatment

C. Psychopharmacology

D. Therapeutic nurse-client relationship

5. How many adults in the United States who need mental health services actually receive care?

A. 1 in 2

B. 1 in 3

C. 1 in 4

D. 1 in 5

Chapter 2 – Neurobiologic Theories and Psychopharmacology

1. The nurse is teaching a client taking an MAOI about foods with tyramine that he or she should avoid. Which of the following statements indicates the client needs further teaching?

A. “I’m so glad I can have pizza as long I don’t order pepperoni.”

B. “I will be able to eat cottage cheese without worrying.”

C. “I will have to avoid drinking nonalcoholic beer.”

D. “I can eat green beans on this diet.”

2. A client who has been depressed and suicidal started taking a tricyclic antidepressant 2 weeks ago and is now ready to leave the hospital to go home. Which of the following is a concern for the nurse as discharge plans are finalized?

A. The client may need a prescription for diphenhydramine (Benadryl) to use for side effects.

B. The nurse will evaluate the risk for suicide by overdose of the tricyclic antidepressant.

C. The nurse will need to include teaching regarding the signs of neuroleptic malignant syndrome.

D. The client will need regular laboratory work to monitor therapeutic drug level.

3. The signs of lithium toxicity include which of the following?

A. Sedation, fever, restlessness

B. Psychomotor agitation, insomnia, increased thirst

C. Elevated white blood cell count, sweating, confusion

D. Severe vomiting, diarrhea, weakness

4. Which of the following is a concern for children taking stimulants for ADHD for several years?

A. Dependence on the drug

B. Insomnia

C. Growth suppression

D. Weight Gain

5. The nurse is caring for a client with schizophrenia who is taking haloperidol (Haldol). The client complains of restlessness, cannot sit still, and has muscle stiffness. Of the following PRN medications, which would the nurse administer?

A. Haloperidol (Haldol), 5 mg PO

B. Benztropine (Cogentin), 2 mg PO

C. Propranolol (Inderal), 20 mg PO

D. Trazodone, 50 mg PO

6. Client teaching for lamotrigine (Lamictal) should include which of the following?

A. Eat a well-balanced diet to avoid weight gain

B. Report any rashes to your doctor immediately

C. Take each dose with food to avoid nausea

D. This drug may cause psychological dependence

7. Which of the following physician orders would the nurse question for a client who has stated “I’m allergic to phenothiazines”?

A. Haldol, 5 mg PO bid

B. Navane, 10 mg PO bid

C. Prolixin, 5 mg PO tid

D. Risperdal, 2 mg bid

8. Clients taking which of the following types of psychotropic medications need close monitoring of their cardiac status?

A. Antidepressants

B. Antipsychotics

C. Mood Stabilizers

D. Stimulants

Chapter 3 – Psychosocial Theories and Therapy

1. Which of the following theorists believed that a corrective interpersonal relationship with the therapist was the primary mode of treatment?

