NUR 356 Exam 4 Practice Questions
A nurse is educating staff on personality disorders. Which statement by the staff
indicates understanding?
A. Antisocial personality disorder can start as conduct disorder
B. It is very easy to categorize the clients based on their disorder
C. All clients with personality disorders were the victims of abuse
D. All clients with personality disorders take advantage of others - answer A. Antisocial
personality disorder can start as conduct disorder
Rationale: APD can start as conduct disorder while in childhood. The different disorders
overlap and can be difficult for even prescribers to identify. These disorders have signs
that you look for and will create a plan of care based on what behaviors and thoughts
the client has.
The nurse working in an acute care psychiatric facility is working with clients that have
personality disorders. The nurse knows that cluster A personality disorders (odd,
eccentric) tend to exhibit what behaviors?
A. Dramatic
B. Dependency
C. Indifference to social situations
D. Splitting between healthcare providers - answerC. Indifference to social situations
Rationale: Cluster A trademarks are odd, eccentric and indifferent to social situations.
These clients do not seek out interaction and when in social situations may not interact
in an appropriate manner. They exhibit some magical thinking or paranoia and are not
perceived by others positively.
Consider this comment to three different nurses by a patient diagnosed with antisocial
personality disorder, "Another nurse said you don't do your job right." Collectively, these
interactions can be assessed as:
A. Insightful
B. Guilt-producing
C. Manipulative
D. Detached - answerC. Manipulative
Rationale: The patient is demonstrating manipulation with this statement. This behavior
is a hallmark of the cluster B personality disorders. This is technically defined as
"splitting".
,A nurse is admitting a client who is in the manic phase of bipolar disorder. The nurse
should plan to make which of the following room assignments for the client?
A. A seclusion room until the client's activity level becomes more subdued
B. A semi-private room with a roommate who has a similar diagnosis
C. A private room away from the nursing station
D. A private room in a quiet location that can easily be monitored - answerD. A private
room in a quiet location that can easily be monitored
Rationale: A private room in a quiet location is ideal for a client with mania. The client
may easily become overstimulated by the number of people and activities in a nursing
care unit. A private room can be used for time-out during the day and to settle down to
sleep at night.
The client states "I just can't fall asleep". The nurse responds, "You are having difficulty
falling asleep?" Why is the nurse using the restating technique?
A. The nurse wants the client to know they understand
B. The nurse is allowing the client to elaborate or clear up misunderstanding
C. The nurse is keeping the conversation going
D. The nurse wants to focus on one idea - answerB. The nurse is allowing the client to
elaborate or clear up misunderstanding
Rationale: Establishes priority with nursing goals and interventions related to
therapeutic interaction. Using the client's words or close to is restating. This technique
allows the client to be able to elaborate or clear up any miscommunications with
nursing. This also gives the feedback that their concerns are being heard
A client is experiencing command hallucinations and appears to be frightened. Which of
the following actions are appropriate nursing interventions?
A. Keep the client physically safe
B. Ignore the client's feelings in response to altered perceptions
C. Assure the client that they are not experiencing something real
D. Inform the client that their hallucinations are just bad dreams - answerA. Keep the
client physically safe
Rationale: Validate the patient's feelings. Keep them physically safe. Determine what
the hallucination is telling them to do and provide reality testing PRN.
A nurse is performing an admission assessment for an adolescent client with a
diagnosis of schizophrenia. Which of the following findings should the nurse identify as
a positive symptom?
A. Somatic Delusions
B. Anhedonia
, C. Waxy Posture (immobile posturing)
D. Anergia - answerA. Somatic Delusions
Rationale: Delusions are example of a positive symptom. Anhedonia, waxy posture, and
anergia are negative symptoms. Positive symptoms, which include delusions,
hallucinations, disorganized thoughts, and disorganized speech; can cause you or
someone you love to lose touch with reality. Negative schizophrenia refers to behaviors
or emotions that are deficient or lacking in people with schizophrenia
A 28-year-old client with body dysmorphic disorder (BDD) tells the nurse that they plan
to have a surgical procedure that will affect their appearance. The nurse understands
that this plan is an effort to
A. Suppress intrusive thoughts
B. Deal with multiple physical complaints
C. Treat associated depression
D. Cure the imagined defect - answerD. Cure the imagined defect
Rationale: With BDD the client has a perceived defect, they will seek to alter this defect
through means such as plastics procedures. These clients seek extreme measures to
cure this defect that only they see.
An unlicensed assistive personnel (UAP) is working with clients that have diagnosis of
obsessive compulsive disorder. The UAP understands the reason not to stop the
carrying out of compulsions is:
A. If this is not done therapeutically the client will have an escalation in anxiety
B. The RNs don't trust the UAPs
C. Stopping compulsions is not part of the treatment plan
D. The obsessions are the client's problems not the compulsions - answerA. If this is not
done therapeutically the client will have an escalation in anxiety
Rationale: The clients with OCD get relief by carrying out compulsions and if this is not
discontinued therapeutically it will increase anxiety and set the client back in therapy.
Both the obsession and the compulsions are problems and need to be addressed
properly. A UAP is part of the healthcare team and should understand the roles that
each member play and that this is not a discriminatory intervention on the part of the
nurse.
A client is pacing the hall near the nurse's station, swearing loudly. An appropriate initial
intervention for the nurse would be to address the client by name and say:
A. "Please quiet down."
B. "You seem upset. Would you like to tell me about it?"
C. "Hey, why are you so upset?"
A nurse is educating staff on personality disorders. Which statement by the staff
indicates understanding?
