RN mental health disorders and addictions EAQ

RN mental health disorders and addictions EAQ A nurse decides to use the CAGE screening questionnaire with a client admitted for substance abuse. What is the client abusing? Alcohol Barbiturates Hallucinogens Multiple drugs A nurse is caring for a hyperactive, manic client who exhibits flight of ideas and is not eating. What may be the reason why the client is not eating? Feeling undeserving of the food Too busy to take the time to eat Wishes to avoid others in the dining room Believes that there is no need for food at this time What childhood problem has legal as well as emotional aspects and cannot be ignored? School phobia Fear of animals Fear of monsters Sleep disturbances A client is admitted to the psychiatric hospital after many self-inflicted nonlethal injuries over the preceding month. Of which level of suicidal behavior is the client's behavior reflective? Threats Ideation Gestures Attempts A nurse has been assigned to care for a client with the diagnosis of obsessive-compulsive disorder (OCD). Before providing care for this client, what should the nurse remember about clients with OCD? Are unaware that the ritual serves no purpose Can alter the ritual depending on the situation Should be prevented from performing the ritual Do not want to repeat the ritual but feel compelled to do so During an interview of a client with a diagnosis of bipolar I disorder, manic episode, what does the nurse expect the client to demonstrate? Flight of ideas Ritualistic behaviors Associative looseness Auditory hallucinationsThe nurse would recognize which behavior as being characteristic of the panic phase of crisis behavior? Being physically immobile Sobbing for no apparent reason Reporting great difficulties falling asleep Startling easily to loud noises and being touched For which clinical indication should a nurse observe a child in whom autism is suspected? Lack of eye contact Crying for attention Catatonia-like rigidity Engaging in parallel play A client with paralysis of the legs is found to have somatoform disorder, conversion type. What must the nurse consider when formulating a plan of care for this client? The illness is very real to the client and requires appropriate nursing care. Although the client believes that there is an illness, there is no cause for concern. There is no physiological basis for the illness; therefore only emotional care is needed. Nursing intervention is needed even though the nurse understands that the client is not ill. The nurse is assigned to work with a 20-year-old client on an inpatient unit. In assessing the woman, the nurse notes that she is mute, does not show any type of movement, is unresponsive, and appears unaware of her surroundings. What is the best term for the nurse to use to describe these symptoms? Alogia Catatonia Echopraxia Affective flattening When planning for a client's care during the detoxification phase of acute alcohol withdrawal, what need should the nurse anticipate? Checking on the client frequently Keeping the client's room lights dim Addressing the client in a loud, clear voice Restraining the client during periods of agitation A female client with obsessive-compulsive disorder has become immobilized by her elaborate handwashing and walking rituals. Which feelings does the nurse recall are often the basis of obsessive-compulsive disorder? Anxiety and guilt Anger and hostilityEmbarrassment and shame Hopelessness and powerlessness A nurse is planning care for a client with substance-induced persisting dementia resulting from long-term alcohol use. Which nutritional problem, in addition to the effect of alcohol on brain tissue, has contributed to substance-induced persisting dementia? Increase in serotonin Deficiency of thiamine Reduction in iron intake Malabsorption of riboflavin A 3-year-old child is found to have a pervasive developmental disorder not otherwise specified. What should the nurse consider most unusual for the child to demonstrate? Interest in music Ritualistic behavior Attachment to odd objects Responsiveness to the parents During a one-on-one interaction with a client with paranoid-type schizophrenia, the client says to the nurse, "I’ve figured out how foreign agents have infiltrated the news media. They want to shut me up before I spill the beans." How should the nurse describe this statement when documenting this client’s response? Nihilistic delusion Delusions of persecution Delusions of control Delusions of grandeur A nurse is caring for a client with a somatoform disorder. What should the nurse anticipate that this client will do? Write down conversations to facilitate the recall of information. Monopolize conversations about the anxiety being experienced. Redirect the conversation with the nurse to physical symptoms. Start a conversation asking the nurse to recommend palliative care. A nurse, understanding the possible cause of alcohol-induced amnestic disorder, should take into consideration that the client is probably experiencing which imbalance? Thiamine deficiency A reduced iron intake An increase in serotonin Riboflavin malabsorption Within a few hours of alcohol withdrawal the nurse should assess the client for the presence of what symptoms? Irritability and tremorsYawning and convulsions Disorientation and paranoia Fever and profuse diaphoresis The nurse is caring for a client with vascular dementia. What does the nurse identify as the cause of this problem? A long history of inadequate nutrition Disruptions in cerebral blood flow, resulting in thrombi or emboli A delayed response to severe emotional trauma in early adulthood Anatomical changes in the brain that produce acute, transient symptoms A client with a history of drug abuse begins group therapy. After attending the first meeting the client says to the nurse, "It helps to know that I'm not the only one with this type of problem." What concept does this statement reflect? Altruism Catharsis Universality Transference A nurse determines that a client is pretending to be ill. What does this behavior usually indicate? Psychosis Malingering Use of conversion Lack of contact with reality An 84-year-old woman is admitted to the hospital with a diagnosis of dementia of the Alzheimer type. What does the nurse know about this disorder? Problem that first emerges in the third decade of life Nonorganic disorder that occurs in the later years of