A. Sigmund Freud

B. William Glasser

C. Hildegard Peplau

D. Harry Stack Sullivan

2. Dream analysis and free association are techniques in which of the following?

A. Client-centered therapy

B. Gestalt therapy

C. Logotherapy

D. Psychoanalysis

3. Four levels of anxiety were described by

A. Erik Erikson

B. Sigmund Freud

C. Hildegard Peplau

D. Carl Rogers

4. Correcting how one thinks about the world and oneself is the focus of

A. Behaviorism

B. Cognitive therapy

C. Psychoanalysis

D. Reality therapy

5. The personality structures of id, ego, and superego were described by

A. Sigmund Freud

B. Hildegard Peplau

C. Frederick Perls

D. Harry Stack Sullivan

6. The nursing role that involves being a substitute for another, such as a parent, is called

A. Counselor

B. Resource person

C. Surrogate

D. Teacher

7. Psychiatric rehabilitation focuses on

A. Client’s strengths

B. Medication compliance

C. Social skills deficits

D. Symptom reduction

8. When a nurse develops feelings toward a client that are based on the nurse’s past experience, it is called

A. Countertransference

B. Role reversal

C. Transference

D. Unconditional regard

9. A group that was designed to meet weekly for 10 sessions to deal with feelings of depression would be a(n)

A. Closed group

B. Educational group

C. Open group

D. Support group

Chapter 4 – Treatment Settings and Therapeutic Programs

1. All the following are characteristics of ACT except

A. Services that are provided in the home or community

B. Services that are provided by the client’s case manager

C. There are no time limitations on ACT services

D. All needed support systems are involved in ACT

2. Research shows that scheduled intermittent hospital admissions result in which of the following?

A. Fewer inpatient hospital stays

B. Increased sense of control for the client

C. Feelings of failure when hospitalized

D. Shorter hospital stays

3. Inpatient psychiatric care focuses on all the following except

A. Brief interventions

B. Discharge planning

C. Independent living skills

D. Symptom management

4. How many persons in the state prison populace have severe mental illness?

A. Less than 9%

B. 16%

C. 33%

D. More than 45%

5. Which of the following interventions is an example of primary prevention implemented by a public health nurse?

A. Reporting suspected child abuse

B. Monitoring compliance with medications for a client with schizophrenia

C. Teaching effective problem-solving skills to high school students

D. Helping a client to apply for disability benefits

6. The primary purpose of psychiatric rehabilitation is to

A. Control psychiatric symptoms

B. Manage clients’ medications

C. Promote the recovery process

D. Reduce hospital readmissions

7. Managed care provides funding for psychiatric rehabilitation programs to

A. Develop vocational skills

B. Improve medication compliance

C. Provide community skills training

D. Teach social skills

8. The mentally ill homeless population benefits most from

A. Case management services

B. Outpatient psychiatric care to manage psychiatric symptoms

C. Stable housing in a residential neighborhood

D. A combination of housing, rehabilitation services, and community support.

Chapter 5 – Therapeutic Relationships

1. Building trust is important in

A. The orientation phase of the relationship

B. The problem identification phase of the relationship

C. All phases of the relationship

D. The exploitation subphase of the relationship

2. Abstract standards that provide a person with his or her code of conduct are

A. Values

B. Attitudes

C. Beliefs

D. Personal philosophy

3. Ideas that one holds as true are

A. Values

B. Attitudes

C. Beliefs

D. Personal philosophy

4. The emotional frame of reference by which one sees the world is

A. Values

B. Attitudes

C. Beliefs

D. Personal philosophy

Chapter 6 – Therapeutic Communication

1. Client: “I had an accident.”

Nurse: “Tell me about your accident.”

This is an example of which therapeutic communication technique?

A. Making observations

B. Offering self

C. General lead

D. Reflection

2. “Earlier today you said you were concerned that your son was still upset with you. When I stopped by your room about an hour ago, you and your son seemed relaxed and smiling as you spoke to each other. How did things go between the two of you?”

This is an example of which therapeutic communication technique?

A. Consensual validation

B. Encouraging comparison

C. Accepting

D. General lead

3. “Why do you always complain about the night nurse? She is a nice woman and a fine nurse and has five kids to support. You’re wrong when you say she is noisy and uncaring.”

This example reflects which nontherapeutic technique?

A. Requesting an explanation

B. Defending

C. Disagreeing

D. Advising

4. “How does Jerry make you upset?” is a nontherapeutic communication technique because it

A. Gives a literal response

B. Indicates an external source of the emotion

C. Interprets what the client is saying

D. Is just another stereotyped comment

5. Client: “I was so upset about my sister ignoring my pain when I broke my leg.”

Nurse: “When are you going to your next diabetes education program?”

This is a nontherapeutic response because the nurse has

A. Used testing to evaluate the client’s insight

B. Changed the topic

C. Exhibited an egocentric focus

D. Advised the client what to do

6. When the client says, “I met Joe at the dance last week,” what is the best way for the nurse to ask the client to describe her relationship with Joe?

A. “Joe who?”

B. “Tell me about Joe.”

C. “Tell me about you and Joe”

D. “Joe, you mean that blond guy with the dark blue eyes?”

7. Which of the following is a concrete message?

A. “Help me put this pile of books on Marsha’s desk.”

B. “Get this out of here.”

C. “When is she coming home?”

D. “They said it is too early to get in.”

Chapter 7 – Client’s Response to Illness

1. Which of the following is important for nurses to remember when administering psychotropic drugs to nonwhites?

A. Lower doses may be used to produce the desired effect

B. Fewer side effects occur with nonwhite clients

C. Response to the drug is similar to that in whites

D. No generalization can be made

2. Which of the following states the naturalistic view of what causes illness?

A. Illness is a natural part of life and therefore unavoidable

B. Illness is caused by cold, heat, wind, and dampness

C. Only natural agents are effective in treating illness

D. Outside agents, such as evil spirits, upset the body’s natural balance

3. Which of the following is most influential in determining health beliefs and practices?

A. Cultural factors

B. Individual factors

C. Interpersonal factors

D. All the above are equally influential

4. Which of the following assessments indicates positive growth and development for a 30-year old adult?

A. Is dissatisfied with body image

B. Enjoys social activities with three or four close friends

C. Frequently changes jobs to “find the right one”

D. Plans to move from parental home in near future

5. Which of the following statements would cause concern for the achievement of developmental tasks of a 55-year old woman?

