Test Bank For Psychiatric Nursing: Contemporary Practice, 7th
Edition (Ann Boyd, 2022), Chapter 1-43 | 9781975161187 | All
Chapters with Answers and Rationals
A client diagnosed with major depressive disorder is receiving cognitive behavioral therapy (CBT).
Which principle is most important in CBT?
A. Identifying and challenging irrational thoughts
B. Exploring the client's past experiences
C. Encouraging free association
D. Using dream analysis - ANSWER: Answer: A. Identifying and challenging irrational thoughts
Rationale: CBT focuses on identifying and challenging irrational thoughts and cognitive distortions to
change behavior and emotions. It is an evidence-based approach widely used in the treatment of
depression.
A client with schizophrenia is experiencing auditory hallucinations. What is the most appropriate
initial nursing intervention?
A. Engage the client in a reality-based conversation
B. Tell the client the hallucinations are not real
C. Ignore the hallucinations
D. Explore the content of the hallucinations - ANSWER: Answer: A. Engage the client in a reality-based
conversation
Rationale: Engaging the client in a reality-based conversation can help distract them from the
hallucinations and reorient them to the present moment. It is important to acknowledge the client's
experience without reinforcing the hallucinations.
A client with bipolar disorder is in the manic phase. Which activity would be most appropriate to
include in the client's plan of care?
A. Group therapy sessions
B. Quiet, solitary activities
C. Competitive games
D. Vigorous exercise - ANSWER: Answer: B. Quiet, solitary activities
Rationale: During the manic phase, clients may have difficulty with impulse control and
overstimulation. Quiet, solitary activities can help reduce stimuli and provide a calming effect.
When caring for a client with obsessive-compulsive disorder (OCD), what is the primary goal of
nursing interventions?
A. Encourage the client to complete rituals faster
B. Assist the client in avoiding triggers for rituals
C. Help the client understand the purpose of their rituals
D. Gradually limit the time spent on rituals - ANSWER: Answer: D. Gradually limit the time spent on
rituals
Rationale: The goal of treatment for OCD is to reduce the time spent on compulsive rituals and
increase the client's control over their compulsions. This can be achieved through exposure and
response prevention techniques.
,A client with generalized anxiety disorder (GAD) is prescribed buspirone (Buspar). What is important
for the nurse to include in the client's education about this medication?
A. Buspirone can cause dependency and withdrawal symptoms
B. It is effective immediately upon administration
C. It may take several weeks to notice an improvement in symptoms
D. Avoid foods containing tyramine - ANSWER: Answer: C. It may take several weeks to notice an
improvement in symptoms
Rationale: Buspirone does not cause dependency and has a delayed onset of action, typically taking
several weeks to show its full therapeutic effects. Patients should be informed to continue taking the
medication as prescribed even if they do not see immediate improvement.
A nurse is teaching a client about electroconvulsive therapy (ECT). Which statement by the client
indicates a need for further teaching?
A. "ECT will help me remember my past experiences better."
B. "I might have some short-term memory loss after the procedure."
C. "I will need someone to drive me home after the treatment."
D. "ECT can help reduce my depressive symptoms." - ANSWER: Answer: A. "ECT will help me
remember my past experiences better."
Rationale: ECT is typically associated with some degree of short-term memory loss, not improvement
in memory of past experiences. The primary purpose of ECT is to alleviate severe depressive
symptoms.
Which dietary instruction should the nurse provide to a client taking monoamine oxidase inhibitors
(MAOIs)?
A. Increase intake of aged cheese and processed meats
B. Avoid foods high in tyramine, such as aged cheese and processed meats
C. Limit fluid intake to prevent hyponatremia
D. Increase intake of high-fiber foods to prevent constipation - ANSWER: Answer: B. Avoid foods high
in tyramine, such as aged cheese and processed meats
Rationale: MAOIs can cause a hypertensive crisis if the client ingests foods high in tyramine. It is
crucial to avoid such foods to prevent serious side effects.
A client with a history of substance abuse is admitted to the psychiatric unit. What is the most
important initial assessment?
A. Assessing the client's level of denial about substance abuse
B. Determining the last time the client used the substance
C. Evaluating the client's willingness to attend group therapy
D. Conducting a thorough physical examination - ANSWER: Answer: B. Determining the last time the
client used the substance
Rationale: It is critical to determine the last time the client used the substance to assess the risk of
withdrawal and plan appropriate medical interventions.
Which nursing intervention is most appropriate for a client experiencing a panic attack?
A. Encouraging the client to explore the underlying cause of the panic
B. Providing a detailed explanation of the physiological mechanisms of panic attacks
C. Staying with the client and remaining calm
D. Instructing the client to focus on the panic attack - ANSWER: Answer: C. Staying with the client and
remaining calm
, Rationale: Staying with the client and remaining calm can help provide reassurance and reduce the
client's anxiety during a panic attack.
