exam 1 practice questions Flashcards
1
Q
The daily record of dysfunctional thoughts (DRDT) is used in cognitive therapy to help clients:
a. Identify automatic thoughts.
b. Modify automatic thoughts.
c. Identify rational alternatives.
d. All of the above.
A
d. All of the above.
2
Q
Nancy says to the nurse, “I worked as a secretary to put my husband through college, and as soon as he graduated, he left me. I hate him! I hate all men!” Which of the following is an empathetic response by the nurse?
a. “You are very angry now. This is a normal response to your loss.”
b. “I know what you mean. Men can be very insensitive.”
c. “I understand completely. My husband divorced me, too.”
d. “You are depressed now, but you will feel better in time.”
A
a. “You are very angry now. This is a normal response to your loss.”
3
Q
Which of the following statements is (are) correct regarding the use of restraints? (Select all that apply.)
a. Restraints may never be initiated without a physician’s order.
b. Orders for restraints must be reissued by a physician every 2 hours for children and adolescents.
c. Clients in restraints must be observed and assessed every hour for issues regarding circulation, nutrition, respiration, hydration, and elimination.
d. An in-person evaluation must be conducted within 1 hour of initiating restraints.
A
b. Orders for restraints must be reissued by a physician every 2 hours for children and adolescents.
d. An in-person evaluation must be conducted within 1 hour of initiating restraints.
4
Q
Anna, age 72, has been grieving the death of her dog, Lucky, for 3 years. She is not able to take care of her activities of daily living, and wants only to make daily visits to Lucky’s grave. Her daughter has likely put off seeking help for Anna because:
a. Women are less likely to seek help for emotional problems than men.
b. Relatives often try to “normalize” the behavior, rather than label it mental illness.
c. She knows that all older people are expected to be a little depressed.
d. She is afraid that the neighbors “will think her mother is crazy.”
A
b. Relatives often try to “normalize” the behavior, rather than label it mental illness.
5
Q
Client teaching is an important nursing function in milieu therapy. Which of the following statements by the client indicates the need for knowledge and a readiness to learn?
a. “Get away from me with that medicine! I’m not sick!”
b. “I don’t need psychiatric treatment. It’s my migraine headaches that I need help with.”
c. “I’ve taken Valium every day of my life for the last 20 years. I’ll stop when I’m good and ready!”
d. “The doctor says I have bipolar disorder. What does that really mean?”
A
d. “The doctor says I have bipolar disorder. What does that really mean?”
6
Q
One of the goals of therapeutic community is for clients to become more independent and accept self-responsibility. Which of the following approaches by staff best encourages fulfillment of this goal?
a. Including client input and decisions into the treatment plan.
b. Insisting that each client take a turn as “president” of the community meeting.
c. Making decisions for the client regarding plans for treatment.
d. Requiring that the client be bathed, dressed and attend breakfast on time each morning.
A
a. Including client input and decisions into the treatment plan.
7
Q
The most appropriate nursing intervention with Ginger (from question 7) would be to:
a. Suggest she move to a college closer to home.
b. Work with Ginger on unresolved dependency issues.
c. Help her find someone in the college town from whom she could seek assistance rather than calling her mother regularly.
d. Recommend that the college physician prescribe an antianxiety medication for Ginger.
A
b. Work with Ginger on unresolved dependency issues.
8
Q
Joe is very restless and is pacing a lot. The nurse says to Joe, “If you don’t sit down in the chair and be still, I’m going to put you in restraints!” With which of the following legal actions might the nurse be charged because of this nursing action?
a. Defamation of character
b. Battery
c. Breach of confidentiality
d. Assault
A
d. Assault
9
Q
Lucille has a diagnosis of somatic symptom disorder, predominantly pain. Which of the following medications would the psychiatric nurse practitioner most likely prescribe for Lucille?
a. Chlorpromazine (Thorazine)
b. Diazepam (Valium)
c. Carbamazepine (Tegretol)
d. Duloxetine (Cymbalta)
A
d. Duloxetine (Cymbalta)
10
Q
The priority nursing intervention before starting ECT therapy is to:
a. Take vital signs and record.
b. Have the patient void.
c. Administer succinylcholine.
d. Ensure that the consent form has been signed.
A
d. Ensure that the consent form has been signed.
11
Q
In establishing trust with Ellen, a client with the diagnosis of DID, the nurse must:
a. Try to relate to Ellen as though she did not have multiple personalities.
b. Establish a relationship with each of the personalities separately.
c. Ignore behaviors that Ellen attributes to other subpersonalities.
d. Explain to Ellen that he or she will work with her only if she maintains the status of the primary personality.
A
b. Establish a relationship with each of the personalities separately.
12
Q
Walter is angry with his psychiatrist and says to the nurse, “He doesn’t know what he is doing. That medication isn’t helping a thing!” The nurse responds, “He has been a doctor for many years and has helped many people.” This is an example of what nontherapeutic technique?
a. Rejecting
b. Disapproving
c. Probing
d. Defending
A
d. Defending
13
Q
Nurse Jones decides to respect family wishes and not tell the client of his terminal status because that would bring the most happiness to the most people. Which of the following ethical theories is considered in this decision?
a. Utilitarianism
b. Kantianism
c. Christian ethics
d. Ethical egoism
A
a. Utilitarianism
14
Q
Situation: B.J. has been out with his friends. He is late getting home. He knows his wife will be angry and will yell at him for being late. He stops at the florist’s and buys a dozen red roses for her. Questions 4, 5, and 6 are related to this situation.
Which of the following behaviors represents positive reinforcement on the part of the wife?
a. She meets him at the door, accepts the roses, and says nothing further about his being late.
b. She meets him at the door, yelling that he is late, and makes him spend the night on the couch.
c. She meets him at the door, expresses delight with the roses, and kisses him on the cheek.
d. She meets him at the door and says, “How could you? You know I’m allergic to roses!”
A
c. She meets him at the door, expresses delight with the roses, and kisses him on the cheek.
15
Q
The nurse assists the physician with electroconvulsive therapy on his client who has refused to give consent. With which of the following legal actions might the nurse be charged because of this nursing action?
a. Assault
b. Battery
c. False imprisonment
d. Breach of confidentiality
A
b. Battery
16
Q
Nurse Jones is the leader of a bereavement group for widows. Nancy is a new member. She listens to the group and sees that one member, Jane, has been a widow for 5 years now. Jane has adjusted well and Nancy thinks maybe she can too. This is an example of which curative factor?
a. Universality
b. Imitative behavior
c. Installation of hope
d. Imparting of information
A
c. Installation of hope
17
Q
Which of the following is thought to facilitate the grief process?
a. The ability to grieve in anticipation of the loss
b. The ability to grieve alone without interference from others
c. Having recently grieved for another loss
d. Taking personal responsibility for the loss
A
a. The ability to grieve in anticipation of the loss
18
Q
In prioritizing care within the therapeutic environment, which of the following nursing interventions would receive the highest priority?
a. Ensuring that the physical facilities are conducive to achievement of the goals of therapy.
b. Scheduling a community meeting for 8:30 each morning.
c. Attending to the nutritional and comfort needs of all clients.
d. Establishing contacts with community resources.
A
c. Attending to the nutritional and comfort needs of all clients.
19
Q
A competent, voluntary client has stated he wants to leave the hospital. The nurse hides his clothes in an effort to keep him from leaving. With which of the following legal actions might the nurse be charged because of this nursing action?
a. Assault
b. Battery
c. False imprisonment
d. Breach of confidentiality
A
c. False imprisonment
20
Q
Anna has been a widow for 20 years. Her maladaptive grief response to the loss of her dog may be attributed to which of the following? (Select all that apply.)
a. Unresolved grief over loss of her husband.
b. Loss of several relatives and friends over the last few years.
c. Repressed feelings of guilt over the way in which Lucky died.
d. Inability to prepare in advance for the loss.
