Term
1. A female college student is admitted to a hospital after a suicide attempt that was precipitated by receiving mediocre grades this semester. She reports, “I'm such a failure. I should have done better. It's not enough to be average.” According to Freud's psychoanalytic theory, which structure of her personality should a nurse recognize as predominant?
A) Id
B) Ego
C) Self
D) Superego |
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Definition
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2. A female client who is very emotional admits to a nurse that her father physically abused her as a child. The next day, the client recants her statement and denies that she was ever abused as a child. The client states, “I tend to exaggerate when I am upset.” According to psychoanalytic theory, this memory is most likely stored in which part of the consciousness?
A) Conscience
B) Conscious
C) Preconscious
D) Unconscious |
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3. A business executive is admitted to a hospital after a suicide attempt. The client reports, “I'm such a failure. I cannot keep my business on track. I have lost so much business this year! To be successful in my line of work, you've got to be the best.” The client's siblings are interviewed by a nurse and reveal that the client was severely punished by the client's father when he did not perform to expectations. When prompted, the client replies, “I've never thought about that connection. I can definitely see where I got my perfectionist tendencies.” According to psychoanalytic theory, this memory is most likely stored in which part of the consciousness?
A) Conscience
B) Conscious
C) Preconscious
D) Unconscious |
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4. A nurse is caring for a female high school student with depression and anxiety who has begun cutting herself. The client started cutting when she was not selected to be on the homecoming court. The client states, "I guess I wasn't good enough to be chosen. I need to change my hair. I look so ugly!" Which statement from the psychoanalytic framework would best explain this client's personality?
A) Excessive psychic energy, stored in the id, has led to impulsive, self-mutilating behaviors.
B) Excessive psychic energy, stored in the superego, has resulted in rigid, self-depreciating behaviors.
C) Insufficient psychic energy, stored in the id, has resulted in decreased fulfillment of basic needs.
D) Insufficient psychic energy, stored in the superego, has resulted in failure to abide by societal norms. |
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Definition
| B) Excessive psychic energy, stored in the superego, has resulted in rigid, self-depreciating behaviors. |
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5. An adult female is admitted to a hospital. The client reports "feeling like a failure" and her elderly father reports that she was scolded as a child during potty training. The client's father reports, “Nothing was ever good enough for her mother.” According to Freud's psychoanalytic theory, the client is most likely fixated in which stage of psychosexual development?
A) Oral
B) Anal
C) Phallic
D) Latency
E) Genital |
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Definition
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6. A psychiatric nurse is caring for an adult client. The client was placed in foster care when he was 4 years old and lived with several different families and was often neglected until he was finally adopted at age 7. The client tells the nurse, "I don't deserve to be loved. I've never been good enough!" According to Erikson's theory of personality development, which crisis has not been adequately resolved?
A) Trust versus mistrust
B) Initiative versus guilt
C) Intimacy versus isolation
D) Ego integrity versus despair |
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Definition
| B) Initiative versus guilt |
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Term
7. A nurse who is operating from a psychoanalytic paradigm would focus on:
A) A possible genetic basis for the client's problems.
B) Unconscious processes and personality structures.
C) Existential choices.
D) Maladaptive cognitions. |
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Definition
| B) Unconscious processes and personality structures. |
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Term
8. According to the psychoanalytic paradigm, a nurse recognizes that a client who experiences excessive and inappropriate guilt is likely to have problems with his or her:
A) Superego.
B) Ego.
C) Id.
D) Defense mechanisms. |
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Definition
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Term
9. A nurse is caring for a 35-year-old client who lives with his mother, attended a community college for one semester, and has a sporadic work history. According to Erikson's stages of personality development, on which activity should the nurse recommend that the client focus?
A) Firmly establishing his career and relationships and making contributions to society
B) Exploring his interests
C) Reviewing his life achievements
D) Mastering various abilities |
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Definition
| A) Firmly establishing his career and relationships and making contributions to society |
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Term
10. A nurse is caring for a 42-year-old client who marries for the first time. The client's wife looks and acts much like the client's mother. The client enjoys being "mothered" by his wife who "takes care of everything." According to Freud, the nurse recognizes that this client is most likely fixated in which stage?
A) Oral
B) Anal
C) Phallic
D) Latency
E) Genital |
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Definition
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Term
11. A nurse is interviewing a 28-year-old, married, female client who works as a schoolteacher. She has just had her first child. The nurse documents that she is successfully passing through which of Erikson's developmental stages?
A) Industry versus inferiority
B) Identity versus role confusion
C) Intimacy versus isolation
D) Generativity versus stagnation |
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Definition
| C) Intimacy versus isolation |
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Term
12. A female client who is 21 years old has flashbacks of sexual abuse by her uncle. She had not been aware of these memories until only recently when she became sexually active with her boyfriend. The nurse recognizes that Sullivan's interpersonal theory would explain this phenomenon as:
A) The “good me.”
B) The “bad me.”
C) The “not me.”
D) The “bad you.” |
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Definition
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Term
13. A 78-year-old female is admitted to a psychiatric unit because she has told her daughter that she no longer has anything to live for, and she threatened to swallow her whole bottle of antihypertensive medication. On the unit, she is quarrelsome with the other clients. Most of the time, she prefers to stay in her room alone rather than interact with the other clients. How should a nurse document the psychoanalytical structure of the client's personality?
A) Weak id, strong ego, weak superego
B) Strong id, weak ego, weak superego
C) Weak id, weak ego, punitive superego
D) Strong id, weak ego, punitive superego |
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Definition
| D) Strong id, weak ego, punitive superego |
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Term
14. A 55-year-old client is admitted to a psychiatric unit stating that he no longer wishes to live. The client admits to holding a gun to his head the night before, but he could not bring himself to pull the trigger. A nurse recognizes that the client is in which level of Erikson's stages of psychosocial development?
A) Trust versus mistrust
B) Industry versus inferiority
C) Generativity versus stagnation
D) Ego integrity versus despair |
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Definition
| D) Ego integrity versus despair |
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Term
15. A nurse is caring for a female client who is going through a divorce. The client tells the nurse that her husband is divorcing her because she cannot control her spending habits. If the client sees something that she likes, she has to buy it immediately. According to Sullivan's interpersonal theory, a nurse realizes that this client is fixed in which stage of development?
A) Infancy. She relieves anxiety through oral gratification.
B) Childhood. She has not learned to delay gratification.
C) Early adolescence. She is struggling to form an identity.
D) Late adolescence. She is working to develop a lasting relationship. |
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Definition
| B) Childhood. She has not learned to delay gratification. |
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Term
16. A student was valedictorian of her high school class. Upon entering college, her superego manifested very strongly. Which characteristics should a nurse anticipate seeing in this client?
A) Partying all the time because it feels good
B) Spending uncontrollably because her parents send her money
C) Acting very proper at social functions
D) Becoming unduly stressed if she gets less than an “A” grade |
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Definition
| D) Becoming unduly stressed if she gets less than an “A” grade |
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Term
17. A client had been experiencing increased stressors regarding finances and relationships. Finally, she confides in a nurse that she got a raise at work, so she is not bothered anymore with financial worries. She and her boyfriend are getting along well now. She feels completely at peace. According to Sullivan, which interpersonal concept has this client achieved?
A) Anxiety
B) Satisfaction of needs
C) Interpersonal security
D) The self-system |
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Definition
| C) Interpersonal security |
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Term
1. A nurse understands the importance of establishing an effective nurse–client relationship when initiating care. Which are characteristics of a therapeutic nurse–client relationship? Select all that apply.