A. “I feel like I’m taking care of my parents now”

B. “I really enjoy just sitting around visiting with friends”

C. “My children need me now just as much as when they were small”

D. “When I retire I want a smaller house to take care of”

6. Which of the following client statements would indicate self-efficacy?

A. “I like to get several opinions before deciding a course of action.”

B. “I know if I can learn to relax, I will feel better.”

C. “I’m never sure if I’m making the right decision.”

D. “No matter how hard I try to relax, something always comes up.”

Chapter 8 - Assessment

1. Which of the following is an example of an open ended question?

A. Who is the current president of the United States?

B. What concerns you most about your health?

C. What is your address?

D. Have you lost any weight recently?

2. Which of the following is an example of a closed-ended question?

A. How have you been feeling lately?

B. How is your relationship with your wife?

C. Have you had any health problems recently?

D. Where are you employed?

3. Assessment data about the client’s speech patterns are categorized in which of the following areas?

A. History

B. General appearance and motor behavior

C. Sensorium and intellectual processes

D. Self-concept

4. When the nurse is assessing whether or not the client’s ideas are logical and make sense, the nurse is examining which of the following?

A. Thought content

B. Thought processes

C. Memory

D. Sensorium

5. The client’s belief that a news broadcast has special meaning for him or her is an example of

A. Abstract thinking

B. Flight of ideas

C. Ideas of reference

D. Thought broadcasting

6. The client who believes everyone is out to get him or her is experiencing a(n)

A. Delusion

B. Hallucination

C. Idea of reference

D. Loose association

7. To assess the client’s ability to concentrate, the nurse would instruct the client to do which of the following?

A. Explain what “a rolling stone gathers no moss” means

B. Name the last three presidents

C. Repeat the days of the week backwards

D. Tell what a typical day is like

Chapter 9 – Legal and Ethical Issues

1. The client who is voluntarily committed to an inpatient psychiatric unit loses which of the following rights?

A. Right to freedom

B. Right to refuse medical treatment

C. Right to sign legal documents

D. The client loses no rights

2. A client has a prescription for Haloperidol, 5 mg orally two times a day, as ordered by the physician. The client is suspicious and refuses to take the medication. The nurse says, “If you don’t take this pill, I’ll get an order to give you an injection.” The nurse’s statement is an example of

A. Assault

B. Battery

C. Malpractice

D. Unintentional tort

3. A hospitalized client is delusional, yelling, “The world is coming to an end. We must all run to safety!” When other clients complain that this client is loud and annoying, the nurse decides to put the client in seclusion. The client has made no threatening gestures or statements to anyone. The nurse’s action is an example of

A. Assault

B. False imprisonment

C. Malpractice

D. Negligence

4. Which of the following would indicate a duty to warn a third party?

A. A client with delusions states, “I’m going to get them before they get me.”

B. A hostile client says, “I hate all police.”

C. A client says he plans to blow up the federal government.

D. A client states, “If I can’t have my girlfriend back, then no one can have her.”

5. The nurse gives the client quetiapine (Seroquel) in error when olanzapine (Zyprexa) was ordered. The client has no ill effects from the quetiapine. In addition to making the medication error, the nurse has committed which of the following?

A. Malpractice

B. Negligence

C. Tort (unintentional)

D. None of the above

Chapter 10 – Anger, Hostility, and Aggression

1. Which of the following is an example of assertive communication?

A. “I wish you would stop making me angry.”

B. “I feel angry when you walk away when I’m talking.”

C. “You never listen to me when I’m talking.”

D. “You make me angry when you interrupt me.”

2. Which of the following statements about anger is true?

A. Expressing anger openly and directly usually leads to arguments.

B. Anger results from being frustrated, hurt, or afraid

C. Suppressing anger is a sign of maturity

D. Angry feelings are a negative response to a situation

3. Which of the following types of drugs requires cautious use with potentially aggressive clients?

A. Antipsychotic medications

B. Benzodiazepines

C. Mood stabilizers

D. Lithium

4. A client is pacing in the hallway with clenched fists and a flushed face. He is yelling and swearing. Which phase of the aggression cycle is he in?

A. Anger

B. Triggering

C. Escalation

D. Crisis

5. The nurse observes a client muttering to himself and pounding his fist in his other hand while pacing in the hallway. Which of the following principles should guide the nurse’s actions?

