MENTAL HEALTH PRACTICE QUESTIONS WITH CERTIFIED CORRECT ANSWERS

MENTAL HEALTH PRACTICE QUESTIONS WITH CERTIFIED CORRECT ANSWERS “Stress - CORRECT ANSWER A condition resulting when a threat or challenge to our well-being requires us to adjust or adapt to the environment" "Distress - CORRECT ANSWER negative stress (exhausting)" "Eustress - CORRECT ANSWER positive, motivating stress (can enhance a sense of well-being)" "Anxiety - CORRECT ANSWER A feeling of uneasiness occurring in response to a real or perceived threat from an unknown source" "Secondary traits - CORRECT ANSWER may surface in some situations" "Obsession - CORRECT ANSWER recurrent, persistent, unwanted thoughts causing intense anxiety" "Compulsion - CORRECT ANSWER repetitive behaviour engaged in to reduce a high level of anxiety" "S+S persistent depressive disorder - CORRECT ANSWER lifetime struggle with depression, Escapes- substance use, spending sprees, Sexual promiscuity- acting out behaviours, Fatigue - decreased concentration and decision-making ability" "Bipolar and related disorders - CORRECT ANSWER brain dysfunction causing abnormal shifts in mood, energy and functional ability, possible genetic factor" "Hypomania (mild to moderate mania) - CORRECT ANSWER more than 4 days, Full-blown manic episodes extreme symptoms more than 1 week, Episode ranges from high manic to low depressive periods" "4 or more mood shifts - CORRECT ANSWER rapid cycling" "Cyclothymic Disorder - CORRECT ANSWER chronic mood disturbances with functioning periods of hypomanic symptoms and periods of depression alternating periods recurrent with short periods of normalcy (usually less than 2 months), No delusional thinking or hallucinationsFunction is not severely impaired, Hospitalization often unnecessary" "Residual - CORRECT ANSWER looks like a prodromal stage. (get better)" "Avolition - CORRECT ANSWER lack of motivation" "Anergia - CORRECT ANSWER no energy" "Anhedonia - CORRECT ANSWER lack of pleasure" "Paranoid Schizophrenia - CORRECT ANSWER prominent hallucinations, delusions" "Disorganized schizophrenia - CORRECT ANSWER unintelligible speech, bizarre behaviour, flat affect" "Catatonic - CORRECT ANSWER Severe decrease in motor activity, responsiveness to the environment" "Residual - CORRECT ANSWER previous psychotic symptoms, no longer evident" "Treatment of Psychotic Disorders - CORRECT ANSWER Antipsychotic drugs (neuroleptics), Psychotherapy, Hospitalization for stabilizations PRN" "Extrapyramidal Side Effects (EPS) - CORRECT ANSWER Physical symptoms, including tremor, slurred speech, akathesia, dystonia, anxiety, distress, paranoia, and bradyphrenia, that are primarily associated with improper dosing of or unusual reactions to neuroleptic (antipsychotic) medications." "Akathisia - CORRECT ANSWER motor restlessness" "Dystonia - CORRECT ANSWER rigidity in muscles controlling posture, gait or eye movement" "Tardive Dyskinesia - CORRECT ANSWER is a disorder that results in involuntary, repetitive body movements. This may include grimacing, sticking out the tongue, or smacking the lips." "Drug-induced parkinsonism - CORRECT ANSWER tremors, rigidity" "Neuroleptic Malignant syndrome - CORRECT ANSWER potentially fatal reaction, onset from 3 to 9 days after treatment started" "Characteristics of personality disorders - CORRECT ANSWER Inflexible behaviours, Consistent and constant symptoms, Treatment rarely sought- noncompliance an issue when sought, Tend to view life as as good or all bad, Arrogant and self-indulgent, Passive-aggressive" "Cluster A Personality Disorders - CORRECT ANSWER paranoid PD, scitzoid PD, Schizotypal" "Narcissistic Personality Disorder S+S - CORRECT ANSWER Exaggerated sense of self-importance, Arrogance, entitlement" "Underlying - CORRECT ANSWER feelings of inferiority, the envy of others, Over-exaggerated personal achievement, Little regard for others feelings, and unrealistic thinking" "Histrionic Personality Disorder S+S - CORRECT ANSWER extreme egocentricity, emotionalism, Demanding personal attention, Melodramatic, fake, exaggerated behaviours, Develop superficial relationships, Provocative dress, mannerisms, Easily influenced, overly trusting" "Cluster C Personality Disorders - CORRECT ANSWER avoidant PD, Dependent PD, Obsessive-compulsive" "Avoidant Personality Disorder S+S - CORRECT ANSWER shy, sensitive to negative comments of others, Avoid interactions with others, Extreme fear of ridicule or disapproval, Social inadequacy, intense anxiety in a group, Expects to be rejected, Self-doubt, low self-esteem" "Dependent Personality Disorder S+S - CORRECT ANSWER consistent, extreme dependence on others, Helpless, incompetent, Insecurity, self-doubt, Extreme fear of being alone, Inability to make decisions, Independent activities, not an option, Increased involvement in abusive relationships" "Obsessive-compulsive Personality Disorder S+S - CORRECT ANSWER highly organized, Preoccupied with an order, perfection, Rigid, controlling, highly critical of self, others, Difficult to feel accomplishment satisfaction, Rigid morals and ethics, Relationships -serious, shallow" "Treatment of Personality Disorders - CORRECT ANSWER Mistrust, resistant to change, Difficult to form therapeutic relationships, Psychotherapies used medications" "Soma - CORRECT ANSWER refers to the body" "Somatization - CORRECT ANSWER predictable syndrome of physical complaints and symptoms, expressed as a result of significant psychological stress" "Somatic symptom disorder S+S - CORRECT ANSWER somatic complaint: valid if required medical treatment ex. Medication, Reported symptoms exaggerated with little factual support, Persistent moderate to severe levels of anxiety, depression common, Excessive mental distress over symptoms is key" "Illness anxiety disorder (formerly hypochondriasis) S+S - CORRECT ANSWER fear, preoccupation with having serious illness despite contrary evidence, Symptoms usually absent or of mild intensity, Concerns/anxiety disproportionate to ïllness.", Reassurance does not affect anxiety, Overconcern regarding health issues consumes life" "Malingered fugue - CORRECT ANSWER occurs in those trying to avoid a legal, financial or unwanted personal situation most with full recovery" "Cannabis-related disorder S+S - CORRECT ANSWER high feeling followed by mental and physical effects, Often used with other substances, High dose can result in anxiety, social withdrawal irritability" "Hallucinogen use disorder S+S - CORRECT ANSWER PCP most common, taken orally, injected, Users, demonstrate dangerous behaviours, Lack of judgement, Mood swings, fearfulness, anxiety, feelings of going insane, dying, The toxic episode, flashbacks" "Inhalant-related disorders S+S - CORRECT ANSWER behavioural changes, Euphoria, Breath smells of pain/ solvent, Permanent CNS/ PNS damage possible" "Opioid-related disorders S+S - CORRECT ANSWER Heroin, Prescription meds: oxycodone, compulsive, prolonged self-admin for no medical reason Initial high, them depression, motor functioning problems" "Stimulant-use disorder S+S - CORRECT ANSWER Crack: most common cocaine, Easily inhaled, Mood changes, weight loss, malnutrition, Chronic abuse" "Caffeine-related disorders S+S - CORRECT ANSWER heavy caffeine use, Anxiety, agitation, sweating, restlessness," "Nicotine-related disorders S+S - CORRECT ANSWER tobacco products, Sedative, hypnotic, or anxiolytic-use disorders" "Eating Disorders - CORRECT ANSWER