NUR 3525 Mental Exams Questions and Answers- Keiser University

NUR 3525 Mental Exams Questions and Answers- Keiser University Exam 2 1.A nursing instructor is teaching about specific phobias. Which student statement indicates that learning has occurred? 1. "These clients do not recognize that their fear is excessive, and they rarely seek treatment." 2. These clients have overwhelming symptoms of panic when exposed to the phobic stimulus." 3. "These clients experience symptoms that mirror a cerebrovascular accident (CVA)." 4. "These clients experience the symptoms of tachycardia, dysphagia, and diaphoresis." 2. A client has a history of excessive fear of water. Which term should the nurse use to describe s specific phobia, and under what subtype is this phobia identified? 1. Aquaphobia; a natural environment type of phobia 2. Aquaphobia; a situational type of phobia 3. Acrophobia; a natural environment type of phobia 4. Acrophobia; a situational type of phobia 3. How would the nurse differentiate a client diagnosed with a social phobia from a client diagnosed with a schizoid personality disorder (SPD)? 1. Clients diagnosed with social phobia can manage anxiety without medications, whereas clients diagnosed with SPD can manage anxiety only with medications. 2. Clients diagnosed with SPD are distressed by the symptoms experienced in social settings, whereas clients diagnosed with social phobia are not. 3. Clients diagnosed with social phobia avoid interactions only in social settings, whereas clients diagnosed with SPD avoid interactions in all areas of life. 4. Clients diagnosed with SPD avoid interactions only in social settings, whereas clients diagnosed with social phobias tend to avoid interactions in all areas of life. 4. How would the nurse differentiate a client diagnosed with panic disorder from a client diagnosed with generalized anxiety disorder (GAD)? 1. GAD is acute in nature, and panic disorder is chronic. 2. Chest pain is a common GAD symptom, whereas this symptom is absent in panic disorders. 3. Hyperventilation is a common symptom in GAD and rare in panic disorder. 4. Depersonalization is commonly seen in panic disorder and absent in GAD. 5. Which treatment should the nurse identify as most appropriate for clients diagnosed with GAD? 1. Long-term treatment with diazepam (Valium) 2. Acute symptom control with citalopram (Celexa) 3. Long-term treatment with buspirone (BuSpar) 4. Acute symptom control with ziprasidone (Geodon) 6. A client diagnosed with obsessive-compulsive disorder (OCD) reports to the nurse that he can't stop thinking about all the potentially life-threatening germs in the environment. Which is the most accurate way for the nurse to document this symptom? 1.Client is expressing an obsession with germs. 2. Client is manifesting compulsive thinking. 3. Client is expressing delusional thinking about germs. 4. Client is manifesting arachnophobia of germs. 7. A cab driver stuck in traffic is suddenly lightheaded, tremulous, and diaphoretic and experiences tachycardia and dyspnea. An extensive work-up in an emergency department reveals no pathology. Which medical diagnosis is suspected, and which nursing diagnosis is the priority? 1. Generalized anxiety disorder (GAD) and a nursing diagnosis of fear 2. Altered sensory perception and a nursing diagnosis of panic disorder 3. Pain disorder and a nursing diagnosis of altered role performance 4.Panic disorder and a nursing diagnosis of panic anxiety 8. A client diagnosed with panic disorder states, "When an attack happens, I feel like I am going to die." Which is the nurse's most appropriate reply? 1."I know it's frightening, but try to remind yourself that it will only last a short time." 2. "Death from a panic attack happens so infrequently that there is no need to worry." 3. "Most people who experience panic attacks have feelings of impending doom." 4. "Tell me why you think you are going to die every time you have a panic attack." 9. A nursing instructor is teaching about the medications used to treat panic disorder. Which student statement indicates that learning has occurred? 1.AClonazepam (Klonopin) is particularly effective in the treatment of panic disorder." 2. "Clozapine (Clozaril) is used off-label for the long-term treatment of panic disorder. 3. "Doxepin (Sinequan) can be used in low doses to relieve symptoms of panic attacks." 4. "Buspirone (BuSpar) is used for its immediate effect to lower anxiety during panic attacks." 10. A client is experiencing a severe panic attack. Which nursing intervention would meet this client's immediate need? 1. Teach deep-breathing relaxation exercises. 2. Place the client in a Trendelenburg position. 3 Stay with the client and offer reassurance of safety. 4. Administer the ordered PRN buspirone (BuSpar). 11. A client living on the beachfront seeks help with an extreme fear of crossing bridges, which interferes with daily life. A psychiatric-mental health nurse practitioner decides to try systematic desensitization. Which explanation of this therapy should the nurse convey to the client? 1. "Using your imagination, we will attempt to achieve a state of relaxation that you can replicate when faced with crossing a bridge." 2. "Because anxiety and relaxation are mutually exclusive states, we can attempt to substitute a relaxation response for the anxiety response." 3Through a series of increasingly anxiety-provoking steps, we will gradually increase your tolerance to anxiety." 4. "In one intense session, you will be exposed to a maximum level of anxiety that you will learn to tolerate." 12. A client diagnosed with OCD is admitted to a psychiatric unit. The client has an elaborate routine for toileting activities. Which should be the initial client outcome during the first week of hospitalization? 1. The client will refrain from ritualistic behaviors during daylight hours. (2) The client will wake early enough to complete rituals prior to breakfast. 3. The client will participate in three unit activities by day 3. 4. The client will substitute a productive activity for rituals by day 1. 13. The nurse is providing discharge teaching to a client taking a benzodiazepine. Which client statement indicates a need for further instructions? 1."I will need scheduled bloodwork to monitor for toxic levels of this drug." 2. "I won't stop taking this medication abruptly, because there could be serious complications." 3. "I will not drink alcohol while taking this medication." 4. "I won't take extra doses of this drug because I can become addicted." 14. A client is newly diagnosed with OCD and spends 45 minutes folding clothes and rearranging them in drawers. Which nursing intervention would best address this client's problem? 1. Distract the client with other activities whenever ritual behaviors begin. 2. Report the behavior to the psychiatrist to obtain an order for medication dosage increase. 3. Lock the room to discourage ritualistic behavior. 4. Discuss the anxiety-provoking triggers that precipitate the ritualistic behaviors. 15. A client presents in the emergency department with complaints of overwhelming anxiety. Which of the following is the priority nursing assessment? 1. Suicide risk 2 Cardiac status 3. Current stressors 4. Substance use history 16. Warren's college roommate actively resists going out with friends whenever they invite him. He says he can't stand to be around other people and confides to Warren "They wouldn't like me anyway." Which disorder is Warren's roommate likely suffering from? 1. Agoraphobia Mysophobia 2. Mysophobia 3. Social anxiety disorder 4. Panic disorder 17. A client has the following symptoms: preoccupation with imagined defect, verbalizations that are out of proportion to actual physical abnormalities, and numerous visits to plastic surgeons to seek relief. Which nursing diagnosis best describes the problems evidenced by these symptoms? 