A. Only one nurse should approach an upset client to avoid threatening the client.

B. Clients who can verbalize angry feelings are less likely to become physically aggressive.

C. Talking to a client with delusions is not helpful, because the client has no ability to reason.

D. Verbally aggressive clients often calm down on their own if staff members don’t bother them.

Chapter 11 – Abuse and Violence

1. Which of the following is the best action for the nurse to take when assessing a child who might be abused?

A. Confront the parents with the facts and ask them what happened.

B. Consult with a professional member of the health team about making a report

C. Ask the child which of his parents caused this injury

D. Say or do nothing; the nurse only has suspicions, not evidence.

2. Which of the following interventions would be most helpful for a client with dissociative disorder having difficulty expressing feelings?

A. Distraction

B. Reality orientation

C. Journaling

D. Grounding techniques

3. Which of the following is true about touching a client who is experiencing a flashback?

A. The nurse should stand in front of the client before touching

B. The nurse should never touch a client who is having a flashback

C. The nurse should touch the client only after receiving permission to do so

D. The nurse should touch the client to increase feelings of security

4. Which of the following is true about domestic violence between same-sex partners?

A. Such violence is less common than that between heterosexual partners

B. The frequency and intensity of violence are greater than between heterosexual partners

C. Rates of violence are about the same as between heterosexual partners

D. None of the above.

5. The nurse working with a client during a flashback says, “I know you’re scared, but you’re in a safe place. Do you see the bed in your room? Do you feel the chair you’re sitting on?” The nurse is using which of the following techniques?

A. Distraction

B. Reality orientation

C. Relaxation

D. Grounding

6. Which of the following assessment findings might indicate elder self-neglect?

A. Hesitancy to talk openly with the nurse

B. Inability to manage personal finances

C. Missing valuables that are not misplaced

D. Unusual explanations for injuries

7. Which type of child abuse can be most difficult to treat effectively?

A. Emotional

B. Neglect

C. Physical

D. Sexual

8. Women in battering relationships often remain in these relationships as a result of faulty or incorrect beliefs. Which of the following beliefs is valid?

A. If she tried to leave, she would be at increased risk for violence

B. If she would do a better job of meeting his needs, the violence would stop

C. No one else would put up with her dependent, clinging behavior

D. She often does things that provoke the violent episodes

Chapter 12 – Grief and Loss

1. Which of the following gives cues to the nurse that a client may be grieving for a loss?

A. Sad affect, anger, anxiety, and sudden changes in mood

B. Thoughts, feelings, behavior, and physiologic complaints

C. Hallucinations, panic level of anxiety, and sense of impending doom

D. Complaints of abdominal pain, diarrhea, and loss of appetite.

2. Situations that are considered risk factors for complicated grief are

A. Inadequate support and old age

B. Childbirth, marriage, and divorce

C. Death of a spouse or child, death by suicide, and sudden and unexpected death

D. Inadequate perception of the grieving crisis

3. Physiologic responses of complicated grieving include

A. Tearfulness when recalling significant memories of the lost one

B. Impaired appetite, weight loss, lack of energy, palpitations

C. Depression, panic disorders, chronic grief

D. Impair immune system, increased serum prolactin level, increased mortality rate from heart disease.

4. Critical factors for successful integration of loss during the grieving process are

A. The client’s adequate perception, adequate support, and adequate coping

B. The nurse’s trustworthiness and health attitude about grief

C. Accurate assessment and intervention by the nurse or helping person

D. The client’s predictable and steady movement from one stage of the process to the next.

Chapter 13 – Anxiety, Anxiety Disorders, and Stress-Related Issues

1. The nurse observes a client who is becoming increasingly upset. He is rapidly pacing, hyperventilating, clenching his jaw, wringing his hands, and trembling. His speech is high pitched and random; he seems preoccupied with his thoughts. He is pounding his fist into his other hand. The nurse identifies his anxiety level as

A. Mild

B. Moderate

C. Severe

D. Panic

2. When assessing a client with anxiety, the nurse’s questions should be

A. Avoided until the anxiety is gone

B. Open ended

C. Postponed until the client volunteers information

D. Specific and direct

3. During the assessment, the client tells the nurse that she cannot stop worrying about her appearance and that she often removes “old” makeup and applies fresh makeup every hour or two throughout the day. The nurse identifies this behavior as indicative of a(n)

A. Acute stress disorder

B. Generalized anxiety disorder

C. Panic disorder

D. Obsessive-compulsive disorder

4. The best goal for a client learning a relaxation technique is that the client will

A. Confront the source of the anxiety directly

B. Experience anxiety without feeling overwhelmed

C. Report no episodes of anxiety

D. Suppress anxious feelings

5. Which of the four classes of medications used for panic disorder is considered the safest because of low incidence of side effects and lack of physiologic dependence?