life Cognitive problem that is a slow and relentless deterioration of the mind Disorder that is easily diagnosed through laboratory and psychological tests A client with obsessive-compulsive disorder performs a specific ritual. Why should the nurse give the client time to perform the ritual? It demonstrates respect for the client's autonomy. This behavior is viewed as a result of anger turned inward. Denying this activity may precipitate an increased level of anxiety. Successful performance of independent activities enhances self-esteem. A 65-year-old man is admitted to a mental health facility with a diagnosis of substance-induced persisting dementia resulting from chronic alcoholism. When conducting the admitting interview, the nurse determines that the client is using confabulation. What does the nurse recall precipitates the client’s use of confabulation?Ideas of grandeur Need for attention Marked memory loss Difficulty in accepting the diagnosis After a cocaine binge an individual is found unconscious and is admitted to the hospital with acute cocaine toxicity. What should the initial nursing action be directed toward? Being understanding Establishing a patent airway Maintaining a drug-free environment Establishing a therapeutic relationship A client with a personality disorder is playing cards with another person in the lounge. When the other person cheats at cards, the client responds by aggressively scattering the cards around the room. What does the nurse conclude about the client’s personality? Poor reality testing A violent personality An antisocial personality Inadequate impulse control A psychotic male client is admitted to the hospital for evaluation. While obtaining the history, the nurse asks why he was brought to the hospital by his parents. The client states, "They lied about me. They said I murdered my mother. You killed her. She died before I was born." What does the nurse recognize that the client is experiencing? Ideas of grandeur Confusing illusions Persecutory delusions Auditory hallucinations A nurse is caring for a client with an obsessive-compulsive disorder. What is the basis for the obsessions and compulsions? Unconscious control of unacceptable feelings Conscious use of this method to punish themselves Acceptance of voices that tell her that doorknobs are unclean Fulfillment of a need to punish others by carrying out the procedure A salesman with a history of heavy drinking is on a detoxification unit. He asks the nurse's permission to skip the Alcoholics Anonymous (AA) meeting held each day. What is the nurse's initial response? "What are your feelings about going to AA meetings?" "What is it that you dislike about going to AA meetings?" "It's all right to wait until you feel like going to AA meetings.""An important part of your treatment is attending AA meetings." A nurse is caring for a client with an obsessive-compulsive personality disorder that involves rituals. What should the nurse conclude about the ritual? It has a purpose but is useless. It is performed after long urging. It appears to be performed willingly. It seems illogical but is needed by the person. A client with schizophrenia is speaking made-up words that have no meaning to other people. What term should the nurse use to document these verbalizations? Avolition Echolalia Anhedonia Neologisms An older adult is admitted for evaluation of anemia and unsteady gait. While obtaining a health history, the nurse notes that the client seems to make up stories to fill in for memory lapses. How should the nurse document what the client is doing? Lying Denying Fantasizing Confabulating A 24-year-old woman states that she no longer enjoys any of the activities that she once found fun and pleasurable, such as socializing, sports, and hobbies. What term should the nurse use to describe this condition? Anergia Anhedonia Grandiosity Learned helplessness A nurse is assessing a client with major depression. Which clinical manifestation reflects a disturbance in affect related to depression? Echolalia Delusions Confusion Hopelessness A client who has been admitted with a diagnosis of schizophrenia says to the nurse, "Yes, it's March. March is Little Women. That's literal, you know." What do these statements illustrate?Echolalia Neologisms Flight of ideas Loosening of associations A nurse is caring for a male client who was admitted to the mental health unit with the diagnosis of schizophrenia. The client is hostile and experiencing auditory hallucinations and states that the voices are saying that they are going to poison him because he is bad. What type of schizophrenic behavior does the nurse identify? Residual Paranoid Catatonic Disorganized A nurse is assessing a child with suspected autism. At what age does the nurse determine that the signs of autism initially may be evident? 2 years 6 years 6 months 1 to 3 months Despite repeated nursing interventions to improve reality orientation, a client insists that he is the commander of an alien spaceship. What is the client experiencing? Illusion Delusion Confabulation Hallucination A nursing assistant interrupts the performance of a ritual by a client with obsessive-compulsive disorder. What is the most likely client reaction? Anxiety Hostility Aggression Withdrawal An older adult client is talking to the nurse about his Vietnam experiences and shares that he still has flashbacks. While assessing him the nurse notes that he is jumpy and exhibits startle reactions and poor concentration. With which mental health disorder does the nurse associate these symptoms? Delusions Hallucinations Posttraumatic stress disorder (PTSD)Obsessive-compulsive disorder (OCD) A nurse knows that children with attention deficit–hyperactivity disorder (ADHD) may be learning disabled. What impact does this disability have on their education? Will probably not be self-directed learners Have intellectual deficits that interfere with learning Experience perceptual difficulties that interfere with learning Are usually performing two grade levels below their age norm When answering questions from the family of a client with Alzheimer disease, how does the nurse describe the disease? Emerges in the fourth decade of life Is a slow, relentless deterioration of the mind Is functional in origin and occurs in the later years Is diagnosed through laboratory and psychological tests A nurse is counseling clients who are attending an