N3381 Exam 1 Practice Questions With Complete Solutions
A 55-year-old lives 100 miles from her parents and mother-in-
law. In the past year, her father had back surgery, her mother
broke her hip, and her mother-in-law had a cardiac event. Which
nursing diagnosis is most applicable to the 55-year-old?
a. Risk for complicated grieving related to impending deaths of
parents
b. Risk for injury related to frequent long drives to care for
aging parents
c. Risk for chronic low self-esteem related to overwhelming
responsibilities
d. Risk for caregiver role strain related to responsibilities for
care of aging parents Correct Answers d. Risk for caregiver
role strain related to responsibilities for care of aging parents
Explanation: the focus of the question is the caregiver. Demands
associated with the care of three elderly persons who live at a
distance have the potential of overwhelming the caregiver.
Because there is no evidence of role strain, a risk diagnosis is
formulated.
A client admitted is assessed and evaluated at an inpatient
behavioral health hospital. What behavior indicates that the
client has a mental illness?
a. Client is able to see the difference between the 'as if' and the
'for real.'
b. Client describes mood as consistently sad, discouraged and
hopeless.
,c. Client responds to rules, norms and customs of their culture.
d. Given limitations, client can perform tasks they are given.
Correct Answers b. Client describes mood as consistently sad,
discouraged and hopeless.
Explanation: A, C, and D describe mentally healthy behavior; B
describes a mood disorder.
A client is diagnosed with obsessive-compulsive disorder
(OCD) and is to receive medication therapy. Which of the
following agents might the nurse expect to be prescribed? Select
all that apply.
a. Clomipramine
b. Lithium
c. Sertraline
d. Fluvoxamine
e. Paroxetine
f. Alprazolam Correct Answers a. Clomipramine
c. Sertraline
d. Fluvoxamine
e. Paroxetine
Explanation: selective serotonin reuptake inhibitors (SSRIs) and
tricyclic antidepressants (TCAs) are considered to be the most
effective treatment agents used for OCD. SSRI's will be the 1st
line treatment. TCA's have increased side effects so not our first
choice. Clomipramine was the first drug to produce significant
advances in treating people with OCD. Other medications have
proved effective, including sertraline, fluoxetine, fluvoxamine,
,and paroxetine. Lithium is used to treat bipolar disorder.
Alprazolam may be used to treat acute, short-term for panic.
A client underwent a procedure before the nurse verified the
client's signature on the consent form. The client actually did not
sign the form before the procedure. If the client is dissatisfied
with the outcome of the procedure and files a suit against the
health care team, which kind of case can the client file?
a. Negligence
b. Malpractice
c. Battery
d. False Imprisonment Correct Answers c. Battery
Explanation: battery involves harmful or unwarranted contact
with a client. False imprisonment is defined as the unjustifiable
detention of a client, such as the inappropriate use of restraint or
seclusion. Negligence is an unintentional tort that involves
causing harm by failing to do what a reasonable and prudent
person would do in similar circumstances. Clients or families
can file malpractice lawsuits in any case of injury, loss, or death.
A client with a long history of mental illness was declared
incompetent several months ago. What aspects of the client's
current condition provide the legal basis for a change to
competence? Select all that apply.
a. The client is able to state when he was originally declared
incompetent
b. The client expresses a clear desire for the change in legal
status
, c. The client is able to summarize the proposed treatment plan
d. The client is able to discuss the rationale for the treatment
plan with the care team
e. The client expresses an understanding of his disease and the
factors that exacerbate it Correct Answers c. The client is able
to summarize the proposed treatment plan
d. The client is able to discuss the rationale for the treatment
plan with the care team
e. The client expresses an understanding of his disease and the
factors that exacerbate it
Explanation: summarizing the components and rationale for the
treatment plan indicate the client understands important
information and appreciates his situation. Similarly, his
description of the disease and symptom triggers shows
competent thinking. Identifying the date when he was declared
incompetent and wanting to have a change in status do not
strengthen the legal case for a change in status.
A critical care nurse asks a psychiatric nurse about the
difference between a diagnosis in the Diagnostic and Statistical
Manual of Mental Disorders (DSM-5) and a nursing diagnosis.
What is the psychiatric nurse's best response?
a. "No functional difference exists between the two diagnoses.
Both serve to identify a human deviance."
b. "The DSM-5 diagnosis disregards culture, whereas the
nursing diagnosis includes cultural variables."
c. "The DSM-5 diagnosis profiles present distress or disability,
whereas a nursing diagnosis considers past and present
responses to actual mental health problems."
