This is a 30 point Pre-Board Exam Drill on Fundamentals of Nursing SET B.
Test your knowledge on nursing concepts, test your test-taking skills and develop your attitude in attacking board exam questions. Answer these questions on a piece of paper. Check your answers and don't forget to review the rationale behind the correct answer. Good luck with your exam!
1. The nurse is inserting an indwelling urinary catheter. Which action is essential to decrease the complications associated with catheter insertion?
a. cleanse the female client using betadine-soaked 4x4’s, cleaning from the rectal area to the clitoris
b. utilizing a catheter that is slightly larger than the external urinary meatus
c. utilize clean technique
d. test the retention balloon prior to insertion
2. The nurse is caring for an adult client who is scheduled for an intravenous pyelogram (IVP). Which nursing intervention is essential?
a. encourage large amounts of fluids prior to the test
b. assess for any indications of allergies
c. administer a laxative
d. restrict fluids only in clients with marginal renal reserve or uncontrolled diabetes
3. The nurse is caring for a client who has a nasogastric tube attached to low wall suction. The suction is not working. Which is the nurse least likely to note when assessing the client?
a. client vomits
b. client has a distended abdomen
c. there is no nasogastric output in the last two hours
d. large amounts of nasogastric output
4. A client who has ascites is admitted to the hospital and will be undergoing a paracentesis. What should be included in the nursing care plan?
a. monitor client closely for evidence of vascular collapse
b. place client in Trendelenburg position for the procedure
c. encourage client to drink plenty of fluids to distend the bladder prior to the procedure
d. have client remain on bed rest for 24 hours following the procedure
5. A patient underwent an exploratory laparotomy two days ago. The physician has just written an order for a soft diet. The nurse assessed the client and did not hear bowel sounds in any quadrant. What is the best nursing action?
a. follow the physician’s order and feed the client
b. cancel the physician’s order and make the client NPO
c. order clear liquids for the client
d. notify the physician that the client does not have bowel sounds at this time
6. Your patient is receiving O2 at 2 liters per nasal cannula. His roommate lights a cigarette and tosses the match catching the curtain on fire. What is the priority action for the nurse?
a. turn off the oxygen
b. sound the fire alarm
c. try to extinguish the fire
d. remove the clients from the room
7. An 84-year-old male patient has been bedridden for two weeks. Which of the following complaints by the patient indicates to the nurse that he is developing a complication of immobility?
a. stiffness of the right ankle joint
b. soreness of the gums
c. short term memory loss
d. decreased appetite
8. Which of the following nursing interventions indicate an understanding on the part of the nurse concerning proper care of pressure ulcers?
a. rub reddened skin to increase circulation
b. use a heat lamp 4 times a day to dry the wound surface
c. cleanse a non-infected pressure ulcer with isotonic saline
d. cleanse a non-infected pressure ulcer with povidone-iodine
ANSWER C: A noninfected pressure ulcer should be cleansed gently with a non-ionic cleanser such as isotonic saline to prevent disruption of healing.
9. A client has been placed in blood and body fluid isolation. The nurse is instructing auxiliary personnel in the correct procedures. Which statement by the nursing assistant indicates the best understanding of the correct protocol for blood and body fluid isolation?
a. masks should be worn with all client contact
b. gloves should be worn for contact with non-intact skin, mucous membranes or soiled items
c. isolation gowns are not needed
d. a private room is always indicated
10. A female client will have to change the dressing on her injured right leg twice a day. The dressing will be a sterile dressing, using 4x4’s, normal saline irrigant, and abdominal pads. Which statement best indicates that the patient understands the importance of maintaining asepsis?
a. “If I drop the 4x4’s on the floor, I can use them as long as they are not soiled.”
b. “If I drop the 4x4's on the floor, I can use them if I rinse them with sterile normal saline.”
c. “If I question the sterility of any dressing material, I should not use it.”
d. “I should put on my sterile gloves, then open the bottle of saline to soak the 4x4’s.”
11. Which of the following nursing interventions would the nurse perform prior to administering a tube feeding?
a. check for placement by aspirating for gastric contents with a syringe and test pH with Testape
b. advance the tube 3-5 inches prior to the feeding
c. instruct the client to swallow
d. instill 30 ml of sterile water into the tube
12. An adult client is being treated in the burn unit for partial and full-thickness burns of the left foot, ankle, and leg. Skin autographs are taken from the right thigh and a skin graft is performed. The nurse planning care for the client on return from the operating room includes which of the following nursing interventions?
a. change dressing on graft sites every shift
b. cover donor site with fine mesh gauze and expose to air
c. lubricate donor site with skin cream every shift
d. hydrotherapy to graft sites daily
13. The nurse is caring for a client who is being transfused for severe gastrointestinal bleeding. The nurse can decrease the danger of hypothermia by:
a. administering blood with normal saline
b. administering blood products through a central line
c. giving only packed cells
d. warming blood to body temperature before administering
14. The mother of a three-year-old child calls the clinic and states that her child has just swallowed an unknown amount of baby aspirin. What is the best initial action for the nurse to take?
a. call the physician
b. instruct the mother to bring the child to the emergency room as soon as possible
c. discuss with the mother observable changes for which she should watch the child
d. tell the mother to give ipecac to the child and then come to the emergency room
15. A 56-year-old is admitted to the burn unit with partial and full-thickness burns of both legs, which occurred when a charcoal grill tipped over on her. The burn area is edematous. Blister formation and a large amount of fluid exudate is noted. Urine output is 30 ml per hour, BP 90/60, and pulses 110. A primary nursing diagnosis during the initial 48-72 hours following the burn is:
a. body image disturbance related to disfiguring burns of both legs
b. high risk for infection related to skin breakdown
c. potential for ineffective airway clearance related to smoke inhalation
d. fluid volume deficit related to increased capillary permeability
16. While assessing the client with burns on the back and trunk, the nurse notes areas that are not painful, grayish–white in color, and leathery in appearance. The nurse documents that these burns are:
a. superficial burns
b. superficial partial thickness burns
c. deep partial thickness burns
d. full thickness burns
17. An adult is scheduled for IVP. Before sending her to have the test the nurse should:
a. ask if she is allergic to barium
b. ask is she is allergic to shellfish
c. give her a full glass of water
d. instruct her not to urinate until after the test
18. An adult has received one unit of packed red blood cells after sustaining severe trauma to his legs with profuse bleeding. To evaluate whether the transfusion has been effective the nurse should:
a. take his blood pressure
b. auscultate lung sounds
c. check hemoglobin and hematocrit results
d. take his temperature
19. The nurse is administering tracheostomy care to an adult. Which of the following should be included in the procedure?
a. soaking the outer cannula with saline solution
b. performing the procedure utilizing medical asepsis
c. soaking the inner cannula in half-strength hydrogen peroxide solution
d. cutting a sterile gauze pad to place between the neck and the tracheostomy tube
20. Which of the following teaching should the nurse include when establishing a bowel-training regimen for a 62-year-old with chronic constipation?
a. avoid laxative
b. decrease exercise
c. increase the fiber content of your diet
d. increase fluid intake 4500-5000 ml
21. The nurse answers the phone in the emergency room, a woman states that she has a nosebleed that has not stopped for the past two hours. The nurse tells her that she should come to the ER immediately but do which of the following first?
a. put pressure on the bridge of the nose for 5 to 30 minutes, applying an icepack and sit with the head forward
b. apply heat to the bridge of the nose and do not eat
c. sit with the head back and use a towel to blot blood drainage
d. when blood is felt in the nose, lightly blow the nose into a tissue
22. A male client has been diagnosed with chronic obstructive pulmonary disease (COPD) for the last 10 years. He continues to smoke 2 packs of cigarettes a day. He requires oxygen to perform his daily activities. Which of the following therapeutic management modalities is necessary?
a. low flow of oxygen is usually ordered
b. oxygen flow is adjusted to a higher level if shortness of breath occurs
c. petroleum jelly should be applied around the nares to prevent irritation
d. oxygen flow rate is not a concern since he will feel better if the rate is high
23. Mrs. X has been diagnosed with acute asthma. she has been admitted to the hospital and all of the following instructions to the nurse are correct, except:
a. the head of the bed should be in the high position to facilitate drainage and breathing
b. a cool and dry environment should be maintained
c. air conditioner filter should be changed often
d. oxygen should never be used as it could restrict airways more
24. A female patient has had a partial gastrectomy with a vagotomy and pyloroplasty today. She has a nasogastric tube in her nares connected to low intermittent suction. The nurse should take which of the following precautions?
a. do not irrigate or reposition the NG tube because the stomach sutures can be ruptured
b. always use wrist restraints to assure placement of NGT
c. the NG tube should not be taped to the nose
d. expect copious amount of bright red blood from the NG tube postoperatively
25. A man complains of cramping abdominal pain. He has been diagnosed with acute diverticulitis. What nursing interventions are likely to be ordered?
a. increase activity and regular diet as tolerated
b. advise bed rest, clear liquids and meperidine (Demerol), 50 mg IM every 3-4 hours as needed
c. use ice packs on the abdomen and place the client in the trendelenburg position
d. use a K-pad (a temperature controlled heating pad) on the abdomen and allow regular diet as tolerated
26. has been diagnosed with esophageal varices. The physician notes there is active bleeding and orders the nurse to insert NG tube. The nurse should do which of the following?
a. insert the NG tube immediately
b. question the order because a varix might be perforated during insertion
c. use copious amount of K-Y jelly to insert the NG tube
d. refuse the order because a varix might be perforated during insertion
27. A 30-year-old patient has been diagnosed with folic acid deficiency. The client asks the nurse which foods are high in folic acid, and the nurse correctly responds:
a. green leafy vegetables, organ meats, nuts and eggs
b. fresh shrimp and oysters
c. dried fruits and oatmeal
d. tofu and tuna
28. Which of the following is an example of pica?
a. a craving for sweets
b. a craving for laundry starch and ice
c. a craving for shellfish
d. craving for pickles
29. An 82-year-old woman living in a long-term care facility develops urinary incontinence. After ruling out the presence of urinary retention or a urinary tract infection (UTI), the nurse should:
a. establish a 3-hour prompted voiding schedule
b. insert a foley catheter or teach the client to self-catheterize
c. restrict her fluid intake to 1500 ml/day
d. use adult diapers and change them frequently
30. Client education for the individual with gout includes:
a. dietary instructions to limit meat, poultry, organ meats and alcohol
b. dietary instructions to limit complex carbohydrates such as flat bread, rice and pasta
c. instructions for proper cast care
d. signs and symptoms of compartment syndrome, a major complication
Friday, December 27, 2013
Wednesday, December 25, 2013
Pre-Board Exam Drill: Psychiatric Nursing C
This is a 30 point Pre-Board Exam Drill on Psychiatric Nursing Set C.
