Albany State University NURS 5410; NURS5410 Final Exam| Answered Correctly_ 100% Update latest 202/26.

Albany State University NURS 5410; NURS5410 Final Exam| Answered Correctly_ 100% Update latest 202/26. Question 1. What are the issues pertaining to general concerns of the professional boundaries of the nurse-client relationship? Select all that apply. Trust Touch Gift-giving Genuineness Self-disclosure Question 2. The nurse accepts a client unconditionally and regards him or her as a worthy person. Which characteristic is exhibited by the nurse? Trust Respect Empathy Genuineness Question 3. The nurse patted a client’s back while providing care. The client felt offended by the nurse’s gesture. Which boundary is in jeopardy in this situation? Social boundary Material boundary Personal boundary Professional boundaryQuestion 4. The nurse is providing feedback to a client. Which statement indicates that the nurse is making a judgment about the client? 1234 Question 5. Which phase of the therapeutic relationship will help the nurse overcome resistance behaviors of the client whose level of anxiety has risen? The working phase The orientation phase The termination phase The preinteraction phase Question 6. The nurse is disciplined for having dinner after hours with a client. Which type of boundary was breached? Material boundaries Professional boundaries Personal boundaries Social boundaries Question 7. What is an example of a negative attitude? Having an idea that alcoholism is a diseaseThe negative stigma associated with mental illness Conveying the truth to all psychotic clients about their medical illness Conjecturing that all people with mental illness are dangerous Question 8. A nurse working in labor and delivery loves her job working with new mothers and babies. Having been a single pregnant teenager who chose not to keep her baby, she often volunteers with the local crisis pregnancy center counseling young women. However, when working with young women who are inquiring about abortion, she unconsciously becomes very mechanical showing little to no emotion. Which component of Johari’s window explains why this occurs? Others are aware of what is occurring, but the nurse is not. Characteristics are unconscious because the private self will not allow for public awareness. Both the nurse and the public are unaware of what is occurring. The nurse is exhibiting characteristics that are known to the public and the nurse, even though they are unconscious. Question 9. The nurse is caring for a psychiatric client who has been rejected by his partner. Which nursing intervention will increase feelings of self-worth in the client? Expressing empathy towards the client Getting acquainted with the client Recognizing and respecting the client Providing a safe environment to the client Question 10. The nurse remains respectful of a client who is engaging in behaviors opposed to the nurse’s religious beliefs. Which describes the nurse’s response? Confidentiality Unconditional positive regard Genuineness Concrete thinkingQuestion 11. The nurse is caring for a client who is in the isolation room. Which statement made by the nurse indicates that the nurse is trying to increase the client’s feeling of self-worth? “I see you put away your clothes.” “I’ll sit in here with you for a while.” “I notice you are pacing a lot.” “Yes, I understand what you said.” Question 12. Which actions of the nurse convey an attitude of respect towards the client? Select all that apply. Being honest while interacting with the client Calling the client by name Spending time with the client Understanding the situation from the client’s point of view Promoting an atmosphere of privacy during therapeutic interaction Question 13. The nurse is in the first phase of relationship development with a client who is an alcoholic. What should be the goal of the nurse during this phase? Establishing trust Promoting client change Exploring self-perceptions Ensuring therapeutic closure Question 14. A client in group therapy is uncomfortable speaking in front of other members but communicates openly in a one-to-one session with the nurse. Which element is contributing to the client’s anxiety? Religion Values Environment Culture Question 15. The nurse is caring for a client during an angermanagement program. Which action represents the working phase of therapeutic relationship management? The nurse preparing a plan for continuing care.The nurse assessing the client’s previous medical records. The nurse helping the client practice various adaptive procedures to control anger. The client and nurse setting goals to develop some adaptive ways to handle anger. Question 16. A client mentions to the nurse that his “girlfriend” is coming by to see him and not to tell his wife. The nurse does not condone this type of behavior and is offended. The client and nurse obviously have a difference in what? Faith Beliefs Values Attitude Question 17. A student nurse has been assigned to care for a client who has been diagnosed with HIV and AIDS related lymphoma. The nurse quickly responds that the client “should have chosen a different lifestyle!”. Which belief does the nurse have towards this client? Bigotry Stereotype Rational beliefs Irrational beliefs Question 18. The nurse knows which is an important characteristic of the therapeutic relationships? Self-directed Goal-oriented One-sided Collaborative Question 19. Which action of the nurse indicates the working phase of relationship development with a client? Formulating nursing diagnoses Examining the client’s feelings, fears, and anxieties Continuously evaluating the client’s progress towards goal attainment Developing a plan of action that is realistic for meeting the goalsQuestion 20. Based on an understanding of Peplau’s subroles, which interventions would be appropriate for a nurse acting as “teacher”? Select all that apply. Assist client in making alternate choices. Identify what is troubling the client at the present time Discuss alternative strategies for creating changes the client desires to make. Discuss with the client which changes are possible and which are not possible. Assist the client to evaluate outcomes of the change and make modifications as required. Question 1. What are the qualifications required to direct a client to enact a real-life situation as a part of milieu therapy? Degree in dietetics Degree in art therapy Degree in recreational therapy Degree in social work, psychology, medicine, or nursing Question 2. Which category of psychotropic medications increases receptor affinity for the neurotransmitter GABA (gamma-aminobutyric acid)? Benzodiazepines MAO (monoamine oxidase) inhibitors SSRIs ( selective serotonin reuptake inhibitor) SSNRIs (selective serotonin-norepinephrine reuptake inhibitor) Question 3. Which term is used to refer to the personal beliefs of the nurse about what is important and desirable in a given situation? Rights Moral behavior Ethics Values Question 4. While caring for a client with mental illness, the nurse finds that the client has no hope for recovery. Which stage of the psychological recovery model does the nurse anticipate in this client?Moratorium- characterized by dark despair and confusion Awareness Preparation Rebuilding Question 5. The nurse is teaching a newly recruited nurse about unlawful acts. Which action described by the nurse would be categorized as intentional tort? Failing to fulfill an obligation to others Stealing hospital supplies and drugs Showing negligence during a medical treatment Touching a client without his or her consent Question 6. Which client may experience triggers, according to the Wellness Recovery Action Plan (WRAP) model? A client who ends a relationship with his or her partner A client who spends time with children A client who drinks at least six 8-ounce glasses of water a day A client who is doing special activities for someone else Question 