Q&A Hero

Q: The nurse utilizes a sound theoretical knowledge base about adolescent growth and development to:1. Integrate truth and fiction.2. Differentiate between normal and abnormal.3. Assess cognitive abilities.4. Incorporate good and evil.

Q: Self-awareness is an important aspect of nursing practice in any specialty. Which of the following questions would the nurse ask to build self-awareness when working with child psychiatric clients?Standard Text: Select all that apply.1. "What don"t I like about this child?"2. "How can I use this opportunity to learn more about myself?"3. "What am I learning about myself as I work with this child?"4. "How do I avoid working with the parents?"

Q: A nurse caring for a child is concerned about remaining therapeutic when working with a child with anger management issues. Which of the following must the nurse avoid in order to remain therapeutic?1. Examining personal feelings about the child2. Reflecting back on a situation3. Projecting his/her feelings onto the child4. Sharing his/her concerns with peers and colleagues

Q: When caring for children in the mental health setting, nurses may become aware of unresolved issues about their own family. If left unaddressed, care for the child may be affected because:1. This experience should not affect nurses.2. There is an increased potential for regression.3. This opportunity will help the nurses heal.4. Nurses' feelings may become activated.

Q: The nurse administering a lithium carbonate (Lithobid) to a child with mental retardation monitors the child for which of the following therapeutic effects?1. Weight loss2. Decreased agitation3. Weight gain4. Elevated mood

Q: The charge nurse is assigned a "float" nurse to help on the children's unit. The nurse normally works with adults and says she feels "out of place" working with the children. In making the assignments, which of the following activities would the charge nurse NOT assign to the "float" nurse?Standard Text: Select all that apply.1. Administering daily medications2. Administering PRN medications3. Obtaining vital signs4. Making rounds with the psychiatrist5. Monitoring the children under "close observation"

Q: A client, age 8, has just been prescribed pemoline (Cylert). The child's parents ask about the long-term effects of this medication. The nurse conducting patient teaching for the parents about this medication will include which of the following statements?1. "Photosensitivity is a problem with long-term use."2. "This is one of the drugs found to be safe for long-term use."3. "At the present time, there is limited information about this."4. "There seems to be a better outcome when the higher dose is given at bedtime."

Q: The new stepfather of a child diagnosed with a conduct disorder wants to know the reason for including him in family therapy sessions. The nurse explains that the goal of family therapy is to:1. Increase the probability that the child's mental health will improve.2. Help the child relive past events and related feelings.3. Provide an opportunity for the parents to interact with their child in a safe environment.4. Speak for the child so the parents can become more aware of the child's potential.

Q: The nurse works with both the child and parents to help the child develop interpersonal skills. Which of the following general outcomes facilitates engaging the parents in the process?1. Increasing knowledge of the child's psychopathology2. Understanding the child's unique temperament and needs3. Responding to separation anxiety4. Administering PRN medications effectively

Q: In working with a preschool-age child, which intervention would be considered as part of an effective plan for time-outs?1. Identify in advance, situations that lead to anger2. Explanations are not important to the child who is out of control3. Length of time depends upon how long it takes the child to calm down4. Incorporate a token economy

Q: The school nurse recommends that the parents of a student seek help because the student is constantly in trouble and recently has set several small fires on school grounds. The nurse is concerned because the child is manifesting signs of:1. Conduct disorder.2. Depression.3. Oppositional defiant disorder.4. Attention deficit hyperactivity disorder.

Q: The parents of a child with a spectrum disorder are asking the nurse about what kind of social expectations are realistic for their child. Which of the following is the overall outcome for a child diagnosed with a spectrum disorder?1. To acknowledge the effects of one's own behavior on others2. To function more effectively in social and emotional interactions3. To stay on task4. To acknowledge personal strengths

Q: When planning a new children's mental health clinic, the nurse understands the importance of including a play area. Play and toys are used to assess children with suspected mental disorders because:1. Children do not usually relate to adults.2. Children express themselves through play.3. Only toys that are developmentally appropriate and specific to the child's biological age are used.4. Play enables the nurse to assess cognitive ability.