Test your knowledge on nursing concepts, test your test-taking skills and develop your attitude in attacking board exam questions. Answer these questions on a piece of paper. Check your answers and don't forget to review the rationale behind the correct answer. Good luck with your exam!
1. An inpatient psychiatric client suddenly becomes loud and visibly anxious. What's the best action for the nurse to take?
a.)Summon help and escort the client to his room.
b.)Face the client squarely and say, "You must be quiet."
c.)Say, "Calm down; you're safe here."
d.)Say, "Let's go talk in your room."
2. A voluntary client on an inpatient psychiatric unit has a history of auditory hallucinations and self-aggression. The nurse is talking with the client when the client suddenly jumps up and says, to no one in particular, "Get away from me." What's the nurse's best response?
a.)Escort the client to his room.
b.)Say, "I won't let them harm you."
c.)Sit quietly until the client becomes calm.
d.)Ask, "Who are you talking to?"
3. A 35-year-old voluntary client suddenly begins yelling, throws a chair, and exhibits extreme agitation. Which of the following would be most important for the nurse to consider when planning an intervention?
a.)Because the client is a voluntary admission, restraints can't be used.
b.)The family must be called for permission to restrain the client.
c.)Restraint should be used as a last resort.
d.)Restraint can't be initiated until the physician is called.
4. Before forcing a client to take a medication, the nurse should give priority to:
a.)the client's danger to self or others.
b.)what the "voices" are saying to the client.
c.)whether the client's admission was voluntary.
d.)the client's insight into the illness.
5. A client was admitted to the hospital 2 days ago for disrupting a town meeting, shouting religious delusions, and fighting with police. The client now refuses to take prescribed haloperidol (Haldol), saying, "I don't want it." Which response by the nurse would be best?
a.)"It will help you feel better."
b.)"You must take it or get an injection."
c.)"What are you afraid of?"
d.)"You sound concerned."
6. A client has been prescribed 75 mg of amitriptyline (Elavil) at bedtime and 15 mg of phenelzine (Nardil) three times per day. Which nursing action takes priority?
a.)Teaching the client about the adverse effects
b.)Calling the physician and questioning the order
c.)Instituting dietary restrictions
d.)Taking baseline vital signs
7. A client on an inpatient psychiatric unit has been taking a tricyclic antidepressant without satisfactory results, so the physician changes to a monoamine oxidase (MAO) inhibitor. In evaluating the physician's order, the nurse must first be sure:
a.)adequate time has elapsed between discontinuing the first medication and beginning the second.
b.)the MAO inhibitor is begun at the same dosage as the tricyclic antidepressant.
c.)the client isn't suicidal.
d.)the client isn't allergic to cheese.
8. A client reports no improvement in mood since beginning a regimen of 15 mg of tranylcypromine (Parnate) twice per day 1 week ago. Which of the following is the best nursing action?
a.)Say to the client, "The medication may need up to 4 weeks to take effect." b.)Say to the client, "You should feel the effects any day now."
c.)Consult with the physician about a dosage adjustment.
d.)Consult with the physician about a change of medication.
9. A client who has been hospitalized with depression is about to be discharged with a prescription of phenelzine (Nardil). In planning for discharge, the nurse should have a teaching plan that emphasizes:
a.)getting adequate rest.
b.)avoiding smoking.
c.)avoiding red wine.
d.)taking the drug with food or milk.
10. The physician prescribes a monoamine oxidase (MAO) inhibitor for a client. Which of the following nursing diagnostic categories would be most appropriate to focus on during client teaching?
a.)Risk for injury
b.)Disturbed thought processes
c.)Deficient fluid volume
d.)Disturbed sleep pattern
11. A nurse is teaching clients in an outpatient clinic about monoamine oxidase (MAO) inhibitors. The nurse would best evaluate the clients' understanding of how their medications work by noting:
a.)food selections.
b.)fluid intake.
c.)potential for self-harm.
d.)level of anxiety.
12. A hospitalized client taking 30 mg of tranylcypromine (Parnate) twice per day complains of a stiff neck and headache. Which action would be best for the nurse to take?
a.)Note the complaints as usual adverse effects.
b.)Withhold the next dose of medication.
c.)Administer an analgesic, as needed and as prescribed.
d.)Help the client relax.
13. A client avoids leaving home to shop for groceries or complete other errands. At times the client feels "crazy" because of her fear. The client seeks out her neighbor, a nurse, for help. The nurse's assessment is phobic reaction. Which of the following statements about a phobia is true?
a.)The condition is a persistent, intrusive image that seems senseless to the person.
b.)It's important not to force the person to face the phobic object or situation. c.)The phobic condition can be cured by hypnosis.
d.)It's necessary to agree with the client's assessment that the phobia is silly.
14. A 76-year-old widowed mother of six is admitted to a long-term care facility with a diagnosis of organic mental disorder. Which of the following approaches would be most helpful for the nurse in meeting the client's needs?
a.)Make sure the client completes tasks that she begins.
b.)Maintain a gentle approach that doesn't set limits.
c.)Give the client alternative choices in making decisions.
d.)Simplify the environment as much as possible.
15. Which of the following snacks would be best for a client with anorexia nervosa who requires a high-protein, high-calorie diet?
a.)Chicken soup and crackers
b.)Doughnut and orange juice
c.)Egg salad and peanuts
d.)Cashews and strawberries
16. What's the most appropriate nursing diagnosis for a client exhibiting obsessive-compulsive behavior?
a.)Ineffective coping
b.)Imbalanced nutrition: Less than body requirements
c.)Imbalanced nutrition: More than body requirements
d.)Interrupted family processes
.
17. A 28-year-old accountant is admitted to the neurologic unit after a sudden onset of blindness the day before an important project is due for her boss. After preliminary evaluation and testing yields no positive findings, the physician's initial reaction is that the client may be demonstrating which defense mechanism?
a.)Repression
b.)Transference
c.)Reaction formation
d.)Conversion
18. A client with bipolar disorder, manic phase, who usually dresses conservatively, appears at breakfast with brightly colored cheeks, wearing a miniskirt, sheer blouse, and designer boots. Which of the following actions should the nurse take to deal with the client's attire?
a.)Redirect the client to her room and help her put on her more customary clothing. b.)Allow her the freedom to wear what she prefers for now.
c.)Remind the client of the dress code and the consequences of violation.
d.)Tell the client what to wear and advise her that she has lost the privilege of choosing her wardrobe.
19. What's the most effective intervention for handling a client with an antisocial personality?
a.)Reason with the client.
b.)Set limits with the client.
c.)Ignore the client.
d.)Agree with the client.
20. A client on the nursing unit, charged with child abuse, doesn't speak to the staff when approached. Which response by the nurse would be best?
a.)"If you need me, I'll be in the nurses' station."
b.)"You need to come to grips with what has happened."
c.)"Not speaking to the staff won't help your situation."
d.)"Admission to a psychiatric unit can be very difficult."
21. After refusing to eat for 4 days, a 17-year-old college freshman is referred to the inpatient eating disorders unit of a general hospital. Her affect is flat, her eyes downcast, and her long blonde hair dull and limp. Her clothes hang loosely on her body, and she appears sullen and frightened. Her weight on admission is 89 lb (40.4 kg); her normal weight is 114 lb (52 kg). Which of the following assessments would best enable the nurse to develop a specific nursing diagnosis?
a.)Family history, including genograms
b.)Psychiatric history, including all hospital admissions
c.)Cardiac and respiratory history
d.)Weight loss history and general condition of skin, hair, and nails
22. A client is admitted for a suspected eating disorder. Which of the following statements would indicate that the client may be suffering from anorexia nervosa? a.)"I've gained 3 pounds in the last month."
b.)"I eat loads of spinach and yellow vegetables each day."
c.)"I'm a perfectionist, and I work hard to get A's."
d.)"I binge frequently in the morning and feel fat."
23. Which of the following nursing interventions would be included in the care of a client with anorexia nervosa as therapy progresses?
a.)Let the client eat alone to avoid embarrassment.
b.)Weigh the client once a week in the same clothing.
c.)Monitor the client for self-destructive tendencies.
d.)Praise the client for "looking better," and remind the client that she isn't "too fat."
24. A client with a personality disorder exhibits manipulative behavior. Care planning for this client should include:
a.)freedom to do as the client chooses when behavior improves.
b.)limitations per unit rules without restrictions for broken rules.
c.)reasonable expectations with varying limits.
d.)verbal reinforcement when the client functions within established limits.
25. A 40-year-old woman is brought to the hospital by her husband, who states that she has refused to eat or get out of bed for 2 days. The woman says that she's tired all the time and doesn't feel up to going to work. Her admitting diagnosis is major depression. Which question would be most appropriate for the admitting nurse to ask?
a.)"What has been troubling you?"
b.)"Why do you dislike yourself?"
c.)"How do you feel about your life?"
d.)"What can we do to help?"