7. The nurse uses the Tidal Model of recovery in a psychiatric nursing practice. Which interventions indicate that the nurse is implementing the “value the voice” commitment? Asking the client for clarification of certain points Helping the client to record his or her own story in own words Encouraging the client to speak in his or her own words Assisting the client to unfold his or her own story at own pace Question 8. During an education session, the psychiatric nurse states that recovery encompasses an individual’s whole life, including mind, body, spirit, and community. Which guiding principle of recovery does the nurse address through this statement? Recovery is holistic Recovery is person-driven.Recovery is based on respect. Recovery occurs via many pathways. Question 9. Which interventions should the nurse implement to prevent malpractice while caring for a client with psychiatric illness? Select all that apply. Responding to the client Careful documentation of the client’s response Educating the client about his or her condition Discussing the client’s condition with other nurses Performing routine body searches in mentally ill clients Question 10. The nurse has educated a client and family members about exercising their legal rights during an unfavorable situation in a health-care facility. Which ethical principle has the nurse demonstrated? Justice Veracity Autonomy Beneficence Question 11. What steps should the nurse follow while making an ethical decision? Arrange the steps in priority. Evaluate the outcomes of the decision. 4 Explore the benefits and consequences of each alternative. 3 Identify the conflict between two or more alternative actions. 2 Gather objective and subjective information about the situation. 5 Implement the decision made and communicate the same to others. 1 Question 12. A client tells the nurse, “I recognize that my illness has not paralyzed me.” What does the nurse interpret from the client’s statement? The client is in the rebuilding stage of recovery.The client is in the preparation stage of recovery. The client is in the awareness stage of recovery. The client is in the moratorium stage of recovery. Question 13. Which statement made by the student nurse about the growth stage of the Psychological Recovery Model needs correction? “Clients in the growth phase exhibit confidence while managing their illnesses.” “Clients in the growth stage develop a sense of optimism and hope fora rewarding future.” “Clients in the growth stage have developed a strong, positive sense of self and identity.” “Clients in the growth phase will make decisions by seeking the advice of others.” Question 14. Which structure of the brain is referred to as the “emotional brain”? Thalamus Hypothalamus Limbic system Cerebrum Question 15. Which actions in the nursing practice can result in the nurse being accused of false imprisonment? Select all that apply. Keeping an aggressive client alone in a room Taking the clothes of a depressed client against his or her wishes Restraining the extremities of a voluntary competent client demanding release Locking the client in a room for the nurse’s convenience Administering tranquilizers to the client who attempts to harm others Question 16. What are the psychiatric disorders in which familial tendencies are indicated? Select all that apply. Schizophrenia Cystic fibrosis Phenylketonuria Down syndrome Anorexia nervosaQuestion 17. During a therapeutic community setting, the therapist assigns responsibilities to the client. What is the rationale behind this intervention of the therapist? To enhance self-esteem in the client To facilitate interpersonal communication of the client To reinforce the democratic posture of the group To facilitate discharge of the client from treatment Question 18. The nurse uses the tidal model of recovery in psychiatric nursing practice. Which interventions indicate that the nurse is implementing the “develop genuine curiosity” commitment? Select all that apply. Showing interest in the client’s story Asking the client for clarification of certain points of the client’s story Encouraging the client to speak in his or her own words in a unique way Assisting the client in unfolding the story at his or her own pace Providing the client with copies of all documents relevant to his or her care Question 19. Which interventions of the nurse indicate his or her moral behavior? Select all that apply. Being truthful to clients Upholding the rights of a client Caring for all clients alike without discrimination Understanding the effect of values on nursing outcomes Identifying and ranking his or her own personal values Question 20. The nurse finds that a client with schizophrenia is aggressive and attempted suicide. On inquiry, the nurse learns that the client harmed the caregiver while the caregiver tried to rescue the client. Which ethical principle should the nurse break in this situation? Justice Autonomy Beneficence Nonmaleficence Question 21. While making an ethical decision, the nurse thinks, “It is my moral duty to convey the truth to the client even if it is not beneficial.” Which phase of ethical decisionmaking is indicated by the nurse’s thought process?Planning Evaluation Assessment Problem identification Question 22. Which client shows decreased levels of norepinephrine in the body? A client with depression A client with mania A client with anxiety A client with schizophrenia Question 23. Which psychiatric client requires the nurse to obtain informed consent from the closest relative before treatment? A client who is aggressive and attempting to harm others A client who is mentally incapable of making decisions and attempts suicide A client who is scheduled for electroconvulsive therapy A client with a life-threatening condition Question 24. The primary health-care provider prescribes antipsychotic medications to a client with bipolar disorder. The client refuses to take the medication. The nurse does not administer the medication, but monitors the client for the presence of psychotic symptoms. What is the most beneficial ethical principle the nurse implements in this situation? Veracity Autonomy Beneficence Nonmaleficence Question 25. Which ethical theory involves a mental conflict between moral values? Kantianism Ethical egoism Ethical dilemma Natural law theory Question 1. Which symptoms indicate that a client with bipolar disorder is experiencing depressive episodes? Select all that apply.Euphoric mood Elevated energy Racing thoughts Suicidal thoughts Sad or empty mood Question 2. Which therapy might be helpful to the client with bipolar II disorder who is not responding to lithium therapy? Cognitive therapy Individual therapy Electroconvulsive therapy Family therapy Question 3. A client with mania has shown progressive improvement with lithium therapy. After successful treatment, the client is discharged. What suggestions should the nurse give to the client? Select all that apply. “Avoid salt in your diet.” “Stop taking the medication if there is an excessive weight gain.” “Notify the primary health-care provider if pregnancy is planned or suspected.” “Contact the primary health-care provider if you have excessive vomiting.” “Rise slowly from a sitting or lying position.” Question 4. Order is for 900 mg in the morning and 900 mg at night daily. The nurse has lithium carbonate extended-release tablets USP in 300 mg per tablet available. How many total tablets should the client take each day? 6 Question 5. The primary health-care provider prescribes lithium carbonate therapy to a client with mania. Which instruction should the nurse provide to the client to prevent adverse effects associated with the medication? “Drink 5 cups of tea each day.” “Drink 5 cups of coffee each day.” “Drink 4 large glasses of cola each day.” “Drink 6 to 8 large glasses of water each day.” Question 6. While interacting with a client, the nurse suspects that the