Q&A Hero

Q: Which of the following would indicate that the client needs more teaching related to coping with constipation as a side effect of antipsychotic medications?1. I will regularly use enemas.2. I will walk and stay active.3. I will include fiber daily in my diet.4. I will have an adequate intake of fluid.

Q: Clients taking an MAOI should be taught to avoid completely which of the following foods?1. White wines, cottage cheese, and ice cream2. Steak, potatoes, and corn3. Bread, apples, and hamburgers4. Liver, sauerkraut, and yogurt

Q: Which of the following laboratory studies is performed because the client is taking lithium?1. Hemoglobin2. CBC3. Liver function4. Thyroid function

Q: A client exhibiting which of the following antipsychotic side effects would require the nurse's immediate intervention?1. Neuroleptic malignant syndrome2. Drowsiness3. Parkinsonism4. Impotence

Q: The client has been taking fluvoxamine (Luvox) for years, has been symptom-free for one year, and is now considering taking a drug holiday. What nursing teaching is necessary?1. The client should be symptom-free for at least two years before trying to go off the medication2. The client should let the prescriber make these decisions and should not suggest this3. A drug holiday should be avoided due to discontinuation symptoms4. This is worth trying since the client has been symptom-free for a year

Q: Which of the following laboratory studies are routinely done on patients taking second generation antipsychotic medications?1. Hemoglobin and hematocrit2. Renal functions3. Thyroid functions4. Serum glucose levels

Q: The nurse should monitor for which of the following in the client taking venlafaxine (Effexor)?1. Increased weight2. Prolonged QTc interval3. Increased blood pressure4. Tardive dyskinesia

Q: The client reports difficulty remembering at home whether the client took the medication or just thought about taking the medication. Which of the following strategies would be most helpful for the nurse to suggest?1. Obtaining and using a pill box2. Wearing a rubber band to remember3. Repeating the need to take the medications routinely4. Putting the pill container near the breakfast table

Q: The client is taking a medication to help cope with EPSEs but can not remember the name of the medication. The nurse would give the client information about which of the following medications that the client is receiving?1. Risperidone (Risperdal)2. Duloxetine (Cymbalta)3. Loxapine (Loxitane)4. Benztropine (Cogentin)

Q: Which of the following are extrapyramidal side effects that the nurse would assess as symptoms of dystonia?Standard Text: Select all that apply.1. Decreased gastric motility and tachycardia2. An inability to sit still3. Forcing the back to arch and the neck to bend backward4. Pulling the neck down into the shoulders5. Spasms of the neck and back

Q: When in the course of treatment with an antipsychotic medication would the nurse be most likely to assess tardive dyskinesia?1. Within 72 hours of initiation2. After long-term use3. Within 48 hours of initiation4. After three or more weeks of treatment

Q: The spouse of a client on an antipsychotic medication asks the nurse why they routinely assess the client for movements, especially around the mouth and extremities. What nursing response is correct?1. "Abnormal involuntary movements can be an irreversible side effect of antipsychotic medications."2. "Antipsychotic medications can lead to this type of dystonia."3. "Abnormal involuntary movements can be easily treated and less annoying to the client."4. "Movements around the mouth herald the approaching medication tolerance that the client is developing."

Q: The nurse observes a client on an antipsychotic medication and notes a pill-rolling movement of the fingers and a tremor of the extremities. The nurse documents this as what type of side effect?1. Drug-induced parkinsonism2. Dystonia3. Anticholinergic effect4. Tardive dyskinesia

Q: A family member says to the nurse, "I think my sister needs more medication because she says she cannot sit still and is moving her legs back and forth." The client's risperidone (Risperdal) was recently increased to 10 mg daily. What is the correct nursing response?1. "I will check with your sister because what you are describing sounds like a side effect called akathisia."2. "I will check to see what your sister has been prescribed because some clients get anxious when their medications are increased."3. "I will see if your sister has been prescribed a medication to counteract the dystonic reaction that she is having."4. "I will call the doctor and report that your sister is developing a tolerance to risperidone and the dose is not effective."