A. Benzodiazepines

B. Tricyclics

C. Monoamine oxidase inhibitors

D. Selective serotonin reuptake inhibitors

6. Which of the following would be the best intervention for a client having a panic attack?

A. Involve the client in a physical activity

B. Offer a distraction such as music

C. Remain with the client

D. Teach the client a relaxation technique

7. A client with generalized anxiety disorder states, “I have learned that the best thing I can do is to forget my worries.” How would the nurse evaluate this statement?

A. The client is developing insight

B. The client’s coping skills have improved

C. The client needs encouragement to verbalize feelings

D. The client’s treatment has been successful

8. A client with anxiety is beginning treatment with lorazepam (Ativan). It is most important for the nurse to assess the client’s

A. Motivation for treatment

B. Family and social support

C. Use of coping mechanisms

D. Use of alcohol

Chapter 14 - Schizophrenia

1. The family of a client with schizophrenia asks the nurse about the difference between conventional and atypical antipsychotic medications. The nurse’s answer is based on which of the following?

A. Atypical antipsychotics are newer medications but act in the same ways as conventional antipsychotics

B. Conventional antipsychotics are dopamine antagonists; atypical antipsychotics inhibit reuptake of serotonin.

C. Conventional antipsychotics have serious side effects; atypical antipsychotics have virtually no side effects.

D. Atypical antipsychotics are dopamine and serotonin antagonists; conventional antipsychotics are only dopamine antagonists

2. The nurse is planning discharge teaching for a client taking clozapine (Clozaril). Which of the following is essential to include?

A. Caution the client not to be outdoors in the sunshine without protective clothing.

B. Remind the client to go to the lab to have blood drawn for a white blood cell count.

C. Instruct the client about dietary restrictions

D. Give the client a chart to record a daily pulse rate.

3. The nurse is caring for a client who has been taking fluphenazine (Prolixin) for 2 days. The client suddenly cries out, his neck twists to one side, and his eyes appear to roll back in the sockets. The nurse finds the following PRN medications ordered for the client. Which one should the nurse administer?

A. Benztropine (Cogentin), 2 mg PO, bid, PRN

B. Fluphenazine (Prolixin), 2 mg PO, tid, PRN

C. Haloperidol (Haldol), 5 mg IM, PRN extreme agitation

D. Diphenhydramine (Benadryl), 25 mg IM, PRN

4. Which of the following statements would indicate that family teaching about schizophrenia had been effective?

A. “If our son takes his medication properly, he won’t have another psychotic episode.”

B. “I guess we’ll have to face the fact that our daughter will eventually be institutionalized.”

C. “It’s a relief to find out that we did not cause our son’s schizophrenia.”

D. “It is a shame our daughter will never be able to have children.”

5. When the client describes fear of leaving his apartment as well as the desire to get out and meet others, it is called

A. Ambivalence

B. Anhedonia

C. Alogia

D. Avoidance

6. The client who hesitates 30 seconds before responding to any questions is described as having

A. Blunted affect

B. Latency of response

C. Paranoid delusions

D. Poverty of speech

7. The overall goal of psychiatric rehabilitation is for the client to gain

A. Control of symptoms

B. Freedom from hospitalization

C. Management of anxiety

D. Recovery from the illness

Chapter 15 - Mood Disorders

1. The nurse observes that a client with bipolar disorder is pacing in the hall, talking loudly and rapidly, and using elaborate hand gestures. The nurse concludes that the client is demonstrating which of the following?

A. Aggression

B. Anger

C. Anxiety

D. Psychomotor agitation

2. A client with bipolar disorder begins taking lithium carbonate (lithium), 300 mg four times a day. After 3 days of therapy, the client says, “My hands are shaking.” The best response by the nurse is

A. “Fine motor tremors are an early effect of lithium therapy that usually subsides in a few weeks.”

B. “It is nothing to worry about unless it continues for the next month.”

C. “Tremors can be an early sign of toxicity, but we’ll keep monitoring your lithium level to make sure you’re okay.”

D. “You can expect tremors with lithium. You seem very concerned about such a small tremor.”

3. What are the most common types of side effects from SSRIs?

A. Dizziness, drowsiness, and dry mouth

B. Convulsions and respiratory difficulties

C. Diarrhea and weight gain

D. Jaundice and agranulocytosis

4. The nurse observes that a client with depression sat at a table with two other clients during lunch. The best feedback the nurse could give the client is