26. A 24-year-old secretary is transferred to your psychiatric unit. Her husband says that she has been overeating and that she vomits soon after she eats. Her weight stays about the same, at 96 lb (44 kg). In planning care for the client, the nurse should anticipate which medical diagnosis?
a.)Anorexia nervosa
b.)Bulimia
c.)Klein-Levin syndrome
d.)Dysthymia
27. For a client with bulimia, which assessment is least important in the care plan? a.)Observe the client after eating for 1 hour.
b.)Note the client's intake.
c.)Note changes in appetite.
d.)Note changes in respiratory rate.
28. A client with personality disorder gets along poorly with the immediate family. The client's manipulative behavior most likely shows a failure to develop:
a.)intimate relationships.
b.)trust.
c.)industry.
d.)feelings of guilt.
29. A 32-year-old client is admitted to the unit. She states, "I'm a well-known, wealthy designer," and begins to order the nurses to prepare her bath while she orders her tray and telephones her colleagues. Her husband states that she's too busy to eat and sleep and is losing weight. Her admitting diagnosis is bipolar disorder, manic phase. For which of the following events should the nurse plan?
a.)Erratic and unpredictable behavior if challenged
b.)Boredom and the need for minute-to-minute activities
c.)Rapid mood changes from elation to depression
d.)One-to-one treatment to occupy the client's time
30. A 32-year-old lawyer is admitted to the neurologic unit with a sudden onset of blindness the night before an important case is scheduled to go to trial. Tests reveal no physical findings. Which of the following is the best assessment of the client's anxiety? a.)It's diffuse and free floating.
b.)It's consciously experienced.
c.)It's localized and relieved by the blindness.
d.)It's projected onto the environment.
Test your knowledge on nursing concepts, test your test-taking skills and develop your attitude in attacking board exam questions. Answer these questions on a piece of paper. Check your answers and don't forget to review the rationale behind the correct answer. Good luck with your exam!
1. An inpatient psychiatric client suddenly becomes loud and visibly anxious. What's the best action for the nurse to take?
a.)Summon help and escort the client to his room.
b.)Face the client squarely and say, "You must be quiet."
c.)Say, "Calm down; you're safe here."
d.)Say, "Let's go talk in your room."
2. A voluntary client on an inpatient psychiatric unit has a history of auditory hallucinations and self-aggression. The nurse is talking with the client when the client suddenly jumps up and says, to no one in particular, "Get away from me." What's the nurse's best response?
a.)Escort the client to his room.
b.)Say, "I won't let them harm you."
c.)Sit quietly until the client becomes calm.
d.)Ask, "Who are you talking to?"
3. A 35-year-old voluntary client suddenly begins yelling, throws a chair, and exhibits extreme agitation. Which of the following would be most important for the nurse to consider when planning an intervention?
a.)Because the client is a voluntary admission, restraints can't be used.
b.)The family must be called for permission to restrain the client.
c.)Restraint should be used as a last resort.
d.)Restraint can't be initiated until the physician is called.
4. Before forcing a client to take a medication, the nurse should give priority to:
a.)the client's danger to self or others.
b.)what the "voices" are saying to the client.
c.)whether the client's admission was voluntary.
d.)the client's insight into the illness.
5. A client was admitted to the hospital 2 days ago for disrupting a town meeting, shouting religious delusions, and fighting with police. The client now refuses to take prescribed haloperidol (Haldol), saying, "I don't want it." Which response by the nurse would be best?
a.)"It will help you feel better."
b.)"You must take it or get an injection."
c.)"What are you afraid of?"
d.)"You sound concerned."
6. A client has been prescribed 75 mg of amitriptyline (Elavil) at bedtime and 15 mg of phenelzine (Nardil) three times per day. Which nursing action takes priority?
a.)Teaching the client about the adverse effects
b.)Calling the physician and questioning the order
c.)Instituting dietary restrictions
d.)Taking baseline vital signs
7. A client on an inpatient psychiatric unit has been taking a tricyclic antidepressant without satisfactory results, so the physician changes to a monoamine oxidase (MAO) inhibitor. In evaluating the physician's order, the nurse must first be sure:
a.)adequate time has elapsed between discontinuing the first medication and beginning the second.
b.)the MAO inhibitor is begun at the same dosage as the tricyclic antidepressant.
c.)the client isn't suicidal.
d.)the client isn't allergic to cheese.
8. A client reports no improvement in mood since beginning a regimen of 15 mg of tranylcypromine (Parnate) twice per day 1 week ago. Which of the following is the best nursing action?
a.)Say to the client, "The medication may need up to 4 weeks to take effect." b.)Say to the client, "You should feel the effects any day now."
c.)Consult with the physician about a dosage adjustment.
d.)Consult with the physician about a change of medication.
9. A client who has been hospitalized with depression is about to be discharged with a prescription of phenelzine (Nardil). In planning for discharge, the nurse should have a teaching plan that emphasizes:
a.)getting adequate rest.
b.)avoiding smoking.
c.)avoiding red wine.
d.)taking the drug with food or milk.
10. The physician prescribes a monoamine oxidase (MAO) inhibitor for a client. Which of the following nursing diagnostic categories would be most appropriate to focus on during client teaching?
a.)Risk for injury
b.)Disturbed thought processes
c.)Deficient fluid volume
d.)Disturbed sleep pattern
11. A nurse is teaching clients in an outpatient clinic about monoamine oxidase (MAO) inhibitors. The nurse would best evaluate the clients' understanding of how their medications work by noting:
a.)food selections.
b.)fluid intake.
c.)potential for self-harm.
d.)level of anxiety.
12. A hospitalized client taking 30 mg of tranylcypromine (Parnate) twice per day complains of a stiff neck and headache. Which action would be best for the nurse to take?
a.)Note the complaints as usual adverse effects.
b.)Withhold the next dose of medication.
c.)Administer an analgesic, as needed and as prescribed.
d.)Help the client relax.
13. A client avoids leaving home to shop for groceries or complete other errands. At times the client feels "crazy" because of her fear. The client seeks out her neighbor, a nurse, for help. The nurse's assessment is phobic reaction. Which of the following statements about a phobia is true?
a.)The condition is a persistent, intrusive image that seems senseless to the person.
b.)It's important not to force the person to face the phobic object or situation. c.)The phobic condition can be cured by hypnosis.
d.)It's necessary to agree with the client's assessment that the phobia is silly.
14. A 76-year-old widowed mother of six is admitted to a long-term care facility with a diagnosis of organic mental disorder. Which of the following approaches would be most helpful for the nurse in meeting the client's needs?
a.)Make sure the client completes tasks that she begins.
b.)Maintain a gentle approach that doesn't set limits.
c.)Give the client alternative choices in making decisions.
d.)Simplify the environment as much as possible.
15. Which of the following snacks would be best for a client with anorexia nervosa who requires a high-protein, high-calorie diet?
a.)Chicken soup and crackers
b.)Doughnut and orange juice
c.)Egg salad and peanuts
d.)Cashews and strawberries
16. What's the most appropriate nursing diagnosis for a client exhibiting obsessive-compulsive behavior?
a.)Ineffective coping
b.)Imbalanced nutrition: Less than body requirements
c.)Imbalanced nutrition: More than body requirements
d.)Interrupted family processes
.
17. A 28-year-old accountant is admitted to the neurologic unit after a sudden onset of blindness the day before an important project is due for her boss. After preliminary evaluation and testing yields no positive findings, the physician's initial reaction is that the client may be demonstrating which defense mechanism?
a.)Repression
b.)Transference
c.)Reaction formation
d.)Conversion
18. A client with bipolar disorder, manic phase, who usually dresses conservatively, appears at breakfast with brightly colored cheeks, wearing a miniskirt, sheer blouse, and designer boots. Which of the following actions should the nurse take to deal with the client's attire?
a.)Redirect the client to her room and help her put on her more customary clothing. b.)Allow her the freedom to wear what she prefers for now.
c.)Remind the client of the dress code and the consequences of violation.
d.)Tell the client what to wear and advise her that she has lost the privilege of choosing her wardrobe.
19. What's the most effective intervention for handling a client with an antisocial personality?
a.)Reason with the client.
b.)Set limits with the client.
c.)Ignore the client.
d.)Agree with the client.
20. A client on the nursing unit, charged with child abuse, doesn't speak to the staff when approached. Which response by the nurse would be best?
a.)"If you need me, I'll be in the nurses' station."
b.)"You need to come to grips with what has happened."
c.)"Not speaking to the staff won't help your situation."
d.)"Admission to a psychiatric unit can be very difficult."
21. After refusing to eat for 4 days, a 17-year-old college freshman is referred to the inpatient eating disorders unit of a general hospital. Her affect is flat, her eyes downcast, and her long blonde hair dull and limp. Her clothes hang loosely on her body, and she appears sullen and frightened. Her weight on admission is 89 lb (40.4 kg); her normal weight is 114 lb (52 kg). Which of the following assessments would best enable the nurse to develop a specific nursing diagnosis?
a.)Family history, including genograms
b.)Psychiatric history, including all hospital admissions
c.)Cardiac and respiratory history
d.)Weight loss history and general condition of skin, hair, and nails
22. A client is admitted for a suspected eating disorder. Which of the following statements would indicate that the client may be suffering from anorexia nervosa? a.)"I've gained 3 pounds in the last month."
b.)"I eat loads of spinach and yellow vegetables each day."
c.)"I'm a perfectionist, and I work hard to get A's."
d.)"I binge frequently in the morning and feel fat."
23. Which of the following nursing interventions would be included in the care of a client with anorexia nervosa as therapy progresses?
a.)Let the client eat alone to avoid embarrassment.
b.)Weigh the client once a week in the same clothing.
c.)Monitor the client for self-destructive tendencies.
d.)Praise the client for "looking better," and remind the client that she isn't "too fat."
