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Nursing
Q:
You are a nurse manager of an ICU in a local hospital and have lost two nurses on your staff. One nurse quit and the other nurse is receiving treatment in a center for alcohol abuse. What type of group would you recommend to your staff before considering a transfer or quitting?1. Nurse-to-nurse support group2. Nurse storytelling group3. Nurse bibliotherapy group4. Nurse Alcoholics Anonymous group
Q:
Clients with chronic persistent mental illness have been attending a creative activities group which focuses on expression of feelings through poetry, music, and art. What client behaviors would be expected?1. Increased paranoid delusions2. Increased physical activity3. Increased auditory hallucinations4. Increased social interaction and self-esteem
Q:
Which of the following group therapies would be most helpful for clients diagnosed with severe and persistent schizophrenia who are living in a nursing home?1. Bible-study groups2. Dialectical behavior groups3. Mutual-help groups4. Social skills training groups
Q:
During group therapy, a male client laughs inappropriately and rolls his eyes when another male client discusses his feelings about "coming out" as a homosexual. The group therapist asks the first client to explain his reaction to the rest of the group. This process is an example of:1. Taboo behavior.2. Clearing the air.3. Hidden homosexuality.4. Attention-seeking and power struggles.
Q:
The therapist for an interactive therapy group has noticed some behaviors among the members that need to be made overt. The therapist would be concerned about:1. Expressing affection and sorrow.2. Suggesting alternatives and denigrating each other.3. Power struggles and attention-seeking.4. Seeking social support and increasing conflict.
Q:
The nurse knows that the primary task of the interactional group therapist is to make sure events in the session take precedence over:1. Outside events.2. Illness prevention.3. Family matters.4. Individual therapy.
Q:
During a group session, a client becomes very angry at a comment by another member of the group. The therapist asks why the client became so angry. The group is using:1. Events for emotional awareness.2. Interpersonal conflict issues to resolve personal issues.3. The self-reflective loop.4. Fear.
Q:
The nursing student knows that group interaction requires the therapist to focus attention on each member's feelings toward other group members, the therapists, and the group to illuminate relationship implications of interpersonal transactions. This process is known as:1. Interactional group therapy.2. The here-and-now.3. Process illumination.4. Objective family burden.
Q:
A few members of an outpatient group have begun meeting socially in a local restaurant for coffee and donuts before going to work each day. What should the group therapist leader do in this situation?1. Discourage social meetings outside regular group sessions2. Encourage all members to meet for coffee and donuts each morning3. Join the members a few mornings a week4. Suggest meeting for dinner once a week instead
Q:
The nurse is planning a group to rehabilitate sex offenders in a forensic psychiatric hospital. Which of the following factors would most likely decrease the degree of trust and cohesion among the members?1. One hour weekly sessions2. Addition of new members3. Confidentiality rights of victims4. Member interaction outside the group
Q:
The nurse is planning a psychoeducation group for substance abusers and is conducting selection interviews. Which of the following individuals with substance abuse issues would not be an appropriate member?1. A client who has attended AA meetings in the past2. A client who has been court ordered to attend group therapy3. A client who has recently been promoted to district manager4. A client who is also being treated for a psychiatric illness
Q:
Clients with mental disorders benefit from therapeutic groups because they provide:1. Feedback from a number of sources.2. A monitoring system that helps clients control impulses.3. The best stimuli for clients.4. A way for them to feel "normal."
Q:
The client is being discharged from an inpatient facility. The nurse explains that part of the outpatient treatment will be to take part in group therapy because it provides a structure for:1. Supporting clients on a regular basis.2. Trying out old and new ways of acting and reacting.3. Using health care benefits in new and exciting ways.4. Supporting clients and families.
Q:
A nurse has been working one-to-one therapy with a client but now tells the client it would be beneficial for the client to be part of a group. The nurse knows that the advantage of group therapy is:1. A therapeutic experience for the benefit of many therapists.2. The nurse can work with more people at one time.3. Multiple associations with various therapists.4. The presence of many people participating in a therapeutic experience.