1. Ineffective coping 2. Disturbed body image 3. Complicated grieving 4. Panic anxiety 18. A client is taking chlordiazepoxide (Librium) for GAD symptoms. In which situation should the nurse recognize that this client is at greatest risk for drug overdose? 1. The client has a knowledge deficit related to the effects of the drug. 2.The client combines the drug with alcohol. 3. The client takes the drug on an empty stomach. 4. The client fails to follow dietary restrictions. 19. During an assessment interview, a client diagnosed with antisocial personality disorder spits, curses, and refuses to answer questions. Which is the most appropriate nursing statement to address this behavior? 1. "You are very disrespectful. You need to learn to control yourself." 2. "I understand that you are angry, but this behavior will not be tolerated." 3. "What behaviors could you modify to improve this situation?" 4. "What antisocial personality disorder medications have helped you in the past?" 20. A client diagnosed with antisocial personality disorder comes to the nurses' station at 11:00 p.m., requesting to phone a lawyer to discuss filing for a divorce. The unit rules state that no calls are permitted after 10:00 p.m. Which nursing reply is most appropriate? 1. "Go ahead and use the phone. I know this pending divorce is stressful." 2. "You know better than to break the rules. I'm surprised at you." 3. "It is after the 10:00 p.m. phone curfew. You will be able to call tomorrow." 4. "The decision to divorce should not be considered until you have had a good night's sleep." 21. A client diagnosed with paranoid personality disorder becomes violent on a unit. Which nursing intervention is most appropriate? 1. Provide objective evidence that violence is unwarranted. 2.Initially restrain the client to maintain safety. 3 Use clear, calm statements and a confident physical stance. 4. Empathize with the client's paranoid perceptions. 22. A highly emotional client presents at an outpatient clinic appointment wearing flamboyant attire, spiked heels, and theatrical makeup. Which personality disorder should the nurse associate with these assessment data? 1. Compulsive personality disorder 2. Schizotypal personality disorder 3.Histrionic personality disorder (HPD) 4. Manic personality disorder 23. A client diagnosed with borderline personality disorder (BPD) brings up a conflict with the staff in a community meeting and develops a following of clients who unreasonably demand modification of unit rules. Which approach is best for the nursing staff to implement? 1.Allow the clients to apply the democratic process when developing unit rules. 2.Maintain consistency of care by open communication to avoid staff manipulation. 3. Allow the client spokesperson to verbalize concerns during a unit staff meeting. 4. Maintain unit order by the application of autocratic leadership. 24. Which nursing approach should be used to maintain a therapeutic relationship with a client diagnosed with BPD? 1.Being firm, consistent, and empathetic while addressing specific client behaviors 2. Promoting client self-expression by implementing laissez-faire leadership 3. Using authoritative leadership to help clients learn to conform to societal norms. 4. Overlooking inappropriate behaviors to avoid promoting secondary gains 25. During an interview, which client statement indicates to the nurse that a potential diagnosis of schizotypal personality disorder should be considered? 1. "I really don't have a problem. My family is inflexible, and every relative is out to get me." 2. "I am so excited about working with you. Have you noticed my new nail polish, 'Ruby Red Roses?"" 3."I spend all my time tending my bees. I know a whole lot of information about bees." 4."I am getting a message from the beyond that we have been involved with each other in a previous life." 26. A nursing instructor is teaching students about clients diagnosed with HPD and the quality of their relationships. Which student statement indicates that learning has occurred? 1. "Their dramatic style tends to make their interpersonal relationships quite interesting and fulfilling." 2. Their interpersonal relationships tend to be shallow and fleeting, serving their dependency needs." 3. "They tend to develop few relationships because generally maintain deep affection." 4. "They pay particular attention to details, which can frustrate the development of strongly independent butrelationships." 27. When planning care for a client diagnosed with BPD, which self-harm behavior should thenurse expect the client to exhibit? 1. The use of highly lethal methods to commit suicide 2) The use of suicidal gestures to evoke a rescue response from others 3. The use of isolation and starvation as suicidal methods 4. The use of self-mutilation to decrease endorphins in the body 28. Which is the priority nursing diagnosis when providing care to a client diagnosed with paranoid personality disorder? 1.Risk for violence: directed toward others R/T suspicious thoughts 2. Risk for suicide R/T altered thought processes 3. Altered sensory perception R/T increased levels of anxiety 4. Social isolation R/T inability to relate to others 29. A kindergarten student is frequently violent toward other children. The school nurse notices bruises and burns on the child's face and arms. Which other symptom would indicate to the nurse that the child might have been physically abused? 1.The child shrinks at the approach of adults. 2. The child begs or steals food or money. 3. The child is frequently absent from school. 4. The child is delayed in physical and emotional development. 30. A woman describes a history of physical and emotional abuse in intimate relationships. Which additional factor would the nurse suspect? 1. The woman may be exhibiting a controlled response pattern. 2. The woman may have a history of childhood neglect. 3. The woman may be exhibiting codependent characteristics. 4. The woman might be a victim of incest. 31. Which statement by an emergency department nurse indicates accurate knowledge of domestic violence? 1. Power and control are central to the dynamic of domestic violence." 2. "Poor communication and social isolation are central to the dynamic of domestic violence." 3. . "Erratic relationships and vulnerability are central to the dynamic of domestic violence." 4. "Emotional injury and learned helplessness are central to the dynamic of domestic violence." 32. A client is brought to an emergency department after being violently raped. Which nursing action is most appropriate? 1. Discourage the client from discussing the event, as this may lead to further emotional trauma. 2) Remain nonjudgmental and actively listen to the client's description of the event. 3. Meet the client's self-care needs by assisting with showering and perineal care. 4. Provide cues, based on police information, to encourage further description of the event. 33. In the emergency department, a client who was raped appears calm and exhibits a blunt affect. The client answers the nurse's questions in a monotone using single words. Which statement indicates the nurse interpretation of this client's responses? 1. The client may be lying about the incident. 2. The client may be experiencing a silent rape reaction. 3.The client may be demonstrating a controlled response pattern. 4. The client may be having a compounded rape reaction. 34. An individual comes to an emergency department with a broken nose and multiple bruises after being beaten by her spouse. She states, "The beatings have been getting worse, and I'm afraid that next time he might kill me." Which reply by the nurse is appropriate? 1. "Leopards don't change their spots, and neither will he."" 2."There are things you can do to prevent him from losing control." 