NUR 356 Exam 3 Practice Questions
A client is diagnosed with schizophrenia. A physician orders haloperidol (Haldol), 50 mg
BID; benztropine (Cogentin), 1 mg PRN; and zolpidem (Ambien), 10 mg HS. Which
client behavior would warrant the nurse to administer benztropine?
A. Tactile hallucinations
B. Visual hallucinations
C. Restlessness and muscle rigidity
D. Reports of hearing disturbing voices - answerC. Restlessness and muscle rigidity
Rationale: An anticholinergic medication such as benztropine (Cogentin) would be used
to treat the extrapyramidal symptoms of restlessness and muscle rigidity. Tardive
dyskinesia, a potentially irreversible condition, would warrant the discontinuation of
haloperidol (Haldol). The symptoms of tactile hallucinations and reports of hearing
disturbing voices would be addressed by an antipsychotic medication such as
haloperidol (Haldol).
A recovering alcoholic relapses and drinks a glass of wine. The client presents in the
ED experiencing severe throbbing headache, tachycardia, flushed face, dyspnea, and
continuous vomiting. The nurse recognizes that the client's symptoms indicate which of
the following?
A. Alcohol poisoning
B. Cardiovascular accident (CVA)
C. A reaction to disulfiram (Antabuse)
D. A reaction to tannins in the red wine - answerC. A reaction to disulfiram (Antabuse)
The client has most likely ingested alcohol while taking disulfiram (Antabuse), a drug
that is administered as a deterrent to drinking. Ingestion of alcohol while disulfiram is in
the body results in a syndrome of symptoms that can produce a good deal of discomfort
for the individual. Symptoms may include flushed skin, throbbing in the head and neck,
respiratory difficulty, dizziness, nausea and vomiting, confusion, hypotension, and
tachycardia.
The nurse is caring for a client with phase III of schizophrenia. The nurse anticipates the
patient will be exhibiting which signs or symptom the disorder?
A. Active positive symptoms
B. Normal behavior patters
C. Active negative symptoms
D. Shy and withdrawn, no wish to attend groups - answerA. Active positive symptoms
,Rationale: Schizophrenia is a chronic illness. Phase III is characterized by acute
episodes in which symptoms are more pronounced. In the active phase of the disorder,
psychotic symptoms (positive symptoms) are typically prominent. Premorbid personality
and behavioral indications may include being very shy and withdrawn, having poor peer
relationships, doing poorly in school, and demonstrating antisocial behavior.
During a nurse-client interaction, an adolescent client with a major depressive disorder
stated, "I was on the basketball team at school, but I don't have the energy to play so I
quit." The client is describing:
A. Aphasia
B. Anergia
C. Anhedonia
D. Ataxia - answerB. Anergia
Rationale: This client is voicing a lack of energy which can be a symptom of depression.
Depression may cause changes in the client's behavior and a lack of enjoyment in
activities that were once enjoyable.
The client states, "I haven't left my house for six years." The nurse suspects that this
client experiences which disorder?
A. Agoraphobia
B. Generalized Anxiety Disorder
C. Social Anxiety Disorder
D. Panic Disorder - answerA. Agoraphobia
Rationale: This client is demonstrating a hallmark trait of those that are afraid of other
environments (agoraphobia). This is an anxiety disorder and also fits in the classification
of a phobia, however it is a very specific statement that applies to this one phobia.
The AIMS or Abnormal Involuntary Movement Scale assesses side effects of which
medications? - answerAntipsychotics
Rationale: AIMS assesses for extrapyramidal side effects seen with antipsychotic use.
The charge nurse on an inpatient psychiatric floor is teaching a floor nurse about signs
and symptoms of alcohol withdrawal. The charge nurse knows the floor nurse
demonstrates understanding when the floor nurse lists which of the following signs and
symptoms? (Select all that apply)
A. Vomiting
B. Tremors
C. Bradycardia
D. Hypotension
E. Hallucinations - answerA. Vomiting
, B. Tremors
E. Hallucinations
Rationale: Patients will exhibit restlessness, nausea and vomiting, tremors,
hallucinations, hypertension, and tachycardia.
A client comes in with signs of alcoholism and substance abuse. As a nurse, you know
that genetics accounts for __% of the client's vulnerability to alcoholism.
A. 10-15
B. 80-90
C. 70-80
D. 40-60 - answerD. 40-60
Rationale: Genetics account for 40-60% of a person's vulnerability to alcoholism. A
study concludes this, and have found some specific genes with this exact correlation,
along with the development of reward centers in the brain.
A client is receiving nursing education after a prescription for disulfiram is ordered. What
will the nurse include in the education?
A. This medication only interacts with orally ingested alcohols
B. If you use alcohol based products this medication will make you ill
C. The only side effect of this medication is drowsiness
D. This medication will only need to be taken a few times - answerB. If you use alcohol
based products this medication will make you ill
Rationale: This medication will make the client ill with any alcohol exposure to the body
orally or otherwise, this medication has many side effects, clients may need to take this
medication for months or more.
An inpatient client is newly diagnosed with anxiety disorder stemming from severe
childhood sexual abuse. Which is the priority nursing intervention?
A. Encourage exploration of sexual abuse.
B. Encourage guided imagery.
C. Establish trust and rapport.
D. Administer anti-anxiety medications. - answerC. Establish trust and rapport.
Rationale: Establishing trust and rapport when beginning to work with a client diagnosed
with DID is the priority intervention, as trust is the basis of every therapeutic
relationship. DID was formerly called multiple personality disorder; each personality
views itself as a separate entity and must be treated as such to establish rapport.