anorexia, nervosa, binge eating, purging, Bulimia nervosa" "Anorexia Nervosa S&S - CORRECT ANSWER intense fear of weight gain, significant self-image disturbance, Weight loss via dieting, starvation or excessive exercise" "Binge eating - CORRECT ANSWER eating more food than normal in a discrete-time span" "Purging - CORRECT ANSWER emptying the GI tract via self-induced vomiting, use of laxatives or diuretics" "Bulimia Nervosa S&S - CORRECT ANSWER binge eating with repeated attacks, self-induced destructive methods to prevent weight gain; purging, nonpurging, Inability to stop eating during a binge eating episode, Ashamed of disorder, attempt to hide symptoms, event trigger binge behaviours, Repeated use of risky methods to prevent weight gain" "Binge-eating disorderS&S - CORRECT ANSWER similar to bulimia except no purging, Overweight, History of other psychological issues" "Which assessment data should the nurse consider as risk factors for possible violence in a client? (Select all that apply.) a. A diagnosis of somatization disorder b. A diagnosis of schizophrenia or bipolar disorder c. Substance intoxication d. Argumentative and demanding behavior e. Past history of violence - CORRECT ANSWER B, C, D, E" "Which statement is true regarding traumatic bereavement? a. The bereavement period is more prolonged but symptoms are less intense. b. Traumatic bereavement is characterized by the presence of survivor guilt. c. Traumatic bereavement only occurs following a natural disaster. d. Symptoms are most often more intense and prolonged than those associated with a natural death. - CORRECT ANSWER D" "A client whose home was destroyed during a tornado expresses to the nurse that they have been having disabling anxiety and nightmares for the past 2 weeks following this disaster. The most appropriate crisis intervention would be to: a. Encourage the client to recognize how lucky they are to be alive b. Discuss stages of grief and feelings associated with each c. Identify community resources that can help the client d. Suggest that the client find a place to live that provides a storm shelter - CORRECT ANSWER B" "A client with a history of violence is yelling in the dayroom and knocking over chairs. The nurse observes their increased agitation, clenched fists, and loud, demanding voice. The client is challenging and threatening staff and the other clients. The nurse's priority intervention would be to: a. Call for assistance b. Draw up a syringe of prn haloperidol c. Ask the client if they would like to talk about their anger d. Tell the client if they do not calm down, they will have to be restrained - CORRECT ANSWER A" "A client who has been in restraints is now calm. The client apologizes to the nurse and says, "I hope I didn't hurt anyone." Which action by the nurse demonstrates the best clinical judgment? a. Ignore the patient's comment to extinguish their aggressive behavior. b. Affirm to the patient that everyone loses control sometimes and tell them not to worry about it. c. Reinforce that it is fortunate that no one was hurt and assist the client to explore alternative behaviors when they become angry. d. Set firm limits with the client, instructing them that if they become angry again they will be secluded and restrained. - CORRECT ANSWER C" "A client is hospitalized following a suicide attempt after breaking up with her boyfriend. Freudian psychoanalytic theory would explain the client's suicide attempt in which of the following ways? a. She feels hopeless about her future without her boyfriend. b. Without her boyfriend, she feels like an outsider with her peers. c. She is feeling intense guilt because her boyfriend broke up with her. d. She is angry at her boyfriend for breaking up with her and has turned the anger inward on herself. - CORRECT ANSWER D" "Which intervention is appropriate for a client on suicide precautions? (Select all that apply.) a. Remove all sharp objects, belts, and other potentially dangerous articles from the client's environment. b. Accompany the client to off-unit activities. c. Reassess intensity of suicidal thoughts and urges on a regular basis. d. Put all of the client's possessions in storage and explain that they will be returned when there is no longer a risk for suicide. - CORRECT ANSWER A, B, C" "Success of long-term psychotherapy with a client (who attempted suicide following a breakup with his girlfriend) could be measured by which behavior? a. The client has a new girlfriend. b. The client has an increased sense of self-worth. c. The client does not take antidepressants anymore. d. The client told his old girlfriend how angry he was with her for breaking up with him - CORRECT ANSWER B" "A 27-year-old female client was admitted to the psychiatric unit from the medical intensive care unit where she was treated for taking a deliberate overdose of her antidepressant medication, trazodone (Desyrel). She says to the nurse, "My boyfriend broke up with me. We had been together for 6 years. I love him so much. I know I'll never get over him." Which is the best response by the nurse? a. "You'll get over him in time." b. "Forget him. There are other fish in the sea." c. "You must be feeling very sad about your loss." d. "Why do you think he broke up with you?" - CORRECT ANSWER C" "The nurse identifies the primary nursing diagnosis for a client as "Risk for suicide related to feelings of hopelessness from loss of relationship." Which outcome criterion is most appropriate for this diagnosis? a. The client has experienced no self-harm. b. The client sets realistic goals. c. The client expresses some optimism and hope for the future. d. The client has reached a stage of acceptance in the loss of the relationship - CORRECT ANSWER A" "A client is hospitalized following a suicide attempt after breaking up with their boyfriend. The client says to the nurse, "When I get out of here, I'm going to try this again, and next time I'll choose a no-fail method." Which is the best response by the nurse? a. "You are safe here. We will make sure nothing happens to you." b. "You're just lucky your roommate came home when she did." c. "What exactly do you plan to do?" d. "I don't understand. You have so much to live for." - CORRECT ANSWER C" "In determining degree of suicide risk with a suicidal client, the nurse assesses the following behavioral manifestations: severely depressed, withdrawn, statements of worthlessness, difficulty accomplishing activities of daily living, no close support systems. The nurse identifies the client's risk for suicide as which of the following? a. Low risk b. High risk c. Imminent risk d. Unable to be determined - CORRECT ANSWER B" "A client who has been hospitalized following a suicide attempt is placed on suicide precautions on the psychiatric unit. The client admits that they are still feeling suicidal. Which of the following interventions is most appropriate in this instance? (Select all that apply.) a. Restrict access to any item that might be harmful by placing the client in a seclusion room. b. Check on the client every 15 minutes at irregular intervals or assign a staff person to stay with them on a one-to-one basis. c. Obtain an order from the physician to give the client a sedative to calm them and reduce suicide ideas. d. Do not allow the client to participate in any unit activities while they are on suicide precautions. e. Ask the client specific questions about their thoughts, plans, and