A) Meeting the psychological needs of the nurse and the client
B) Ensuring therapeutic termination
C) Promoting client insight into problematic behavior
D) Collaborating on a set of goals |
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Definition
B) Ensuring therapeutic termination
C) Promoting client insight into problematic behavior
D) Collaborating on a set of goals |
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Term
2. A nurse on an inpatient psychiatric unit prepares for the arrival of a client who has threatened to kill himself and his wife if his wife follows through with divorce proceedings. The client has a history of violent behavior toward his wife and their four young children. Which should be the priority nursing intervention in the pre-interaction phase of this nurse–client relationship?
A) Acknowledging the client's actions and generating alternative behaviors
B) Establishing rapport and developing treatment goals
C) Attempting to find alternative placement
D) Exploring how the nurse's thoughts and feelings about this client may adversely impact the provision of care |
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Definition
| D) Exploring how the nurse's thoughts and feelings about this client may adversely impact the provision of care |
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Term
3. A nurse is preparing to establish a therapeutic relationship with a client. Which is the first essential nursing intervention that the nurse should complete?
A) Clarifying one's own attitudes, values, and beliefs
B) Obtaining thorough assessment data
C) Determining the client's length of stay
D) Establishing personal goals for the interaction |
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Definition
| A) Clarifying one's own attitudes, values, and belief |
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Term
4. A newly admitted schizophrenic client refuses to complete the admission interview. A nurse determines that the client has been living on the streets for several weeks and has barely eaten. The nurse streamlines the assessment, establishing baseline safety, and offers the client a warm meal. The nurse then shows the client to his room to rest. Which characteristic of the therapeutic nurse–client relationship has the nurse established?
A) Sympathy
B) Trust
C) Self-disclosure
D) Expectations |
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Definition
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Term
5. A nurse's client is demonstrating transference. How should the nurse proceed?
A) Immediately terminate therapy with the client to promote safety.
B) Encourage the client to ignore these thoughts and feelings.
C) Automatically reassign the client to another contact person or to another unit or institution.
D) Explore these thoughts and feelings with the client, unless it would pose a serious threat to safety or to the therapy itself. |
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Definition
| D) Explore these thoughts and feelings with the client, unless it would pose a serious threat to safety or to the therapy itself. |
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Term
6. A nurse on an inpatient psychiatric unit prepares for the arrival of a client who has threatened to kill himself and his wife if his wife follows through with divorce proceedings. The client has a history of violent behavior toward his wife and their four young children. What should be the priority nursing intervention in the working phase of the nurse–client relationship?
A) Acknowledging the client's actions and generating alternative behaviors
B) Establishing a rapport and developing treatment goals
C) Attempting to find alternative placement
D) Exploring how the nurse's thoughts and feelings about this client may adversely impact the provision of care |
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Definition
| A) Acknowledging the client's actions and generating alternative behaviors |
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Term
7. A psychiatric nurse learns that a client who is a registered sex offender is to be admitted to the unit. The nurse thinks about personal feelings associated with caring for this type of client. Which phase of the nurse–client relationship focuses on the nurse's self-analysis (feelings, fantasies, strengths, and limitations)?
A) Pre-interaction
B) Orientation
C) Working
D) Termination |
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Definition
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Term
8. A client has been admitted to a psychiatric unit, following a suicide attempt, for the past few weeks. The client's primary nurse is preparing for the client's discharge and arranging for outpatient care. The client begins to feel anxious about going home. Which phase of the nurse–client relationship that may be the most difficult for the client because anxieties reappear and past losses are reviewed?
A) Pre-interaction
B) Orientation
C) Working
D) Termination |
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Definition
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Term
9. A client with paranoid schizophrenia is admitted to a psychiatric unit. A nurse introduces herself to the client and begins the admission assessment. Which phase of the nurse–client relationship begins when the individuals first meet and is characterized by an agreement to continue meeting and assessing needs?
A) Pre-interaction
B) Orientation
C) Working
D) Termination |
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Definition
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10. A psychiatric nurse is caring for a client who was molested as a child. The nurse and client have established a therapeutic nurse–client relationship and communicate effectively. The nurse notes that the client is hesitant about discussing the client's childhood and often attempts to change the subject of the conversation. Resistance, although potentially present in all stages, is most often found in which phase of the nurse–client relationship?
A) Pre-interaction
B) Orientation
C) Working
D) Termination |
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Definition
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Term
11. A nurse receives a report at the beginning of a shift that a client has a long history of drug abuse, uses prostitution to support a drug addiction, and has lost custody of four children. What is the nurse's most appropriate initial action during the pre-interaction phase of the nurse–client relationship?
A) Assisting the patient in changing his or her value system
B) Examining the nurse's own feelings and anxieties with regard to the client
C) Reviewing the literature pertaining to the drug addiction
D) Attempting to identify the underlying reasons for the client's apparent lack of values |
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Definition
| B) Examining the nurse's own feelings and anxieties with regard to the client |
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Term
12. A female client has made the decision to leave her alcoholic husband. She is feeling very depressed. Which nursing statement best conveys sympathy?
A) “I know you are feeling very depressed right now. I felt the same way when I decided to leave my husband. But I can tell you from personal experience, you are doing the right thing.”
B) “I can understand that you are feeling depressed right now. It was a very difficult decision to make. I'll sit here with you for awhile.”
C) “You seem depressed. It is a difficult decision you are making. Would you like to talk about it?”
D) “I know this is a difficult time for you. It might help you if you talked about your feelings.” |
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Definition
| A) “I know you are feeling very depressed right now. I felt the same way when I decided to leave my husband. But I can tell you from personal experience, you are doing the right thing.” |
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Term
13. A female client has made the decision to leave her alcoholic husband. She is feeling very depressed. Which statement by the nurse best conveys empathy?
A) “I know you are feeling very depressed right now. I felt the same way when I decided to leave my husband. But I can tell you from personal experience, you are doing the right thing.”
B) “I can understand that you are feeling depressed right now. It was a very difficult decision to make. I'll sit here with you for awhile.”
C) “I am very sorry you are going through this difficult time. I wish things could be better for you.”
D) “It is a sad thing to have to break up a marriage. It's unfortunate that it didn't work out for you.” |
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Definition
| B) “I can understand that you are feeling depressed right now. It was a very difficult decision to make. I'll sit here with you for awhile.” |
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Term
14. A nurse counsels an 18-year-old client who is pregnant and is considering giving her baby up for adoption. The client asks the nurse about what she should do. The nurse presents all possible options and praises the client's decision to have the baby rather than to terminate the pregnancy. The nurse then refers the client to a social worker who can help with the adoption process. By demonstrating congruence between what the nurse felt and what the nurse expressed to the client, which characteristic did the nurse convey?
A) Respect
B) Genuineness
C) Sympathy
D) Rapport |
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Definition
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Term
15. A nurse counsels an 18-year-old client who is pregnant and is considering giving her baby up for adoption. The client asks the nurse about what she should do. The nurse presents all possible options to the client. Which task would the nurse focus on during the working phase of this nurse–client relationship?
A) Establishing a contract for intervention
B) Examining feelings about working with a particular client
C) Establishing a plan for continuing aftercare
D) Promoting the client's insight and perception of reality |
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Definition
| D) Promoting the client's insight and perception of reality |
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Term
16. The Johari window is a representation of the self and a tool that can be used to increase self-awareness. Because a nurse suppresses painful memories of an abortion, the nurse would prefer not to discuss these issues with anyone. However, she volunteers her time to counsel clients who are thinking about abortion at a women's clinic. In the Johari window, this is an example of:
A) The open or public self.
B) The unknowing self.
C) The private self.
D) The unknown self. |
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Definition
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Term
17. Using the Johari window, an increase in self-awareness would be represented by an increase in the size of which quadrant(s)? Select all that apply.