Q: The nurse knows that the client did not adhere to a medication plan in the past due to severe side effects. What information would be most important to include in the client's teaching?1. The need to monitor all body changes on a continuous basis2. Hopefulness about managing side effects3. Reassurance that side effects will not occur4. A detailed explanation of all potential side effects

Q: The nurse tells a psychotic client with alcohol dependence not to drink while taking the antipsychotic medication. How would the nurse's supervisor evaluate this teaching statement?1. There is no reason why the client cannot have one or two drinks per day.2. It is not possible for a client with a psychotic disorder to be successful in staying sober.3. It is a correct statement that should motivate the client to quit drinking.4. Without treatment for the alcohol dependence, the client will be more likely to not take the medication.

Q: What is the primary rationale for the nurse asking a client on antidepressant medication about changes in sexual functioning?1. Antidepressants used frequently contributes to sexual promiscuity and tragic regrets.2. A side effect of antidepressants may be sexual dysfunction that contributes to nonadherence.3. Cultural attitudes about sexual functioning may impact the effectiveness of the antidepressant medication.4. A lack of libido is a symptom of depression that may interfere with the client's relationships.

Q: The client tells the nurse that their spouse does not believe that medications are needed to improve depression. What nursing response would be most helpful in improving the client's medication adherence?1. Suggest that the spouse's views are not important2. Ask the client to consider marriage counseling3. Tell the client to ignore the spouse4. Include the spouse in medication teaching

Q: The nurse instructs the clients to take the medications that are prescribed because the psychiatrist knows what is best for the client. How would the nurse's supervisor evaluate the effectiveness of the nurse's teaching?1. The nurse is demonstrating a paternalistic attitude that may contribute to client nonadherence.2. Teaching the client to take all medications should help keep the client out of the hospital.3. The nurse is helping the client develop trust in the psychiatrist.4. The nurse is giving simple instructions that will be readily accepted by the client.

Q: Which of the following would indicate to the nurse that fluoxetine (Prozac) is effective for the client with major depressive disorder?1. The client remained up all night discussing negative life situations with the nursing staff.2. The client ate 100% of breakfast and lunch and ate 25% of the evening meal the past two days.3. The client remained in the room reading and watching listening to music 90% of the day.4. The client slept 60% of the night while remaining in bed from 11 p.m. to 5 a.m.

Q: Which of the following is an indication that the client understands the teaching related to buspirone (BuSpar)?1. I will not drink grapefruit juice while taking this medication.2. I should sleep though the night on this medication.3. I should feel a relief of anxiety within a half hour.4. I will not hear voices after being on this medication for two weeks.

Q: The client received aripiprazole (Abilify) on admission to the inpatient unit with a diagnosis of schizophrenia, paranoid type. Which of the following would the nurse note as a sign that the aripiprazole is becoming effective?1. The client paces in the hall and engages in solitary activities most of the day.2. The client sleeps for shorter periods of time during the day.3. The client establishes eye contact and remains in conversation with the nurse for longer periods.4. The client eats only the food that is in its original container such as individual packages of crackers.

Q: Which of the following client behaviors would indicate a need for further intervention in the anxious patient on a benzodiazepine?1. The client asking to be taken off the medication gradually2. The client relying more on coping skills and taking less medication3. The client inquiring about behavior methods for anxiety control4. The client requesting a higher dose of drug to achieve the intended effect

Q: Which of the following medications carries the highest risk of QTc prolongation and, therefore, the need to monitor cardiac side effects most carefully?1. Thioridazine (Mellaril)2. Risperidone (Risperdal)3. Quetiapine (Seroquel)4. Olanzapine (Zyprexa)

Q: The nurse would assess which of the following as early signs of lithium poisoning?1. Elevated blood pressure, paralysis, and impulsivity2. Cardiac arrest, seizures, and change in level of consciousness3. Vomiting, diarrhea, lethargy, and muscle twitching4. Hallucinations, agitation, and anger

Q: The nurse would be alert to assess for signs of lithium toxicity in a patient with which of the following lithium levels?1. 1.5 mEq/l2. 0.1 mEq/l3. 0.5 mEq/l4. 1.0 mEq/l

Q: Which of the following is a priority assessment for a child in the initial stages of antidepressant treatment?1. School successes2. Food preferences3. Suicide assessment4. Family functioning

Q: Which of the following questions would the nurse ask a woman to assess for hyperprolactinemia as a side effect of an antipsychotic medication?1. Are you having trouble sitting still?2. Are you constipated?3. Are you having any discharge from your breasts?4. Do you have a dry mouth?

