Term
1. A psychiatric nurse is observing inpatients who are participating in a group activity. The nurse understands the principles of group process and function and seeks to define each client's role within the group dynamic. The nurse knows that compromiser, encourager, follower, gatekeeper, and harmonizer are all which type of role?
A) Individual/personal
B) Task
C) Maintenance
D) Coordinator |
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Definition
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Term
2. During a supportive therapeutic group, a depressed client and a substance abuser engage in an angry verbal exchange. The nurse leader interrupts the exchange and excuses both of the clients from the group. Which leadership style has the nurse demonstrated?
A) Autocratic
B) Democratic
C) Laissez-faire
D) Individualistic |
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Definition
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Term
3. During a community meeting, a client raises the concern that noise at the nurses' station keeps him awake at night. A nurse, who is present in the meeting, interrupts, stating, “I'll handle this matter. We need to move on.” The nurse then assists the clients in facilitating implementation of the suggestion. Which leadership style is the nurse demonstrating?
A) Democratic
B) Autocratic
C) Laissez-faire
D) Surrogate |
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Definition
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Term
4. During a supportive therapeutic group, a depressed client and a substance abuser engage in an angry verbal exchange. The nurse leader sits silently as the angry exchange continues. Several other group members leave. Which leadership style has the nurse demonstrated?
A) Autocratic
B) Democratic
C) Laissez-faire
D) Individualistic |
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Definition
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Term
5. A nurse is leading a single mothers' parenting class. A pregnant teenager discloses her ambivalence toward the pregnancy and the subsequent guilt that these thoughts cause. A 34-year-old mother of three admits to having felt that way herself. Which of Yalom's curative group factors is illustrated by the 34-year-old mother's statement?
A) Imparting of information
B) Instillation of hope
C) Altruism
D) Universality |
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Definition
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Term
6. A nurse is leading a group counseling session in which a pregnant teenager discloses her disappointment in becoming pregnant. A 34-year-old mother of three reports, “I felt that way, but I learned I could be a loving and caring mother. My children are thriving.” Which of Yalom's curative group factors is illustrated by the 34-year-old mother's statement?
A) Imparting of information
B) Instillation of hope
C) Catharsis
D) Universality |
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Definition
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Term
7. A nurse is observing an Al-Anon group meeting. When several group members share their experiences and suggestions, which of Yalom's curative group factors is illustrated?
A) Imparting of information
B) Instillation of hope
C) Altruism
D) Universality |
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Definition
| A) Imparting of information |
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Term
8. A community health nurse is visiting a new mother in a domestic violence shelter. The new mother participates in a group meeting at the shelter and discusses her personal situation with the members of the group. In the next session, several of the mothers bring in used baby clothes for the new mother. Which of Yalom's curative group factors does this gesture illustrate?
A) Imparting of information
B) Instillation of hope
C) Altruism
D) Universality |
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Definition
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Term
9. A psychiatric nurse observes a new mother participating in a group therapy session. The new mother says, “I hate being a mother! I wish that my baby would just disappear!” A 34-year-old mother of three states, “You need to stop talking like that! How would you feel if your mom said that about you?” What role is the 34-year-old group member playing?
A) Aggressor
B) Initiator
C) Gatekeeper
D) Blocker |
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Definition
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Term
10. A nurse is planning a parenting skills class at a local community center. The nurse asks the members of the parenting group to make a list of the types of skills they would like to develop during the class. The nurse knows that this action would be most likely to occur during which phase of group process?
A) Initial/orientation
B) Middle/working
C) Middle/motivated
D) Final/termination |
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Definition
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Term
11. A nurse is conducting a parenting skills class at a local community center. The members of the parenting class learn and practice a new technique each week for 6 weeks. The nurse knows that this action is most likely to occur during which phase of group process?
A) Initial/orientation
B) Middle/working
C) Middle/motivated
D) Final/termination |
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Definition
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Term
12. A nurse has conducted a parenting skills class at a local community center. The members of the parenting class summarize the skills that they have learned. Two members express sadness over the group's end, and two others become angry at each other over a missing notepad and pen. The nurse understands that these actions would be most likely to occur during which phase of group process?
A) Initial/orientation
B) Middle/working
C) Middle/motivated
D) Final/termination |
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Definition
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Term
13. A client in an inpatient detoxification unit asks a nurse about Alcoholics Anonymous (AA). Which nursing statement is appropriate regarding self-help groups?
A) “There is little research to support AA's effectiveness. You'd be better off by attending a professionally led psychotherapy group.”
B) “Self-help groups used to be the treatment of choice, but their popularity is waning.”
C) “There is no outside regulation of these groups, so you've got to be cautious.”
D) “Members themselves run the group, with leadership usually rotating among the members.” |
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Definition
| D) “Members themselves run the group, with leadership usually rotating among the members.” |
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Term
14. A nurse in an inpatient detoxification unit for pregnant, substance-dependent women leads a group on parenting skills. What type of group is the nurse leading?
A) Task group
B) Teaching group
C) Therapeutic group
D) Self-help group |
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Definition
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Term
15. A client with schizophrenia is admitted to an inpatient psychiatric unit. A nurse notes that the client is isolative and withdrawn, and encourages him to attend a community meeting. After 3 days, the client attends his first community meeting. Which function is the group providing at this time?
A) Information
B) Empowerment
C) Socialization
D) Support |
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Definition
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Term
16. A nurse is preparing for a therapeutic group meeting. Which describes the most optimal conditions for a therapeutic group? (A task group may need a table to perform its task.)
A) Open-ended membership; circle of chairs; group size of 5 to 10 members
B) Open-ended membership; chairs around a table; group size of 10 to 15 members
C) Closed membership; circle of chairs; group size of 5 to 10 members
D) Closed membership; chairs around a table; group size of 10 to 15 members |
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Definition
| C) Closed membership; circle of chairs; group size of 5 to 10 members |
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Term
17. A nurse conducts a 10-week parenting skills class at a local community center. Nine members are enrolled in this close-ended group. During the initial orientation phase, which group activity is most likely taking place?
A) Establishing rules and goals
B) Confronting differences and disagreements
C) Solving problems and making decisions
D) Reminiscing about the activities of the group |
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Definition
| A) Establishing rules and goals |
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Term
18. A nurse conducts a 10-week parenting skills class at a local community center. During the fifth week, several members get off topic by getting into a heated dispute about the justifiability of physical discipline, such as spanking. As a group, they decide to create a pros and cons poster on the use of physical discipline. What should be the role of the group leader at this time?
A) Referee the debate.
B) Remain in adamant opposition to physical disciplining measures.
C) Redirect the group back to the topic at hand.
D) Encourage the group to solve the problem collectively. |
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Definition
| D) Encourage the group to solve the problem collectively. |
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Term
19. A nurse concludes a 10-week parenting skills class at a local community center. At the last group meeting, the three most faithful and participative members of the group are absent. How should the nurse interpret their absence?
A) These members have difficulty with termination, leading to feelings of abandonment.
B) These members did not think there would be any new material covered at the last session.
C) These members were angry with the leader for not extending the length of the group.
D) These members grew weary of attending the class. |
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Definition
| A) These members have difficulty with termination, leading to feelings of abandonment. |
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Term
20. A registered nurse with 3 years of experience in a psychiatric inpatient unit has taken a position in a day treatment program where he will be leading some groups. Which group is the registered nurse qualified to lead?
A) Parenting group
B) Psychotherapy group
C) Psychodrama group
D) Family therapy group |
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Definition
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Term
21. A psychiatric nurse leads a supportive-therapeutic group in a psychiatric unit. It is an open group and clients come and go from the group as they are admitted and discharged from the unit. Members discuss unresolved issues and ways to cope with stress in their lives. One evening, when the group was breaking up, the psychiatric nurse heard one client say to another, “I never thought that other people had the same problems that I have.” Which of Yalom's curative factors does this statement represent?