A) Unknown self
B) Private self
C) Unknowing self
D) Open or public self |
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Definition
B) Private self
D) Open or public self |
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Term
18. A nurse overhears a staff member say, “All of these drug abusers on our unit are just bums.” How should the nurse characterize this statement?
A) Rational belief
B) Irrational belief
C) Blind belief
D) Stereotype |
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Definition
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Term
19. A client has told a nurse how angry she is about losing her job. She says her boss was unfair and did not give her a chance. Which is the most appropriate empathetic nursing response?
A) “I would agree. It sounds like he was horrible.”
B) “My last boss wasn't very kind, either.”
C) “I know how you feel. It's sad to be treated unfairly.”
D) “That must have felt quite hurtful to you.” |
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Definition
| D) “That must have felt quite hurtful to you.” |
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Term
20. A nurse has just received an expensive gift from a client. Which is the most appropriate nursing response?
A) “Thank you so much!”
B) “What a nice gift! I can't wait to use it.”
C) “I am so sorry, but I cannot accept this generous gift.”
D) “I have a gift here for you, as well.” |
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Definition
| C) “I am so sorry, but I cannot accept this generous gift.” |
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Term
21. A nurse on an inpatient psychiatric unit prepares for the arrival of a client who has threatened to kill himself and his wife if his wife follows through with divorce proceedings. The client has a history of violent behavior toward his wife and their four young children. What should be the priority nursing intervention in the orientation (introductory) phase of this nurse–client relationship?
A) Acknowledging the client's actions and generating alternative behaviors
B) Establishing a rapport and developing treatment goals
C) Attempting to find alternative placement
D) Exploring how the nurse's thoughts and feelings about this client may adversely impact the provision of care. |
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Definition
| B) Establishing a rapport and developing treatment goals |
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Term
1. A client's teenaged son recently committed suicide. She discovered her son's body and subsequently received a diagnosis of posttraumatic stress disorder. A nurse is helping her work through the trauma. Which nursing statement reflects the therapeutic technique of “placing the event in time or sequence?”
A) “The day you discovered your son's body, you were arriving home from work. What happened then?”
B) “Tell me about finding your son's body.”
C) “I notice you seem uncomfortable discussing this.”
D) “What is it that you would like to see change during your stay here?” |
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Definition
| A) “The day you discovered your son's body, you were arriving home from work. What happened then?” |
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Term
2. A nurse is preparing to converse with a hostile client. Which location should the nurse avoid during this encounter?
A) The client's room with the door shut
B) A designated interview room with the door open
C) The common dayroom
D) The common dining area |
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Definition
| A) The client's room with the door shut |
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Term
3. A client states, “Every time I get angry, I wind up taking it out on my wife and kids.” A nurse responds, “What sort of situations triggers your anger?” Which therapeutic technique is reflected by the nurse?
A) Restating
B) Exploring
C) Formulating a plan of action
D) Making observations |
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Definition
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Term
4. A client states, “Every time I get angry, I wind up taking it out on my wife and kids.” A nurse responds, “You express your anger through physical violence directed at your family.” Which therapeutic technique is reflected by the nurse?
A) Restating
B) Exploring
C) Formulating a plan of action
D) Making observations |
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Definition
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Term
5. A client states, “Every time I get angry, I yell and scream at my wife or I take it out on the kids.” A nurse responds, “What other alternatives have you thought about, other than verbal abuse, when dealing with your anger?” Which therapeutic technique is reflected by the nurse?
A) Restating
B) Exploring
C) Formulating a plan of action
D) Making observations |
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Definition
| C) Formulating a plan of action |
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Term
6. A nurse is interviewing a newly admitted psychiatric client. Which nursing statement reflects a broad opening?
A) “Do you know why you are here?”
B) “Are you feeling depressed or anxious?”
C) “Tell me about what has been happening lately.”
D) “Can you name the specific events that have contributed to your admittance?” |
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Definition
| C) “Tell me about what has been happening lately.” |
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Term
7. As a nurse prepares to leave a room he says to his client, “Please let me know if there is anything I can do to help you.” Which therapeutic technique does this reflect?
A) Offering self
B) Broad openings
C) General leads
D) Making stereotyped comments |
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Definition
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Term
8. A client's teenaged son recently committed suicide. She discovered her son's body and subsequently received a diagnosis of posttraumatic stress disorder. The client was then admitted to an inpatient psychiatric unit for evaluation and medication stabilization. Which nursing statement reflects the therapeutic technique of “giving broad openings?”
A) “The day you discovered your son's body, you were arriving home from work. What happened then?”
B) “Tell me about finding your son's body.”
C) “I notice you seem uncomfortable discussing this.”
D) “What is it that you would like to see change during your stay here?” |
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Definition
| B) “Tell me about finding your son's body.” |
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Term
9. A client is currently living in a shelter with her four children after escaping her abusive husband. Early in her stay, the client attends but does not participate in the support group held for the residents. One week later, the client speaks up and appropriately confronts another peer who has stolen her hairbrush. The group leader states, “I'm so proud of you for being assertive. You are so good!” Which technique has the leader used?
A) Translating words into feelings
B) Interpreting
C) Giving approval
D) Offering reassurance |
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Definition
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Term
10. A client's teenaged son recently committed suicide. She discovered her son's body and subsequently received a diagnosis of posttraumatic stress disorder. The client was then admitted to an inpatient psychiatric unit for evaluation and medication stabilization. Which nursing statement reflects the therapeutic technique of “formulating a plan of action?”
A) “The day you discovered your son's body, you were arriving home from work. What happened then?”
B) “Tell me about it.”
C) “I notice you seem uncomfortable discussing this.”
D) “What is it that you would like to see change during your stay here?” |
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Definition
| D) “What is it that you would like to see change during your stay here?” |
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Term
11. A nurse is interviewing a newly admitted client. The nurse uses active listening to hear and understand the information being given by the client. Which components are parts of the SOLER acronym for active listening? Select all that apply.
A) Sit squarely facing client.
B) Observe an open posture.
C) Lean away from client.
D) Establish eye contact. |
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Definition
A) Sit squarely facing client.
B) Observe an open posture
D) Establish eye contact. |
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Term
12. A nurse observes four individuals in a waiting room. In which scenarios is an individual communicating a message? Select all that apply.
A) A mother scolds her son and grounds him.
B) A teenaged boy isolates himself on a sofa and listens to his headset.
C) A biker sports a tattoo of an eagle on his bicep.
D) An elderly man reads a magazine |
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Definition
A) A mother scolds her son and grounds him.
B) A teenaged boy isolates himself on a sofa and listens to his headset.
C) A biker sports a tattoo of an eagle on his bicep. |
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Term
13. A female client is currently living in a shelter with her four children after escaping her abusive husband. Early in her stay, the client attends but does not participate in the support group held for the residents. One week later, the client speaks up and appropriately confronts another peer who has stolen her hairbrush. Which response to the client's actions is the best example of nursing feedback?
A) “You can't trust a thief. As long as we are all living under one roof, we need to respect one another.”
B) “This is the first time I have heard you speak up in group. You handled this situation in an assertive and effective manner.”
C) “You need to use your assertiveness skills in your relationship with your husband.”
D) “Remember three weeks ago when you failed to confront the other roommate? Well, I just wanted to tell you how pleased I am with your improvement.” |
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Definition
| B) “This is the first time I have heard you speak up in group. You handled this situation in an assertive and effective manner.” |
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Term
14. A nurse is leading a group therapy session. Following the session, the nurse offers feedback to a client who had shared an experience with the other members of the group. The purpose of providing feedback is to:
A) Give the client good advice.