24. A client with a personality disorder exhibits manipulative behavior. Care planning for this client should include:
a.)freedom to do as the client chooses when behavior improves.
b.)limitations per unit rules without restrictions for broken rules.
c.)reasonable expectations with varying limits.
d.)verbal reinforcement when the client functions within established limits.
25. A 40-year-old woman is brought to the hospital by her husband, who states that she has refused to eat or get out of bed for 2 days. The woman says that she's tired all the time and doesn't feel up to going to work. Her admitting diagnosis is major depression. Which question would be most appropriate for the admitting nurse to ask?
a.)"What has been troubling you?"
b.)"Why do you dislike yourself?"
c.)"How do you feel about your life?"
d.)"What can we do to help?"
26. A 24-year-old secretary is transferred to your psychiatric unit. Her husband says that she has been overeating and that she vomits soon after she eats. Her weight stays about the same, at 96 lb (44 kg). In planning care for the client, the nurse should anticipate which medical diagnosis?
a.)Anorexia nervosa
b.)Bulimia
c.)Klein-Levin syndrome
d.)Dysthymia
27. For a client with bulimia, which assessment is least important in the care plan? a.)Observe the client after eating for 1 hour.
b.)Note the client's intake.
c.)Note changes in appetite.
d.)Note changes in respiratory rate.
28. A client with personality disorder gets along poorly with the immediate family. The client's manipulative behavior most likely shows a failure to develop:
a.)intimate relationships.
b.)trust.
c.)industry.
d.)feelings of guilt.
29. A 32-year-old client is admitted to the unit. She states, "I'm a well-known, wealthy designer," and begins to order the nurses to prepare her bath while she orders her tray and telephones her colleagues. Her husband states that she's too busy to eat and sleep and is losing weight. Her admitting diagnosis is bipolar disorder, manic phase. For which of the following events should the nurse plan?
a.)Erratic and unpredictable behavior if challenged
b.)Boredom and the need for minute-to-minute activities
c.)Rapid mood changes from elation to depression
d.)One-to-one treatment to occupy the client's time
30. A 32-year-old lawyer is admitted to the neurologic unit with a sudden onset of blindness the night before an important case is scheduled to go to trial. Tests reveal no physical findings. Which of the following is the best assessment of the client's anxiety? a.)It's diffuse and free floating.
b.)It's consciously experienced.
c.)It's localized and relieved by the blindness.
d.)It's projected onto the environment.
Saturday, December 21, 2013
Pre-Board Exam Drill: Psychiatric Nursing B
This is a 30 point Pre-Board Exam Drill on Psychiatric Nursing Set B.
Test your knowledge on nursing concepts, test your test-taking skills and develop your attitude in attacking board exam questions. Answer these questions on a piece of paper. Check your answers and don't forget to review the rationale behind the correct answer. Good luck with your exam!
1. The nurse must administer a medication to reverse or prevent Parkinson-type symptoms in a client receiving an antipsychotic. The medication the client will likely receive is:
a.)benztropine (Cogentin).
b.)diphenhydramine (Benadryl).
c.)propranolol (Inderal).
d.)haloperidol (Haldol).
2. The nurse is providing care for a female client with a history of schizophrenia who is experiencing hallucinations. The physician orders 200 mg of haloperidol (Haldol) orally or I.M. every 4 hours as needed. What's the nurse's best action?
a.)Administer the haloperidol orally if the client agrees to take it.
b.)Call the physician to clarify whether the haloperidol should be given orally or I.M.
c.)Call the physician to clarify the order because the dosage is too high.
d.)Withhold haloperidol because it may worsen hallucinations.
3. The nurse is providing care to a client with catatonic type of schizophrenia who exhibits extreme negativism. To help the client meet his basic needs, the nurse should:
a.)ask the client which activity he would prefer to do first.
b.)negotiate a time when the client will perform activities.
c.)tell the client specifically and concisely what needs to be done.
d.)prepare the client ahead of time for the activity.
4. Which information is most important for the nurse to include in a teaching plan for a schizophrenic client taking clozapine (Clozaril)?
a.)Monthly blood tests will be necessary.
b.)Report a sore throat or fever to the physician immediately.
c.)Blood pressure must be monitored for hypertension.
d.)Stop the medication when symptoms subside.
5. A client with manic episodes is taking lithium. Which electrolyte level should the nurse check before administering this medication?
a.)Calcium
b.)Sodium
c.)Chloride
d.)Potassium
6. A client is admitted to the inpatient unit of the mental health center with a diagnosis of paranoid schizophrenia. He's shouting that the government of France is trying to assassinate him. Which of the following responses is most appropriate?
a.)"I think you're wrong. France is a friendly country and an ally of the United States. Their government wouldn't try to kill you."
b.)"I find it hard to believe that a foreign government or anyone else is trying to hurt you. You must feel frightened by this."
c.)"You're wrong. Nobody is trying to kill you."
d.)"A foreign government is trying to kill you? Please tell me more about it."
7. A client has been receiving chlorpromazine (Thorazine), an antipsychotic, to treat his psychosis. Which finding should alert the nurse that the client is experiencing pseudoparkinsonism?
a.)Restlessness, difficulty sitting still, pacing
b.)Involuntary rolling of the eyes
c.)Tremors, shuffling gait, masklike face
d.)Extremity and neck spasms, facial grimacing, jerky movements
8. A 54-year-old female was found unconscious on the floor of her bathroom with self-inflicted wrist lacerations. An ambulance was called and the client was taken to the emergency department. When she was stable, the client was transferred to the inpatient psychiatric unit for observation and treatment with antidepressants. Now that the client is feeling better, which nursing intervention is most appropriate?
a.)Observing for extrapyramidal symptoms
b.)Beginning a therapeutic relationship
c.)Canceling any no-suicide contracts
d.)Continuing suicide precautions
9. A 26-year-old male reports losing his sight in both eyes. He's diagnosed as having a conversion disorder and is admitted to the psychiatric unit. Which nursing intervention would be most appropriate for this client?
a.)Not focusing on his blindness
b.)Providing self-care for him
c.)Telling him that his blindness isn't real
d.)Teaching eye exercises to strengthen his eyes
10. A client has a diagnosis of borderline personality disorder. She has attached herself to one nurse and refuses to speak with other staff members. She tells the nurse that the other nurses are mean, withhold her medication, and mistreat her. The staff is discussing this problem at their weekly conference. Which intervention would be most appropriate for the nursing staff to implement?
a.)Provide an unstructured environment for the client.
b.)Rotate the nurses who are assigned to the client.
c.)Ignore the client's behaviors.
d.)Bend unit rules to meet the client's needs.
11. A client is being admitted to the substance abuse unit for alcohol detoxification. As part of the intake interview, the nurse asks him when he had his last alcoholic drink. He says that he had his last drink 6 hours before admission. Based on this response, the nurse should expect early withdrawal symptoms to:
a.)not occur at all because the time period for their occurrence has passed.
b.)begin anytime within the next 1 to 2 days.
c.)begin within 2 to 7 days.
d.)begin after 7 days.
12. The nurse in the substance abuse unit is trying to encourage a client to attend Alcoholics Anonymous (AA) meetings. When the client asks the nurse what he must do to become a member, the nurse should respond:
a.)You must first stop drinking.
b.)Your physician must refer you to this program.
c.)Admit you're powerless over alcohol and that you need help.
d.)You must bring along a friend who will support you.
13. The nurse is assessing a 15-year-old female who is being admitted for treatment of anorexia nervosa. Which clinical manifestation is the nurse most likely to find?
a.)Tachycardia
b.)Warm, flushed extremities
c.)Parotid gland tenderness
d.)Coarse hair growth
14. The nurse is assessing an adult's developmental stage. The nurse should consider: a.)height and weight.
b.)blood pressure.
c.)previous problem-solving strategies.
d.)pulse rate.
15. Which of the following factors would have the most influence on the outcome of a crisis situation?
a.)Age
b.)Previous coping skills
c.)Self-esteem
d.)Perception of the problem
16. The nurse is caring for an elderly client in a long-term care facility. The client has a history of attempted suicide. The nurse observes the client giving away personal belongings and has heard the client express feelings of hopelessness to other residents. Which intervention should the nurse perform first?
a.)Setting aside time to listen to the client
b.)Removing items that the client could use in a suicide attempt
c.)Communicating a nonjudgmental attitude
d.)Referring the client to a mental health professional
17. The nurse is caring for an adolescent female who reports amenorrhea, weight loss, and depression. Which additional assessment finding would suggest that the woman has an eating disorder?
a.)Wearing tight-fitting clothing
b.)Increased blood pressure
c.)Oily skin
d.)Excessive and ritualized exercise
18. A high school student is referred to the school nurse for suspected substance abuse. Following the nurse's assessment and interventions, what would be the most desirable outcome?
a.)The student discusses conflicts over drug use.
b.)The student accepts a referral to a substance abuse counselor.
c.)The student agrees to inform his parents of the problem.
d.)The student reports increased comfort with making choices.
19. The nurse is using drawing, puppetry, and other forms of play therapy while treating a terminally ill, school-age child. The purpose of these techniques is to help the child: a.)internalize his feelings about death and dying.
b.)accept responsibility for his situation.
c.)express feelings that he can't articulate.
d.)have a good time while he's in the hospital.
20. The nurse is working with a client who abuses alcohol. Which of the following facts should the nurse communicate to the client?
a.)Abstinence is the basis for successful treatment.
b.)Attendance at Alcoholics Anonymous (AA) meetings every day will cure alcoholism.
c.)For treatment to be successful, family members must participate.
d.)An occasional social drink is acceptable behavior for the alcoholic.