A client is diagnosed with post-traumatic stress disorder (PTSD). Which symptom would the nurse
expect the client to exhibit?
A. Euphoric mood
B. Flashbacks
C. Delusions
D. Somatic complaints - ANSWER: Answer: B. Flashbacks
Rationale: Flashbacks, or reliving the traumatic event, are a common symptom of PTSD, along with
hyperarousal and avoidance of triggers related to the trauma.
A client with borderline personality disorder exhibits self-mutilating behavior. What is the most
appropriate nursing intervention?
A. Ignore the behavior to avoid reinforcement
B. Encourage the client to discuss feelings instead of self-harming
C. Isolate the client to prevent further self-harm
D. Use restraints to prevent injury - ANSWER: Answer: B. Encourage the client to discuss feelings
instead of self-harming
Rationale: Encouraging the client to discuss feelings can help address the underlying emotional
distress that leads to self-mutilation. It is important to promote healthy coping mechanisms.
A nurse is providing discharge teaching to a client prescribed lithium. What should the nurse include
in the teaching?
A. Increase salt intake if lithium levels are too high
B. Maintain a consistent salt and fluid intake
C. Reduce fluid intake to prevent dilution of lithium
D. Avoid foods high in potassium - ANSWER: Answer: B. Maintain a consistent salt and fluid intake
Rationale: Maintaining consistent salt and fluid intake is essential for clients taking lithium to avoid
fluctuations in lithium levels, which can lead to toxicity or subtherapeutic effects.
A client with antisocial personality disorder is admitted to the psychiatric unit. What behavior is most
characteristic of this disorder?
A. Excessive need for attention
B. Manipulative behaviors
C. Fear of abandonment
D. Obsessive thoughts - ANSWER: Answer: B. Manipulative behaviors
Rationale: Manipulative behaviors and a disregard for the rights of others are characteristic of
antisocial personality disorder. Clients with this disorder may exhibit deceitful and exploitative
behaviors.
A client with major depressive disorder is started on sertraline (Zoloft). What is a common side effect
the nurse should monitor for?
A. Hypertension
B. Weight loss
C. Sexual dysfunction
D. Bradycardia - ANSWER: Answer: C. Sexual dysfunction
Edition (Ann Boyd, 2022), Chapter 1-43 | 9781975161187 | All
Chapters with Answers and Rationals
A client diagnosed with major depressive disorder is receiving cognitive behavioral therapy (CBT).
Which principle is most important in CBT?
A. Identifying and challenging irrational thoughts
B. Exploring the client's past experiences
C. Encouraging free association
D. Using dream analysis - ANSWER: Answer: A. Identifying and challenging irrational thoughts
Rationale: CBT focuses on identifying and challenging irrational thoughts and cognitive distortions to
change behavior and emotions. It is an evidence-based approach widely used in the treatment of
depression.
A client with schizophrenia is experiencing auditory hallucinations. What is the most appropriate
initial nursing intervention?
A. Engage the client in a reality-based conversation
B. Tell the client the hallucinations are not real
C. Ignore the hallucinations
D. Explore the content of the hallucinations - ANSWER: Answer: A. Engage the client in a reality-based
conversation
Rationale: Engaging the client in a reality-based conversation can help distract them from the
hallucinations and reorient them to the present moment. It is important to acknowledge the client's
experience without reinforcing the hallucinations.
A client with bipolar disorder is in the manic phase. Which activity would be most appropriate to
include in the client's plan of care?
A. Group therapy sessions
B. Quiet, solitary activities
C. Competitive games
D. Vigorous exercise - ANSWER: Answer: B. Quiet, solitary activities
Rationale: During the manic phase, clients may have difficulty with impulse control and
overstimulation. Quiet, solitary activities can help reduce stimuli and provide a calming effect.
When caring for a client with obsessive-compulsive disorder (OCD), what is the primary goal of
nursing interventions?
A. Encourage the client to complete rituals faster
B. Assist the client in avoiding triggers for rituals
C. Help the client understand the purpose of their rituals
D. Gradually limit the time spent on rituals - ANSWER: Answer: D. Gradually limit the time spent on
rituals
Rationale: The goal of treatment for OCD is to reduce the time spent on compulsive rituals and
increase the client's control over their compulsions. This can be achieved through exposure and
response prevention techniques.
,A client with generalized anxiety disorder (GAD) is prescribed buspirone (Buspar). What is important
for the nurse to include in the client's education about this medication?
