Q&A Hero

Q: A client is newly diagnosed with dissociative identity disorder. To support this client, who is struggling to accept the diagnosis, the nurse would:1. Flood the client with stressful stimuli.2. Actively listen to each identity state and provide support.3. Assess for secondary gain to confront the client.4. Discourage the use of psychometric tests.

Q: The nurse is caring for a 15-month-old who is admitted to the hospital for the fifth time in six months with severe diarrhea. The patient's mother has been diagnosed with Munchausen by proxy syndrome (MBPS) as she has been giving her child large doses of laxatives to make the child sick. The nurse is having difficulty dealing with the situation. Which of the following is the best way for the nurse to proceed?1. Confront the mother about making her child sick.2. Seek clinical supervision to cope with situation.3. Refuse to take care of the child and family.4. Have as little contact with the mother as possible.

Q: To intervene effectively with clients with somatoform disorders, it is essential that the nurse:1. Help the client express a decreased degree of comfort regarding physical symptoms.2. Encourage the client's expression of feelings symbolically through physical symptoms.3. Address client anxiety at a later time.4. Recognize and understand the client's self-perception as demonstrating an inability to cope.

Q: When working with clients with somatoform disorders, the nurse knows the priority intervention is to:1. Encourage clients to participate in group therapy to receive feedback about the effect of their behavior on others.2. Tone down clients' characteristic extravagance.3. Establish a trusting relationship.4. Express respectful skepticism regarding clients' oversimplifications and overdramatizations.

Q: The nurse is caring for a client who has been diagnosed with dissociative disorder. The nurse knows that an appropriate intervention to promote effective role performance is to:1. Encourage the client to have no contact with friends and family.2. Ignore the client's other personalities.3. Help the client alienate family members who do not believe the client is sick.4. Include family members is therapy.

Q: The nurse is working with a client who has been diagnosed with a somatoform disorder. The nurse knows it is important to include which of the following interventions in the client's plan of care?Standard Text: Select all that apply.1. Encourage verbalization of feelings.2. Encourage the client to write in a journal3. Establish a weekly routine4. Establish a trusting relationship.5. Encourage the discussion of physical symptoms

Q: The nurse knows that performing an assessment on a client with dissociative disorder can be challenging. The nurse knows it is important to include which of the following in the assessment?Standard Text: Select all that apply.1. Memory2. Identity3. Consciousness4. Client's spouse5. Awareness of time

Q: A client presents to the community clinic describing abdominal pain, refuses to complete informational forms, and dismisses the nurse's assessment attempts while demanding to be seen immediately by a doctor. Which approach would be best for the nurse to use when assessing for somatoform disorders?1. Realize client judgment is intact.2. Avoid personalizing the behavior by recognizing that somatization is part of the illness.3. Have sympathy for the psychopathology of the disorder.4. Expect the client to respond appropriately to the nurse's need to complete the assessment.

Q: The nurse cares for several clients with somatoform disorders, regularly reassessing their status. The nurse is aware that it is:1. Easy to be kind, nonjudgmental, and understanding.2. Challenging because of the psychobiologic factors involved.3. Best to include objective information only.4. Best to include subjective information only.

Q: A client is certain she has cancer and peritonitis despite her doctor's reassurance she does not. She most likely is experiencing:1. Malingering.2. Conversion disorder.3. Hypochondriasis.4. Factitious disorder.

Q: An 18-year-old client who joined the military shortly after graduating from high school is admitted to the mental health unit for depression and suicidal ideation. He tells the nurse the military is not what he expected and he wants to go home. The nurse observes a variance in affect between his interaction with peers and staff. The nurse suspects:1. Conversion disorder.2. Factitious disorder.3. Malingering.4. Body dysmorphic disorder.

Q: The nurse is caring for a client with somatization disorder. When providing a report to the staff on the next shift, it is important for the nurse to relate the:1. Amount of time the client talked about physical complaints.2. Trigger for the client's worries.3. Use of abdominal breathing at the first sign of anxiety.4. The client's source of the original anxiety.