A) Catharsis
B) Group cohesiveness
C) Universality
D) Imitative behavior |
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Definition
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Term
22. A client in a psychiatric unit talks excessively during group sessions. A psychiatric nurse group leader notices that much of this client's expressions are kept on a superficial level. The nurse decides that the client might benefit from psychodrama. The nurse makes a referral after discussing psychodrama with the client. Which client statement regarding psychodrama requires further teaching by the nurse?
A) “It provides a safe setting in which to discuss painful issues.”
B) “Peers will act out roles that represent individuals with whom I have unresolved conflicts.”
C) “I choose who plays my role, and I observe the interaction from the audience.”
D) “After the drama has been completed, a discussion will be held with members of the audience.” |
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Definition
| C) “I choose who plays my role, and I observe the interaction from the audience.” |
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Term
23. During a group session, several members express their dissatisfaction with another group member to a nurse leader. They state that this group member has been dominating the conversation and is not permitting others to participate and decide, collectively, that all members who wish to do so will get a turn to talk and time will be monitored so that everyone gets a turn. The nurse remains silent during this group interaction. Which leadership style is demonstrated by the nurse?
A) Autocratic
B) Democratic
C) Laissez-faire
D) Individualistic |
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Definition
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Term
24. A client has been in a supportive-therapeutic group in the psychiatric unit for 2 weeks. The nurse observes that the client dominates the conversation and does not permit others to participate. Which role within the group is the client assuming?
A) Aggressor
B) Dominator
C) Recognition seeker
D) Monopolizer |
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Definition
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Term
25. A nurse leads a group of date-rape survivors who meet monthly to support each other and promote awareness of how college students should protect themselves from this type of encounter. What function does this group perform?
A) Socialization
B) Camaraderie
C) Normative
D) Empowerment |
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Definition
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Term
26. The nursing staff of a unit gets together once a month to have dinner and go bowling. What functions does this group perform? Select all that apply.
A) Socialization
B) Camaraderie
C) Normative
D) Empowerment
E) Governance |
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Definition
A) Socialization
B) Camaraderie |
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Term
27. During a community meeting, a client raises the concern that noise at the nurses' station keeps him awake at night. A nurse, who is present in the meeting, encourages discussion of this problem among members of the community who then generate possible solutions. The nurse then assists the clients in facilitating implementation of the suggestion. Which leadership style is the nurse demonstrating?
A) Democratic
B) Autocratic
C) Laissez-faire
D) Surrogate |
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Definition
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Term
28. During a community meeting, a client raises the concern that noise at the nurses' station keeps him awake at night. A nurse, who is present in the meeting, sits quietly as the clients attempt to generate a solution. Which leadership style is the nurse demonstrating?
A) Democratic
B) Autocratic
C) Laissez-faire
D) Surrogate |
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Definition
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Term
29. During a supportive therapeutic group, a depressed client and a substance abuser engage in an angry verbal exchange. The nurse leader states, “I sense there is tension in the group. What does everyone think about opening the discussion to everyone?” The other clients agree and then begin to discuss their observations. Which leadership style has the nurse demonstrated?
A) Autocratic
B) Democratic
C) Laissez-faire
D) Individualistic |
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Definition
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Term
1. A client asks a nurse what the difference is between modified (or passive) progressive relaxation and progressive relaxation. Which is the most appropriate nursing response?
A) “There is an increased focus on deep breathing in the modified version.”
B) “Only large muscle groups are targeted in the modified version.”
C) “There is no muscle contraction in the modified version.”
D) “The modified version is for clients with preexisting cardiovascular disease.” |
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Definition
| C) “There is no muscle contraction in the modified version.” |
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Term
2. A 37-year-old company president recently suffered a myocardial infarction. He focuses on being discharged so that he can return to work. He explains, “I built that company from nothing. They'll have to kill me to keep me from going back.” The client tells the nurse, “Just give me my meds, tell me what I've got to do, and let me go home.” Which nursing response reflects holistic care?
A) “In addition to medication, other lifestyle changes may be in order, including diet, exercise, and stress management.”
B) “You'll need to talk to your doctor about that.”
C) “It's obvious that your job is causing you considerable stress.”
D) “You need to see your doctor regularly.” |
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Definition
| A) “In addition to medication, other lifestyle changes may be in order, including diet, exercise, and stress management.” |
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Term
3. A nurse is caring for a client who has suffered a stress-related myocardial infarction. Which client statement is indicative of a readiness to learn about the role of stress in physical illness?
A) “I just need to take my blood pressure medication religiously.”
B) “What's this mumbo-jumbo about deep breathing?”
C) “My father had six heart attacks and survived them all. I plan to do the same.”
D) “I eat well and exercise. What else do you think could have led to my heart attack?” |
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Definition
| D) “I eat well and exercise. What else do you think could have led to my heart attack?” |
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Term
4. Which positive physical benefit would relaxation provide for a client who has experienced a stress-related myocardial infarction?
A) Increased pulse
B) Decreased blood pressure
C) Increased oxygen consumption
D) Decreased alpha brain waves |
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Definition
| B) Decreased blood pressure |
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Term
5. A nurse is teaching a client deep breathing exercises. The client asks, “Why do I need to make that funny shape with my lips when I breathe out?” What is the most appropriate nursing response?
A) “You can actually exhale anyway you like; the lip shape is not important."
B) “Pursed lip breathing helps you control the exhalation and helps to keep your airways open as long as possible.”
C) “Don't worry about that the lip shape; concentrate instead on the pace of your breathing.”
D) “The shape of the lip decreases the cough reflex.” |
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Definition
| B) “Pursed lip breathing helps you control the exhalation and helps to keep your airways open as long as possible.” |
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Term
6. During a psychoeducational group on stress management, a client asks about meditation. Which nursing statement is most accurate regarding meditation?
A) “It is a procedure whereby various muscle groups are contracted and relaxed, bringing about an overall sense of relaxation.”
B) “The procedure is one whereby you use your imagination to reduce tension in the body.”
C) “The purpose is to become aware of one's bodily processes, such as blood pressure and pulse, and to bring them under conscious control.”
D) “The goal is to gain mastery and control over one's attention, bringing about a special state of consciousness.” |
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Definition
| D) “The goal is to gain mastery and control over one's attention, bringing about a special state of consciousness.” |
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Term
7. During a psychoeducational group on stress management a client asks, “Which one of these relaxation techniques costs money?” Which is the appropriate nursing response?
A) Meditation
B) Biofeedback
C) Physical exercise
D) Deep breathing |
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Definition
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Term
8. A client with depression refuses to get out of bed for group sessions. Which nursing statement appropriately educates the client about the benefits of physical activity?
A) “People with depression lack certain chemicals in their brains that are improved through physical activity.”
B) “Physical activity is good for everyone.”
C) “Low-intensity exercise is more beneficial than high-impact exercise.”
D) “When you are active physically, it helps you mentally.” |
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Definition
| A) “People with depression lack certain chemicals in their brains that are improved through physical activity.” |
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Term
9. Which action should be taken by a nurse before educating clients on relaxation techniques?
A) Assisting the client in identifying triggers or sources of stress
B) Taking a thorough history of the client's past coping skills
C) Obtaining an order from the physician
D) Educating the client's family on the same techniques so they can reinforce the learning |
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Definition
| A) Assisting the client in identifying triggers or sources of stress |
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Term
10. A nurse recognizes that physical exercise is an effective relaxation technique because it:
A) Stresses and strengthens the cardiovascular system.
B) Decreases the metabolic rate.
C) Decreases levels of norepinephrine in the brain.
