Q&A Hero

Q: A nurse is effective in crisis work when the nurse:Standard Text: Select all that apply.1. Collaborates with other health professionals.2. Stays in control of clients.3. Has realistic expectations.4. Respects clients.5. Develops own outlets for stress.

Q: The nurse working in disaster situations should also attend to his/her own self-care. To maintain positive self-care, the nurse should avoid:1. Utilizing healthy coping mechanisms.2. Monitoring one's own reactions.3. Keeping a journal to write thoughts and feelings.4. Focusing on improving interventions for the next crisis.

Q: Identify which of the following would be detrimental for the nurse desiring to manage stress when working with a client/family in crisis.1. Drink plenty of water and eat a balanced and healthy diet2. Participate in memorials and rituals3. Talk about your emotions4. Maintain a consistent work assignment

Q: A nurse working with clients affected by a disaster event must be conscious not only of the clients' responses, but also the nurse's own responses. Which of the following would not be a common experience?1. Not wanting to leave the scene until work is finished2. Denying the need for rest and recovery time3. Inability to engage in problem solving4. Profound sadness, grief, and anger toward an abnormal event

Q: The caregiving team may also need support to process traumatic events in the community or in the care setting. Critical Incident Stress Debriefing (CISD) is a model of effective group crisis intervention. This group intervention:Standard Text: Select all that apply.1. Includes a several-phase group discussion.2. Includes psychological and psychoeducational elements.3. Includes guidelines similar to AA.4. Is most effective in emergency settings.

Q: Clients require stress management when they are easily frustrated, feel hopeless, cry easily, and are reluctant to leave home. An action that would not lead to a healthy decrease in the stress is to:1. Utilize all familiar coping strategies.2. Spend time with family and friends.3. Not hold themselves directly responsible.4. Maintain a daily routine.

Q: The nurse is working with a family that has just survived a tornado. As part of the intervention, the nurse is reviewing emotions they may be experiencing which are considered normal reactions to a traumatic event, including:Standard Text: Select all that apply.1. Each family member talks to the nurse openly and freely.2. Each member of the family has different ways of coping.3. Some family members have difficulty accepting help.4. Anxiety about self and family's safety.5. All family members will process the experience at about the same pace.

Q: Communication intervention strategies are significant for the nurse to utilize. These techniques include:Standard Text: Select all that apply.1. Personal revelations about the nurse's feelings to "break the ice."2. Reflecting statements that encourage the client to express feelings.3. Paraphrasing client statements using clinical terms.4. Statements that promote expression of the client's emotions.5. Clarifying statements the client has made.

Q: The nurse is conducting training for crisis counselors. The nurse would include the intervention strategies of safety and security, ventilate and validate, predict and prepare which are:1. A way to identify when the crisis is maturational.2. Best used before a crisis.3. Applied when the clients are unable to progress.4. Referred to as the ABCs of crisis counseling.

Q: The first step in crisis intervention is to achieve contact. When initiating contact with a client after a crisis, the nurse should not:1. Collect information regarding health conditions.2. Provide for emotional and physical safety of client.3. Discuss the nurse's personal experiences with crises.4. Identify feelings, reactions, and perceptions of client.

Q: Which statement by a client would suggest that the ABCs of crisis counseling have been met?1. "I am really glad we did this counseling."2. "I will call you if I need you."3. "I now know some better ways of coping."4. "I will miss working with you."

Q: Which of the following reflects the concepts of crisis intervention?Standard Text: Select all that apply.1. Includes interdisciplinary treatment2. Restoring the individual to a sense of equilibrium3. Used when client is unable to overcome the effects of a crisis4. Utilized when client becomes suicidal5. Short-term, action-oriented assistance, focused on problem-solving

Q: A client is participating in therapy that explores the effects of unrealistic thought patterns on daily life. Which type of therapy is the client likely engaging in?1. Family therapy to explore dynamics2. Cognitive therapy techniques3. Alternate-Nostril Breathing4. Repetitive Transcranial Magnetic Stimulation

Q: The nurse has observed a number of behaviors in the client that indicate that stress management is needed. The behavior the nurse did not observe was:1. Increased tendency to feel frustrated.2. Verbalization of feelings.3. Loss of objectivity.4. Unnecessary risk-taking.