A. “Do you feel better after talking with others during lunch?”

B. “I’m so happy to see you interacting with other clients.”

C. “I see you were sitting with others at lunch today.”

D. “You must feel much better than you were a few days ago.”

5. Which of the following typifies the speech of a person in the acute phase of mania?

A. Flight of ideas

B. Psychomotor retardation

C. Hesitant

D. Mutism

6. What is the rationale for a person taking lithium to have enough water and salt in his or her diet?

A. Salt and water are necessary to dilute lithium to avoid toxicity

B. Water and salt convert lithium into a usable solute

C. Lithium is metabolized in the liver, necessitating increased water and salt

D. Lithium is a salt that has greater affinity for receptor sites than sodium chloride

7. Identify the serum lithium level for maintenance and safety

A. 0.1 to 1.0 mEq/L

B. 0.5 to 1.5 mEq/L

C. 10 to 50 mEq/L

D. 50 to 100 mEq/L

B. 0.5 to 1.5 mEq/L

8. A client says to a nurse, “You are the best nurse I’ve ever met. I want you to remember me.” What is an appropriate response by the nurse?

A. “Thank you. I think you are special, too.”

B. “I suspect you want something from me. What is it?”

C. “You probably say that to all your nurses.”

D. “Are you thinking of suicide?”

9. A client with mania begins dancing around the day room. When she twirled her skirt in front of the male clients, it was obvious she had no underpants on. The nurse distracts her and takes her to her room to put on underpants. The nurse acted as she did to:

A. Minimize the client’s embarrassment about her present behavior

B. Keep her from dancing with the other clients

C. Avoid embarrassing the male clients who are watching

D. Teach her about proper attire and hygiene.

Chapter 16 - Personality Disorders

1. When working with a client with a paranoid personality disorder, the nurse would use which of the following approaches?

A. Cheerful

B. Friendly

C. Serious

D. Supportive

2. Which of the following underlying emotions is commonly seen in a passive-aggressive personality disorder?

A. Anger

B. Depression

C. Fear

D. Guilt

3. Cognitive restructuring techniques include all of the following except

A. Decatastrophizing

B. Positive self-talk

C. Reframing

D. Relaxation

4. Transient psychotic symptoms that occur with borderline personality disorder are most likely treated with which of the following?

A. Anticonvulsant mood stabilizers

B. Antipsychotics

C. Benzodiazepines

D. Lithium

5. Clients with a histrionic personality disorder are most likely to benefit from which of the following nursing interventions?

A. Cognitive restructuring techniques

B. Improving community functioning

C. Providing emotional support

D. Teaching social skills

6. When interviewing any client with a personality disorder, the nurse would assess for which of the following?

A. Ability to charm and manipulate people

B. Desire for interpersonal relationships

C. Disruption in some aspects of his or her life

D. Increased need for approval from others

7. The nurse would assess for which of the following characteristics in a client with narcissistic personality disorder?

A. Entitlement

B. Fear of abandonment

C. Hypersensitivity

D. Suspiciousness

8. The most important short-term goal for the client who tries to manipulate others would be to

A. Acknowledge own behavior

B. Express feelings verbally

C. Stop initiating arguments

D. Sustain lasting relationships

Chapter 17 - Substance Abuse

1. Which of the following statements would indicate that teaching about naltrexone (ReVia) has been effective?

A. “I’ll get sick if I use heroin while taking this medication.”

B. “This medication will block the effects of any opioid substance I take.”

C. “If I use opioids while taking naltrexone, I’ll become extremely ill.”

D. “Using naltrexone may make me dizzy.”

2. Clonidine (Catapres) is prescribed for symptoms of opioid withdrawal. Which of the following nursing assessments is essential before giving a dose of this medication?

A. Assess the client’s blood pressure

B. Determine when the client last used an opiate

C. Monitor the client for tremors

D. Complete a thorough physical assessment

3. Which of the following behaviors would indicate stimulant intoxication?

A. Slurred speech, unsteady gait, impaired concentration

B. Hyperactivity, talkativeness, euphoria

C. Relaxed inhibitions, increased appetite, distorted perceptions

D. Depersonalization, dilated pupils, visual hallucinations

4. The 12 steps of AA teach that

A. Acceptance of being an alcoholic will prevent urges to drink

B. Higher Power will protect individuals if they feel like drinking

C. Once a person has learned to be sober, he or she can graduate and leave AA

D. Once a person is sober, he or she remains at risk to drink

5. The nurse has provided an in-service program on impaired professionals. She knows that teaching has be effective when staff indentify the following as the greatest risk for substance abuse among professionals

A. Most nurses are codependent in their personal and professional relationships

B. Most nurses come from dysfunctional families and are at risk for developing addiction

C. Most nurses are exposed to various substances and believe they are not at risk to develop the disease

D. Most nurses have preconceived ideas about what kind of people become addicted

C. Most nurses are exposed to various substances and believe they are not at risk to develop the disease

6. A client comes to day treatment intoxicated, but says he is not. The nurse identifies that the client is exhibiting symptoms of

A. Denial

B. Reaction formation

C. Projection

D. Transference

7. The client tells the nurse that she takes a drink every morning to calm her nerves and stop her tremors. The nurse realizes the client is at risk for

A. An anxiety disorder

B. A neurologic disorder

C. Physical dependence

D. Psychologic addiction

Chapter 18 - Eating Disorders

1. Treating clients with anorexia nervosa with a selective serotonin reuptake inhibitor antidepressant such as fluoxetine (Prozac) may present which of the following problems?