alcohol rehabilitation program. Which substance poses the greatest risk of addiction for these clients? Heroin Cocaine Nicotine Marijuana A nurse is providing information about Alcoholics Anonymous (AA) meetings to a client with a history of alcohol abuse. What will be required when the client attends AA meetings? Speaking aloud at weekly meetings Maintaining controlled drinking after 6 months Promising to attend at least 12 meetings yearly Acknowledging an inability to control the alcoholism When being admitted to a mental health facility, a young male adult tells the nurse that the voices he hears frighten him. The nurse knows that clients tend to hallucinate more vividly at what point in their routine? Before meals After going to bed During group activities While watching television A female client is admitted to the hospital after attempting suicide. She reveals that her desire for sex has diminished since her child's birth 3 years ago. What is most directly related to the client's loss of interest in sex? Depression DependencyMarital stress Identity confusion A client with a history of atrial fibrillation has a stroke, and vascular dementia (multiinfarct dementia) is diagnosed. In a comparison of assessment findings in clients with vascular dementia and dementia of the Alzheimer type, which factor is unique to vascular dementia? Memory impairment Abrupt onset of symptoms Difficulty making decisions Inability to use words to communicate What does a nurse expect to determine about a child with a diagnosis of reactive attachment disorder? Has been physically abused Tries to cling to the mother on separation Is able to develop just superficial relationships with others Has a more positive relationship with the father than with the mother A nurse is caring for a newly admitted client with obsessive-compulsive disorder. When should the nurse anticipate that the client's anxiety level will increase? As the day progresses When family members visit During a physical assessment by the nurse When limits are set on the performance of a ritual What defense mechanism should the nurse anticipate that a client with the diagnosis of schizophrenia, undifferentiated type, will most often exhibit? Projection Regression Repression Rationalization While caring for an older adult client, what symptom requires an immediate reassessment of the client’s needs and plan of care? Memory loss or confusion Neglect of self-care Increased daily fatigue Withdrawal from usual activities A client with a history of chronic alcoholism is admitted to the mental health unit. What does the nurse identify as the cause of a client's use of confabulation? Ideas of grandeur Need to get attentionMarked loss of memory Difficulty accepting the truth A mother brings her 7-year-old son into an outpatient clinic for a follow-up appointment. The mother appears angry and agitated with the boy. Looking at the boy's medical chart, the nurse notes that the boy has a diagnosis of encopresis. What is the primary symptom of encopresis? Practicing self-mutilation Practicing self-induced vomiting Passing feces either voluntarily or involuntarily into inappropriate places Passing urine either voluntarily or involuntarily into inappropriate places A nurse is discussing Alcoholics Anonymous (AA) with a client. What behavior expected of members of AA should the nurse include in the discussion? Speaking aloud at weekly meetings Promising to attend at least 12 meetings yearly Maintaining controlled drinking after 6 months Acknowledging an inability to control the problem An individual whose employment has been terminated because his company has been acquired by another company is brought by a family member to the mental health clinic because of extreme depression. While talking with the nurse the client says, "I'm a useless, worthless person. No wonder I lost my job." What type of delusion does the nurse identify? Reference Persecution Alien control Self-deprecation A client in the psychiatric hospital is attempting to communicate by stating, "Sky, flower, angry, green, opposite, blanket." The nurse recognizes what term as describing this type of communication? Echolalia Word salad Confabulation Flight of ideas A mental health nurse is admitting a client with anorexia nervosa. When obtaining the history and physical assessment, the nurse expects the client's condition to reveal which symptom? Edema Diarrhea Amenorrhea Hypertension A mental health nurse is admitting a client with anorexia nervosa. When obtaining the history and physical assessment, the nurse expects the client's condition to reveal what?Edema Diarrhea Amenorrhea Hypertension A 70-year-old retired man has difficulty remembering his daily schedule and finding the right words to express himself. He is found to have dementia of the Alzheimer type. What does the nurse know about symptoms of this disorder? Occur fairly rapidly Have periods of remission Begin after a loss of self-esteem Demonstrate a progression of disintegration A client arrives at the mental health clinic complaining about feelings of extreme terror when attempting to ride in an elevator and feelings of uneasiness in large crowds. He reports that these fears are interfering with his concentration at work. What does the nurse identify as the source of these symptoms? Conflict with society, resulting in an obsession Depression about life events, resulting in unreasonable fears Generalized anxiety about conflicts, resulting in unreasonable fears Repression of a terrifying incident in an elevator, resulting in a phobia During an interview a 32-year-old man describes symptoms of decreased appetite, insomnia, anhedonia, and feelings of worthlessness that have been present for the past few weeks. He reports having had a few episodes of feeling depressed in the past but says that the feelings subsided. Recently he has felt worse, and he is now concerned that his symptoms are negatively affecting his job performance and fears he may lose his job "if someone doesn't help me soon." The nurse suspects these symptoms are related to which disorder? Schizophrenia Bipolar disorder Dysthymic disorder Major depressive disorder A nurse is caring for several clients with the diagnosis of bulimia nervosa. What primary feeling does the nurse anticipate that these clients experience after an episode of bingeing? Depressed mood Paranoia Euphoria Satisfaction A recovering alcoholic