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Q:
The nurse is presenting information to a gatekeeper training class about the people in a suicide victim's life, including the most commonly recognized risk factors for suicidal behavior, symptoms of mental illness, and barriers to mental health treatment. The nurse teaches that both parents and friends were equally able to recognize many risk factors, but friends were better than parents at recognizing risk factors for:1. Suicide.2. Mania.3. Substance abuse.4. Depression.
Q:
The nurse knows that including family members in the plan of care for a suicidal client is extremely important. Two important strategies that families need to know are:Standard Text: Select all that apply.1. How to help loved ones avoid acting on suicidal thoughts.2. How to work with other families.3. How to prevent suicide.4. How to communicate with hospital staff.5. How to communicate with one another.
Q:
When working with suicidal clients, the nurse must be compassionate enough to:1. Be able to form an effective link with suicidal clients without being overwhelmed by the client's pain.2. Communicate effectively to solve the client's problems.3. Avoid asking the client difficult questions in order to prevent an escalation in symptoms.4. Ask the right questions in order to stop the client from getting angry.
Q:
Suicide prevention hotline callers had a significant decrease in suicidality during the course of the telephone session when crisis hotline workers demonstrated:1. Faith, respect, and trepidation.2. Hope, support, and happiness.3. Empathy, support, and hopelessness.4. Empathy, respect, and support.
Q:
In an effort to prevent suicide, an important advocacy strategy for all nurses to implement is to:1. Increase nurses' pay.2. Increase cultural and spiritual diversity.3. Reduce barriers to health care.4. Reduce financial burden for all patients through charities.
Q:
The nurse knows that basic suicide precautions may be started without a physician's order and maximum suicide precautions (or restrictions):1. Need a physician's order and a psychiatric consult.2. May be started on the recommendation of the psychiatric nurse.3. Can be instituted without a physician's order only under emergency conditions.4. Cannot be instituted without the client's consent.
Q:
The nurse on a psychiatric unit looks through a suicidal client's belongings, removing craft materials and mirrors. This is an example of:1. Common precautions.2. An invasion of privacy.3. A crime in progress.4. Maximum suicide precautions.
Q:
When teaching students about suicide, the nursing instructor knows that basic suicide precautions include:1. Beginning measures with an order from the psychiatrist.2. Checking the client's whereabouts and safety every 15 minutes.3. Maintaining one-to-one supervision during visits.4. Providing one-to-one nursing supervision at all times.
Q:
The nurse knows that when performing a lethality assessment, asking the client, "Have you ever thought of taking your own life?" may:Standard Text: Select all that apply.1. Cause the client to think about suicide.2. Alleviate the client's anxiety about considering suicide.3. Be direct enough to promote effective communication.4. Give the client an idea about suicide methods.5. Cause the client to open up about other attempts.
Q:
According to biologic theory, there is considerable evidence that what system, partly under genetic control, may influence the risk for suicidal behavior?1. HPA-axis system2. Serotonergic system3. Neurotransmitter system4. System of PET
Q:
A 22-year-old suicidal client acknowledges being molested by her stepfather since she was eight-years-old. The nurse knows this client's self-destructive behavior is best explained by:1. Interpersonal theory.2. Sociocultural theory.3. Biologic theory.4. Self-destructive behavior.
Q:
A suicidal client tells his psychiatric nurse practitioner, "My death will benefit my family; I"m 83-years-old and have outlived my usefulness." The nurse practitioner knows this is an example of:1. Suicide theory.2. Sociocultural theory.3. Interpersonal theory.4. Biologic theory.
Q:
A high school nurse is sharing the results of a national survey with school faculty and staff. The nurse states that, if the students in their school are similar to those surveyed, close to one out of five have seriously considered suicide in the:1. Springtime.2. Winter months.3. Past year.4. 3 months preceding the survey.