21. A client exhibits the following defining characteristics: denial of problems that are evident to others, expressions of shame or guilt, perceptions of self as being unable to deal with events, and projection of blame or responsibility for problems onto others. How would a nurse diagnose this client?
a.)Anxiety
b.)Chronic low self-esteem
c.)Ineffective denial
d.)Ineffective individual coping
22. What herbal medication for depression, widely used in Europe, is now being introduced in the Philippines and in the United States?
a.)Ginkgo biloba
b.)Echinacea
c.)St. John's wort
d.)Ephedra
23. The nurse is caring for a client with bulimia. Strict management of dietary intake is necessary. Which intervention is also important?
a.)Fill out the client's menu and make sure she eats at least half of what's on her tray.
b.)Let the client eat her meals in private then engage her in social activities for at least 2 hours after each meal.
c.)Let the client choose her own food. If she eats everything she orders, then stay with her for 1 hour after each meal.
d.)Let the client eat food brought in by the family if she chooses, but keep a strict calorie count.
24. A 15-year-old client is brought to the clinic by her mother. Her mother expresses concern about her daughter's weight loss and constant dieting. The nurse conducts a health history interview. Which of the following comments indicates that the client may be suffering from anorexia nervosa?
a.)"I like the way I look. I just need to keep my weight down because I'm a cheerleader."
b.)"I don't like the food my mother cooks. I eat plenty of fast food when I'm out with my friends."
c.)"I just can't seem to get down to the weight I want to be. I'm so fat compared to other girls."
d.)"I do diet around my periods, otherwise I just get so bloated.”
25. Which psychological or personality factors are most likely to predispose an individual to medication abuse?
a.)Low self-esteem and unresolved rage
b.)Desire to inflict pain upon oneself
c.)Obsessive-compulsive disorder
d.)Codependency
26. A client chronically complains of being unappreciated and misunderstood by others. She's argumentative and sullen. She always blames others for her failure to complete work assignments. She expresses feelings of envy toward people she perceives as more fortunate. She voices exaggerated complaints of personal misfortune. The client most likely suffers from which of the following personality disorders?
a.)Dependent personality
b.)Passive-aggressive personality
c.)Avoidant personality disorder
d.)Obsessive-compulsive disorder
27. A client diagnosed with depression tells the nurse, "I won't allow myself to cry because it upsets the whole family when I cry." This is an example of:
a.)manipulation.
b.)insight.
c.)rationalization.
d.)repression.
28. A client diagnosed with major depression has started taking amitriptyline (Elavil), a tricyclic antidepressant. What's a common adverse effect of this drug?
a.)Weight loss
b.)Dry mouth
c.)Increased blood pressure
d.)Muscle spasms
29. A client has received treatment for depression for 3 weeks. Which behavior suggests that the client is recovering from depression?
a.)The client talks about the difficulties of returning to college after discharge.
b.)The client spends most of the day sitting alone in the corner of the room.
c.)The client wears a hospital gown instead of street clothes.
d.)The client shows no emotion when visitors leave.
30. A client in the manic phase of bipolar disorder constantly belittles other clients and demands special favors from the nurses. Which nursing intervention would be most appropriate for this client?
a.)Ask other clients and staff members to ignore the client's behavior.
b.)Set limits with consequences for belittling or demanding behavior.
c.)Offer the client an antianxiety drug when belittling or demanding behavior occurs.
d.)Offer the client a variety of stimulating activities to distract him from belittling or making demands of others.
Test your knowledge on nursing concepts, test your test-taking skills and develop your attitude in attacking board exam questions. Answer these questions on a piece of paper. Check your answers and don't forget to review the rationale behind the correct answer. Good luck with your exam!
1. The nurse must administer a medication to reverse or prevent Parkinson-type symptoms in a client receiving an antipsychotic. The medication the client will likely receive is:
a.)benztropine (Cogentin).
b.)diphenhydramine (Benadryl).
c.)propranolol (Inderal).
d.)haloperidol (Haldol).
2. The nurse is providing care for a female client with a history of schizophrenia who is experiencing hallucinations. The physician orders 200 mg of haloperidol (Haldol) orally or I.M. every 4 hours as needed. What's the nurse's best action?
a.)Administer the haloperidol orally if the client agrees to take it.
b.)Call the physician to clarify whether the haloperidol should be given orally or I.M.
c.)Call the physician to clarify the order because the dosage is too high.
d.)Withhold haloperidol because it may worsen hallucinations.
3. The nurse is providing care to a client with catatonic type of schizophrenia who exhibits extreme negativism. To help the client meet his basic needs, the nurse should:
a.)ask the client which activity he would prefer to do first.
b.)negotiate a time when the client will perform activities.
c.)tell the client specifically and concisely what needs to be done.
d.)prepare the client ahead of time for the activity.
4. Which information is most important for the nurse to include in a teaching plan for a schizophrenic client taking clozapine (Clozaril)?
a.)Monthly blood tests will be necessary.
b.)Report a sore throat or fever to the physician immediately.
c.)Blood pressure must be monitored for hypertension.
d.)Stop the medication when symptoms subside.
5. A client with manic episodes is taking lithium. Which electrolyte level should the nurse check before administering this medication?
a.)Calcium
b.)Sodium
c.)Chloride
d.)Potassium
6. A client is admitted to the inpatient unit of the mental health center with a diagnosis of paranoid schizophrenia. He's shouting that the government of France is trying to assassinate him. Which of the following responses is most appropriate?
a.)"I think you're wrong. France is a friendly country and an ally of the United States. Their government wouldn't try to kill you."
b.)"I find it hard to believe that a foreign government or anyone else is trying to hurt you. You must feel frightened by this."
c.)"You're wrong. Nobody is trying to kill you."
d.)"A foreign government is trying to kill you? Please tell me more about it."
7. A client has been receiving chlorpromazine (Thorazine), an antipsychotic, to treat his psychosis. Which finding should alert the nurse that the client is experiencing pseudoparkinsonism?
a.)Restlessness, difficulty sitting still, pacing
b.)Involuntary rolling of the eyes
c.)Tremors, shuffling gait, masklike face
d.)Extremity and neck spasms, facial grimacing, jerky movements
8. A 54-year-old female was found unconscious on the floor of her bathroom with self-inflicted wrist lacerations. An ambulance was called and the client was taken to the emergency department. When she was stable, the client was transferred to the inpatient psychiatric unit for observation and treatment with antidepressants. Now that the client is feeling better, which nursing intervention is most appropriate?
a.)Observing for extrapyramidal symptoms
b.)Beginning a therapeutic relationship
c.)Canceling any no-suicide contracts
d.)Continuing suicide precautions
9. A 26-year-old male reports losing his sight in both eyes. He's diagnosed as having a conversion disorder and is admitted to the psychiatric unit. Which nursing intervention would be most appropriate for this client?
a.)Not focusing on his blindness
b.)Providing self-care for him
c.)Telling him that his blindness isn't real
d.)Teaching eye exercises to strengthen his eyes
10. A client has a diagnosis of borderline personality disorder. She has attached herself to one nurse and refuses to speak with other staff members. She tells the nurse that the other nurses are mean, withhold her medication, and mistreat her. The staff is discussing this problem at their weekly conference. Which intervention would be most appropriate for the nursing staff to implement?
a.)Provide an unstructured environment for the client.
b.)Rotate the nurses who are assigned to the client.
c.)Ignore the client's behaviors.
d.)Bend unit rules to meet the client's needs.
11. A client is being admitted to the substance abuse unit for alcohol detoxification. As part of the intake interview, the nurse asks him when he had his last alcoholic drink. He says that he had his last drink 6 hours before admission. Based on this response, the nurse should expect early withdrawal symptoms to:
a.)not occur at all because the time period for their occurrence has passed.
b.)begin anytime within the next 1 to 2 days.
c.)begin within 2 to 7 days.
d.)begin after 7 days.
12. The nurse in the substance abuse unit is trying to encourage a client to attend Alcoholics Anonymous (AA) meetings. When the client asks the nurse what he must do to become a member, the nurse should respond:
a.)You must first stop drinking.
b.)Your physician must refer you to this program.
c.)Admit you're powerless over alcohol and that you need help.
d.)You must bring along a friend who will support you.
13. The nurse is assessing a 15-year-old female who is being admitted for treatment of anorexia nervosa. Which clinical manifestation is the nurse most likely to find?
a.)Tachycardia
b.)Warm, flushed extremities
c.)Parotid gland tenderness
d.)Coarse hair growth
14. The nurse is assessing an adult's developmental stage. The nurse should consider: a.)height and weight.
b.)blood pressure.
c.)previous problem-solving strategies.
d.)pulse rate.
15. Which of the following factors would have the most influence on the outcome of a crisis situation?
a.)Age
b.)Previous coping skills
c.)Self-esteem
d.)Perception of the problem
16. The nurse is caring for an elderly client in a long-term care facility. The client has a history of attempted suicide. The nurse observes the client giving away personal belongings and has heard the client express feelings of hopelessness to other residents. Which intervention should the nurse perform first?
a.)Setting aside time to listen to the client
b.)Removing items that the client could use in a suicide attempt
c.)Communicating a nonjudgmental attitude
d.)Referring the client to a mental health professional
17. The nurse is caring for an adolescent female who reports amenorrhea, weight loss, and depression. Which additional assessment finding would suggest that the woman has an eating disorder?
a.)Wearing tight-fitting clothing
b.)Increased blood pressure
c.)Oily skin
d.)Excessive and ritualized exercise
18. A high school student is referred to the school nurse for suspected substance abuse. Following the nurse's assessment and interventions, what would be the most desirable outcome?
a.)The student discusses conflicts over drug use.
b.)The student accepts a referral to a substance abuse counselor.
c.)The student agrees to inform his parents of the problem.
d.)The student reports increased comfort with making choices.
19. The nurse is using drawing, puppetry, and other forms of play therapy while treating a terminally ill, school-age child. The purpose of these techniques is to help the child: a.)internalize his feelings about death and dying.
b.)accept responsibility for his situation.
c.)express feelings that he can't articulate.
d.)have a good time while he's in the hospital.