client is having a manic episode of bipolar disorder. Which statement supports the nurse’s suspicion?The client has 8 hours of sleep. The client has deflated grandiosity. The client has elevated or irritable mood. The client has decreased goal-directed activity. Question 7. What are the characteristic cognitive symptoms observed in a client with delirious mania? Select all that apply. Stupor Confusion Disorientation Loquaciousness Disjointed thinking Question 8. Which behavioral characteristics does the nurse observe in a client with hypomania? Weight gain Pressured speech Increased goal directed activity Increased perception of environment Question 9. Which actions by the nurse will help a hyperactive client to achieve much-needed rest? Providing juice and snacks to the client often Sitting with the client while eating Providing a structured schedule of activities for the client Providing stimulating drinks to the client before bedtime Question 10. The nurse is caring for a client who is diagnosed with hypomania. Which behavior does the nurse find in the client? Select all that apply. The client is cheerful and expansive with an underlying irritability. The client shows extreme fluctuating emotions. The client tries to maintain a close friendship with the nurse. The client engages in excessive personal hygiene and grooming. The client talks and laughs very loudly while communicating with the nurse. Question 11. Which stage of mania is associated with the behavior of being socially and sexually uninhibited?Psychosis Hypomania Acute mania Delirious mania Question 12. When teaching the client about bipolar disorder, the nurse knows that which is true? Bipolar disorder affects approximately 5.7 million American adults, or about 2.6 percent of the U.S. population ages 18 and older in a given year. 30% percent of the cases of bipolar disorder are considered severe. The average age of onset for bipolar disorder is 35 years of age, and following the first manic episode, the disorder tends to be recurrent. Bipolar disorder is the ninth leading cause of disability in the middle age group. Question 13. A nurse caring for a manic client observes that the client has persistent gastrointestinal upset and blurred vision. After reviewing the laboratory reports, the nurse finds that the client has signs of lithium toxicity. What concentration of lithium does the nurse find in the client’s blood serum? 0.5 mEq/L 1.8 mEq/L 2.5 mEq/L 3.4 mEq/L Question 14. While educating a client diagnosed with bipolar disorder, the nurse teaches the client to avoid excessive exposure to very high or low temperatures. Which category of medications might be present on the medication list of the client? Antimanic Antipsychotic- may increase skin sensitivity toward extreme temperatures Anticonvulsant Calcium channel blocker Question 15. What should the nurse assess in the client with mania who reports short periods of sleep? Select all that apply. Skin color Temperature Fine tremors Slurred speechPuffy , dark circles under eyes Question 16. The nurse is caring for a client who is experiencing very frequent manic episodes. Which intervention by the nurse may help the client to reduce the manic episodes of bipolar disorder? Providing a milieu unit Providing a brightly lit unit Providing a private room in a quiet unit Providing a private room with embellished decor in a quiet unit Question 17. What does the nurse expect in a client who shows hypomanic episodes of bipolar disorder? The client shows social impairment The client shows psychotic features. The client shows manic symptoms that last for a week. The client shows manic symptoms that last for at least 4 consecutive days Question 18. A client who is experiencing frequent manic episodes has a delusional thought process and low self-esteem. The nurse finds that the client is trying to manipulate others for self-gratification. Which interventions included in the client’s care plan should the nurse expect to improve the client’s self-esteem? Setting limits on manipulative behaviors Maintaining a calm and matter-of-fact attitude Reinforcing acceptable behaviors in the client Helping the client to accept the consequences of manipulative behaviors Question 19. While communicating with a client, the nurse suspects that the client has a manic episode of bipolar disorder. Which statement of the client supports the nurse’s suspicion? “I sleep for 8 hours daily.” “I pinch myself when I feel guilty.” “I communicate better than anyone else.” “I participate in debates frequently.”Question 20. A client is diagnosed with bipolar II disorder with delirious symptoms of mania. Which interventions should the nurse include in the client’s care plan? Engage the client in rigorous physical activities. Provide information about support groups. Take measures to prevent suicidal ideations in the client. Provide low-calorie foods and fluids. Question 21. The nurse is teaching high school students the dangers of certain drugs. The nurse would teach them that withdrawal from which type of drugs does not cause bipolar disorder? Inhalants Alcohol Cocaine Amphetamines Question 22. What should the nurse advise for a client with bipolar disorder who is on lithium carbonate therapy to prevent persistent vomiting and diarrhea? Discontinue the use of lithium Consume a diet with adequate sodium Provide one liter of fluid per day Observe for drowsiness and dizziness in the client Question 23. A client is admitted into the psychiatric unit with symptoms of hypomania. The client’s history indicates that the client has never experienced a full manic episode. What should the nurse infer from these findings? The client has schizophrenia. The client has bipolar I disorder The client has bipolar II disorder.- has symptoms of depression or hypomania, but the client does not experience full manic episodes. The client has obsessive-compulsive disorder. Question 24. What is the daily dose range of lithium carbonate? 100 to 800 mg 200 to 1600 mg600 to 2400 mg 1800 to 2400 mg Question 25. A client with mania reports an inability to sleep. What appropriate actions does the nurse take to help the client sleep better? Select all that apply. Provide a low-protein diet. Administer sedative agents as prescribed. Provide a warm bath before sleep. Provide tea or coffee before sleep. Help to perform relaxation exercises before sleep. Question 1. A client who is on antidepressant therapy visits the hospital after a week and complains, “Ever since I started taking the medication I am dizzy, and moreover, I can see no improvement in my condition.” What information provided by the nurse is beneficial to the client? “Stop taking the drug until the dizziness subsides, and resume the course later.” “Avoid consuming red wine and aged cheese because they increase depression.” “Rest when you feel dizzy, it may take some time for your medication to work.” “Never stop the therapy. Take over-the-counter medications if a headache accompanies your dizziness.” Question 2. The nurse is caring for a client who lost his or her brother in a plane crash. Which indicates effectiveness of the nursing care? The client will not harm himself or herself. The client participates in daily activities. The client expresses anger about the loss. The client will be able to take control of his or her life situations. Question 3. Which type of depression occurs with everyday disappointments? Mild depression Severe depression Transient depressionModerate depression Question 4. The nurse is caring for a client who has suicidal thoughts. What should be the primary intervention by the nurse? The nurse should create a safe environment for the client. The nurse should make frequent rounds at irregular intervals. The nurse should take special care while administering medications. The nurse should take a promise from the client that he or she will seek out help from the staff members if thoughts of