ch 17-24 Flashcards
(196 cards)
1
Q
which best explains the neuro chemical process responsible for depression
A
decreased serotonin and norepinephrine activity
2
Q
which is a freudian explanation of the etiology of depression
A
depression is anger turned inward
3
Q
a concerned family member tells the nurse, I am concerned about my brother. he has been acting very different lately. Knowing the family has a history of bipolar disorder, which behavior during the past week might indicate that the brother has bipolar disorder
A
taking unnecessary risks
4
Q
a client is admitted for major depression. what should the nurse expect to find during the assessment
A
anhedonia, feelings of worthlessness, and difficulty focusing
5
Q
a client has just been diagnosed with as having major depression. at which time would the client be at highest risk for self harm
A
approx. 2 weeks after starting antidepressant medication
6
Q
a nurse is planning care for a clients with major depression. which is an appropriate expected outcome?
A
the client will independently carry out activities of daily living
7
Q
a client who is depressed begins to cry and states, I am just really sick of feeling this way. nothing ever seems to go right in my life. what would be the most appropriate response by the nurse?
A
you are feeling really sad right now. It’s a hard time
8
Q
a client who is manic threatens others on the unit. which would be the initial nursing action in response to this behavior
A
setting limits on aggressive and intimidating behavior
9
Q
which meal would the nurse provide to best meet the nutritional needs of a client who is manic
A
ham sandwich, cheese slices, milk
10
Q
a client who is manic states, what item is it? I have to see the doctor. Is breakfast here yet? I’ve got to see the doctor first. Can I get my cereal out of the kitchen? What is the appropriate response from the nurse
A
please slow down. I’m not sure what you need first
11
Q
a client with mania is demonstrating hyper sexual behavior by blowing kisses to other clients, making suggestive remarks, and removing some articles of clothing. Which nursing intervention would be most appropriate at this time?
A
accompany the client to his or her room to get dressed
12
Q
the client with mania attempts to hit the nurse. Which is the best response by the nurse
A
Do not swing at me again. If you cannot control yourself, we will help you
13
Q
during report, the nurse learns that a client with mania has not slept in 2 days. on entering the room in the morning, they are listening to loud music. which would be the most appropriate statement by the nurse?
A
Let’s go to the conference room and talk for a while
14
Q
at 1 am, a client with mania asks to see the psychiatrist. what is the nurse’s most therapeutic response?
A
I cant call the doctor now, but you an I can talk about your request
15
Q
a client with mania is in the dining room at lunchtime and is observed taking food from other client’s trays. the nurse’s intervention should be based on which rationale?
A
other clients need to be protected from the intrusive behavior
16
Q
a client with bipolar disorder is admitted to the unit. the client is talking loudly, walking back and forth, and exhibiting a short attention span. which nursing intervention should occur first?
A
decreased the client’s environmental stimuli
17
Q
the nurse observes a client sitting alone at a table, looking sad and preoccupied. the nurse sits down and says, I saw you sitting alone and thought I might keep you company. The client turns away from the nurse. which would be the most therapeutic nursing intervention
A
move to a chair a little further away and say, we can just sit together quietly
18
Q
a client with depression appears lethargic and apathetic but agrees to participate in a leisure activity group. which nursing intervention is most likely to help the client successfully participate?
A
structuring the activity to facilitate completion of one specific task
19
Q
a client asks the nurse why he has to go to therapy and cannot just take his medication. which would be the most therapeutic nursing intervention
A
medications help your brain function better, but the therapy helps you achieve lasting behavior changes
20
Q
a client who has been discharged home on Celexa (citalopram) calls the nurse saying it makes them feel drowsy. the nurse would make which of the following suggestions
A
take the medication at night
21
Q
the wife of a client with bipolar disorder calls the nurse expressing distress about recent spending patterns of her husband. the nurse suggests the wife implement the limit setting skills she has learned in family therapy . in this instance, the nurse’s actions would be considered
A
appropriate; the wife needs support in setting boundaries
22
Q
the nurse is teaching a 70 year old man about his depression. which statement by the client would indicate that teaching has been effectiveJ?
A
I never knew depression could happen for no specific reason
23
Q
which individual is at highest risk for committing suicide?
A
a 71 year old male, alcohol user, independent minded
24
Q
which is a possible explanation for the increased risk of suicide in persons who have had a relative who committed suicide?