20. The nurse is working with a client who abuses alcohol. Which of the following facts should the nurse communicate to the client?
a.)Abstinence is the basis for successful treatment.
b.)Attendance at Alcoholics Anonymous (AA) meetings every day will cure alcoholism.
c.)For treatment to be successful, family members must participate.
d.)An occasional social drink is acceptable behavior for the alcoholic.
21. A client exhibits the following defining characteristics: denial of problems that are evident to others, expressions of shame or guilt, perceptions of self as being unable to deal with events, and projection of blame or responsibility for problems onto others. How would a nurse diagnose this client?
a.)Anxiety
b.)Chronic low self-esteem
c.)Ineffective denial
d.)Ineffective individual coping
22. What herbal medication for depression, widely used in Europe, is now being introduced in the Philippines and in the United States?
a.)Ginkgo biloba
b.)Echinacea
c.)St. John's wort
d.)Ephedra
23. The nurse is caring for a client with bulimia. Strict management of dietary intake is necessary. Which intervention is also important?
a.)Fill out the client's menu and make sure she eats at least half of what's on her tray.
b.)Let the client eat her meals in private then engage her in social activities for at least 2 hours after each meal.
c.)Let the client choose her own food. If she eats everything she orders, then stay with her for 1 hour after each meal.
d.)Let the client eat food brought in by the family if she chooses, but keep a strict calorie count.
24. A 15-year-old client is brought to the clinic by her mother. Her mother expresses concern about her daughter's weight loss and constant dieting. The nurse conducts a health history interview. Which of the following comments indicates that the client may be suffering from anorexia nervosa?
a.)"I like the way I look. I just need to keep my weight down because I'm a cheerleader."
b.)"I don't like the food my mother cooks. I eat plenty of fast food when I'm out with my friends."
c.)"I just can't seem to get down to the weight I want to be. I'm so fat compared to other girls."
d.)"I do diet around my periods, otherwise I just get so bloated.”
25. Which psychological or personality factors are most likely to predispose an individual to medication abuse?
a.)Low self-esteem and unresolved rage
b.)Desire to inflict pain upon oneself
c.)Obsessive-compulsive disorder
d.)Codependency
26. A client chronically complains of being unappreciated and misunderstood by others. She's argumentative and sullen. She always blames others for her failure to complete work assignments. She expresses feelings of envy toward people she perceives as more fortunate. She voices exaggerated complaints of personal misfortune. The client most likely suffers from which of the following personality disorders?
a.)Dependent personality
b.)Passive-aggressive personality
c.)Avoidant personality disorder
d.)Obsessive-compulsive disorder
27. A client diagnosed with depression tells the nurse, "I won't allow myself to cry because it upsets the whole family when I cry." This is an example of:
a.)manipulation.
b.)insight.
c.)rationalization.
d.)repression.
28. A client diagnosed with major depression has started taking amitriptyline (Elavil), a tricyclic antidepressant. What's a common adverse effect of this drug?
a.)Weight loss
b.)Dry mouth
c.)Increased blood pressure
d.)Muscle spasms
29. A client has received treatment for depression for 3 weeks. Which behavior suggests that the client is recovering from depression?
a.)The client talks about the difficulties of returning to college after discharge.
b.)The client spends most of the day sitting alone in the corner of the room.
c.)The client wears a hospital gown instead of street clothes.
d.)The client shows no emotion when visitors leave.
30. A client in the manic phase of bipolar disorder constantly belittles other clients and demands special favors from the nurses. Which nursing intervention would be most appropriate for this client?
a.)Ask other clients and staff members to ignore the client's behavior.
b.)Set limits with consequences for belittling or demanding behavior.
c.)Offer the client an antianxiety drug when belittling or demanding behavior occurs.
d.)Offer the client a variety of stimulating activities to distract him from belittling or making demands of others.
Wednesday, December 18, 2013
Pre-Board Exam Drill: Psychiatric Nursing A
This is a 30 point Pre-Board Exam Drill on Psychiatric Nursing Set A.
Test your knowledge on nursing concepts, test your test-taking skills and develop your attitude in attacking board exam questions. Answer these questions on a piece of paper. Check your answers and don't forget to review the rationale behind the correct answer. Good luck with your exam!
1. A client has approached the nurse asking for advice on how to deal with his alcohol addiction. The nurse should tell the client that the only effective treatment for alcoholism is:
a.)psychotherapy.
b.)total abstinence.
c.)Alcoholics Anonymous (AA).
d.)aversion therapy.
2. The nurse is providing care for a client undergoing opiate withdrawal. Opiate withdrawal causes severe physical discomfort and can be life-threatening. To minimize these effects, opiate users are commonly detoxified with:
a.)barbiturates.
b.)amphetamines.
c.)methadone.
d.)benzodiazepines.
C. RATIONALE: Methadone is used to detoxify opiate users because it binds with opioid receptors at many sites in the central nervous system but doesn't have the same deleterious effects as other opiates, such as cocaine, heroin, and morphine. Barbiturates, amphetamines, and benzodiazepines are highly addictive and would require detoxification treatment.
3. The nurse is caring for a client who experiences false sensory perceptions with no basis in reality. These perceptions are known as:
a.)delusions.
b.)hallucinations.
c.)loose associations.
d.)neologisms.
B. RATIONALE: Hallucinations are visual, auditory, gustatory, tactile, or olfactory perceptions that have no basis in reality. Delusions are false beliefs, rather than perceptions, that the client accepts as real. Loose associations are rapid shifts among unrelated ideas. Neologisms are bizarre words that have meaning only to the client.
4. The nurse is caring for a client who is suicidal. When accompanying the client to the bathroom, the nurse should:
a.)give him privacy in the bathroom.
b.)allow him to shave.
c.)open the window and allow him to get some fresh air.
d.)observe him.
5. The nurse is developing a care plan for a client with anorexia nervosa. Which action should the nurse include in the plan?
a.)Restrict visits with the family until the client begins to eat.
b.)Provide privacy during meals.
c.)Set up a strict eating plan for the client.
d.)Encourage the client to exercise, which will reduce her anxiety.
6. A client whose husband recently left her is admitted to the hospital with severe depression. The nurse suspects that the client is at risk for suicide. Which of the following questions would be most appropriate and helpful for the nurse to ask during an assessment for suicide risk?
a.)"Are you sure you want to kill yourself?"
b.)"I know if my husband left me, I'd want to kill myself. Is that what you think?"
c.)"How do you think you would kill yourself?"
d.)"Why don't you just look at the positives in your life?"
7. The nurse is caring for a client who she believes has been abusing opiates. Assessment findings in a client abusing opiates, such as morphine, include:
a.)dilated pupils and slurred speech.
b.)rapid speech and agitation.
c.)dilated pupils and agitation.
d.)euphoria and constricted pupils.
8. The nurse is caring for a client experiencing an anxiety attack. Appropriate nursing interventions include:
a.)turning on the lights and opening the windows so that the client doesn't feel crowded. b.)leaving the client alone.
c.)staying with the client and speaking in short sentences.
d.)turning on stereo music.
9. The nurse is teaching a new group of mental health aides. The nurse should teach the aides that setting limits is most important for:
a.)a depressed client.
b.)a manic client.
c.)a suicidal client.
d.)an anxious client.
10. A client is admitted with a diagnosis of delusions of grandeur. This diagnosis reflects a belief that one is:
a.)highly important or famous.
b.)being persecuted.
c.)connected to events unrelated to oneself.
d.)responsible for the evil in the world.
11. The nurse is caring for a client, a Vietnam veteran, who exhibits signs and symptoms of posttraumatic stress disorder. Signs and symptoms of posttraumatic stress disorder include:
a.)hyperalertness and sleep disturbances.
b.)memory loss of traumatic event and somatic distress.
c.)feelings of hostility and violent behavior.
d.)sudden behavioral changes and anorexia.
12. The nurse is caring for a client with manic depression. The care plan for a client in a manic state would include:
a.)offering high-calorie meals and strongly encouraging the client to finish all food.
b.)insisting that the client remain active throughout the day so that he'll sleep at night. c.)allowing the client to exhibit hyperactive, demanding, manipulative behavior without setting limits.
d.)listening attentively with a neutral attitude and avoiding power struggles.
13. A client is a Vietnam War veteran with a diagnosis of posttraumatic stress disorder. He has a history of nightmares, depression, hopelessness, and alcohol abuse. Which option offers the client the most lasting relief of his symptoms?
a.)The opportunity to verbalize memories of trauma to a sympathetic listener b.)Family support
c.)Prescribed medications taken as ordered
d.)Alcoholics Anonymous (AA) meetings
14. A client is admitted for detoxification after a cocaine overdose. The client tells the nurse that he frequently uses cocaine but that he can control his use if he chooses. Which coping mechanism is he using?
a.)Withdrawal
b.)Logical thinking
c.)Repression
d.)Denial
15. A 22-year-old client is diagnosed with dependent personality disorder. Which behavior is most likely evidence of ineffective individual coping?
a.)Inability to make choices and decisions without advice
b.)Showing interest only in solitary activities
c.)Avoiding developing relationships
d.)Recurrent self-destructive behavior with history of depression
16. The major goal of therapy in crisis intervention is to:
a.)withdraw from the stress.
b.)resolve the immediate problem.
c.)decrease anxiety.
d.)provide documentation of events.
17. A 38-year-old client is admitted for alcohol withdrawal. The most common early sign or symptom that this client is likely to experience is:
a.)impending coma.
b.)manipulating behavior.
c.)suppression.
d.)perceptual disorders.