Q: The nurse is assessing a child diagnosed with conduct disorder. Which would be the most appropriate question to ask the parents?1. "Does your child have a history of cruelty to other people and animals?"2. "Does your child unconsciously direct feelings and desires from other relationships toward others?"3. "Does your child seem to be reassured by your presence?"4. "Does your child readily seek out caregivers in times of stress?"

Q: The nurse is assessing a depressed child who was referred by the elementary school nurse. What is the best approach to use when assessing the child's socialization?1. "Tell me about the friends you enjoy being with."2. "So you spend a lot of time with your friends?"3. "You seem like a person who would have a lot of friends."4. "How many friends do you have at school?"

Q: The school nurse is observing a young child who has episodes of rage toward peers during recess and at lunchtime. The advantage of conducting an assessment in this environment is:1. This will assist in identifying the bullies who trigger the explosive episodes.2. This provides an opportunity to collect data in the event that other children are injured and legal documentation is needed.3. To provide data for the parents who are in denial about the problem.4. This provides a picture of problems and strengths in a realistic context.

Q: Which of the following behaviors observed by the nurse will be important to disclose to the teacher of a child with a stereotypic movement disorder?1. An episode of self-mutilation2. Depression that results from feelings of inadequacy3. Tendency to be hypoactive4. Flexibility and ability to contribute to learning

Q: A mother questions why it is important to list when her child sat up, began crawling, started walking, and was potty trained as she is bringing the toddler in because the child screams at night. The nurse explains to the mother that:1. It is not normal for a young child to scream at night.2. Children who scream at night have more difficulty with problem solving.3. Children with mental disorders have difficulty with elimination at night.4. A developmental history is part of assessing well-being of a child.

Q: A 7-year-old child recently experienced the death of the family's pet dog, which was the child's constant companion. The child is at risk for:1. A conduct disorder.2. Elimination disorder.3. Angoraphobia.4. Separation anxiety disorder.

Q: A mother is concerned because her 6-year-old son stutters. She wants to know if she did anything during her pregnancy to cause this. Which of the following would be the best response? The nurse should:1. Assess for impaired thermoregulation during the postnatal period.2. Assess for a family history of the disorder.3. Verbalize the implied by asking, "Are you saying you feel responsible for his problem?"4. Ask if the mother had preeclampsia during labor.

Q: A mother told the nurse she was "appalled" that the nurse would dare to ask if she took any drugs during her pregnancy. The nurse explains that the information is important in understanding the child's health because embryonic exposure to toxins during pregnancy is the major risk factor for:1. Depression in preschoolers.2. Lactose intolerance.3. Mental retardation.4. Mental illness.

Q: A nurse is describing the multicausal perspective of mental health and illness to the parents of a child recently diagnosed with a spectrum disorder. Which statement would the nurse utilize when describing this approach?1. Exposure to drugs and alcohol has been associated with psychiatric disorders.2. The feedback mechanism appears dysfunctional, creating neurotoxic effects on brain development and function.3. The child's genetically determined attributes and life experiences interact to influence mental health outcomes.4. Early psychological trauma may create deficits or abnormalities in brain structure.

Q: The nurse providing case management to a child with a mental illness will collect data from the child's parents, teachers, and other health care providers in order to:1. Complete a mental status exam.2. Complete a comprehensive evaluation.3. Collaborate with individuals that are significant to the child.4. Complete a personality profile.

Q: The nurse is meeting for the first time with a child who was brought to the clinic with a mental health concern. When planning care for a child with a mental health problem, the nurse must understand both the child's mental health problems and the child's:1. Previous hospitalizations.2. Life experiences.3. Physiological health problems.4. Artistic ability.