Q: The nurse is caring for a client with a history of admissions to several hospitals over the last several years. Each hospitalization was for a different disorder in which there was no physical evidence. The medical record indicates the client is a pathological liar. Which of the following disorders does the client suffer from?1. A somatoform disorder2. Factitious disorder by proxy3. Adult factitious disorder4. Dissociative identity disorder

Q: The nurse is working with a client who is being admitted to the psychiatric"mental health unit. The client was missing for two weeks and returned home not knowing any time had passed. Which of the following dissociative disorders has this client experienced?1. Amnesia2. Depersonalization disorder3. Fugue4. Dissociative identity disorder (DID)

Q: The client states that she has been ill and in pain since childhood. Her many symptoms are not caused intentionally, nor are they feigned. She has seen many doctors. Consistent with this client's disorder, the nurse believes the pain the client experiences is:1. Fake.2. Exaggerated.3. Real.4. For attention.

Q: A 24-year-old client with body dysmorphic disorder (BDD) tells the nurse that he plans to have a surgical procedure that will affect his appearance. The nurse understands that this plan is an effort to:1. Suppress intrusive thoughts.2. Deal with multiple physical complaints.3. Treat associated depression.4. Cure the imagined defect.

Q: The nurse would teach the adolescent with a conversion disorder what the person "gets" from having the disorder. This explanation would include a discussion of:1. Preoccupation with the belief that the person has a serious disease without physical evidence.2. Primary and secondary gains.3. An overreaction by caregivers to the client's somatic complaints.4. A pain cure.

Q: A client is newly diagnosed with an anxiety disorder. To support this client, who is struggling to accept the diagnosis, the nurse would:1. Actively listen to the client and provide support.2. Discourage the use of psychometric tests.3. Flood the client with stressful stimuli.4. Assess for secondary gain to confront the client.

Q: Teaching clients and family members about the physical cues that indicate increasing anxiety would include information on:1. Short attention span.2. Forgetfulness.3. Urinary retention.4. Urinary frequency.

Q: The mental health nurse is training primary care providers about treatment options for anxiety disorders, including pharmacologic options. The nurse knows that SSRIs are the choice class of medications for treating anxiety disorders because they:1. Have fewer side effects than other anti-anxiety medications.2. Have a short half-life.3. Are metabolized in the liver.4. Are adrenergic blocking agents.

Q: The nurse is working with a client who has a fear of driving a car. An intervention strategy planned to help this client face the fear is to teach:1. Goal-oriented contracting.2. Meditation.3. Cognitive behavioral therapy.4. Physical exercise.

Q: The nurse is teaching a client with social phobia about anxiety medications. The nurse knows the teaching has been effective when the client states, "I know I:1. Can use other medications."2. Can"t consume alcohol."3. Can stop the medication any time."4. Can"t drink decaffeinated beverages."

Q: The nurse knows that medication teaching has been ineffective when the client with an anxiety disorder states, "My SSRI isn"t working. I"ve been on it for:1. One week."2. Four weeks."3. 12 weeks."4. Eight weeks."

Q: After administering medication for an anxiety disorder, it is important for the nurse to record whether the client:1. Uses caffeine.2. Takes other medications.3. Exhibits drowsiness.4. Uses alcohol.

Q: In treating clients with prolonged anxiety, the nurse knows it is most important to:1. Teach communication skills.2. Explore old and ineffective coping strategies.3. Encourage the expression of anger.4. Help clients use anxiety to increase self-awareness and develop coping strategies.

Q: A client in the inpatient mental health unit is experiencing severe anxiety. The nurse knows that the client:1. Is able to focus.2. May be easily distracted.3. Will be able to communicate in writing.4. Retains information.

Q: In developing a plan of care for a client with extreme panic, the nurse knows that:1. Anxiety may be communicated through behavioral responses.2. Behaviors are mobilized.3. Social skills are intact.4. Anxiety may be communicated through verbalizations.

Q: When caring for a new client with OCD, it is most important for the nurse to:1. Not interrupt the ritual.2. Teach ritual interruption skills.3. Interrupt the ritual.4. Teach about anti-anxiety foods.

Q: A client having a severe panic attack may require the nurse to provide:1. Teaching about anxiety.2. Firm reassurance and protection until the episode subsides.3. A physical activity for the client to focus on.4. Teaching about ways to decrease anxiety.

Q: During the assessment of a client with an anxiety disorder, the client becomes very anxious. The nurse should:1. Suspend data gathering and wait until the next day to resume the assessment.2. Suspend data gathering and take action to reduce anxiety.3. Continue data gathering and ask what the precipitating factor for the anxiety is.4. Continue data gathering and ask clarifying questions.