3. "Let's talk about your options so that you don't have to go home." 4."Why don't we call the police so that they can confront your husband with his behavior?" 35. A college student was sexually assaulted when out on a date. After several weeks of crisis intervention therapy, which client statement would indicate to the nurse that the student is handling this situation in a healthy manner? 1. I know that it was not my fault." 2. "My partner has trouble controlling his sexual urges." 3. "If I don't put myself in a dating situation, I won't be at risk." 4. "Next time I will think twice about wearing a sexy dress." 36. Which action by the parent leads the nurse to suspect they may be emotionally abusing their child? 1. The child has bite marks on their arms. 2.The child shows up for school without a lunch. 3. The parent blames the child whenever something goes wrong. 4. The child has no coat, and it is very cold outside. 37. When questioned about bruises, an individual states, "It was an accident. My spouse just had a bad day at work. He's being so gentle now and even brought me flowers. He's going to get a new job, so it won't happen again." The nurse recognizes this client is in which phase of the cycle of battering? 1. Phase 1: The tension-building phase 2. Phase II: The acute battering incident phase 3. Phase III: The honeymoon phase 4. Phase IV: The resolution and reorganization phase 38. Which teaching would the nurse in an employee assistance program provide to an employee who exhibits symptoms of domestic physical abuse? 1. Have ready access to a gun and learn how to use it. 2. Research lawyers who can aid in divorce proceedings. 3. File charges of assault and battery. 4.Have ready access to the number of a shelter for battered women. 39. A client who has been raped is crying, pacing, and cursing her attacker in an emergency department. Which behavioral defense would the nurse recognize? 1. Controlled response pattern 2. Compounded rape reaction 3. Expressed response pattern 4. Silent rape reaction. 40. Which assessment data should the school nurse recognize as signs of physical neglect? 1.The child is often absent from school and seems apathetic and tired. 2. The child is very insecure and has poor self-esteem. 3. The child has multiple bruises on various body parts. 4. The child has sophisticated knowledge of sexual behaviors. 41. An anorexic client states to the nurse, "My parent has recently moved back to town." Since that time, the client has experienced insomnia, nightmares, and panic attacks that occur nightly. She has never married or dated and lives alone. Which should the nurse suspect? 1.Possible major depressive disorder 2 Possible history of childhood incest 3. Possible histrionic personality disorder 4. Possible history of childhood bulimia 42. Which statement describes the main goal of crisis intervention for sexual assault? 1.Help survivors return to their previous lifestyle as quickly as possible. 2. Determine the appropriate long-term assistance needed. 3. Treat any physical symptoms that have resulted from the assault. 4. Focus on the rape incident alone. 43. As a domestic violence nurse specialist, you are asked to testify in a court case involving intimate partner abuse. The defense attorney asks, "When Mr. and Mrs. Smith came to the emergency room, several people were around, yet Mrs. Smith still did not say that Mr. Smith hit her." Which statement describes the rationale for Mrs. Smith not accusing her husband? 1.Abuse victims are not likely to accuse spouses without photographic evidence. 2.Abuse victims who are accompanied by the person who battered them are not likely to be truthful about the cause of the injuries. 3. Abuse victims are not always aware of the resources available to them. 4. Abuse victims often lie about their injuries because they are afraid they will be killed or their children will be harmed. 44. Which medications could be used to reduce aggression by dampening excessive nonadrenergic activity? 1.Tegretol 2. Dilantin 3. Lithium. 4. Propranolol 45. When Beverly told her sister Liz about the repeated episodes of abuse she'd experienced, her sister replied, "If you leave him, how will you be able to pay your bills?" Liz's reply supports which notion? 1. Battered women are often encouraged by their social network to remain in the abusive relationship. 2. Women who are battered often take blame for their situations. 3. The sisters were victims of child abuse. 4. Family members rarely believe that intimate partner violence is occurring. Exam 3 Chapter 16 Suicide Prevention Chapter 23 schizophrenia and Psychotic Disorders Chapter 24 Substance Related and other Addictive Disorders 1.A nurse discovers a client's suicide note that details the time, place, and means to commit suicide. Which is the priority nursing intervention and the rationale for this action? A. Administering lorazepam (Ativan) prn, because the client is angry about the discovery of the note B. Establishing room restrictions because the client's threat is an attempt to manipulate the staff C. Placing this client on one-to-one suicide precautions, because the more specific the plan, the more likely the client will attempt suicide D. Calling an emergency treatment team meeting because the client's threat must be addressed 2. During the planning of care for a suicidal client, which correctly written outcome should be the nurse's priority? A. The client will not physically harm self. B. The client will express hope for the future by day 3. C. The client will establish a trusting relationship with the nurse. D. The client will remain safe during the hospital stay. 3. A client diagnosed with Major Depressive Disorder with psychotic features hears voices commanding self-harm. The client refuses to commit to developing a plan for safety. Which is the nurse's priority intervention now? A. Obtaining an order for locked seclusion until client is no longer suicidal B. Conducting 15-minute checks to ensure safety C. Placing the client on one-to-one observation while monitoring suicidal ideations D. Encouraging client to express feelings related to suicide 4. A client with a history of three suicide attempts has been taking fluoxetine (Prozac) for 1 month. The client suddenly presents with a bright affect, is much more communicative, and rates mood at 9/10. Which action should be the nurse's priority at this time? A. Give the client off-unit privileges as positive reinforcement. B. Encourage the client to share mood improvement C. Increase frequency of client observation. in group. D. Request that the psychiatrist reevaluate the current medication protocol. 5. During a one-to-one session, the client states, "Nothing will ever get better," and "Nobody can help me." Which nursing diagnosis is most appropriate for the nurse to assign at this time? A. Powerlessness R/T altered mood AEB client statements B. Risk for injury R/T altered mood AEB client statements C. Risk for suicide R/T altered mood AEB client statements D. Hopelessness R/T altered mood AEB client statements 6. The treatment team is making a discharge decision regarding a previously suicidal client. Which client assessment information should a nurse recognize as contributing to the team's decision? A. No previous admissions for major depressive disorder B. Vital signs stable; no psychosis noted C. Able to comply with medication regimen; able to problem-solve life issues D. Able to participate in a plan for safety; family agrees to constant observation 7. The family of a suicidal client is supportive and requests more facts related to caring for their family member after discharge. Which information should the nurse provide? A. Address only serious suicide threats to avoid the possibility of secondary gain. B. Promote trust by verbalizing a promise to keep suicide attempt information within the family. C. Offer a private environment to provide needed time alone at least once a day. D. D. Be available to actively listen, support, and accept the client's feelings. 