Q: A client is brought to the emergency department after being in a house fire. After determining the client is stable physically, what is the first phase of crisis intervention?1. Assess the impact this experience has had on the client2. Confront the reality of the crisis3. Reassure client and family4. Teach coping skills to client

Q: The nurse working with a client who is a survivor of a four-car accident knows that there are risk factors that influence this client's response to the traumatic experience. The risk factors are:Standard Text: Select all that apply.1. Prior history of crises.2. Believing that receiving help is a sign of weakness.3. Cultural expectations that prohibit asking others for help.4. Feelings of loss.5. Pre-existing psychiatric symptoms and diagnosis.

Q: The nurse is working with a client whose brother had recently died as a result of a brain aneurism. The client reports spending the days crying or sleeping. The nurse intervenes in this situation to:1. Encourage the client to stay busy.2. Help the client focus on other aspects of life.3. Provide respite from a painful reality.4. Restore the client to pre-trauma level of functioning.

Q: A client describes being depressed, out of control, and unable to make decisions. Upon assessment, the nurse determines that the client has recently experienced a fire at home in which many important files as well as family mementos were destroyed. Many things that were not totally burned were water damaged. The nurse knows that identifying the origin of the crisis:1. Motivates the client and family to take significant action in relationships.2. Promotes an increased opportunity for interventions to be effective.3. Decreases communication with significant others.4. Assists with identifying the level of grief.

Q: Which of the following are risk factors that may continue to promote disequilibrium?1. Sudden experience, no warning signs2. Poverty, abuse, pre-existing psychiatric disorder3. Coping skills, strong self-esteem4. Communication with others

Q: Balancing factors that help clients after a crisis would not include:1. Degree of threat to life.2. Realistic perception of the event.3. Decreased or limited communication.4. Adequate coping mechanisms.

Q: Which statement should include communication strategies when a client has had a situational crisis?1. "I am sorry this happened to you."2. "I know just how you feel."3. "It's best to stay busy."4. "It could have been worse."

Q: Effective planning for a client's crisis intervention is:1. Organized with follow-up.2. Developed prior to meeting with the client.3. Based on complete assessment.4. Focused on long-term problems.

Q: The nursing diagnosis that would not be made for a client having experienced a situational crisis is:1. Risk for Loneliness.2. Risk for Self-directed Violence.3. Spiritual Distress.4. Impaired Social Interaction.

Q: Crisis situations are turning points in a client's life. This can result in:Standard Text: Select all that apply.1. Something close to a pre-crisis state of functioning.2. A realistic perception of the event.3. Dysfunctional personal coping.4. Anticipatory guidance assistance.5. A more negative or positive state.

Q: Which of the following statements by a client would reflect a turning point?1. "This was difficult for me, but I have learned how to manage myself in my new job."2. "If only they would give me another chance, I know I could do better."3. "I will get them for this."4. "I guess I deserved this. I was not a great employee."

Q: A client, divorced for one year, has recently had crisis counseling. The client has begun to take classes at the community college and has enrolled the children in day care. These new actions could be referred to as:1. A response to stress.2. A situational crisis.3. A turning point in life.4. A maturational crisis.

Q: Different types of crises arise from different causes. Maturational crises can involve:Standard Text: Select all that apply.1. Transition from student to worker.2. Normal transitions of human development.3. Life cycle changes.4. Changes such as marriage or retirement.5. Life changes from a flood.

Q: A client who has been divorced for six months has recently been lying in bed most days, unable to care for the children. This is referred to as:1. A situational crisis.2. A stressful situation.3. Lack of resilience.4. Regression.

Q: One of the following statements regarding crises is incorrect. Identify the incorrect statement.1. A maturational crisis involves life cycle changes or transitions of human development.2. A situational crisis can originate from material, environmental, or personal sources.3. Experiencing a crisis always develops into post-traumatic stress disorder.4. A crisis is an acute time-limited state of disequilibrium.