joins Alcoholics Anonymous (AA) to help maintain sobriety. What type of group is AA? Social groupSelf-help group Resocialization group Psychotherapeutic group Which client assessment does the nurse determine is inconsistent with the diagnosis of anorexia nervosa, restricting type? Engages in episodes of purging Denies the seriousness of the disorder Fears gaining weight and becoming fat Has a disturbance in the way the body is viewed What is a priority nursing intervention in the care of a drug-dependent mother and infant? Supporting the mother's positive responses toward her infant Requesting that family members share responsibility for infant care Keeping the infant separated from the mother until the mother is drug free Helping the mother understand that the infant's problems are a result of her drug intake A client proclaims that he is "the second son of God." What type of delusion does the nurse identify? Influence Religious Reference Persecutory A student is anxious about an upcoming examination but is able to study intently and does not become distracted by a roommate's talking and loud music. What level of anxiety is demonstrated by the student's ability to shut out the distractions? Mild Panic Severe Moderate It is determined that a staff nurse has a drug abuse problem. What approach to the staff nurse’s addiction should be taken as an initial intervention? Counseled by the staff psychiatrist Dismissed from the job immediately Referred to the employee assistance program Forced to promise to abstain from drugs in the future The client repeatedly performs ritualistic behaviors throughout the day to limit anxious feelings. How does the nurse characterize these behaviors? ObsessionsCompulsions Under personal control Related to rebelliousness What is the primary concern for a nurse caring for a client who is grossly impaired by stimulants? Drowsiness Seizure activity Fluid imbalance Suicidal ideation A client is admitted to an alcohol rehabilitation center. On the fourth day after admission, the nurse detects a strong odor of alcohol on the client's breath. What is the nurse's first action? Asking where the client got the alcohol Locating and removing the alcoholic substance Conveying the staff's disappointment in this behavior Documenting and notifying the practitioner of the client's drinking What are the "four As" for which nurses should assess clients with suspected Alzheimer disease? Amnesia, apraxia, agnosia, aphasia Avoidance, aloofness, asocial, asexual Autism, loose association, apathy, affect Aggressive, amoral, ambivalent, attractive A nurse knows that individuals who are alcoholics use alcohol for what reason? Blunt reality Precipitate euphoria Promote social interaction Stimulate the central nervous system On the third day of hospitalization, a client with a history of heavy drinking begins experiencing delirium alcohol withdrawal syndrome. What is the most appropriate response by the nurse when the client begins experiencing hallucinations? Withholding intervention, because the client may be having vivid dreams Asking the client to describe the hallucinations and explaining that they are not real Administering the prescribed medication to the client to subdue the agitated behavior Pretending to visualize the imaginary things the client is describing to foster acceptance What characteristic of an adolescent girl suggests to the nurse that she has bulimia? History of gastritisPositive self-concept Excessively stained teeth Frequent re-swallowing of food A female accountant comes to the health clinic for a preemployment physical. During the health history the new employee frequently states, "I feel so nervous about starting this job." She is able to connect with her feelings, thoughts, and actions but constantly focuses her attention on starting the new job. What does the nurse determine that the client is exhibiting? A moderate level of job-related anxiety A severe level of anxiety related to new situations An inappropriate response to handling new situations An ineffective coping mechanism in handling job-related stress For what most common characteristic of autism should a nurse assess a child in whom the disorder is suspected? Responds to any stimulus Responds to physical contact Unresponsiveness to the environment Interacts with children rather than adults A nurse in an outpatient mental health setting has been assigned to care for a new client who has been found to have an antisocial personality disorder. What does the nurse expect to observe in the client during the assessment? Pays great attention to detail and demonstrates a high level of anxiety Has scars from self-mutilation and a history of many negative relationships Displays charm, has an above-average intelligence, and tends to manipulate others Demonstrates suspiciousness, avoids eye contact, and engages in limited conversation A person with a history of alcoholism says, "I've been drinking since last Friday to celebrate my son's graduation from college." What defense mechanism does the nurse identify? Denial Projection Identification Rationalization A client is admitted to the mental health unit with the diagnosis of anorexia nervosa. What typical signs and symptoms of anorexia nervosa does the nurse expect the client to exhibit? Slow pulse, mild weight loss, and alopecia Compulsive behaviors, excessive fears, and nausea Amenorrhea, excessive weight loss, and abdominal distentionExcessive activity, memory lapses, and an increase in the pulse rate What is a major recognizable difference between anorexia nervosa clients and bulimia nervosa clients? Anorexia nervosa clients tend to be more extroverted than clients with bulimia. Anorexia nervosa clients seek intimate relationships, whereas clients with bulimia avoid them. Anorexia nervosa clients are at greater risk for fluid and electrolyte imbalances than are clients with bulimia. Anorexia nervosa clients deny the problem, whereas clients with bulimia generally recognize that their eating pattern is abnormal. A nurse is in the process of developing a therapeutic relationship with a client who has an addiction problem. What client communication permits the nurse to conclude that they are making progress in the working stage of the relationship? Select all that apply. Describes how others have caused the addiction Verbalizes difficulty identifying personal strengths Expresses uncertainty about