A
a. Unresolved grief over loss of her husband.
b. Loss of several relatives and friends over the last few years.
c. Repressed feelings of guilt over the way in which Lucky died.
d. Inability to prepare in advance for the loss.
21
Q
The ultimate goal of therapy for a client with DID is:
a. Integration of the personalities into one
b. For the client to have the ability to switch from one personality to another voluntarily
c. For the client to select which personality he or she wants to be the dominant self
d. For the client to recognize that the various personalities exist
A
a. Integration of the personalities into one
22
Q
Situation: B.J. has been out with his friends. He is late getting home. He knows his wife will be angry and will yell at him for being late. He stops at the florist’s and buys a dozen red roses for her. Questions 4, 5, and 6 are related to this situation.
Which of the following behaviors represents negative reinforcement on the part of the wife?
a. She meets him at the door, accepts the roses, and says nothing further about his being late.
b. She meets him at the door, yelling that he is late, and makes him spend the night on the couch.
c. She meets him at the door, expresses delight with the roses, and kisses him on the cheek.
d. She meets him at the door and says, “How could you? You know I’m allergic to roses!”
A
a. She meets him at the door, accepts the roses, and says nothing further about his being late.
23
Q
You’re on your way to the laundry room when you encounter a fellow dorm tenant who often asks you to “throw a few of my things in with yours.” You view this as an imposition. He asks you where you’re going. Which of the following is an example of a passive-aggressive response?
a. “I’m on my way to the Celtics game. Where do you think I’m going?”
b. “I’m on my way to do some laundry. Do you have anything you want me to wash with mine?”
c. “It’s none of your damn business!”
d. “I’m going to the laundry room. Please don’t ask me to do some of yours. I resent being taken advantage of in that way.”
A
a. “I’m on my way to the Celtics game. Where do you think I’m going?”
24
Q
Succinylcholine is administered to a client receiving ECT for what purpose?
a. To alleviate anxiety
b. To decrease secretions
c. To relax muscles
d. As a short-acting anesthetic
A
c. To relax muscles
25
Paul is a member of an anger management group. He knew that people did not want to be his friend because of his violent temper. In the group, he has learned to control his temper and form satisfactory interpersonal relationships with others. This is an example of which curative factor?
a. Catharsis
b. Altruism
c. Imparting of information
d. Development of socializing techniques
d. Development of socializing techniques
26
The desired outcome of working with an individual who has witnessed a traumatic event and is now experiencing panic anxiety is:
a. The individual will experience no anxiety.
b. The individual will demonstrate hope for the future.
c. The individual will maintain anxiety at manageable level.
d. The individual will verbalize acceptance of self as worthy.
c. The individual will maintain anxiety at manageable level.
27
Lorraine, a client diagnosed with somatic symptom disorder, tells the nurse about a pain in her side. She says she has not experienced it before. Which is the most appropriate response by the nurse?
a. “I don't want to hear about another physical complaint. You know they are all in your head. It's time for group therapy now.”
b. “Let's sit down here together and you can tell me about this new pain you are experiencing. You'll just have to miss group therapy today.”
c. “I will report this pain to your physician. In the meantime, group therapy starts in 5 minutes. You must leave now to be on time.”
d. “I will call your physician and see if he will order a new pain medication for your side. The one you have now doesn't seem to provide relief. Why don't you get some rest for now?”
c. “I will report this pain to your physician. In the meantime, group therapy starts in 5 minutes. You must leave now to be on time.
28
A client who has been in restraints is now calm. He apologizes to the nurse and says, “I hope I didn't hurt anyone.” The nurse's best response is:
a. “This is our job. We know how to handle violent clients.”
b. “We understand you were out of control and didn't really mean to hurt anyone.”
c. “It is fortunate that no one was hurt. You will not be placed in restraints as long as you can control your behavior.”
d. “It is an unpleasant situation to have to restrain someone, but we have to think of the other clients. We can't have you causing injury to others. I just hope it won't happen again.”
c. “It is fortunate that no one was hurt. You will not be placed in restraints as long as you can control your behavior.”
29
Which of the following is not true regarding grieving by an adolescent?
a. Adolescents may not show their true feelings about the death.
b. Adolescents tend to have an immortal attitude.
c. Adolescents do not perceive death as inevitable.
d. Adolescents may exhibit acting out behaviors as part of their grief.
c. Adolescents do not perceive death as inevitable.
30
Which of the following activities would be a responsibility of the clinical psychologist member of the IDT?
a. Locates halfway house and arranges living conditions for client being discharged from the hospital.
b. Manages the therapeutic milieu on a 24-hour basis.
c. Administers and evaluates psychological tests that assist in diagnosis.
d. Conducts psychotherapy and administers electroconvulsive therapy treatments.
c. Administers and evaluates psychological tests that assist in diagnosis.
31
When there is congruence between what is felt and what is being expressed, the nurse is exhibiting which of the following characteristics?
a. Trust
b. Respect
c. Genuineness
d. Empathy
c. Genuineness
32
J.J. is a staff nurse on a surgical unit. He has been selected as leader of a newly established group of staff nurses organized to determine ways to decrease the number of medication errors occurring on the unit. J.J. has definite ideas about how to bring this about. He has also applied for the position of Head Nurse on the unit and believes that if he is successful in leading the group toward achievement of its goals, he can also facilitate his chances for promotion. At each meeting he addresses the group in an effort to convince the members to adopt his ideas. Which type of group and style of leadership is described in this situation?
a. Task/autocratic
b. Teaching/autocratic
c. Self-help/democratic
d. Supportive-therapeutic/laissez-faire
a. Task/autocratic
33
Sandra is the nurse leader of a supportive-therapeutic group for individuals with anxiety disorders. In this group, Helen talks incessantly. When someone else tries to make a comment, she refuses to allow him or her to speak. What type of member role is Helen assuming in this group?
a. Aggressor
b. Monopolizer
c. Blocker
d. Seducer
b. Monopolizer
34
Marie, age 56, is the mother of five children. Her youngest child, who had been living at home and attending the local college, recently graduated and accepted a job in another state. Marie has never worked outside the home and has devoted her life to satisfying the needs of her husband and children. Since the departure of her last child from home, Marie has become more and more despondent. Her husband has become very concerned, and takes her to the local mental health center. This type of crisis is called:
a. Dispositional crisis
b. Crisis of anticipated life transitions
c. Psychiatric emergency
d. Crisis resulting from traumatic stress
b. Crisis of anticipated life transitions
35
Nurse Mary has been providing care for Tom during his hospital stay. On Tom's day of discharge, his wife brings a bouquet of flowers and box of chocolates to his room. He presents these gifts to Nurse Mary saying, “Thank you for taking care of me.” What is a correct response by the nurse?
a. “I don't accept gifts from patients.”
b. “Thank you so much! It is so nice to be appreciated.”
c. “Thank you. I will share these with the rest of the staff.”
d. “Hospital policy forbids me to accept gifts from patients.”
c. “Thank you. I will share these with the rest of the staff.”