B) Tell the client how to behave.
C) Evaluate the client's behavior.
D) Give the client information |
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Definition
| D) Give the client information. |
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Term
15. A client in a psychiatric unit has received a diagnosis of antisocial personality disorder. Occasionally, the client loses his temper and expresses his anger inappropriately. Which nursing statement provides appropriate feedback regarding the client's angry outbursts?
A) “You were very rude to interrupt the group the way you did.”
B) “You accomplish nothing when you lose your temper like that.”
C) “Showing your anger in that manner is very childish and insensitive.”
D) “You became angry in the group session, raised your voice, stomped out, and slammed the door.” |
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Definition
| D) “You became angry in the group session, raised your voice, stomped out, and slammed the door.” |
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Term
16. A client in a psychiatric unit has received a diagnosis of antisocial personality disorder. The client says to the nurse, “I don't belong in this place with all these loonies. My doctor must be crazy!” Which nursing response is most appropriate?
A) “You are here for a psychological evaluation.”
B) “I'm sure your doctor has your best interests in mind.”
C) “Why do you think you don't belong here?”
D) “Just bide your time. You'll be out of here soon.” |
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Definition
| A) “You are here for a psychological evaluation.” |
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Term
17. A pregnant adolescent asks a nurse on a psychiatric unit, “Do you think I should give my baby up for adoption?” Which nursing statement is most appropriate?
A) “It would probably be best for you and the baby.”
B) “Why would you want to give it up for adoption?”
C) “What do you think would be the best thing for you to do?”
D) “I'm afraid you would feel very guilty afterward if you gave your baby away.” |
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Definition
| C) “What do you think would be the best thing for you to do?” |
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Term
18. When interviewing a psychiatric client, which nonverbal behavior should a nurse plan to avoid?
A) Maintaining eye contact
B) Leaning back with arms crossed
C) Sitting directly facing the client
D) Smiling |
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Definition
| B) Leaning back with arms crossed |
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Term
19. A single mother of four escaped her burning row house but was able to rescue only two of her children. She has been brought to the emergency department for evaluation. She cries, “I should have gone back in to get them. I should have died, not them. I'm such a terrible mother. God, please forgive me!” What is the most appropriate nursing response?
A) “The smoke was too thick. You couldn't have gone back in.”
B) “You're feeling guilty because you weren't able to save your children.”
C) “Focus on the fact that you did save two of your children. They need their mother to be strong.”
D) “It's best if you try not to think about what happened. Try to move on.” |
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Definition
| B) “You're feeling guilty because you weren't able to save your children.” |
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Term
20. A nurse is preparing to interview a client who acts very suspicious of other people. The nurse plans to conduct the interview in an interview room, rather than in her own office. Which environmental principle has the nurse observed?
A) Territoriality
B) Density
C) Personal distance
D) Social distance |
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Definition
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Term
21. A nurse is caring for a client with low self-esteem. Which nonverbal communication should the nurse anticipate?
A) Arms crossed
B) Eyes pointed downward
C) Staring at the nurse
D) Smiling inappropriately |
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Definition
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Term
22. A client states, “Every time I get angry, I wind up getting into a fistfight with my wife or I take it out on the kids.” A nurse responds, “I notice that you are smiling as you talk about this physical violence.” Which therapeutic technique is reflected by the nurse?
A) Restating
B) Exploring
C) Formulating a plan of action
D) Making observations |
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Definition
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Term
23. A client's teenaged son recently committed suicide. She discovered her son's body and subsequently received a diagnosis of posttraumatic stress disorder. The client was then admitted to an inpatient psychiatric unit for evaluation and medication stabilization. Which nursing statement reflects the therapeutic technique of “making observations?”
A) “The day you discovered your son's body, you were arriving home from work. What happened then?”
B) “Tell me about it.”
C) “I notice you seem uncomfortable discussing this.”
D) “What is it that you would like to see change during your stay here?” |
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Definition
| C) “I notice you seem uncomfortable discussing this.” |
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Term
24. A client has been living in a shelter with her four children after escaping her abusive husband. The client's move-out date is getting closer. The client states, “I'm afraid to leave here. I'm afraid for my safety and the safety of my children.” Which is the most appropriate nursing response?
A) “Let's work together to summarize what you've learned into a plan to keep you and your family safe.”
B) “It's the policy that clients can live here for only 30 days. It's unfortunate, but there's nothing I can do.”
C) “You've had a month to come up with a plan for keeping you and your family safe.”
D) “Your husband has probably moved on by now. That's how they all are.” |
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Definition
| A) “Let's work together to summarize what you've learned into a plan to keep you and your family safe.” |
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Term
1. During a one-to-one session with a client, the client says, “nothing will ever get better” and “nobody can help me.” The nurse understands that these are expressions of ______ and indicate a(n) ______ suicide risk.
A) powerlessness/fearfulness; decreased
B) powerlessness/fearfulness; increased
C) hopelessness/helplessness; decreased
D) hopelessness/helplessness; increased |
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Definition
| D) hopelessness/helplessness; increased |
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Term
2. A nurse is caring for four clients. Which clients should the nurse recognize as being at risk for suicide? Select all that apply.
A) A 65-year-old newly retired man with severe insomnia
B) A 25-year-old married woman with adjustment disorder
C) An 18-year-old man who is struggling to acknowledge his homosexuality
D) A 48-year-old schizophrenic who hears command hallucinations to harm himself |
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Definition
A) A 65-year-old newly retired man with severe insomnia
C) An 18-year-old man who is struggling to acknowledge his homosexuality
D) A 48-year-old schizophrenic who hears command hallucinations to harm himself |
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Term
3. Which assessment question would be least likely to elicit information relevant to suicidality?
A) “Have you had any thoughts about harming yourself?”
B) “How many times have you threatened to kill yourself in the past but didn't act on it?”
C) “Do you have a particular plan in mind?”
D) “Do you have access to the means to carry out the plan?” |
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Definition
| B) “How many times have you threatened to kill yourself in the past but didn't act on it?” |
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Term
4. A psychiatric crisis nurse has determined that a suicidal client does not need to be admitted. Which information should the nurse gather that would support sending this client home?
A) Able to establish trust and rapport with nurse; has supportive family; has no mental health follow-up scheduled
B) Able to identify stressors; has limited support network; has appointment with therapist 1 week from today
C) Able to comply with medication regimen; able to problem-solve life issues
D) Able to contract for safety; family agrees to remain at all times; has therapy appointment tomorrow |
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Definition
| D) Able to contract for safety; family agrees to remain at all times; has therapy appointment tomorrow |
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Term
5. A psychiatric crisis nurse determines that a suicidal client does not need to be admitted. The client's family is very supportive and is requesting more information about how to help. Which teaching should the nurse provide?
A) Only serious threats of suicide should be addressed to avoid any secondary gain she might otherwise receive.
B) Promise to maintain confidentiality with her because this promotes trust.
C) Try not to invade her privacy; give her some time alone to explore her feelings.
D) Acknowledge and accept her feelings by being an active listener. |
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Definition
| D) Acknowledge and accept her feelings by being an active listener. |
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Term
6. A 16-year-old teenager recently revealed to his mother that he is gay. The teenager begged his mother not to tell his father, but she did. The teen's father hit him repeatedly upon learning of his son's homosexuality. The next morning, the teenager was found hanging in his room. Which parental emotions should a nurse anticipate? Select all that apply.
A) Shock and disbelief
B) Guilt and remorse
C) Anger and resentment
D) Relief and disbelief |
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Definition
A) Shock and disbelief
B) Guilt and remorse
C) Anger and resentment |
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Term
7. A teenager commits suicide after revealing to his parents that he is a homosexual. Which information would be appropriate for a nurse to share with the family at this time?