8. A stockbroker commits suicide after being convicted of insider trading. While speaking with the family, which statement by the nurse demonstrates accurate and appropriate sharing of information? A. "Your grieving will subside within 1 year; until then, I recommend antidepressants." B. "Support groups are available specifically for survivors of suicide, and I would be glad to help you locate one in this area." C. "The only way to deal effectively with this kind of grief is to write a letter to the brokerage firm to express your anger with them. D. " Since stigmatization often occurs in these situations, it would be best if you avoid discussing the suicide with anyone." 9. After years of dialysis, an 84-year-old states, “I'm exhausted, depressed, and done with these attempts to keep me alive." Which question should the nurse ask the spouse when preparing a discharge plan of care? A. "Have there been any changes in your spouse's appetite or sleep?" B. "How often is your spouse left alone?” C. "Has your spouse been following a diet and exercise program consistently?” D."How would you characterize your relationship with your spouse?" 10. A nursing instructor is teaching about suicide in the elderly population. Which information does the instructor include? A. Elderly people use less lethal means to commit suicide. B. Although the elderly makes up less than 13 percent of the population, they account for 15 percent of all suicides. C. Suicide is the second-leading cause of death among the elderly. D. It is normal for to elderly individuals to express a desire die because they have come to terms with their mortality. 11. A nurse is caring for a client threatening to commit suicide by hanging. The client states, "I'm going to use a knotted shower curtain when no one is around." Which information will determine the nurse's plan of care for this client? A. The more specific the plan is, the more likely the client will attempt suicide. B. Clients who talk about suicide never actually commit it. C. Clients who threaten suicide should be observed every 15 minutes. D. After a brief assessment, the nurse should avoid the topic of suicide. 12. A suicidal client says to a nurse, "There's nothing to live for anymore." Which is the best nursing reply? A. "Why don't you consider doing volunteer work in a homeless shelter?" B. "Let's discuss the negative aspects of your life." C. "Things will look better in the morning." D. "It sounds like you are feeling pretty hopeless." 13.A new nursing graduate asks the psychiatric nurse manager how to best classify suicide. Which is the nurse manager's best reply? A. "Suicide is a Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition diagnosis." B. "Suicide is a mental disorder." C. "Suicide is a behavior." D. "Suicide is an antisocial affliction." 14. A nursing student is developing a plan of care for a suicidal client. Which intervention should the student implement first? A. Communicate therapeutically. B. Observe the client. C. Provide a hazard-free environment. D. Assess suicide risk. 15. A nursing instructor is teaching about suicide. Which student statement indicates that learning has occurred? A. "Suicidal threats and gestures should be considered manipulative attention seeking." B. "Suicide is the act of a psychotic person." C. "All suicidal individuals are mentally ill." D. "Fifty to 80 percent of all people who kill themselves have a history of a previous attempt." 16. A nurse is caring for four clients diagnosed with Major Depressive Disorder. When considering each client's belief system, the nurse should conclude which client would potentially be at highest risk for suicide? A. Roman Catholic B. Protestant C. Atheist D. Muslim 17. Which strategy should the nurse implement first with a suicidal client? A. Ask a direct question such as, "Do you ever think about killing yourself?" B. Ask the client to rate his or her mood on a scale from 1 to 10. C. Establish a trusting nurse-client relationship. D. Apply the nursing process to the planning of client care. 8. A client is newly committed to an inpatient psychiatric unit. Which nursing intervention best lowers this client's risk for suicide? A. Encouraging participation in the milieu to promote hope B. Developing a strong personal relationship with the client C. Observing the client at intervals determined by assessed data D. Encouraging and redirecting the client to concentrate on happier times 19. Which statement indicates that the nurse is acting as an advocate for a client who was hospitalized after a suicide attempt and is now nearing discharge? A. "I must observe you continually for 1 hour to keep you safe." B. "Let's confer with the treatment team about the resources that you may discharge." C. "You must have been very upset to do what you did today." D. "Are you currently thinking about harming yourself?" 20. Which is the priority nursing diagnosis for a client experiencing alcohol withdrawal? A. Risk for injury R/T central nervous system stimulation B. Disturbed thought processes R/T tactile hallucinations C. Ineffective coping R/T powerlessness over alcohol use D. Ineffective denial R/T continued alcohol use despite negative consequences 21. The nurse evaluates a client's patient-controlled analgesia (PCA) pump and notices 100 attempts within a 30-minute period. Which is the best rationale for assessing this client for substance use disorder? A. Narcotic pain medication is contraindicated for all clients with active substance use problems. B. Clients who are regularly using alcohol or benzodiazepines may have developed crosstolerance to analgesics and require increased doses to achieve effective pain control. C. There is no need to assess the client for substance use disorder. There is an obvious PCA malfunction. D. The client is experiencing symptoms of withdrawal and needs to be accurately assessed for lorazepam (Ativan) dosage. 22. On the first day of a client's alcohol detoxification, which nursing intervention is the priority? A. Strongly encourage the client to attend 90 Alcoholics Anonymous meetings in 90 days. B. Educate the client about the biopsychosocial consequences of alcohol abuse. C. Administer ordered chlordiazepoxide (Librium) in a dosage per protocol. D. Administer vitamin B1 to prevent Wernicke-Korsakoff syndrome. 23. Which client statement indicates a knowledge deficit related to substance use? A. "Although it's legal, alcohol is one of the most widely abused drugs in our society." B. "Tolerance to heroin develops quickly." C. "Flashbacks from lysergic acid diethylamide (LSD) use may reoccur spontaneously." D. "Everyone smokes marijuana. It's like smoking cigarettes. It's harmless." 24. A lonely, depressed divorcée has been self-medicating with cocaine for the past year. Which term does the nurse identify that best describes the client's situation? A. The client is experiencing psychological addiction B. The client is experiencing physical addiction. C. The client is experiencing substance addiction. D. The client is experiencing social addiction. 