meeting with the nurse Acknowledges the effects of the addiction on the family Addresses how the addiction has contributed to family distress What is the prognosis for a normal, productive life for a child with autism? Dependent on an early diagnosis Often related to the child's overall temperament Ensured as long as the child attends a school tailored to meet needs Guarded because of interference with so many parameters of function During an assessment interview the client reports overwhelming, irresistible attacks of sleep. Which sleep disorder does the nurse conclude that the client is experiencing? Insomnia Narcolepsy Sleep terror Sleep apnea A client with a history of chronic alcoholism was admitted to a surgical unit after surgery to repair a severely fractured right ankle. The nurse is concerned that the client is experiencing manifestations of acute alcohol withdrawal when certain documentation and assessment data from the last 6 hours seem to indicate this problem. Which data are the cause of the nurse's concern? Select all that apply. Tremors in both hands make it difficult for the client to hold a cup. The client's systolic blood pressure has dropped 6 points over last 6 hours. The client was observed falling asleep while talking on the telephone to family.The client's bed linens and pajamas had to be changed during the night as a result of increased diaphoresis. The usually cooperative client becomes verbally abusive when asked to lower the volume of the television. A nurse is caring for a client with a diagnosis of catatonic schizophrenia. What clinical finding does the nurse expect the client to exhibit? Crying Self-mutilation Immobile posturing Repetitive activities A nurse is caring for a client with the diagnosis of bulimia nervosa. What does the nurse understand to be the function of food for individuals with bulimia? Gain attention Control others Avoid growing up Meet emotional needs What should a nurse identify as the most important factor in rehabilitation of a client addicted to alcohol? Motivational readiness Availability of community resources Accepting attitude in the client's family Qualitative level of the client's physical state A nurse is working with clients with a variety of eating disorders. Which characteristic unique to bulimia nervosa differentiates this disorder from anorexia nervosa? The client is obese and attempting to lose weight. The client behaves appropriately and looks normal. The client has a distorted body image and sees the body as fat. The client is struggling with a conflict of dependence versus independence. A client is admitted to the mental health hospital with the diagnosis of major depression. What is a common problem that clients experience with this diagnosis? Loss of faith in God Visual hallucinations Decreased social interaction Feelings about the future are absent A client with schizophrenia repeatedly says to the nurse, "No moley, jandu!" What does the nurse determine that the client is exhibiting? EcholaliaNeologism Concretism Perseveration A 5-foot 5-inch (165 cm) 15-year-old girl who weighs 80 lb (36.3 kg) is admitted to a mental health facility with a diagnosis of anorexia nervosa. The nurse recognizes what factor as the most likely cause of her problem? A desire to control her life The wish to be accepted by her peers The media's emphasis on the beauty of thinness A delusion in which she believes that she must be thin Clients addicted to alcohol often use the defense mechanism of denial. What is the reason that this defense is so often used? It reduces their feelings of guilt. It creates the appearance of independence. It helps them live up to others' expectations. It makes them look better in the eyes of others. The practitioner prescribes a diet high in vitamin B 1 (thiamine) for a client with a long history of alcohol abuse. The nurse concludes that the client understands the teaching about foods high in thiamine when the client makes which statement? "I'll choose fish, aged cheese, and breads." "I'll choose lean beef, organ meat, and nuts." "I'll choose poultry, milk products, and eggs." "I'll choose green vegetables, lentils, and citrus fruits." A man has completed an alcohol detoxification program and is setting goals for rehabilitation. When the client sets outcomes, what need is it important for him to understand? Plan to avoid people who drink. Accept that he is a fragile person. Develop new social drinking skills. Restructure his life without alcohol. When planning care for a client who has just completed withdrawal from multiple-drug abuse, what reality in relation to the client should the nurse take into consideration? Unable to give up drugs Unconcerned with reality Unable to delay gratification Unaware of the danger of drug addictionAn obviously upset client comes to the mental health clinic and, after pushing ahead of the other clients, states, "I had an argument with my daughter, and now I'm tense, and worried, and angry." What level of anxiety does the nurse determine that the client is experiencing? Mild Panic Severe Moderate While a nurse is assisting with morning care for a client with the diagnosis of schizophrenia, the client suddenly throws off the covers and starts shouting, "My body is disintegrating! I'm being pinched." What term best describes the client's behavior? Somatic delusion Paranoid ideation Loose association Ideas of reference An executive assistant experiences an overwhelming impulse to count and arrange the rubber bands and paper clips in his desk. The client feels that something dreadful will occur if the ritual is not carried out. Considering the client's symptoms, what does the nurse conclude about the rituals? They are useful in our society as long as they can be controlled They serve to control anxiety resulting from unconscious impulses They are a displacement of general anxiety onto an unrelated specific fear They serve to consciously limit the associated anxiety that otherwise is overwhelming A nurse uses the CAGE screening test for alcoholism to determine an individual's potential for a drinking problem. What is one of the four questions included on this test? "Do you feel that you are a normal drinker?" "Have you ever felt bad or guilty about your drinking?" "Are you always able to stop drinking when you want to?" "How often did you have a drink containing alcohol in the past year?" A nurse is discussing plans