Quiz 7.

Weight loss in clients with manic behavior is not

uncommon. Which of the following will most likely
1. The nurse observes that a client with depression prevent further weight loss?
sat at a table with 2 other clients during lunch. The A.Restrict between meal snacks, so that the client will be
best feedback the nurse could give the client is? more hungry at mealtime
A. Do you feel better after taking with others during lunch? B.Remain with the client at meals to ensure that he eats
B. You must feel much better than you were a few days everything
ago. C.Increase the size of the client's portions at each meal
C. I see you were sitting with others at lunch today D.Provide between meals, nutritious foods that the
D. I’m so happy to see you interacting with other clients. client can eat in a short time.

2. Mrs. Moreno has been brought to the hospital by 8. A potential suicide is most likely to be committed
her husband, who states she has become when:
increasingly agitated and overactive during the past A.Just before discharge
2 weeks. She did not sleep last night, upon B.At the point of her deepest depression
admission, Mrs. Moreno refuses to sit down and C.Immediately after admission
continues to move about rapidly, speaking in a loud, D.When the depression begins to lift
tense voice. Which of the following would be the best
initial response to Mrs. Moreno? 9. A client with mania begins dancing around the day
A. "Let me introduce you to another new client. Mrs. room. When she twirled her skirt in front of the male
Santos" clients, it was obvious she had no underpants on.
B. "I will go with you to your room. Mrs. Santos." The nurse distracts her and takes her to her room to
C. "I need you to help me pass the breakfast trays Mrs. put on underpants. The nurse acted as she did to:
Santos" A.Keep her from dancing with other clients.
D. "I'm glad to see you to have so much energy today. B.Teach her about proper attire and hygiene.
Mrs. Santos C.Avoid embarrassing the male clients who are watching
D.Minimize the client's embarrassment about her
3. When a depressed client becomes angry, three of present behavior
the following nursing actions are appropriate.
A.Encourage client to verbalize feelings and concerns. 10. Clients in the manic phase of bipolar disorder
B.Offer medication to calm the client. may fail to eat because they
C.Use simple, direct explanations and open-ended A.Feel the food is poisoned
questions. B.Feel they do not deserve to eat
D.Make plans with client for physical activity and C.Are too busy
exercise. D.Do not like hospital food.