Q:
A nursing student learns that group therapy reveals distortions in interpersonal relationships in an effort to:1. Learn how to stifle emotions.2. Examine and resolve issues.3. Process and examine emotions.4. Effectively handle emotions.
Q:
The nurse knows that any group moves through three interpersonal phases in a particular order, which includes:1. Inclusion, control, and affection.2. Reasoning, inclusion, and self-confidence.3. Control, love, and affection.4. Reasoning, self-confidence, and religion.
Q:
A group leader states that he respects the competence and responsibility of members of the group but gets annoyed when one of the group members "takes over" a group meeting. The group leader is demonstrating the interpersonal need for:1. Self-respect.2. Religion.3. Control.4. Social reasoning.
Q:
The nursing student knows that clients' need for inclusion allows the group members to:1. Remain emotionally available.2. Become great communicators.3. Interact with one another satisfactorily.4. Use the client's need to obtain group privacy.
Q:
The nurse notices that one of the group members seems frustrated. He is very friendly with everyone in the group but seems upset when some group members do not reciprocate with an equal amount of friendliness. The nurse understands that the group member is demonstrating his interpersonal needs for:1. Love2. Affection3. Grief4. Reasoning
Q:
An inpatient group has decided to focus on developing better communication skills. Each member will practice initiating a conversation with a partner while a third member observes the interaction and provide feedback. Which stage of group development best describes these actions?1. Performing2. Forming3. Norming4. Storming
Q:
When planning sessions for a group of battered women, which stage of group development would it be most appropriate for the nurse to lead a discussion regarding legal solutions and alternative living arrangements?1. Forming2. Norming3. Storming4. Performing
Q:
The nurse leading a group of inpatient clients observes a client trying to control the group by monopolizing the discussion. The nurse knows this will most likely decrease:1. Therapeutic alliance.2. Leader credibility.3. Cohesion.4. Power and influence.
Q:
The nurse mentions to a colleague that yesterday's therapy group was developing cohesion and understands that this is important for:1. Flexibility.2. Boundaries.3. Goal attainment.4. Communication.
Q:
The nurse knows the Johari Window is a theoretical tool used to represent:1. The id and the superego in relation to self-awareness.2. Depression in family members.3. A multidimensional model of self.4. Self-disclosure in relation to others.
Q:
The nurse facilitating a group session is concerned that the members are hesitant about sharing feelings and experiences. The nurse knows that there is a low level of trust among the group members, which will also determine the level of:1. Cohesion.2. Family history.3. Risk-taking.4. Uniqueness.
Q:
The student nurse asks if advance practice training is needed to lead psychoeducation groups and assist families. The instructor tells the nurse that all nurses can lead the groups as long as they:1. Support a loss of autonomy.2. Promote rigidity and chaos.3. Understand family and group dynamics.4. Isolate family members from one another.
Q:
Which of the following statements is true regarding financial roadblocks to mental health care services for people over the age of 65?1. Medicare covers inpatient but not community mental health services.2. Medicare Part D provides simple options for prescription coverage.3. Medicare provides little coverage for long-term care services.4. Medicare offers low copayments for most psychotropic medications.
Q:
Which of the following statements represents a myth about aging?1. Advancing age does not condemn one to dependence and isolation.2. Older adults do not benefit from supportive psychosocial services.3. Senility and sadness are not inevitable outcomes with advancing age.4. Aging itself is not a problem.
Q:
A nurse is discussing the demanding and dependent behavior of an older, depressed female client with the treatment team. Which of the following comments indicates ageism?1. "She is demanding and dependent because she is lonely and not receiving enough attention from staff members."2. "She is feeling depressed and could benefit from counseling or an antidepressant."3. "She should be encouraged to attend more activities and do as much as possible by herself."4. "She should be encouraged to spend more time with people her own age instead of trying to look or act younger."