with a client who has decided to withdraw from alcohol. What should the nurse recommend as one of the most effective treatments for alcoholism? Daily administration of disulfiram Individual or group psychotherapy Admission to an alcoholic unit in a hospital Active membership in Alcoholics Anonymous Clients with eating disorders often exhibit similar symptoms. What should the nurse expect an adolescent with anorexia nervosa to exhibit? Affective instability Repetitive motor mechanismsDepersonalization and derealization Disheveled and unkempt physical appearance An adolescent with a conduct disorder is undergoing behavioral therapy in an attempt to limit behaviors that violate societal norms. What specific outcome criterion is unique to adolescents with this problem? Increased impulse control Identification of two positive personal attributes Demonstration of respect for the rights of others Age-appropriate play activities with at least one peer A nurse uses behavior modification to foster toilet-training efforts in a cognitively impaired child. What reward should the nurse provide to reinforce appropriate use of the toilet? Candy bar Piece of fruit Hug with praise Choice of rewards A nurse is caring for a client with the diagnosis of schizophrenia. What is a common problem for clients with this diagnosis? Chronic confusion Disordered thinking Defined personal boundaries Violence directed toward others A client who has been experiencing excessive stress is hospitalized because of an inability to walk. After a physiologic cause for the problem is ruled out, a diagnosis of somatoform disorder, conversion type, is made. What does the nurse conclude is the cause of the client’s paralysis? Nondisabling illness Way to get attention Loss of contact with reality Result of intrapsychic conflict A nurse is making an assessment of a client's hallucinatory behavior. What is the most common type of hallucination? Visual Tactile Auditory Olfactory A 56-year-old man is admitted to the inpatient unit after family members report that he seems to be experiencing auditory hallucinations. The man has a history of schizophrenia and has had several previous admissions. Which statement indicates to the nurse that the client is experiencing auditory hallucinations?"Get these horrible snakes out of my room!" "I am not the devil! Stop calling me those names!" "The food on this plate has poison in it, so take it away—I won't eat it." "I did see an alien spaceship last night outside in my yard, and I've felt worse ever since." A nurse plans to give greater responsibility for self-control to clients with a long history of alcohol abuse who are about to enter a detoxification program. What should the nurse plan to do? Tell them about the detoxification program. Help them adopt more healthful coping patterns. Confront them with their history of substance abuse. Administer their medications in accordance with the prescribed schedule. A nurse working on a substance abuse unit knows that the individual uses opioids most commonly for what reason? Desires independence Is trying to reduce stress Wants to fit in with the peer group Enjoys the social interrelationships that occur A client with a history of alcohol abuse says to the nurse, "Drinking is a way out of my depression." Which strategy will probably be most effective for the client at this time? A self-help group Psychoanalytical therapy A visit with a religious advisor Talking with an alcoholic friend A mental health nurse is working on a unit where many clients have the diagnosis of alcoholism. Which defense mechanism does the nurse identify as most commonly used by clients who are alcoholics? Denial Projection Displacement Compensation A child would be demonstrating outwardly focused anger or aggression in an overt manner when engaging in which behavior? Dominating a class discussion Intentionally forgetting to do homework Scribbling on a classmate's art assignment Crying when told he or she must wait his or her turnA nurse interviews a young female client with anorexia nervosa to obtain information for the nursing history. What will the client's history most likely reveal? Strong desire to improve her body image Close, supportive mother-daughter relationship Satisfaction with and desire to maintain her current weight Low level of achievement in school and little concern for grades An anxious client reports experiencing pain in the abdomen and feeling empty and hollow. A diagnostic workup reveals no physical causes of these clinical findings. What term best reflects what the client is experiencing? Dissociation Somatization Stress response Anxiety reaction A 6-year-old child has been wetting the bed at night since the birth of a baby brother. What defense mechanism is the child using to cope with the stress of accepting a new family member? Regression Repression Dissociation Displacement A mother brings her 5-year-old daughter to the children's clinic after teachers report that the girl is disobedient and hostile. The child has a negative attitude and argues often with her teachers. At this time she has not violated the rights of other students. The mother reports that she has also noticed this behavior at home. The nurse suspects that the behavior described is associated with what disorder? Anxiety disorder Conduct disorder Major depressive disorder Oppositional defiant disorder A man is admitted to the psychiatric unit after attempting suicide. The client's history reveals that his first child died of sudden infant death syndrome 2 years ago, that he has been unable to work since the death of the child, and that he has attempted suicide before. When talking with the nurse he says, "I hear my son telling me to come over to the other side." What should the nurse conclude that the client is experiencing? Fixed delusion Magical thought Pathological regression Command hallucinationA young adolescent is found to have anorexia nervosa. What does the nurse understand probably precipitated the anorexia nervosa? The acting out of aggressive impulses, resulting in feelings of hopelessness An unconscious wish to punish a parent who tries to dominate the adolescent's life The inability to deal with being the center of attention in the family and a desire for independence An inaccurate perception of hunger stimuli and a struggle between dependence and independence What should the nurse teach parents about childhood