25. Which term should the nurse use to describe the administration of a CNS depressant during alcohol withdrawal? A. Antagonist therapy B. Deterrent therapy C. Codependency therapy D. Substitution therapy 26. A client diagnosed with Chronic Alcohol Use Disorder is being discharged from an inpatient treatment facility after detoxification. Which client outcome related to Alcoholics Anonymous (AA) is most appropriate for the nurse to discuss with the client during discharge teaching? A. After discharge, the client will immediately attend 90 AA meetings in 90 days. B. After discharge, the client will rely on an AA sponsor to help control alcohol cravings. C. After discharge, the client will incorporate family in AA attendance. D. After discharge, the client will seek appropriate deterrent medications through AA. 27. A client with a history of heavy alcohol use is brought to an emergency department (ED) by family members who state that the client has had nothing to drink in the last 24 hours. Which client symptom should the nurse immediately report to the ED physician? A. Antecubital bruising B. Blood pressure of 180/100 mm Hg C. Mood rating of 2/10 on numeric scale D. Dehydration 28. Which client statement demonstrates positive progress toward recovery from a substance use disorder? A. "I have completed detox and therefore am in control of my drug use." B ."I will faithfully attend Narcotics Anonymous (NA) when I can't control my cravings." C."As a church deacon, my focus will now be on spiritual renewal.” D. "Taking those pills got out of control. It cost me my job, marriage, and children." 29. Upon admission for symptoms of alcohol withdrawal, a client states, “I haven't eaten in 3 days." Assessment reveals BP 170/100 mm Hg, P 110, R 28, and T 97°F (36°C) with dry skin, dry mucous membranes, and poor skin turgor. Which of the following is the priority nursing diagnosis? A. Knowledge deficit B. Fluid volume excess C. Imbalanced nutrition: less than body requirements D. Ineffective individual coping 30. During group therapy, a client diagnosed with Alcohol Use Disorder states, "I would not have boozed it up if my wife hadn't been nagging me all the time to get a job. She never did think that I was good enough for her." How should the nurse interpret this statement? A. The client is using denial by avoiding responsibility. B. The client is using displacement by blaming his wife. C. The client is using rationalization to excuse his alcohol dependence. D. The client is using reaction formation by appealing to the group for sympathy. 31. A client is admitted for alcohol detoxification. During detoxification, which symptoms should the nurse expect to assess? A. Gross tremors, delirium, hyperactivity, and hypertension B. Disorientation, peripheral neuropathy, and hypotension C. Oculogyric crisis, amnesia, ataxia, and hypertension D. Hallucinations, fine tremors, confabulation, and orthostatic hypotension 32. A paranoid client presents with bizarre behaviors, neologisms, and thought insertion. Which is the priority nursing action to maintain this client's safety? A. Assess for medication noncompliance. B. Note escalating behaviors and intervene immediately. C. Interpret attempts at communication. D. Assess triggers for bizarre, inappropriate behaviors. 33. A client diagnosed with Schizoaffective Disorder is admitted for social skills training. Which information should be taught by the nurse? A. The side effects of medications B. Deep breathing techniques to decrease stress C. How to make eye contact when communicating D. How to be a leader 34. A 16-year-old client diagnosed with Schizophrenia experiences command hallucinations tow harm others. The client's parents ask the nurse, "Where do the voices come from?" Which is the appropriate nursing reply? A. "Your child has a chemical imbalance of the brain, which leads to altered thoughts." B. "Your child's hallucinations are caused by medication interactions." C. "Your child has too little serotonin in the brain, causing delusions and hallucinations." D. "Your child's abnormal hormonal changes have precipitated auditory hallucinations." 35.Parents ask the nurse how they should reply when their child, diagnosed with Schizophrenia, tells them that voices command him to harm others. Which is the appropriate nursing reply? A. "Tell him to stop discussing the voices." B. "Ignore what he is saying, while attempting to discover the underlying cause." C. "Focus on the feelings generated by the hallucinations and present reality." D. "Present objective evidence that the voices are not real." 36.The nurse is assessing a client diagnosed with Schizophrenia. The nurse asks the client, "Do you receive special messages from certain sources, such as the television or radio?" Which potential symptom is the nurse assessing? A. Thought insertion. B. Paranoia C. Magical thinking D. Delusions of reference 37. A client diagnosed with Schizophrenia tells the nurse, "The 'Shopatouliens' took my shoes out of my room last night." Which is the correct charting entry to describe this client's statement? A. "The client is experiencing command hallucinations." B. "The client is expressing a neologism." C. "The client is experiencing a paranoia." D. "The client is verbalizing a word salad." 38. A client diagnosed with Schizophrenia states, “Can't you hear him? It's the devil. He's telling me I'm going to hell." Which is the most appropriate nursing reply? A. "Did you take your medicine this morning?" B. "You are not going to hell. You are a good person." C. "I'm sure the voices sound scary. I don't hear any voices speaking." D. "The devil only talks to people who are receptive to his influence." 40. Which nursing intervention is most appropriate when caring for an acutely agitated client with paranoia? A. Provide neon lights and soft music. B. Maintain continual eye contact throughout the interview. C. Use therapeutic touch to increase trust and rapport. D. Provide personal space to respect the client's boundaries. 41. Which nursing behavior will enhance the establishment of a trusting relationship with a client A diagnosed with Schizophrenia? A. Establishing personal contact with family members B. Being reliable, honest, and consistent during interactions C. Sharing limited personal information D. Sitting close to the client to establish rapport 42. A client diagnosed with Schizophrenia states, "My psychiatrist is out to get me. I'm sad that the voice is telling me to stop him." Which symptom is the client exhibiting, and what is the nurse's legal responsibility related to this symptom? A. Magical thinking; administer an antipsychotic medication. B. Persecutory delusions; orient the client to reality. C. Command hallucinations; warn the psychiatrist. D. Altered thought processes; call an emergency treatment team meeting. Chapters Behavioral Therapy Chapter 18 Electro convulsant Therapy Chapter20 Bipolar Disorder 26 1. A kindergarten rule states that if unacceptable behavior occurs, a child's personalized fish will be moved to the sea grass. Children who behave keep their fish out of the sea grass. The school nurse identifies this intervention is based on which principle of behavior therapy? A. Classical conditioning B. Conditioned response C. Positive reinforcement D.Negative reinforcement 2. An adolescent comes from a family where physical and verbal abuse prevails. The adolescent bullies and fights with classmates at school. Which of the following is the probable source of this behavior? A.Shaping B. Modeling C. Premack principle D. Reciprocal inhibition 3. A 2-year-old engages in frequent temper tantrums that usually result in the parents giving in to demands. During family therapy, which is the best nursing statement when counseling the parents? A. "You are shaping your child's behavior." B. "Your child has modeled your behavior." C."You are positively reinforcing your child's behavior." D. "You are negatively reinforcing your child's behavior." 4. A mother tells her teenager that for college tuition to be paid, the teenager must quit smoking. They develop a written agreement stipulating time frames and consequences. This is an example of which technique of behavior modification? A. Shaping B. Modeling C. Contracting D.Premack principle6. 