D) Provides a natural outlet for releasing muscle tension. |
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Definition
| D) Provides a natural outlet for releasing muscle tension. |
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Term
11. Which relaxation technique is thought to improve concentration and attention?
A) Biofeedback
B) Physical exercise
C) Meditation
D) Mental imagery |
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Definition
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Term
12. A nurse who works in an employee health facility for a large corporation teaches many types of preventative health-care strategies to the employees including relaxation therapy. Which technique should the nurse teach first that is also useful in conjunction with many other forms of relaxation therapy?
A) Deep-breathing exercise
B) Mental imagery
C) Biofeedback
D) Meditation |
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Definition
| A) Deep-breathing exercise |
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Term
13. 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 |
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Definition
| C) Reduced metabolic rate |
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Term
14. A nurse is teaching principles of mental imagery to a group. Which relaxing environments are appropriate for the nurse to recommend that the clients focus on? Select all that apply.
A) Looking at a seashore
B) Visualizing a snowy cabin
C) Driving in traffic
D) Floating through the air on a cloud
E) Lying at home in front of the fireplace |
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Definition
A) Looking at a seashore
B) Visualizing a snowy cabin
D) Floating through the air on a cloud
E) Lying at home in front of the fireplace |
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Term
15. A client who has been undergoing stress management training asks a nurse how long he/she will have to practice stress reduction. Which is the most appropriate nursing response?
A) “Until this stressor has resolved.”
B) “Usually, several months helps someone manage stress.”
C) “Whenever you feel better, you can stop.”
D) “Managing stress is a lifelong function.” |
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Definition
| D) “Managing stress is a lifelong function.” |
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Term
1. A student nurse has just entered his psychiatric rotation. He asks a nursing instructor, “How will we know if someone may get violent?” Which is the most appropriate response by the nursing instructor?
A) “You can't really say for sure. You've got to be on guard with all clients at all times.”
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 begins destroying property or hitting others, we can be sure that violence is well underway.” |
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Definition
| B) “Certain behaviors indicate a potential for violence. They are labeled as a 'prodromal syndrome' and include rigid posture, clenched fists, and raised voice.” |
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Term
2. A student nurse asks a nursing instructor, “Which clients are most likely to become violent?” What is the most appropriate response by the nursing instructor?
A) “All individuals are prone to become violent, so we must maintain vigilance at all times.”
B) “Those individuals with a past history of violence are most likely to engage in future violent episodes.”
C) “A client's diagnosis is the best predictor of whether he or she will become violent.”
D) “Younger clients and minority clients are most likely to have violent outbursts.” |
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Definition
| B) “Those individuals with a past history of violence are most likely to engage in future violent episodes.” |
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Term
3. Which client statement demonstrates improvement in terms of anger/aggression management?
A) “I realize I have a problem expressing my anger appropriately.”
B) “I know I can't hit and punch anymore, but, boy, can I tear a person down with my stare and a few choice words.”
C) “It's bad to feel as angry as I feel. I'm working on ridding myself of this emotion entirely. It's poison.”
D) “Because my wife seems to be the one to set me off, I've decided to remain separated from her.” |
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Definition
| A) “I realize I have a problem expressing my anger appropriately.” |
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Term
4. When managing an angry and aggressive individual, which factor should a nurse address first?
A) Denial
B) Trust
C) Self-esteem
D) Safety |
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Definition
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Term
5. A nurse is caring for four clients. Which client should the nurse identify as least prone to developing problems with anger management?
A) A child raised by a physically abusive parent
B) An adult with a frontal lobe injury secondary to a motor vehicle accident
C) A young adult living in the ghetto of an inner city
D) A married adult employed 30 years at the same company |
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Definition
| D) A married adult employed 30 years at the same company |
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Term
6. One adult client assaults another client in a psychiatric unit and is unable to be managed through less restrictive means. The client is placed in restraints at 1345 hours. When should the nurse remind the physician to see the client?
A) 1445 h
B) 1545 h
C) 1745 h
D) 1945 h |
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Definition
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Term
7. An adult client assaults another client and is placed in restraints at 1345 hours. Which statement should a nurse further assess while the client is in restraints?
A) “I hate all of you!”
B) “My fingers are tingly.”
C) “You wait 'till I tell my lawyer.”
D) “It was John who started it. He should be in here.” |
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Definition
| B) “My fingers are tingly.” |
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Term
8. After assaulting another client, an adult client is placed in restraints. After the client is removed from restraints, the staff discusses the incident and establishes guidelines for the client's return to the therapeutic milieu. This discussion is considered to be:
A) Post-restraint intervention.
B) Treatment planning.
C) Post-conference.
D) Debriefing. |
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Definition
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Term
9. How often should a nurse plan to observe a client in restraints?
A) At least every 5 minutes
B) Continually
C) At least every 15 minutes
D) Every 2 hours |
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Definition
| C) At least every 15 minutes |
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Term
10. Physical restraint is considered a beneficial intervention for select clients and is based on which premise?
A) Clients with poor boundaries do not respond to verbal redirection and they need firm and consistent limit setting.
B) Clients with limited internal control over their behavior need external controls to prevent harm to themselves and others.
C) Clients with antisocial tendencies need to submit to authority.
D) Whereas clients with behavioral dysfunction need behavioral intervention, clients with cognitive dysfunction require cognitive intervention. |
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Definition
| B) Clients with limited internal control over their behavior need external controls to prevent harm to themselves and others. |
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Term
11. A client with paranoid schizophrenia is admitted after attempting to injure his father with a butcher knife. A nurse who writes the client's care plan gives him the priority nursing diagnosis of risk for other-directed violence. Based on this nursing diagnosis, which should be the priority goal for this client during hospitalization?
A) The client will not verbalize anger or hit anyone.
B) The client will verbalize anger rather than hit others.
C) The client will not harm himself or others.
D) The client will be restrained if he becomes verbally or physically abusive. |
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Definition
| C) The client will not harm himself or others. |
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Term
12. Certain client psychiatric diagnoses have been associated with risk factors for assaultive behaviors. Which diagnoses have been associated with violent behavior? Select all that apply.
A) Schizophrenia
B) Bipolar disorder
C) Somatization disorder
D) Dependent personality disorder
E) Borderline personality disorder
F) Substance use disorder |
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Definition
A) Schizophrenia
B) Bipolar disorder
E) Borderline personality disorder
F) Substance use disorder |
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Term
13. Which risk factor should a nurse recognize as the most reliable indicator of potential client violence?
A) Prior treatment for schizophrenia
B) History of violence
C) Family history of violence
D) Recent discharge from a drug rehabilitation program |
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Definition
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Term
14. Because of the high incidence of violence among psychiatric clients, nurses in psychiatric units commonly have violence-intervention protocols. Which intervention would be contraindicated as part of such a protocol?
A) Administration of psychotropic medication
B) Soothing the client by stroking an arm or shoulder
C) Application of leather restraints
D) Observation for symptoms of the prodromal syndrome |
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Definition
| B) Soothing the client by stroking an arm or shoulder |
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Term
15. A client with a history of violence begins to lose control of his anger, and a nurse decides that an intervention is warranted. The client cannot be “talked down,” and he refuses medication. Which is the most appropriate nursing intervention?
A) Call for assistance from the assault team.
B) Ask the ward clerk to put in a call for the physician.
C) Make the client go to his room.
D) Tell the client that if he does not calm down, he will be placed in restraints. |
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Definition
| A) Call for assistance from the assault team. |
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Term
16. A 16-year-old client assaults another client in a psychiatric unit and is unable to be managed through less restrictive means. The client is placed in restraints at 1345 hours. When should a nurse remind the physician to see this client?
A) 1445 h
B) 1545 h
C) 1745 h
D) 1945 h |
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Definition
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Term
1. A nurse is preparing a client for electroconvulsive therapy (ECT). Which state is induced during ECT?
A) Unconsciousness
B) Grand mal seizure
C) Catatonia
D) Petit mal seizure |
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Definition
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Term
2. A client is admitted to a psychiatric unit following a suicide attempt and is scheduled for electroconvulsive therapy (ECT). Which documentation accurately describes the suicide assessment of a client undergoing ECT?