A) Funeral arrangement information
B) Education on the grieving process
C) Medication evaluation referrals
D) Gay and lesbian support group times and locations |
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Definition
| B) Education on the grieving process |
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Term
8. An 84-year-old man who is receiving dialysis treatments on an outpatient basis reports depressed mood and low energy and makes reference to death and dying. His wife and son are ready to take him home after the procedure. Which question should a nurse ask the client's wife when preparing a discharge plan of care?
A) “Has he had any appetite or sleep changes as well?”
B) “How often is he left alone?”
C) “Has he been following his diet and exercise program consistently?”
D) “How would you characterize your relationship with your husband?” |
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Definition
| B) “How often is he left alone?” |
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Term
9. A home health nurse is concerned about a recently widowed client who is depressed. Which statement about suicide among the elderly population is most accurate?
A) Elderly people use less lethal means to commit suicide.
B) The percentage of suicides completed by elderly individuals is greater than the percentage of elderly in the population.
C) Elderly people attempt suicide twice as often as they complete it.
D) It is normal for elderly individuals to express a desire to die because they have come to terms with their mortality. |
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Definition
| B) The percentage of suicides completed by elderly individuals is greater than the percentage of elderly in the population. |
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Term
10. A nurse is caring for a client who has threatened to commit suicide by hanging himself. The nurse understands that which statement regarding suicide is accurate?
A) The more specific the plan is, the more likely the client will attempt suicide.
B) Clients who talk about suicide never actually commit it.
C) The client who fails to complete a suicide attempt will not try again.
D) The nurse should refrain from actually saying the word “suicide” because this may give the client ideas. |
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Definition
| A) The more specific the plan is, the more likely the client will attempt suicide. |
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Term
11. A suicidal client says to a nurse, “There's nothing to live for anymore.” Which is the most appropriate nursing response?
A) “Now, you know that isn't true.”
B) “In your situation, I might feel the same way.”
C) “Things will look better in the morning.”
D) “It sounds like you are feeling pretty hopeless.” |
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Definition
| D) “It sounds like you are feeling pretty hopeless.” |
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Term
12. A 67-year-old lawyer who has received a diagnosis of major depression and is taking fluoxetine (Prozac) threatens suicide by overdose. In creating the care plan for this client, which should a nurse identify as the priority nursing diagnosis?
A) Risk for self-mutilation related to low self-esteem
B) Risk for suicide related to depressed mood
C) Complicated grieving related to unresolved loss
D) Powerlessness related to complicated grieving process |
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Definition
| B) Risk for suicide related to depressed mood |
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Term
13. A 67-year-old white lawyer has received a diagnosis of major depression. He was widowed 3 years ago and has had no interest in attending synagogue services since that time. He has taken fluoxetine (Prozac) for several years. He made a suicide attempt 45 years ago, during his first year in law school. He has been transported to the emergency department by ambulance after telling his son he was thinking of swallowing his whole bottle of fluoxetine. How many risk factors for suicide will the triage nurse document?
A) Three
B) Five
C) Seven
D) Nine |
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Definition
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Term
14. Which intervention is not consistent with the outcome criteria for a suicidal client?
A) Accepting the client with unconditional positive regard
B) Encouraging the client to talk about his or her pain
C) Providing the client with tasks to occupy his or her time
D) Providing the client with ample privacy |
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Definition
| D) Providing the client with ample privacy |
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Term
15. When planning care, what is the most important outcome criterion for a suicidal client?
A) The client will not physically harm himself or herself.
B) The client will express hope for the future.
C) The client will reveal his or her suicide plan.
D) The client will establish a trusting relationship with the nurse. |
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Definition
| A) The client will not physically harm himself or herself. |
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Term
16. A nurse is caring for four clients. Which client should the nurse recognize as having a higher potential for suicide attempt?
A) Roman Catholic
B) Protestant
C) Muslim
D) Atheist |
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Definition
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Term
1. A 47-year-old accountant lost his job 5 months ago and experiences, for the first time in his life, a marked state of depression. He makes an appointment to see a nurse psychotherapist at a clinic. During the assessment, the nurse notes that the client exhibits poor personal hygiene, an altered activity level, and withdrawal. How should the nurse label these findings in documentation?
A) Affective
B) Physiological
C) Cognitive
D) Behavioral |
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Definition
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Term
2. While completing an assessment, a nurse discovers that a client's older brother has been hospitalized several times for depression. The nurse understands that this client's chances of developing the same disorder are:
A) The same as for the general population.
B) Less than for the general population.
C) Greater than for the general population.
D) Minimal if he is immunized with lithium. |
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Definition
| C) Greater than for the general population. |
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Term
3. A 48-year-old woman is admitted to a psychiatric unit after trying to shoot herself in the head. Her husband reports that she had seemed despondent since their youngest child left for college 4 months ago. Which should be a nurse's priority intervention for this client?
A) Administration of prescribed sedation
B) Initiation of suicide observation
C) Review of the treatment plan
D) Orientation to the unit |
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Definition
| B) Initiation of suicide observation |
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Term
4. A 24-year-old man who has recently received a diagnosis of bipolar disorder is brought to a hospital by the police. On the unit, he is highly agitated, paces about, and speaks to unseen others. His mood fluctuates from fits of laughter to outbursts of yelling. How should a nurse document this client's behavior?
A) Blunted
B) Flat
C) Euphoric
D) Labile |
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Definition
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Term
5. A 24-year-old man who has recently received a diagnosis of bipolar disorder is brought to a hospital by the police. On the unit, he is highly agitated, paces about, and speaks to unseen others. His mood fluctuates from fits of laughter to outbursts of yelling. He has not slept in 3 days and has lost 12 pounds over the past 2 weeks. What is the appropriate priority nursing intervention for this client?
A) Reviewing his treatment plan with him and teaching him about his medication (lithium)
B) Encouraging him to attend and participate in the various therapeutic group activities
C) Conducting relaxation techniques so he can sleep
D) Administering prescribed medications to him and maintaining a safe environment |
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Definition
| D) Administering prescribed medications to him and maintaining a safe environment |
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Term
6. A nurse is caring for a 36-year-old client who is divorced and who has major depression, severe with psychotic features. During the admission assessment, the client talks about feeling depressed and hearing voices that tell her to cut her wrists with the plastic knives from the unit's cafeteria. She already has several cuts on her wrists from a recent suicide attempt that occurred before she was brought to the emergency department. She will not complete a contract for safety at this time. Which is the most appropriate nursing intervention under these circumstances?
A) Obtain an order for locked seclusion until she denies suicidal intent.
B) Conduct 15-minute checks on her to ensure her safety.
C) Place her on one-to-one staff observation until she can verbalize and demonstrate that she is no longer an imminent danger to herself.
D) Remove the plastic wear from the unit's cafeteria and order finger food for all clients. |
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Definition
| C) Place her on one-to-one staff observation until she can verbalize and demonstrate that she is |
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Term
7. In the initial stages of caring for a client who is experiencing an acute manic episode, which should be the priority nursing diagnosis?
A) Risk for injury related to excessive hyperactivity
B) Insomnia related to manic hyperactivity
C) Imbalanced nutrition, less than body requirements, related to inadequate intake
D) Situational low self-esteem related to embarrassment |
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Definition
| A) Risk for injury related to excessive hyperactivity |
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Term
8. A nurse is performing a suicide assessment on a newly admitted client. Which components are parts of a suicide assessment? Select all that apply.