suicide emerge. Question 5. Which affective symptoms observed in a client will enable the nurse to confirm that the client is suffering from transient depression? Select all that apply. Low-self esteem Denial of feelings Feelings of sadness Feeling downhearted Feelings of worthlessness Question 6. A nurse is conducting the clinical interview of a client with depression. Which statement by the client indicates low selfesteem? “I get angry without any reason.” “I am not worthy enough to do my job.” “I don’t have any control over situations.” “I do not find pleasure and interest in the usual activities.” Question 7. The nurse is caring for a client who is a musician and goes into a state of depression after the death of his or her spouse. The nurse tells the client, “It is normal to feel sadness after losing a spouse. It will help if you will refocus on something you love, such as your music.” What statement made by the client after a few days indicates effective nursing intervention? “Music was my passion until caring for my spouse started taking up all my time.” “I need more time to refocus on music.” “I will now be able to record good music for my upcoming album.” “God has not helped me to understand the meaning of life.”Question 8. The nurse is providing information about dietary restrictions to a client who was prescribed a Monoamine Oxidase Inhibitor (MAOI) to treat depression. Which food product can the client consume safely while on MAOI therapy? Beer Soy sauce Blue cheese Cottage cheese Question 9. Which therapy is beneficial to a client who frequently expresses the thought, “I am a complete failure,” and feels depressed? Light therapy Family therapy Cognitive therapy- this therapy helps relieve the thought distortions that cause depression in the client. Electroconvulsive therapy (ECT) Question 10. The nurse is caring for a client with depression. What is be the primary nursing intervention in this client? Develop a trusting relationship with the client. Help the client openly express his or her feelings. Help discharge pent-up anger in the client. Tell the client that crying is acceptable and relieves depression Question 11. The nurse reviews the prescription of a client with depression and informs the client, “You should make sure you slowly rise up from the sitting or lying down position.” What is the nurse expecting to control in the client? Variation in blood pressure Variation in urinary patterns Variation in serotonin levels Variation in blood glucose levelsQuestion 12. A client reports to the psychiatrist, “I feel very confident in the morning, but I get worse as the day progresses. I am unable to sleep at night due to headache, backache, chest pain, and abdominal pain. It all started after I broke up with my girlfriend.” Which type of depression is the client experiencing? Mild depression Severe depression Transient depression Moderate depression Question 13. A nurse is caring for a client with suicidal tendencies. Which client outcome would be the best indicator of the effectiveness of the nursing interventions? The client has avoided self-harm. The client sleeps without any difficulty. The client interacts appropriately with others. The client has good perceptions about him- or herself. Question 14. Which type of depression involves mood variation that is worse in the morning and gets better as the day progresses? Mild depression Severe depression Moderate depression Transient depression Question 15. Which behavioral symptoms are observed in a client with moderate depression? Select all that apply. Slowed physical movement Sitting in curled-up position Rapid, agitated, and purposeless movements Limited verbalization reflecting delusional thinking Decreased interest in personal hygiene and grooming Question 16. When prioritizing nursing diagnoses for a client with depressive disorder, which has the highest priority? Risk for suicide Spiritual distress Imbalanced nutrition: Less than body requirementsDisturbed thought processes Question 17. A mother of a 16-year-old client reports, “My daughter has been in an irritable mood for two weeks and has lost weight considerably.” The primary health-care provider suspects the client has major depressive disorder. Which further questions will help the primary health-care provider to confirm major depressive disorder? Select all that apply. “Does your daughter have a history of seizures?” “Do you ever notice your child talking about suicide?” “Does your daughter still participate in her usual activities?” “Is your daughter currently under therapy for hyperthyroidism?” “Are there any signs of mood swings expressed by your daughter?” Question 18. In a client with depression, which part of the brain is associated with psychomotor retardation or agitation? A B C DQuestion 19. Which type of treatment modality is beneficial to a client who experiences winter “blues”? Light therapy Cognitive therapy Electroconvulsive therapy (ECT) Transcranial magnetic stimulation (TMS) Question 20. A client says, “I am just hopeless. I hate myself. I do not have any reason to live.” What would be the best response of the nurse to this client? “Don’t feel that everyone will leave you. Your family will always be with you.” “Don’t feel that you cannot do anything. You can be independent.” “Don’t live in the past. I will be your friend.” “Don’t think that way. I will spend time with you because you are a worthwhile person. Question 21. A nurse is caring for a client who is in a depressed mood and states, “I am worthless. I want to go away because my family no longer needs me.” The nurse encourages the client to express honest feelings and suggests working on adaptive coping skills. What outcome can be expected from the nursing intervention? The client will set realistic goals for him-/herself. The client will have decreased self-harming behavior. The client will understand the stage of his or her grief process. The client will be able to discuss his or her feelings of loss. Question 22. A primary health-care provider observes that a client with dysthymia has a slumped posture and slowed speech. Which spheres of human functioning might be altered in the client? Affective Cognitive Behavioral Physiological Question 23. A client with severe depressive disorder is found to be obsessively washing hands and is scheduled for therapy. Which therapy would be beneficial to control this condition in the client?Light therapy Group therapy Cognitive therapy Electroconvulsive therapy Question 24. A geriatric client who is tolerant to antidepressants was brought to the hospital after attempting suicide. What would be the best treatment approach for such a client? Group therapy Family psychotherapy Interpersonal therapy Electroconvulsive therapy Question 25. Which side effect of the drug trazodone may result in impotence? Amnesia Anorexia Priapism Hypertensive crisis Question 1. While communicating with a client, the nurse suspects that the client has agoraphobia. Which response of a client supports the nurse’s suspicion? Select all that apply. The client is repeating words silently. The client is afraid to venture out alone. The client is afraid to be in parking lots. The client has fear of taking the bus for transportation. The client is scratching his/her own body to relieve from tension. Question 2. A client who is being treated for anxiety develops sexual dysfunction. Which medication in the prescription would need to be replaced? Diazepam Fluoxetine Propranolol PentobarbitalQuestion 3. Which conditions should the nurse monitor in the client with anxiety disorder who is on buspirone therapy and report to the primary health-care provider? Select all that apply. Fever Bruising Dry mouth Sore throat Orthostatic hypotension Question 4. The nurse educator is teaching nursing students about anxiety. Which statement included in the teaching is correct? Select all that apply. Anxiety, which provides the