Q:
A recent study about suicide risk based on the cultural worldview of African-American and European-Americans shows that:1. Resilience gives individuals more reasons to live.2. Difficulty communicating and the ability to integrate new and old information is the reason for suicidal behavior.3. Constriction of thought, a dyadic event, and/or increased communication skills give individuals more reasons to live.4. High parental conflict is the reason for suicidal behavior.
Q:
The student nurse realizes that individuals who self-mutilate may:1. Process feeling verbally if someone listens.2. Never learn how to control their urges.3. Cut for attention only.4. Have difficulty processing feelings.
Q:
When teaching students about suicide, the nursing instructor knows to include facts such as:1. Over 31,000 people kill themselves each year, and suicide is the primary reason for their deaths.2. Suicide is the fourth leading cause of death among African-American teenagers and the ninth leading cause of Caucasian teen deaths.3. Suicide is the 11th leading cause of self-inflicted injuries, accounting for over 325,000 people each year going to the emergency department.4. Suicide is the leading cause of death among mentally ill clients, and over three million people kill themselves each year according to the CDC.5. Suicide is the 11th leading cause of death among Americans, and as many as 44% of psychiatric emergency clients are at increased risk for suicide.
Q:
While taking care of a client at the mental health clinic, the student nurse notices scars and healing lacerations on the client's arms. The client states, "I did all of that." The student nurse knows this type of behavior is:Standard Text: Select all that apply.1. Self-destructive.2. A prank.3. A maladaptive measure.4. A coping mechanism.5. A waste of time.
Q:
The nurse is learning how to handle feelings of frustration and helplessness when caring for clients with cluster B personality disorders. Which of the following statements by the nurse would reflect that learning has taken place?1. "I can just ignore my feelings and focus on the client's needs."2. "As long as my words are therapeutic, the client cannot tell what I am really thinking."3. "I need to maintain professional distance by using empathy."4. "I can talk about my feelings with my friends."
Q:
A client with a diagnosis of antisocial personality disorder comes to the nurses' station at 11:00 p.m. requesting to use the phone. The client insists on consulting a lawyer immediately to discuss filing for a divorce. The unit rules prohibit phone calls after 10:00 p.m. Which of the following responses is therapeutic for this client?1. "It is after 10:00 p.m. You can call tomorrow."2. "You know better than to break the rules. I'm surprised at you."3. "You really don't want to file for a divorce, do you?"4. "You may go ahead and use the phone. I know this is hard for you."
Q:
A client with borderline personality disorder approaches the nurse voicing concerns about being ignored by the nursing staff and feeling unimportant. The client blames the nursing staff for not paying attention to the client. The nurse's best therapeutic response to this client would include which of the following statements?1. "Tell me more about your feeling of being ignored."2. "That's all in your imagination."3. "You need to share your feelings with the nurses you feel are ignoring you."4. "I will bring it up at the next meeting."
Q:
The nurse is planning care for an individual diagnosed with borderline personality disorder. The nurse realizes that interventions will have to be focused on which of the following behaviors?1. Desiring order and perfection2. Not being able to make decisions3. Acting out when feeling abandoned or disrespected4. Withdrawing and becoming isolative
Q:
Clients with antisocial personality disorder display a lack of empathy and will put their own needs above the needs of others. Interventions for clients with antisocial personality disorder will be targeted toward which of the following behaviors?1. Displaying a great deal of responsibility toward others2. Displaying a disregard for the rights of others3. Displaying a great deal of self-control4. Displaying a great deal of anxiety
Q:
Which of the following interventions would the nurse implement to address the client with feelings of abandonment?1. Assist client to suppress feelings of abandonment.2. Encourage client to never get involved in a relationship again.3. Assist client to express deep rage at the ending of the relationship.4. Assist client to verbalize feelings of abandonment in an appropriate manner.
Q:
A client with a diagnosis of borderline personality disorder has had several hospitalizations for suicide attempts and self-mutilation. A priority nursing intervention for this client would include which of the following?1. Safety maintenance2. Social interaction3. Anxiety reduction4. Concrete communication
Q:
The nurse and a client talk about healthy ways to meet needs. The client states, "When I am looking really good, it is not asking too much for people to acknowledge me." The nurse recognizes that this experience is indicative of:1. Affective instability.2. Splitting.3. Feelings of emptiness.4. A sense of entitlement.