Q: A client who is nearing high school graduation is unable to finish out the year, cries at night, has difficulty sleeping, and does not want to attend classes. Which type of crisis does the nurse identify?1. Trauma from previous crisis2. Situational crisis3. Recoil response4. Maturational crisis

Q: NCCAM has identified five major domains of complementary and alternative therapies. The fifth domain of energy therapies does not include:1. Healing touch.2. Reiki.3. Bioelectromagnetic-based therapies.4. Ayurveda.

Q: Which of the following statements by a nursing student indicates the need for further training on the use of CAM techniques?1. "I should practice deep breathing exercises before trying to teach a client how to use them."2. "Massage therapy can help alleviate pain for clients with cancer."3. "It is important to assess the client's motivation to participate in treatment before beginning."4. "These techniques should be used for all clients."

Q: Nurses who wish to use hypnosis in their practice:1. Recognize that hypnosis is an advanced intervention that requires specialized training in hypnotherapy.2. Are qualified to do so if they can effectively use guided meditation.3. Do not need special training in hypnosis.4. Do not need to be concerned with whether or not hypnosis is within the scope of nursing practice.

Q: In order to improve diet, an eager mental health client bought a juicing machine. The nurse knows that grapefruit juice may interfere with some psychotropic medications. Upon checking the client's medical records, the nurse finds the client's medication should not cause a problem with including grapefruit juice in the client's diet. The client is probably taking:1. Antidepressants.2. Anticonvulsants.3. Atypical antipsychotics.4. Benzodiazepines.

Q: A client is taking lithium for treatment of a mood disorder. Which of the following herbal products is contraindicated for this client?1. American ginseng2. Evening primrose oil3. Yohimbe4. Caffeine

Q: A client taking fluoxetine (Prozac) asks about adding herbal therapy to the treatment. The nurse advises that select serotonin reuptake inhibitors should not be taken with:Standard Text: Select all that apply.1. Grapefruit juice.2. St. John's wort.3. Melatonin.4. Sage.5. SAMe.

Q: Knowing that the nurse is familiar with CAM modalities, a colleague asks the nurse for advice on dealing with the symptoms of the colleague's mother's recent diagnosis of early-stage Alzheimer's disease. The nurse discusses the potential for the use of certain dietary supplements and suggests that the mother's diet include:1. Kava.2. Thiamine.3. Omega-3 fatty acids.4. Ginkgo leaf extract.

Q: A client is taking fluoxetine (Prozac) and wonders if adding St. John's wort would help. Knowing that St. John's wort acts similar to selective serotonin reuptake inhibitors (SSRIs), the nurse is concerned that by taking both, the client may develop:1. Nothing since these substances do not interact.2. Serotonin syndrome.3. Mania.4. Depression.

Q: A client taking central nervous system (CNS) depressants asks the nurse what natural medicines would be safe to use. The nurse suggests that there is no contraindication for taking CNS depressants with:1. Melatonin.2. Lavender.3. Hawthorn.4. Stinging nettle.

Q: Massage with aromatherapy is useful for persons diagnosed with:1. Alzheimer's disease.2. Mania.3. Acute psychosis.4. Dementia.

Q: A client asks the nurse for help in learning to relax. The client claims to know about meditation and understands it is supposed to help a person relax but every time the client tries to meditate, the client is easily distracted. Considering the four major requirements that facilitate successful meditation practice, the nurse advises the client to:Standard Text: Select all that apply.1. Focus on one word, object, or symbol to look at or think about if the client finds it helpful.2. Find a position that will be comfortable to hold for a while.3. Find a quiet place away from distractions.4. Have a religious belief in order for meditation to be successful.5. Pay attention to "how well the client is doing at meditating."

Q: Meditation, with or without cognitive behavioral therapy (CBT):Standard Text: Select all that apply.1. Increases levels of dopamine.2. Increases mood disturbance.3. May reduce cognitive decline associated with aging.4. Is equivalent to a state of rest.5. Is a difficult technique to master.

Q: There are several ways to encourage clients and their families to become educated consumers of CAM practices and products by gathering information about advantages, disadvantages, or risks related to CAM. Such information might be gained through:Standard Text: Select all that apply.1. Contacting their state licensing board.2. Personal testimonials from friends.3. Reading the latest research.4. Websites that report guides to fraud or quackery.5. Nothing since there is no specific thing they can do to gain enough information to be an educated consumer.