Q: Which of the following is part of the ongoing nursing assessments of the client on psychiatric medications?Standard Text: Select all that apply.1. How well the medication is managing the client's symptoms2. The client's cultural belief system related to illness and medication3. Whether the medication is causing side effects4. The client's favorite activities5. The client's readiness to learn

Q: The nursing instructor notes a nursing student is very imaginative. When teaching students about designing and adjusting behavioral contracts, the nursing instructor knows that this particular student will have an advantage in developing contracts because:1. Monitoring nonverbal communication is a secondary goal.2. Effective communication skill is the key negotiating tool.3. Reprioritization of goals is the most important issue.4. Creativity is an essential component.

Q: A nurse comes to the mental health clinic tired, angry, and in a hurry. After making several minor mistakes, the nurse realizes that in order to help clients and improve their functioning through the development of behavioral contracts, he/she must first take his/her time and change his/her attitude in order to:1. Formulate practical and measurable objectives.2. Develop goals based on client and family needs.3. Normalize the family's experience.4. Teach the client communication skills.

Q: A client diagnosed with bipolar disorder is hyperverbal during the initial assessment. In an effort to help the client understand what is required in treatment, the nurse has a calm demeanor, decreases stimuli, and talks to the client one-on-one. The nurse is responding to the client's:1. Cognitive style.2. Negative behavior.3. Positive behavior style.4. Mania.

Q: When speaking with a client who has a mental illness, the nurse uses medical terminology and is condescending. This type of behavior negates the basic rules of negotiating a behavioral contract and:1. Encourages the client to ask questions.2. Causes the client to feel uncomfortable with the contract.3. Appropriately introduces the client to important terminology.4. Helps the client understand behavioral contracts on his/her terms.

Q: A nurse skillful in the writing process knows that this talent may benefit the client because a well-written behavioral contract:1. Teaches the client about past mistakes to lead to a successful outcome.2. Provides everything needed for a cure.3. Teaches the client to embrace the future helps overcome past misdeeds.4. Can promote successful outcomes.

Q: During the assessment, the family nurse therapist inquires about weaknesses regarding learning the client may have. The client becomes defensive and states, "You sure are nosy!" Smiling, the nurse states, "I don"t mean to seem nosy, but I must ask these questions to develop a plan that will work for you." The nurse's therapeutic response is an attempt to ascertain:Standard Text: Select all that apply.1. How the client interacts with family members.2. Anecdotes from family and friends.3. The psychiatrist's progress notes.4. Specific factors that have interfered with the success of a goal.

Q: A client being discharged from the mental health clinic is fearful about not being able to keep up with therapy and treatments after leaving the clinic. The nurse knows that to ensure client success after discharge, the client's behavioral contract should:1. Support the client's family and friends.2. Ensure client success.3. Build and maintain treatments to help the community.4. Address issues the client will face in community living.

Q: The nurse student taking care of a client with schizophrenia has difficulty keeping up with the client's music therapy and individual therapy times. The nurse knows, however, that the case manager is helpful in maintaining the routines and schedules of:1. Self-study.2. All clients on the unit.3. Cognitive behavioral interventions..4. Clients in music therapy.

Q: The night nurse at the mental health clinic is designing a behavioral contract for a client diagnosed with panic attacks. During the assessment phase, the client is negative and exhibits low self-esteem. However, the nurse knows that in order to develop an effective contract, the focus must be on:1. Specific social weaknesses.2. The client's abilities and strengths.3. The client's family.4. The goals of discharge.