Q:
The client with a diagnosis of borderline personality disorder shows the nurse multiple superficial cuts to the arms that were made during the night. The client states, "I told the night staff that I was feeling alone." The nurse recognizes that the self-mutilation may be a result of:1. Manipulation.2. Anxiety.3. Splitting.4. Impulsive behavior.
Q:
A student nurse is working with a client on the inpatient unit who exhibits manipulative behavior. What action should the student incorporate into interactions with this client?1. Limit setting2. No-harm contract3. Confront negative self-concepts4. Matter-of-fact approach
Q:
The nursing staff is discussing boundary setting. Which of the following statements about boundary setting is inaccurate?1. "Boundaries are established by providing consistent expectations."2. "Boundaries define the therapeutic relationship."3. "Boundaries provide guidelines for self-control."4. "Boundaries are established to make the nursing staff's job easier."
Q:
A client with borderline personality disorder gives written notice of intention to leave the hospital after a voluntary admission. The client tells the nurse, "I will rescind my notice if you expand my smoking privileges." The nurse should respond in a way that:1. Convinces the client to rescind the notice.2. Provides exceptions to the unit rules.3. Refers the client to the physician.4. Consistently reinforces the unit rules.
Q:
The nurse is working with a client who has a history of impulsive and self-harming behavior. The nurse will need to address which of the following in the plan of care?1. Boundary setting2. Confidentiality3. Safety4. Appropriate self-disclosure
Q:
A 30-year-old man is accused of sexual assault and is arrested by law enforcement. During the interview with the forensic nurse, the client uses flattery and compliments the nurse's interview skills. He asks the nurse for her phone number so his lawyer can contact her as an expert witness for his case. How should the nurse respond?1. Tell the client that she is listed in the phone book.2. In a way that establishes the boundaries of the nurse"client relationship.3. Tell the client that the nurse is working for the prosecution.4. In a way that nurtures the client's feelings.
Q:
The student nurse is comparing the essential characteristics of each cluster of personality disorders. The student correctly identifies the essential characteristics of cluster C disorders as:1. Anxiety.2. Pervasive distrust.3. Impulsivity.4. Openness.
Q:
The nurse admits a client who initially presents as intelligent, articulate, and superficially charming. The client claims his admission to the mental health unit is a big mistake. He states that there was a mix-up in the emergency room and he was incorrectly identified. A probable diagnosis is:1. Antisocial personality disorder.2. Avoidant personality disorder.3. Dependent personality disorder.4. Obsessive-compulsive personality disorder.
Q:
A client presents with an inability to make decisions and function independently. The nurse knows these symptoms are indicative of which of the following disorders?1. Dependent personality disorder2. Paranoid personality disorder3. Schizotypal personality disorder4. Schizoid personality disorder
Q:
The nurse is preparing to assess a client with a diagnosis of paranoid personality disorder. What client characteristics will the nurse expect to observe?1. Grandiosity2. Superficial charm3. Affective instability4. Suspicions and rigidity
Q:
The nurse is working with a client who exhibits a pervasive, excessive, and unrealistic need to receive care. This client's behavior is a characteristic of which of the following personality disorders?1. Histrionic personality disorder2. Narcissistic personality disorder3. Dependent personality disorder4. Avoidant personality disorder
Q:
The nurse is working with a client who exhibits a grandiose sense of self-importance. This characteristic is associated with which of the following personality disorders?1. Narcissistic personality disorder2. Avoidant personality disorder3. Histrionic personality disorder4. Dependent personality disorder
Q:
A client with a diagnosis of paranoid personality disorder appears hypervigilant and sits alone in an isolated area of the unit. The client does not acknowledge other clients and often uses sarcasm when addressing staff. The nurse invites the client to attend a milieu group, but the client ignores the nurse's efforts. An appropriate nursing diagnosis for this client is which of the following?1. Activity Intolerance2. Fear3. Impaired Social Interaction4. Powerlessness
Q:
What would the nurse expect to find when assessing a client with obsessive-compulsive personality disorder?1. Difficulty completing projects2. A sense of spontaneity3. Open expression of feelings4. Ability to tolerate mistakes
Q:
Impulse control is part of the care plan for a client with borderline personality disorder. Which of the following is particularly important to include?1. A no-harm contract2. Identification of behavior patterns3. Identification of support sources4. Management of emotions
Q:
The nurse is caring for a client with schizoid personality disorder. Which nursing diagnosis is most appropriate for this client with a cluster A personality disorder?1. Fear related to feelings of abandonment2. High Risk for Violence, Self-Directed, related to poor impulse control3. Social Isolation related to inadequate social skills, craving of solitude4. Ineffective Individual Coping related to high dependency needs
Q:
The nurse is working with a client who has been diagnosed with a personality disorder. Which situation best describes the client's external response to stress?1. The client attends group therapy.2. The client uses meditation when upset.3. The client tries to change the environment instead of changing him- or herself.4. The client engages in self-awareness exercises.
Q:
A client consistently fails to accept the consequences of his or her own behavior. The nurse identifies this behavior as characteristic of:1. Immaturity.2. A lack of structure.3. A need for medication.4. A personality disorder.
Q:
In describing personality disorders to a group of consumers, which statement by the nurse is accurate?1. "People with personality disorders are unable to experience painful feelings."2. "These disorders usually develop during the toddler stage."3. "People with personality disorders view their problems as separate from themselves."4. "Behavior is sporadic with no particular pattern."
Q:
A nurse is working with a client who has a diagnosis of obsessive-compulsive personality disorder. It is important for the nurse and client to discuss:1. The effect of anger on perfectionism.2. The need to feel superior.3. The link between anxiety and perfectionism.4. The need for medication.
Q:
How can the nurse differentiate the client with obsessive-compulsive personality disorder from a client with perfectionist personality traits?1. Clients with obsessive-compulsive personality disorder will exhibit order in all areas of their lives.2. Clients with obsessive-compulsive personality disorder will exhibit fear, anxiety, and an excessive need for order.3. Clients with obsessive-compulsive personality disorder will exhibit the need for perfection in everyone but themselves.4. Clients with obsessive-compulsive personality disorder will exhibit order in their work lives but are able to relax when away from work.
Q:
A nurse is studying personality disorders. What statement would indicate that the nurse can differentiate between personality traits and personality disorders?1. "Personality traits are persistent behavior traits that do not significantly interfere with an individual's life."2. "Personality traits are lifelong maladaptive patterns."3. "Personality traits are rigid, stereotyped behavioral patterns."4. "Personality traits are enduring and deviate from societal norms."
Q:
Which of the following interventions might facilitate the nurse's understanding of how clients with eating disorders view their bodies?1. Observe the client's interactions with other clients with eating disorders.2. Assess the client's response to limit setting when eating.3. Discuss the importance of food and exercise in maintaining body image.4. Ask the clients to draw a picture of themselves as they are now and as they desire to be.
Q:
An adolescent student tells the nurse, "I lost ten pounds in the last three months. I believe I have anorexia." The nurse's response should be based on the following understanding:1. Since the student is willing to talk about the issue, the student is probably not anorexic.2. The student may be anorexic if the weight loss has lead to maintenance body weight less than 85% of the expected.3. The student is not anorexic because the student's physical development has not been affected by nutritional status.4. There is cause for alarm since most adolescent females experience anorexia.
Q:
The client is diagnosed with bulimia nervosa. What is the most appropriate nursing intervention that focuses on purging behaviors?1. Provide frequent small meals.2. Weigh the client after eating.3. Observe the client for at least one hour after meals.4. Have the nurse eat with the client.