18. A client is admitted with a diagnosis of schizotypal personality disorder. Which signs would this client exhibit during social situations?
a.)Aggressive behavior
b.)Paranoid thoughts
c.)Emotional affect
d.)Independence needs
19. The nurse is caring for a client in an acute manic state. What's the most effective nursing action for this client?
a.)Assigning him to group activities
b.)Reducing his stimulation
c.)Assisting him with self-care
d.)Helping him express his feelings
20. The nurse is caring for a client diagnosed with bulimia. The most appropriate initial goal for a client diagnosed with bulimia is to:
a.)avoid shopping for large amounts of food.
b.)control eating impulses.
c.)identify anxiety-causing situations.
d.)eat only three meals per day.
21. The nurse is caring for a 40-year-old client. Which behavior by the client indicates adult cognitive development?
a.)Has perceptions based on reality
b.)Assumes responsibility for actions
c.)Generates new levels of awareness
d.)Has maximum ability to solve problems and learn new skills
22. The nurse is assessing a client suffering from stress and anxiety. A common physiological response to stress and anxiety is:
a.)sedation.
b.)diarrhea.
c.)vertigo.
d.)urticaria.
23. The nurse is assessing a client for lifestyle factors that might affect normal coping. Which factor would the nurse most likely consider?
a.)Inadequate diet
b.)Divorce
c.)Job promotion
d.)Adopting a child
24. A client with bipolar disorder is being treated with lithium for the first time. The nurse should observe the client for which common adverse effect of lithium?
a.)Sexual dysfunction
b.)Constipation
c.)Polyuria
d.)Seizures
25. A client is admitted for an overdose of amphetamines. When assessing this client, the nurse should expect to see:
a.)tension and irritability.
b.)slow pulse.
c.)hypotension.
d.)constipation.
26. During a shift report, the nurse learns that she'll be providing care for a client who is vulnerable to panic attack. Treatment for panic attacks includes behavioral therapy, supportive psychotherapy, and medication such as:
a.)barbiturates.
b.)antianxiety drugs.
c.)depressants.
d.)amphetamines.
27. A client comes to the emergency department while experiencing a panic attack. The nurse can best respond to a client having a panic attack by:
a.)staying with the client until the attack subsides.
b.)telling the client everything is under control.
c.)telling the client to lie down and rest.
d.)talking continually to the client by explaining what's happening.
28. A 24-year-old client is experiencing an acute schizophrenic episode. He has vivid hallucinations that are making him agitated. The nurse's best response at this time would be to:
a.)take the client's vital signs.
b.)explore the content of the hallucinations.
c.)tell him his fear is unrealistic.
d.)engage the client in reality-oriented activities.
29. A client with paranoid type schizophrenia becomes angry and tells the nurse to leave him alone. The nurse should:
a.)tell him that she'll leave for now but will return soon.
b.)ask him if it's okay if she sits quietly with him.
c.)ask him why he wants to be left alone.
d.)tell him that she won't let anything happen to him.
30. A client begins taking haloperidol (Haldol). After a few days, he experiences severe tonic contractures of muscles in the neck, mouth, and tongue. The nurse should recognize this as:
a.)psychotic symptoms.
b.)parkinsonism.
c.)akathisia.
d.)dystonia.
Test your knowledge on nursing concepts, test your test-taking skills and develop your attitude in attacking board exam questions. Answer these questions on a piece of paper. Check your answers and don't forget to review the rationale behind the correct answer. Good luck with your exam!
1. A client has approached the nurse asking for advice on how to deal with his alcohol addiction. The nurse should tell the client that the only effective treatment for alcoholism is:
a.)psychotherapy.
b.)total abstinence.
c.)Alcoholics Anonymous (AA).
d.)aversion therapy.
2. The nurse is providing care for a client undergoing opiate withdrawal. Opiate withdrawal causes severe physical discomfort and can be life-threatening. To minimize these effects, opiate users are commonly detoxified with:
a.)barbiturates.
b.)amphetamines.
c.)methadone.
d.)benzodiazepines.
C. RATIONALE: Methadone is used to detoxify opiate users because it binds with opioid receptors at many sites in the central nervous system but doesn't have the same deleterious effects as other opiates, such as cocaine, heroin, and morphine. Barbiturates, amphetamines, and benzodiazepines are highly addictive and would require detoxification treatment.
3. The nurse is caring for a client who experiences false sensory perceptions with no basis in reality. These perceptions are known as:
a.)delusions.
b.)hallucinations.
c.)loose associations.
d.)neologisms.
B. RATIONALE: Hallucinations are visual, auditory, gustatory, tactile, or olfactory perceptions that have no basis in reality. Delusions are false beliefs, rather than perceptions, that the client accepts as real. Loose associations are rapid shifts among unrelated ideas. Neologisms are bizarre words that have meaning only to the client.
4. The nurse is caring for a client who is suicidal. When accompanying the client to the bathroom, the nurse should:
a.)give him privacy in the bathroom.
b.)allow him to shave.
c.)open the window and allow him to get some fresh air.
d.)observe him.
5. The nurse is developing a care plan for a client with anorexia nervosa. Which action should the nurse include in the plan?
a.)Restrict visits with the family until the client begins to eat.
b.)Provide privacy during meals.
c.)Set up a strict eating plan for the client.
d.)Encourage the client to exercise, which will reduce her anxiety.
6. A client whose husband recently left her is admitted to the hospital with severe depression. The nurse suspects that the client is at risk for suicide. Which of the following questions would be most appropriate and helpful for the nurse to ask during an assessment for suicide risk?
a.)"Are you sure you want to kill yourself?"
b.)"I know if my husband left me, I'd want to kill myself. Is that what you think?"
c.)"How do you think you would kill yourself?"
d.)"Why don't you just look at the positives in your life?"
7. The nurse is caring for a client who she believes has been abusing opiates. Assessment findings in a client abusing opiates, such as morphine, include:
a.)dilated pupils and slurred speech.
b.)rapid speech and agitation.
c.)dilated pupils and agitation.
d.)euphoria and constricted pupils.
8. The nurse is caring for a client experiencing an anxiety attack. Appropriate nursing interventions include:
a.)turning on the lights and opening the windows so that the client doesn't feel crowded. b.)leaving the client alone.
c.)staying with the client and speaking in short sentences.
d.)turning on stereo music.
9. The nurse is teaching a new group of mental health aides. The nurse should teach the aides that setting limits is most important for:
a.)a depressed client.
b.)a manic client.
c.)a suicidal client.
d.)an anxious client.
10. A client is admitted with a diagnosis of delusions of grandeur. This diagnosis reflects a belief that one is:
a.)highly important or famous.
b.)being persecuted.
c.)connected to events unrelated to oneself.
d.)responsible for the evil in the world.
11. The nurse is caring for a client, a Vietnam veteran, who exhibits signs and symptoms of posttraumatic stress disorder. Signs and symptoms of posttraumatic stress disorder include:
a.)hyperalertness and sleep disturbances.
b.)memory loss of traumatic event and somatic distress.
c.)feelings of hostility and violent behavior.
d.)sudden behavioral changes and anorexia.
12. The nurse is caring for a client with manic depression. The care plan for a client in a manic state would include:
a.)offering high-calorie meals and strongly encouraging the client to finish all food.
b.)insisting that the client remain active throughout the day so that he'll sleep at night. c.)allowing the client to exhibit hyperactive, demanding, manipulative behavior without setting limits.
d.)listening attentively with a neutral attitude and avoiding power struggles.
13. A client is a Vietnam War veteran with a diagnosis of posttraumatic stress disorder. He has a history of nightmares, depression, hopelessness, and alcohol abuse. Which option offers the client the most lasting relief of his symptoms?
a.)The opportunity to verbalize memories of trauma to a sympathetic listener b.)Family support
c.)Prescribed medications taken as ordered
d.)Alcoholics Anonymous (AA) meetings
14. A client is admitted for detoxification after a cocaine overdose. The client tells the nurse that he frequently uses cocaine but that he can control his use if he chooses. Which coping mechanism is he using?
a.)Withdrawal
b.)Logical thinking
c.)Repression
d.)Denial
15. A 22-year-old client is diagnosed with dependent personality disorder. Which behavior is most likely evidence of ineffective individual coping?
a.)Inability to make choices and decisions without advice
b.)Showing interest only in solitary activities
c.)Avoiding developing relationships
d.)Recurrent self-destructive behavior with history of depression
16. The major goal of therapy in crisis intervention is to:
a.)withdraw from the stress.
b.)resolve the immediate problem.
c.)decrease anxiety.
d.)provide documentation of events.
17. A 38-year-old client is admitted for alcohol withdrawal. The most common early sign or symptom that this client is likely to experience is:
a.)impending coma.
b.)manipulating behavior.
c.)suppression.
d.)perceptual disorders.
18. A client is admitted with a diagnosis of schizotypal personality disorder. Which signs would this client exhibit during social situations?
a.)Aggressive behavior
b.)Paranoid thoughts
c.)Emotional affect
d.)Independence needs
19. The nurse is caring for a client in an acute manic state. What's the most effective nursing action for this client?
a.)Assigning him to group activities
b.)Reducing his stimulation
c.)Assisting him with self-care
d.)Helping him express his feelings
20. The nurse is caring for a client diagnosed with bulimia. The most appropriate initial goal for a client diagnosed with bulimia is to:
a.)avoid shopping for large amounts of food.
b.)control eating impulses.
c.)identify anxiety-causing situations.
d.)eat only three meals per day.
21. The nurse is caring for a 40-year-old client. Which behavior by the client indicates adult cognitive development?
a.)Has perceptions based on reality
b.)Assumes responsibility for actions
c.)Generates new levels of awareness
d.)Has maximum ability to solve problems and learn new skills
22. The nurse is assessing a client suffering from stress and anxiety. A common physiological response to stress and anxiety is:
a.)sedation.
b.)diarrhea.
c.)vertigo.
d.)urticaria.