5. A nurse administers pure oxygen to a client during and after electroconvulsive therapy (ECT). What is the nurse's rationale for this procedure? A. To prevent increased intracranial pressure resulting from anoxia B. To prevent hypotension, bradycardia, and bradypnea due to electrical stimulation C. To prevent anoxia due to medication-induced paralysis of respiratory muscles D. To prevent blocked airway resulting from seizure activity 6. Which position should the nurse place the client in immediately after ECT? A. On his or her side to prevent aspiration B. In semi-Fowler's position to promote oxygenation C. In Trendelenburg's position to promote blood flow to vital organs D. In prone position to prevent airway blockage 7. Parents decide to try the nurse practitioner's suggestion of time-out when their child misbehaves. Which is the nurse practitioner's best statement when teaching the parents? A. "Correct your child's behavior by spanking for a specified time period." B. "Ignore the child's negative behavior." C."Add positive reinforcement for acceptable behavior." D."Temporarily move your child to an area where behavior is not being reinforced." 8. A nursing instructor is teaching about ECT. Which student statement indicates learning has occurred? A. "During ECT, a state of euphoria is induced." (B.) "ECT induces a grand mal seizure." C. "During ECT, a state of catatonia is induced." D. "ECT induces a petit mal seizure." I ndicates that learning 9. A chronically depressed and suicidal client is admitted to a psychiatric unit. The client is scheduled for ECT. During the course of ECT, a nurse should recognize the continued need for which critical intervention? A. Suicide assessment must continue throughout the ECT course. B. Antidepressant medications are contraindicated throughout the ECT course. C. Discourage expressions of hopelessness throughout the ECT course. D. Encourage a high-caloric diet throughout the ECT course. 10. After undergoing two of nine ECT procedures, a client states, "I can't even remember eating breakfast, so I want to stop the ECT." Which is the most appropriate nursing reply? A. "After you begin the course of treatments, you must complete all of them." B. "You'll need to talk with your doctor about what you're thinking." C.It is within your right to discontinue the treatments, but let's talk about your patient concerns." D. "Memory loss is a rare side effect of the treatment. I don't think it should be a concern." 11. Immediately after an initial ECT procedure, a client states, "I'm not hungry and just want to stay in bed and sleep." Based on this information, which is the most appropriate nursing intervention? A Allow the client to remain in bed. B. Encourage the client to join the milieu to promote socialization. C. Obtain a physician's order for parenteral nutrition. D. Involve the client in physical activities to stimulate circulation. 12. A client scheduled for ECT at 9:00 a.m. is discovered eating breakfast at 8:00 a.m. Based on this observation, which is the most appropriate nursing action? A. The nurse notifies the client's physician of the situation and cancels the ECT. B. The nurse removes the breakfast tray and assists the client to the ECT procedure room. C. The nurse allows the client to finish breakfast and reschedules ECT for 10:00 a.m. D. The nurse increases the client's fluid intake to facilitate the digestive process. 13. A client who is learning about ECT asks a nurse, "Isn't this treatment dangerous?" Which is the most appropriate nursing reply? A. "ECT is not dangerous because there are no side effects. B. "There can be temporary paralysis, but full functioning returns within 3 hours of treatment. C. You will have a thorough examination beforehand to ensure you can safely undergo an ECT." D. "Transient ischemic attacks can occur but are rare." 14. A client experienced bradycardia during ECT. A nurse assigns a nursing diagnosis of decreased cardiac output R/T vagal stimulation occurring during ECT. Which outcome would the nurse expect the client to achieve? A. The client will verbalize an understanding of the need for moving slowly after treatment. B. The client will maintain an oxygen saturation level of 88 percent 1 hour after treatment. C.The client will continue adequate tissue perfusion 1 hour after treatment. D. The client will verbalize an understanding of common side effects of ECT. 15. A client states, "My doctor has told me I am a candidate for ECT. Where will the treatment take place, and how much time would this entail?" Which nursing reply is best? A."Clients typically receive ECT in their hospital room, daily for 1 month." B. "Clients typically undergo 6 to 12 ECT procedures, three times a week in an outpatient setting." C. "Clients typically receive an unlimited number of treatments, in the hospital procedure room." D. "Clients typically receive two to three treatments, in either an outpatient or inpatient setting." 16. A client is scheduled for an initial ECT procedure. Which information will the nurse include when teaching about the potential side effects of ECT? A. "You may experience transient tangential thinking." B. "You may experience some memory deficit surrounding the ECT." C. "You may experience avolution for the remainder of the day." D. "You may experience a higher risk for subsequent seizures." 17. When scheduling ECT, which client should the nurse prioritize? A. A client in bed in a fetal position who is experiencing active suicidal ideations B. A client with an irritable mood who is exhibiting angry outbursts C. A client experiencing command hallucinations and delusions of reference D. A client experiencing manic episodes of bipolar disorder 18. A client with cognitive deficits is extremely suicidal. The client has not responded to antidepressants and the treatment team is considering ECT. Which client information would impact the feasibility of this treatment option? A. Because the client is extremely suicidal, ECT is an appropriate option. B. Because antidepressant medications have been ineffective, ECT is a good alternative. C. Because informed consent is required for ECT, cognitive deficits could preclude this option. D. Because of the client's cognitive deficits, a signed consent is waived. 19. The nurse recognizes that ECT would potentially improve the symptoms of clients with which of the following diagnoses? Select all that apply. A.Major depressive disorder B.Bipolar I disorder: Acute mania C.Schizoaffective disorder D. Obsessive-compulsive disorder (OCD) E. Body dysmorphic disorder 20. A client diagnosed with Bipolar I Disorder is distraught over insomnia experienced over the last 3 nights and a 12-pound weight loss over the past 2 weeks. Which should be this client's priority nursing diagnosis? A. Knowledge deficit R/T bipolar disorder AEB concern about symptoms B. Altered nutrition: less than body requirements R/T hyperactivity AEB weight loss C. Risk for suicide R/T powerlessness AEB insomnia and anorexia D. Altered sleep patterns R/T mania AEB insomnia for the past 3 nights 21. The nurse is planning care for a client diagnosed with Bipolar Disorder: Manic Episode. Which should be the first priority of the listed client outcomes? A. Maintains nutritional status B. Interacts appropriately with peers C. Remains free from injury D. Sleeps 6 to 8 hours a night 22. A client diagnosed with Bipolar Disorder: Depressive Episode intentionally overdoses on sertraline (Zoloft). Family reports that the client has experienced anorexia, insomnia, and recent job loss. Which should be the priority nursing diagnosis for this client? A. Risk for suicide R/T hopelessness B. Anxiety: severe R/T hyperactivity C. Imbalanced nutrition: less than body requirements R/T refusal to eat D. Dysfunctional grieving R/T loss of employment 23. A nursing instructor is teaching about the prevalence of bipolar disorder. Which student statement indicates learning has occurred? A. "This disorder is more prevalent in lower socioeconomic groups." (B) "This disorder is more prevalent in higher socioeconomic groups." C. "This disorder is equally prevalent in all socioeconomic groups." D. "This disorder's prevalence cannot be evaluated on the basis of socioeconomic groups." 