A) Suicide assessment continues to remain vigilant during the course of ECT.
B) Suicide assessment is on hold until the course of ECT is completed.
C) Suicide assessment is unnecessary while the client undergoes ECT because he or she won't remember being depressed.
D) Suicide assessment remains the highest priority. The client should remain on one-to-one observation throughout the course of ECT. |
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Definition
| A) Suicide assessment continues to remain vigilant during the course of ECT. |
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Term
3. A client gives consent to begin electroconvulsive therapy (ECT) for the treatment of severe depression. After receiving two of nine treatments, the client approaches the nurses' station and says, “I don't want anymore ECT. I can't remember what I had for lunch. Tell the doctor I don't want it!” Which is the most appropriate nursing response?
A) “After you begin the course of treatments, you must complete all of them.”
B) “You'll need to talk with your doctor about what you're thinking.”
C) “It is within your right to discontinue the treatments at this time, but let's talk about your concerns a little more.”
D) “Memory loss is a rare side effect of the treatment. I don't think it is related.” |
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Definition
| C) “It is within your right to discontinue the treatments at this time, but let's talk about your concerns a little more.” |
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Term
4. After undergoing two electroconvulsive therapy (ECT) treatments, a client decides to discontinue the therapy. The client then changes her mind and continues with ECT treatment. Later that week, the client refuses to get dressed, eat meals in the dining area, or go to group therapy. When planning care, which nursing diagnosis should be the lowest priority at this time?
A) Anxiety related to confusion and memory loss
B) Risk for injury related to post-ECT confusion and memory loss
C) Disturbed thought process related to confusion and memory loss
D) Activity intolerance related to post-ECT confusion and memory loss |
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Definition
| D) Activity intolerance related to post-ECT confusion and memory loss |
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Term
5. After undergoing two electroconvulsive therapy (ECT) treatments, a client decides to discontinue the therapy. The client then changes her mind and continues with ECT treatment. Later that week, the client refuses to get dressed, eat meals in the dining area, or go to group therapy. Based on this information, which is the most appropriate nursing intervention?
A) Allowing the client to remain on bed rest
B) Encouraging the client to join the milieu at increasingly greater intervals
C) Locking the client's door so that the client cannot remain in her room from 0700 to 1900
D) Discharging the client and allowing her to continue with treatments as an outpatient |
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Definition
| B) Encouraging the client to join the milieu at increasingly greater intervals |
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Term
6. A client who is undergoing electroconvulsive therapy (ECT) treatment awakens 2 hours before the ECT begins, and asks, “Can I please get something to eat? I missed dinner last night because I wasn't feeling well.” Which is the most appropriate nursing response?
A) “Go ahead and grab something light, such as crackers.”
B) “You'll need to ask the doctor. He'll be in shortly.”
C) “You may eat something, but avoid anything containing tyramine, such as aged meats and cheeses.”
D) “I realize you are very hungry, but you cannot eat before treatment because it can lead to complications.” |
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Definition
| D) “I realize you are very hungry, but you cannot eat before treatment because it can lead to complications.” |
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Term
7. A client undergoing electroconvulsive therapy (ECT) is given pure oxygen during and after the treatment because:
A) Electrical stimulation temporarily causes blood pressure, pulse, and respiration to cease.
B) Succinylcholine chloride (Anectine) paralyzes the respiratory muscles.
C) Seizure occasionally blocks the airway, leading to complications.
D) Electrical stimulation causes the trachea to constrict. |
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Definition
| B) Succinylcholine chloride (Anectine) paralyzes the respiratory muscles. |
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Term
8. During the recovery period immediately after electroconvulsive therapy (ECT), a nurse should place the client in which position?
A) Lying on his or her side to prevent aspiration
B) In high Fowler's position to promote consciousness
C) In Trendelenburg's position to promote blood flow to the vital organs
D) Prone to prevent self-harm |
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Definition
| A) Lying on his or her side to prevent aspiration |
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Term
9. The family of a client who is to receive electroconvulsive therapy (ECT) asks a nurse what to expect when they visit the client after a treatment. Which is the most appropriate nursing response?
A) “There will be no noticeable change in his behavior”
B) “There's no point in coming. He won't remember your visit.”
C) “He will be very confused so it would be best not to visit him.”
D) “There will probably be a temporary and expected loss of memory for recent events.” |
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Definition
| D) “There will probably be a temporary and expected loss of memory for recent events.” |
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Term
10. A nurse develops a plan of care for a client who is receiving a series of electroconvulsive therapy (ECT) treatments in a hospital. Which should be the priority nursing diagnosis for this client?
A) Anxiety related to receiving ECT
B) Knowledge deficit related to receiving ECT
C) Confusion related to the side effects of ECT
D) Risk for injury related to the risks and side effects of ECT |
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Definition
| D) Risk for injury related to the risks and side effects of ECT |
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Term
11. A nurse teaches a family what to expect immediately after their loved one receives electroconvulsive therapy (ECT) treatment. Which statement by a family member should indicate to the nurse that further teaching is needed?
A) “He will most likely wake up right away and no longer be depressed.”
B) “He will probably be confused and somewhat disoriented.”
C) “He will be sleepy and very likely sleep for a number of hours.”
D) “He may experience some soreness in his muscles.” |
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Definition
| A) “He will most likely wake up right away and no longer be depressed.” |
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Term
12. A client who is learning about electroconvulsive therapy (ECT) treatment asks a nurse “Isn't this treatment dangerous?” Which is the most appropriate nursing response?
A) “No, this treatment is absolutely safe.”
B) “There are some risks involved, but the benefits outweigh the risks.”
C) “There are some risks involved, but you will have a thorough examination in advance to ensure that you are a good candidate for the treatment.”
D) “There are some side effects to the treatment, but they are not life threatening.” |
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Definition
| C) “There are some risks involved, but you will have a thorough examination in advance to ensure that you are a good candidate for the treatment.” |
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Term
13. Psychiatric nurses often care for clients who are preparing for or have undergone electroconvulsive therapy (ECT). Which statement is accurate regarding ECT?
A) Electrical stimulation to the brain produces a grand mal seizure.
B) Maximal muscle movement is required to ensure efficacy of the treatment.
C) The client will sleep for about 12 hours after treatment.
D) The client will fully recall what occurred during the treatment. |
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Definition
| A) Electrical stimulation to the brain produces a grand mal seizure. |
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Term
14. A nurse tells a client that an injection of medication called atropine sulfate (Atropen) will be administered about 30 minutes before electroconvulsive therapy (ECT) treatment. Which rationale should the nurse provide to the client for giving this medication?
A) “It will alleviate your anxiety.”
B) “It will relax your muscles.”
C) “It will decrease secretions.”
D) “It will put you to sleep for the treatment.” |
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Definition
| C) “It will decrease secretions.” |
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Term
15. A physician orders a medication to be administered by a nurse 30 minutes before each electroconvulsive therapy (ECT) treatment. This medication will decrease secretions and will maintain heart rate during the convulsion. Which medication would the physician most likely prescribe for this purpose?
A) Thiopental sodium (Pentothal)
B) Atropine sulfate (Atropen)
C) Succinylcholine (Anectine)
D) Clonazepam (Klonopin) |
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Definition
| B) Atropine sulfate (Atropen) |
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Term
16. A nurse notes that multiple clients are scheduled for electroconvulsive therapy (ECT) over the next month. For which conditions is ECT indicated? Select all that apply.
A) Major depression
B) Mania
C) Schizoaffective disorder
D) Obsessive–compulsive disorder
E) Antisocial personality disorder |
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Definition
A) Major depression
B) Mania
C) Schizoaffective disorder |
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Term
17. A client will be undergoing electroconvulsive therapy (ECT). Which assessments should be performed before the client is cleared for ECT treatment? Select all that apply.