Q: Involving families with the client's treatment is an important aspect of family nursing. It is important to involve them as much as appropriate for the formulation and implementation of:1. Family identity.2. Hope, support, and happiness.3. Behavioral contracts.4. Positive client behavior.

Q: A client diagnosed with schizoaffective disorder has threatened suicide. While developing the care plan, the nurse puts in the nurse's notes, "The client, though disheveled, is articulate and has a clear plan for suicide, but has made no current attempts." The nursing note helps the nurse develop the behavioral contract by:1. Orienting the client to the nursing process.2. Considering interactions during the assessment process.3. Observing essential information.4. Cooperating with the family.

Q: The nurse knows that nursing diagnoses for cognitive behavioral assessment include:1. Pseudohostility and Ineffective Coping.2. Knowledge Deficit and Effective Coping.3. Interrupted Family Processes and Hopelessness.4. Hopelessness and Functional Family Processes.

Q: A nursing student is praised for the comprehensive assessment of a client diagnosed with suicidal ideation. Based on the assessment interview, the student develops a plan to keep the client safe, and the client signs the resulting:1. DNR contract.2. Behavioral contract.3. Patient bill of rights contract.4. Acceptance letter.

Q: A nursing student attempting to use a behavioral modification contract found in the textbook is having trouble getting the client to follow through with everything in the contract. The nursing instructor knows to tell the student that behavioral contracts must be:1. Affected by the functionality of the client.2. Reflective of the client's mental illness.3. Tailored for the individual.4. Reflective of the characteristics within the client's family.

Q: The nurse knows that a client who has panic attacks when she sees waterfalls because she had been physically assaulted in a park with a waterfall, would benefit from the feature of cognitive and behavioral treatment of:1. Suggesting alternative behavior.2. Seeking social support.3. Reframing.4. Expressing affection.

Q: The nurse knows that being a competent provider of cognitive behavioral interventions involves understanding and being aware of cultural considerations. Characteristics that nurses must be aware of during assessment include:1. Gender, sexual orientation, and age.2. Illness prevention, disability, and gender.3. Group expression, self-awareness, and religion.4. Family matters, self-awareness, and age.

Q: A client admitted with borderline personality disorder complains during group therapy that she, "always falls for the bad guy." She has been in and out of rehabilitation and abuse crisis centers. The nursing student knows this client would benefit from:1. Intrapsychic cognitive therapy.2. Family conflict therapy.3. Dialectical behavioral therapy.4. Self-reflective therapy.

Q: The nursing student working on a group project brings healthy snacks to the meeting so he and his fellow classmates will not gain unwanted pounds as they did on a previous massive assignment. The student has employed:1. Unobserved behaviors tracked in subjective measurable terms.2. Behavior modification.3. Process illumination.4. Interactional group therapy.

Q: Clients with mental disorders who form inferences from rational beliefs are:1. Better supported by family members.2. Significantly more functional than clients who hold irrational beliefs.3. Able to control impulses.4. On their way to feeling "normal."

Q: The nursing student knows that the therapist's goal in behavior therapy is to:1. Decrease classical conditioning.2. Increase self-confidence.3. Deny religiosity in mental health clients.4. Increase social reasoning.

Q: The nurse therapist skilled in rational emotive therapy (RET) helps clients identify:1. Cognitive causes for rational beliefs.2. Health-damaging beliefs and practices.3. Rational thoughts and healthy emotions.4. Irrational thoughts and develop more rational life philosophies.

Q: The nurse knows that obtaining a smoking cessation contract from a client will:1. Help clients adapt through change.2. Increase positive reinforcement through adaptation.3. Facilitate change through contracts.4. Formulate well-thought-out plans.

Q: The nurse knows that when the mental health client has learned how to successfully adapt in new or different circumstances, the client has developed a sense of:1. Pride.2. Self-efficacy.3. Self.4. Self-esteem.