Q: Introspective or meditative techniques may be useful for clients who:1. Are highly anxious.2. Have multiple problems.3. Are severely depressed, delusional, or hallucinating.4. Are mentally and emotionally healthy.

Q: Nurses are particularly suited to helping clients become informed consumers of CAM products and practices. One valid and reliable internet website to which nurses might refer clients or their family members is:1. EMedicine.2. Medscape.3. Science Daily.4. NCCAM.

Q: The psychiatric"mental health nurse is assessing a new client recently diagnosed with an anxiety disorder and high blood pressure. The nurse knows to closely monitor vital signs and review this client's medication list for:Standard Text: Select all that apply.1. Haloperidol (Haldol).2. Acetaminophen (Tylenol).3. Aspirin.4. Olanzapine (Zyprexa).5. Thioridazine (Mellaril).

Q: The nurse's friend is taking a benzodiazepine to help with anxiety. The friend tells the nurse about reading that kava is good for anxiety too, and says, "I bought some at the local health store. After all, it's "natural". I"d rather use natural products than a medication to help my anxiety."The nurse's response should be which of the following?1. "It's a medicine too and should not be mixed with your other meds."2. "Have you told your doctor about this? Benzo's can be addictive."3. "That's great, I"m glad you"re going natural."4. "Kava is harmless. Good for you to take such initiative."

Q: Taking into consideration the client's level of motivation and ability to manage complex instructions, a nurse counsels a client seen for repeated episodes of anxiety to consider adding the use of complementary and/or alternative modalities to help manage the anxiety. The nurse may suggest which of the following CAM modalities?1. Kudzu2. Running3. Acupressure4. Ginkgo

Q: The nurse working in a clinic specializing in treating addiction knows that, in addition to Alcoholics Anonymous and other support groups, a complementary way in which someone might deal with alcohol abuse is to:Standard Text: Select all that apply.1. Drink chamomile tea.2. Do nothing since there are no CAM practices that support AA recovery.3. Drink kudzu tea.4. Receive auricular acupuncture.5. Practice yoga.

Q: A client has come to a nurse practitioner with concerns about health care costs. The client, who had one myocardial infarction and later suffered from severe anxiety, asks for a plan of care that includes appropriate complementary and alternative therapies. Which of the following CAM modalities is not appropriate for someone with a history of cardiac problems?1. Massage2. Moderate exercise3. Active progressive relaxation4. Finger-holds for general well-being

Q: Which statement would have the best potential to obtain assessment data from a client about possible use of complementary and alternative practices or products?1. "Tell me everything you takeprescription medicines, over-the-counter medicines, vitamins, dietary supplements, herbs, as well as how much coffee, tea, and soda you drink daily and any recreational drugs you use."2. "Tell me about the medicines the doctor prescribed and the amounts prescribed."3. "What things do you do for yourself to maintain or improve your health?"4. "Do you take dietary supplements and herbs on top of the medicines the doctor prescribes for you?"

Q: A variety of techniques available to clients, their families, and healthcare professionals serve to alleviate muscle tension, anxiety, fatigue, headaches, and more. The technique that is specifically identified as adjunctive treatment for sinus headaches is:1. Passive progressive relaxation.2. Tai chi.3. Alternate-nostril breathing.4. Guided imagery.

Q: A nurse is asked to provide a brief presentation comparing and contrasting the modalities within one category of complementary and alternative therapies, as identified by NCCAM. The nurse chooses to speak about whole medical systems; therefore, the presentation would include:Standard Text: Select all that apply.1. Traditional Chinese medicine.2. Herbal products.3. Naturopathic medicine.4. Homeopathic medicine.5. Ayurveda.

Q: Eye movement desensitization and reprocessing (EMDR) mimics rapid eye movement (REM) sleep. The nurse working with injured soldiers knows that EMDR is an intervention suggested for the treatment of:1. Bipolar I.2. Childhood-onset trauma victims.3. Dissociative identity disorder.4. Depression.

Q: The nurse is caring for an older client with depression who has begun having trouble sleeping. In addition to antidepressants, a safe, nonpharmacologic and potentially effective adjunctive treatment for insomnia in persons with a diagnosis of depression is:1. Medical meditation.2. Watching TV.3. Progressive relaxation.4. Alternate-nostril breathing.