A. Antisocial personality disorder can start as conduct disorder
B. It is very easy to categorize the clients based on their disorder
C. All clients with personality disorders were the victims of abuse
D. All clients with personality disorders take advantage of others - answer A. Antisocial
personality disorder can start as conduct disorder
Rationale: APD can start as conduct disorder while in childhood. The different disorders
overlap and can be difficult for even prescribers to identify. These disorders have signs
that you look for and will create a plan of care based on what behaviors and thoughts
the client has.
The nurse working in an acute care psychiatric facility is working with clients that have
personality disorders. The nurse knows that cluster A personality disorders (odd,
eccentric) tend to exhibit what behaviors?
A. Dramatic
B. Dependency
C. Indifference to social situations
D. Splitting between healthcare providers - answerC. Indifference to social situations
Rationale: Cluster A trademarks are odd, eccentric and indifferent to social situations.
These clients do not seek out interaction and when in social situations may not interact
in an appropriate manner. They exhibit some magical thinking or paranoia and are not
perceived by others positively.
Consider this comment to three different nurses by a patient diagnosed with antisocial
personality disorder, "Another nurse said you don't do your job right." Collectively, these
interactions can be assessed as:
A. Insightful
B. Guilt-producing
C. Manipulative
D. Detached - answerC. Manipulative
Rationale: The patient is demonstrating manipulation with this statement. This behavior
is a hallmark of the cluster B personality disorders. This is technically defined as
"splitting".
,A nurse is admitting a client who is in the manic phase of bipolar disorder. The nurse
should plan to make which of the following room assignments for the client?
A. A seclusion room until the client's activity level becomes more subdued
B. A semi-private room with a roommate who has a similar diagnosis
C. A private room away from the nursing station
D. A private room in a quiet location that can easily be monitored - answerD. A private
room in a quiet location that can easily be monitored
Rationale: A private room in a quiet location is ideal for a client with mania. The client
may easily become overstimulated by the number of people and activities in a nursing
care unit. A private room can be used for time-out during the day and to settle down to
sleep at night.
The client states "I just can't fall asleep". The nurse responds, "You are having difficulty
falling asleep?" Why is the nurse using the restating technique?
A. The nurse wants the client to know they understand
B. The nurse is allowing the client to elaborate or clear up misunderstanding
C. The nurse is keeping the conversation going
D. The nurse wants to focus on one idea - answerB. The nurse is allowing the client to
elaborate or clear up misunderstanding
Rationale: Establishes priority with nursing goals and interventions related to
therapeutic interaction. Using the client's words or close to is restating. This technique
allows the client to be able to elaborate or clear up any miscommunications with
nursing. This also gives the feedback that their concerns are being heard
A client is experiencing command hallucinations and appears to be frightened. Which of
the following actions are appropriate nursing interventions?
A. Keep the client physically safe
B. Ignore the client's feelings in response to altered perceptions
C. Assure the client that they are not experiencing something real
D. Inform the client that their hallucinations are just bad dreams - answerA. Keep the
client physically safe
Rationale: Validate the patient's feelings. Keep them physically safe. Determine what
the hallucination is telling them to do and provide reality testing PRN.
A nurse is performing an admission assessment for an adolescent client with a
diagnosis of schizophrenia. Which of the following findings should the nurse identify as
a positive symptom?
A. Somatic Delusions
B. Anhedonia
, C. Waxy Posture (immobile posturing)
D. Anergia - answerA. Somatic Delusions
Rationale: Delusions are example of a positive symptom. Anhedonia, waxy posture, and
anergia are negative symptoms. Positive symptoms, which include delusions,
hallucinations, disorganized thoughts, and disorganized speech; can cause you or
someone you love to lose touch with reality. Negative schizophrenia refers to behaviors
or emotions that are deficient or lacking in people with schizophrenia
A 28-year-old client with body dysmorphic disorder (BDD) tells the nurse that they plan
to have a surgical procedure that will affect their appearance. The nurse understands
that this plan is an effort to
A. Suppress intrusive thoughts
B. Deal with multiple physical complaints
C. Treat associated depression
D. Cure the imagined defect - answerD. Cure the imagined defect
Rationale: With BDD the client has a perceived defect, they will seek to alter this defect
through means such as plastics procedures. These clients seek extreme measures to
cure this defect that only they see.
An unlicensed assistive personnel (UAP) is working with clients that have diagnosis of
obsessive compulsive disorder. The UAP understands the reason not to stop the
carrying out of compulsions is:
A. If this is not done therapeutically the client will have an escalation in anxiety
B. The RNs don't trust the UAPs
C. Stopping compulsions is not part of the treatment plan
D. The obsessions are the client's problems not the compulsions - answerA. If this is not
done therapeutically the client will have an escalation in anxiety
Rationale: The clients with OCD get relief by carrying out compulsions and if this is not
discontinued therapeutically it will increase anxiety and set the client back in therapy.
Both the obsession and the compulsions are problems and need to be addressed
properly. A UAP is part of the healthcare team and should understand the roles that
each member play and that this is not a discriminatory intervention on the part of the
nurse.
A client is pacing the hall near the nurse's station, swearing loudly. An appropriate initial
intervention for the nurse would be to address the client by name and say:
A. "Please quiet down."
B. "You seem upset. Would you like to tell me about it?"
C. "Hey, why are you so upset?"