Q: A nursing student receiving D's on quizzes decides to begin studying with a group of students known to make A's. The nursing instructor knows that the student is exhibiting what type of behavior?1. Modeling2. Attributing3. Self-efficacy4. Assuming

Q: A client diagnosed with depression states, "Even in high school I was a failure. It's a wonder I was associated with successful friends." The nurse knows this client is making:1. A hard situation worse.2. Attributions about his life.3. Excuses about his present behavior.4. Assumptions about his friends.

Q: A client complains of feeling angry whenever he sees families relating well with one another. During a family group session, the nursing student observes a family member belittling every statement made by the client. The nursing student knows that the client's thinking is often:1. What leads the client to negative behaviors.2. Erratic and problematic.3. Conscious and deliberate.4. Automatic, without active or conscious effort.

Q: The nurse is assessing a client with nicotine addiction. The nurse knows the client plans to compete in a marathon several months away and asks the client to imagine snapping a cigarette in half and winning the marathon whenever the urge to smoke occurs. The nurse knows that shaping one's thoughts so that they have control over a particular situation, thereby creating a successful behavior change, is called:1. Communication.2. Mastery imagery.3. Image restructuring.4. Positive imagery.

Q: Nurses are instrumental in helping clients during cognitive therapy. The nurse helps clients:1. Correct the id and the superego in relation to self-awareness.2. Examine connections of the mind, body, and spirit.3. Determine the best course of treatment.4. Identify unrealistic and negative thoughts.

Q: During a group session, the nursing student notes one of the clients imitating another client's manner of speaking and communicating. The client being imitated has actively participated in all groups and is going home tomorrow. The nursing student suspects the client doing the imitating is:1. Modeling behavior.2. Being a comedian.3. Expecting an award.4. Jealous of the other client.

Q: The nurse knows that attributions are perceived causes that:1. Isolate family members from one another.2. Promote rigidity and chaos.3. May or may not be objectively accurate.4. Support a loss of autonomy.

Q: The nursing student taking care of a client in the mental health clinic learns through assessment that the client's wife insisted he admit himself into the clinic even though his wife is the one with a documented history of mental illness. The client states, "I just want her to be happy." The nursing student suspects that the client's relationship with his wife may be:1. Enmeshed.2. Disengaged.3. Hostile.4. Skewed.

Q: For the last three generations, the men of the family have worked in logging. The younger son wants to go to college and become a marine biologist. His parents tell him that "logging is what our family does" and refuse to discuss the issue. The son chooses to pursue employment in logging rather than upset his parents' desires for their son. This family is experiencing:1. Enmeshment.2. Pseudohostility.3. Pseudomutuality.4. Schism.

Q: The nurse knows that when clients are unable or unwilling to perform assigned family roles, the family experiences:1. Stress and disequilibrium.2. Recognition and communication.3. Personal and political advocacy.4. Acceptance.

Q: A client with a diagnosis of bipolar disorder lives with his family and discontinues taking medication when he begins feeling his symptoms are under control. Family members express their concern to the client's therapist whenever they realize the client is "off his meds." The therapist understands that within the client's family, each person's behavior is contingent on and:1. Reflects the characteristics of the client's family.2. Affects the behavior of others.3. Is affected by the functionality of the group.4. Is reflective of the client's mental illness.

Q: The mother of a young child diagnosed with conduct disorder asks the nurse to recommend a qualified nurse to provide family therapy. The nurse knows that:1. Nurse family therapists should be clinical specialists or advanced practitioners in mental health nursing.2. Nurses with a bachelor's degree are qualified to provide family therapy if they are nationally certified in mental health nursing.3. Nurses are not reimbursed by third party insurers to provide family therapy.4. Nurses specializing in family therapy are expensive and it is difficult to get a timely appointment.