intentions related to suicide. - CORRECT ANSWER B, E" "1. Which technique is used to promote adequate nutritional intake for a client in an acute manic episode who is not eating? a. Sit with the client during meals to reinforce the importance of eating everything on the tray. b. Have family members bring food from home so the client will have only favorite foods. c. Provide high-calorie, nutritious finger foods and snacks that can be eaten "on the run." d. Restrict the client to their room until they begin to gain weight - CORRECT ANSWER C" "2. A client who has been prescribed lithium carbonate for bipolar I disorder asks the nurse what is a normal range for lithium blood levels. Which is the most accurate response? a. 0.6 to 1.2 mEq/L b. 0.1 to 5 mEq/L c. Above 1.2 mEq/L d. 6 to 12 mEq/L - CORRECT ANSWER A" "3. Although historically lithium has been the medication of choice for mania, several others have been used with good results. Which medication is used in the treatment of bipolar disorder? (Select all that apply.) a. Olanzapine (Zyprexa) b. Oxycodone (Oxycontin) c. Carbamazepine (Tegretol) d. Gabapentin (Neurontin) e. Tranylcypromine (Parnate) - CORRECT ANSWER A, C, D" "4. A client who is experiencing a manic episode is admitted to the psychiatric unit after being brought to the emergency department by a family member. The client yells, "I need to get out of here because the interplanetary council has elected me president of the universe." This is an example of: a. A delusion of grandeur b. A delusion of persecution c. Auditory hallucinations d. Lithium toxicity - CORRECT ANSWER A" "5. Which is the most common comorbid condition in children with bipolar disorder? a. Schizophrenia b. Substance disorders c. Oppositional defiant disorder d. Attention deficit-hyperactivity disorder - CORRECT ANSWER D" "6. A nurse is educating a client about lithium therapy and is explaining signs and symptoms of lithium toxicity. Which findings should the nurse instruct the client to be on the alert for? a. Fever, sore throat, malaise b. Tinnitus, severe diarrhea, ataxia c. Occipital headache, palpitations, chest pain d. Skin rash, marked rise in blood pressure, bradycardia - CORRECT ANSWER B" "7. A client is brought to the emergency department by a family member who reports that the client stopped taking mood stabilizer medication a few months ago and is now agitated, pacing, demanding, and speaking very loudly. The client's family member reports that they eat very little, is losing weight, and almost never sleeps. What is the priority nursing diagnosis? a. Imbalanced nutrition: Less than body requirements related to not eating b. Risk for injury related to hyperactivity c. Disturbed sleep pattern related to agitation d. Ineffective coping related to denial of depression - CORRECT ANSWER B" "8. A female client, who is experiencing a manic episode, enters the milieu area dressed in a provocative and physically revealing outfit. Which is the most appropriate intervention by the nurse? a. Tell her, in front of the other clients, that she cannot dress like a ***** while she is in the hospital. b. Do nothing and allow her to learn from the responses of her peers. c. Quietly walk with her back to her room and help her change into something more appropriate. d. Explain to her that if she wears this outfit, she must remain in her room. - CORRECT ANSWER C" "9. The nurse is providing medication education to a client on lithium. Which is an important point to include? (Select all that apply.) a. Significant reductions in sodium intake increase the risk for lithium toxicity. b. Weight loss is a common side effect of lithium. c. Serum lithium levels will need to be checked at regular intervals throughout treatment. d. Lithium therapy should be continued even during periods when the client feels well. - CORRECT ANSWER A, C, D" "10. A client admitted to the inpatient psychiatric unit with bipolar disorder tells the nurse, "I need to sit in on change-of-shift report because I have been appointed director of this unit." Which action by the nurse demonstrates the best clinical judgment at this point? a. Invite the client to sit in on the change-of-shift report, but do not share any confidential client information. b. Instruct the client that this is not permitted and redirect the client to other unit activities that are available. c. Tell the client that they are delusional but that these symptoms will go away with medication. d. Place the client in seclusion for protection of self and others. - CORRECT ANSWER B" "1. A client, who is a veteran of the war in Iraq, is diagnosed with PTSD. The client, John, says to the nurse, "I can't figure out why God took my buddy instead of me." From this statement, the nurse assesses which of the following in John? a. Repressed anger b. Survivor's guilt c. Intrusive thoughts d. Spiritual distress - CORRECT ANSWER B" "2. Which treatment regimen would most appropriately be ordered for a client with PTSD? a. Paroxetine and group therapy b. Diazepam and implosion therapy c. Alprazolam and behavior therapy d. Carbamazepine and cognitive therapy - CORRECT ANSWER A" "3. Which finding may be influential in the predisposition to PTSD? a. Resilient personality traits b. Ketamine deficiency c. History of dementia d. Severity of the stressor and availability of support systems - CORRECT ANSWER D" "4. Which statement is true regarding the diagnosis of an adjustment disorder? a. The client will require long-term psychotherapy to achieve relief. b. The client likely inherited a genetic tendency for the disorder. c. Symptoms will likely remit once the client has accepted the changes that precipitated difficulties with adjustment. d. Adjustment disorders are not typically related to an identified stressor. - CORRECT ANSWER C" "5. The physician orders sertraline (Zoloft) for a client who is hospitalized with an adjustment disorder with depressed mood. Which benefit is intended? a. Increase energy and elevate mood b. Stimulate the central nervous system c. Prevent psychotic symptoms d. Produce a calming effect - CORRECT ANSWER A" "10. A client, age 16, has recently been diagnosed with diabetes mellitus. The client must watch their diet and take an oral hypoglycemic medication daily. The client has become very depressed, and the client's mother reports that they refuse to change their diet and often skips their medication. The client has been hospitalized for stabilization of their blood glucose level. The psychiatric nurse practitioner has been called in as a consultant. Which nursing diagnosis by the psychiatric nurse would be a priority for the client at this time? a. Anxiety related to hospitalization evidenced by nonadherence b. Low self-esteem related to feeling different from their peers evidenced by social isolation c. Risk for suicide related to new diagnosis of diabetes mellitus as evidenced by reports of depression d. Risk-prone health behavior related to denial of seriousness of their illness evidenced by refusal to follow diet an - CORRECT ANSWER D" "1. Which drug class is most commonly used for management of the child with ADHD? a. CNS depressants (e.g., diazepam [Valium]) b. CNS stimulants (e.g., methylphenidate [Ritalin]) c. Anticonvulsants (e.g., phenytoin [Dilantin]) d. Major tranquilizers (e.g., haloperidol [Haldol]) - CORRECT ANSWER B" "2. The nursing history and assessment of an adolescent with a conduct