A
the relative’s suicide offers a sense of permission or acceptance of suicide as a method of escaping a difficult situation
25
which client is at highest risk for carrying out a suicide plan
a client who has a private gun collection
26
a client who is depressed states, I think my family would be better off without me. They don’t need to worry. Which would be the most appropriate response from the nurse?
are you planning to commit suicide?
27
a visitor comes to see a client who is suicidal. Upon entering the unit, the nurse notices that the visitor has brought the client their favorite soda. Which action should the nurse take at this time?
pour the soda into a cup
28
a client who just went through an upsetting divorce is threatening to commit suicide with a handgun. The client is involuntarily admitted to the psych unit. which nursing diagnosis has the highest priority?
risk for suicide related to a highly lethal plan
29
the nursing instructor is conducting a pre conference with a group of nursing students on a psychiatric unit. which statement made by a student reflects the greatest barrier to being able to provide professional care to the client who is suicidal?
I think suicide is wrong and selfish
30
which disorder is characterized by pervasive mistrust and suspiciousness of others
paranoid personality disorder
31
which would most likely be a type of behavior that would be manifested by a client who has histrionic personality disorder
having a tantrum if not getting enough attention
32
a nursing student appears to cooperate with the group but does not complete agreed upon tasks at the appropriate time repeatedly and then displays negativity. the student is showing signs of which personality disorder?
passive aggressive behavior
33
which thought process would cause a client with antisocial personality disorder to want to do everything for himself?
sense of mistrust of others
34
what would the nurse expect to assess in a client with narcissistic personality disorder?
grandiose and superior self concept
35
which term describes the extent to which a person considers themselves to be an integral part of the universe
self transcendence
36
a person with temperament traits of high harm avoidance would most likely suffer from which personality disorder
avoidant
37
which of the following is a psychosocial explanation for the development of personality disorders?
failure to complete a developmental task jeopardizes future personality development
38
the nurse is teaching a client with paranoid personality disorder to validate ideas with another person before taking action on him. which is the best rationale for this intervention?
it will assist the client to start basing decisions and actions on reality
39
the nurse is teaching a client with schizoid personality to function more comfortably with others in the community. which nursing intervention would be effective to improve the client’s social skills?
teach the client to make necessary requests in writing or over the phone
40
which of the following is a realistic outcome for the care of a person with a personality disorder
outcomes that focus on change in behavior
41
a client with antisocial personality disorder is begging to use the phone to call his wife, even though it is against the rules. which would be the appropriate response from the nurse
you may not use the phone to call your wife
42
which is the main reason why the periodic team meetings are important when caring for a client with antisocial personality?
team consistency is important to prevent manipulation from the client
43
a client with borderline personality disorder says to the nurse, I feel so comfortable talking with you. you seem to have a special way about you that really helps me. Which would be the most appropriate response by the nurse?
I’m here to help you just as all the staffs are
44
when establishing a relationship with a client who has borderline personality disorder, which is most important for the nurse to do
respect the client’s boundaries at all times
45
when planning care for a client with passive aggressive personality disorder, the nurse will need to include interventions for which behavior
procrastination and intentional inefficiency
46
a client with dependent personality disorder has a goal to increase their problem solving skills. which behavior would indicate progress toward meeting that goal
asking questions
47
the nurse is talking to a client with schizoid personality disorder about finding a job. which suggestion by the nurse would be most helpful
there is a job posting at the hospital for a file clerk in medial records
48
the nurse teaches an antisocial client to take a time out in his room when challenged by another person instigating an argument. what is the main reason for this
it allows an opportunity for the client to regain control of emotions
49
a nurse is teaching a client with borderline personality disorder to reshape thinking patterns. which is an example of a cognitive restructuring technique that would be helpful for this client
recognize negative thoughts and replace them with positive ones
50
upon admission, a client with personality disorder identified the following as areas of concern for which the client would like help. according to studies, which will most likely be addressed by the healthcare team
psychological distress
51
a female client with borderline personality was formerly cooperative with treatment but suddenly refuses. what is the best action for the nurse to take regarding personal frustration with the client
discuss the frustration with a colleague or supervisor in a private setting
52
a community health nurse is planning a substance abuse prevention program. which group would be the target audience for the nurse to plan a program
school age children in an after school program
53
which of the following groups could benefit most from a prevention program
children prior to first use
54
which of the following neuro chemical influences is a probable cause for substance abuse
stimulation of dopamine pathways in the brain
55
the nurse is assessing a client’s risk factors for developing a substance abuse disorder. which family characteristics would the nurse identify as a significant risk factor?