Q: Which of the following behaviors indicate that family therapy has been effective and can be terminated?1. Family members are able to give feedback to others, telling them how they appear2. Family members are able to identify faults and failures of others, telling them how to act better3. Family members are able to give praise and criticism in equal measure4. Family members are able to identify problems with communication

Q: Which of the following information should be included in psychoeducation with a family of a client recently diagnosed with a mental illness?1. "Most mental illnesses are inherited so the entire family should be tested for the same disorder."2. "Mental illness is extremely complex and it may take several years for the right treatment to be effective."3. "Most mental illnesses are caused by an imbalance of chemicals in the brain and can be treated with medications and therapy."4. "Earlier screening and diagnosis could have prevented the severity of symptoms and behavior problems."

Q: When instructing nursing students on therapy termination strategies for families and clients with mental health disorders, the nursing instructor teaches that effective family nursing strategies include:1. Helping families achieve realistic goals.2. Giving criticism in a calm voice.3. Knowing effective communication skills.4. Monitoring nonverbal communication.

Q: In order to help improve the functioning of mental health clients and their families, nurses must:1. Teach the client communication skills.2. Help each member negotiate what they need within the family.3. Decrease the client's stress by compromising the integrity of family interactions.4. Normalize the family's experience.

Q: A client diagnosed with bipolar disorder is starting the first family therapy session. The nurse knows the client's children, aged 2 and 4, will:1. Not be included in the therapy session.2. Help the client acclimate to the mental health clinic.3. Benefit from the therapy session.4. Help the client understand the importance of getting well.

Q: Which of the following is a grassroots, self-help support organization of families, friends, and clients with severe mental illness?1. National Institute of Mental Health (NIMH)2. American Mental Health Association (AMHA)3. A mental health clinic4. National Alliance on Mental Illness (NAMI)

Q: Parents of adult clients with mental health disorders struggle to find a balance between emotional support and fostering independence. The nurse helps by:1. Teaching the client and family about past mistakes.2. Providing psychoeducation group therapy.3. Providing interaction with family members.4. Teaching the client to embrace the future.

Q: Which of the following interventions is not an appropriate strategy for the family therapist?1. Openly disagree with one another when appropriate2. Showing that anger and pain are not safe emotions to examine3. Delineating family roles and functions4. Openly discuss problems with one another

Q: When developing a care plan for a client in family therapy, which of the following questions will provide the best information for planning appropriate interventions?1. "What kinds of activities does your family enjoy together?"2. "Who is the primary caregiver in your family?"3. "What is the most important problem that you want help with?"4. "How often do you attend church together as a family?"

Q: The family nurse therapist, in an effort to learn more details about family patterns and interactions over time, may use:1. The psychiatrist's progress notes.2. Anecdotes from family and friends.3. Police reports.4. A genogram.

Q: The nurse knows that because people with mental illness continue to be ostracized by mainstream society, families must cope with the burden of:1. Dementia.2. Shame.3. Isolation.4. Stigma.

Q: When collecting family interactional data, the nurse knows to ask:1. "How do the actions of your family worsen your symptoms of schizophrenia?"2. "Since you have been in the hospital, who is taking care of your children?"3. "How often do you shop for nutritional items for your family?"4. "What do you buy when you shop at the local market?"

Q: In order to obtain detailed information that gives insight into how a client's family may function, the nurse knows to ask:1. "What are your goals after discharge?"2. "How often do you attend church?"3. "What are your favorite foods?"4. "Do you take your medicine at the same time every day?"

Q: The nursing student knows that involving families with the client's treatment is an important aspect of family nursing. Certain biases, such as believing families are responsible for the client's mental illness, prevents:1. Social interaction and violates family rights.2. Hope, support, and happiness.3. Future episodes of negative client behavior.4. Family identity and reduces negative perceptions.

Q: A child with ADHD is referred to the nurse practitioner for family therapy. The father and mother are out of the country and have been out of touch for three months. The child's older sister has assumed the role of parenting her younger sibling. This is an example of a:1. Disengaged family.2. Enmeshed family.3. Skewed family.4. Schismatic family.

Q: The nurse is working with a family in the process of a divorce. The parents are pressuring the children to decide which parent to live with after the divorce. The children are conflicted because they love both parents equally and want the family to stay together. This is an example of a:1. Schismatic family.2. Skewed family.3. Hostile family.4. Disengaged family.