Q:
The client with bulimia is experiencing anxiety. What action should the nurse take to assist the client to avoid binge eating and purging in response to the anxiety?1. Assume a matter-of-fact attitude and positive expectations of the client.2. Project a calm reassuring attitude and provide a quiet non-stimulating environment.3. Contract for safety since the client is likely to engage in self-injurious behavior.4. Maintain total control of the environment and project an attitude of authority.
Q:
What are suggested outcomes for the nursing diagnosis of "Ineffective Individual Coping" for a client with anorexia nervosa?Standard Text: Select all that apply.1. Actions to manage stressors that tax an individual's resources2. Ability to self-restrain altered perceptions3. Ability to self-restrain compulsive or impulsive behaviors4. Ability to acquire, organize, and use information5. Adequate nutrients taken into the body
Q:
Which medication should the nurse expect to administer to the client with bulimia nervosa?1. Prozac2. Prolixin3. Benadryl4. Ritalin
Q:
The client with binge-eating disorder reports a lack of involvement in activities, loss of interest in self-care activities, and oversleeping. The client's speech is filled with despondency. What nursing diagnosis is most appropriate for this client?1. Hopelessness2. Anxiety3. Social Isolation4. Knowledge Deficit
Q:
Despite the fact that the patient is 5"6" and weighs 72 lbs, the patient reported feeling "fat and overweight." What is the most appropriate nursing diagnosis for this patient?1. Chronic Low Self-Esteem2. Ineffective Coping3. Altered Nutrition4. Body Image Disturbance
Q:
What factor contributes to a poor outcome for clients with anorexia nervosa?1. Treatment approaches are fragmented and controversial.2. The client with anorexia nervosa actively resents or refuses treatment.3. There is no cure for anorexia nervosa.4. Changes in the client's behavior are irreversible.
Q:
A client with an eating disorder is trying to develop new coping skills. The process the nurse can use to help family members as they support the client is to:1. Assist the family to explore their own coping strategies.2. Encourage the family to avoid discussing their feelings about the client's illness.3. Assist the family to challenge the client's behavior.4. Teach the family how to manipulate the client's environment to avoid problem situations.
Q:
Which of the following physical findings regarding the client's weight is consistent with binge-eating disorders?1. The client is usually of normal or slightly above average weight.2. Weight tends to fluctuate but is generally low.3. All of the clients are overweight.4. The client is generally underweight.
Q:
Which of the following physical findings would lead the nurse to suspect that the client has bulimia nervosa?1. A skeletal appearance2. Lanugo growth on face and extremities3. Abrasions and calluses on the knuckles4. Sunken eyes
Q:
Which of the following questions would the nurse ask the client when assessing for a common condition thought to relate to the degree of stress that occurs with anorexia nervosa?1. Has your hair been falling out?2. Do you exercise after eating?3. Has your menstrual period stopped?4. Are you purging after you eat?
Q:
Which of the following physical manifestations would the nurse expect in a client who is emaciated, has sunken eyes, and a skeletal appearance?1. Tachycardia, arrhythmia, dry skin2. Tachycardia, hypotension, and edema3. Bradycardia, hypotension, arrhythmia4. Bradycardia, hypertension, alopecia
Q:
When assessing the client with dramatic weight loss or gain, the nurse should consider:1. The focus of the assessment must be on the psychological findings.2. There is usually a direct cause and effect.3. The focus of the assessment must be on the physical findings.4. Both can be caused by physical or mental conditions.
Q:
Which of the following behaviors should the nurse anticipate in the client with anorexia nervosa?1. Positive self-image2. Constant over-eating3. Obsessive rituals4. Little anxiety regarding food
Q:
The nurse is assessing a male client who is suspected of having an eating disorder. What additional information should the nurse include in her assessment of this client?1. Use of anabolic steroids2. Relationship with family3. Ethnic origin4. History of illegal substance use
Q:
To which of the following information sources for the client with an eating disorder should the nurse limit exposure because of the many societal influences on perceptions of attractiveness?1. Information about coping behaviors2. Articles about eating disorders3. Programs that emphasize good nutrition4. Media that glamorizes thinness
Q:
Since purging and excessive exercise are not features of binge-eating disorders, these individuals often become:1. Anorexic.2. Emaciated.3. Hungry.4. Obese.