Q: The nurse caring for a client with an anxiety disorder knows to be most attentive to the nurse's:1. Inability to assess the situation accurately.2. Anxiety causing forgetfulness.3. Inability to identify personal somatic problems.4. Own overall feelings.

Q: The client, a combat veteran, was recently diagnosed with PTSD. Which symptoms, if present, would be characteristic of PTSD?Standard Text: Select all that apply.1. Fear of returning to sleep2. Fitful sleep3. Excessive sleeping4. Hair pulling5. Terrifying nightmares

Q: A client has compulsive cleaning behaviors, scrubbing areas throughout the house over and over, especially areas where the family gathers. It is most important for the nurse to assess:1. For vomiting during cleaning.2. The impact of symptoms on the family system.3. How frequently the client cleans the house.4. For forgetfulness.

Q: Some clients are at increased risk of being dually diagnosed with a mental health disorder and a substance abuse disorder. The client with a mental health disorder that is more likely to exhibit substance abuse in an attempt to avoid traumatic memories is the client with:1. PTSD.2. Dissociative fugue.3. OCD.4. Generalized anxiety disorder.

Q: A client is admitted to the hospital after being found in a car on the side of a bridge with complaints of having a heart attack. Following extensive tests, it was found the client did not have a heart attack. The client most likely was having:1. PTSD.2. Transitory cardiac symptoms.3. A panic attack.4. Suicidal feelings.

Q: The nurse assesses a client during a panic attack and determines the client's level of anxiety to be acute. What physical changes did the nurse likely observe?Standard Text: Select all that apply.1. Sweating2. Breathing difficulty3. Trembling4. Impaired cognition5. Vomiting

Q: The nurse is caring for a client who is complaining of a number of somatic discomforts associated with chronic anxiety. The nurse knows that somatic discomforts associated with anxiety include:Standard Text: Select all that apply.1. Heartburn2. Diarrhea3. Epigastric pain4. Constipation5. Muscular tension

Q: The nurse is preparing an in-service regarding the commonalties of anxiety disorders. The nurse should plan to include that all anxiety disorders have which one thing in common?1. All anxiety disorders can be so disabling that functioning may be adversely affected.2. All anxiety disorders require treatment with medication.3. All anxiety disorders first occur during adolescents.4. All anxiety disorders cause depression.

Q: A client stays to the nurse, "Everything makes me anxious now." The nurse knows that this free-floating anxiety is a common theme in:1. OCDs.2. Generalized anxiety disorders.3. Phobias.4. Dissociative identity disorders.

Q: Freud identified a number of defense mechanisms. It is evident that the nurse recognizes one of these common defense mechanisms for a client with dissociative identity disorder when the nurse charts that the client has used:1. Denial.2. Fixation.3. Repression.4. Rationalization.

Q: The nurse would expect clients with dissociative disorders to have what in common with clients with anxiety disorders? Anxiety that is:1. So disabling that they are totally nonfunctional.2. So disabling that their functioning is adversely affected.3. Objective.4. Nonthreatening.

Q: The client is experiencing an episode of anxiety. The nurse will expect to observe which common coping behaviors?Standard Text: Select all that apply.1. Problem solving2. Indulgence3. Somatization4. Acting out5. Withdrawal

Q: Your client states, "I haven"t left my house for six years." The nurse knows that the most helpful theory for dealing with this problem would come from the:1. Behavioral theorists.2. Humanistic theorists.3. Genetic theorists.4. Psychosocial theorists.

Q: A parent asks the school nurse, "How did my child get OCD?" Which theory supports the hypothesis that there is an alteration in serotonin synthesis in the brain of a child with OCD?1. Genetic2. Humanistic3. Psychosocial4. Behavioral

Q: The nurse is explaining biophysicalsocial theory to a group of students. Which biopsychosocial theory would most support tracing anxiety back to birth trauma?1. Behavioral2. Humanistic3. Psychosocial4. Genetic

Q: Which action should the nurse take to prevent emotional contagion when working with hospitalized depressed clients? Expect the clients to:1. Be appreciative of a daily one-to-one session.2. Be open to working on their problems.3. Show improvement within 24 hours after admission.4. Be disinterested in a nurse"client relationship.

Q: To work effectively with mood-disordered clients, it is most important that the nurse have:1. Self-awareness.2. The ability to sympathize.3. An extroverted personality.4. Good recall.