4. Which of the following would be the most 11. The nurse is caring for a 39-year-old man with a
appropriate goal for a nursing diagnosis of generalized anxiety disorder. In assisting the client to
"ineffective individual coping related to feelings of be less anxious, which of the following nursing
hopelessness and anger"? actions would be most appropriate?
A.The client will demonstrate cheerful affect. A.Administering major tranquilizing drugs
B.The client will voice no complaints. B.Beginning intensive psychotherapy
C.The client will share feelings with nurse and others. C.Maintaining calm and supportive manner while
D.The client will deny feelings of hopelessness and anger. interacting
D.Encouraging the client to cry
5. Which of the following would not be appropriate
questions for the nurse to ask when assessing the 12. Ms. Cory is experiencing a severe level of anxiety.
depressed client? Which of the following statements concerning the
A."What kinds of things are pleasurable for you?" concept of anxiety is not true?
B."Don't you know that it is morally wrong to think of A.Anxiety occurs as the result of a threat to person's
suicide?" self-hood, self-esteem, or identity
C."What are your expectation of yourself?" B.Anxiety is an energy and as such cannot be observed
D."What are your expectation of yourself?" e "What kinds directly
of things are pleasurable for you?" b. "Don't you know C.Anxiety is multidimensional concept and is manifested
that it is morally wrong to think of suicide? d. "How do as a somatic, experiential, and interpersonal
you cope with anger?" phenomenon
D.Anxiety on any level is a destructive force and thus
6. The nurse observes that a client with bipolar moves the individual to change
disorder is pacing in the hall, talking loudly and
rapidly, and using elaborate hand gestures. The 13. A client with Acute Stress Disorder states to the
nurse concludes that the client is demonstrating nurse, "I keep having horrible nightmares about the
which of the following? car accident that killed my daughter, I shouldn't have
A.Anger taken her with me to the store". Which of the
B.Aggression following responses by the nurse would be most
C.Anxiety therapeutic?
D.Psychomotor agitation A."The accident just happened and could not have
been predicted
B."Let's talk about something that is a bit more pleasant" D."Nothing will help me feel better physically."
C."Stop blaming yourself, It's only hurting you"
D.'Don't keep torturing yourself with such horrible 21. The client with a fear of eating in public place or
thoughts in front of other people has finished eating lunch in
the dining areas in the nurse’s presence. Which of
14. A client who is pacing and wringing his hands, the following statements by the nurse would
"just need to walk": when questioned by the nurse reinforce the clients positive actions?
about what he is feeling. Which of the following A.It’s a sign of progress to eat in the dining area.
responses by the nurse would be most therapeutic? B. At super, I hope to see you eat with a group of people
A."Are you feeling anxious?" C.You must have been hungry today
B."Is something bothering you?" D.It wasn’t so hard now, wasn’t
C.You need to sit down and relax
D.You must be experiencing a problem now" 22. When planning the care of a patient who has
post-traumatic stress disorder, a nurse should
15.Which of the following observations would be include which of the following outcomes?
most definitive when assessing a patient with post- A.The patient will intellectualize about the traumatic
traumatic stress disorder? experience
A.Aggression B.The patient will be able to use stress management
B.Depression techniques
C.Substance abuse C.The patient will work through conflicting emotions
D.Flashbacks about trauma
D.The patient will demonstrate a normal range of moods
16. Which of the following points would the nurse
include when teaching a client about panic disorder? 23. A patient was diagnosed with somatic symptom
A.Symptoms of a panic attack are time limited and disorder. The nurse understands that this disorder is
will abate characterized by the following characteristics except:
B.Medication should be taken when symptoms A. Symptoms are not feigned nor are they under the
C.Staying in the house will eliminate panic attacks. control of the sufferer
D. Maintaining self-control will decrease symptoms of B. Patient resists explanation that they have no organic
panic pathology and that their illness is pyschological
C. Patient is typically not worried, affected or
17. Nurse Moly is caring for a client admitted 1 week emotionally distressed by the symptoms.
ago with a diagnosis of PTSD. Today he begins to D. Symptoms usually begin or worsen after losses or
describe the traumatic event that occurred in his life during periods of increased stress.
6 months ago. The best response by the nurse would
be to: 24. A client has a compulsive bedtime ritual that
A.Change the subject because the topic is clearly includes making and remaking his bed 10 times
upsetting the client before she can retire. Occasionally, she does not get
B.Allow the client to describe the event and listen to bed until 3:00am. Which nursing intervention is
empathetically most helpful?
C.Encourage the client to share his experience in the A. Taking turns making and remaking the bed with betty
therapeutic group meeting to conserve her energy and allow her to retire sooner.
D.Tell the client that the event was not as bad as he B. Prohibiting Betty from carrying out her bedtime ritual
remembers C. Discussing the ridiculousness of her repetitive
behavior
18. The nurse must recognize the obsessive D. Suggesting that she begins her ritual earlier in the
compulsive rituals are an attempt to: evening so she can retire by 10 pm.
A.Increase self-esteem
B.Reduce anxiety 25. An appropriate nursing intervention to reduce
C.Express anxiety anxiety and the need for ritualistic behavior of a
D.Control others client with OCD is which of the following?
A. Provide client opportunities to express feeling
19. In implementing treatment for a client with a B. Encourage client to use problem solving to deal with
phobic disorder, nursing actions include: environmental stress
A.Crisis intervention C. Focus on the clients strength and potentials
B.Administering lithium D. Encourage client to examine her own perception
C.Systemic desensitization
D.Insight-oriented 26. The nurse is caring for a 35-year old woman with
agoraphobia. Which of the following behaviors would
20. Which of the following statements would indicate the nurse expect to observe in the client?
that teaching about somatic symptom disorder has A. The client is afraid of talking to other peopls
been effective? B. The client is afraid to leave her home
A."If I try harder to control my symptoms, I will feel C. The client is afraid of pain
better." D. The client is afraid of fire
B."I will feel better when I begin handling stress more
effectively." 27. A depressed 70 year old woman says to the nurse,
C."The physician believes I am faking my symptoms." “I’m really not worth all the time it takes for you to
help me,” What is the best response for the nurse to effective in helping a depressed client cope with
make? painful feelings?
A. Soon you will be able to start doing more for yourself, A. Encourage the client to share feelings
so it won’t take so much of time B. Focus on the positive aspects of life
B. Even though you feel that way, I am here to help C. Provide reality orientation, and encourage realistic
you. I think it is worthwhile expectations of self
C. You should not think of yourself that way D. Help the client to identify feelings
D. I don’t have anything else I have to do right now.
35.Which of the following is the most important
28. Which of the following typifies the speech of a nursing action for a severely depressed client?
person in the acute phase of mania? A. Institute suicide precautions
A. Psychomotor retardation B. Reassure the client that the physical complaints are
B. Hesitant imaginary
C. Mutism C. Encourage her interest in her family
D. Flight of ideas D. Monitor her food intake