Q: The parents of a premature infant are visiting their baby in the neonatal intensive care unit for the first time. The nurse observes the couple standing beside the incubator. Which of the following interventions will help facilitate the infant's immediate mental health needs?1. Notify the infant's physician to come and talk with the parents2. Facilitate stroking and touching their infant3. Continue to observe their interactions to rule out a problem with bonding4. Have them meet with other parents of premature infants

Q: The nurse observes an 8-year-old child regressing to behavior that is characteristic of a toddler when faced with new situations. The child has been in several foster care families over the past three years. Which of the following interventions is appropriate for this child?1. Providing for unmet needs2. Providing consistency and continuity of caregivers3. Ignoring the regressive behavior4. Ignoring the negative behavior and reinforcing the positive behavior

Q: When discussing indicators of emotionally disturbed children or children with disruptive behavior disorders with a group of student nurses, the psychiatric nurse states that one of the best indicators of emotionally disturbed children is that they have difficulty:1. Seeking out peers.2. Digesting a balanced diet.3. Interpreting internal stimuli or external cues.4. Following rules and norms of behavior.

Q: A growing role of the child psychiatric"mental health nurse is:1. Scrutinizing the public.2. Promoting infant mental health.3. Monitoring adult inpatient psychiatric clients.4. Preventing mental health problems.

Q: A nurse generalist and advanced practice nurse both work on the staff of an inpatient unit. The advanced practice nurse has a comprehensive role as a primary caregiver in child psychiatry. Which of the following will be performed by the advanced practice nurse but not by the nurse generalist?1. Explaining the treatment plan to a family2. Performing admission assessments3. Participating in discharge planning4. Providing one-to-one counseling

Q: There are many roles involved in caring for clients in the specialized area of child psychiatry. Which of the following diverse clinical functions includes the role of the nurse generalist working in child psychiatry?Standard Text: Select all that apply.1. Administer medication2. Utilize knowledge and skills related to the mental health needs of clients3. Prescribe psychotropic medications4. Utilize knowledge related to the physical health needs of clients5. Order diagnostic tests necessary to monitor effects of psychotropic medications

Q: In caring for victims of violence it is important for nurses to be aware of their personal feelings and attitudes about the situation because:1. Intense negative feelings interfere with assessment and judgment.2. It allows the nurse to express sympathy for the client.3. Intense protective feelings result in appropriate interventions for the victim's care.4. Self-awareness protects the nurse's own mental health.

Q: Nurses working with abused clients most commonly feel:1. Sadness for the victim, tolerance toward the abuser.2. Sympathy for the victim, indifference toward the abuser.3. Anger toward the victim, dislike for the abuser.4. Sympathy for the victim, anger toward the abuser.

Q: Which statement by a nurse would indicate a nonjudgmental attitude toward violence and abuse?1. "Parents should not allow their children to party in the middle of the night; this is when most date rapes happen."2. "I admitted an 18-year-old for a suicide attempt following a date rape."3. "Most people who have sex when drunk tend to perceive it as rape."4. "Most adolescents call it rape when they don"t enjoy a sexual experience."

Q: A new nurse feels that it is hopeless to provide sexual and physical abuse victims with community resources when most of them choose to go back and live with their abusers. What would be an appropriate response by the counselor?1. "Some of these clients don"t know any better."2. "We are mandated by law to give clients information on resources prior to discharge."3. "It is important to empower clients and help them see that they can make positive changes."4. "Sometimes things do improve at home."

Q: As a nurse advocate for the reduction of family elder abuse, a nurse:1. Locates community resources for families.2. Educates the public about legal consequences of violent acts.3. Helps abused victims make it to the hospital for treatment.4. Encourages abusers to come forward to talk about their issues.

Q: Which of the following statements made by an abusive family member in a counseling session indicates that the individual has learned positive coping skills?1. "I feel more prepared to care for my father now that I know where to go for assistance."2. "I am so sorry I lost control; it will never happen again."3. "From now on I will make sure that my father's needs are met."4. "Now that I realize I treated my father unfairly, I will change my ways."

Q: When working with a client who has exhibited a pattern of violent outbursts followed by remorse, a nurse's plan of care should focus on:1. Decreasing the client's stressors.2. Developing effective anger management techniques.3. Offering the client family counseling.4. Identifying the client's strengths.

Q: A community health-planning group is meeting to discuss increasing violence among children in the community. Which setting would be expected to have the lowest occurrence of violence?1. Schools2. Streets3. Residential centers4. Homes

Q: An abused client in the inpatient unit recovering from injuries asks to attend Mass at the hospital chapel. The nurse understands that it is important for the client to:1. Attend to spiritual needs in order to deal with what has happened.2. Get back to a normal routine as soon as possible.3. Find a distraction from the injuries.4. Show an interest in what is going on in the world.