36
Barbara burned the toast. She thinks, “I'm a totally incompetent person.” What automatic thought does this statement represent?
a. Selective abstraction
b. Magnification
c. Minimization
d. Personalization
b. Magnification
37
A client tells the therapist, “I thought I would just die when my husband told me he was leaving me. If I had been a better wife, he wouldn't have fallen in love with another woman. It's all my fault.” The therapist wants to use the technique of “examining the evidence.” Which of the following statements reflects this technique?
a. “How do you think you could have been a better wife?”
b. “Okay, you say it's all your fault. Let's discuss why it might be your fault and then we will look at why it may not be.”
c. “Let's talk about what would make you a happier person.”
d. “Would you have wanted him to stay if he didn't really want to?”
b. “Okay, you say it's all your fault. Let's discuss why it might be your fault and then we will look at why it may not be.”
38
Nancy, a depressed client who has been unkept and untidy for weeks, today comes to group therapy wearing makeup and a clean dress and having washed and combed her hair. Which of the following responses by the nurse is most appropriate?
a. “Nancy, I see you have put on a clean dress and combed your hair.”
b. “Nancy, you look wonderful today!”
c. “Nancy, I'm sure everyone will appreciate that you have cleaned up for the group today.”
d. “Now that you see how important it is, I hope you will do this every day.”
a. “Nancy, I see you have put on a clean dress and combed your hair.”
39
Which of the following ego defense mechanisms describes the underlying psychodynamics of somatic symptom disorder?
a. Denial of depression
b. Repression of anxiety
c. Suppression of grief
d. Displacement of anger
b. Repression of anxiety
40
On the milieu unit, duties of the staff psychiatric nurse include which of the following? (Select all that apply.)
a. Medication administration
b. Client teaching
c. Medical diagnosis
d. Reality orientation
e. Relationship development
f. Group therapy
a. Medication administration
b. Client teaching
d. Reality orientation
e. Relationship development
41
Guidelines relating to “duty to warn” state that a therapist should consider taking action to warn a third party when his or her client: (Select all that apply.)
a. Threatens violence toward another individual
b. Identifies a specific intended victim
c. Is having command hallucinations
d. Reveals paranoid delusions about another individual
a. Threatens violence toward another individual
| b. Identifies a specific intended victim
42
Anna, who is 72 years old, is of the age when she may have experienced many losses coming close together. What is this called?
a. Bereavement overload
b. Normal mourning
c. Isolation
d. Cultural relativity
a. Bereavement overload
43
M.K. is a psychiatric nurse who has been selected to lead a group for women who desire to lose weight. The criterion for membership is that they must be at least 20 lb. overweight. All have tried to lose weight on their own many times in the past without success. At their first meeting, M.K. provides suggestions as the members determine what their goals will be and how they plan to go about achieving those goals. They decided how often they wanted to meet, and what they planned to do at each meeting. Which type of group and style of leadership is described in this situation?
a. Task/autocratic
b. Teaching/democratic
c. Self-help/laissez-faire
d. Supportive-therapeutic/democratic
d. Supportive-therapeutic/democratic
44
You have been studying for a nursing exam all afternoon and lost track of time. Your husband expects dinner on the table when he gets home from work. You have not started cooking yet when he walks in the door and shouts, “Why the heck isn't dinner ready?” Which of the following is an example of a passive-aggressive response?
a. “I'm sorry. I'll have it done in no time, honey.” But then you move very slowly and take a long time to cook the meal.
b. “I'm tired from studying all afternoon. Make your own dinner, you bum! I'm tired of being your slave!”
c. “I haven't started dinner yet. I'd like some help from you.”
d. “I'm so sorry. I know you're tired and hungry. It's all my fault. I'm such a terrible wife!”
a. “I'm sorry. I'll have it done in no time, honey.” But then you move very slowly and take a long time to cook the meal.
45
Which of the following behaviors suggest a possible breach of professional boundaries? (Select all that apply.)
a. The nurse repeatedly requests to be assigned to a specific client.
b. The nurse shares the details of her divorce with the client.
c. The nurse makes arrangements to meet the client outside of the therapeutic environment.
d. The nurse shares how she dealt with a similar difficult situation.
a. The nurse repeatedly requests to be assigned to a specific client.
b. The nurse shares the details of her divorce with the client.
c. The nurse makes arrangements to meet the client outside of the therapeutic environment.
46
The environment in which the communication takes place influences the outcome of the interaction. Which of the following are aspects of the environment that influence communication? (Select all that apply.)
a. Territoriality
b. Density
c. Dimension
d. Distance
e. Intensity
a. Territoriality
b. Density
d. Distance
47
Judy has been in the hospital for 3 weeks. She has used Valium “to settle my nerves” for the past 15 years. She was admitted by her psychiatrist for safe withdrawal from the drug. She has passed the physical symptoms of withdrawal at this time, but states to the nurse, “I don't know if I will be able to make it without Valium after I go home. I'm already starting to feel nervous. I have so many personal problems.” Which is the most appropriate response by the nurse?
a. “Why do you think you have to have drugs to deal with your problems?”
b. “Everybody has problems, but not everybody uses drugs to deal with them. You'll just have to do the best that you can.”
c. “We will just have to think about some things that you can do to decrease your anxiety without resorting to drugs.”
d. “Just hang in there. I'm sure everything is going to be okay.”
c. “We will just have to think about some things that you can do to decrease your anxiety without resorting to drugs.”
48
A decrease in which of the following neurotransmitters has been implicated in depression?
a. GABA, acetylcholine, and aspartate
b. Norepinephrine, serotonin, and dopamine
c. Somatostatin, substance P, and glycine
d. Glutamate, histamine, and opioid peptides
b. Norepinephrine, serotonin, and dopamine
49
The nurse leader is explaining about group “curative factors” to members of the group. She tells the group that group situations are beneficial because members can see that they are not alone in their experiences. This is an example of which curative factor?
a. Altruism
b. Imitative behavior
c. Universality
d. Imparting of information
c. Universality
50
Jenny reported to the high school nurse that her mother drinks too much. She is drunk every afternoon when Jenny gets home from school. Jenny is afraid to invite friends over because of her mother's behavior. This type of crisis is called:
a. Crisis resulting from traumatic stress
b. Maturational/developmental crisis
c. Dispositional crisis
d. Crisis reflecting psychopathology
c. Dispositional crisis
51
Dorothy was involved in an automobile accident while under the influence of alcohol. She swerved her car into a tree and narrowly missed hitting a child on a bicycle. She is in the hospital with multiple abrasions and contusions. She is talking about the accident with the nurse. Which of the following statements by the nurse is most appropriate?
a. “Now that you know what can happen when you drink and drive, I'm sure you won't let it happen again.”
b. “You know that was a terrible thing you did. That child could have been killed.”
c. “I'm sure everything is going to be okay now that you understand the possible consequences of such behavior.”
d. “How are you feeling about what happened?”
d. “How are you feeling about what happened?”
52
A major difference between normal and maladaptive grieving has been identified by which of the following?
a. There are no feelings of depression in normal grieving.
b. There is no loss of self-esteem in normal grieving.
c. Normal grieving lasts no longer than 1 year.
d. In normal grief the person does not show anger toward the loss.
b. There is no loss of self-esteem in normal grieving.
53
Henry is a member of an Alcoholics Anonymous group. He learned about the effects of alcohol on the body when a nurse from the chemical dependency unit spoke to the group. This is an example of which curative factor?
a. Catharsis
b. Altruism
c. Imparting of information
d. Universality
c. Imparting of information
54
John and his girlfriend had an argument during her visit. Which behavior by John would indicate he is learning to adaptively problem-solve his frustrations?
a. John says to the nurse, “Give me some of that medication before I end up in restraints!”
b. When his girlfriend leaves, John goes to the exercise room and punches on the punching bag.
c. John says to the nurse, “I guess I'm going to have to dump that broad!”
d. John says to his girlfriend, “You'd better leave before I do something I'm sorry for.”
b. When his girlfriend leaves, John goes to the exercise room and punches on the punching bag.