A. Buspirone can cause dependency and withdrawal symptoms
B. It is effective immediately upon administration
C. It may take several weeks to notice an improvement in symptoms
D. Avoid foods containing tyramine - ANSWER: Answer: C. It may take several weeks to notice an
improvement in symptoms
Rationale: Buspirone does not cause dependency and has a delayed onset of action, typically taking
several weeks to show its full therapeutic effects. Patients should be informed to continue taking the
medication as prescribed even if they do not see immediate improvement.
A nurse is teaching a client about electroconvulsive therapy (ECT). Which statement by the client
indicates a need for further teaching?
A. "ECT will help me remember my past experiences better."
B. "I might have some short-term memory loss after the procedure."
C. "I will need someone to drive me home after the treatment."
D. "ECT can help reduce my depressive symptoms." - ANSWER: Answer: A. "ECT will help me
remember my past experiences better."
Rationale: ECT is typically associated with some degree of short-term memory loss, not improvement
in memory of past experiences. The primary purpose of ECT is to alleviate severe depressive
symptoms.
Which dietary instruction should the nurse provide to a client taking monoamine oxidase inhibitors
(MAOIs)?
A. Increase intake of aged cheese and processed meats
B. Avoid foods high in tyramine, such as aged cheese and processed meats
C. Limit fluid intake to prevent hyponatremia
D. Increase intake of high-fiber foods to prevent constipation - ANSWER: Answer: B. Avoid foods high
in tyramine, such as aged cheese and processed meats
Rationale: MAOIs can cause a hypertensive crisis if the client ingests foods high in tyramine. It is
crucial to avoid such foods to prevent serious side effects.
A client with a history of substance abuse is admitted to the psychiatric unit. What is the most
important initial assessment?
A. Assessing the client's level of denial about substance abuse
B. Determining the last time the client used the substance
C. Evaluating the client's willingness to attend group therapy
D. Conducting a thorough physical examination - ANSWER: Answer: B. Determining the last time the
client used the substance
Rationale: It is critical to determine the last time the client used the substance to assess the risk of
withdrawal and plan appropriate medical interventions.
Which nursing intervention is most appropriate for a client experiencing a panic attack?
A. Encouraging the client to explore the underlying cause of the panic
B. Providing a detailed explanation of the physiological mechanisms of panic attacks
C. Staying with the client and remaining calm
D. Instructing the client to focus on the panic attack - ANSWER: Answer: C. Staying with the client and
remaining calm
, Rationale: Staying with the client and remaining calm can help provide reassurance and reduce the
client's anxiety during a panic attack.
A client is diagnosed with post-traumatic stress disorder (PTSD). Which symptom would the nurse
expect the client to exhibit?
A. Euphoric mood
B. Flashbacks
C. Delusions
D. Somatic complaints - ANSWER: Answer: B. Flashbacks
Rationale: Flashbacks, or reliving the traumatic event, are a common symptom of PTSD, along with
hyperarousal and avoidance of triggers related to the trauma.
A client with borderline personality disorder exhibits self-mutilating behavior. What is the most
appropriate nursing intervention?
A. Ignore the behavior to avoid reinforcement
B. Encourage the client to discuss feelings instead of self-harming
C. Isolate the client to prevent further self-harm
D. Use restraints to prevent injury - ANSWER: Answer: B. Encourage the client to discuss feelings
instead of self-harming
Rationale: Encouraging the client to discuss feelings can help address the underlying emotional
distress that leads to self-mutilation. It is important to promote healthy coping mechanisms.
A nurse is providing discharge teaching to a client prescribed lithium. What should the nurse include
in the teaching?
A. Increase salt intake if lithium levels are too high
B. Maintain a consistent salt and fluid intake
C. Reduce fluid intake to prevent dilution of lithium
D. Avoid foods high in potassium - ANSWER: Answer: B. Maintain a consistent salt and fluid intake
Rationale: Maintaining consistent salt and fluid intake is essential for clients taking lithium to avoid
fluctuations in lithium levels, which can lead to toxicity or subtherapeutic effects.
A client with antisocial personality disorder is admitted to the psychiatric unit. What behavior is most
characteristic of this disorder?
A. Excessive need for attention
B. Manipulative behaviors
C. Fear of abandonment
D. Obsessive thoughts - ANSWER: Answer: B. Manipulative behaviors
Rationale: Manipulative behaviors and a disregard for the rights of others are characteristic of
antisocial personality disorder. Clients with this disorder may exhibit deceitful and exploitative
behaviors.
A client with major depressive disorder is started on sertraline (Zoloft). What is a common side effect
the nurse should monitor for?
A. Hypertension
B. Weight loss
C. Sexual dysfunction
D. Bradycardia - ANSWER: Answer: C. Sexual dysfunction