disorder might reveal all behaviors except: a. Manipulation of others for fulfillment of own desires b. Chronic violation of rules c. Feelings of guilt associated with the exploitation of others d. Inability to form close peer relationships - CORRECT ANSWER C" "3. Certain family dynamics are believed to predispose adolescents to the development of conduct disorder. Which pattern is thought to be a contributing factor? a. Parents who are overprotective b. Parents who have high expectations for their children c. Parents who consistently set limits on their children's behavior d. Parents who are alcohol dependent - CORRECT ANSWER D" "4. Which statement about oppositional behavior in children is true? a. Oppositional behavior in a child over 2 years of age is diagnostic of ODD. b. Oppositional behavior at various stages of development is normal and healthy. c. Oppositional behavior is genetic. d. Oppositional behavior is characterized by limited and repetitive rituals - CORRECT ANSWER A" "5. . Which of the following medications is used to treat Tourette's disorder? a. Methylphenidate (Ritalin) b. Haloperidol (Haldol) c. Imipramine (Tofranil) d. Phenytoin (Dilantin) - CORRECT ANSWER B" "6. A child with ADHD has a nursing diagnosis of impaired social interaction. Which nursing interventions are appropriate for this child? (Select all that apply.) a. Socially isolate the child when interactions with others are inappropriate. b. Set limits with consequences on inappropriate behaviors. c. Provide rewards for appropriate behaviors. d. Provide group situations for the child. - CORRECT ANSWER B, C, D" "1. During the admission assessment for a 72-year-old male client the nurse notices an open sore on his arm. When she questions him about it, he says, "I scraped it on the fence two weeks ago. It's smaller than it was." Which of the following is the best interpretation of this finding? a. Lower testosterone levels in older adult men results in injury-prone skin. b. Confusion is common in older adults, so the client probably doesn't remember how long ago he sustained the injury. c. A diminished inflammatory response in older adults increases healing time. d. The supply of blood vessels to the skin increases with age and delays healing time - CORRECT ANSWER C" "2. What is the most appropriate way to communicate with an older client who is deaf in their right ear? a. Speak loudly into their left ear. b. Speak to the client from a position on their left side. c. Speak face-to-face in a high-pitched voice. d. Speak face-to-face in a low-pitched voice. - CORRECT ANSWER D" "3. Which factor is most associated with mental health in older adults? a. Pureed foods and warm beverages b. Physical activity and socialization c. Moderate alcohol and lower calorie intake d. Living alone and adhering to antidepressant medications - CORRECT ANSWER B" "4. In a group exercise class, Mr. B., a 79-year-old man with major depression, becomes tired and short of breath very quickly. This symptom is most likely due to which cause? a. Age-related changes in the cardiovascular system b. Anxiety c. The effects of pathological depression d. Medication the physician has prescribed for depression - CORRECT ANSWER A" "5. The developmental task of transcendence suggests that mental health in older adulthood is contingent upon: a. Being able to ignore the stigmas associated with being old b. Developing the ability to be alone c. Transcending physical limitations imposed by age-related changes in the body d. Having a sense of meaning in life and a sense of satisfaction - CORRECT ANSWER D" "6. A male client, age 79, is admitted to the psychiatric unit for depression. He has lost weight and become socially isolated. His wife died 5 years ago, and his son tells the nurse, "He did very well when Mom died. He didn't even cry." Which is the priority nursing diagnosis? a. Maladaptive grieving b. Imbalanced nutrition: less than body requirements c. Social isolation d. Risk for injury - CORRECT ANSWER A" "7. A male client, age 79, is admitted to the psychiatric unit for depression. He has lost weight and has become socially isolated. His wife died 5 years ago, and his son tells the nurse, "He did very well when Mom died. He didn't even cry." Which is the priority nursing intervention? a. Take blood pressure once each shift. b. Ensure that the client attends group activities. c. Encourage the client to eat all of the food on his food tray. d. Encourage the client to talk about his wife's death. - CORRECT ANSWER D" "8. A 75-year-old male client, who is taking a selective serotonin reuptake inhibitor (SSRI) for depression, reports to the nurse that he recently began having erectile dysfunction. Which is the most appropriate action by the nurse? a. Set clear boundaries that this is not an appropriate topic to discuss with the nurse. b. Instruct the client that this is a potential side effect of his medication and ask whether he would prefer to explore other treatment options. c. Educate the client that this is a normal age-related change and cannot be treated. d. Reinforce that this is a common symptom of depression and should subside after 4 to 6 weeks of antidepressant treatment. - CORRECT ANSWER B" "9. An 80-year-old client says to the nurse, "I'm all alone now. My husband is gone. My best friend is gone. My daughter is busy with her work and family. I might as well just go, too." Which is the best response by the nurse? a. "Are you having thoughts of wanting to hurt yourself or take your own life?" b. "You have lots to live for, but we need to talk to your daughter about her priorities." c. "It's hard getting old." d. "Tell me about your family." - CORRECT ANSWER A" "10. An older male client with depression says to the nurse, "I don't want to go to that crafts class. I'm too old to learn anything." Which of these is the most appropriate action by the nurse at this point? a. Tell the client that groups are mandatory and escort him by the hand. b. Pat the client on the shoulder and tell him "We all feel that way sometimes." c. Educate the client that people don't typically lose the ability to learn as they age and encourage him to express his thoughts and feelings associated with aging. d. Assess the client for suicide risk and warning signs. - CORRECT ANSWER C" "1. A soldier who was deployed to Afghanistan a year ago is returning home this week. Which of the following postdeployment situations may be likely to occur during the first few months after returning home to his spouse and family? (Select all that apply.) a. A honeymoon period of physical reconnection b. Resistance from the spouse regarding possible loss of autonomy c. Rejection by the children for perceived abandonment d. A period of adjustment to reconnect emotionally - CORRECT ANSWER A, B, C, D" "7. A veteran of the war in Iraq has been diagnosed with PTSD. He has been hospitalized on the psychiatric unit following an attempted suicide. In the middle of the night, he wakes up yelling and tells the nurse he was having a flashback to when his unit transport drove over an improvised explosive device and most of his fellow soldiers were killed. He is breathing heavily and perspiring, and his heart is pounding. Which is the nurse's most appropriate initial intervention? a. Contact the doctor on call to report the incident. b. Administer the prn order for chlorpromazine. c. Stay with the client and reassure him of his safety. d. Instruct