A. Clients object to the side effect of weight gain

B. Fluoxetine can cause appetite suppression and weight loss

C. Fluoxetine can cause clients to become giddy and silly

D. Clients with anorexia get no benefit from fluoxetine

2. Which of the following is an example of cognitive behavioral technique?

A. Distraction

B. Relaxation

C. Self-Monitoring

D. Verbalization of emotions

3. The nurse is working with a client with anorexia nervosa. Even though the client has been eating all her meals and snacks, her weight has remained unchanged for 1 week. Which of the following interventions is indicated?

A. Supervise the client closely for 2 hours after meals and snacks

B. Increase the daily caloric intake from 1,500 to 2,000 calories

C. Increase the client’s fluid intake

D. Request an order from the physician for fluoxetine

4. Which of the following statements is true?

A. Anorexia nervosa was not recognized as an illness until the 1960s

B. Cultures where beauty is linked to thinness have an increased risk for eating disorders

C. Eating disorders are a major health problem only in the United States and Europe

D. Persons with anorexia nervosa are popular with their peers as a result of their thinness

5. All but which of the following are initial goals for treating the severely malnourished client with anorexia nervosa?

A. Correction of body image disturbance

B. Correction of electrolyte imbalances

C. Nutritional rehabilitation

D. Weight restoration

6. The nurse is evaluation the progress of a client with bulimia. Which of the following behaviors would indicate that the client is making positive progress?

A. The client can identify calorie content for each meal

B. The client identifies healthy ways of coping with anxiety

C. The client spends time resting in her room after meals

D. The client verbalizes knowledge of former eating patterns as unhealthy

7. A teenaged girl is being evaluated for an eating disorder. Which of the following would suggest anorexia nervosa?

A. Guilt and shame about eating patterns

B. Lack of knowledge about food and nutrition

C. Refusal to talk about food-related topics

D. Unrealistic perception of body size

8. A client with bulimia is learning to use the technique of self-monitoring. Which of the following interventions by the nurse would be most beneficial for this client?

A. Ask the client to write about all feelings and experiences related to food

B. Assist the client to make out daily meal plans for 1 week

C. Encourage the client to ignore feelings and impulse related to food

D. Teach the client about nutrition content and calories of various foods

Chapter 19 - Somatoform Disorders

1. The nurse is caring for a client with a conversion disorder. Which of the following assessments will the nurse expect to see?

A. Extreme distress over the physical symptoms

B. Indifference about the physical symptoms

C. Labile mood

D. Multiple physical complaints

2. Which of the following statements would indicate that teaching about somatization disorder has been effective?

A. “The doctor believes I am faking my symptoms.”

B. “If I try harder to control my symptoms, I will feel better.”

C. “I will feel better when I begin handling stress more effectively.”

D. “Nothing will help me feel better physically.”

3. Paroxetine (Paxil) has been prescribed for a client with a somatoform disorder. The nurse instructs the client to watch for which of the following side effects?

A. Constipation

B. Increased appetite

C. Increased flatulence

D. Nausea

4. Emotion-focused coping strategies are designed to accomplish which of the following outcomes?

A. Helping the client manage difficult situations more effectively

B. Helping the client manage the intensity of symptoms

C. Teaching the client the relationship between stress and physical symptoms

D. Relieving the client’s physical symptoms

5. Which of the following is true about clients with hypochondriasis?

A. They may interpret normal body sensations as signs of disease

B. They often exaggerate or fabricate physical symptoms for attention

C. They do not show signs of distress about their physical symptoms

D. All the above are true statements

6. The client’s family asks the nurse, “What is hypochondriasis?” The best response by the nurse is, “Hypochondriasis is

A. A persistent preoccupation with getting a serious disease.”

B. An illness not fully explained by a diagnosed medical condition.”

C. Characterized by a variety of symptoms over a number of years.”

D. The eventual result of excessive worrying about diseases.”

7. A client with somatization disorder has been attending group therapy. Which of the following statements indicates that therapy is having a positive outcome for this client?