55
4. The most appropriate crisis intervention with Amanda (from question 3) would be to:
a. Encourage her to recognize how lucky she is to be alive.
b. Discuss stages of grief and feelings associated with each.
c. Identify community resources that can help Amanda.
d. Suggest that she find a place to live that provides a storm shelter.
( Amanda's mobile home was destroyed by a tornado. Amanda received only minor injuries, but is experiencing disabling anxiety in the aftermath of the event. This type of crisis is called:)
b. Discuss stages of grief and feelings associated with each.
56
Crises occur when an individual:
a. Is exposed to a precipitating stressor
b. Perceives a stressor to be threatening
c. Has no support systems
d. Experiences a stressor and perceives coping strategies to be ineffective
d. Experiences a stressor and perceives coping
57
Situation: B.J. has been out with his friends. He is late getting home. He knows his wife will be angry and will yell at him for being late. He stops at the florist's and buys a dozen red roses for her. Questions 4, 5, and 6 are related to this situation.
Which of the following behaviors represents an aversive stimulus on the part of the wife?
a. She meets him at the door, accepts the roses, and says nothing further about his being late.
b. She meets him at the door, yelling that he is late, and makes him spend the night on the couch.
c. She meets him at the door, expresses delight with the roses, and kisses him on the cheek.
d. She meets him at the door and says, “How could you? You know I'm allergic to roses!”
b. She meets him at the door, yelling that he is late, and makes him spend the night on the couch.
58
The ultimate goal of therapy for a client with DID is most likely achieved through:
a. Crisis intervention and directed association
b. Psychotherapy and hypnosis
c. Psychoanalysis and free association
d. Insight psychotherapy and dextroamphetamines
b. Psychotherapy and hypnosis
59
Carol, an adolescent, just returned from group therapy and is crying. She says to the nurse, “All the other kids laughed at me! I try to fit in, but I always seem to say the wrong thing. I've never had a close friend. I guess I never will.” Which is the most appropriate response by the nurse?
a. “What makes you think you will never have any friends?”
b. “You're feeling pretty down on yourself right now.”
c. “I'm sure they didn't mean to hurt your feelings.”
d. “Why do you feel this way about yourself?”
b. “You're feeling pretty down on yourself right now.”
60
A negative reinforcer:
a. Increases the probability that a behavior will recur
b. Decreases the probability that a behavior will recur
c. Has nothing to do with modifying behavior
d. Always results in unacceptable behavior
a. Increases the probability that a behavior will recur
61
Which of the following is a correct statement when attempting to distinguish normal grief from clinical depression?
a. In clinical depression, anhedonia is prevalent.
b. In normal grieving, the person has generalized feelings of guilt.
c. The person who is clinically depressed relates feelings of depression to a specific loss.
d. In normal grieving, there is a persistent state of dysphoria.
a. In clinical depression, anhedonia is prevalent.
62
Psychotropic medications that block the acetylcholine receptor may result in which of the following side effects?
a. Dry mouth
b. Sexual dysfunction
c. Nausea
d. Priapism
a. Dry mouth
63
Ginger, age 19 and an only child, left 3 months ago to attend a college of her choice 500 miles away from her parents. It is Ginger's first time away from home. She has difficulty making decisions and will not undertake anything new without first consulting her mother. They talk on the phone almost every day. Ginger has recently started having anxiety attacks. She consults the nurse practitioner in the student health center. This type of crisis is called:
a. Crisis resulting from traumatic stress
b. Dispositional crisis
c. Psychiatric emergency
d. Maturational/developmental crisis
d. Maturational/developmental crisis
64
Which of the following parts of the brain has control over the pituitary gland and autonomic nervous system, as well as regulation of appetite and temperature?
a. Temporal lobe
b. Parietal lobe
c. Cerebellum
d. Hypothalamus
d. Hypothalamus
65
Nurse Carol, who is the adult child of an alcoholic, is working with John, a client who abuses alcohol. John has experienced a successful detoxification process and is beginning a program of rehabilitation. He says to Carol, “I'm not going to go to those stupid AA meetings. They don't help anything.” Carol, whose father died of complications from alcoholism, responds with anger: “Don't you even care what happens to your children?” Carol's response is an example of which of the following?
a. Transference
b. Countertransference
c. Self-disclosure
d. A breach of professional boundaries
b. Countertransference
66
Nurse Jones is working with Kim, a client in the anger-management program. Which of the following identifies actions associated with the working phase of the therapeutic relationship?
a. Kim tells Nurse Jones she wants to learn more adaptive ways to handle her anger. Together, they set some goals.
b. The goals of therapy have been met, but Kim cries and says she has to keep coming to therapy in order to be able to handle her anger appropriately.
c. Nurse Jones reads Kim's previous medical records. She explores her feelings about working with a woman who has abused her child.
d. Nurse Jones helps Kim practice various techniques to control her angry outbursts. She gives Kim positive feedback for attempting to improve maladaptive behaviors.
d. Nurse Jones helps Kim practice various techniques to control her angry outbursts. She gives Kim positive feedback for attempting to improve maladaptive behaviors.
67
A client tells the therapist, “I thought I would just die when my husband told me he was leaving me. If I had been a better wife, he wouldn't have fallen in love with another woman. It's all my fault.” The therapist asks the client to think back to the day her husband told her he was leaving and to describe the situation and her feelings. What cognitive therapy technique is the therapist using?
a. Imagery
b. Role play
c. Problem solving
d. Thought recording
a. Imagery
68
Nursing care for a client with somatic symptom disorder would focus on helping her to:
a. Eliminate the stress in her life.
b. Discontinue her numerous physical complaints.
c. Take her medication only as prescribed.
d. Learn more adaptive coping strategies.
d. Learn more adaptive coping strategies.
69
Electroconvulsive therapy is thought to effect a therapeutic response by:
a. Stimulation of the CNS
b. Decreasing the levels of acetylcholine and monoamine oxidase
c. Increasing the levels of serotonin, norepinephrine, and dopamine
d. Altering sodium metabolism within nerve and muscle cells
c. Increasing the levels of serotonin, norepinephrine, and dopamine
70
John, a client with a history of violence, has been hospitalized on the psychiatric unit. He becomes agitated and begins to threaten the staff and other clients. When all other interventions fail, John is placed in restraints in the seclusion room for his and others’ protection. Which of the following are interventions for the client in restraints? (Select all that apply.)
a. Check temperature and pulse of extremities.
b. Document all observations.
c. Explain to the client that restraint is his punishment for violent behavior
d. Provide ongoing assessment and observation.
e. Withhold food and fluid until client is calm and can be released from restraints.
a. Check temperature and pulse of extremities.
b. Document all observations.
d. Provide ongoing assessment and observation.
71
N.J. is the nurse leader of a childbirth preparation group. Each week she shows various films and sets out various reading materials. She expects the participants to utilize their time on a topic of their choice or practice skills they have observed on the films. Two couples have dropped out of the group, stating, “This is a big waste of time.” Which type of group and style of leadership is described in this situation?
a. Task/democratic
b. Teaching/laissez-faire
c. Self-help/democratic
d. Supportive-therapeutic/autocratic
b. Teaching/laissez-faire
72
A client states: “I refuse to shower in this room. I must be very cautious. The FBI has placed a camera in here to monitor my every move.” Which of the following is the therapeutic response?
a. “That's not true.”
b. “I have a hard time believing that is true.”
c. “Surely you don't really believe that.”
d. “I will help you search this room so that you can see there is no camera.”
b. “I have a hard time believing that is true.”