Q: A victim of sexual abuse expresses the belief to the nurse that the abuse is a punishment for not having lived a spiritually pure life prior to the event. The nurse:1. Indicates to the victim that this is an incorrect view.2. Makes it clear to the client that the rape was not a punishment for the client's own behavior.3. Acknowledges the client's spiritual frustration and invites the client to express these feelings.4. Explains that rape can happen even to the most religious people.

Q: In assessing a client who has suffered domestic violence, the nurse observes that the client is regressing back to childhood, is having difficulty trusting the nurse, is expressing rage and grief, and is talking about how unfair God has been and wondering why God has been "so insensitive." Based on these observations, what would be the most appropriate plan of action for the nurse?1. Suggest that the client join a survivor support group.2. Encourage the client to attend religious activities at the local church.3. Refer the client to a religious counselor.4. Explain to the client that God has his own reasons that most of us do not understand.

Q: A client who is being physically and sexually abused states, "God doesn"t want to bother with me. Am I an evil person? Why do these things always happen to me? What's wrong with God?" These statements indicate that the client is most likely experiencing:Standard Text: Select all that apply.1. Spiritual distress2. Anger3. Altered thought process4. Fear5. Hopelessness

Q: An appropriate ongoing, long-term treatment goal for a victim who experienced sexual abuse eight months ago is to:1. Establish rapport and build a trusting nurse"client relationship.2. Move from victim to survivor status.3. Become aware of legal rights.4. Involve significant others in the treatment plan.

Q: What is the most therapeutic approach of a nurse toward a victim of violence?1. Being supportive, nurturing, and empathetic2. Educating the client on how to avoid future incidents3. Distracting the client to minimize feelings of despair and guilt4. Maintaining objectivity and offering short, to-the-point responses

Q: A client comes to the clinic complaining of headaches. Further assessment reveals three one-inch bald spots at different locations on the client's scalp. The client states the headache and the bald spots resulted from an "accident." The client's partner, who has accompanied the client into the exam room, often finishes the client's sentences. The nurse should:1. Ask the partner to remain in the waiting room while the client is examined.2. Alert hospital security about the potential for violence.3. Encourage the partner to remain with the client to provide information about the client's health.4. Contact the local authorities.

Q: What is the most therapeutic approach when caring for a client who has been the victim of domestic violence?1. Acknowledge the client's inability to change the situation.2. Do not ask direct questions about abuse as this will intimidate the client.3. Invite the abuser to the assessment session.4. Avoid pressuring the client to leave the abuser.

Q: A client with a history of physical and sexual abuse by her husband is admitted to the hospital for treatment of vaginal lacerations. While hospitalized, the client expresses concerns to the nurse about her safety when she returns home. The first priority for the nurse is to:1. Offer to contact outpatient services if the client promises that she will not return home after her discharge.2. Encourage the client to take charge of her situation.3. Make it clear to the client that her husband needs to see a therapist.4. Assist the client to devise a safety or escape plan.

Q: A psychiatric nurse is providing an educational session to the emergency room staff to raise awareness on the topic of elder abuse. Which client is most at risk for elder abuse?1. An 82-year-old woman with middle-stage dementia2. A 73-year-old woman living in a poor neighborhood3. A 70-year-old man with the recent diagnosis of heart disease4. An 89-year-old man living with a mentally ill family member

Q: Who among the following females is at greatest risk of becoming a victim of sexual abuse?1. A female who carpools with a male coworker2. The partner of a man with a strong sex drive3. An attractive 14-year-old female who dresses in a manner that makes her appear older4. A 45-year-old widow who goes to a local club to meet new people

Q: Who is at greatest risk for becoming the victim of intrafamily violence?1. The child who has a stepfather2. The male child3. The child born out of an unplanned pregnancy4. The child living in a home in which a parent is being abused

Q: A nurse is taking the history of a client and suspects that the client has been sexually abused. Which question will prompt a response that will aid the nurse in making an accurate assessment?1. "Do you like to dress in provocative outfits?"2. "Has anyone touched you in a way that made you feel uneasy or uncomfortable?"3. "Do you have any bruises anywhere on your body?"4. "How is your relationship with your parents and older siblings?"