23. The nurse is assessing a client for lifestyle factors that might affect normal coping. Which factor would the nurse most likely consider?
a.)Inadequate diet
b.)Divorce
c.)Job promotion
d.)Adopting a child
24. A client with bipolar disorder is being treated with lithium for the first time. The nurse should observe the client for which common adverse effect of lithium?
a.)Sexual dysfunction
b.)Constipation
c.)Polyuria
d.)Seizures
25. A client is admitted for an overdose of amphetamines. When assessing this client, the nurse should expect to see:
a.)tension and irritability.
b.)slow pulse.
c.)hypotension.
d.)constipation.
26. During a shift report, the nurse learns that she'll be providing care for a client who is vulnerable to panic attack. Treatment for panic attacks includes behavioral therapy, supportive psychotherapy, and medication such as:
a.)barbiturates.
b.)antianxiety drugs.
c.)depressants.
d.)amphetamines.
27. A client comes to the emergency department while experiencing a panic attack. The nurse can best respond to a client having a panic attack by:
a.)staying with the client until the attack subsides.
b.)telling the client everything is under control.
c.)telling the client to lie down and rest.
d.)talking continually to the client by explaining what's happening.
28. A 24-year-old client is experiencing an acute schizophrenic episode. He has vivid hallucinations that are making him agitated. The nurse's best response at this time would be to:
a.)take the client's vital signs.
b.)explore the content of the hallucinations.
c.)tell him his fear is unrealistic.
d.)engage the client in reality-oriented activities.
29. A client with paranoid type schizophrenia becomes angry and tells the nurse to leave him alone. The nurse should:
a.)tell him that she'll leave for now but will return soon.
b.)ask him if it's okay if she sits quietly with him.
c.)ask him why he wants to be left alone.
d.)tell him that she won't let anything happen to him.
30. A client begins taking haloperidol (Haldol). After a few days, he experiences severe tonic contractures of muscles in the neck, mouth, and tongue. The nurse should recognize this as:
a.)psychotic symptoms.
b.)parkinsonism.
c.)akathisia.
d.)dystonia.
CH I
1. A client has approached the nurse asking for advice on how to deal with his alcohol addiction. The nurse should tell the client that the only effective treatment for alcoholism is:
a.)psychotherapy.
b.)total abstinence.
c.)Alcoholics Anonymous (AA).
d.)aversion therapy.
2. The nurse is providing care for a client undergoing opiate withdrawal. Opiate withdrawal causes severe physical discomfort and can be life-threatening. To minimize these effects, opiate users are commonly detoxified with:
a.)barbiturates.
b.)amphetamines.
c.)methadone.
d.)benzodiazepines.
3. The nurse is caring for a client who experiences false sensory perceptions with no basis in reality. These perceptions are known as:
a.)delusions.
b.)hallucinations.
c.)loose associations.
d.)neologisms.
4. The nurse is caring for a client who is suicidal. When accompanying the client to the bathroom, the nurse should:
a.)give him privacy in the bathroom.
b.)allow him to shave.
c.)open the window and allow him to get some fresh air.
d.)observe him.
5. The nurse is developing a care plan for a client with anorexia nervosa. Which action should the nurse include in the plan?
a.)Restrict visits with the family until the client begins to eat.
b.)Provide privacy during meals.
c.)Set up a strict eating plan for the client.
d.)Encourage the client to exercise, which will reduce her anxiety.
6. A client whose husband recently left her is admitted to the hospital with severe depression. The nurse suspects that the client is at risk for suicide. Which of the following questions would be most appropriate and helpful for the nurse to ask during an assessment for suicide risk?
a.)"Are you sure you want to kill yourself?"
b.)"I know if my husband left me, I'd want to kill myself. Is that what you think?"
c.)"How do you think you would kill yourself?"
d.)"Why don't you just look at the positives in your life?"
7. The nurse is caring for a client who she believes has been abusing opiates. Assessment findings in a client abusing opiates, such as morphine, include:
a.)dilated pupils and slurred speech.
b.)rapid speech and agitation.
c.)dilated pupils and agitation.
d.)euphoria and constricted pupils.
8. The nurse is caring for a client experiencing an anxiety attack. Appropriate nursing interventions include:
a.)turning on the lights and opening the windows so that the client doesn't feel crowded. b.)leaving the client alone.
c.)staying with the client and speaking in short sentences.
d.)turning on stereo music.
9. The nurse is teaching a new group of mental health aides. The nurse should teach the aides that setting limits is most important for:
a.)a depressed client.
b.)a manic client.
c.)a suicidal client.
d.)an anxious client.
10. A client is admitted with a diagnosis of delusions of grandeur. This diagnosis reflects a belief that one is:
a.)highly important or famous.
b.)being persecuted.
c.)connected to events unrelated to oneself.
d.)responsible for the evil in the world.
11. The nurse is caring for a client, a Vietnam veteran, who exhibits signs and symptoms of posttraumatic stress disorder. Signs and symptoms of posttraumatic stress disorder include:
a.)hyperalertness and sleep disturbances.
b.)memory loss of traumatic event and somatic distress.
c.)feelings of hostility and violent behavior.
d.)sudden behavioral changes and anorexia.
12. The nurse is caring for a client with manic depression. The care plan for a client in a manic state would include:
a.)offering high-calorie meals and strongly encouraging the client to finish all food.
b.)insisting that the client remain active throughout the day so that he'll sleep at night. c.)allowing the client to exhibit hyperactive, demanding, manipulative behavior without setting limits.
d.)listening attentively with a neutral attitude and avoiding power struggles.
13. A client is a Vietnam War veteran with a diagnosis of posttraumatic stress disorder. He has a history of nightmares, depression, hopelessness, and alcohol abuse. Which option offers the client the most lasting relief of his symptoms?
a.)The opportunity to verbalize memories of trauma to a sympathetic listener b.)Family support
c.)Prescribed medications taken as ordered
d.)Alcoholics Anonymous (AA) meetings
14. A client is admitted for detoxification after a cocaine overdose. The client tells the nurse that he frequently uses cocaine but that he can control his use if he chooses. Which coping mechanism is he using?
a.)Withdrawal
b.)Logical thinking
c.)Repression
d.)Denial
15. A 22-year-old client is diagnosed with dependent personality disorder. Which behavior is most likely evidence of ineffective individual coping?
a.)Inability to make choices and decisions without advice
b.)Showing interest only in solitary activities
c.)Avoiding developing relationships
d.)Recurrent self-destructive behavior with history of depression
16. The major goal of therapy in crisis intervention is to:
a.)withdraw from the stress.
b.)resolve the immediate problem.
c.)decrease anxiety.
d.)provide documentation of events.
17. A 38-year-old client is admitted for alcohol withdrawal. The most common early sign or symptom that this client is likely to experience is:
a.)impending coma.
b.)manipulating behavior.
c.)suppression.
d.)perceptual disorders.
18. A client is admitted with a diagnosis of schizotypal personality disorder. Which signs would this client exhibit during social situations?
a.)Aggressive behavior
b.)Paranoid thoughts
c.)Emotional affect
d.)Independence needs
19. The nurse is caring for a client in an acute manic state. What's the most effective nursing action for this client?
a.)Assigning him to group activities
b.)Reducing his stimulation
c.)Assisting him with self-care
d.)Helping him express his feelings
20. The nurse is caring for a client diagnosed with bulimia. The most appropriate initial goal for a client diagnosed with bulimia is to:
a.)avoid shopping for large amounts of food.
b.)control eating impulses.
c.)identify anxiety-causing situations.
d.)eat only three meals per day.
21. The nurse is caring for a 40-year-old client. Which behavior by the client indicates adult cognitive development?
a.)Has perceptions based on reality
b.)Assumes responsibility for actions
c.)Generates new levels of awareness
d.)Has maximum ability to solve problems and learn new skills
22. The nurse is assessing a client suffering from stress and anxiety. A common physiological response to stress and anxiety is:
a.)sedation.
b.)diarrhea.
c.)vertigo.
d.)urticaria.
23. The nurse is assessing a client for lifestyle factors that might affect normal coping. Which factor would the nurse most likely consider?
a.)Inadequate diet
b.)Divorce
c.)Job promotion
d.)Adopting a child
24. A client with bipolar disorder is being treated with lithium for the first time. The nurse should observe the client for which common adverse effect of lithium?
a.)Sexual dysfunction
b.)Constipation
c.)Polyuria
d.)Seizures
25. A client is admitted for an overdose of amphetamines. When assessing this client, the nurse should expect to see:
a.)tension and irritability.
b.)slow pulse.
c.)hypotension.
d.)constipation.
26. During a shift report, the nurse learns that she'll be providing care for a client who is vulnerable to panic attack. Treatment for panic attacks includes behavioral therapy, supportive psychotherapy, and medication such as:
a.)barbiturates.
b.)antianxiety drugs.
c.)depressants.
d.)amphetamines.
27. A client comes to the emergency department while experiencing a panic attack. The nurse can best respond to a client having a panic attack by:
a.)staying with the client until the attack subsides.
b.)telling the client everything is under control.
c.)telling the client to lie down and rest.
d.)talking continually to the client by explaining what's happening.
28. A 24-year-old client is experiencing an acute schizophrenic episode. He has vivid hallucinations that are
making him agitated. The nurse's best response at this time would be to:
a.)take the client's vital signs.
b.)explore the content of the hallucinations.
c.)tell him his fear is unrealistic.
d.)engage the client in reality-oriented activities.
29. A client with paranoid type schizophrenia becomes angry and tells the nurse to leave him alone. The nurse should:
a.)tell him that she'll leave for now but will return soon.
b.)ask him if it's okay if she sits quietly with him.
c.)ask him why he wants to be left alone.
d.)tell him that she won't let anything happen to him.
30. A client begins taking haloperidol (Haldol). After a few days, he experiences severe tonic contractures of muscles in the neck, mouth, and tongue. The nurse should recognize this as:
a.)psychotic symptoms.
b.)parkinsonism.
c.)akathisia.
d.)dystonia.
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