24. A client diagnosed with Bipolar Disorder, who has taken lithium carbonate (Lithane) for 1 year, presents in an emergency department with severe diarrhea, blurred vision, and tinnitus. The nurse should interpret these symptoms to be indicative of which of the following? A. Consumption of foods high in tyramine B. Lithium carbonate discontinuation syndrome C. Development of lithium carbonate tolerance D.Lithium carbonate toxicity 25.Which tool should the nurse use to differentiate occasional spontaneous behaviors of children from behaviors associated with bipolar disorder? A.Risky Activity tool B. FIND tool C.Consensus Committee tool D. Monotherapy tool 26. A client is diagnosed with Bipolar I Disorder: Manic Episode. Which nursing intervention should be implemented to achieve the outcome of "Client will gain 2 pounds by the end of the week?" A. Provide client with high-calorie finger foods throughout the day. B. Accompany client to cafeteria to encourage adequate dietary consumption. C. Initiate total parenteral nutrition to meet dietary needs. D. Teach the importance of a varied diet to meet nutritional needs. Mental Health Test Bank 1, 5, 25 Chapter 1 Chapter 01. The Concept of Stress Adaptation Multiple Choice 1. A client has experienced the death of a close family member and at the same time becomes unemployed. This situation has resulted in a 6-month score of 110 on the Recent Life Changes Questionnaire. How should the nurse evaluate this client data? A. The client is experiencing severe distress and is at risk for physical and psychological illness. B. A score of 110 on the Miller and Rahe Recent Life Changes Questionnaire indicates no significant threat of stress-related illness. C. Susceptibility to stress-related physical or psychological illness cannot be estimated without knowledge of coping resources and available supports. D. The client may view these losses as challenges and perceive them as opportunities. ANS: C 2. A physically and emotionally healthy client has just been fired. During a routine office visit he states to a nurse: Perhaps this was the best thing to happen. Maybe Ill look into pursuing an art degree. How should the nurse characterize the clients appraisal of the job loss stressor? A. Irrelevant B. Harm/loss C. Threatening D. Challenging ANS: D 3. Which client statement should alert a nurse that a client may be responding maladaptively to stress? A. I’ve found that avoiding contact with others helps me cope. B. I really enjoy journaling; its my private time. C. I signed up for a yoga class this week. D. I made an appointment to meet with a therapist. ANS: A 4. A nursing student finds that she comes down with a sinus infection toward the end of every semester. When this occurs, which stage of stress is the student most likely experiencing? A. Alarm reaction stage B. Stage of resistance C. Stage of exhaustion D. Fight-orflight stage ANS: C At the stage of exhaustion, the students exposure to stress has been prolonged and adaptive energy has been depleted. Diseases of adaptation occur more frequently in this stage. 5. A school nurse is assessing a female high school student who is overly concerned about her appearance. The clients mother states, Thats not something to be stressed about! Which is the most appropriate nursing response? A. Teenagers! They dont know a thing about real stress. B. Stress occurs only when there is a loss. C. When you are in poor physical condition, you cant experience psychological wellbeing. D. Stress can be psychological. A threat to self-esteem may result in high stress levels. ANS: D 6. A bright student confides in the school nurse about conflicts related to attending college or working to add needed financial support to the family. Which coping strategy is most appropriate for the nurse to recommend to the student at this time? A. Meditation B. Problem-solving training C. Relaxation D. Journaling ANS: B 7. An unemployed college graduate is experiencing severe anxiety over not finding a teaching position and has difficulty with independent problem-solving. During a routine physical examination, the graduate confides in the clinic nurse. Which is the most appropriate nursing intervention? A. Encourage the student to use the alternative coping mechanism of relaxation exercises. B. Complete the problem-solving process for the client. C. Work through the problem-solving process with the client. D. Encourage the client to keep a journal. ANS: C 8. A school nurse is assessing a distraught female high school student who is overly concerned because her parents cant afford horseback riding lessons. How should the nurse interpret the students reaction to her perceived problem? A. The problem is endangering her well-being. B. The problem is personally relevant to her. C. The problem is based on immaturity. D. The problem is exceeding her capacity to cope. ANS: B 9. Meditation has been shown to be an effective stress management technique. When meditation is effective, what should a nurse expect to assess? A. An achieved state of relaxation B. An achieved insight into ones feelings C. A demonstration of appropriate role behaviors D. An enhanced ability to problem-solve ANS: A 10. A distraught, single, first-time mother cries and asks a nurse, How can I go to work if I cant afford childcare? What is the nurses initial action in assisting the client with the problem-solving process? A. Determine the risks and benefits for each alternative. B. Formulate goals for resolution of the problem. C. Evaluate the outcome of the implemented alternative. D. Assess the facts of the situation. ANS: D 11. A nursing instructor is asking students about diseases of adaptation and when they are likely to occur. Which student response indicates that learning has occurred? A. When an individual has limited experience dealing with stress B. When an individual inherits maladaptive genes C. When an individual experiences existing conditions that exacerbate stress D. When an individuals physiological and psychological resources have become depleted ANS: D 12. When an individuals stress response is sustained over a long period of time, which physiological effect of the endocrine system should a nurse anticipate? A. Decreased resistance to disease B. Increased libido C. Decreased blood pressure D. Increased inflammatory response ANS: A 13. Which symptom should a nurse identify as typical of the fight-or-flight response? A. Pupil constriction B. Increased heart rate C. Increased salivation D. Increased peristalsis ANS: B 14. A nurse is evaluating a clients response to stress. What would indicate to the nurse that the client is experiencing a secondary appraisal of the stressful event? A. When the individual judges the event to be benign B. When the individual judges the event to be irrelevant C. When the individual judges the resources and skills needed to deal with the event D. When the individual judges the event to be pleasurable ANS: C 15. Research undertaken by Miller and Rahe in 1997 demonstrated a correlation between the effects of life change and illness. This research led to the development of the Recent Life Changes Questionnaire (RLCQ). Which principle most limits the effectiveness of this tool? A. Specific illnesses are not identified. B. The numerical values associated with specific life events are randomly assigned C. Stress is viewed as only a physiological response. D. Personal perception of the event is excluded. ANS: D 16. A client who experiences stress on a regular basis asks a nurse what causes these feelings. Which is the most appropriate nursing response? A. Genetics have nothing to do with your temperament. B. How you reacted to past experiences influences how you feel now. C. If youre in good physical health, your stress level will be low. D. Stress can always be avoided if appropriate coping mechanisms are