depression? May appear as acting-out behavior Looks almost identical to adult depression Does not respond to conventional treatment Is short in duration and has an early resolution During a home visit to an older adult, the nurse observes a change in behavior and suspects delirium. The nurse assesses the client for one of several conditions that may have precipitated the delirium. Select all that apply. Infection Dementia Dehydration Urine retention Restricted mobility A client arrives at the mental health clinic disheveled, agitated, and demanding that the nurse "do something to make these feelings stop." What clinical manifestation is evident? Feelings of panic Suicidal tendencies Narcissistic ideation Demanding personality A nurse is interviewing a client newly admitted to an outpatient program after withdrawal from alcohol. What behavior best indicates that the client has accepted that drinking is a problem? Participates in scheduled counseling sessions Attends Alcoholics Anonymous meetings daily Volunteers to be a sponsor for another alcoholic Apologizes to family members for causing distress A nurse assesses a client recently admitted to an alcohol detoxification unit. What common clinical manifestation should the nurse expect during the initial stage of alcohol detoxification? Nausea EuphoriaBradycardia Hypotension The nurse is caring for a client with dementia whose expression of emotions is altered. Which behavior is unexpected with this client? Lability Passivity Curiosity Withdrawal As a nurse enters a room and approaches a client who has schizophrenia, the client shouts, "Get out of here before I hit you! Go away!" What does the nurse conclude provoked the client’s aggressive behavior? Voices are directing his behavior. He felt confined when the nurse walked into the room. He was afraid of doing harm to the nurse if the nurse came closer. He thought that the nurse was similar to someone who had frightened him in the past. A client in the outpatient clinic is denying that he is addicted to alcohol. He tells the nurse that he is not an alcoholic and that it is his nagging wife who causes him to drink. What is the most therapeutic response by the nurse? "I don't think that your wife is the problem." "Everyone is responsible for his own actions." "Perhaps you should have marriage counseling." "Why do you think that your wife is the cause of your problems?" A client who has been found to have bipolar disorder, manic episode, has been sleeping very little and has not eaten in the 2 weeks preceding hospitalization. What does the nurse conclude is the frequent cause of feeding problems in the overactive client? Feeling of unworthiness Inability to take the time to eat Unconscious desire for punishment Preoccupation with ritualistic behavior A nurse is assessing a client with the diagnosis of schizophrenia, undifferentiated type. What defense mechanisms should the nurse anticipate that this client might use? Projection Repression Regression Conversion What should a nurse conclude that a client is doing when he makes up stories to fill in blank spaces of memory?Lying Denying Rationalizing Confabulating What is a primary component of the nursing plan of care for a client with the diagnosis of anorexia nervosa? Observing the client after meals Weighing the client before meals Measuring the client's fluid balance Limiting the client's interaction with peers A client is found to have a borderline personality disorder. What behavior does the nurse consider is most typical of these clients? Inept Eccentric Impulsive Dependent What is most important for the nurse to do when caring for a client who is in an alcohol detoxification program? Accept the client as a worthwhile person. Provide nurturing because the client needs it. Discuss with the client the ill effects of alcohol. Promote compliance by gently prodding the client. It is observed that at times a client with a personality disorder clings to the nurse and at other times he maintains a noticeable distance. From this pattern of behavior what does the nurse determine are the client’s conflicting fears? Shame versus rejection Lost self-esteem versus hostility Abandonment versus identity loss Engulfment versus interdependence When planning interventions to help a client with bipolar I disorder, manic episode, meet rest and sleep needs, what must the nurse remember about the manic client? Experiences few sleep pattern disturbances Requires less sleep than the average person Is easily stimulated, and this interferes with sleep Needs to expend energy to be tired enough to sleepA client who has been found to have bipolar disorder, manic episode, has been sleeping very little and had not eaten in the 2 weeks preceding hospitalization. What does the nurse conclude is a frequent cause of feeding problems in the overactive client? Feeling of unworthiness Inability to take the time to eat Unconscious desire for punishment Preoccupation with ritualistic behavior A male client with the dual diagnosis of major depression and polysubstance abuse has been attending group therapy. One day the client tells the nurse, "The things they talk about in group don't really pertain to me." What is the most therapeutic response by the nurse? Confronting the client with realistic feedback Identifying the client's stress-coping tolerance Informing the client that he needs to get more involved Asking the client what therapy he thinks would be more helpful When the nurse is managing the care of an acutely depressed client, which of these demonstrates that the nurse recognizes the client's fundamental mental health need? Role modeling a hopeful attitude regarding life and the future Sharing that life has presented depressing situations for all of us at times Devoting time with the client and trying to focus on happy, positive memories Identifying the client's personal weaknesses and designing interventions to strengthen them At a staff meeting, the question of a staff nurse's returning to work after completing a drug rehabilitation program is discussed. What is the most therapeutic way for the staff to handle the nurse's return? Offering the nurse support in a straightforward manner Avoiding mention of the problem unless the nurse brings it up Having another staff member keep the nurse under close observation Ensuring that the nurse is assigned to administer only noncontrolled medications A nurse is