73
The nurse hears John, a client with a history of violence, yelling in the dayroom. The nurse observes his increased agitation, clenched fists, and loud, demanding voice. He is challenging and threatening staff and the other clients. The nurse's priority intervention would be to:
a. Call for assistance.
b. Draw up a syringe of prn haloperidol.
c. Ask John if he would like to talk about his anger.
d. Tell John if he does not calm down he will have to be restrained.
a. Call for assistance.
74
Amanda's mobile home was destroyed by a tornado. Amanda received only minor injuries, but is experiencing disabling anxiety in the aftermath of the event. This type of crisis is called:
a. Crisis resulting from traumatic stress
b. Maturational/developmental crisis
c. Dispositional crisis
d. Crisis of anticipated life transitions
a. Crisis resulting from traumatic stress
75
You and your best friend, Jill, have had plans for 6 months to go on vacation together to Hawaii. You have saved your money and have plane tickets to leave in 3 weeks. She has just called you and reported that she is not going. She has a new boyfriend, they are moving in together, and she does not want to leave him. You are very angry with Jill for changing your plans. Which of the following is an example of an assertive response?
a. “I'm very disappointed and very angry. I'd like to talk to you about this later. I'll call you.”
b. “I'm very happy for you, Jill. I think it's wonderful that you and Jack are moving in together.”
c. You tell Jill that you are very happy for her, but then say to another friend, “Well, that's the end of my friendship with Jill!”
d. “What? You can't do that to me! We've had plans! You're acting like a real slut!”
a. “I'm very disappointed and very angry. I'd like to talk to you about this later. I'll call you.”
76
Anna's dog, Lucky, got away from her while they were taking a walk. He ran into the street and was hit by a car. Anna cannot remember any of these circumstances of his death. This is an example of what defense mechanism?
a. Rationalization
b. Suppression
c. Denial
d. Repression
d. Repression
77
Nancy's new in-laws came to dinner for the first time. When Nancy's mother-in-law left some food on her plate, Nancy thought, “I must be a lousy cook.” What automatic thought does this statement represent?
a. Dichotomous thinking
b. Overgeneralization
c. Minimization
d. Personalization
d. Personalization
78
The most appropriate nursing intervention with Marie (from question 9) would be to:
a. Refer her to her family physician for a complete physical examination.
b. Suggest she seek outside employment now that her children have left home.
c. Identify convenient support systems for times when she is feeling particularly despondent.
d. Begin grief work and assist her to recognize areas of self-worth separate and apart from her children.
d. Begin grief work and assist her to recognize areas of self-worth separate and apart from her children.
79
Nurse Jones decides to go against family wishes and tell the client of his terminal status because that is what she would want if she were the client. Which of the following ethical theories is considered in this decision?
a. Kantianism
b. Christian ethics
c. Natural law theories
d. Ethical egoism
b. Christian ethics
80
When it has been assessed that a client is in control and no longer requires restraining, how does the nurse proceed?
a. The nurse removes the restraints.
b. The nurse calls for assistance to remove the restraints.
c. With assistance, the nurse removes one restraint
.
d. The nurse tells the client he will have to wait until the doctor comes in.
c. With assistance, the nurse removes one restraint
81
Which of the following parts of the brain is concerned with visual reception and interpretation?
a. Frontal lobe
b. Parietal lobe
c. Temporal lobe
d. Occipital lobe
d. Occipital lobe
82
Which of the following best describes the average number of ECT treatments given and the timing of administration?
a. One treatment per month for 6 months
b. One treatment every other day for a total of 6 to 12 treatments
c. One treatment three times per week for a total of 20 to 30 treatments
d. One treatment every day for a total of 10 to 15 treatments
b. One treatment every other day for a total of 6 to 12 treatments
83
In the community meeting, which of the following actions is most important for reinforcing the democratic posture of the therapy setting?
a. Allowing each person a specific and equal amount of time to talk.
b. Reviewing group rules and behavioral limits that apply to all clients.
c. Reading the minutes from yesterday's meeting.
d. Waiting until all clients are present before initiating the meeting.
b. Reviewing group rules and behavioral limits that apply to all clients.
84
Mrs. S. asks the nurse, “Do you think I should tell my husband about my affair with my boss?” Which is the most appropriate response by the nurse?
a. “What do you think would be best for you to do?”
b. “Of course you should. Marriage has to be based on truth.”
c. “Of course not. That would only make things worse.”
d. “I can't tell you what to do. You have to decide for yourself.”
a. “What do you think would be best for you to do?”
85
Which of the following parts of the brain is associated with voluntary body movement, thinking and judgment, and expression of feeling?
a. Frontal lobe
b. Parietal lobe
c. Temporal lobe
d. Occipital lobe
a. Frontal lobe
86
For which of the following reasons may an individual be considered gravely disabled? (Select all that apply.)
a. A person, because of mental illness, cannot fulfill basic needs.
b. A mentally ill person is in danger of physical harm based on inability to care for self.
c. A mentally ill person lacks the resources to provide the necessities of life.
d. A mentally ill person is unable to make use of available resources to meet daily living requirements.
a. A person, because of mental illness, cannot fulfill basic needs.
b. A mentally ill person is in danger of physical harm based on inability to care for self.
d. A mentally ill person is unable to make use of available resources to meet daily living requirements.
87
Psychotropic medications that block the reuptake of serotonin may result in which of the following side effects?
a. Dry mouth
b. Constipation
c. Blurred vision
d. Sexual dysfunction
d. Sexual dysfunction
88
Which of the following is most likely to initiate a grief response in an individual?
a. Death of the pet dog
b. Being told by her doctor that she has begun menopause
c. Failing an exam
d. A only
e. All of the above.
e. All of the above.
89
For what reason would Anna's illness be considered a neurosis rather than a psychosis?
a. She is unaware that her behavior is maladaptive.
b. She exhibits inappropriate affect (emotional tone).
c. She experiences no loss of contact with reality.
d. She tells the nurse, “There is nothing wrong with me!”
c. She experiences no loss of contact with reality.
90
Psychotropic medications that are strong blockers of the D2 receptor are more likely to result in which of the following side effects?
a. Sedation
b. Urinary retention
c. Extrapyramidal symptoms
d. Hypertensive crisis
c. Extrapyramidal symptoms
91
Which of the following behaviors are associated with the phenomenon of transference? (Select all that apply.)
a. The client attributes toward the nurse feelings associated with a person from the client's past.
b. The nurse attributes toward the client feelings associated with a person from the nurse's past.
c. The client forms an overwhelming affection for the nurse.
d. The client becomes excessively dependent on the nurse and forms unrealistic expectations of him or her.
a. The client attributes toward the nurse feelings associated with a person from the client's past.
c. The client forms an overwhelming affection for the nurse.
d. The client becomes excessively dependent on the nurse and forms unrealistic expectations of him or her.