A) Determining how many times the client has threatened to commit suicide
B) Determining whether the client has a well-developed plan
C) Determining specifically when the client intends to follow through with the attempt
D) Determining whether the client has access to the items needed to follow through with the plan |
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Definition
B) Determining whether the client has a well-developed plan
C) Determining specifically when the client intends to follow through with the attempt
D) Determining whether the client has access to the items needed to follow through with the plan |
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Term
9. A client has been severely depressed and suicidal. After admission to an inpatient psychiatric unit, antidepressant medication is administered. As the client becomes more energized and communicative, what should be the priority nursing intervention for this client?
A) Allowing the client to have unsupervised passes to his or her home
B) Encouraging the client to participate in group activities
C) Increasing the vigilance regarding the client's suicidal precautions
D) Recognizing that the client's suicidal potential has decreased |
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Definition
| C) Increasing the vigilance regarding the client's suicidal precautions |
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Term
10. A client who demonstrates manic behavior becomes demanding and active. Which is the most appropriate nursing intervention for this client?
A) Maintaining a supportive, structured environment and setting limits as necessary in a firm but nonthreatening manner
B) Warning the client that he or she may be restrained if these behaviors do not subside
C) Helping to lessen the client's feelings of guilt and rejection
D) Broadening the client's interpersonal contact with other clients and staff members |
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Definition
| A) Maintaining a supportive, structured environment and setting limits as necessary in a firm but |
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Term
11. Several clients in an inpatient psychiatric unit are experiencing depression. Client A was recently laid off, Client B's mother passed away last month, and Client C's girlfriend broke up with him. A nurse assesses that these clients have which characteristic in common?
A) They have all experienced a recent loss.
B) They have all chosen to come to the same hospital.
C) They have nothing in common.
D) They have all experienced a change in lifestyle. |
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Definition
| A) They have all experienced a recent loss. |
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Term
12. A client comes to an emergency department reporting severely depressed mood and suicidal ideation. Toxicology tests reveal that the client is abusing cocaine. Because the client is unable to contract for safety, the client is admitted to an inpatient psychiatric unit for evaluation. Within 2 days, the client is in a normal mood, performing all self-care, laughing and interacting with peers, and eating all of his meals. How should a nurse analyze the client's behavior at admission?
A) Dysthymia, late onset
B) Major depression, single episode, severe
C) Substance-induced mood disorder
D) Bipolar disorder, type I, most recent manic |
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Definition
| C) Substance-induced mood disorder |
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Term
13. A client with depression asks a nurse why it is necessary to have a full physical assessment. Which is the most appropriate nursing response?
A) “The assessment is beneficial in decreasing any social isolation.”
B) “Physiological changes may be the underlying cause of depression and, if present, must be addressed.”
C) “Physical health complications are likely to arise from antidepressant therapy.”
D) “Depressed clients are less likely to complain about their physical health and may have an undiagnosed medical problem.” |
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Definition
| B) “Physiological changes may be the underlying cause of depression and, if present, must be addressed.” |
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Term
14. How should a nurse rank outcomes for a manic client, in order of priority, when planning care?
I. Maintains nutritional status
II. Interacts appropriately with peers
III. Remains free from injury and self-harm
IV. Remains reality oriented
A) II, I, III, IV
B) IV, I, II, III
C) III, I, IV, II
D) I, IV, II, III |
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Definition
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Term
15. Which factor should be identified as the most important contributing factor to the diagnosis of bipolar disorder?
A) Genetics and biochemical alterations
B) A poor mother–child relationship
C) Evidence of a lesion in the temporal lobe
D) Learned helplessness within a dysfunctional family system |
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Definition
| A) Genetics and biochemical alterations |
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Term
16. A client has been hospitalized for severe depression in the past, but has had difficulty finding stabilization on medication. The client is found unconscious, but still breathing, with an empty bottle of sertraline (Zoloft) beside her. She is stabilized in an emergency department and is then admitted to a psychiatric unit. A nurse understands that a physician may order electroconvulsive therapy (ECT) for this client for what reason?
A) Because the physician does not want to try further medication
B) Because ECT has proven to be effective in acutely suicidal clients and in clients whose therapeutic regimen has been ineffective
C) Because it is a less expensive treatment than prescribing further medication
D) Because ECT should abolish the client's suicidal and depressive symptoms instantly |
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Definition
| B) Because ECT has proven to be effective in acutely suicidal clients and in clients whose therapeutic regimen has been ineffective |
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Term
17. A client receives a diagnosis of bipolar I disorder, current episode depressed. A physician prescribes paroxetine (Paxil) for the client. The client is encouraged to participate in unit activities and to talk about her feelings. Despite all efforts, the client's depression becomes profound. The client is in total despair and is in a vegetative state. The physician obtains consent to perform electroconvulsive therapy (ECT). What is the rationale behind this treatment for profound depression?
A) The client is made to forget painful memories from the past and to go on with her life.
B) The treatment causes stimulation of the central nervous system (CNS) similar to CNS stimulant medication, thereby lifting mood.
C) The treatment satisfies the need for punishment that severely depressed clients sometimes think they deserve.
D) The treatment is thought to increase levels of norepinephrine and serotonin, resulting in mood elevation. |
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Definition
| D) The treatment is thought to increase levels of norepinephrine and serotonin, resulting in mood elevation. |
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Term
18. A client who has been hospitalized for mania in the past is laid off from her job. She becomes very depressed, refuses to look for another job, stays in her room, eats very little, and neglects her personal hygiene. The client is found unconscious, but still breathing, with an empty bottle of sertraline (Zoloft) beside her. She is stabilized in an emergency department and is then admitted to a psychiatric unit with a diagnosis of bipolar I disorder, current episode depressed. Which should be the priority nursing diagnosis for this client?
A) Imbalanced nutrition, less than body requirements, related to refusal to eat
B) Anxiety (severe) related to threat to self-esteem
C) Risk for suicide related to depressed mood
D) Complicated grieving related to loss of employment |
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Definition
| C) Risk for suicide related to depressed mood |
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Term
19. A client with a diagnosis of bipolar I disorder, current episode manic, tells a physician that she does not want to take lithium carbonate because she has gained a lot of weight while taking this medication. She says that if the physician sends her home on this drug she will just stop taking it. The physician decides to change the client's medication so she will be more compliant. Which medication should a nurse anticipate that the physician will choose to prescribe for this client?
A) Sertraline (Zoloft)
B) Valproic acid (Depakote)
C) Trazodone (Desyrel)
D) Paroxetine (Paxil) |
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Definition
| B) Valproic acid (Depakote) |
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Term
20. A client has bipolar I disorder. She has been taking lithium carbonate 300 mg three times daily for maintenance therapy. Her mother reports that the client stopped taking her lithium about 3 months ago because it caused her to gain weight. In the psychiatric unit, the client is agitated, pacing back and forth, talking loudly and abusively as if in response to an unseen person, and flailing her arms in exaggerated gestures. She is begun on lithium carbonate and olanzapine (Zyprexa) immediately. What is the rationale for the olanzapine order?
A) Olanzapine (Zyprexa) cures manic symptoms.
B) Olanzapine (Zyprexa) prevents extrapyramidal side effects.
C) Olanzapine (Zyprexa) will ensure that she gets a good night's sleep.
D) Olanzapine (Zyprexa) will calm her hyperactivity until the lithium takes effect. |
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Definition
| D) Olanzapine (Zyprexa) will calm her hyperactivity until the lithium takes effect. |
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Term
21. A nurse is caring for a client with major depressive disorder. The client is also experiencing delusions. The nurse understands that this is an example of which type of major depressive disorder?