Q:
The wife of a man with early stage Parkinson's disease expresses frustration and despair while caring for him at home because she is unable to leave him while she plays bridge with her friends twice a week. Which of the following community-based resources would be most appropriate in this situation?1. Hospice care2. Long-term care3. Respite care4. Restorative care
Q:
The nurse case manager has become concerned that an older adult confused client is no longer safe at home due to wandering outside when the caregiver is not watching. Which of the following community-based programs would be most appropriate for referral?1. Long-term care facilities2. Assisted living communities3. Senior citizen centers4. Residential care facilities
Q:
Which of the following nursing interventions would be useful when caring for elders with behavioral disturbances who bite, hit, kick, or scream at caregivers during delivery of care?Standard Text: Select all that apply.1. Return at a later time to resume care when clients are calmer.2. Order clients to stop biting, hitting, and screaming.3. Continue the activity by restraining their hands and feet.4. Allow clients to refuse bathing if no body odor is present.5. Distract clients by encouraging them to sing with you.
Q:
The nurse is a case manager for several older adults living in the community. Which of the following goals are relevant for community or home based nursing care?Standard Text: Select all that apply.1. Educate clients and caregivers about adult daycare programs2. Diagnose and treat psychiatric illnesses3. Coordinate supportive services to compensate for deficits4. Encourage relocation to assisted living or skilled nursing facilities5. Maintain safety and optimal functional independence
Q:
Which of the following outcomes would indicate successful reality orientation of an older adult client?1. Ability to identify personal strengths2. Ability to perform basic tasks and personal care activities3. Ability to identify place and person4. Ability to express faith and meaning in life
Q:
Which of the following behaviors would indicate that the nurse's remotivation therapy group for long-term care residents was effective?1. Orientation to time, place, and person2. Active discussion of dating practices in teenage years3. Active discussion of presidential candidates in the next election4. Orientation to the long-term care surroundings
Q:
The nurse plans to increase self-esteem and reduce social isolation for residents living at the long-term care facility. Which one of the following strategies should the nurse include to meet these goals?1. Reality orientation2. Reminiscence therapy3. Respite services4. Restorative care
Q:
The nurse's evaluation of the outcomes of care for an older adult mentally ill client should be guided by the knowledge that:1. Cultural preferences that conflict with treatment goals take precedence.2. Complete absence of psychiatric symptoms is the gold standard.3. Client's values and preferences should be honored whenever possible.4. Families and significant others are not routinely involved in this process.
Q:
The nurse is planning teaching for a staff seminar regarding psychiatric medication administration. The nurse's teaching should be guided by the knowledge that:1. Sedation is a desirable side effect for older adults.2. Falls and choking risk are increased by psychiatric medications.3. Older adults are less prone to side effects than other age groups.4. Standard adult dosages are well tolerated by older adults.
Q:
The nurse plans to implement health promotion activities at the local senior citizen center. Which one of the following strategies should the nurse include to meet the goal of promoting relaxation and restoring balance?1. Pet therapy2. Tai Chi exercises3. Social support groups4. Reality orientation
Q:
Which of the following outcomes would be the most important for an older adult who recently lost his wife of 50 years after a long history of breast cancer?1. Ability to recognize behaviors that reduce feelings of hopelessness2. Ability to focus on specific stimuli3. Ability to acquire, organize, and use information4. Ability to dress self and maintain own hygiene
Q:
Which of the following nursing diagnoses would be most appropriate for an older adult who recently lost his wife of 50 years after a long history of breast cancer?1. Activity Intolerance2. Ineffective Role Performance3. Feeding Self-Care Deficit4. Risk for Other-Directed Violence
Q:
An elderly client has presented to the clinic with multiple physical complaints. Biologic assessment information must be obtained before any physical illnesses can be ruled out. Which of the following objective measurements would be most helpful?1. Electroencephalogram (EEG)2. Standard diagnostic laboratory analyses3. Lumbar puncture4. Drug toxicology screening
Q:
Which of the following signs would lead the nurse to suspect elder abuse is occurring?1. Leaving a competent elder at the doctor's office to wait for an appointment2. Leaving a confused elder at home alone3. Complaints of a person poisoning their food or robbing them4. Skin tears on the arms and hands
Q:
The nurse is assessing the social and financial status of an older adult. Which of the following questions would be appropriate to ask?1. "Do you have transportation to get to doctor's appointments?"2. "Do you have problems with your family taking advantage of you?"3. "How often do you forget to pay your bills?"4. "How much money do you get from social security?"