92
At a synapse, the determination of further impulse transmission is accomplished by means of which of the following?
a. Potassium ions
b. Interneurons
c. Neurotransmitters
d. The myelin sheath
c. Neurotransmitters
93
An aversive stimulus or punisher:
a. Increases the probability that a behavior will recur
b. Decreases the probability that a behavior will recur
c. Has nothing to do with modifying behavior
d. Always results in unacceptable behavior
b. Decreases the probability that a behavior will recur
94
Which of the following parts of the brain is concerned with hearing, short-term memory, and sense of smell?
a. Temporal lobe
b. Parietal lobe
c. Cerebellum
d. Hypothalamus
a. Temporal lobe
95
A positive reinforcer:
a. Increases the probability that a behavior will recur
b. Decreases the probability that a behavior will recur
c. Has nothing to do with modifying behavior
d. Always results in positive behavior
a. Increases the probability that a behavior will recur
96
Electroconvulsive therapy is most commonly prescribed for:
a. Bipolar disorder, manic
b. Paranoid schizophrenia
c. Major depression
d. Obsessive-compulsive disorder
c. Major depression
97
The therapist teaches a client that when the idea of herself as a worthless person starts to form in her mind, she should immediately start to whistle the tune of “Dixie.” This is an example of the cognitive therapy technique of:
a. Behavioral rehearsal
b. Social skills training
c. Distraction
d. Generating alternatives
c. Distraction
98
Which of the following conditions is considered to be the only absolute contraindication for ECT?
a. Increased intracranial pressure
b. Recent myocardial infarction
c. Severe underlying hypertension
d. Congestive heart failure
a. Increased intracranial pressure
99
Based on the information in Question 1, Anna's grieving behavior would most likely be considered to be:
a. Delayed
b. Inhibited
c. Prolonged
d. Distorted
(Three years ago, Anna's dog, Lucky, whom she had had for 16 years, was hit by a car and killed. Anna's daughter reports that since that time, Anna has lost weight, rarely leaves her home, and just sits and talks about Lucky. Anna's behavior would be considered maladaptive because)
Distorted
100
Gloria, a recent widow, states, “I'm going to have to learn to pay all the bills. Hank always did that. I don't know if I can handle all of that.” This is an example of which of the tasks described by Worden?
a. Task I: Accepting the reality of the loss
b. Task II: Processing the pain of grief
c. Task III: Adjusting to a world without the lost entity
d. Task IV: Finding an enduring connection with the lost entity in the midst of embarking on a new life
c. Task III: Adjusting to a world without the lost entity
101
Which of the following is a correct assumption regarding the concept of crisis?
a. Crises occur only in individuals with psychopathology.
b. The stressful event that precipitates crisis is seldom identifiable.
c. A crisis situation contains the potential for psychological growth or deterioration.
d. Crises are chronic situations that recur many times during an individual's life.
c. A crisis situation contains the potential for psychological growth or deterioration.
102
Which of the following tasks are associated with the orientation phase of relationship development? (Select all that apply.)
a. Promoting the client's insight and perception of reality.
b. Creating an environment for the establishment of trust and rapport.
c. Using the problem-solving model toward goal fulfillment.
d. Obtaining available information about the client from various sources.
e. Formulating nursing diagnoses and setting goals.
b. Creating an environment for the establishment of trust and rapport.
e. Formulating nursing diagnoses and setting goals.
103
Which of the following assessment data would the nurse consider as risk factors for possible violence in a client? (Select all that apply.)
a. A diagnosis of somatization disorder
b. A diagnosis of bipolar disorder
c. Substance intoxication
d. Argumentative and demanding behavior
e. Past history of violence
b. A diagnosis of bipolar disorder
c. Substance intoxication
d. Argumentative and demanding behavior
e. Past history of violence
104
Hildegard Peplau identified seven subroles within the role of the nurse. She believed the emphasis in psychiatric nursing was on which of the subroles?
a. The resource person
b. The teacher
c. The surrogate
d. The counselor
d. The counselor
105
Janet failed her first test in nursing school. She thinks, “Well, that's it! I'll never be a nurse.” What automatic thought does this statement represent?
a. Overgeneralization
b. Magnification
c. Catastrophic thinking
d. Personalization
c. Catastrophic thinking
106
Fourteen-year-old Sally has been spending many hours after school watching TV. She has virtually stopped practicing her piano lessons. Sally's parents ask for advice about how to encourage Sally to practice more. The nurse believes the Premack principle may be helpful. Which of the following does she suggest to Sally's parents?
a. She tells Sally's parents to reward Sally each time she practices the piano, even if it is only for 5 minutes.
b. She tells Sally's parents to ignore this behavior and eventually she will start practicing on her own.
c. She tells Sally's parents to draw up a contract with Sally stating what the consequences will be if she doesn't practice the piano.
d. She tells Sally's parents to explain to Sally that she may watch TV only after she has practiced the piano for 1 hour.
d. She tells Sally's parents to explain to Sally that she may watch TV only after she has practiced the piano for 1 hour.
107
A typewritten report for your psychiatric nursing class is due tomorrow at 8 a.m. The assignment was made 4 weeks ago, and yours is ready to turn in. Your roommate says, “I finally finished writing my report, but now I have to go to work, and I don't have time to type it. Please be a dear and type it for me, otherwise I'll fail!” You have a date with your boyfriend. Which of the following is an example of an aggressive response?
a. “Okay, I'll call Ken and cancel our date.”
b. “I don't want to stay here and type your report. I'm going out with Ken.”
c. “You've got to be kidding! What kind of a fool do you take me for, anyway?”
d. “Okay, I'll do it.” However, when your roommate returns from work at midnight, you are asleep and the report has not been typed.
c. “You've got to be kidding! What kind of a fool do you take me for, anyway?”
108
Opal is a 43-year-old woman who is suffering from depression and suicidal ideation. Opal says, “I'm such a worthless person. I don't deserve to live.” The therapist responds, “I would like for you to think about what problems committing suicide would solve.” The therapist is using which of the following cognitive therapy techniques?
a. Imagery
b. Role play
c. Problem solving
d. Thought recording
c. Problem solving
109
Lorraine has been diagnosed with somatic symptom disorder. Which of the following symptom profiles would you expect when assessing Lorraine?
a. Multiple somatic symptoms in several body systems
b. Fear of having a serious disease
c. Loss or alteration in sensorimotor functioning
d. Belief that her body is deformed or defective in some way
a. Multiple somatic symptoms in several body systems
110
Intervention with Andrew (from question 12) would include:
a. Encouraging expression of feelings
b. Antianxiety medications
c. Participation in a support group
d. a and c
e. All of the above
e. All of the above
111
When Jack is not accepted at the law school of his choice, he thinks, “I'm so stupid. No law school will ever accept me.” What automatic thought does this statement represent?
a. Overgeneralization
b. Magnification
c. Selective abstraction
d. Minimization
a. Overgeneralization
112
Sam has a diagnosis of major depression. After an unsuccessful trial of antidepressant medication, Sam's physician has hospitalized Sam for a course of ECT treatments. Sam says to the nurse on admission, “I don't want to end up like McMurphy in One Flew Over the Cuckoo's Nest! I'm scared!” Sam's priority nursing diagnosis at this time would be:
a. Anxiety related to deficient knowledge about ECT
b. Risk for injury related to risks associated with ECT
c. Deficient knowledge related to negative media presentation of ECT
d. Acute confusion related to side effects of ECT
a. Anxiety related to deficient knowledge about ECT
113
You are having company for dinner and they are due to arrive in 20 minutes. You are about to finish cooking and still have to shower and dress. The doorbell rings and it is a man selling a new product for cleaning windows. Which of the following is an example of an aggressive response?
a. “I don't do windows!” and slam the door in his face.
b. “I'll take a case,” and write him a check.
c. “Sure, I'll take three bottles.” Then to yourself you think: “I'm calling this company tomorrow and complaining to the manager about their salespeople coming around at dinnertime!”
d. “I'm very busy at the moment. I don't wish to purchase any of your product. Thank you.
a. “I don't do windows!” and slam the door in his face.
114
The client says to the nurse, “I've been offered a promotion, but I don't know if I can handle it.” The nurse replies, “You're afraid you may fail in the new position.” This is an example of which therapeutic technique?
a. Restating
b. Making observations
c. Focusing
d. Verbalizing the implied
a. Restating
115
The most appropriate nursing intervention with Jenny (from question 5) would be to:
a. Make arrangements for her to start attending Alateen meetings.
b. Help her identify the positive things in her life and recognize that her situation could be a lot worse than it is.
c. Teach her about the effects of alcohol on the body and that it can be hereditary.
d. Refer her to a psychiatrist for private therapy to learn to deal with her home situation.
a. Make arrangements for her to start attending Alateen meetings.