A) With psychotic features
B) With catatonic features
C) With melancholic features
D) With seasonal pattern |
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Definition
| A) With psychotic features |
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Term
22. A nurse is caring for a client with major depressive disorder. The client is also experiencing a lack of physical movement and stupor. The nurse understands that this is an example of which type of major depressive disorder?
A) With psychotic features
B) With catatonic features
C) With melancholic features
D) With seasonal pattern |
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Definition
| B) With catatonic features |
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Term
23. A nurse is caring for a client with major depressive disorder. The client takes no pleasure in journaling, which the client usually enjoys. The nurse understands that this is an example of which type of major depressive disorder?
A) With psychotic features
B) With catatonic features
C) With melancholic features
D) With seasonal pattern |
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Definition
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Term
1. A nurse hears a clinician state, “This client has a phobia of elevators because he had a frightening experience in an elevator when he was a young child, or because he observed his mother's fear of elevators.” The nurse understands that this statement would most likely be made by a clinician who is operating from which paradigm?
A) Physiological
B) Psychoanalytic
C) Humanistic
D) Behavioral |
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Definition
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Term
2. A client tells a nurse that she refuses to eat in a restaurant because she is afraid others will laugh at the way she eats. The nurse understands that this behavior is associated with which condition?
A) Posttraumatic stress disorder
B) Generalized anxiety disorder
C) Social phobia
D) Obsessive–compulsive disorder |
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Definition
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Term
3. Since starting college, a client has been unrealistically worried about his academic performance as well as his relationship with his girlfriend. He cannot sleep or concentrate because he cannot stop worrying about the numerous papers and assignments that are due over the course of the semester. He is irritable and on edge. A nurse understands that this behavior is associated with which condition?
A) Posttraumatic stress disorder
B) Generalized anxiety disorder
C) Social phobia
D) Obsessive–compulsive disorder |
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Definition
| B) Generalized anxiety disorder |
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Term
4. Since starting college, a client has been unrealistically worried about his academic performance as well as his relationship with his girlfriend. He cannot sleep or concentrate because he cannot stop worrying about the numerous papers and assignments that are due over the course of the semester. He is irritable and on edge. Which actions should be included in the plan of care for this client? Select all that apply.
A) Increasing caffeine intake
B) Engaging in physical activity three times per week
C) Practicing relaxation techniques
D) Identifying signs and symptoms of escalating anxiety |
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Definition
B) Engaging in physical activity three times per week
C) Practicing relaxation techniques
D) Identifying signs and symptoms of escalating anxiety |
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Term
5. A client with obsessive–compulsive disorder develops a number of compulsive washing rituals over the years. The client then becomes confused and has difficulty remembering the proper sequence of her routines, which causes great distress. A nurse understands that the client's behavioral rituals served the purpose of:
A) Blocking delusions and hallucinations from awareness.
B) Providing temporary and partial relief from her anxiety.
C) Drawing attention and approval from significant others.
D) Increasing the inhibitory powers of her superego. |
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Definition
| B) Providing temporary and partial relief from her anxiety. |
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Term
6. Which statement about the treatment of clients with panic disorder is inaccurate?
A) Benzodiazepines (e.g., Valium) are the long-term pharmacological treatment of choice because of their nonaddicting quality.
B) Treatment includes identification of triggers that escalate anxiety symptoms.
C) A select group of antidepressants (selective serotonin reuptake inhibitors [SSRIs]) has been found helpful in long-term treatment.
D) Relaxation exercises, guided imagery, and meditation are effective in preventing or reducing anxiety symptoms. |
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Definition
| A) Benzodiazepines (e.g., Valium) are the long-term pharmacological treatment of choice because of their nonaddicting quality. |
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Term
7. In treating a client with obsessive–compulsive disorder, a nurse should allow the client to spend ____________ time on the ritual at the beginning of treatment, and encourage the client to spend ____________ time on the ritual later in the treatment.
A) the same amount of; more
B) more; less
C) less; incrementally less
D) the same amount of; incrementally less |
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Definition
| D) the same amount of; incrementally less |
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Term
8. While stuck in traffic, a cab driver unexpectedly begins to feel lightheaded, tremulous, and sweaty. His heart begins pounding and his breathing becomes rapid and labored. He thinks that he is having a heart attack. Driving on the shoulder of the road, he immediately heads for an emergency department. An extensive cardiac workup reveals no abnormalities. Which diagnosis should a nurse anticipate that a physician will assign to this client?
A) Generalized anxiety disorder
B) A specific phobia
C) Posttraumatic stress disorder
D) A panic attack |
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Definition
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Term
9. A client presents to an emergency department while having a panic attack. The client asks a nurse, “Am I going crazy?” Which is the most appropriate nursing response?
A) “Although it may feel that way during an attack, you actually suffer from panic disorder.”
B) “Thank goodness it's only in your head and not a real heart attack.”
C) “Let me get the psychiatrist to explain it to you.”
D) “We're all a little crazy at times. You'll be fine.” |
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Definition
| A) “Although it may feel that way during an attack, you actually suffer from panic disorder.” |
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Term
10. After receiving treatment for a panic attack, a client asks a nurse, “What can be done about this disorder? I need to go to work! I need to make a living!” Which components should the nurse include in the teaching plan for this client? Select all that apply.
A) Medication management
B) Relaxation techniques
C) Identification of signs, symptoms, and triggers of escalating anxiety
D) Referral to a social worker to assist in filing a disability claim |
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Definition
A) Medication management
B) Relaxation techniques
C) Identification of signs, symptoms, and triggers of escalating anxiety |
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Term
11. A nurse is conducting a psychoeducational group about anxiety in an inpatient unit. Which teaching by the nurse is accurate?
A) “Anxiety is considered abnormal when it is out of proportion to the stimulus causing it and when it impairs functioning.”
B) “Anxiety is a purely psychological phenomenon and can be overcome using mind over matter.”
C) “Anxiety is the third most common psychological disorder in the United States.”
D) “Anxiety is a complex phenomenon and is effectively treated only with psychotropic medications.” |
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Definition
| A) “Anxiety is considered abnormal when it is out of proportion to the stimulus causing it and when it impairs functioning.” |
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Term
12. A psychiatric nurse is working with a client with generalized anxiety disorder (GAD). Which phenomenon best describes the cognitive theory of GAD?
A) Overuse or ineffective use of ego defense mechanisms results in maladaptive responses to anxiety.
B) When an individual feels vulnerable in a given situation, distorted thinking results in an irrational appraisal, fostering a negative outcome.
C) The elevations in cortisol that occur during the fight-or-flight response.
D) Worry is a learned response to anxiety and serves to keep it within the control of the individual. |
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Definition
| B) When an individual feels vulnerable in a given situation, distorted thinking results in an irrational appraisal, fostering a negative outcome. |
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Term
13. A nurse therapist is using cognitive therapy to address anxiety. This entails encouraging the client to face frightening situations to be able to view them:
A) In a positive manner.
B) In a cautious manner.
C) In a realistic manner.
D) In an individualized manner. |
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Definition
| C) In a realistic manner. |
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Term
14. A nurse therapist is using systematic desensitization to address a client's severe test anxiety. How should the nurse describe this process to the client?
A) “Using your imagination, we will attempt to achieve a state of relaxation.”
B) “Because anxiety and relaxation are mutually exclusive states, we can attempt to substitute a relaxation response for the anxiety response.”
C) “Through a series of increasingly anxiety-provoking steps, we will gradually increase your tolerance to anxiety.”
D) “In one intense session, you will be exposed to a maximum level of anxiety that you will learn to tolerate.” |
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Definition
| C) “Through a series of increasingly anxiety-provoking steps, we will gradually increase your tolerance to anxiety.” |
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Term
15. A nurse therapist is using systematic desensitization to address a client's severe test anxiety. The client wants to see faster progress because the client is facing expulsion from school. Which technique should the nurse therapist choose to use next?