counseling the spouse of a client who has a history of alcohol abuse. What does the nurse explain is the main reason for drinking alcohol in people with a long history of alcohol abuse? They are dependent on it. They lack the motivation to stop. They use it for coping. They enjoy the associaed socialization. The wife of a client who has completed alcohol detoxification relates that she is concerned about her husband's behavior if he starts drinking again. She says, "When the drinking starts it really disrupts my family, and I'm not sure how to handle it." What is the best response by the nurse? "Include your husband in the family's activities even when he's been drinking.""Attend Al-Anon meetings and avoid assuming responsibility for your husband's behavior." "Search the house regularly for hidden alcohol and accompany your husband outside the home." "Help your husband avoid embarrassment by making excuses for him when it's impossible for him to function." A woman with bipolar disorder, manic episode, has been spending thousands of dollars on clothing and makeup. She has been partying in bars every night and rarely sleeps or eats. The nurse in the outpatient clinic knows that this client rarely eats. What does the nurse recognize as the most likely cause of her eating problems? Feelings of guilt Need to control others Desire for punishment Excessive physical activity A client tells the nurse, "All my friends experiment with drugs. I like the high I get when I huff paint. Nothing bad is going to happen to me." What is the best response by the nurse? "Inhalants can cause a mild state of intoxication." "Huffing paint can damage your lungs, kidneys, and liver." "Withdrawal problems will start if you continue huffing paint." "Limiting the type of inhalant used decreases respiratory irritation." A nurse is teaching a client and family about the characteristics of dementia of the Alzheimer type. What physiologic characteristic should the nurse include? Periodic exacerbations Aggressive acting-out behavior Hypoxia of selected areas of brain tissue Areas of brain destruction called senile plaques When caring for clients who are demonstrating manic behavior, the nurse must constantly reassess these clients' physical needs. What characteristic about these clients makes this particularly important? Will withdraw to their rooms if left alone Have difficulty making their needs known May gain too much weight from overeating May become exhausted from excessive activity A client who has a long history of alcoholism has not worked for the past 10 years. When the nurse asks about daily activities the client responds, "I currently work in the office of a local construction company." Which mental mechanism should the nurse suspect that the client is using? RegressionSublimation Compensation Confabulation What is the greatest difficulty for nurses caring for the severely depressed client? Client's lack of energy Negative cognitive processes Client's psychomotor retardation Contagious quality of depression A client with a history of gambling is experiencing legal difficulties for embezzling money and has been required to obtain counseling. During an intake interview the client says, "I never would have done this if I'd been paid what I am worth." What factor will create the greatest difficulty in helping this client develop insight? Feelings of boredom and emptiness Grandiosity related to personal abilities Projection of reasons for difficulties onto others Anger toward those who are in authority positions A female client with a diagnosis of alcohol abuse appears disheveled and disorganized. How can the nurse best gain the client's involvement in personal hygienic care? Devising a schedule with her and making certain that she adheres to it Assisting her in bathing and dressing by giving her clear, simple directions Bathing and dressing her each morning until she is willing to do it for herself Giving her a schedule that requires her to bathe and dress herself each morning A nurse in the mental health clinic is counseling a client with the diagnosis of depression. During the counseling session the client says, "Things always seem the same. They never change." The nurse suspects that the client is feeling hopeless. For what indication of hopelessness should the nurse assess the client? Outbursts of anger Focused concentration Preoccupation with delusions Intense interpersonal relationships The nurse is working with a client who has a diagnosis of borderline personality disorder. What personality traits should the nurse expect the client to exhibit? Select all that apply. Engaging Indecisive Withdrawn Manipulative PerfectionisticA nurse who plans to care for a client with an obsessive-compulsive disorder should understand that the client’s personality can usually be characterized in what way? Marked emotional maturity Rapid, frequent mood swings Elaborate delusional systems Doubts, fears, and indecisiveness A client with a long history of alcohol abuse who has been hospitalized for 1 week tells the nurse, "I feel much better and probably won't need any more treatment." What does the nurse conclude when evaluating the client's progress? The client has accepted the illness and now must use willpower to resist alcohol. The client will probably not use alcohol again as long as the client's family remains supportive. The client's lack of insight into the emotional aspects of the illness indicates the need for continued supervision. The client's statement should be communicated to the practitioner so aversion therapy can be started before the client's discharge. A client with a history of alcoholism returns to a previously attended in-house alcohol treatment program. What is the best initial statement by the nurse when the client returns to the facility? "It's too bad that you failed this time. Do you think you might do better next time?" "You could die of postnecrotic cirrhosis if you keep drinking. Doesn't that bother you?" "You've made some progress. Now let's start focusing on strategies to prevent a relapse." "Hospitalization is useless unless you comply with the health team's recommendations." In what situation should a nurse anticipate that a client will experience a phobic reaction? When seeking attention from others When thinking about the feared object When coming into contact with the feared object When being exposed to an unfamiliar environment