116
Which of the following is true about aggression? (Select all that apply.)
a. It is goal directed.
b. Its aim is to do harm to a person or object.
c. It has a requisite of intent.
d. It energizes and mobilizes the body for self-defense.
a. It is goal directed.
b. Its aim is to do harm to a person or object.
c. It has a requisite of intent.
117
Lucky sometimes refused to obey Anna, and indeed did not come back to her when she called to him on the day he was killed. But Anna continues to insist, “He was the very best dog. He always minded me. He always did everything I told him to do.” This represents the defense mechanism of:
a. Sublimation
b. Compensation
c. Reaction Formation
d. Undoing
c. Reaction Formation
118
Sandra is the nurse leader of a supportive-therapeutic group for individuals with anxiety disorders. Violet, who is beautiful but lacks self-confidence, states to the group, “Maybe if I became a blond my boyfriend would love me more.” Larry responds, “Listen, dummy, you need more than blond hair to keep the guy around. A bit more in the brains department would help!” What type of member role is Larry assuming in this group?
a. Aggressor
b. Monopolizer
c. Blocker
d. Seducer
a. Aggressor
119
Nancy has a fear of dogs. In helping her overcome this fear, the therapist is using systematic desensitization. List the following steps in the order in which the therapist would proceed.
Having Nancy:
a. Look at a real dog.
b. Look at a stuffed toy dog.
c. Pet a real dog.
d. Pet the stuffed toy dog.
e. Walk past a real dog.
f. Look at a picture of a dog.
f. Look at a picture of a dog.
b. Look at a stuffed toy dog.
d. Pet the stuffed toy dog.
a. Look at a real dog.
e. Walk past a real dog.
c. Pet a real dog.
120
Lorraine, a client diagnosed with somatic symptom disorder, states, “My doctor thinks I should see a psychiatrist. I can't imagine why he would make such a suggestion.” What is the basis for Lorraine's statement?
a. She thinks her doctor wants to get rid of her as a client.
b. She does not understand the correlation of symptoms and stress.
c. She thinks psychiatrists are only for “crazy” people.
d. She thinks her doctor has made an error in diagnosis.
b. She does not understand the correlation of symptoms and stress.
121
The most common side effects of ECT are:
a. Permanent memory loss and brain damage
b. Fractured and dislocated bones
c. Myocardial infarction and cardiac arrest
d. Temporary memory loss and confusion
d. Temporary memory loss and confusion
122
Attempting to calm an angry client by using “talk therapy” is an example of which of the following clients’ rights?
a. The right to privacy
b. The right to refuse medication
c. The right to the least-restrictive treatment alternative
d. The right to confidentiality
c. The right to the least-restrictive treatment alternative
123
Which of the following hormones has been implicated in the etiology of mood disorder with seasonal pattern?
a. Increased levels of melatonin
b. Decreased levels of oxytocin
c. Decreased levels of prolactin
d. Increased levels of thyrotropin
a. Increased levels of melatonin
124
Andrew, a New York City firefighter, and his entire unit responded to the terrorist attacks at the World Trade Center. Working as a team, he and his best friend, Carlo, entered the area together. Carlo was killed when the building collapsed. Andrew was injured, but survived. Since that time, Andrew has had frequent nightmares and anxiety attacks. He says to the mental health worker, “I don't know why Carlo had to die and I didn't!” This statement by Andrew suggests that he is experiencing:
a. Spiritual distress
b. Night terrors
c. Survivor's guilt
d. Suicidal ideation
c. Survivor's guilt
125
John, age 27, was brought to the emergency department by two police officers. He smelled strongly of alcohol and was combative. His blood alcohol level was measured at 293 mg/dL. His girlfriend reports that he drinks excessively every day and is verbally and physically abusive. The nurses give John the nursing diagnosis of Risk for Other-Directed Violence. What would be appropriate outcome objectives for this diagnosis? (Select all that apply.)
a. The client will not verbalize anger or hit anyone.
b. The client will verbalize anger rather than hit others.
c. The client will not harm self or others.
d. The client will be restrained if he becomes verbally or physically abusive.
b. The client will verbalize anger rather than hit others.
| c. The client will not harm self or others.
126
When the nurse shows unconditional acceptance of an individual as a worthwhile and unique human being, he or she is exhibiting which of the following characteristics?
a. Trust
b. Respect
c. Genuineness
d. Empathy
b. Respect
127
Nancy, who is dying of cancer, says to the nurse, “I just want to see my new grandbaby. If only God will let me live until she is born. Then I'll be ready to go.” This is an example of which of Kübler-Ross's stages of grief?
a. Denial
b. Anger
c. Bargaining
d. Acceptance
c. Bargaining
128
Engel identifies which of the following as successful resolution of the grief process?
a. When the bereaved person can talk about the loss without crying
b. When the bereaved person no longer talks about the lost entity
c. When the bereaved person puts all remembrances of the loss out of sight
d. When the bereaved person can discuss both positive and negative aspects about the lost entity
d. When the bereaved person can discuss both positive and negative aspects about the lost entity
129
The nurse says to a client, “You are being readmitted to the hospital. Why did you stop taking your medication?” What communication technique does this represent?
a. Disapproving
b. Requesting an explanation
c. Disagreeing
d. Probing
b. Requesting an explanation
130
At a hospital committee meeting, a fellow nurse who is the chairperson has interrupted you each time you have tried to make a statement. The next time it happens, you intend to respond assertively. Which of the following is an example of an assertive response?
a. “You make a lousy leader! You won't even let me finish what I'm trying to say!”
b. You say nothing.
c. “Excuse me. I would like to finish my statement.”
d. You say nothing, but you fail to complete your assignment and do not show up for the next meeting.
c. “Excuse me. I would like to finish my statement.”
131
Your husband says, “You're crazy to think about going to college! You're not smart enough to handle the studies and the housework, too.” Which of the following is an example of a nonassertive response?
a. “I will do what I can, and the best that I can.”
b. (Thinking to yourself): “We'll see how he likes cooking dinner for a change.”
c. “You're probably right. Maybe I should reconsider.”
d. “I'm going to do what I want to do, when I want to do it, and you can't stop me!”
c. “You're probably right. Maybe I should reconsider.”
132
Ellen has a history of childhood physical and sexual abuse. She was diagnosed with dissociative identity disorder (DID) 6 years ago. She has been admitted to the psychiatric unit following a suicide attempt. The primary nursing diagnosis for Ellen would be:
a. Disturbed personal identity related to childhood abuse
b. Disturbed sensory perception related to repressed anxiety
c. Impaired memory related to disturbed thought processes
d. Risk for suicide related to unresolved grief
d. Risk for suicide related to unresolved grief
133
John, who was hospitalized with alcohol intoxication and violent behavior, is sitting in the dayroom watching TV with the other clients when the nurse approaches with his 5 p.m. dose of haloperidol. John says, “I feel in control now. I don't need any drugs.” The nurse's best response is based on which of the following statements?
a. John must have the medication, or he will become violent.
b. John knows that if he will not take the medication orally, he will be restrained and given an intramuscular injection.
c. John has the right to refuse the medication provided there is no immediate danger to self or others.
d. John must take the medication at this time in order to maintain adequate blood levels.
c. John has the right to refuse the medication provided there is no immediate danger to self or others.