Q: When communicating with a client who has major depressive disorder, the nurse should avoid being:1. Warm and patient.2. Gently encouraging.3. Cheerful and outgoing.4. Slow and empathic.

Q: The nurse is teaching a client with bipolar disorder about their newly prescribed lithium carbonate (Lithobid). Which is the correct instructional information?1. Serum levels must be tested regularly2. For fine hand tremors, take a double dose of the medication.3. Decrease salt and fluid intake4. Discontinue the medication when feeling better

Q: The nurse instructs the family and client on phenelzine (Nardil) about:1. No risk for concomitant use with a Selective Serotonin Reuptake Inhibitor (SSRI).2. No risk for concomitant use with opioids.3. Use of a low glycemic diet.4. Use of a low-tyramine diet.

Q: The nurse knows that teaching has been effective when the clients state that upon awakening following electroconvulsive therapy they:1. Should be assisted to ambulate.2. May have water immediately.3. May be confused and disoriented.4. Should eat breakfast.

Q: The nurse tells the client with acute mania that an effective treatment may be:1. Electroconvulsive therapy.2. Fluoxetine (Prozac).3. Seclusion and restraint.4. Group therapy.

Q: In preparing the care plan for a client to reduce negative thinking and promote improved self-esteem, identify all of the appropriate short-term goals. Client will:Standard Text: Select all that apply.1. Wash and comb hair.2. Eat meals and snacks to meet daily calorie requirements.3. Sit and walk erectly.4. Participate in activities that can be completed successfully.5. Verbalize positive aspects of self.

Q: In planning care for a client with negative thinking, the nurse would intervene by teaching the client to:1. Identify and reframe negative thoughts.2. Discuss personal worthlessness with all unit peers.3. Make a list of things the client does poorly.4. Avoid unit activities until the client desires to participate.

Q: A hospitalized client with a mood disorder is assessed to be high risk for suicide. The nurse should intervene by:1. Encouraging repetitive discussions of suicidal ruminations.2. Removing dangerous objects from the client's room.3. Evaluating suicide intention every three days.4. Using a strict regular schedule for client observation.

Q: A severely depressed client's risk for self-directed violence increases when:1. A no-suicide contract is made with the client.2. The client is encouraged to discuss feelings.3. The client is asked to discuss the suicide plan.4. The antidepressant medication begins to work.

Q: The nurse's priority intervention for a newly hospitalized suicidal client is to:1. Obtain a no-suicide contract for the day.2. Have the client write a list of the client's weaknesses.3. Require the client to participate in the goals group.4. Request the client to describe previous stressors.

Q: When a client with a major depressive disorder states, "I don"t care about anything anymore," the nurse would respond:1. "You have such a good life!"2. "Are you feeling suicidal?"3. "What about your children? They are so cute and wonderful!"4. "Don"t worry. You"ll feel better tomorrow."

Q: In assessing a client, which of the following would indicate that the client is experiencing mania?Standard Text: Select all that apply.1. Pressured speech2. Feeling worthless3. Isolating4. Flight of ideas5. Constant motor activity

Q: During the admission nursing assessment for a new client, the nurse recognizes which objective assessment data consistent with a diagnosis of major depression?1. Fatigue2. Feeling sad3. Psychomotor retardation4. Impaired concentration

Q: What items should be included in the admission nursing assessment for a new client?Standard Text: Select all that apply.1. Genetic counseling2. Health history3. Support systems4. Current stressors5. Genetic testing

Q: A client with a mood disorder is admitted to the mental health unit. The priority nursing activity should be to:1. Orient the client to group therapy.2. Complete the mental and physical assessment.3. Work on client's current stressors.4. Teach social skills.

Q: A client describes being very sad during dreary winter seasons. The nurse knows that this disorder may be treated with:Standard Text: Select all that apply.1. Light therapy.2. Haloperidol (Haldol).3. Group therapy.4. Assertiveness training.5. Bupropion ER (Wellbutrin ER).

Q: A client with bipolar disorder, mania, states, "I had a test to look at my ventricles before I came in." The nurse thinks it most likely was a/an:1. Electroencephalography (EEG).2. Magnetic Resonance Imaging (MRI).3. Polysomnography.4. Single photon-emission computed tomography.