motivation for achievement, is a necessary force for survival. Anxiety is the same as stress. A stressor is an external pressure that is brought to bear on the individual. Anxiety may be distinguished from fear in that anxiety is an emotional process while fear is a cognitive one. Anxiety involves the intellectual appraisal of a threatening stimulus; fear involves the emotional response to that appraisal. Question 5. While caring for a client with anxiety, the nurse suspects that the client has ineffective impulse control. Which behavior of the client supports the nurse’s suspicion? The client is afraid to venture out alone. The client repeatedly pulls out his/her own hair. The client is unable to meet basic needs of life. The client visited a plastic surgeon many times. Question 6. What characteristic symptoms does a client who has social phobia exhibit? Select all that apply. The client has a fear of using public restrooms. The client is afraid of snakes. The client does not cook food because of the fear of fire. The client is afraid to present a speech in an auditorium. The client gets embarrassed during stage performances.Question 7. During the assessment the client says, “I need to visit my daughter.” The client repeats this sentence many times even without any context. What condition would the nurse suspect in the client? Panic disorder Hoarding disorder Generalized anxiety disorder Obsessive-compulsive disorder Question 8. The nurse is caring for a client with intense physical discomfort. On interaction with the client, the nurse learns that the client has panic anxiety disorder. Based on what observations does the nurse make this conclusion? Select all that apply. The client has ataxia. The client has feelings of choking. The client has feelings of derealization. The client has feelings of being detached from the self. The client has poor memory and difficulty in concentrating. Question 9. Which psychological change will be observed in a client with posttraumatic stress disorder after undergoing successful cognitive therapy? The client will be able to share his experiences with others. The client can verbalize the problems related to social adaptation. The client will have more accurate and less distressing thoughts. The client will no longer experience anxious arousal due to memories of the traumatic event. Question 10. A client diagnosed with posttraumatic stress disorder (PTSD) is undergoing group therapy. What treatment outcome can be expected in the client after successful group therapy? The client will not express guilt about the traumatic event. The client becomes more optimistic and hopeful about the future. The client will manage his or her aggressive behavior toward others. The client will no longer attempt to avoid the memories of traumatic events. Question 11. Which medications may cause substance-induced anxiety disorder? Select all that apply.Hypnotics Anxiolytics Analgesics Amphetamines Antihistamines Question 12. Which medication for treating posttraumatic stress disorder (PTSD) has a risk of drug dependence? Sertraline Paroxetine Alprazolam Propranolol Question 13. Which action by the client being treated for posttraumatic stress disorder (PTSD) indicates the effectiveness of the therapy? Expressing anger toward the loss Discussing the traumatic incident without fear Coping effectively with change in daily activities Beginning a healthy grief resolution with physiological healing Question 14. Which therapy may help the client to recognize and modify trauma-related thoughts? Group therapy Cognitive therapy Prolonged exposure (PE) therapy Eye movement desensitization and processing (EMDR) therapy Question 15. What is the goal of behavior therapy for a client with maladaptive behaviors? To examine the stressor To emphasize communication To resolve the immediate crisis To improve adaptive responses in the client Question 16. Which event may lead to posttraumatic stress disorder (PTSD)?Chronic illness Marital conflict Unemployment Natural disaster Question 17. Which statement of the client supports the nurse’s suspicion that the client has obsessive-compulsive disorder? “I wash my hands every 15 minutes.” “I have 12 puppies and I love caring for them.” “My nose has a deformity even after rhinoplasty.” “I bite my nails and scratch myself in extreme tension.” Question 18. A client is receiving treatment for generalized anxiety disorder. What outcomes in the client indicate that the nursing interventions are effective? Select all that apply. The client recognizes the signs of escalating anxiety. The client manages anxiety while taking a challenging exam. The client manages anxiety without using repetitive behaviors. The client expresses that he or she has a good physique and attractive eyes. The client is able to make independent decisions about future studies. Question 19. Which statement of the client indicates the symptom of marked alterations in arousal and reactivity associated with the traumatic event? “I can never trust anybody.” “I feel detached from the world.” “I feel irritable and annoyed most of the time.” “I avoid any activity that reminds me of the trauma.” Question 20. Which therapy of adjustment disorder includes roleplaying and coaching to alter maladaptive response patterns? Psychotherapy Cognitive therapy Behavior therapy Prolonged exposure therapyQuestion 21. The nurse is caring for a client with body dysmorphic disorder. The nurse knows that the client will probably be prescribed a medication from which classification of medication? Antidepressants Beta blockers Anxiolytics Antihypertensive agents Question 22. Which type of stress reactions can lead to posttraumatic stress disorder? Select all that apply. Divorce Failure in love Surviving a hurricane Serious accidents Loss of employment Question 23. A client presents to the emergency department insisting that he is sure he is about to die because he suddenly feels hot and is experiencing a choking sensation. Physical problems are ruled out and a psychiatric consultation is ordered. The nurse expects the client will be diagnosed with which disorder? Panic Generalized anxiety disorder Agoraphobia Social anxiety disorder Question 24. A client with anxiety disorder is prescribed buspirone. The nurse explains to the client about safe drug administration. Which information, if not included in the medication instruction, may result in the therapy being perceived to be ineffective? The drug shows its action in 10 to 14 days. The drug may cause nausea and vomiting. The drug can be taken with milk and food. The drug may cause orthostatic hypotension. Question 25. What side effects does the nurse expect in a client who is on buspirone therapy? Select all that apply. DiarrheaInsomnia Headache Constipation Sexual dysfunction Question 1. The client says, “I don’t know why the doctor put me in the psychiatric unit. I have a physical problem.” Which statement would indicate the effectiveness of the nursing care plan for this client? The client verbalizes psychological factors affecting his or her physical condition. The client recovers deficits in memory and develops more adaptive coping mechanisms. The client demonstrates the ability to perceive stimuli correctly. The client recognizes signs and symptoms of escalating anxiety. Question 2. A client is describing herself as having a profound sense of internal conflicts between parts of herself, even giving these parts separate names. The nurse knows that this a symptom of which diagnosis currently found in the DSM-5? Dissociative identity disorder-characterized by the existence of two or more personality states in a single individual. Multiple Personality Disorder- newer name for multiple personality disorder Schizophrenia Schizoaffective disorder Question 3. Which symptoms in a client indicate depersonalization? Select all that apply. Feelings of unreality about one’s thoughts Feelings of detachment from his or her own body Feelings of detachment from surrounding objects Feelings of unreality with respect to individuals Feelings of being an outside observer with respect to one’s actions Question 4. A client with somatic symptom disorder says, “I always feel this crushing pain in my abdomen. I think I have appendicitis.” How should the nurse respond to this client? “It must be causing a lot of discomfort to you. Isn’t it?” “You are perfectly fine; try to ignore the pain.” “Your physician says that you don’t have any complications.”