29. A depressed 28-year-old woman is slow about 36. A client with bipolar disorders begins taking
getting herself dressed and ready for breakfast. What lithium carbonate (lithium), 300 mg 4 times a day.
should the nurse do? After 3 days of therapy, the client says, “ my hands
A. Help her to get dressed and get to breakfast are shaking” The best response by the nurse is:
B. Tell her she will not get breakfast if she arrives late A. It is nothing to worry about unless it continues for the
C. Permit her to take as much time as she wishes next month.
D. Serve her breakfast in her room. B. Fine motor tremors are an early effect of lithium
therapy that usually subsides in a few weeks
30. A 49 year old homemaker, was recently admitted C. Tremors can be an early sign of toxicity, but we’ll keep
to the psychiatric unit because of anxiety and monitoring your lithium level to make sure you’re okay
suicidal behavior. Her adult life has always been D. You can expect tremors with lithium. You seem very
centered on her family and home. She had expressed concerned about such a small tremor.
feelings of hopelessness and somatic complaints
before hospitalization. Mrs. Pinky presents the 37. A client with compulsive personality
typical symptoms of which of the following? characteristics usually exhibits specific symptoms
A. Schizoprenia that are typical of this particular disorder. Which of
B. Bipolar 1 disorder the following traits would be most identifiable as
C. Substance abuse compulsive personality disorder?
E. Major depressive disorder A. Lack of adaptability
B. Poor interpersonal relationships
31. which of the following points would the nurse C.Cold, Rigid and excessive perfectionism
include when teaching a client about panic disorders? D. Indecisive but a higher achiever
A. Staying in the house will eliminate panic attacks
B. Medication should be taken when symptoms start 38. Which ego defense mechanisms are most
C. Maintaining self-control will decrease symptoms of prominently used in obsessive- compulsive
panic disorders?
D. Symptoms of a panic attack are time limited and A.Compensation and isolation
will abate. B.Displacement and undoing
C.Rationalization and repression
32. A week ago, a landslide destroyed the client’s D.Introjection and projection
home and seriously injured her husband. The client
has been walking around the hospital in a daze 39. The mother of a 17-year-old female, hospitalized
without any outward display of emotions. She tells for extremely disturbed acting-out behavior, leaves a
the nurse she feels like she’s going crazy. Which of shopping bag at the desk saying, "This is for my
the following actions would the nurse use initially? daughter's birthday. I'm too busy to visit today." The
A. Explain the effect of stress on the mind and body gift is an unwrapped expensive pocketbook with the
B. Reassure the client that her symptoms are temporary price tags attached. The daughter becomes upset
C. Reassure the client that her feelings are typical and tearful after being given the message and
reactions to serious trauma. opening the package. The mother's action is an
D. Acknowledge the unfairness of the client’s situations. example of:
A.Projective behavior
33. An appropriate nursing intervenion to reduce B.Double-bind message
anxiety and the need for ritualistic behavior of a C.Passive-aggressive behavior
client with OCD is which of the following D.Maternal rejection
A. Provide client opportunities to express feeling
B. Encourage client to examine her own perception 40. The nurse is caring for a female client who was
C. Focus on the clients strength and potentials admitted to the mental health unit recently for
D. Encourage client to use problem solving to deal with anorexia nervosa. The nurse enters the client's room
environmental stress and notes that the client is engaged in rigorous push-
ups. Which nursing action is most appropriate?
34. Which of the following actions would be least A.Allow the client to complete her exercise program.
B.Tell the client that she is not allowed to exercise C. Grandiose feeling of self-importance, beauty and
rigorously. power
C.Interrupt the client and weigh her immediately. D. Keeping self the center of attention and dramatic
D.Interrupt the client and offer to take her for a walk expression of feeling

