Final - Ch 3-12 Flashcards
A depressed client states, “I have a chemical imbalance in my brain. I have no control over my behavior. Medications are my only hope to feel normal again.” Which nursing response is appropriate?
A.
“Medications only address biological factors. Environmental and interpersonal factors must also be considered.”
B.
“Because biological factors are the sole cause of depression, medications will improve your mood.”
C.
“Environmental factors have been shown to exert the most influence in the development of depression.”
D.
“Researchers have been unable to demonstrate a link between nature (biology and genetics) and nurture (environment).”
A
A client diagnosed with major depressive disorder asks, “What part of my brain makes me depressed?” Which nursing response is appropriate?
A.
“The occipital lobe governs perceptions, judging them as positive or negative.”
B.
“The parietal lobe has been linked to depression.”
C.
“The medulla regulates key biological and psychological activities.”
D.
“The limbic system is largely responsible for one’s emotional state.”
D
Which part of the nervous system should a nurse identify as playing a major role during stressful situations?
A. Peripheral nervous system. B. Somatic nervous system. C. Sympathetic nervous system. D. Parasympathetic nervous system.
C
Which client statement reflects an understanding of circadian rhythms in psychopathology?
A.
“When I dream about my mother’s horrible train accident, I become hysterical.”
B.
“I get really irritable during my menstrual cycle.”
C.
“I’m a morning person. I get my best work done in the a.m.”
D.
“Every February, I tend to experience periods of sadness.”
C
Which types of adoption studies should a nurse determine as providing useful information for the psychiatric community?
A.
Studies in which children with mentally ill biological parents are raised by adoptive parents who were mentally healthy.
B.
Studies in which children with mentally healthy biological parents are raised by adoptive parents who were mentally ill.
C.
Studies in which monozygotic twins from mentally ill parents were raised separately by different adoptive parents.
D.
Studies in which monozygotic twins were raised together by mentally ill biological parents.
E.
All of the above
E
A nurse is caring for a wife diagnosed with colitis 6 months after her husband and children were killed in a car accident. Which study perspective would this situation validate?
A. Neuroendocrinology B. Psychoimmunology C. Diagnostic technology D. Neurophysiology
B
A withdrawn client, diagnosed with schizophrenia, expresses little emotion and refuses to attend group therapy. What altered component of the nervous system should a nurse recognize as most responsible for this behavior?
A. Dendrites B. Axons C. Neurotransmitters D. Synapses
C
A group of nursing students is receiving instruction from a nurse educator about neurotransmitters. Which process best explains how neurotransmitters released into the synaptic cleft may return to the presynaptic neuron?
A. Regeneration B. Reuptake C. Recycling D. Retransmission
B
A nurse concludes that a restless, agitated client is manifesting a fight or flight response. With which neurotransmitter should the nurse associate this response?
A. Acetylcholine B. Dopamine C. Serotonin D. Norepinephrine
D
A client is admitted to a psychiatric unit with the diagnosis of catatonic schizophrenia. Which neurotransmitter should a nurse expect to be elevated in the client?
A. Serotonin B. Dopamine C. Gamma-aminobutyric (GABA) D. Histamine
B
A client’s wife of 34 years dies unexpectedly. The client cries often and becomes socially isolated. The client’s therapist encourages open discussion of feelings, proper nutrition, and exercise. What is the best rationale for the therapist’s advice?
A.
The therapist is using an interpersonal approach.
B.
The client has an alteration in neurotransmitters.
C.
It is routine practice to remind clients about nutrition, exercise, and rest.
D.
The client is susceptible to illness due to effects of stress on the immune system.
D
A nurse is caring for a client in the third trimester of pregnancy. Which illness, if diagnosed during the mental assessment of this client, should the nurse associate with a decrease in prolactin level?
A. Major depression B. Schizophrenia C. Anorexia nervosa D. Alzheimer’s disease
B
Which cerebral structure should a nursing instructor describe to students as the “emotional brain”?
A. The cerebellum B. The limbic system C. The cortex D. The left temporal lobe
B
A nurse understands that abnormal secretion of growth hormone may play a role in which illness?
A. Acute mania B. Schizophrenia C. Anorexia nervosa D. Alzheimer’s disease
C
A client is admitted to an emergency department experiencing memory deficits and decreased motor function. What alteration in brain chemistry should a nurse correlate with the production of these symptoms?
A. Abnormal levels of serotonin. B. Decreased levels of dopamine. C. Increased levels of norepinephrine. D. Decreased levels of acetylcholine.
D
In which illness should a nurse anticipate that a decrease in norepinephrine level would play a significant role?
A. Mania B. Schizophrenia C. Anxiety D. Depression
D
Which client diagnosis should a nurse associate with a decrease in gamma-aminobutyric acid (GABA)?
A. Alzheimer’s disease B. Schizophrenia C. Panic disorder D. Depression
C
A should nurse expects that an increase in dopamine activity may play a significant role in which client illness?
A. Schizophrenia B. Depression C. Body dysmorphic disorder D. Parkinson’s disease
A
What is the most essential task for a nurse to accomplish prior to forming a therapeutic relationship with a client?