“I don’t think so because your laboratory reports do not indicate any abnormality.” Question 5. The nurse is creating a care plan for a client with a diagnosis of conversion disorder. Which intervention would be inappropriate to include in the creation of this plan? Meeting with the client to discuss the disability. Withdraw attention if client continues to focus on physical limitation. Identify primary or secondary gains that the physical symptom may be providing for the client Help identify physical symptoms as a coping mechanism that is used in times of extreme stress. Question 6. A client presents to the primary care physician’s office claiming that she suddenly cannot speak, see, or smell. This does not seem to bother her, but is alarming her husband. All physical origins for illness have been ruled out, so the nurse knows that the client most likely has which disorder? Conversion disorder Illness anxiety disorder Somatic symptom disorder Trigeminal neuralgia Question 7. A client is diagnosed with depersonalization-derealization disorder. Which outcome would the nurse expect while planning care for this client? The client can recall all events of his life. The client verbalizes understanding regarding the existence of multiple personalities. The client can demonstrate more adaptive coping strategies to avert dissociative behaviors. The client effectively uses adaptive coping strategies during stressful situations without resorting to physical symptoms Question 8. Which statement by the family member makes the nurse suspect generalized amnesia in the client? “My child does not even remember his name.” “My child is able to recollect only few events of the accident.” “My child does not remember any incident about the accident.”“My child does not remember the incident, but she remembers being transported to the hospital.” Question 9. What are the symptoms that can be observed in the client diagnosed with depersonalization? Unreality, detachment, and distorted sense of time Altered behavior, consciousness, and memory Inability to recall important autobiographical information Falsification of physical or psychological signs or symptoms Question 10. Which outcome indicates the effectiveness of therapy for depersonalization-derealization disorder? The client interprets bodily sensations rationally. The client understands the existence of multiple personalities. The client is able to recall the events associated with trauma. The client is able to maintain a sense of reality during stressful situations Question 11. The nurse is caring for a client who has somatic symptom disorder. The primary health-care provider plans a treatment to attain tertiary gain. Which procedure would the nurse expect to be performed in the client? Explaining the process and stages of grieving to the client Hypnotizing the client to help in regaining the memory Shifting the focus from family discord to concern for the client Helping the subpersonalities understand that integration would unify them all into one Question 12. What would the nurse expect in the client diagnosed with dissociative localized amnesia? The client has amnesia due to a skull injury The client has amnesia for his or her identity and total life history. The client is unable to recall all incidents associated with stressful events. The client can only recall certain incidents associated with a stressful event. Question 13. Knowing the goal of therapy for clients with dissociative personality disorder, which is the most therapeutic statement a nurse can say?“The goal of therapy will be to optimize your function and potential.” “You must persist with therapy until integration is completed.” “Abreaction will make you feel good about your past. “ “During therapy, the therapist will silence certain personalities that are bothering you.” Question 14. A client with somatic symptom disorder is able to understand the correlation between physical symptoms and psychological problems. Which nursing intervention would have brought this change in the client? Providing pain medication Explaining medical assessment data Encouraging the client to verbalize fears and anxieties Helping the client to identify ways to achieve recognition from others Question 15. After a traumatic event a client reports severe throbbing pain in the left side of the chest. The laboratory reports of the client indicate that there is no underlying organic pathology. Which disorder might the nurse suspect in this client? Factious disorder Conversion disorder- includes physical disability with no underlying organic patho Illness anxiety disorder Somatic symptom disorder- cannot be explained medically. Question 16. What is a probable cause for dissociative identity disorder in a client? Alcohol abuse History of abuse as a child Drug abuse and overmedication Detachment with respect to surroundings Question 17. Which statement made by the client’s family may indicate the client of having dissociative amnesia with dissociative fugue? “My son assumed a new identity after the accident.”“My son is intentionally harming himself.” “My son is disoriented and detached from the environment.” “My son developed negative feelings about his capabilities.” Question 18. What are the predisposing factors of somatic symptom disorder? Select all that apply. Decreased levels of serotonin Increased levels of endorphins Increased levels of norepinephrine Impaired information processing center of brain Presence of somatic symptom disorder in first-degree relatives of the client Question 19. The client was recently raped and is seeking help from a support group. She is concerned that she can only remember some events of that night she was raped. The nurse documents this as which? Selective amnesia Dissociative fugue Generalized amnesia Localized amnesia Question 20. On regular follow-up exams, the primary health-care provider determines that there is no recurrence of cancer and no residual effects in a client who has undergone colon resection. The client regularly complains of abdominal pain and bowel rumblings. An organic pathology report of the client is negative. Which statement supports a desired outcome for this client? The client has fears of cancer occurrence. The client has come to realize that fears about his or her symptoms are not rational. The client refers all new complaints to the health-care provider. The client is able to intervene immediately after the appearance of minor physical symptoms. Question 21. Which characteristic applies to a client with dissociative fugue? Discontinuity in the sense of self Unexpected travel or bewildered wandering to another location Existence of two or more personalitiesDetachment with body or surroundings Question 22. Which outcome in the client receiving nursing care for depersonalization-derealization disorder would evaluate the effectiveness of the nursing care? The client will retrieve the memories of the past life. The client will demonstrate recovery of lost or altered function. The client will cooperate with the plan for teaching provided by the nurse. The client will learn to confront distorted thoughts and challenge feelings of unreality. Question 23. While collecting data on a client who is a victim of childhood sexual abuse, the nurse finds that the client has various personalities dominating at different points of time. What would be the primary