one parent who is an alcoholic
56
a client reports drinking one to two drinks when drinking behavior first began. now the client reports drinking at least six drinks with every episode in order to have a good time. which term best describes this phenomenon
tolerance
57
the nurse is talking with the friend of a client with alcoholism. the friend tells the nurse that his relationship with the client was codependent and enabling. which is an example of codependent behavior?
the friend called the client every night to make sure he got home safely and went looking for him if he was not at home
58
when interviewing the family members of a client being treated for substance abuse problems, which behavior would alert the nurse to the possibility of codependency?
blaming themselves for their family’s problems
59
the nurse is discussing the principles of 12 step programs for recovery with a client. which statement is consistent with the principles of 12 step programs
the client will need to abstain from all substances for successful recovery
60
which characteristic of the 12 step program distinguishes is from other programs
it is a self help group that does not necessarily use health professionals as leaders
61
the nurse is assessing the drinking history of a client being admitted for alcohol abuse. which statement would the nurse expect the client to make
i don’t really have a problem with alcohol. i’ve just been having a streak of bad luck lately
62
a client in treatment from drug abuse makes the statement, I am a winner. you are all the losers because you can’t beat this on your own. what common characteristic of persons addicted to drugs is revealed in this statement
defending against a negative self concept
63
a client is being discharged from treatment for addiction to cocaine. which statement made by the client would cause the most concern for the nurse
i can still hang out with my old friends. I am just not going to use
64
the client is being discharged on disulfiram (antabuse). which instruction should the client receive
read products carefully to avoid all products containing alcohol
65
the client asks the nurse, what will happen if i drink while taking antabuse? what should be the nurse’s reply
you will experience a severe reaction, including a throbbing headache and vomiting
66
a nurse is exploring treatment options with a client addicted to heroin. which information regarding the use of methadone is important for the nurse to include
methadone will meet the physical need for opiates without producing cravings for more
67
a client with a history of heavy alcohol use, whose last drink was 24 hours ago, is seen in the ER. the client is oriented but tremulous, weak, sweaty, and has GI symptoms. which of the following is typical of these symptoms
alcohol withdrawal
68
a client with alcohol dependence is admitted to the hospital with pancreatitis. which intervention should be included in the clients plan of care
glucometer check BID
69
a client is admitted for drug overdose with a barbiturate. what is the priority action
monitor respiratory function
70
a client is read titled to the substance abuse program for the second time in 6 months for alcohol abuse. on admission, the client tells the nurse they feel ashamed. how should the nurse respond
tell me what has happened since your last admission
71
a client has been admitted after using inhalants. which is the antidote to treat inhalant toxicity
there is no antidote
72
the nurse is coleading a family therapy group with a client addicted to alcohol. which statement made by the wife indicates the need for additional education regarding alcoholism as a family illness?
i have to call in sick for my husband when he is too hung over to go to work
73
a nurse is working with a couple seeking counseling for marital discord. the history indicates the husband was treated for substance abuse 4 years ago and attends AA meetings occasionally. which statement made by the recovering husband should alert the nurse for a need for further education
she gets upset when i hang out with my old buddies on the weekend
74
a client calls the emergency department of the local hospital reporting that after 16 years of heavy drinking, he is tried and wants to quit cold turkey. what would be the best response from the nurse
it is not safe to stop drinking suddenly without medicine
75
an unconscious client comes to the ER with blood alcohol level 1.7 what information should the nurse request from the family
are there other indications that the client may be a heavy drinker?
76
the wife of an alcoholic asks the nurse how to respond in a helpful way when he is disruptive in family life. what is the best response?
try to maintain a normal home environment for yourself and the children
77
a client will be taking disulfiram upon discharge. which statement indicates the teaching was effective
drinking alcohol while taking antabuse can cause dangerous symptoms
78
a nurse suspects a coworker is signing out narcotics for clients and using them herself. which action should be taken
report the observations to the supervisor
79
what should the nurse do if they suspect a peer is intoxicated
ask the peer if she feels alright and express concern
80
a client is readmitted to the detox unit for the fourth time in 3 years. the nurse says, why should we help them, they just keep coming back. what does this statement reflect
the nurse lacks self awareness to work effectively with the addicted client
81
which is a characteristic of anorexia
body weight less than normal for age, height, and overall physical health
82
when working with the family of a client with anorexia, which of the following issues must be addressed
control issues
83
which would indicate to the nurse that the client might have anorexia
severe weight loss due to self imposed dieting
84
what is the difference between anorexia and bulimia
clients with anorexia are proud of their behavior, while bulimics may be ashamed
85
while assessing the family dynamics of a client with an eating disorder, which of the following does the nurse most likely discover
over controlling parents
86
several medications are prescribed for a client with anorexia. which medication may be prescribed to help with the client’s distorted body image
olanzapine (zyprexa)
87
the nurse uses cognitive behavioral approaches to assist the client with bulimia toward recovery. which statement by the nurse would be consistent with this approach?