him to sit outside the nurses' station until he is calm. - CORRECT ANSWER C" "8. Mike, a veteran of combat in Afghanistan, has a diagnosis of mild TBI. The psychiatric home health nurse from the VA medical center is assigned to make home visits to Mike and his wife, Marissa, who is his caregiver. Which of the following would be an appropriate nursing intervention by the home health nurse? (Select all that apply.) a. Assess for the use of substances by Mike or Marissa. b. Encourage Marissa to do everything for Mike to prevent further deterioration in his condition. c. Assess Marissa's level of stress and potential for burnout. d. Encourage Marissa to allow Mike to be as independent as possible. e. Suggest that Marissa ask the physician for a nursing home placement for Mike - CORRECT ANSWER A, C, D" "9. A veteran who has returned 6 months ago reports to the mental health clinic, stating, "I'm falling apart. I think I'm losing it." Based on an understanding of common problems among military personnel and veterans, which item should the nurse prioritize in conducting an assessment? (Select all that apply.) a. Screen for alcohol and other drug abuse. b. Assess for suicide risk. c. Evaluate for evidence of TBI. d. Assess for signs and symptoms of PTSD. e. Assess whether the client had evidence of any mental illness symptoms before entry in the military. - CORRECT ANSWER A, B, C, D" "1. Two students fail their introductory nursing course. One student plans to seek tutoring and retake the course next fall. The second student attempts suicide. Which of the following factors would have been influential in the development of the second student's crisis? A. The time of year in which the event occurred B. The presence of support systems C. A lack of adequate coping mechanisms D. The individual's family birth order - CORRECT ANSWER C -coping influences crisis -lack of coping=lead to suicide" "2.For the past 3 days, a student has skipped classes, cried constantly, experienced panic attacks, and is now exhibiting difficulty with short-term memory. In her assessment of this student, what crucial information should the nurse initially obtain prior to planning interventions? A. The student's description of the precipitating stressor B. The student's usual ability to cope with stress C. The student's available support system D. The student's access to community resources - CORRECT ANSWER A -stressor is crucial for planning" "1.Which is a misconception about suicide? A. Eight out of ten individuals who commit suicide give warnings about their intentions. B. Most suicidal individuals are ambivalent about their feelings regarding suicide. C. Most individuals commit suicide by taking an overdose of drugs. D. Initial mood improvement can precipitate suicide. - CORRECT ANSWER C -gunshot is leading cause" "2.The nurse is caring for an actively suicidal client on the psychiatric unit. What is the nurse's priority intervention? A. Discuss strategies for the management of anxiety, anger, and frustration. B. Provide opportunities for increasing the client's self-worth, morale, and control. C. Place client on suicide precautions with one-to-one observation. D. Explore experiences that affirm self-worth and self-efficacy. - CORRECT ANSWER C -one to one observation equals a safe environment -safety is priority" "3.A client with a history of a suicide attempt has been discharged and is being followed in an outpatient clinic. At this time, which is the most appropriate nursing intervention for this client? A. Provide the client with a safe and structured environment. B. Isolate the client from all stressful situations that may precipitate a suicide attempt. C. Observe the client continuously to prevent self-harm. D. Assist the client to develop more effective coping mechanisms. - CORRECT ANSWER D -coping is best" "1.Two months ago, Ms. T was sexually assaulted while jogging in an isolated park. She is hospitalized for suicidal ideation at this time. She awakens in the middle of the night screaming about having nightmares of the incident. Which of the following is the most appropriate initial nursing intervention? A. Call the doctor to report the incident. B. Stay with Ms. T until the anxiety has subsided. C. Administer p r n alprazolam D. Allow her some privacy to work through the emotions. - CORRECT ANSWER B -do not leave client alone experiencing nightmares or anxiety" "2.Which of the following medications is considered to be a first-line medication of choice in the treatment of P T S D? A. Alprazolam B. Propranolol C. Carbamazepine D. Paroxetine - CORRECT ANSWER D -SSRIs are first line" "1.Which of the following complementary therapies has been used successfully to alleviate symptoms in veterans with P T S D? A. Vitamin B12 B. Hypnosis C. Prolonged exposure therapy D. Propranolol - CORRECT ANSWER B -relieves pain, anxiety, nightmares" "1.A suicidal client with a history of manic behavior is admitted to the emergency department. The client's diagnosis is documented as bipolar 1 disorder: current episode depressed. What is the rationale for this diagnosis instead of a diagnosis of major depressive disorder A. The physician does not believe the client is suffering from major depression. B. The client has experienced a manic episode in the past. C. The client does not exhibit psychotic symptoms. D. There is no history of major depression in the client's family. - CORRECT ANSWER B -past history of mania and current suicide attempt support diagnosis of bipolar 1" "2.In the initial stages of caring for a client experiencing an acute manic episode, what should the nurse consider to be the priority nursing diagnosis? A. Risk for injury related to excessive hyperactivity B. Disturbed sleep pattern related to manic hyperactivity C. Imbalanced nutrition, less than body requirements, related to inadequate intake D. Situational low self-esteem related to embarrassment secondary to high-risk behaviors - CORRECT ANSWER A -safety is always most important" "1.An adolescent diagnosed with ADHD is having difficulty maintaining concentration in the inpatient milieu. Which nursing intervention would help improve the client's task performance? A. Mandate that the client remains in his room until all homework is complete. B. Remove privileges if homework is not completed within a 2-hour period. C. Encourage dividing tasks into smaller, attainable steps and reward successful completion. D. Seek a physician's order to discontinue the stimulant methylphenidate (Ritalin). - CORRECT ANSWER C -short span can be overwhelmed with big tasks -reward for completion" "2.Conduct disorder may be a precursor to the diagnosis of which personality disorder? A. Narcissistic personality disorder B. Antisocial personality disorder C. Histrionic personality disorder D. Passive-aggressive personality disorder - CORRECT ANSWER B" "A nurse is assessing a client following a natural disaster that occurred 2 weeks ago. The client is experiencing difficulty sleeping due to nightmares, feelings of survivor guild, and issues concentrating. Which of the following describes the client's symptoms? A. Histrionic personality disorder B. Post-traumatic stress syndrome C. Generalized anxiety disorder D. Acute stress disorder - CORRECT ANSWER D -2 weeks!!!" "A veteran is diagnosed with PTSD. He says "All those wonderful people died, and yet God allowed me to live." Which is the client experiencing - CORRECT