A client is diagnosed with schizophrenia. A physician orders haloperidol (Haldol), 50 mg
BID; benztropine (Cogentin), 1 mg PRN; and zolpidem (Ambien), 10 mg HS. Which
client behavior would warrant the nurse to administer benztropine?
A. Tactile hallucinations
B. Visual hallucinations
C. Restlessness and muscle rigidity
D. Reports of hearing disturbing voices - answerC. Restlessness and muscle rigidity
Rationale: An anticholinergic medication such as benztropine (Cogentin) would be used
to treat the extrapyramidal symptoms of restlessness and muscle rigidity. Tardive
dyskinesia, a potentially irreversible condition, would warrant the discontinuation of
haloperidol (Haldol). The symptoms of tactile hallucinations and reports of hearing
disturbing voices would be addressed by an antipsychotic medication such as
haloperidol (Haldol).
A recovering alcoholic relapses and drinks a glass of wine. The client presents in the
ED experiencing severe throbbing headache, tachycardia, flushed face, dyspnea, and
continuous vomiting. The nurse recognizes that the client's symptoms indicate which of
the following?
A. Alcohol poisoning
B. Cardiovascular accident (CVA)
C. A reaction to disulfiram (Antabuse)
D. A reaction to tannins in the red wine - answerC. A reaction to disulfiram (Antabuse)
The client has most likely ingested alcohol while taking disulfiram (Antabuse), a drug
that is administered as a deterrent to drinking. Ingestion of alcohol while disulfiram is in
the body results in a syndrome of symptoms that can produce a good deal of discomfort
for the individual. Symptoms may include flushed skin, throbbing in the head and neck,
respiratory difficulty, dizziness, nausea and vomiting, confusion, hypotension, and
tachycardia.
The nurse is caring for a client with phase III of schizophrenia. The nurse anticipates the
patient will be exhibiting which signs or symptom the disorder?
A. Active positive symptoms
B. Normal behavior patters
C. Active negative symptoms
D. Shy and withdrawn, no wish to attend groups - answerA. Active positive symptoms
,Rationale: Schizophrenia is a chronic illness. Phase III is characterized by acute
episodes in which symptoms are more pronounced. In the active phase of the disorder,
psychotic symptoms (positive symptoms) are typically prominent. Premorbid personality
and behavioral indications may include being very shy and withdrawn, having poor peer
relationships, doing poorly in school, and demonstrating antisocial behavior.
During a nurse-client interaction, an adolescent client with a major depressive disorder
stated, "I was on the basketball team at school, but I don't have the energy to play so I
quit." The client is describing:
A. Aphasia
B. Anergia
C. Anhedonia
D. Ataxia - answerB. Anergia
Rationale: This client is voicing a lack of energy which can be a symptom of depression.
Depression may cause changes in the client's behavior and a lack of enjoyment in
activities that were once enjoyable.
The client states, "I haven't left my house for six years." The nurse suspects that this
client experiences which disorder?
A. Agoraphobia
B. Generalized Anxiety Disorder
C. Social Anxiety Disorder
D. Panic Disorder - answerA. Agoraphobia
Rationale: This client is demonstrating a hallmark trait of those that are afraid of other
environments (agoraphobia). This is an anxiety disorder and also fits in the classification
of a phobia, however it is a very specific statement that applies to this one phobia.
The AIMS or Abnormal Involuntary Movement Scale assesses side effects of which
medications? - answerAntipsychotics
Rationale: AIMS assesses for extrapyramidal side effects seen with antipsychotic use.
The charge nurse on an inpatient psychiatric floor is teaching a floor nurse about signs
and symptoms of alcohol withdrawal. The charge nurse knows the floor nurse
demonstrates understanding when the floor nurse lists which of the following signs and
symptoms? (Select all that apply)
A. Vomiting
B. Tremors
C. Bradycardia
D. Hypotension
E. Hallucinations - answerA. Vomiting
, B. Tremors
E. Hallucinations
Rationale: Patients will exhibit restlessness, nausea and vomiting, tremors,
hallucinations, hypertension, and tachycardia.
A client comes in with signs of alcoholism and substance abuse. As a nurse, you know
that genetics accounts for __% of the client's vulnerability to alcoholism.
A. 10-15
B. 80-90
C. 70-80
D. 40-60 - answerD. 40-60
Rationale: Genetics account for 40-60% of a person's vulnerability to alcoholism. A
study concludes this, and have found some specific genes with this exact correlation,
along with the development of reward centers in the brain.
A client is receiving nursing education after a prescription for disulfiram is ordered. What
will the nurse include in the education?
A. This medication only interacts with orally ingested alcohols
B. If you use alcohol based products this medication will make you ill
C. The only side effect of this medication is drowsiness
D. This medication will only need to be taken a few times - answerB. If you use alcohol
based products this medication will make you ill
Rationale: This medication will make the client ill with any alcohol exposure to the body
orally or otherwise, this medication has many side effects, clients may need to take this
medication for months or more.
An inpatient client is newly diagnosed with anxiety disorder stemming from severe
childhood sexual abuse. Which is the priority nursing intervention?
A. Encourage exploration of sexual abuse.
B. Encourage guided imagery.
C. Establish trust and rapport.
D. Administer anti-anxiety medications. - answerC. Establish trust and rapport.
Rationale: Establishing trust and rapport when beginning to work with a client diagnosed
with DID is the priority intervention, as trust is the basis of every therapeutic
relationship. DID was formerly called multiple personality disorder; each personality
views itself as a separate entity and must be treated as such to establish rapport.