Q: A priority nursing intervention for a client with bipolar mania who has difficulty sleeping is to:1. Have the night nurse talk with the client.2. Encourage long naps during the day.3. Administer PRN zolpidem tartrate (Ambien).4. Provide strenuous exercise prior to bedtime.

Q: Your client with a mood disorder states, "My husband never calls to tell me he will be late for dinner, and then dinner is always ruined." The nurse knows that a priority teaching for this client would be:1. Cognitive theory2. Psychoanalytic Theory3. Object loss theory4. Genetic theory

Q: When taking the admission history of a client with bipolar disorder, which information would be most significant to determine circadian rhythm dysfunction?1. Negative thought patterns2. Sleep and appetite patterns3. Psychiatric diagnosis4. Personality patterns

Q: Which biopsychosocial theory would most support the development of depression in a client who went to live with his father at 3 months of age when his mother was sentenced to jail for 15 years?1. Object loss theory2. Gender theory3. Genetic theory4. Cognitive theory

Q: A client describes being sad since his wife died three weeks ago. When he describes the memorial service, funeral, and his plans for the future, the nurse assesses this as:Standard Text: Select all that apply.1. A crisis.2. Bereavement.3. Delayed grief.4. Normal grief.5. Dysfunctional grieving.

Q: What treatment approach(es) would the nurse use for a client with dysfunctional grieving?Standard Text: Select all that apply.1. Teach about maladaptive dependence on the nurse2. Talk therapies3. Antidepressants4. Cognitive therapy5. Teach anger management

Q: A client told the nurse that even though his wife died three years ago, he continues to have dinner with his wife every Saturday night. He includes a table setting for her and he prepares their "usual" steak dinner. He also lights a candle for her each week marking the time of her death. This is evidence of:1. Dysfunctional grieving.2. Anticipatory grief.3. Normal grief.4. Bereavement.

Q: During a nurse"client interaction, an adolescent client with a major depressive disorder stated, "I was on the swim team at school, but I don"t enjoy swimming anymore so I quit." The client is describing:1. Anhedonia.2. Aphasia.3. Anergia.4. Antagonism.

Q: The treatment plan for a client with acute mania has been effective when the nurse charts that the client has:1. Pressured speech and wears short shorts and a low-cut blouse.2. An expansive mood and has organized a unit pool tournament.3. An irritable mood and sat for one minute to eat lunch.4. Been intrusive with peer conversations.

Q: The major difference between bipolar disorder and major depressive disorder is that in bipolar disorder there is:1. Suicidal ideation.2. Only one week of symptoms.3. A mania component.4. No history of depressive feelings.

Q: The nurse would expect a client who is exhibiting the vegetative signs of depression to have:1. Constipation and insomnia.2. Helplessness.3. Hopelessness.4. Suicidal ideation and a plan.

Q: Which of the following indicates sensitivity toward a client with schizophrenia?1. Reporting a client's compliance with medication to the psychiatrist2. Providing privacy for the client to visit with his or her family3. Eating in the dining room with the clients4. Providing encouragement for a client to attend groups

Q: Which answer choice, when placed in the blank, creates a correct statement?The nurse maintaining a ______________ attitude will be more likely to understand the experiences and difficulties of a client with schizophrenia.1. sympathetic2. enmeshed3. complementary4. nonjudgmental

Q: The nurse manager of the inpatient psychiatric unit is talking with the staff about the interventions to promote independent actions of clients on the chronic schizophrenia unit. Which of the following responses made by the staff indicates lack of insight into the client's illness?1. "I want to learn more about the side effects of the medication."2. "I know when clients hear voices they are not real."3. "I understand that some clients are not able to put on their clothes."4. "I believe clients sometimes need to be isolated help them feel safe."

Q: Which of the following interventions will increase the client's likelihood of complying with taking psychotropic medications?1. Give family members information about the client's medication.2. Encourage the client to take all medication at the same time.3. Give the client a pamphlet explaining the positive effects of psychotropic medication.4. Encourage the client to use measures to manage side effects.

Q: Lower relapse rates in schizophrenia have been found to be effective with which of the following treatment approaches?Standard Text: Select all that apply.1. Psychosocial treatment only2. Recognizing schizophrenia as an acute illness3. Antipsychotic medication exclusively4. Early intervention5. The combined use of antipsychotic medication and psychosocial treatment