Q:
A thorough biopsychosocial assessment of elders includes:Standard Text: Select all that apply.1. Spirituality2. Social supports3. Coping strategies4. Sexuality5. Early childhood interactions
Q:
When interviewing elders the psychiatric nurse is guided by the knowledge that:1. Shame may inhibit the expression of feelings in elders.2. Touch is inappropriate during the interview.3. Family and staff members may provide inaccurate information.4. Less time may be needed with elders than with other age groups.
Q:
The nurse is teaching a group of older adults about changes in sleep patterns due to the aging process. Which statement by older adults indicates understanding of the nurse's teaching regarding the use of nonpharmacologic therapies for sleep?1. "We should avoid coffee, tea, or other fluids in the evening hours."2. "An herbal remedy such as melatonin can help us sleep better."3. "Taking long naps during the day will help us sleep better at night."4. "Taking a sleeping pill every night will improve our total sleep time."
Q:
The wife of an older client is concerned that her husband has recently experienced memory lapses, is unusually aggressive and was involved in three traffic accidents in the past month. In planning a response, the nurse is guided by the knowledge that:1. Further intervention is needed to prevent elder abuse of the wife.2. Further assessment is needed to determine if alcohol abuse is possible.3. These are normal responses to aging.4. These are signs of depression or dementia.
Q:
During the nursing assessment of the older adult female client, the nurse finds the client believes others are poisoning her food. Which of the following psychiatric disorders would not be indicated?1. Delirium2. Adjustment disorder3. Anxiety disorder4. Dementia
Q:
The nurse suspects a 75-year-old male client is contemplating suicide. Which of the following factors place him at greater risk for suicide?Standard Text: Select all that apply.1. Being non-Hispanic Black2. Frequent alcohol consumption3. Being married4. High socio-economic status5. Having chronic pain caused by cancer
Q:
The nurse suspects a 75-year-old male client with a recent diagnosis of cancer is contemplating suicide. Which one of the following cues indicates the highest suicide potential?1. Yearly updating his will2. Complaining of chronic pain3. Vague statements about future funeral plans4. Buying a hand revolver
Q:
The nurse is teaching staff at a long-term health care facility about depression in older adults. Which comment by staff indicates to the nurse the need for further teaching?1. "Inability to organize and abstract information may indicate depression in older adults."2. "Depressed older adults may exhibit an excessive preoccupation with chronic constipation or pain."3. "Sadness or feeling blue are normal aspects of the aging process and are not a cause for concern."4. "Lack of interest or apathy may be a sign of depression in older adults."
Q:
The nurse is teaching a seminar for health professionals on the differences between the normal aging process and Alzheimer's disease. Which of the following biopsychosocial theories of normal aging should be discussed regarding cellular changes?Standard Text: Select all that apply.1. Genetic theory2. Immunology theory3. Wear-and-tear theory4. Environmental theory5. Disengagement theory
Q:
Which of the following biopsychosocial theories of aging is the nurse using when taking a small group of older adults out in the community to a local restaurant for dinner and dancing?1. Wear-and-tear theory2. Activity theory3. Nutritional theory4. Environmental theory
Q:
Which of the following statements should the nurse include in a presentation to the community regarding mental health care resources for elders?1. "Better pharmacological treatments have increased the normal life span of individuals afflicted with mental illness."2. "Medicare coverage will pay for most mental health services provided to elders."3. "Most elders require frequent hospitalization due to chronic illness and mental disability."4. "More long-term care facilities are admitting geropsychiatric clients."