A) Cardiovascular exam
B) Pulmonary exam
C) Physical examination
D) Blood samples
E) Urine samples |
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Definition
A) Cardiovascular exam
B) Pulmonary exam
C) Physical examination
D) Blood samples
E) Urine samples |
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Term
1. Complementary therapy is especially suitable to nursing because both practices approach the concept of health:
A) Medically.
B) Holistically.
C) Diagnostically.
D) Nontraditionally. |
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Definition
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Term
2. A nurse asks a client, “Are you taking any herbal medicines or other over-the-counter supplements?” The client asks, “Well, yeah, isn't everybody? Why do you need to know?” Which is the most appropriate nursing response?
A) “Actually, I probably do not need to know. We can move on to the next question.”
B) “The government keeps a close eye on the quality of those products, but we want to make sure they won't interfere with any other medications.”
C) “Those products are exceptionally safe; these questions are just a formality.”
D) “Those remedies are not subjected to rigorous FDA standards, and they may interact with prescription medications and other medical treatments.” |
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Definition
| D) “Those remedies are not subjected to rigorous FDA standards, and they may interact with prescription medications and other medical treatments.” |
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Term
3. A young woman with severe nausea and diarrhea presents in an emergency department for treatment. She has taken St. John's wort at the recommended daily dosage several times that day. After she has been stabilized, she tells a nurse that she thought, “If two capsules are good, four must be better!” Which is the most appropriate nursing response?
A) “Herbal medicines are more likely to cause adverse reactions.”
B) “You can overdose on herbal medicines just as you can with prescription medications, so more is not always better.”
C) “Because the FDA does not regulate herbal remedies, who knows what was in those capsules?”
D) “Certain companies are better than others. Always frequent reputable stores.” |
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Definition
| B) “You can overdose on herbal medicines just as you can with prescription medications, so more is not always better.” |
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Term
4. A client with chronic lower back pain says, “My nurse practitioner told me to check out acupuncture. He said it might help me along with the medications and physical therapy he's ordering for me.” What type of therapy is the nurse practitioner most likely recommending?
A) Alternative therapy
B) Complementary therapy
C) Physiotherapy
D) Biopsychosocial therapy |
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Definition
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Term
5. A client with chronic lower back pain asks, “How does acupuncture work?” Which is the most appropriate nursing response?
A) “Western philosophy believes that acupuncture stimulates the body's release of pain-fighting chemicals called endorphins.”
B) “We have no idea why it works, or even if it really works.”
C) “Acupuncture works by encouraging the body to increase its development of serotonin and norepinephrine.”
D) “The nurse practitioner will need to answer that question for you.” |
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Definition
| A) “Western philosophy believes that acupuncture stimulates the body's release of pain-fighting chemicals called endorphins.” |
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Term
6. A nurse is assessing a client who states, “I was thinking of getting a weekly massage.” Which condition is contraindicated for massage therapy?
A) Anxiety
B) Chronic back pain
C) Insomnia
D) Phlebitis |
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Definition
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Term
7. A home health nurse is visiting an elderly client who is in good health but is lonely and depressed. Which therapy could be used to decrease loneliness and depression in nursing home residents?
A) Yoga
B) Pet therapy
C) Massage
D) Chiropractic therapy |
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Definition
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Term
8. A client asks a nurse to explain the difference between complementary and alternative medicine. Which is the most appropriate nursing response?
A) “Alternative medicine is more radical than complementary medicine.”
B) “Complementary therapies partner alternative approaches with traditional medical practice.”
C) “Complementary medicine disregards traditional medical approaches.”
D) “Alternative and complementary medicine mean the same thing.” |
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Definition
| B) “Complementary therapies partner alternative approaches with traditional medical practice.” |
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Term
9. A client begins antidepressant therapy and asks a nurse whether she can continue taking St. John's wort. Which is the most appropriate nursing response?
A) “You shouldn't use these medications at the same time because they interact with one another.”
B) “Your doctor can tell you if you can use it while taking antidepressants.”
C) “Because it's an over-the-counter product, there shouldn't be any adverse reactions.”
D) “St. John's wort has not been shown to be effective in the treatment of depression, so taking it is unnecessary.” |
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Definition
| A) “You shouldn't use these medications at the same time because they interact with one another.” |
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Term
10. A client who prefers to use St. John's wort and psychotherapy in lieu of antidepressant therapy asks for tips on using herbal remedies. Which is the most appropriate nursing teaching? Select all that apply.
A) Select a reputable brand.
B) Increased dosages do not lead to improved effectiveness.
C) Monitor carefully for reactions to new products.
D) Avoid using other herbal remedies when taking St. John's wort. |
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Definition
A) Select a reputable brand.
B) Increased dosages do not lead to improved effectiveness.
C) Monitor carefully for reactions to new products. |
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Term
11. A client who has been taking antidepressant therapy for 6 weeks complains of persistent fatigue and low energy; symptoms that were originally thought to be associated with depression. What nutritional deficiency should the nurse suspect?
A) Vitamin A deficiency
B) Vitamin C deficiency
C) Iron deficiency
D) Folic acid deficiency |
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Definition
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Term
12. A client inquires about the practice of therapeutic touch. Which statement regarding therapeutic touch is most accurate?
A) “Therapeutic touch has been shown to improve mood and energy level.”
B) “Heat is felt by the therapist where energy is blocked and that site is massaged.”
C) “Therapeutic touch is the treatment of choice for lower back pain and spasms.”
D) “Heat is felt where energy flow is optimal. Surrounding sites are massaged.” |
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Definition
| B) “Heat is felt by the therapist where energy is blocked and that site is massaged.” |
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Term
13. Several nurses are discussing alternative health practices. One nurse says, “It's a bogus practice. There's no value in it. It's like a fad and it will fade away.” Which is the most appropriate response by an informed nurse?
A) “Complementary therapies are similar to nursing practice in that they take a holistic approach to healing.”
B) “The government is conducting research to prove that these therapies are ineffective.”
C) “Complementary therapies are not compatible with traditional nursing practice.”
D) “There's no evidence to show that any complementary therapy is effective.” |
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Definition
| A) “Complementary therapies are similar to nursing practice in that they take a holistic approach to healing.” |
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Term
14. An elderly client asks a nurse to recommend a homeopathic remedy that improves memory. Which herbal remedy is thought to improve memory and blood circulation?
A) Ginkgo
B) Ginseng
C) Kava kava
D) St. John's wort |
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Definition
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Term
15. A client's parents who both died in their sixties developed cancers linked to a high-fat diet. When teaching the client about diet, a nurse would recommend moderation of which foods?
A) Fruits and grains
B) Meat and cheese
C) Meat and starches
D) Reduced fat milk and cereal |
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Definition
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Term
16. A client who is feeling mildly depressed after a break up with her boyfriend wishes to try an herbal supplement instead of medication. Which option might a therapist recommend?
A) Chamomile
B) Echinacea
C) St. John's wort
D) Feverfew |
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Definition
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Term
17. A client who is seeing a chiropractor for low back pain learns that the chiropractor documented some displacement of vertebrae in the client's spine. Which term, provided by a nurse, describes what these displacements are called?
A) Maladjustments
B) Manipulations
C) Meridians
D) Subluxations |
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Definition
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Term
18. A long-term care nurse arranges for yoga classes for the residents of the facility. Which techniques will be used when the residents perform yoga? Select all that apply.
A) Deep breathing
B) Meditation
C) Balanced body postures
D) Aerobics |
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Definition
A) Deep breathing
B) Meditation
C) Balanced body postures |
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Term
19. Several clients in an assisted living facility want to participate in massage therapy. A nurse knows that massage therapy is contraindicated in which conditions? Select all that apply.