is there anyway you can look at that sandwich as fuel for your body
88
which may help a person to overcome an eating disorder that causes weight gain
believing that going in weight is a side effect of unhealthy lifestyle behaviors
89
the nurse is assessing a client with an eating disorder. which personality characteristic would the nurse expect to detect when interacting with the client
eager to please
90
when documenting the mental status exam findings in the chart of a client with anorexia, the nurse notes poor judgment and insight. which client statement would support this impression
others are just trying to keep me from looking good
91
which nursing diagnosis for anorexia has the highest priority
imbalanced nutrition: less than body requirements
92
which nursing intervention would be most likely to help the client with anorexia to establish healthy eating patterns
offer liquid protein supplements if the client is unable to complete a meal
93
the nurse is teaching a client with bulimia how to use self monitoring techniques. which statement shows the teaching was successful
i am learning to recognize events and emotions that trigger my binges and am working on responses other than binging and purging
94
the nurse understands that before a client with an eating disorder can accept their body image, he or she must learn effective coping skills. which statement describes the best relationship between the two
being able to cope in healthy ways improves the ability to accept a realistic body image
95
when preparing a client with bulimia for discharge, the nurse suggests that the client and family continue therapy on an outpatient basis. what is the rationale for this suggestion
family members often need to learn role dependence and autonomy
96
which nursing diagnosis is the most difficult to resolve in a patient with anorexia
disturbed body image
97
which of the following interventions would be appropriate for a client with anorexia
having the client in view of staff for 90 minutes after each meal
98
what is the primary objective of nursing interventions in the care of clients with anorexia
restoring nutritional status to normal
99
which nursing statement is most effective in communicating a positive expectation of the client
i will sit here quietly with you while you eat
100
a 16 year old female with anorexia is admitted to the unit. what is the most appropriate short term outcome
the client will admit she has a fear of gaining weight
101
a nurse is presenting information to a community group about health. which information should the nurse provide regarding calorie restriction diets at an early age in children
dieting at an early age may lead to the development of eating disorders
102
the nurse is teaching the family of a client who has bulimia about nutritional needs. which dietary pattern would be most helpful to assist the client in recovering from bulimia
encourage the entire family to engage in balanced and regular diet pattern
103
which of the following would be most supportive for family and friends of client with an eating disorder?
emotional support, love, and attention
104
the nurse has been teaching the client’s family about the client’s eating disorder, anorexia. which statement indicates the teaching was effective
we will negotiate resolutions to family conflicts
105
the nurse has been teaching a client about bulimia. which statement indicates the teaching was effective
i will eat small meals and snacks regularly
106
a client who has an eating disorder is becoming dependent on the nurse for direction in food choices. which approach by the nurse would demonstrate the nurse’s self awareness
approach the client with an adult-like objectivity
107
the client asks the nurse what having psychosomatic symptoms means. what should the nurse reply
it means that stress and/or emotions are causing your symptoms
108
which is the primary gain associated with developing physical symptoms in response to stress
decrease anxiety
109
a client with a somatic symptom illness asks what is causing her physical symptoms. what is the appropriate explanation
physical symptoms are an involuntary way of dealing with psychic conflict
110
the husband of a woman with a somatic symptom illness asks the nurse why the doctors cannot find anything wrong with her. which would be the appropriate explanation for the nurse to offer
there is no physical cause. mental distress is causing the symptoms, even though she is not aware of it
111
which is the primary gain for a client with conversion disorder
relief from emotional conflict
112
a client with somatic symptom illness tells the nurse that she is sick so often that her husband and her children take over the household duties. which is this evidence of
secondary gain
113
psychosocial theorists propose that somatic symptom illnesses are an indirect expression of stress and anxiety through physical symptoms. which is the primary defense mechanism used in somatoform disorders
internalization
114
a client is seen in the primary care clinic for headaches. the client appears stressed and insists she must have a brain tumor. which diagnosis is most probable
hypochondriasis
115
an actor has prepared extensively for his first stage production. on the morning of the opening of the play, the actor awakens with laryngitis. from which disorder is he most likely suffering
conversion disorder
116
the nurse is planning care for a client with somatic symptom illness disorder. which should the nurse plan to reasses on a daily basis
frequency of generalized somatic complaints
117
a newly graduated nurse cannot see anything the day of her NCLEX but says, oh don’t worry it will all work out. which might this statement result from
la belle indifference
118
a middle aged client goes to the physician falsely complaining of hip pain. the client’s intention is to fake chronic hip pain to apply for disability. which reflects the possible diagnosis
malingering
119
which of the following accurately describes how somatic symptoms are distinguished from facetious disorders and malingering?