Q:
A young nurse charted that a 70-year-old client was "unable to perform ADL's due to old age." What should the nursing supervisor do in response to this attitude?1. Reassign the nurse to another unit with younger clients2. Explain how aging does not prevent one from performing ADLs3. Reprimand the nurse for charting opinions rather than facts4. Suggest the young nurse encourage the client to be more independent
Q:
A nurse has been offered a transfer to an adolescent substance abuse treatment center. Which of the following will assist the nurse in deciding whether to accept or decline the assignment?1. Assess his/her self-awareness related to working with substance abusers2. Make a list of the benefits of accepting the position3. Review his/her experience to determine if this will be a worthwhile endeavor4. Examine the repercussions for declining the transfer
Q:
Prior to intervening with an adolescent projecting anger on the nurse, the nurse should:1. Encourage the adolescent to engage in reflection.2. Engage in introspection to examine how he/she reacts to others when they are angry.3. Organize the rapid response team due to the aggressive action.4. Enlist an adolescent peer to intervene with the adolescent.
Q:
A nurse making rounds hears sounds coming from an adolescent's room. When checking on the client, the nurse hears noises coming from the bathroom, and suspects that the client is masturbating. Which are the most appropriate actions in this situation?Standard Text: Select all that apply.1. Wait until the client comes out of the bathroom.2. Pretend she did not hear anything.3. Discuss the inappropriate behavior.4. Examine his/her personal feelings about what might be happening.5. Knock on the door before entering the bathroom.
Q:
A therapeutic contract with a client will be renegotiated:1. Daily.2. As needed.3. During the treatment team meeting.4. At the beginning of each shift.
Q:
When negotiating a behavior contract with adolescents, the nurse ensures that:Standard Text: Select all that apply.1. The expectations for behavior are clear.2. The contract is oral.3. There is no room to renegotiate.4. Consequences outlined in the contract will be administered consistently.5. The terms are rigid.
Q:
The nurse is explaining the purpose of negotiating a behavioral contract to an adolescent's parents. A primary reason for the contract is:1. The contract is just between the client and nurse.2. It is a legal document.3. The terms cannot be changed once the contract is formed.4. There is less room for misinterpretation.
Q:
The nurse educator is discussing manipulation that can occur when working with adolescent clients. Which nurse is most at risk for being manipulated by an adolescent client? The nurse who:1. Avoids power struggles.2. Rewards appropriate behavior.3. Consistently enforces the rules.4. Maintains an all-accepting attitude.
Q:
The parent of an adolescent tells the nurse that the adolescent used to be on the honor roll at school, but now is failing every subject, skipping school, and doesn"t care about anything except a new group of "friends". The nurse recognizes this adolescent may be in need of counseling related to:1. Adolescent substance abuse.2. Growth and development.3. Self-esteem.4. Independent living.
Q:
An adolescent client is attempting to manipulate the nurse into giving a special privilege. The nurse recognizes the manipulation and responds by saying:1. "All the clients must follow the rules."2. "If I do it for you, I would have to do it for everyone."3. "If I granted you that privilege, I"d be in trouble"4. "That would not be fair to the others."
Q:
An adolescent client is being verbally abusive toward staff and is refusing to comply with the unit's rules. The first action is to:1. Separate the client from other clients.2. Administer a PRN medication.3. Tell the client the behavior is unacceptable.4. Ignore the client as the behavior is part of the illness.
Q:
A 14-year-old female inpatient, diagnosed with depression and self-mutilating behavior, is scheduled to be discharged in the morning.Her parents divorced when she was 10 and she hasn"t seen her father for almost a year, but for the past three months she has been looking forward to his taking her to a special concert a few days after discharge. Her father has just called to tell his daughter he will not be able to make their "date" because he has been detained longer than expected on a business trip. The client takes the phone receiver and begins hitting herself in the chest with it. Which of the following nursing interventions will be most therapeutic in helping the client deal with her anger?1. Provide emotional support by telling the client she has a right to be angry.2. Tell the client you understand how she feels.3. Revoke the discharge and transfer the client to a more restrictive environment.4. Suggest that the client write her father a letter telling him how she feels.
Q:
An adolescent female client who had lived on the street for at least a year dresses provocatively, wears heavy make-up, and is flirtatious in her interactions with adults. The nurse:1. Directs her to wash her face and put on appropriate clothing.2. Recognizes the client may be acting out her life script.3. Restricts the client to her room.4. Encourages her to seek spiritual guidance.