employed. ANS: B Multiple Response 17. A nurse is interviewing a distressed client, who relates being fired after 15 years of loyal employment. Which of the following questions would best assist the nurse to determine the clients appraisal of the situation? Select all that apply. A. What resources have you used previously in stressful situations? B. Have you ever experienced a similar stressful situation? C. Who do you think is to blame for this situation? D. Why do you think you were fired from your job? E. What skills do you possess that might lead to gainful employment? ANS: A, B, E 18. A nurse is working with a client who has recently been under a great deal of stress. Which nursing recommendations would be most helpful when assisting the client in coping with stress? Select all that apply. A. Enjoy a pet. B. Spend time with a loved one. C. Listen to music. D. Focus on the stressors. E. Journal your feelings. ANS: A, B, C, E 19. A nurse is conducting education on anxiety and stress management. Which of the following should be identified as the most important initial step in learning how to manage anxiety? A. Diagnostic blood tests B. Awareness of factors creating stress C. Relaxation exercises D. Identifying support systems ANS: B 20. A patient presents in the Emergency Department immediately following a shooting incident in a school where she has been teaching. There is no evidence of physical injury, but she appears very hyperactive and talkative. Which of these symptoms manifested by the patient are common initial biological responses to stress? Select all that apply. A. Constricted pupils B. Watery eyes C. Unusual food cravings D. Increased heart rate E. Increased respirations ANS: B, D, E Chapter 05. Ethical and Legal Issues in Psychiatric/Mental Health Nursing Multiple Choice 1. In response to a students question regarding choosing a psychiatric specialty, a charge nurse states, Mentally ill clients need special care. If I were in that position, Id want a caring nurse also. From which ethical framework is the charge nurse operating? A. Kantianism B. Christian ethics C. Ethical egoism D. Utilitarianism ANS: B 2. During a hiring interview, which response by a nursing applicant should indicate that the applicant operates from an ethical egoism framework? A. I would want to be treated in a caring manner if I were mentally ill. B. This job will pay the bills, and the workload is light enough for me. C. I will be happy caring for the mentally ill. Working in Med/Surg kills my back. D. It is my duty in life to be a psychiatric nurse. It is the right thing to do. ANS: B 3. Without authorization, a nurse administers an extra dose of narcotic tranquilizer to an agitated client. The nurses coworker observes this action but does nothing for fear of repercussion. What is the ethical interpretation of the coworkers lack of involvement? A. Taking no action is still considered an action by the coworker. B. Taking no action releases the coworker from ethical responsibility. C. Taking no action is advised when potential adverse consequences are foreseen. D. Taking no action is acceptable, because the coworker is only a bystander. ANS: A 4. Group therapy is strongly encouraged, but not mandatory, on an inpatient psychiatric unit. The unit managers policy is that clients can make a choice about whether or not to attend group therapy. Which ethical principle does the unit managers policy preserve? A. Justice B. Autonomy C. Veracity D. Beneficence ANS: B 5. Which is an example of an intentional tort? A. A nurse fails to assess a clients obvious symptoms of neuroleptic malignant syndrome. B. A nurse physically places an irritating client in four-point restraints. C. A nurse makes a medication error and does not report the incident. D. A nurse gives patient information to an unauthorized person. ANS: B 6. An involuntarily committed client is verbally abusive to the staff and repeatedly threatening to sue. The client records the full names and phone numbers of the staff. Which nursing action is most appropriate to decrease the possibility of a lawsuit? A. Verbally redirect the client, and then limit one-on-one interaction. B. Involve the hospitals security division as soon as possible. C. Notify the client that documenting personal staff information is against hospital policy. D. Continue professional attempts to establish a positive working relationship with the client. ANS: D 7. Which statement should a nurse identify as correct regarding a clients right to refuse treatment? A. Clients can refuse pharmacological but not psychological treatment. B. Clients can refuse any treatment at any time. C. Clients can refuse only electroconvulsive therapy (ECT). D. Professionals can override treatment refusal if the client is actively suicidal or homicidal. ANS: D 8. Which client should a nurse identify as a potential candidate for involuntarily commitment? A. A client living under a bridge in a cardboard box B. A client threatening to commit suicide C. A client who never bathes and wears a wool hat in the summer D. A client who eats waste out of a garbage can ANS: B 9. A client diagnosed with schizophrenia refuses to take medication, citing the right of autonomy. Under which circumstance would a nurse have the right to medicate the client against the clients wishes? A. When the client makes inappropriate sexual innuendos to a staff member B. When the client constantly demands inappropriate attention from the nurse C. When the client physically attacks another client after being confronted in group therapy D. When the client refuses to bathe or perform hygienic activities ANS: C 10. A psychiatric nurse working on an inpatient unit receives a call asking if an individual has been a client in the facility. Which nursing response reflects appropriate legal and ethical obligations? A. Refusing to give any information to the caller, citing rules of confidentiality B. Refusing to give any information to the caller by hanging up C. Affirming that the person has been seen at the facility but providing no further information D. Suggesting that the caller speak to the clients therapist ANS: A 11. A client requests information on several medications in order to make an informed choice about management of depression. A nurse should provide this information to facilitate which ethical principle? A. Autonomy B. Beneficence C. Nonmaleficence D. Justice ANS: A 12. An inpatient psychiatric physician refuses to treat clients without insurance and prematurely discharges those whose insurance benefits have expired. Which violation of an ethical principle should a nurse recognize in this situation? A. Autonomy B. Beneficence C. Nonmaleficence D. Justice ANS: D 13. Which situation contradicts the ethical principle of veracity? A. A nurse provides a client with outpatient resources to benefit recovery. B. A nurse refuses to give information to a physician who is not responsible for the clients care. C. A nurse tricks a client into seclusion by asking the client to carry linen to the seclusion room. D. A nurse treats all of the clients equally regardless of illness severity. ANS: C 14. A client who will be receiving electroconvulsive therapy (ECT) must provide informed consent. Which situation should cause a nurse to question the validity of the informed consent? A. The client is paranoid. B. The client is 87 years old. C. The client incorrectly reports his or her spouses name, the date, and the time of day. D. The client relies on his or her spouse to interpret the information. ANS: C 15. A client diagnosed with schizophrenia receives fluphenazine decanoate (Prolixin Decanoate) from a home health nurse. The client refuses medication at one regularly scheduled home visit. Which nursing intervention is ethically appropriate? A. Allow the client to decline the medication and document. B. Tell the client that if the