41.A client with anorexia nervosa is a member of a 47. When a child is diagnosed as being moderate
pre-discharge support group. The client verbalizes intellectual disability, it would be most helpful for the
that she would like to buy some new clothes, but her nurse to suggest that the parents:
finances are limited. Group members have brought A.Offer challenging, competitive situations
some used clothes to the client to replace the client's B.Offer simple, repetitive tasks
old clothes. The client believes that the new clothes C.Provide complete directions at the beginning of the
are much too tight and has reduced her calorie intake task to be carried out
to 800 calories daily. How should the nurse evaluate D.Concentrate on teaching, competitive situation
this behavior?
A.Indicative of the client's ambivalence about hospital 48. A nurse is counseling a parent whose 11 year old
discharge child has attention deficit hyperactivity disorder. The
B.Normal behavior parent reports that the child is disruptive at home.
C.Evidence of the client's disturbed body image Which of the following approaches should the nurse
D.Regression as the client is moving toward the suggest that the parent take?
community A.Establish a specific schedule for activities
B.Vary the methods by which rewards are given
42. A client with antisocial personality, when asked C.Confine the child to the bedroom
about his family, states "I've been married 4 times. D.Explain to the child why the behavior is disturbing
Three of those marriages were 'shotgun' wedding. I
never really loved my wives. I didn't know much of 49. A 7 year old child has attention deficit
my three children. I've lost track on them" One hyperactivity disorder. The child is most likely to
reason that a person with such disorder may marry exhibit which of the following symptoms?
repeatedly or get into trouble with legal authorities is: A.Poor concentration, decreased attention span, and
A.They are too psychotic to understand what's going on somatic complaints
B.They usually don't care B.Restlessness, decreased attention span, and
C.They do not learn from their experiences distructibility
D.They are mentally retardate C.Hyperactivity, somatic complaints, and distractibility
D.Impulsiveness, anhedonia and shyness
43.Which symptoms support a diagnosis of
borderline personality disorder? 50. A client is admitted to the hospital with a
A.Flat affect, social withdrawal, and unusual dress diagnosis of Rett's disorder. The nurse assesses the
B.Insensitivity to others, sexual acting out, and violence client for which sign associated with this disorder
C.Lack of self-esteem, clinging and impulsive A.Loss of previously acquired language
behavior, and self-mutilating behavior B.Delayed inappropriate language
D.Suspiciousness, hypervigilance, and emotional C.Stereotype behavior
coldness D.Common in boys