Q: An older client comes to the health center with vague complaints of abdominal discomfort. Assessment findings include several old and fresh bruises in the abdominal area, and signs of malnutrition. What is the most appropriate question for the nurse to ask?1. "Are you dieting?"2. "Did you have any falls lately?"3. "Do you have an alcohol problem?"4. "Did anyone hurt you?"

Q: A 10-year-old is brought to the clinic for assessment. During the interview, the nurse learns that the child has been the victim of domestic violence. Which of the following messages would the nurse expect to hear in the assessment of the child due to the child's experience of abuse?Standard Text: Select all that apply.1. It is appropriate to love the people you hit.2. Violence does not resolve conflict.3. If you are small and weak, you deserve to be hit.4. Violence is appropriate if the end result is good.5. People who love you don"t hit you.

Q: When working with sibling abuse victim, the nurse should recognize that:1. Most adults were victims of sibling abuse.2. 40% of all child homicides are caused by sibling abuse.3. Parents recognize and condone physical confrontation.4. Hitting increases the probability of violence.

Q: Which of the following combinations of clinical presentations constitutes the most compelling indication that a client may have been abused?1. Poor eye contact, depressed mood, unwillingness to give history data2. Multiple bruises and scars, low self-esteem3. Acting-out behaviors, disobedience, trouble with the law4. Sores around the mouth, brittle hair

Q: A client with a long history of experiencing domestic violence tells the nurse, "There is no way out for me, this situation will never change." What nursing diagnosis would be most appropriate?1. High Risk for Violence2. Self-Esteem Disturbance3. Alteration in Health Maintenance4. Powerlessness

Q: During an education session, a community member asks what causes domestic violence. The best response is:1. The statistics indicate that it is caused by poverty.2. It is caused by the demanding workload of either parent.3. The police commissioner can provide complete and accurate data on the causes.4. There is no single cause of this type of violence.

Q: Domestic violence is often associated with:1. High school dropouts.2. The poor and undereducated.3. Blue-collar workers.4. All levels of society.

Q: The nurse understands that the underlying issue of most abusers is:1. An uncontrollably urge to love.2. The inability to control intense anxiety.3. A desire to enslave and control.4. A desire to play out fantasies.

Q: A client with a poorly regulated corticotropin-releasing factor (CRF) will most likely have difficulties:1. Relating to others.2. Coping with stress.3. Balancing life issues.4. Interpreting the environment.

Q: The psychiatric nurse knows that maladaptive grief reactions and perceptions of blame are reduced in nurse-led counseling programs. Nursing students should be taught to include the following outreach services for families and significant others who survive suicide:Standard Text: Select all that apply.1. Take the bereaved on family outings for a year.2. Arrange for staff or a representative to attend any funeral services.3. Involve families in psychoeducational and family network services.4. Make frequent telephone calls to the family immediately after the suicide and periodically until the first anniversary of the death.5. Involve the family in a bereavement support group.

Q: A child or adolescent who experiences a parent's or friend's suicide are at greater risk for suicide and should be:1. Screened for possible drug overdose.2. Evaluated for depression.3. Observed for suicidal attempts.4. Immediately hospitalized.

Q: The nurse knows that family members of suicide victims rarely seek assistance from mental health care professionals. One way to help survivors may be to:1. Get families involved with the American Association of Suicidology.2. Teach families how to bear the burden alone.3. Talk to the physician about their case.4. Assure the family they will soon feel better.

Q: A client was admitted to the psychiatric unit on a suicide watch. In an effort to include family members in the client's care, the nurse must:Standard Text: Select all that apply.1. Be prepared to deal with family members who may be confused, angry, or uninterested. Strive to remain neutral, and do not make assumptions about the family's behavior.2. Involve the family in a bereavement support group.3. Involve the family in psychoeducational and family network services.4. Take the bereaved on a family outing.5. Decide with the client which family members and friends are to be contacted and by whom.

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.