A) Macular rash
B) Acute viral infection
C) Old injury, now healed
D) New injury, still somewhat painful
E) Whiplash |
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Definition
A) Macular rash
B) Acute viral infection
D) New injury, still somewhat painful |
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Term
1. A graduate nurse is assigned a client who is mentally handicapped. Which developmental characteristic should the new nurse recognize as typical of a person with severe mental retardation?
A) The client can perform some self-care activities independently.
B) The client has little, if any, speech development.
C) The client's psychomotor skills are usually not affected, except for possible coordination problems.
D) The client's wants and needs are often communicated by acting out behaviors. |
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Definition
| D) The client's wants and needs are often communicated by acting out behaviors. |
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Term
2. Which nursing interventions related to self-care would be most appropriate for a moderately mentally-retarded teenager?
A) The nurse will perform all self-care to avoid injury to the client.
B) The nurse will provide simple directions and praise the client's efforts to independently perform self-care.
C) To promote autonomy, the nurse will not interfere with the client's self-care regimen.
D) To promote bonding, the nurse will encourage family members to perform the client's self-care. |
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Definition
| B) The nurse will provide simple directions and praise the client's efforts to independently perform self-care. |
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Term
3. The mother of a child with a new diagnosis of an autistic disorder has come to an emergency department of a children's hospital after an episode of head banging by her son. She is sobbing as a nurse enters the room. Upon inquiring, the mother cries, “I'm such a terrible mother. What did I do to cause this behavior in my son?” Which is the most appropriate nursing response concerning the cause of autism?
A) “Researchers really don't know what causes autism.”
B) “Poor parenting doesn't cause autism. Research has shown that abnormalities in brain structure or function that are beyond your control are to blame.”
C) “The mother appears to play a greater role in the development of the disorder than the father.”
D) “Lack of early infant bonding with the mother may be a cause of autism. Did you breast-feed or bottle-feed?” |
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Definition
| B) “Poor parenting doesn't cause autism. Research has shown that abnormalities in brain structure or function that are beyond your control are to blame.” |
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Term
4. A nurse is planning care for an autistic child. Which is a positive and realistic outcome for this client?
A) The client communicates his or her needs verbally.
B) The client participates with peers in a team sport.
C) The client has established trust with at least one caregiver.
D) The client performs all self-care tasks independently. |
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Definition
| C) The client has established trust with at least one caregiver. |
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Term
5. A 13-year-old client with attention-deficit/hyperactivity disorder (ADHD) has difficulty completing his homework due to distractions. Which strategy should a nurse teach the client's father to encourage task performance and completion?
A) Mandate that the child remain in his room until he finishes all his homework.
B) Punish the child by removing privileges if he does not complete his homework within a 2-hour period.
C) Encourage the child to break the task into smaller, more attainable steps and reward the completion of each step with a physical activity break.
D) Administer an extra dose of methylphenidate (Ritalin) to the child in the evening. |
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Definition
| C) Encourage the child to break the task into smaller, more attainable steps and reward the completion of each step with a physical activity break. |
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Term
6. The parent of a child with attention-deficit/hyperactivity disorder (ADHD) asks a nurse why the child has lost 10 pounds in the past 2 months. Which is the most appropriate nursing response?
A) “Medications used to treat people with ADHD often cause decreased appetite.”
B) “Hyperactivity causes excess physical activity and increased caloric expenditure.”
C) “Side effects of the medications used to treat people with ADHD include nausea and vomiting.”
D) “Loss of appetite is a symptom of ADHD.” |
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Definition
| A) “Medications used to treat people with ADHD often cause decreased appetite.” |
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Term
7. The mother of a 13-year-old child with conduct disorder says, “Oh, fighting and stealing—yeah, he's always been this way. In fact, when he was 8 years old, he was already in trouble with the law.” How should a nurse interpret this information?
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 8 years, so the client is likely to improve.
D) Childhood-onset conduct disorder has no treatment or cure, and children with this diagnosis should be removed from society because they are likely to develop antisocial personality disorder. |
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Definition
| A) Childhood-onset conduct disorder is more severe than the adolescent-onset type, and these individuals likely develop antisocial personality disorder in adulthood. |
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Term
8. The nursing assessment of a child with separation anxiety disorder is most likely to reveal which factor?
A) The child has a history of antisocial behaviors.
B) The mother has an anxiety disorder.
C) The child previously had an extroverted temperament.
D) The parents have an inconsistent parenting style. |
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Definition
| B) The mother has an anxiety disorder. |
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Term
9. A client was just informed of cognitive test results that indicate her daughter has mild mental retardation (MR). The client questions what this means. Which is the most appropriate nursing response regarding mild MR?
A) “Children with mild MR need constant supervision.”
B) “Children with mild MR develop academic skills up to a sixth-grade level.”
C) “Children with mild MR appear different from their peers.”
D) “Children with mild MR have significant sensory–motor impairment.” |
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Definition
| B) “Children with mild MR develop academic skills up to a sixth-grade level.” |
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Term
10. A nurse is planning care for a client with moderate mental retardation (MR). Which statements are accurate regarding moderate MR? Select all that apply.
A) Children with moderate MR can work in a sheltered workshop setting.
B) Children with moderate MR can perform some personal care activities.
C) Children with moderate MR may have difficulties relating to peers.
D) Children with moderate MR can be educated to a fifth-grade level. |
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Definition
A) Children with moderate MR can work in a sheltered workshop setting.
B) Children with moderate MR can perform some personal care activities.
C) Children with moderate MR may have difficulties relating to peers. |
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Term
11. A nurse should anticipate that the nursing history and assessment of a child with mental retardation may reveal:
Select all that apply.
A) Premature birth.
B) Childhood meningococcal infection.
C) Deprivation of nurturance and other stimulation.
D) Full term birth.
E) Rheumatic fever. |
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Definition
A) Premature birth.
B) Childhood meningococcal infection. |
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Term
12. A nurse is providing care for the family of a child with mental retardation. Which treatment should the nurse recommend?
A) Psychodynamic therapy
B) Hypnosis
C) Movement therapy
D) Behavior modification |
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Definition
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Term
13. A nurse is caring for a young child with autistic disorder. According to the DSM-IV-TR, autistic disorder includes impairments in all areas except:
A) Mood.
B) Communication abilities.
C) Behaviors.
D) Social interactions. |
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Definition
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Term
14. A parent questions a nurse regarding what treatments are available for attention-deficit/hyperactivity disorder (ADHD). Which treatments should the nurse recommend? Select all that apply.
A) Behavior modification
B) Family therapy
C) Psychopharmacology
D) Electroconvulsive therapy (ECT) |
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Definition
A) Behavior modification
B) Family therapy
C) Psychopharmacology |
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Term
15. When planning care, a nurse working with a conduct-disordered youth should use which premise to guide his or her work?
A) The entire family unit as a whole contributes in some way to the identified problem and thus should be included in treatment.
B) The child is the identified patient and should be focused on during treatment.
C) The parents are responsible for the proper upbringing of the child, and teaching parenting skills should be the sole intervention.
D) The child is responsible for his or her behavior, and behavioral modification should be used. |
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Definition
| A) The entire family unit as a whole contributes in some way to the identified problem and thus should be included in treatment. |
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Term
16. The mother of a 4-year-old child with autism reports that the child has begun head banging since she returned to full-time employment. The mother has had difficulty finding adequate and appropriate caregivers for her son. Which priority nursing diagnosis for the child should the nurse assign?
A) Risk for self-mutilation
B) Impaired social interaction
C) Impaired verbal communication
D) Complicated grieving |
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Definition
| A) Risk for self-mutilation |
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Term
17. A pediatric nurse is caring for a 4-year-old child with autism who keeps banging his head against the wall. Which is the appropriate nursing intervention for the child?