Q:
From a psychoanalytic perspective, eating disorders are related to:1. Conscious intrapersonal and interpersonal conflict.2. Learned behavior regarding the affect of food.3. Disturbance in the body system.4. Regression to pubertal conflicts and repudiation of developing sexuality.
Q:
The most appropriate intervention for the nurse to use when integrating cognitive behavioral approaches into therapy for clients with bulimia nervosa is:1. Individual interventions.2. Behavior modification.3. Family groups.4. Client education.
Q:
Which of the following must the nurse consider when deciding appropriate boundaries for the client with eating disorders and their family members?1. Family members of clients with anorexia become enmeshed2. Family members of clients with bulimia are overly affectionate3. Family members of individuals with bulimia tend to bond together4. Family members of clients with anorexia are usually very autonomous
Q:
Which of the following neurotransmitters affect eating disorders?Standard Text: Select all that apply.1. Neuropeptide Y2. Dopamine3. Acetylcholine4. Serotonin5. Norepinephrine
Q:
Which of the following groups is more accepting of the way they look which may serve as a protective factor against the development of eating disorders?1. Asian Americans2. Homosexual males3. Latino women4. African American women
Q:
A client with an eating disorder is in the demographic group that represents those at highest risk for developing an eating disorder. The client is a/an:1. Male.2. Older adult.3. Child.4. Female.
Q:
A client who cross-dresses is intent on keeping it a secret and not disclosing it to his partner. The nurse should:1. Offer education and support.2. Determine where cross-dressing will take place.3. Determine when cross-dressing will take place.4. Disclose the cross-dressing secret to the partner.
Q:
The primary nursing goal for treatment with clients who are transsexual is to help them:1. Experience guilt for enjoying sex.2. Live and function in society in the cross-gender role.3. Internalize the negative expectations and beliefs of others about sex.4. Make a list of anxiety-producing sexual interactions.
Q:
Which of the following interventions is most appropriate for the nurse to offer when helping a client with gender dysphoria?1. Focus on promoting comfort with the chosen gender role.2. Encourage living as their assigned gender.3. Avoid client discussions of hormonal treatment.4. Discourage genital reassignment surgery.
Q:
Which one of the following assessment questions would the nurse use when completing a client's sensation assessment during a sexual history?1. "Does the use of fantasy increase or decrease your sexual desire?"2. "Do you experience any physical discomfort during sexual activity?"3. "What negative thoughts do you have about sex?"4. "How rigidly were gender roles enforced in your family of origin?"
Q:
To complete a cognitive assessment during a sexual history, the nurse would ask:1. "How has your religion influenced your sexual values and behaviors?"2. "What are the negative aspects of your own sexual functioning?"3. "What are your partner's concerns about current or future sexual functioning?"4. "What concerns do you have about your future sexual functioning?"
Q:
To complete a behavioral assessment during a sexual history, the nurse would ask:1. "In what way(s) do you experience anxiety about sex?"2. "What is your level of satisfaction with the frequency of your sexual activity?"3. "Can you describe the type of love and affection in this relationship?"4. "In what way(s) do you experience guilt about sex?"
Q:
A client is being admitted to the mental health unit. When completing the affective assessment of the client's sexual history, the nurse asks:1. "When you were growing up, how did you learn about sex?"2. "With whom do you feel most intimate and connected?"3. "To what degree do you experience pleasure during sexual activity?"4. "What are the positive aspects of your own sexual functioning?"
Q:
The nursing instructor is discussing theories to explain sexual dysfunction. The nurse states that behavioral theorists believe sexual dysfunction may be related to learned responses to:1. Lack of concern with sexual performance.2. Poor communication skills.3. Vast sexual experience with a variety of partners.4. Effective stimulation by a sexual partner.