44. A client with borderline personality disorder is 51. The most commonly prescribed drug for ADHD is?
complaining to other clients about not being allowed A.Lithium (Escalith)
by the staff to keep food in her room. Which of the B.Methylphenidate (Ritalin)
following interventions would be most appropriate? C. Diazepam (Valium)
A.Ignoring the client's behavior D.Pemoline (Cylert)
B.Reprimanding the client
C.Setting limits on the behavior 52.During assessment, the nurse observed a child to
D.Allowing the snack to be kept in her room.. have a tendency to bark out words and exhibit facial
twitches. The nurse should further assess the child
45. A client with antisocial personality disorder has a for
potential for evidence and aggressive behavior. A.Rett's Disorder
Which of the following client outcomes to be B.Chronic Motor or Vocal tic Disorder
accomplished in the short term would be most C.Asperger's Disorder
appropriate for the nurse to include in the plan of D.Tourette's syndrome
care?
A.Use the indirect behavior to express anger. 53. Which of the following would be important
B.Use humor when expressing anger circumstances to gather assessment data for a child
C.Ask the nurse for medication when upset with ADHD? Select all that apply.
D.Discuss feelings of anger with staff. 1. Direct observation of the child
2. Interviewing the client's teachers
46. An individual who is with histrionic personality is 3. Assessing the client in a group of peers
characterized by: 4. Giving the child an exam
A.Magical thinking and paranoid ideation A. 1,2,4 B. 1,2,3
B.Marked dependency and difficulty making decisions C. 2,3,4 D. 1,3,4
54. In assessing the behavior of an autistic child, the 62. The daughter of a client with dementia complains
nurse notes that a symptom that characteristically that her mother is always distorting things. The nurse
differentiates an autistic child from one with Down understands that the daughter needs further teaching
syndrome is: about dementia when she makes which of the
A.Difficulty in responding to a nurturing relationship following statements?
B.Inattentiveness A. "I tell her she is wrong and then I tell her what's
C.Retardation of activity right"
D.Short attention span B. "I understand the misperceptions are part of the
disease."
55. Which of the following symptoms are C. "I'll turn off the radio when we're in another room"
characteristic of ADHD? Select all that apply. D. "I tell her reality, such as "That the noise is the wind in
1. Inattentiveness the tress"
2. Overactivity
3. 3. Encopresis 63. Mrs. Cruz who is at early stage of dementia, has
4. 4. Impulsiveness difficulty deciding what to wear in the morning. The
A. 1,2,4 B. 1,2,3 most effective nursing intervention would be to:
C. 2,3,4 D. 1,3,4 A. Give her as much time as she needs to make her own
decision.
56. Which of the following disorders involves B. Tell her she must hurry or she will miss breakfast
problems with forming sounds associated with C. Lay out her clothes each morning before she
speech? awakens.
A. Phonologic disorder D. Help her select an outfit and get dressed.
B. Mixed receptive expressive language disorder
C. Expressive language disorder 64. Which of the following would be most critical
D. Stuttering when caring for a client who is experiencing delirium?
A. Decreasing or discontinuing any nonessential
57. When assessing a client with dementia, which of medications
the following behaviors would the nurse interpret as B. Controlling behavioral symptoms with low dose
a manifestations of disinhibitions? psychotropics
A. Decreased interest in bathing and hygiene C. Manipulating the environment to increase orientation
B. Inappropriate language and sexual behaviors D. Correcting the underlying causative conditions or
C. Wandering and getting lost illness
D. Auditory and/or visual hallucinations
65. A patient has been diagnosed with Alzheimer's
58. A 75 year old female client was admitted in a disease, stage 1. The nurse would expect to help the
health care facility with a diagnosis ofdementia of family plan measures to assist the patient with:
Alzheimer's disease. During assessment, the nurse is A. Perseveration
aware that the symptom not indicative of this B. Progressive gait disturbances
disorder is? C. Catastrophic reactions
A. Akathisia D. Recent memory loss
B. Apraxia
C. Agnosia 66. Which of the following interventions is most
D. Aphasia appropriate in helping a client with early stage of
dementia complete her ADL?
59. Which of the following would the nurse identify as A. Allow enough time for the client to complete ADL
realistic short-term goal tobe accomplished in 2 to 3 as independently as possible
days for a client with delirium B. Provide the client with a written list of all the steps
A.Become oriented to time, place and person needed to complete ADLs
B.Explain the experience of having a delirium C. Plan to provide step-by-step prompting to complete
C.Establish a normal bowel and bladder function the ADLs
D.Regain a normal sleep-wake cycle D. Tell the client to finish ADLs before breakfast or the
nursing assistant will do them
60. A patient has been diagnosed with Alzheimer's
disease, stage 1. The nurse would expect to help the
family plan measures to assist the patient with:
A. Catastrophic reactions
B. Progressive gait disturbances
C. Perseveration
D. Recent memory loss

61. When caring for elderly clients, the nurse would

be especially alert for which of the following as the
most common cause of delirium?
A. Congestive heart failure
B. Impaired hearing
C. Cancer of any kind
D. Prescription drug intoxication