A 55-year-old lives 100 miles from her parents and mother-in-
law. In the past year, her father had back surgery, her mother
broke her hip, and her mother-in-law had a cardiac event. Which
nursing diagnosis is most applicable to the 55-year-old?
a. Risk for complicated grieving related to impending deaths of
parents
b. Risk for injury related to frequent long drives to care for
aging parents
c. Risk for chronic low self-esteem related to overwhelming
responsibilities
d. Risk for caregiver role strain related to responsibilities for
care of aging parents Correct Answers d. Risk for caregiver
role strain related to responsibilities for care of aging parents
Explanation: the focus of the question is the caregiver. Demands
associated with the care of three elderly persons who live at a
distance have the potential of overwhelming the caregiver.
Because there is no evidence of role strain, a risk diagnosis is
formulated.
A client admitted is assessed and evaluated at an inpatient
behavioral health hospital. What behavior indicates that the
client has a mental illness?
a. Client is able to see the difference between the 'as if' and the
'for real.'
b. Client describes mood as consistently sad, discouraged and
hopeless.
,c. Client responds to rules, norms and customs of their culture.
d. Given limitations, client can perform tasks they are given.
Correct Answers b. Client describes mood as consistently sad,
discouraged and hopeless.
Explanation: A, C, and D describe mentally healthy behavior; B
describes a mood disorder.
A client is diagnosed with obsessive-compulsive disorder
(OCD) and is to receive medication therapy. Which of the
following agents might the nurse expect to be prescribed? Select
all that apply.
a. Clomipramine
b. Lithium
c. Sertraline
d. Fluvoxamine
e. Paroxetine
f. Alprazolam Correct Answers a. Clomipramine
c. Sertraline
d. Fluvoxamine
e. Paroxetine
Explanation: selective serotonin reuptake inhibitors (SSRIs) and
tricyclic antidepressants (TCAs) are considered to be the most
effective treatment agents used for OCD. SSRI's will be the 1st
line treatment. TCA's have increased side effects so not our first
choice. Clomipramine was the first drug to produce significant
advances in treating people with OCD. Other medications have
proved effective, including sertraline, fluoxetine, fluvoxamine,
,and paroxetine. Lithium is used to treat bipolar disorder.
Alprazolam may be used to treat acute, short-term for panic.
A client underwent a procedure before the nurse verified the
client's signature on the consent form. The client actually did not
sign the form before the procedure. If the client is dissatisfied
with the outcome of the procedure and files a suit against the
health care team, which kind of case can the client file?
a. Negligence
b. Malpractice
c. Battery
d. False Imprisonment Correct Answers c. Battery
Explanation: battery involves harmful or unwarranted contact
with a client. False imprisonment is defined as the unjustifiable
detention of a client, such as the inappropriate use of restraint or
seclusion. Negligence is an unintentional tort that involves
causing harm by failing to do what a reasonable and prudent
person would do in similar circumstances. Clients or families
can file malpractice lawsuits in any case of injury, loss, or death.
A client with a long history of mental illness was declared
incompetent several months ago. What aspects of the client's
current condition provide the legal basis for a change to
competence? Select all that apply.
a. The client is able to state when he was originally declared
incompetent
b. The client expresses a clear desire for the change in legal
status
, c. The client is able to summarize the proposed treatment plan
d. The client is able to discuss the rationale for the treatment
plan with the care team
e. The client expresses an understanding of his disease and the
factors that exacerbate it Correct Answers c. The client is able
to summarize the proposed treatment plan
d. The client is able to discuss the rationale for the treatment
plan with the care team
e. The client expresses an understanding of his disease and the
factors that exacerbate it
Explanation: summarizing the components and rationale for the
treatment plan indicate the client understands important
information and appreciates his situation. Similarly, his
description of the disease and symptom triggers shows
competent thinking. Identifying the date when he was declared
incompetent and wanting to have a change in status do not
strengthen the legal case for a change in status.
A critical care nurse asks a psychiatric nurse about the
difference between a diagnosis in the Diagnostic and Statistical
Manual of Mental Disorders (DSM-5) and a nursing diagnosis.
What is the psychiatric nurse's best response?
a. "No functional difference exists between the two diagnoses.
Both serve to identify a human deviance."
b. "The DSM-5 diagnosis disregards culture, whereas the
nursing diagnosis includes cultural variables."
c. "The DSM-5 diagnosis profiles present distress or disability,
whereas a nursing diagnosis considers past and present
responses to actual mental health problems."