in malingering or facetious disorders, people willfully control the symptoms, and in somatic symptom illnesses, clients do not voluntarily control their physical symptoms
120
which of the following terms are applicable when a person inflicts illness or injury on someone else to gain the attention of emergency medical personnel or the be a hero in saving the victim?
munchausens syndrome by proxy
121
a nurse is caring for a client who was in a motorcycle accident 2 months ago. the client says he still has terrible neck pain, but will be better after the insurance settlement. what condition might the nurse suspect
malingering
122
a client is seeking relief for undiagnosed pain. there is no history of significant physical illness. the history reveals that the client was laid off 4 months ago from her job. which statement made by the client would most strongly suggest a somatorform disorder?
I seem to have more pain now that I got laid off
123
the nurse performs a thorough physical examination for a client being admitted for a somatic symptom illness. which of the following is the best rationale for the physical exam?
underlying pathology should be ruled out
124
the client states i can’t go to group today. I have a very upset stomach. how should the nurse respond?
I know you don’t feel well, but it’s important for you to participate in therapy
125
the nurse has encouraged the client with a somatic symptom illness to keep a journal. which treatment outcome might be met by journaling
the client will identify the occurrence of physical symptoms when stressed
126
the nurse is working with a client to develop emotion focused coping skills. which should the nurse include
deep breathing techniques
127
the nurse is identifying outcomes for a client with a somatic symptom illness. which is an appropriate outcome to include in the plan of care?
the client will verbally express his or her emotions
128
a client with recurrent headaches has been told by the physician that the cause is likely to be psychosomatic. the client says this can’t be true. how should the nurse respond?
the pain in your head is very real
129
the family members of a client with somatic symptom illness report to the nurse that every team they invite the client out they decline. which of the following approaches should the nurse suggest to encourage activity
I know that this is difficult, but exercise is importance. it will be a short walk
130
the husband of a client with hypochondriasis has accompanied his wife to the doctors visit. the husband expresses his frustration about the wife’s obsession with illness. how should the nurse respond
try finding an activity you enjoy doing together to help her feel better overall
131
which statement shows understanding about somatic symptom illness
how i handle stress and emotions can affect my physical health
132
a client yells at the nurse and says can’t you see i’m sick. which knowledge would help the nurse to work most effectively with the client
client progress is expected to be very slow
133
a mother expresses concern to the nurse that the child’s regularly scheduled vaccines may not be safe. the mother states that she has heard they cause autism. what is the most appropriate response
there has been no research to establish a relationship between vaccines and autism
134
a parent is concerned their child might suffer from ADHD. which of the following behaviors is consistent with the diagnosis
the child interrupts others
135
a client is repeating the last heard sound over and over again. which speech pattern disturbance is this
echolalia
136
which of the following terms describes the repeating of ones own words or sounds
palilalia
137
which of the following disorders involves problems with forming sounds associated with speech
phonologic disorder
138
a parent of a child with autism asks the nurse if there is anything that can be done about their tantrums. which option is most appropriate
explore the use of antipsychotic mediations to control tantrums
139
a child with adhd complains to his parents that he does not like the effect of his adderall. which option can help reduce side effects
have the child eat a good breakfast and snacks late in the day and at bedtime
140
what is the best approach to assist a child with adhd to complete their ADLs
break tasks into small steps
141
which one of the following nursing interventions should talk priority for a child with ADHD
ensuring the child’s safety and that of others
142
an 8 yr old with adhd is jumping on the bed. which should be the nurse’s first step
stop that right now
143
which the the most therapeutic response to a parent who has a child with ADHD
it must be difficult to handle your son at home
144
a child with adhd is taking methylphenidate (ritalin) in divided doses. if the first dose is at 8 am, which behavior might the nurse see soon
increased impulsivity or hyperactivity
145
the parents with a child with autism ask if their child will ever be normal. what is the most appropriate response
your child will probably always have some autistic traits
146
which one of the following statements about educating parents of a child with adhd is true
parents feel empowered and relieved to have specific strategies that can help them and their child be more successful
147
when teaching the parents of a child with adhd, what statement indicates the need for further teaching
we’ll have him do his hw at the kitchen table with his brothers and sisters