Q: A client who has hallucinations is no longer benefiting from medication. The client's wife has heard that repetitive transcranial magnetic stimulation (rTMS) might be helpful. The nurse knows that rTMS may be promising for this client because it:1. Acts more quickly than electroconvulsive therapy (ECT).2. Does not cause pain and, therefore, does not require anesthesia.3. Acts more quickly than antipsychotic medications.4. Has been around longer than ECT and has more research evidence for its use.

Q: The nurse refers a client for acupuncture. Stimulating acupuncture points has been shown to be a promising treatment for:Standard Text: Select all that apply.1. Mood-related mental disorders.2. Headache.3. Posttraumatic stress syndrome.4. Alcohol withdrawal.5. Schizophrenia.

Q: After explaining active progressive relaxation to the client as a potentially useful technique to help manage anxiety, a nurse guides a client through the experience of "active progressive relaxation." The nurse tells the client that:1. This relaxation technique can be used by anyone at any time.2. This relaxation technique is useful for postoperative clients.3. Muscles of the neck and back should not be excessively tightened.4. This is a safe process and nothing bad can happen.

Q: A client with high blood pressure is concerned about medication side effects and wants to try "natural" strategies to treat it. The nurse suggests:1. Using a combination of visual imagery and music.2. Doing nothing.3. Sleeping.4. Receiving massage.

Q: A client with a high level of anxiety asks the nurse for suggestions to decrease stress. The nurse suggests which of the following successful stress management strategies?Standard Text: Select all that apply.1. Passive progressive relaxation2. Playing preferred music3. Body scanning4. Eye movement desensitization reprocessing (EMDR)5. Racing nonstop throughout the day

Q: Which of the following statements made by the nurse displays a positive attitude about client autonomy and self-determination?1. "I comfortable with clients deciding what the programs, schedule, activities, or rules will be."2. "Clients should not be permitted to decide their own treatment goals."3. "Clients should not be permitted to comment on each other's behaviors or treatment goals while in group."4. "I am sad when a client does not choose my plan of care."

Q: The nurse is working with a male client who is approximately the same age as the nurse's father. The client is a substance abuser who has relapsed for the third time this year. The nurse's father is also a substance abuser. The client asks the nurse a question and the nurse "snaps" at him in response. Which of the following characteristics that contribute to a positive outcome of rehabilitation is the nurse having issues with concerning this client?1. Empathy2. Autonomy3. Intuition4. Patience

Q: The nurse knows that working with clients through rehabilitation and recovery may cause a conflict in value systems. Which of the following circumstances may cause your personal values to influence your effectiveness when working with a client?1. An insurance company that approves your plan of care for the client2. A client who chooses a different plan of care than you have mapped out3. A family that works closely with the treatment team4. A client who agrees with your opinion on the plan of care

Q: The nurse is caring for a client with a personality disorder. The client feels as if she is not accomplishing any of her goals. Which of the following is the most appropriate response by the nurse?1. "Would you like to increase your therapy visits?"2. "Let's look at the plan of care together."3. "Who told you that you weren"t accomplishing your goals?"4. "I will discuss your feelings with the doctor."

Q: The nurse is reviewing the plan of care with a client who has been diagnosed with schizophrenia. The client is not compliant with the medications he has been placed on for treatment of his illness. Which of the following is the most appropriate response by the nurse in order to modify the plan of care?1. "I am going to tell the doctor you have not been taking your medication and she will be upset with you."2. "Why would you stop taking your medications? That is stupid."3. "Tell me what is going on with your medications."4. "Does your family know you stopped taking your medication?"

Q: The nurse is admitting a client to the unit after a substance abuse relapse. The nurse assesses that the client's family has not been supportive of recovery efforts and requires education. Which of the following is a priority for client teaching?1. Relapse triggers for the client2. The effects of substance abuse on the client3. Unit visiting hours4. Local support group information

Q: A client with bipolar disorder is being seen for a follow up appointment in the mental health clinic. The client asks the nurse why she is asked the same questions with each visit. Which of the following is the most appropriate response from the nurse?1. "Does it bother you to have to answer the same questions with each visit?"2. "It is important to keep your plan of care up to date. This is why you are asked the same questions at each visit."3. "We don"t share information with others because of HIPAA regulations."4. "I will have the doctor address this question for you."