ANSWER Survivor's Guilt" "A nurse is caring for a client who was involved in heavy combat and observed war causalities. The nurse should suspect the client is suffering from PTSD if the client makes what comment? - CORRECT ANSWER 'In my dreams, all I can see are the wounded reaching out trying to grab me"" "A nurse is assessing the suicide risk of a group of clients on a mental healthunit. Which of the following clients should the nurse identify as having a risk factor for a suicide attempt? - CORRECT ANSWER A client who usually acts impulsively" "A nurse asks a client who is suicidal to make a safety contract, but the client declines. Which of the following actions should the nurse identify as the priority? - CORRECT ANSWER Assign a staff member to stay with client at all times" "A nurse is collecting data from an adolescent. Which of the following should the nurse identify as the greatest risk for suicide? - CORRECT ANSWER Active psychiatric disorder" "After 3 days of treatment on an acute care mental health unit for depression, the nurse notices the client suddenly seems cheerful and relaxed and there are no longer signs of a depressive state. Which intervention is appropriate? - CORRECT ANSWER Monitor client's whereabouts at all times" "A nurse is making a home visit for a 16-year old who attempted suicide. Which of the following behaviors should alert the nurse that the adolescent still has suicidal intent? - CORRECT ANSWER Planning to give his CD collection to his girlfriend" "A nurse is assessing a client who has PTSD following an assault that caused hospitalization. Which of the following is expected finding? - CORRECT ANSWER Increasing feelings of anger" "A client commits suicide in an acute mental health facility. Which if the priority intervention for staff following incident? - CORRECT ANSWER Identify cues in client's behavior that might have warned them that he was contemplating suicide." "4 levels of Anxiety - CORRECT ANSWER Mild- natural, motivating, Moderate- uncomfortable, Severe- exhausting, Panic- can be violent" "Grief - CORRECT ANSWER The emotional process of coping with loss" "Loss - CORRECT ANSWER Actual or perceived status change in relationship to a valued object or person" "Anticipatory grief - CORRECT ANSWER those expecting a significant loss in the future" "Conventional grief - CORRECT ANSWER grief experienced following a loss" "Bereavement grief - CORRECT ANSWER a natural, healthy, healing process which emerges in response to any significant loss" "Stages of Grief - CORRECT ANSWER Denial, Anger, Bargaining, Depression, Acceptance" "Dysfunctional Grief - CORRECT ANSWER Failure to complete the grieving process and successfully cope with a loss" "Unresolved Grief - CORRECT ANSWER Incomplete grief process resulting in manipulative symptoms continuing months after a loss" "Central traits - CORRECT ANSWER general, prominent features" "Generalized Anxiety Disorder - CORRECT ANSWER experience increased anxiety level and worry re various situations on most days, over a period of at least 6 months" "3 of the following S+S - CORRECT ANSWER excessive worry and anxiety plus (at least 3) of the following: • Restlessness, muscle tension, irritability• Difficulty falling asleep/ staying asleep, fatigue • Chest pain, hyperventilation, headaches • Tremors, increased urinary frequency, GI disturbances" "Panic Disorder - CORRECT ANSWER recurrent, unexpected panic attacks" "Panic Attack - CORRECT ANSWER an intense feeling of fear occurring suddenly and intermittently without warning" "Agoraphobia - CORRECT ANSWER avoidance of specific places, situations tending to trigger panic attacks" "Specific phobia - CORRECT ANSWER excessive, persistent irrational fear of specific objects or situations that pose little danger" "Social Anxiety Disorder - CORRECT ANSWER excessive fear of any social situations in which embarrassment is possible" "Post-traumatic Stress Disorder (PTSD) - CORRECT ANSWER response to a situation involving actual death or threat of severe injury" "Obsessive-compulsive Disorder - CORRECT ANSWER is a common, chronic and long-lasting disorder in which a person has uncontrollable, reoccurring thoughts and behaviours that he or she feels the urge to repeat over and over." "For diagnosis of OCD - CORRECT ANSWER a significant decline in functioning level with actions consuming more than 1 hr per day Invasive, inappropriate thoughts commonly related to sexuality, violence, illness, death or contamination Inability to finish tasks" "Treatment of Anxiety Disorders - CORRECT ANSWER Focus: reduce the anxiety level, Meds: Antianxiety drugs (Valium in the 1950s and now benzodiazepines), Most success combined with psychotherapy" "Mood - CORRECT ANSWER an emotion that is prolonged to the point it colours one's entire psychological thinking" "Affect - CORRECT ANSWER facial expression displayed in association with one's mood" "Euphoria - CORRECT ANSWER the excessive feeling of happiness may escalate to mania" "Mania - CORRECT ANSWER frenzied, unstable mood, may be out of touch with reality" "Major Depressive Disorder - CORRECT ANSWER experience depressed moos/ loss of interest in activities most of each day for 2 weeks; single or recurrent episodes" "S+S major depressive disorders - CORRECT ANSWER hopelessness, guilt, Self-blame, fatigue, appetite loss, weight changes, Decreased libido, crying episodes, irritability, anxiety, Excessive worry, Lack of concentration, difficulty making decisions" "Persistent Depressive Disorder (dysthymic disorder) - CORRECT ANSWER recurrent state of depression for more than 2 years" "Treatment of depressive disorders - CORRECT ANSWER Antidepressants (MAOs, TCAs, SSRIs), mood-stabilizing drugs, Psychotherapy, Electroconvulsive therapy (ECT)" "Treatment of Bipolar and related disorders - CORRECT ANSWER Mood stabilizing drugs (alone or with antipsychotic drugs), Psychotherapy, Meds: Lithium carbonate: effective of manias not on lows, Anticonvulsant" "Psychosis - CORRECT ANSWER a set of symptoms evidencing disorganization in mental processes, Perceptual disturbances, Disorganized thinking, Behaviour alterations, Tend to withdraw from society into own unreal world" "Hallucinations - CORRECT ANSWER false sensory perceptions, unrelated to reality" "Delusion - CORRECT ANSWER fixed, false ideas or beliefs without external stimuli" "Illusions - CORRECT ANSWER sensory stimuli misinterpreted" "Schizophrenia - CORRECT ANSWER a form of psychosis, Disorganized thoughts, perceptual alterations, Inappropriate affect decreased emotional response, Unlinked from reality, Withdrawl into delusional thoughts, misperceptions" "Prodromal - CORRECT ANSWER increased anxiety, distraction, paranoia, delusional thinking, deteriorating relationships" "Acute (Active) - CORRECT ANSWER positive symptoms (Added ex. hallucinations) Negative (taken away ex. Flat affect)" "Paranoid personality disorderS+S - CORRECT ANSWER persistent pattern of suspicion or mistrust, Angry or hostile outbursts, Rigid, inflexible nature, Inability to achieve closeness in relationships, Can't take constructive criticism but is critical to others" "Schizoid personality disorder S+S - CORRECT ANSWER self-absorbed loners, Get less pleasure from soothing, sensual activities, Bland affect, Unresponsive to positive emotions in others, Oblivious to the perception of behaviours by others" "Schizotypal personality disorder S+S - CORRECT ANSWER socially