148
which statement would indicate that medication teaching for the parents of a child with adhd has been effective
we’ll be sure to record his weight on a weekly basis
149
the mother of a 15 yr old tells the nurse that the son is becoming more assertive in conflict situations and wants to get a job. the parent asks if it is normal for them to be so independent. which is the appropriate response
his behaviors affect normal growth and development
150
the nurse understands that when working with a child with a mental health problem, the family must be included in the care. which is one of the best ways the nurse can advocate for the child
teach the parents age appropriate expectations of the child
151
for which reason is it crucial for nurses to advocate for children and adolescents regarding psychiatric disorders
it is much more difficult to diagnose psychiatric disorders in children and adolescents
152
the nurse has been working with the family of a small child with a psychiatric disorder. the nurse is feeling very frustrated because the parents refuse it implements effective parenting skills that the nurse has taught. what is the best action for the nurse at this time
try to remember that the parents are trying their best to carry out suggestions
153
when the prognosis of improvement in a child with psychiatric disorders is poor, what can the nurse do to positively influence children and adolescents and their parents
assist the child and the parents to develop coping mechanisms
154
a child is expelled rom school for repeated fighting. the child is experiencing signs of which disorder
conduct disorder
155
which disorder is exemplified by vandalism, conning others, running away from home, verbal bullying, drinking alcohol, and sexual promiscuity
moderate conduct disorder
156
a child talk to the school nurse about a single episode of disruptive behavior in class. the child says they had a stomach ache and couldn’t help it and they were mad at their dad. which would be the most appropriate response by the nurse
i can see that you are angry. lets look at better ways to express it
157
the nurse is using limit setting with a child diagnosed with conduct disorder. which statement reflects the most effective way for the nurse to set limits with the child?
that is not allowed here. you will lose a privilege. you need to stop
158
a client with conduct disorder starts yelling at another client and calling the client insulting names. which is the most appropriate response by the nurse
yelling at others is unacceptable. you need to let staff know you’re upset
159
which is the most commonly used treatment for oppositional defiant disorder
parent training models of behavioral interventions
160
which is likely to be most effective for adolescents with conduct disorder
early intervention
161
a 14 year old girl is being treated for conduct disorder. she refuses to attend class today, stating that yesterday the other nurse told her she did not have to go if she did not want to. which would be the best response from the nurse
missing class is against the rules
162
the nurse is meeting with a family of a client with conduct disorder. the nurse discusses changes the parents can make to help their child change problematic behaviors. which parenting technique would the nurse encourage the parents to use
provide consistent consequences for behaviors
163
which is true of the time out strategy that may be used with children who have conduct disorder
time out is retreat to a neutral place, so clients can regain self control
164
the nurse understands that when working with a child with a disruptive behavior disorder, the family must be included in the care. which is one of the best ways the nurse can advocate for the child
teach the parents age appropriate expectations of the child
165
when presenting information about conduct disorders to a community group the nurse is asked which is the best setting for care of a client with conduct disorders when the parent cannot provide a safe environment. which would be an appropriate response from the nurse
residential treatment settings
166
which is an effective way for parents to deal with problem behaviors in children and to prevent later development of conduct disorders
group based parenting classes
167
which is the most important reason for the nurse who cares for children with conduct disorders to discuss feelings, fears or frustrations with colleagues
the keep negative emotions from interfering with the ability to provide care to clients with problems with aggression
168
which behavior documented in the nursing notes would be consistent with delirium
disoriented to person
169
a nurse working in an assisted living facility is holding an in service for the nursing assistants. the nurse reviews common behaviors associated with cognitive deterioration associated with dementia. which would cause the nurse to know that the assistants correctly understood if it were expressed during a post test
the clients may not recognize their family when they come to visit
170
which is believed to be a risk factor specific to the development of delirium
older age
171
which patient is most likely suffering from dementia
a 90 year old male who has experienced progressive mental decline that started with forgetfulness
172
a client with dementia is unable to recognize ordinary objects. what would this be a symptom of
agnosia
173