nursing intervention in this client? Developing a trusting relationship with the client Helping the client to understand the existence of other subpersonalities Helping subpersonalities understand that their being would not be destroyed Helping the client to identify stressful situations that precipitate transition of personalities Question 24. When is a client with the somatic symptom disorder said to have tertiary gain according to the learning theory? When the client postpones unwelcome challenges When the client learns that he or she may avoid stressful obligations When the client becomes the prominent focus of attention because of the illness When the client comes to know that the concern towards him or her has relieved the conflict within the familyQuestion 25. Which parameters will help the nurse evaluate the effectiveness of the nursing interventions in a client with dissociative identity disorder? Select all that apply. Ability of the client to recognize the signs and symptoms of escalating anxiety Ability of the client to demonstrate a decrease in ruminations about physical symptoms Ability of the client to demonstrate full recovery from a previous loss or alteration of physical functioning Ability of the client to connect the occurrence of psychological stress to loss of memory Ability of the client to discuss various personalities within the self Question 1. The medical history of a client with alcoholic intoxication shows congestive heart failure. Which medication is contraindicated for this client? Oxazepam Disulfiram Desipramine Chlordiazepoxide Question 2. A client has a score of two on the Clinical Institute Withdrawal Assessment of Alcohol Scale (CIWA-AR) for orientation and clouding of sensorium. What does the nurse interpret from the score? The client is disoriented regarding place The client is uncertain about the date. The client is disoriented for more than 2 calendar days. The client is disoriented for not more than 2 calendar days. Question 3. The client who uses drugs says, “I am not a drug addict. I can stop any time I want.” Which nursing intervention would the nurse most likely apply in this client? Identifying recent maladaptive behaviors Conveying an attitude of acceptance to the client Developing a trusting relationship with the client Correcting misconceptions about substance abuseQuestion 4. A client who is a smoker says, “Smoking relaxes me. It is not harmful.” What could be the foremost nursing intervention in this client? Teaching about substitution therapy Including significant others in teaching Assessing the client’s level of knowledge Providing information about physical effects of smoking on the body Question 5. Which symptoms does a nurse observe in an alcoholic client diagnosed with acute pancreatitis? Select all that apply. Vomiting Weight loss Hemorrhage Severe epigastric pain Abdominal distention Question 6. Which complications are observed in a client with peripheral neuropathy? Select all that apply. Ascites Paralysis Liver cirrhosis Portal hypertension Permanent muscle wasting Question 7. Which laboratory procedures will be helpful to access the effectiveness of treatment in a client with alcoholic cardiomyopathy? Select all that apply. Chest x-ray Urine analysis Assessment of blood pressure Electrocardiogram Blood coagulation studies Question 8. A client who is a chronic alcoholic says, “My fingers are aching. I can feel a burning and prickling sensation.” Which disorder will the nurse suspect in the client? Alcoholic myopathy Korsakoff’s psychosisPeripheral neuropathy Wernicke’s encephalopathy Question 9. Which therapy protects the client from the risk of death due to Wernicke’s encephalopathy? Disulfiram therapy Substitution therapy Conductance therapy Thiamine replacement therapy Question 10. Why will the nurse not accept rationalization or projection made by an alcoholic client who tries to make excuses for or blame others for his or her own behavior? To improve the self-esteem of the client and decrease his or her defensive attitude To help the client focus on his or her own behaviors as an illness that requires help To make the client understand the relationship between substance abuse and personal problems To prevent denial in the client about the problems in his or her life because of substance abuse Question 11. A client who is a heavy smoker complains of a reduction in excretion of urine. What could be the most appropriate reason for this? Stimulation of the hypothalamus- smoking stimulates the hypothalamus of the brain. Stimulation of the hypothalamus increases production of an antidiuretic hormone that reduces the excretion of urine. Stimulation of ganglionic synapses Stimulation of the central nervous system Stimulation of the sympathetic nervous system Question 12. The urine analysis of a client with alcohol addiction shows a reddish tinge in the urine. What would the nurse suspect in the client? Alcoholic hepatitis Alcoholic myopathy Peripheral neuropathy Wernicke’s encephalopathyQuestion 13. A chronic alcoholic client in her first trimester of pregnancy asks the nurse, “Can I drink small amounts of alcohol to sleep better?” How should the nurse respond to the client? “You can have small amounts of alcohol until the second trimester.” “The damaging effects of alcohol depend on the genetic nature of mother.” “Any amount of alcohol is dangerous during pregnancy. So try to avoid it.” “You can drink small amounts of alcohol which has proved beneficial for the growth of fetus.” Question 14. A client diagnosed with hepatic encephalopathy completely abstains from alcohol, eats a low-protein diet, and is on neomycin therapy. Which laboratory findings indicate a successful treatment modality? Decrease in epigastric pain Decrease in white blood cell (WBC) count Decrease in serum ammonia levels Decrease in serum muscle enzymes Question 15. Which phase of alcohol abuse is characterized by the use of alcohol to relieve everyday stress and tensions of life? Crucial phase- third phase of alcohol addiction, which is characterized by loss of control and physiological addiction to alcohol. Chronic phase- final phase of alcoholic progression that is characterized by emotional and physical disintegration. Prealcoholic phase- first phase of alcohol abuse, which is characterized by the use of alcohol to relieve everyday stress and tensions of life. Early alcoholic phase- second phase of alcoholic progression, which is characterized by a brief period of amnesia after drinking. Question 16. Which are symptoms of an amphetamine overdose? Select all that apply. Coma Convulsions Bradycardia Hypotension Cardiac arrhythmia Question 17. What are the diagnostic criteria of gambling disorder? Select all that apply.Often gambles when depressed Persistent thoughts of past gambling experience Frequently returns to gambling to interact with lost friends Acts aggressively to conceal the extent of involvement with gambling Avoids interaction with others to come out of the desperate financial situations caused by gambling Question 18. Which physiological effects are associated with the ingestion of small amounts of alcohol? Select all that apply. Inhibition Relaxation Drowsiness Slurred speech Agitation Question 19. A client is unconscious due to barbiturate toxicity. What is the primary goal of treatment for this client? Decreasing cardiac output Normalizing the blood pressure Preserving the renal function Reducing the body temperature Question 20. The nurse is educating about necessary precautions to a client on disulfiram therapy. Which statement of the client would most likely indicate effective learning? “I should avoid alcohol.” “I should avoid cocaine.” “I should avoid nicotine.” “I should avoid marijuana.” Question 21. The client is unable to meet his or her role expectations due to alcohol abuse. Which nursing intervention would help the client? Reviewing family history of the