secluded, withdrawn, Strange, unusual patterns of thinking/ communicatinPsychotic behaviour may occur in brief episodes, Magical thinking, Illusions are common Emotions - rigid and inflexible, Little ability to respond to feelings of others" "Cluster B Personality Disorders - CORRECT ANSWER antisocial PD, borderline PD, Narcissistic PD, histrionic PD" "Antisocial personality disorder S+S - CORRECT ANSWER disregard, infringement on rights of others, Cold indifference to laws of society, humanity, A sociopath has no conscience" "Chronic disorder - CORRECT ANSWER difficult to treat" "Impulsive - CORRECT ANSWER victimize others for materialistic self-gain, Continual involvement with law enforcement, Ex. Ted Bundy, Jeffery Dhamer" "Borderline personality disorder S+S - CORRECT ANSWER Unstable relationships, insecurity, mood swings, Impulsive, angry outbursts, easily detached, Chronic sense of emptiness, abandonment, anxiety" "Splitting - CORRECT ANSWER brief episodes of paranoia, hallucinations, Suicide threats and self-mutilation, Experiences of happiness, well-being: rare" "Conversion disorder (functional neurological symptom disorder) S+S - CORRECT ANSWER sensory or neurological impairment, unsupported by diagnostic testing" "Balance, speech, swallowing etc, Contain factor of anxiety to divert attention from the underlying stress situation, Display little concern regarding the implications of symptoms - CORRECT ANSWER " "Factitious disorder S+S - CORRECT ANSWER Intentional falsification of medical or psychological signs/ symptoms to assume the sick role, Imposed on self, another" "Inconsistencies between history + objective findings, Symptoms may be intentionally induced, Planned mimicking of disorders for attention - CORRECT ANSWER " "Dissociation - CORRECT ANSWER a mechanism that allows the mind to separate certain memories, most often of unpleasant situations or traumatic events" "Dissociative Disorder - CORRECT ANSWER disturbance in the ordinarily organized functions of conscious awareness, memory, identity, and view of oneself in relation to the environment" "Dissociative Amnesia - CORRECT ANSWER S+S: inability to remember important personal info, usually of stressful or traumatic nature" "Localized amnesia - CORRECT ANSWER amnesia occurs within a few hours of a traumatic event" "Selective amnesia - CORRECT ANSWER retains a memory of portion of the event only" "Generalized amnesia - CORRECT ANSWER Unable to recall any aspect of life" "Continuous amnesia - CORRECT ANSWER encompasses period up to/ including the present" "Dissociative amnesia with Dissociative Fugue S+S - CORRECT ANSWER Inability to recall some/ all of one's past/ identity, accompanied by sudden, unexpected travel, away from home or place of work, Often remember things unrelated to identity, Unable to remember the time of altered identity upon recovery" "Dissociative Identity Disorder S+S - CORRECT ANSWER formerly known as multiple personality disorder, 2+ distinct identities present in the same person, Each identity may have - name, personal history, memories, behaviour patterns, social relationships, One personality comes out at a time Memory gaps" "Depersonalization/ derealization disorder S+S - CORRECT ANSWER the persistent, repetitive experience of feeling detached from mental processes or body without disorientation, Unsure of personal identity or info" "Derealization - CORRECT ANSWER perceive the external environment as unreal or changing, Anxiety, panic, depression, obsessive + somatic complaints" "Phases of Substance Dependency - CORRECT ANSWER Phase 1- first use, Phase 2- user experiences hangover effects (begins to feel guilty), Phase 3- dependant lifestyle begins, Phase 4- addicted (blackouts, paranoia, helplessness)," "The cycle of Addiction - CORRECT ANSWER Precontemplation, Contemplation, Preparation, Action, Maintenance, (relapse can occur during the action or maintenance stage)" "Substance Intoxication S+S - CORRECT ANSWER psychological changes related to effects of a substance on CNS, Disturbances in attention, concentration, thinking and judgement, Substance Withdrawals, Impaired functioning , Develop several hours to a few days after quitting a drug, Symptoms range from mild to severe, Mild 2-3 symptoms, Moderate 4-5, Severe more than 6" "Alcohol Use Disorder S+S - CORRECT ANSWER Wernicke-Korsakoff Syndrome - psychosis, A nutritional disease of CNS found in alcoholics, Progressive memory loss, weakness, fatigue" "Delirium tremens (DTs) - CORRECT ANSWER profound confusion, delusion and withdrawal symptoms, Anxiety, tremors, seizures, hallucinations, Lasts 72 to 80 hours 20% fatality rate" "Anorexia Nervosa - CORRECT ANSWER antidepressants, antianxiety meds and therapy" "Bulimia therapy - CORRECT ANSWER antidepressants, education, relaxation techniques" "Sexual Disorders - CORRECT ANSWER Gender dysphoria and transsexualism, Paraphilic disorders, Exhibitionist disorderSexual masochism disorder, Sexual sadism disorder, Tranvestic disorder, Voyeuristic disorders, Fetishistic disorder, Pedophilic disorder," 1. Which of the following is a correct assumption regarding the concept of crisis? a. Crises occur only in individuals with psychopathology. b. The stressful event that precipitates crisis is seldom identifiable. c. A crisis situation contains the potential for psychological growth or deterioration. d. Crises are chronic situations that recur many times during an individual's life - CORRECT ANSWER C" "Crises occur when an individual: a. Is exposed to a precipitating stressor b. Perceives a stressor to be threatening c. Has no support systems d. Experiences a stressor and perceives coping strategies to be ineffective - CORRECT ANSWER D" "Which of the following is a desired outcome of working with an individual who has witnessed a traumatic event and is now experiencing panic anxiety? a. The individual will experience no anxiety. b. The individual will demonstrate hope for the future. c. The individual will identify that anxiety is at a manageable level. d. The individual will verbalize the acceptance of self as worthy. - CORRECT ANSWER C" "The client, a firefighter who responded to an industrial explosion, lost a coworker and close friend when they entered a building that collapsed. The client reports that since this event, they have had frequent nightmares and anxiety attacks. The client says to the mental health worker, "I should have died, but instead I lost my best friend!" This statement suggests that the client is experiencing: a. Spiritual distress b. Night terrors c. Survivor's guilt d. Suicidal ideation - CORRECT ANSWER C" "A client is noted to be pacing with clenched fists and saying, "I'm not putting up with this anymore. They've been trying to trick me all along." Which action by the nurse is most appropriate at this point? a. Gently touch the client's shoulder and reassure them that no one is trying to trick them. b. Ask the client to describe what's upsetting them. c. Offer the client medication. d. Don't intervene but continue to watch the client from a distance. - CORRECT ANSWER B" "A client is brought to the emergency room by her roommate, who reports that she was raped at a party earlier that evening. The client appears emotionless. Which action by the nurse is a priority? a. Ask the client if she would like to shower before she is examined. b. Confront the client about her apparent lack of emotion and ask if this