A) Placing him in restraints until the aggression subsides
B) Sedating him with neuroleptic agents
C) Having him wear a helmet
D) Distracting him with a variety of games and puzzles |
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Definition
| C) Having him wear a helmet |
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Term
18. A parent asks a school nurse about ways to manage her son's attention-deficit/hyperactivity disorder (ADHD). The parent reports that her son has difficulty completing his homework and that he is often found playing video games instead of completing his work. Which are the most appropriate nursing recommendations? Select all that apply.
A) Create an environment as free from distractions as possible.
B) Provide immediate reinforcement for acceptable behaviors.
C) Break larger projects into smaller, attainable tasks and have him take physical-activity breaks in between.
D) Medicate the child 1 hour before starting his homework.. |
|
Definition
A) Create an environment as free from distractions as possible.
B) Provide immediate reinforcement for acceptable behaviors.
C) Break larger projects into smaller, attainable tasks and have him take physical-activity breaks in between. |
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Term
19. A nurse is caring for a 5-year-old child with Tourette syndrome. Which class of medications is effective in the treatment of Tourette syndrome?
A) Neuroleptics
B) Antimanics
C) Tricyclic antidepressants
D) MAOIs (monoamine oxidase inhibitors) |
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Definition
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Term
20. A clinic nurse is assessing a child who takes methylphenidate (Ritalin) for the treatment of attention-deficit/hyperactivity disorder (ADHD). The nurse knows that a potential side effect from the prolonged use of methylphenidate (Ritalin) is:
A) Psychosis.
B) Decreased intelligence.
C) Sore throat.
D) A decrease in rate of growth and development. |
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Definition
| D) A decrease in rate of growth and development. |
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Term
21. A 9-year-old child has received a diagnosis of autistic disorder. A psychiatric nurse frequently visits the child and his family, which includes a second son who is 3 years old. Which behavior should the nurse regard as age appropriate for the 3-year-old child and not indicative of autistic disorder?
A) Intense fascination with fans
B) Parallel play
C) Lack of eye contact
D) Does not smile |
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Definition
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Term
22. A pediatric nurse is assessing a child with oppositional defiant disorder. What essential feature distinguishes oppositional defiant disorder from other disorders?
A) Gender ratio
B) Passive–aggressiveness
C) Violence toward others
D) Role of genetic predisposition |
|
Definition
| B) Passive–aggressiveness |
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Term
23. A mother tells a psychiatric nurse that her 3-year-old son is in constant motion and is unable to sit still long enough to listen to a story or to watch TV. The mother asks the nurse if he could be “hyperactive.” What is the most appropriate nursing response?
A) “I wouldn't worry about it.”
B) “It's certainly possible.”
C) “It's hard to tell with a 3-year-old child.”
D) “Why would you think that?” |
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Definition
| C) “It's hard to tell with a 3-year-old child.” |
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Term
24. A mother tells a psychiatric nurse that her 3-year-old son is in constant motion and is unable to sit still long enough to listen to a story or to watch TV. The mother asks the nurse if he could be “hyperactive.” Which factor should prompt the nurse to continue to evaluate this child for attention-deficit/hyperactivity disorder (ADHD)?
A) The child's father is a smoker.
B) The child was born 7 weeks premature.
C) The child develops hives when he eats foods that contain red food coloring.
D) The child has a cousin with ADHD on his father's side. |
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Definition
| B) The child was born 7 weeks premature. |
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Term
25. Recently, a client with moderate mental retardation scored 47 on an IQ test. The client's parents have called a local agency that serves the developmentally disabled and asked for advice regarding their child's potential. Which nursing statement provides the best estimate of this child's eventual level of development?
A) “Your child may develop minimal verbal skills.”
B) “Your child may be able to work at an unskilled job.”
C) “Your child may eventually function at about a sixth-grade level.”
D) “Your child will require constant supervision and care.” |
|
Definition
| B) “Your child may be able to work at an unskilled job.” |
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Term
26. A school nurse suspects that a 6-year-old student may be experiencing attention-deficit/hyperactivity disorder (ADHD). The nurse knows that calming effects on hyperactive children have been achieved with the administration of which medication?
A) Central nervous system (CNS) stimulants
B) CNS depressants
C) Nonsteroidal anti-inflammatory drugs
D) Antimanic drugs such as lithium |
|
Definition
| A) Central nervous system (CNS) stimulants |
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Term
27. A school nurse is working with a child's parents to help modify the child's behavior at school. Which is the primary nursing intervention in working with a child with a conduct disorder?
A) Plan activities that provide opportunities for success.
B) Give the child unconditional acceptance for good behaviors.
C) Recognize behaviors that precede the onset of aggression and intervene before violence occurs.
D) Provide immediate positive feedback for acceptable and unacceptable behaviors. |
|
Definition
| C) Recognize behaviors that precede the onset of aggression and intervene before violence occurs. |
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Term
28. When providing care for an adolescent with a (overanxious) separation anxiety disorder, what should be the primary initial goal that a nurse identifies?
A) Setting very strict limits on what behavior can be tolerated
B) Making the adolescent aware of the outcome of his or her desire to excel
C) Establishing an atmosphere of calm, trust, and unconditional acceptance
D) Excluding parents from goal setting with the adolescent about anxious behaviors |
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Definition
| C) Establishing an atmosphere of calm, trust, and unconditional acceptance |
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Term
29. Which psychosocial influences may predispose some individuals to attention-deficit/hyperactivity disorder (ADHD)? Select all that apply.
A) Mother with bipolar disorder
B) Father who is incarcerated
C) Middle socioeconomic class
D) Raised in unstable foster care
E) Institutional living |
|
Definition
A) Mother with bipolar disorder
B) Father who is incarcerated
D) Raised in unstable foster care
E) Institutional living |
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Term
1. A psychiatric nurse is preparing to receive a client with anorexia nervosa. According to biological theorists, anorexia may be caused partly by:
A) A fixation in the oral stage of psychosexual development.
B) Excessively controlling and perfectionist parenting styles.
C) Dysfunction in the hypothalamus.
D) Aloof and disconnected family relationships. |
|
Definition
| C) Dysfunction in the hypothalamus. |
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Term
2. Family dynamics are thought to be a major influence in the development of anorexia nervosa. Which characteristic most likely describes the anorexic client's home environment?
A) Loose personal boundaries
B) Overemphasis on food
C) Overprotection and perfectionism
D) Paternal abusiveness |
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Definition
| C) Overprotection and perfectionism |
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Term
3. A client's disturbance of body image is evidenced by her claims of “feeling fat” even though she is emaciated. Which outcome criterion should a nurse assign to the client to address this nursing diagnosis?
A) Consuming adequate calories to sustain normal weight
B) Ceasing a strenuous exercise program
C) Perceiving ideal body weight and shape as normal
D) Demonstrating an absence of preoccupation with food |
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Definition
| C) Perceiving ideal body weight and shape as normal |
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Term
4. During assessment, a nurse should be mindful that clients with bulimia often:
A) Are below normal weight.
B) Binge whenever they experience hunger.
C) Are highly motivated to seek help.
D) Are within their normal weight range. |
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Definition
| D) Are within their normal weight range. |
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Term
5. A nurse's inspection of the teeth and gums of a client with bulimia will most likely reveal deterioration because of:
A) The high acidity of emesis.
B) A lack of dietary calcium.
C) Rapid ingestion of food without proper mastication.
D) Poor dental and oral hygiene. |
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Definition
| A) The high acidity of emesis. |
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Term
6. A psychiatric nurse arranges for a client with bulimia to participate in a behavioral modification program. The nurse understands that behavioral modification programs designed for clients with eating disorders attempt to:
A) Control the client's maladaptive behaviors.
B) Ignore the client's maladaptive behaviors.
C) Focus on adaptive behaviors.