A.
To clarify personal attitudes, values, and beliefs.
B.
To obtain thorough assessment data.
C.
To determine the client’s length of stay.
D.
To establish personal goals for the interaction.
A
A hungry, homeless client, diagnosed with schizophrenia, refuses to participate in an admission interview. A nurse streamlines the assessment, verbally assures safety, and provides a warm meal. What is the nurse promoting by these actions?
A. Sympathy B. Trust C. Veracity D. Manipulation
B
If a client demonstrates transference toward a nurse, how should the nurse respond?
A.
By promoting safety and immediately terminating the relationship with the client.
B.
By encouraging the client to ignore these thoughts and feelings.
C.
By immediately reassigning the client to another staff member.
D.
By helping the client to clarify the meaning of the relationship, based on the present situation.
D
What should be the priority nursing action during the orientation (introductory) phase of the nurse-client relationship?
A.
Acknowledge the client’s actions and generate alternative behaviors.
B.
Establish rapport and develop treatment goals.
C.
Attempt to find alternative placement.
D.
Explore how thoughts and feelings about this client may adversely impact nursing care.
B
Which client action should a nurse expect during the working phase of the nurse-client relationship?
A.
The client gains insight and incorporates alternative behaviors.
B.
The client establishes rapport with the nurse and mutually develops treatment goals.
C.
The client explores feelings related to reentering the community.
D.
The client explores personal strengths and weaknesses that impact behavioral choices.
A
What should be the nurse’s primary goal during the preinteraction phase of the nurse-client relationship?
A. To evaluate goal attainment and ensure therapeutic closure. B. To establish trust and formulate a contract for intervention. C. To explore self-perceptions. D. To promote client change.
C
Which phase of the nurse-client relationship begins when the individuals first meet and is characterized by an agreement to continue to meet and work on setting client-centered goals?
A. Preinteraction B. Orientation C. Working D. Termination
B
Which client statement should a nurse identify as a typical response to stress most often experienced in the working phase of the nurse-client relationship?
A.
“I can’t bear the thought of leaving here and failing.”
B.
“I might have a hard time working with you because you remind me of my mother.”
C.
“I really don’t want to talk any more about my childhood abuse.”
D.
“I’m not sure that I can count on you to protect my confidentiality.”
C
A client has made the decision to leave her alcoholic husband. She is feeling very depressed. Which nontherapeutic statement by the nurse conveys sympathy?
A.
“You are feeling very depressed. I felt the same way when I decided to leave my husband.”
B.
“I can understand you are feeling depressed. It was a difficult decision. I’ll sit with you.”
C.
“You seem depressed. It was a difficult decision to make. Would you like to talk about it?”
D.
“I know this is a difficult time for you. Would you like a prn medication for anxiety?”
A
A mother notified that her child was killed in a tragic car accident states, “I can’t bear to go on with my life.” Which nursing statement conveys empathy?
A.
“This situation is very sad, but time is a great healer.”
B.
“You are sad, but you must be strong for your other children.”
C.
“Once you cry it all out, things will seem so much better.”
D.
“It must be horrible to lose a child, and I’ll stay with you until your husband arrives.”
D
If an individual is “two-faced,” which characteristic essential to the development of a therapeutic relationship should a nurse identify as missing?
A. Respect B. Genuineness C. Sympathy D. Rapport
B
On which task should a nurse place priority during the working phase of relationship development?
A.
Establishing a contract for intervention.
B.
Examining feelings about working with a particular client.
C.
Establishing a plan for continuing aftercare.
D.
Promoting the client’s insight and perception of reality.
D
Which therapeutic communication technique is being used in this nurse-client interaction?
Client: “Every time I get angry, I get into a fistfight with my wife or I take it out on the kids.”
Nurse: “I notice that you are smiling as you talk about this physical violence.”
A. Encouraging comparison B. Exploring C. Formulating a plan of action D. Making observations
D
Which therapeutic communication technique is being used in this nurse-client interaction?
Client: “My father spanked me often.”
Nurse: “Your father was a harsh disciplinarian.”
A. Restatement B. Offering general leads C. Focusing D. Accepting
A
Which therapeutic communication technique is being used in this nurse-client interaction?
Client: “When I am anxious, the only thing that calms me down is alcohol.”
Nurse: “Other than drinking, what alternatives have you explored to decrease anxiety?”
A. Reflecting B. Making observations C. Formulating a plan of action D. Giving recognition
C
The nurse is interviewing a newly admitted psychiatric client. Which nursing statement is an example of offering a “general lead”?
A. “Do you know why you are here?” B. “Are you feeling depressed or anxious?” C. “Yes, I see. Go on.” D. “Can you order the specific events that led to your admission?”
D
A nurse states to a client, “Things will look better tomorrow after a good night’s sleep.” This is an example of which communication technique?
A.
The therapeutic technique of “giving advice.”
B.
The therapeutic technique of “defending.”
C.
The nontherapeutic technique of “presenting reality.”
D.
The nontherapeutic technique of “giving reassurance.”
D
