EXAM -RETAKE GUIDE QUESTIONS
AND ANSWERS
1. A nurse is caring for a school-aged child who has conduct disorder and is being
physically aggressive toward other children in the unit. Which of the following actions
should the nurse take first?
a. Place the child in seclusion
b. Use therapeutic hold technique
c. Apply wrist restraints
d. Administer risperidone - Answer-a. Place the child in seclusion
2• A nurse is caring for a client who has a new diagnosis of bulimia nervosa. Which
of the following diagnosis procedures should the nurse anticipate the provider should
describe during the medical evaluation?
a. Chest x-ray
b. ECG
c. Coagulation studies
d. Liver function test - Answer-b. ECG
3. A nurse is caring for a client who exhibits excessive compliance, passivity, and
self-denial. The nurse should recognize that these findings are associated with which
of the following personality disorders?
a. Dependent
b. Paranoid
c. Borderline
d. Histrionic - Answer-a. Dependent
4. A nurse is caring for a client who is involuntarily admitted for major depressive
disorder and refuses to take prescribed antianxiety medication. Which of the
following actions should the nurse take?
a. Inform the client that he does not have the right to refuse medication
b. Administer the medication to the client via IM injection
c. Offer the client the medication at the next scheduled dose time
d. Implement consequences until the client take the medication - Answer-c. Offer the
client the medication at the next scheduled dose time
5. A nurse is caring for a client in the emergency department who states she was
beaten and sexually assaultby her partner. After a rapid assessment, which of the
following actions should the nurse plan to take next?
a. Conduct a pregnancy test
b. Requests mental health consultation for the client
c. Provide a trained advocate to stay with the clientd.
d. Offer prophylactic medication to prevent STI's - Answer-d. Offer prophylactic
medication to prevent STI's
, 6. A nurse is caring for a client who has major depressive disorder. After discussing
the treatment with his partner, the client verbally agrees to electroconvulsive therapy
(ECT) but will not sign the consent form. Which of the following actions should the
nurse take?
a. Request that the client's partner sign the consent formb.
b. Cancel the scheduled ECT procedure
c. Proceed with the preparation for ECT based on implied consent
d. Inform the client about the risks of refusing the ECT - Answer-b. Cancel the
scheduled ECT procedure
7. A nurse is caring for a client who reports that he is angry with his partner because
she thinks he is just trying to gain attention. When the nurse attempts to talk to the
client, he becomes angry and tells her to leave. Which of the following defense
mechanisms is the client demonstrating?
a. Rationalization
b. Denial
c. Compensationd.
d. Displacement - Answer-d. Displacement
8. A nursing is advising an assistive personnel (AP) on the care of a client who has
major depressive disorder. The AP states that he is irritated by the client's
depression. Which of the following statements by the nurse is appropriate?
a. Please don't take what the client said seriously when she is depressedb.
b. It's important that the client feel safe verbalizing how she is feeling
c. Everybody feels that way about this client so don't worry about it
d. I'll change your assignment to someone who doesn't have depressive disorder -
Answer-b. It's important that the client feel safe verbalizing how she is feeling
9. A nurse is assessing a child in the emergency department. Which of the following
findings places the childat the greatest risk for physical abuse?
a. The child is 10years old
b. The child is homeschooled
c. The has no siblings
d. The child has cystic fibrosis - Answer-d. The child has cystic fibrosis
10. A nurse is providing behavioral therapy for a client who has obsessive-
compulsive disorder. The client repeatedly checks that the doors are locked at night.
Which of the following instructions should the nurse give the client when using
thought stopping technique?
a. Keep a journal of how often you check the locks each night
b. Snap a rubber band on your wrist when you think about checking the locks
c. Ask a family member to check the lock for you at night
d. Focus on abdominal breathing whenever you go to check the locks - Answer-b.
Snap a rubber band on your wrist when you think about checking the locks
11. A nurse is assessing a client who is experiencing alcohol withdrawal. For which
of the following findings should the nurse anticipate administration of lorazepam/
a. Bradycardia
b. Stupor
c. Afebrile