which client would have an increases risk for delirium
a 3 year old with a temp of 103
174
the daughter of a woman with dementia asks the nurse if her mother will ever be able to live independently again. which would be an appropriate answer
symptoms of dementia gradually get worse. unfortunately she will not be able to be independent again
175
which statement made by the nurse would be most appropriate to an 89 year old patient who is confused but has no history of dementia and is hospitalized for an acute urinary tract infection
i know things are upsetting and confusing right now, but your confusion should clear as you get better
176
which distinguishes delirium from dementia
dementia has a gradual onset and is progressive in course
177
a client voluntarily admitted to the inpatient psychiatric unit is currently experiencing mild delirium. the client approaches the nurse and states I am going to take a walk outside. ill be back in about 10 minutes. which is the most appropriate nursing action
designate a staff member to accompany the client on the walk
178
a client with dementia is starting pharmacotherapy to slow the progression of cognitive decline. the client has a history of moderate but steady alcohol use over the past 45 years. which medication should the nurse question as least suitable for this client
tacrine (Cognex)
179
the nursing supervisor in an extended care facility is managing the environment to better help the clients with dementia. which should the nurse include in planning the living environment
plan for the same caregivers to provide care to individuals as much as possible
180
the nurse encourages the client with dementia to meet nutritional needs. which is the best approach to assist in meeting adequate dietary intake
serve meals in small bite size pieces
181
the nurse caring for an elderly woman with dementia has asked the woman’s children to bring old photos. which best describes the benefit of viewing old photos in clients with dementia
viewing photos is a form of reminiscence therapy for the client
182
the nurse is encouraging a group of clients with dementia to join in upper body range of motion exercise using light dumbbells. which technique will most likely result in the greatest amount of participation
demonstrate the exercise while clients simultaneously perform them
183
a client with dementia gets angry and begins to yell at the nurse. the nurse leaves and returns after 5 minutes. which of the following best explains the nurses behavior
the nurse gave the client a change to calm down before resuming the meal
184
which is the most effective intervention for clients with delirium
managing environmental stimuli
185
the nurse is assessing a client with early signs of dementia. what is the nurse trying to determine when asking what the client had from breakfast that morning
recent memory
186
the nurse is working with a client who has hallucinations and delusions. the client says they cannot shower because she is waiting to go home. which response is best
you have plenty of time to shower before it’s time to go home
187
the nurse is caring for a client with alzheimer’s disease. the nurse observes that the client’s pacing and mumbling. what should the nurse implement first
move the client to a quieter area during these times
188
the nurse is developing interceptions to promote socialization in a client with moderate dementia. which would provide a safe and secure environment for for the client
an activity with the nurse
189
the daughter of a client with dementia has been the primary caregiver for 5 months and is overwhelmed. which is a helpful response from the nurse
here is the number of a caregiver’s support group. how do you think you would feel talking with others about the situation
190
which statement by the nurse would be most appropriate to the family member who is the primary caregiver to a client with dementia
yes, it is important for you to spend some time relaxing and doing what you like to do. this will help you to be better prepared to manage the demands of the caregiver role
191
a client with moderate alzheimer’s disease is living with her grown daughter. which statement by the daughter would indicate the need for intervention
mother won’t let anyone else do anything for her
192
a nurse is educating a group of elderly community members about cognitive disorders. which would the nurse include as a measure most likely to prevent alzheimer’s
reading
193
the caregiver of a client with alzheimer’s reports the client will become angry. which response is an example of using distraction techniques
let’s look at what is on television
194
the adult son of a client with dementia asks the nurse how he should respond when his mother repeatedly says she has had a busy day at work. the mother has not worked in 20 years. how would the nurse respond
go along with her thought of having a busy day, but don’t refer to her work
195
the grown daughter of a woman with alzheimer’s tells the nurse she is trying to keep her mother from getting worse by asking lots of questions. which will be accomplished by this intervention
increased frustration
196
a new nurse has been working with clients with alzheimer’s disease for almost 6 months during a staff meeting, the nurse expresses frustration because the same instructions have to be given on a daily basis. what should the supervisor say
try to stay supportive and meet the client’s needs at the current moment