Q:
The nurse observes that an adolescent client relates, reacts, and consistently behaves with one of the male staff in an inappropriate manner. Based on the adolescent's history, the nurse is concerned this client may be:1. Manifesting manic behavior.2. Experiencing a side effect from the medication.3. Acting out a life script.4. Afraid of being alone.
Q:
The staff observes that a young male manifests oppositional behavior when he interacts with male staff. He has recently been placed in the custody of his father, since his mother has been deployed in the military. The client told the nurse that his mother relied on him a lot when he lived with her. He tells the nurse that his father is always on his case, never speaks to him without yelling, and tells him he can"t do anything right. Identify the appropriate intervention for the client when he feels oppositional toward the staff.1. Provide opportunities for the client to get to know the staff.2. Encourage the client to "take five to revive."3. Have the client chose the consequences for his behavior.4. Ask the client if he is upset.
Q:
Following a difficult family session, an adolescent client in the inpatient psychiatric"mental health unit has become combative. Prior to communicating with this client, the nurse must consider:1. The child's emotional state.2. The number of points to take away.3. Which consequences to use for punishment.4. The developmental age of the client.
Q:
During an admission to the inpatient adolescent unit, a client tells the nurse that his foster parents punish him too severely. The appropriate response of the nurse is to:1. Inform the psychiatrist.2. Notify the authorities.3. Gather data from the foster parents regarding their disciplinary practices.4. Tell the parents they need to be more therapeutic, not punitive.
Q:
An anxious parent reports feeling his adolescent child is depressed because when the adolescent is at home he/she would sleep all the time if not woken up. Which of the following would the nurse say when conducting a comprehensive assessment about the adolescent's mental health?Standard Text: Select all that apply.1. "What has happened that might have lead to him/her becoming depressed?"2. "Perhaps your anxiety is affecting your adolescent child."3. "Are there other behaviors you are concerned about?"4. "I see you are anxious."5. "Is there a history of depression in the family?"
Q:
The nurse completing an assessment for an adolescent from a humanistic"interactionist perspective will include which of the following assessments? Choose the best response.1. Developmental and psychosocial2. Spiritual only3. Psychosocial and physiological4. Physiological and spiritual
Q:
The nurse is conducting an assessment of an adolescent client. Which of the following information will the nurse obtain from the parents rather than the client?1. Academic achievement2. The adolescent's perception of the reason for seeking care3. The age at which developmental milestones occurred4. Dietary food preferences and allergies
Q:
A parent brings an adolescent child to the doctor's office. The nurse will be assessing both physical and psychosocial concerns. Which of the following actions by the nurse demonstrates a developmental approach to interviewing the adolescent?1. Interview the adolescent in private.2. Refer the psychosocial assessment to the mental health counselor at school.3. Ask the parent to wait for the doctor in the next room.4. Include the parent in the interview.
Q:
During an admission assessment of an adolescent client, the nurse inquires about friends or peer groups. The adolescent smiles and jokingly tells the nurse that "I consider myself a loner and I don"t need any friends." The nurse's next action is to:1. Ask the client how he/she gets along in school.2. Ask the client to explain why he/she feels this way.3. Document this in the admission assessment.4. Encourage exploration of feelings.
Q:
The nurse observes that an adolescent admitted to the inpatient unit for "failed outpatient treatment for depression" is very shy about interacting with peers. In planning care for this client, the nurse will integrate which of the following to help the client become more comfortable in the milieu?1. Limit choices2. Establish a trusting relationship3. Establish concrete boundaries4. Provide physical activity
Q:
The nurse plans to use a group approach when conducting a teaching session for adolescents about dealing with stress. A group approach works well with adolescents because:1. Problem-solving is less focused in groups.2. Peer support and values are important elements to an adolescent.3. Confidentiality is not an issue.4. The nurse therapist is the authority figure for the group.
Q:
During group, the adolescents are asked to identify their role models. One of the teens responds, "My parents." The nurse recognizes this response as:1. Developmentally appropriate.2. Grammatically incorrect.3. Regressive behavior.4. Inappropriate for the situation.