A) Imagery
B) Counter-conditioning
C) Cognitive therapy
D) Implosion therapy |
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Definition
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Term
16. For clients taking a benzodiazepine, which teaching by a nurse would be considered inaccurate?
A) “Do not eat foods containing tyramine while taking this medication.”
B) “Do not stop taking this medication abruptly because serious complications may arise.”
C) “Do not use this medication in combination with alcohol or any other central nervous system depressant.”
D) “Take only the dose your doctor has prescribed and for the period of time the doctor has indicated because addiction can occur.” |
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Definition
| A) “Do not eat foods containing tyramine while taking this medication.” |
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Term
17. A nursing instructor states, “Recently, the biochemical theory of the etiology of obsessive–compulsive disorder (OCD) has been given an increasing amount of credibility. Which neurotransmitter has been associated with this disorder?” Which is the most accurate response by the instructor's students?
A) Norepinephrine
B) Dopamine
C) Serotonin
D) Acetylcholine |
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Definition
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Term
18. A client with a diagnosis of obsessive–compulsive disorder (OCD) has been folding and unfolding her clothes and arranging and rearranging them in the drawers for an hour. How should the nurse interpret this client's behavior?
A) It relieves the client's anxiety.
B) Her mother taught her to be very neat.
C) She is too shy to go out in the dayroom.
D) It makes her feel good about herself. |
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Definition
| A) It relieves the client's anxiety. |
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Term
19. On admission to a psychiatric unit, a client with obsessive–compulsive disorder (OCD) folds and unfolds her clothes and arranges and rearranges them in the drawers for an hour. What is the most appropriate nursing intervention for this client?
A) Explain to the client that she must come out of her room and join the others in the dayroom.
B) Give the client a task to complete to get her mind off the ritual.
C) Allow the client as much time as she wants to perform the ritual.
D) Take the client by the hand and say, “It's time to go to group therapy now.” |
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Definition
| C) Allow the client as much time as she wants to perform the ritual. |
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Term
20. A nurse is caring for a client with obsessive–compulsive disorder (OCD). The client walks around the unit, checking and rechecking the lock on each door. Which is the most appropriate nursing intervention for this client?
A) Distract the client with other activities whenever she tries to check the locks.
B) Report the behavior to the physician every time she begins the ritual.
C) Lock the client's room so that she cannot engage in the ritualistic behavior.
D) Help the client to identify what is causing the anxiety that leads to the ritualistic behavior. |
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Definition
| D) Help the client to identify what is causing the anxiety that leads to the ritualistic behavior. |
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Term
21. A nurse is caring for a client with obsessive–compulsive disorder (OCD) who has been on the unit for several days. The client is becoming more comfortable and is beginning to interact with others. What change, if any, should the nurse make in her initial plan of care?
A) Begin to set limits on the amount of time that the client can engage in the ritualistic behavior.
B) Give negative reinforcement to the behavior by pointing it out.
C) Establish firm consequences if the client performs the ritualistic behavior.
D) Do not make any change in the plan of care. |
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Definition
| A) Begin to set limits on the amount of time that the client can engage in the ritualistic behavior. |
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Term
22. A nurse notifies a health-care provider to obtain a new prescription for a client with obsessive–compulsive disorder (OCD). Which is an appropriate prescription for a client with OCD?
A) Diazepam (Valium)
B) Fluvoxamine (Luvox)
C) Propranolol (Inderal)
D) Alprazolam (Xanax) |
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Definition
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Term
23. When caring for a client who is experiencing a panic attack, which nursing interventions are most appropriate? Select all that apply.
A) Leaving the client alone to maintain privacy
B) Reducing stimuli in the immediate environment
C) Speaking loudly and forcefully to gain client's attention
D) Administering anti-anxiety medication as ordered |
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Definition
B) Reducing stimuli in the immediate environment
D) Administering anti-anxiety medication as ordered |
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Term
24. A nurse is caring for a newly admitted client with obsessive–compulsive disorder (OCD) who performs a 15-minute ritual with his dietary tray before eating. Which nursing actions are most appropriate for this client? Select all that apply.
A) Allowing the client sufficient time to perform ritual
B) Requiring the client to eat in his room
C) Arranging the tray for the client
D) Supporting the client's efforts to understand the meaning of this behavior
E) Removing the tray when the client performs the ritual
F) Giving positive reinforcement for nonritualistic behaviors |
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Definition
A) Allowing the client sufficient time to perform ritual
D) Supporting the client's efforts to understand the meaning of this behavior
F) Giving positive reinforcement for nonritualistic behaviors |
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Term
25. A nurse is discussing treatment options with a client whose life has been negatively impacted by claustrophobia. Which behavioral therapies are most commonly used for phobias? Select all that apply.
A) Contracting about avoiding phobic stimuli
B) Systematic desensitization
C) Imploding (flooding)
D) Token economy
E) Aversion stimulus |
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Definition
B) Systematic desensitization
C) Imploding (flooding) |
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Term
26. A nurse is caring for a military veteran with posttraumatic stress disorder (PTSD). When planning care, which realistic goals should be included in this client's plan of care? Select all that apply.
A) The client will not have flashbacks.
B) The client will participate in a support group for veterans.
C) The client will not need hypnotics to obtain adequate sleep.
D) The client will refrain from discussing the traumatic event.
E) The client will verbalize the ability to feel a wider range of emotions. |
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Definition
B) The client will participate in a support group for veterans.
C) The client will not need hypnotics to obtain adequate sleep.
E) The client will verbalize the ability to feel a wider range of emotions. |
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Term
27. A nurse is caring for a client who is being evaluated for panic attacks. The client experiences an episode. Which symptoms, reported by the client, would support the diagnosis of panic attacks? Select all that apply.
A) Palpitations
B) Nausea
C) Powerlessness
D) Headache
E) Dizziness
F) Tinnitus |
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Definition
A) Palpitations
B) Nausea
C) Powerlessness
E) Dizziness |
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Term
28. A nurse has been caring for a client with generalized anxiety disorder. The nurse should evaluate that the care has been effective when the client is able to:
Select all that apply.
A) Recognize signs of escalating anxiety.
B) Avoid any situation that causes stress.
C) Utilize relaxation techniques to limit anxiety.
D) Maintain anxiety at a manageable level without the use of medications.
E) Discuss plans to handle panic attacks if they occur. |
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Definition
A) Recognize signs of escalating anxiety.
C) Utilize relaxation techniques to limit anxiety.
D) Maintain anxiety at a manageable level without the use of medications.
E) Discuss plans to handle panic attacks if they occur. |
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Term
29. A nurse is caring for a client who is 9 years old. At this developmental stage, this client's fearfulness would most likely be related to which condition?
A) Loud noises
B) Strangers and darkness
C) Death
D) Social rejection |
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Definition
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Term
30. A nurse is caring for a client who is 14 years old. At this developmental stage, this client's fearfulness would most likely be related to which condition?
A) Loud noises
B) Strangers and darkness
C) Death
D) Social rejection |
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Definition
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Term
31. A nurse is caring for a client who is 2 years old. At this developmental stage, this client's fearfulness would most likely be related to which condition?
A) Loud noises
B) Strangers and darkness
C) Death
D) Social rejection |
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Definition
| B) Strangers and darkness |
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Term
32. A nurse is caring for a client who is 6 months old. At this developmental stage, this client's fearfulness would most likely be related to which condition?
A) Loud noises
B) Strangers and darkness
C) Death
D) Social rejection |
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Definition
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