134
Which of the following parts of the brain integrates all sensory input (except smell) on the way to the cortex?
a. Temporal lobe
b. Thalamus
c. Limbic system
d. Hypothalamus
b. Thalamus
135
Which of the following parts of the brain is associated with multiple feelings and behaviors and is sometimes referred to as the “emotional brain?”
a. Frontal lobe
b. Thalamus
c. Hypothalamus
d. Limbic System
d. Limbic System
136
Which grief reaction can the nurse anticipate in a 10-year-old child?
a. Statements that the deceased person will soon return
b. Regressive behaviors, such as loss of bladder control
c. A preoccupation with the loss
d. Thinking that they may have done something to cause the death
c. A preoccupation with the loss
137
You are in a movie theater that prohibits smoking. The person in the seat next to you just lit a cigarette and the smoke is very irritating. Which of the following is an example of an assertive response?
a. You say nothing.
b. “Please put your cigarette out. Smoking is prohibited.”
c. You say nothing, but begin to frantically fan the air in front of you and cough loudly and convulsively.
d. “Put your cigarette out, you slob! Can't you read the ‘no smoking’ sign?”
b. “Please put your cigarette out. Smoking is prohibited.”
138
Which of the following are basic assumptions of milieu therapy? (Select all that apply.)
a. The client owns his or her own environment.
b. Each client owns his or her behavior.
c. Peer pressure is a useful and powerful tool.
d. Inappropriate behaviors are punished immediately.
a. The client owns his or her own environment.
b. Each client owns his or her behavior.
c. Peer pressure is a useful and powerful tool.
139
Which of these procedures is important in following up an episode of violence on the unit? (Select all that apply.)
a. Document all observations and occurrences.
b. Conduct a debriefing with staff.
c. Discuss what occurred with other clients who witnessed the incident.
d. Warn the client that it could happen again if he becomes violent.
Which of these procedures is important in following up an episode of violence on the unit? (Select all that apply.)
a. Document all observations and occurrences.
b. Conduct a debriefing with staff.
c. Discuss what occurred with other clients who witnessed the incident.
140
Atropine sulfate is administered to a client receiving ECT for what purpose?
a. To alleviate anxiety
b. To decrease secretions
c. To relax muscles
d. As a short-acting anesthetic
b. To decrease secretions
141
A fellow worker often borrows small amounts of money from you with the promise that she will pay you back “tomorrow.” She currently owes you $15, and has not yet paid back any that she has borrowed. She asks if she can borrow a couple of dollars for lunch. Which of the following is an example of a nonassertive response?
a. “I've decided not to loan you any more money until you pay me back what you already borrowed.”
b. “I'm so sorry. I only have enough to pay for my own lunch today.”
c. “Get a life, will you? I'm tired of you sponging off me all the time!”
d. “Sure, here's two dollars.” Then to the other workers in the office: “Be sure you never lend Cindy any money. She never pays her debts. I'd be sure never to go to lunch with her if I were you!”
b. “I'm so sorry. I only have enough to pay for my own lunch today.”
142
John tells the nurse, “I think lights out at 10 o'clock on a weekend is stupid. We should be able to watch TV until midnight!” Which of the following is the most appropriate response from the nurse on the milieu unit?
a. “John, you were told the rules when you were admitted.”
b. “You may bring it up before the others at the community meeting, John.”
c. “Some people want to go to bed early, John.”
d. “You are not the only person on this unit, John. You must think of others besides yourself.”
b. “You may bring it up before the others at the community meeting, John.”
143
3. Nurse Jones decides to tell the client of his terminal status because she believes it is her duty to do so. Which of the following ethical theories is considered in this decision?
a. Natural law theories
b. Ethical egoism
c. Kantianism
d. Utilitarianism
c. Kantianism
144
Sam, who has been hospitalized for ECT treatments, says to the nurse on admission, “I don't want to end up like McMurphy in One Flew Over the Cuckoo's Nest! I'm scared!” Which of the following statements would be most appropriate by the nurse in response to Sam's expression of concern?
a. “I guarantee you won't end up like McMurphy, Sam.”
b. “The doctor knows what he is doing. There's nothing to worry about.”
c. “I know you are scared, Sam, and we're going to talk about what you can expect from the therapy.”
d. “I'm going to stay with you as long as you are scared.”
c. “I know you are scared, Sam, and we're going to talk about what you can expect from the therapy.”
145
Which of the following parts of the brain deals with sensory perception and interpretation?
a. Hypothalamus
b. Cerebellum
c. Parietal lobe
d. Hippocampus
c. Parietal lobe
146
The thought recording (2-column and 3-column) cognitive therapy techniques help clients:
a. Identify automatic thoughts.
b. Modify automatic thoughts.
c. Identify rational alternatives.
d. All of the above.
a. Identify automatic thoughts.
147
You are asked to serve on a committee on which you do not wish to serve. Which of the following is an example of a nonassertive response?
a. “Thank you, but I don't wish to be a member of that committee.”
b. “I'll be happy to serve.” But then you don't show up for any of the meetings.
c. “I'd rather have my teeth pulled!”
d. “Okay, if I'm really needed, I'll serve.”
d. “Okay, if I'm really needed, I'll serve.”
148
Which of the following statements by Anna might suggest that she is achieving resolution of her grief over Lucky's death?
a. “I don't cry anymore when I think about Lucky.”
b. “It's true. Lucky didn't always mind me. Sometimes he ignored my commands.”
c. “I remember how it happened now. I should have held tighter to his leash!”
d. “I won't ever have another dog. It's just too painful to lose them.”
“It's true. Lucky didn't always mind me. Sometimes he ignored my commands.”
149
Three years ago, Anna's dog, Lucky, whom she had had for 16 years, was hit by a car and killed. Anna's daughter reports that since that time, Anna has lost weight, rarely leaves her home, and just sits and talks about Lucky. Anna's behavior would be considered maladaptive because:
a. It has been more than three years since Lucky died.
b. Her grief is too intense just over the loss of a dog.
c. Her grief is interfering with her functioning.
d. People in this culture would not comprehend such behavior over loss of a pet.
c.Her grief is interfering with her functioning
150
Sandra is the nurse leader of a supportive-therapeutic group for individuals with anxiety disorders. On the first day the group meets, Valerie speaks first and begins by sharing the intimate details of her incestuous relationship with her father. What type of member role is Valerie assuming in this group?
a. Aggressor
b. Monopolizer
c. Blocker
d. Seducer
d. Seducer
151
Sally was sexually abused as a child. She is a client on the milieu unit with a diagnosis of borderline personality disorder. She has refused to talk to anyone. Which of the following therapies might the IDT team choose for Sally? (Select all that apply.)
a. Music therapy
b. Art therapy
c. Psychodrama
d. Electroconvulsive therapy
a. Music therapy
b. Art therapy
c. Psychodrama
152
Which of the following activities would be a responsibility of the psychiatric clinical nurse specialist on the IDT team?
a. Manages the therapeutic milieu on a 24-hour basis.
b. Conducts group therapies and provides consultation and education to staff nurses.
c. Directs a group of clients in acting out a situation that is otherwise too painful for a client to discuss openly.
d. Locates halfway house and arranges living conditions for client being discharged from the hospital.
b. Conducts group therapies and provides consultation and education to staff nurses.
153
When Frank's wife of 34 years dies, he is very stoic, handles all the funeral arrangements, doesn't cry or appear sad, and comforts all of the other family members in their grief. Two years later, when Frank's best friend dies, Frank has sleep disturbances, difficulty concentrating, loss of weight, and difficulty performing on his job. This is an example of which of the following maladaptive responses to loss?
a. Delayed grieving
b. Distorted grieving
c. Prolonged grieving
d. Exaggerated grieving
a. Delayed grieving