was consensual sex. c. Affirm the client for seeking help and ask her to describe what happened. d. Ask the roommate if the client is typically so emotionless. - CORRECT ANSWER C" "A client is admitted to the inpatient psychiatric unit after a suicide attempt. The client reports that they have a history of depression, but they became acutely suicidal after they recently lost their job. Which nursing action is a priority in response to this client's psychiatric crisis? a. Assess why the client lost their job. b. Ensure that the client remains safe and free from further self-injury. c. Explore career interests and other job opportunities. d. Assess for substance use disorder. - CORRECT ANSWER B" "1. Which individual demonstrates the highest number of risk factors for suicide? a. A client who reports that they are in deep emotional pain, feels hopeless, and says "No one is there for me" b. A client who has been seeing a doctor for chronic, intractable pain and is taking pain medication c. An American Indian client who graduated from high school with honors d. A physician who reports feeling "burnt out" and is considering retirement - CORRECT ANSWER A" "The nurse in the emergency department encounters a client who is expressing suicide ideation. The nurse recognizes which consideration as important to good suicide risk assessment? (Select all that apply.) a. Collaborating with the client b. Asking specific questions about leisure activities c. Establishing trust and open communication with the client d. Asking the client specific questions about the strength of their intention to die e. Identifying whether the client has thought about a plan for trying to kill themselves - CORRECT ANSWER A, C, D, E" "6. Trauma-informed care is a philosophical approach that includes which principles? (Select all that apply.) a. Nurses need to be aware of the potential for trauma in any client and provide care that minimizes the risk of revictimization or retraumatization. b. Medications need to be given before any other interventions are considered. c. Trauma-informed care highlights the importance of providing care that protects the physical, psychological, and emotional safety of the client. d. Trauma-informed care is based on the principle that traumas are not correlated with depression or increased risk for suicide. - CORRECT ANSWER A, C" "7. A client experiences a nightmare during their first night in the hospital. The client explains to the nurse that they were dreaming about gunfire all around and people being killed. Which is the nurse's most appropriate initial intervention? a. Administer alprazolam as ordered prn for anxiety. b. Call the physician and report the incident. c. Stay with the client and reassure them of their safety. d. Have the client listen to a tape of relaxation exercises. - CORRECT ANSWER C" "8. . A client who recently divorced after 10 years of marriage is admitted to the hospital with a diagnosis of adjustment disorder with depressed mood. The client acknowledges difficulty adjusting to an independent lifestyle and having thoughts of taking an overdose of acetaminophen. Which is the priority nursing diagnosis for this client? a. Risk-prone health behavior b. Maladaptive grieving c. Ineffective communication d. Risk for suicidal behavior - CORRECT ANSWER D" "9. A client, who is depressed following the breakup of a very stormy marriage, says to the nurse, "I feel so bad. I thought I would feel better once I left, but I feel worse!" Which is the best response by the nurse? a. "Cheer up. You have a lot to be happy about." b. "You are grieving the loss of your marriage. It's natural for you to feel bad." c. "Try not to dwell on how you feel. If you don't think about it, you'll feel better." d. "You did the right thing. Knowing that should make you feel better." - CORRECT ANSWER B" "7. To help a child with mild to moderate intellectual developmental disorder develop satisfying relationships with others, which nursing intervention is most appropriate? a. Interpret the child's behavior for others. b. Set limits on behavior that is socially inappropriate. c. Allow the child to behave spontaneously without the concept of right or wrong. d. Discourage relationships because the child is not capable of forming social relationships. - CORRECT ANSWER B" "8. The child with autism spectrum disorder often has difficulty with trust. With this in mind, which nursing action would be most appropriate? a. Encourage all staff to hold the child as often as possible, conveying trust through touch. b. Assign a different staff member each day so the child will learn that everyone can be trusted. c. Assign the same staff person as often as possible to promote feelings of security and trust. d. Avoid eye contact because it is extremely uncomfortable for the child and may even discourage trust. - CORRECT ANSWER C" "9. Which nursing diagnosis would be considered the priority in planning care for a child with a severe ASD? a. Risk for self-mutilation evidenced by banging head against wall b. Impaired social interaction evidenced by unresponsiveness to people c. Impaired verbal communication evidenced by absence of verbal expression d. Disturbed personal identity evidenced by inability to differentiate self from others - CORRECT ANSWER A" "10. A client with ODD has been admitted to a residential treatment setting and tells the nurse, "I don't want to be here and you're not in charge of me." Which intervention by the nurse is a priority? a. Instruct the client that they will have to follow the rules, or they will be put in seclusion. b. Provide information about the structured activities and behavioral expectations in the treatment program. c. Give positive feedback to the client for their assertive communication. d. Ask the client whether they would rather go to jail. - CORRECT ANSWER B" "2. Which of the following is the leading cause of traumatic brain injury (TBI) in active-duty military personnel in combat? a. Military vehicle accidents b. Blasts from explosive devices c. Falls d. Blows to the head from falling debris - CORRECT ANSWER B" "3. A veteran of the war in Iraq has been diagnosed with post-traumatic stress disorder (PTSD). He is a client of a VA outpatient clinic. He tells the nurse during his outpatient clinic visit that he experiences panic attacks. Which of the following medications may be prescribed to treat his panic attacks? a. Alprazolam b. Lithium c. Carbamazepine d. Haldol - CORRECT ANSWER A" "4. Which of the following psychosocial therapies has been shown to be helpful for clients with TBI? a. Eye movement desensitization b. Psychoanalysis c. Reality therapy d. Cognitive behavior therapy - CORRECT ANSWER D" "5. A client who was injured during combat in Afghanistan has a diagnosis of TBI. Which of the following medications might the physician prescribe to improve his memory and thinking capability? a. Carbamazepine b. Duloxetine c. Donepezil d. Bupropion - CORRECT ANSWER C" "6. A veteran of the war in Iraq has been diagnosed with PTSD. He has been hospitalized after swallowing a handful of his antianxiety medication. His physical condition was stabilized in the emergency department, and he has been admitted to the psychiatric unit. In developing his initial plan of care, which is the priority nursing diagnosis? a. Post-trauma syndrome b. Risk for suicide c. Complicated grieving d. Disturbed thought processes - CORRECT ANSWER B"