A. “I feel better physically just from getting a chance to talk.”

B. “I haven’t said much, but I get a lot from listening to others.”

C. “I shouldn’t complain too much; my problems aren’t as bad as others.”

D. “The other people in this group have emotional problems.”

8. A client who developed numbness in the right hand could not play the piano at a scheduled recital. The consequence of the symptom, not having to perform, is best described as

A. Emotion-focused coping

B. Phobia

C. Primary Gain

D. Secondary Gain

Chapter 20 - Child and Adolescent Disorders

1. A child is taking pemoline (Cylert) for ADHD. The nurse must be aware of which of the following side effects?

A. Decreased thyroid-stimulating hormone

B. Decreased red blood cell count

C. Elevated white blood cell count

D. Elevated liver function tests

2. Teaching for methylphenidate (Ritalin) should include which of the following?

A. Give the medication after meals

B. Give the medication when the child becomes overactive

C. Increase the child’s fluid intake when he or she is taking the medication

D. Take the child’s temperature daily

3. The nurse would expect to see all the following symptoms in a child with ADHD except

A. Easily distracted and forgetful

B. Excessive running, climbing, and fidgeting

C. Moody, sullen, and pouting behavior

D. Interrupts others and can’t take turns

4. Which of the following is a normal adolescent behavior?

A. Critical of self and others

B. Defiant, negative, and depressed behavior

C. Frequent hypochondriacal complaints

D. Unwillingness to assume greater autonomy

5. Which of the following is used to treat enuresis?

A. Imipramine (Tofranil)

B. Methylphenidate (Ritalin)

C. Olanzapine (Zyprexa)

D. Risperidone (Risperdal)

6. An effective nursing intervention for the impulsive and aggressive behaviors that accompany conduct disorder is

A. Assertiveness training

B. Consistent limit setting

C. Negotiation of rules

D. Open expressions of feelings

7. The nurse recognizes which of the following as a common behavioral sign of autism?

A. Clinging behavior towards parents

B. Creative imaginative play with peers

C. Early language development

D. Indifference to being hugged or held

Chapter 21 - Cognitive Disorders

1. The nurse is talking with a woman who is worried that her mother has Alzheimer’s disease. The nurse knows that the first sign of dementia is

A. Disorientation to person, place, or time

B. Memory loss that is more than ordinary forgetfulness

C. Inability to perform self-care tasks without assistance

D. Variable with different people

2. The nurse has been teaching a caregiver about donepezil (Aricept). The nurse knows that teaching has been effective by which of the following statements?

A. “Let’s hope this medication will stop the Alzheimer’s disease from progressing any further.”

B. “It is important to take this medication on an empty stomach.”

C. “I’ll be eager to see if this medication makes any improvement in concentration.”

D. “This medication will slow the progress of Alzheimer’s disease temporarily.”

3. When teaching a client about memantine (Namenda), the nurse will include:

A. Lab tests to monitor the client’s liver function are needed

B. Namenda can cause elevated blood pressure

C. Taking Namenda will improve the client’s cognitive functioning

D. The most common side effect of Namenda is GI bleeding.

4. Which of the following statements by the caregiver of a client newly diagnosed with dementia requires further intervention by the nurse?

A. “I will remind Mother of things she has forgotten.”

B. “I will keep Mother busy with favorite activities as long as she can participate.”

C. “I will try to find new and different things to do every day.”

D. “I will encourage Mother to talk about her friends and family.”

5. A client with delirium is attempting to remove the intravenous tubing from his arm, saying to the nurse, “Get off me! Go away!” The client is experiencing which of the following?

A. Delusions

B. Hallucinations

C. Illusions

D. Disorientation

6. Which of the following statements indicates the caregiver’s accurate knowledge about the needs of a parent at the onset of the moderate state of dementia?

A. “I need to give my parent a bath at the same time every day.”

B. “I need to postpone any vacations for 5 years.”

C. “I need to spend time with my parent doing things we both enjoy.”

D. “I need to stay with my parent 24 hours a day for supervision.”

7. Which of the following interventions is most appropriate in helping a client with early-stage dementia complete activities of daily living (ADLs)?

A. Allow enough time for the client to complete ADLs as independently as possible

B. Provide the client with a written list of all the steps needed to complete the ADLs

C. Plan to provide step-by-step prompting to complete the ADLs

D. Tell the client to finish ADLs before breakfast or the nursing assistant will do them

8. A client with late moderate stage dementia has been admitted to a long-term care facility. Which of the following nursing interventions will help the client to maintain optimal cognitive function?

A. Discuss pictures of children and grandchildren with the client

B. Do word games or crossword puzzles with the client

C. Provide the client with a written list of daily activities

D. Watch and discuss the evening news with the client