Q: The nurse knows that when designing a plan of care for a client with serious mental illness, the recovery and rehabilitation goals must be:Standard Text: Select all that apply.1. Attainable2. Realistic3. Permanent4. Immediate5. Flexible

Q: The nurse is working with a mentally ill client who has just recently been diagnosed with HIV. The client lost her job and has been living in different shelters each night. Which of the following is a priority goal for this client?Standard Text: Select all that apply.1. Refer to the client to another physician for medication management2. Maintain access to support services as needed3. Avoid exposure to infectious diseases4. Get adequate amounts of rest5. Maintain nutritional requirements

Q: The nurse is caring for a client who has been diagnosed with schizophrenia and who is currently seeking treatment for drug addiction to crack cocaine. In planning care for this patient, which of the following is a priority goal for psychiatric rehabilitation?1. Treating the drug addiction2. Treatment in an integrated program for both diagnoses3. Medication compliance4. Treating the schizophrenia

Q: Which of the following nursing interventions is not consistent with the philosophy of psychiatric rehabilitation?1. Performing a functional assessment of the client2. Discharging a client from services when treatment goals are reached3. Planning behavioral interventions that target specific functional deficits4. Identifying highly individualized goals with the client

Q: The nurse is working with a client who has been diagnosed with bipolar disorder. The nurse has suggested that the client volunteer in community activities with others who have a psychiatric diagnosis. How does this activity reinforce learning?1. It teaches the client about their own diagnosis.2. It allows the client to make social connections.3. It allows the client to offer something to the community.4. It allows the client to help another cope with problems similar to their own.

Q: The nurse is working with a client who is participating in social skills training. The nurse knows that the client is learning instrumental role behavior, problem solving skills, and intrapersonal skills through:Standard Text: Select all that apply.1. Reinforcement2. Substance abuse3. Role-playing4. Practicing5. Readmission to the hospital

Q: A client with chronic paranoid schizophrenia was recently referred to a sheltered workshop and has been participating in a supported employment program for three weeks. Which of the following client outcomes would indicate that the client is demonstrating successful behaviors in this program?1. The client attended 85% of recreational and educational group activities.2. The client applied for and obtained subsidized housing from the local housing authority.3. The client worked four hours per day making protective facemasks for a local company.4. The client applied for and was approved by the Medicaid program for supplemental income.

Q: A client with chronic paranoid schizophrenia was recently referred to a psychosocial rehabilitation "clubhouse" program following discharge from the inpatient psychiatric unit. Which of the following client goals is most appropriate for this situation?1. The client will attend recreational and educational group activities on a daily basis.2. The client will obtain food, clothing, and transportation services.3. The client will obtain a sponsor and attend weekly AA meetings.4. The client will identify career goals and develop a resume of job experiences.

Q: Which of the following community support programs are uniquely suited to meet the needs of clients with severe and persistent mental illness (SPMI)?Standard Text: Select all that apply.1. Partial hospitalization programs2. Nursing homes3. Depot medication therapy4. Vocational training programs5. Residential group homes

Q: The nurse is working with a male client undergoing psychiatric rehabilitation. Which of the following actions by the client exhibits reaching a goal of rehabilitation?1. Eating only one meal per day and drinking many energy drinks2. Refusing to take prescribed medications3. Doing his own laundry4. Having his mother go grocery shopping for him

Q: The nurse knows that planning for recovery can begin:1. At discharge.2. Once the client expresses a need for greater autonomy.3. At admission.4. With an inflexible treatment team.

Q: The nurse is working with a client who is striving to meet the goal of psychiatric rehabilitation. The nurse knows the client is most likely to meet goals when:1. Strengths and needs are acknowledged.2. The nurse takes care of all the client's needs.3. The client states he wants to go home.4. The client wants family involved in recovery.

Q: Because of the risk of postural hypotension, the client on clozapine (Clozaril) should be taught which of the following?1. To wear sunscreen if going outdoors2. To rise slowly from a lying position3. To check for involuntary movements of the mouth4. To have weekly blood work