D) Provide control to the client. |
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Definition
| D) Provide control to the client. |
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Term
7. A nursing instructor is teaching a group of nursing students about anorexia nervosa. Which brain structure may be implicated in anorexia nervosa?
A) Cerebral cortex
B) Hypothalamus
C) Cerebellum
D) Parietal lobe |
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Definition
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Term
8. A 17-year-old client suffers from anorexia nervosa. The client's treatment team is planning to use behavior modification. Which of the following characterizes this modality?
A) The client collaborates in developing a system of rewards for adaptive behaviors and ultimately decides whether to follow the plan or not.
B) The treatment team determines the number of pounds that the client must gain each week to obtain a certain privilege.
C) The client is punished by removing privileges if a certain number of calories are not consumed each day.
D) The treatment team establishes guidelines for diet and exercise with the family's approval. |
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Definition
| A) The client collaborates in developing a system of rewards for adaptive behaviors and ultimately decides whether to follow the plan or not. |
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Term
9. A 17-year-old client suffers from anorexia nervosa. The client's treatment team is planning to use behavior modification. The success of behavior modification for the client with anorexia nervosa is based on which principle?
A) Motivation
B) Reward
C) Control
D) Protection |
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Definition
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Term
10. A 17-year-old client suffers from anorexia nervosa. As class valedictorian, the client achieved a perfect score on her SATs and has been offered full tuition support to an Ivy League school beginning in the fall. The client recently collapsed during cheerleading practice and was hospitalized for severe malnutrition. Which client statement should the nurse interpret as evidence of improvement in the client's condition?
A) “I refuse to be obese like my sister. It just shows a lack of respect for your body.”
B) “Everyone else is dieting. I just want to be pretty, too.”
C) “I'm in control of my eating. I can eat as much or as little as I want. I have perfect self-control.”
D) “I am angry at my parents for forcing me to always do things their way.” |
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Definition
| D) “I am angry at my parents for forcing me to always do things their way.” |
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Term
11. A nurse is caring for a client whose body mass index (BMI) is 32. How should the nurse classify this client according to BMI?
A) Normal weight
B) Overweight
C) Obese
D) Anorexic |
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Definition
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Term
12. A 17-year-old client suffers from anorexia nervosa. The client's treatment team calls for a family meeting. The client's mother inquires of the nurse, “What is it that you want to ask us? This is our daughter's problem that has now become this family's problem. We are tired of dealing with her issues.” Which is the most appropriate response by the nurse?
A) “Don't be so defensive. Every client is required to participate in two family sessions.”
B) “Eating disorders have been shown to have their roots in certain familial patterns; without addressing these, your daughter's disorder is likely to continue.”
C) “Family dynamics are not at all linked to eating disorders. The meeting is to show your daughter that she is loved and supported.”
D) “Individuals with anorexia cause disruptions in the family system that need to be addressed.” |
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Definition
| B) “Eating disorders have been shown to have their roots in certain familial patterns; without addressing these, your daughter's disorder is likely to continue.” |
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Term
13. Which nursing intervention concerning mealtimes is most appropriate for clients with eating disorders?
A) Staying with the client during meals; allowing him or her to take as long as needed to consume 90 percent of the meal
B) Encouraging the client to journal about types, consistencies, and textures of foods in addition to nutritional information such as calories, fat grams, and carbohydrate amounts
C) Restricting the client's privileges if he or she does not consume at least 50 percent of the meal within 20 minutes
D) Remaining with the client for at least 1 hour after the meal to prevent discarding of stashed food or self-induced vomiting |
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Definition
| D) Remaining with the client for at least 1 hour after the meal to prevent discarding of stashed food or self-induced vomiting |
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Term
14. A 23-year-old client calls an eating disorders clinic for an appointment. The client was hospitalized and diagnosed with anorexia nervosa when she was 14 years old. At the clinic, the client tells a nurse that she has been taking laxatives every day and that some days after eating she will self-induce vomiting. She knows this is not good but feels powerless to stop it. She is 5′6″ tall and weighs 105 pounds. The nurse should base this client's plan of care on which primary nursing diagnosis?
A) Ineffective denial
B) Disturbed body image
C) Low self-esteem
D) Imbalanced nutrition, less than body requirements |
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Definition
| D) Imbalanced nutrition, less than body requirements |
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Term
15. A 23-year-old client calls an eating disorders clinic for an appointment. The client was hospitalized and diagnosed with anorexia nervosa when she was 14 years old. At the clinic, the client tells a nurse that she has been taking laxatives every day and that some days after eating she will self-induce vomiting. She knows this is not good but feels powerless to stop it. She is 5′6″ tall and weighs 105 pounds. What other physical manifestation should the nurse expect to find on assessment of this client?
A) Fever
B) Hypotension
C) Tachycardia
D) Polyuria |
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Definition
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Term
16. A physician orders sibutramine (Meridia) medications for a client with an eating disorder. A nurse understands that sibutramine (Meridia) and phentermine (Pro-Fast SA) are part of which drug classification?
A) Antidepressants
B) Anorexiants
C) Antianxiety agents
D) Anticonvulsants |
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Definition
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Term
17. A client is 5′4″ and weighs 250 pounds. When the client first came to the clinic 2 years ago, she weighed 347 pounds. A dietitian put her on a 1500-calorie per-day diet and a physician at the clinic prescribed fenfluramine and phentermine, the “fen-phen” drugs. Since then, fenfluramine has been taken off the market because it caused pulmonary hypertension in a number of individuals. The client says to a nurse, “I don't know what to do! I know I can't lose weight without those drugs.” The nurse tells the client that she will lose weight, even without medication, if she just sticks to her diet and adds some exercise to her routine. What kind of exercise should the nurse suggest to this client?
A) Low-impact aerobics three times a week
B) Jogging 1 mile twice a week
C) Swimming at the YWCA 30 minutes per day
D) Walking around her neighborhood for 20 minutes per day (weather permitting) |
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Definition
| D) Walking around her neighborhood for 20 minutes per day (weather permitting) |
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Term
18. A client who is 5′4″ and weighs 250 pounds has been taking anorexiant medications that have been taken off the market. A nurse explains to the client that a physician may be able to prescribe another medication to help her lose weight. Which medication should the nurse expect the physician to prescribe?
A) Diazepam (Valium)
B) Orlistat (Alli)
C) Sibutramine (Meridia)
D) Zolpidem (Ambien) |
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Definition
| C) Sibutramine (Meridia) |
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Term
19. Which pharmacotherapy should a nurse anticipate that a physician will prescribe for a client with bulimia nervosa?
A) Fluoxetine (Prozac)
B) Diazepam (Valium)
C) Orlistat (Alli)
D) Sibutramine (Meridia) |
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Definition
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Term
20. A nurse is caring for a client with anorexia nervosa. Which intervention should be included in the plan of nursing care for this client? Select all that apply.
A) Grant privileges based on weight gain and treatment compliance.
B) Weigh client at different times of the day to prevent manipulation.
C) Keep mealtime to 30 minutes.
D) Focus discussions on the issues of food, eating, weight, and exercise.
E) Allow the client to select the diet.
F) Supervise client for 1 hour after meals. |
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Definition
A) Grant privileges based on weight gain and treatment compliance.
C) Keep mealtime to 30 minutes.
F) Supervise client for 1 hour after meals. |
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Term
21. A nurse is leading a weight loss group for morbidly obese people. Which teaching should the nurse include?
A) Focus only on food intake rather than physical activity.
B) Try to eat as little as possible during the day.
C) Keep a food diary.
D) Learn alternative ways to handle stress.
E) Seek a rapid weight gain to reinforce success. |
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Definition
C) Keep a food diary.
D) Learn alternative ways to handle stress. |
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Term
22. A nurse is caring for a client whose body mass index (BMI) is 21. How should the nurse classify this client according to BMI?
A) Normal weight
B) Overweight
C) Obese
D) Anorexic |
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Definition
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