client Monitoring protein intake of the client Conveying an attitude of acceptance to the client Encouraging the client to express feelings of fear and anxiety Question 22. A chronic alcoholic client has elevated levels of muscle enzymes and symptoms of decreased exercise tolerance, dyspnea, edema, and palpitations. As directed by the primary health-careprovider, the nurse restrains the client from alcohol use and initiates therapy with digitalis and diuretics. What outcome will the nurse expect in the client? The client will not express reddish tinge during urination. The client verbalizes no pain or burning sensation in the extremities. The client will be able to recollect recent memory and maintain orientation. The chest x-ray of the client will show a proper functioning of the heart. Question 23. The laboratory findings of a client with alcoholism indicate thiamine deficiency. The client reports severe vomiting. What alcoholism-related conditions does the nurse expect in the client? Select all that apply. Esophagitis Alcoholic myopathy Peripheral neuropathy Alcoholic cardiomyopathy Wernicke’s encephalopathy Question 24. Which statement of the spouse makes the nurse suspect that the client is in the crucial phase of alcohol addiction? “My partner consumes alcohol to relieve tensions and everyday stress.” “My partner consumes alcohol secretly.” “My partner is willing to risk anything for alcohol.” “My partner is emotionally and physically disturbed.” Question 25. Which statement from an alcoholic client indicates the chronic phase of alcoholism? “I am not able to sleep at nights without drinking alcohol.” “I usually drink alcohol only to relax from daily tensions.” “I am unable to decide whether to stop drinking alcohol or not.” “I feel sorry for myself because I cannot get rid of this addiction.” Question 1. The nurse observes that the client with osteoarthritis exploits other group members during group activities. On further interaction, the nurse learns that the client thinks that all the staff members are planning to harm him. Which phase of schizophrenia does this behavior of the client indicate?Phase I (premorbid phase)- experiences schizoid or schizotypal personalities, which are characterized as quiet, passive, and introverted. Phase II (prodromal phase)- experiences nonspecific symptoms such as social withdrawal and positive symptoms such as suspiciousness. Phase III (active psychotic phase)- experiences prominent psychotic symptoms such as delusions and hallucinations Phase IV (residual phase)- experiences periods of remission or exacerbation. Question 2. After assessing a client with a psychiatric illness, the nurse concludes that the client is experiencing paranoia. Which client response is most consistent with paranoia? “It is raining cats and dogs.” “The world no longer exists.” “I won’t eat this food. I know it is poisoned.” “It snowed last night because I wished very, very hard that it would.” Question 3. The nurse asks the client what he wants for lunch and he replies “Lemonade, Band-Aid, handmade, and strandaid. “The nurse would use which nursing diagnosis for this behavior? Impaired verbal communication Disturbed thought process Social isolation Self-care deficit Question 4. When discussing schizophrenia with a newly diagnosed client, the nurse is aware of which fact? The client probably came from a dysfunctional family. Schizophrenia spectrum disorders are far more prevalent in clients who live in cold areas. Schizophrenia spectrum disorders may appear at birth, or happen due to biochemical dysfunction, physiological factors, and psychosocial stress. Psychiatrists agree that there is only one effective treatment for schizophrenia. Question 5. Which instructions should the nurse provide to a client who is undergoing antipsychotic therapy to overcome anticholinergic effects? Select all that apply Have sugarless candies and frequent sips of water Do not drive a vehicleTake medication at bedtime Rise slowly from a lying or sitting position Take calorie-controlled diet and do physical exercise Question 6. In caring for a client with schizophrenia, the nurse might consider which of these to be appropriate outcomes? Select all that apply. Demonstrates the ability to trust others. Relinquishes the need for delusions and hallucinations. Performs self-care activities independently. Perceives self realistically. Increases reliance on family members for support. Does not report any suicidal ideations. Question 7. A client writes, “My kolege konducts unikornth festewel evry year. I vant this buk for studying.” Which symptoms should the nurse document in the client record after reading this writing? Select all that apply. Mutism Neologisms Word salad Clang association Associative looseness Question 8. The nurse finds that a client is imitating all the hand movements of a family member while communicating. What does the nurse infer from this behavior? The client is exhibiting echolalia. The client is exhibiting anhedonia. The client is exhibiting echopraxia. The client is exhibiting neologisms. Question 9. A client in therapy tells everyone that she has the power to make them all rich and famous if she just puts a blessing on them. The nurse documents this as which behavior? Magical thinking Paranoia Delusions of referenceSomatic delusion Question 10. A client with schizophrenia tells the nurse, “When I eat this pungent ice cream, I hear the voice of god.” What does the nurse infer from this statement of the client? Select all that apply The client has visual type of hallucination. The client has tactile type of hallucination. The client has auditory type of hallucination. The client has olfactory type of hallucination. The client has gustatory type of hallucination. Question 11. While caring for a client with a psychotic disorder, the nurse finds that the client has severe delusions, hallucinations, and frequent derailment. What does the nurse infer from these findings? The client is in the residual phase. The client is in the premorbid phase. The client is in the prodromal phase. The client is in the active psychotic phase. Question 12. The nurse is reviewing the prescription of different clients’ prescribed antipsychotic medications. Which client is at a risk of high weight gain? Client 1 Client 2 Client 3 Client 4 Question 13. When considering clients with schizophrenia spectrum disorders, which therapies have been found to be therapeutic? Select all that apply. Social skills therapy Cognitive therapy Family therapy Assertive Community Treatment (ACT) Anger managementQuestion 14. The nurse begins group therapy by saying, “Today we will be talking about medications.” A client then states, “Today we will be talking about medications.” This is an example of which behavior? Echolalia Word Salad Clang Associations Neologisms Question 15. The nurse weighs the client, but when asked to step off the scale, the client continues to stand, staring at the wall stiffly and does not move. The nurse knows this is indicative of which symptom of schizophrenia? Waxy flexibility- Waxy flexibility describes a condition in which the client with schizophrenia allows body parts to be placed in bizarre or uncomfortable positions. This symptom is associated with catatonia. Once placed in position, the arm, leg, or head remains in that position for long periods, regardless of how uncomfortable it is for the client. Pacing and rocking Regression Anergia Question 16. The client has been diagnosed with Grandiose Delusional Disorder. Which behavior would the nurse expect to see on the unit? The client claims to be Jesus Christ. The client claims his wife has affairs when he is not near her. The client claims that the nurses are trying to poison him. The client believes that he has cancer, but no imagery can see it. Question 17. While caring for a client with schizophrenia, the client says to the nurse, “Will you come every day to feed