Exam (elaborations) NUR 2212 PSYCH EAQ Questions and Answers

Exam (elaborations) NUR 2212 PSYCH EAQ Questions and Answers A team approach is used to help a 6-year-old boy with attention deficit-hyperactivity disorder (ADHD). What behaviors indicate that the interventions have been effective? Select all that apply. 1 Is not inhibited by rules or routines 2 Has fun playing with toys by himself Incorrect3 Is no longer enuretic during the night Correct4 Has an increased attention span in school Correct5 Is able to wait his turn when in line with others A nurse is assigned to lead a relaxation group. Which techniques should the nurse incorporate? Select all that apply. Correct1 Meditation Correct2 Mental imagery 3 Token economy 4 Operant conditioning Correct5 Deep-breathing exercises NUR 2212 PSYCH EAQ Questions and Answers How should a nurse characterize a sudden terrorist act that causes the deaths of thousands of adults and children and negatively affects their families, friends, communities, and the nation? 1 Recurring 2 Situational Incorrect3 Maturational Correct4 Adventitious A nurse has just completed a mental status examination on a newly admitted psychiatric client and returns to the nurses’ station to document the results. The nurse reflects on the client’s drawn-out explanation of the reason for the admission and concludes that excessive detail was given before the client eventually answered the questions. What mental process does the nurse identify? 1 Flight of ideas Correct2 Circumstantiality When talking with a client who has alcoholism, the nurse notes that the client becomes irritable, makes excuses, and blames family and friends for the drinking problem. Which defense mechanisms does the nurse conclude that the client is using? Select all that apply. Correct1 Projection Incorrect2 Suppression 3 Sublimation 4 Identification Correct5 Rationalization The registered nurse managing the care of four clients is determining individual priorities. Place the following clients in order of priority, with 1 as the highest priority. Incorrect 1. A client whose auditory hallucinations are saying, “They’re going to get you.” Correct 2. A manic client who has spent the last 8 hours refusing liquids and pacing around the unit. Incorrect 3. A depressed client who shares with the roommate that the client is “very happy today.” Correct 4. A cognitively impaired older adult who believes that the deceased spouse will visit today. A newly admitted client with schizophrenia has a treatment plan that includes participation in a physical activity group for several days before assignment to an analytical group. The basis for this decision is that the client will do what? Incorrect1 Develop skills in managing leisure time 2 Have time to develop insight into personal problems 3 Be too disruptive to benefit from group therapy at this time Correct4 Cultivate trust before moving into a potentially anxiety-producing group The mother of an 18-year-old man comes to the local mental health center. She is extremely upset because of her son’s behavior since the young man returned from his freshman year at college. He takes his brother’s clothing, comes in at all hours, and refuses to get a job. Sometimes he is happy and outgoing, but at other times he is withdrawn. The mother asks why her son is like this. While contemplating this situation, the nurse considers that which adjectives usually apply to adolescents? 1 Anxious and unhappy 2 Angry and irresponsible Correct3 Impulsive and self-centered A young adult is being treated in the emergency department for injuries sustained as a result of physical battering by her partner. On learning that there is a history of such abuse, the nurse plans which tertiary nursing interventions? Select all that apply. Incorrect1 Contacting family members to provide support 2 Discussing the legal ramifications of not pressing charges Incorrect3 Offering to discuss the abusive behavior with the woman's partner Correct4 Identifying the benefits of attending a support group for battered women Correct5 Providing her with information regarding local domestic violence shelters Certain questions are applicable in determining nursing negligence. Select all that apply. Correct1 "Was reasonable care provided?" Correct2 "Was there a breach of nursing duty?" Correct3 "Was there an act of omission that resulted in harm?" Correct4 "Except for the nurse’s action, would the injury have occurred?" The parents of a toddler with recently diagnosed moderate cognitive impairment state, "Our child should be able to attend college with help and medication." What should the nurse conclude? 1 They accept the child’s diagnosis. Correct2 Denial is being used as a defense mechanism. A nurse is caring for a 20-year-old client. According to Erikson’s developmental psychosocial theory, what is expected by 20 years of age? 1 Having the capacity for love and a commitment to work Incorrect2 Being creative and productive and having concern for others Correct3 Having a coherent sense of self and plans for self-actualization A small fire has been set in the dayroom garbage can by a client who is currently demonstrating manic behavior. Place the following nursing interventions in the appropriate order to best ensure client and milieu safety. Incorrect 1. Administer appropriate medications as prescribed if indicated. Incorrect 2. Move all clients to a safe, controlled area. Incorrect 3. Activate the unit's fire alarm system. Incorrect 4. Place the manic client in a quiet environment with low stimulation. Ensuring the safety of the milieu is the priority. The fire alarm is activated immediately after all clients and staff have been removed from the area of the fire. The next intervention is providing the manic client with a quiet, low-stimulation environment. If the nursing assessment indicates a need for medication to manage the client's behavior, it should then be administered. After an electroconvulsive therapy treatment, a client complains of loss of memory. What is the nurse's best response? Correct1 "This is temporary; your memory will return after the therapy is done." A nurse facilitating a support group of widows and widowers recalls that research indicates that the probability of a spouse having a pathological or morbid grief response will be greater in what case? Incorrect1 The couple had an ambivalent relationship. Correct2 The cause of the spouse's death was suicide. Based on the following documentation, to best address the client's needs, what is the nurse's initial intervention? Incorrect1 Having male staff interact with the client only in public areas of the unit Correct2 Offering the client a high-protein drink every hour in a quiet area of the unit A client who had to be cut out of a car after a motor vehicle collision has no visible physical effects from the ordeal. The client responds to the emergency department nurse's questions factually in a soft voice with a composed manner. What may this behavior indicate about the client? Correct1 The client is controlling the expression of feelings. An older woman comes to the mental health clinic and reports, "I've not been feeling right and haven't been able to sleep or eat since my husband died 8 months ago." The nurse determines that the client is experiencing grief associated with the loss of the husband. What supports this conclusion? 1 Inability to talk about her loss 2 Difficulty in expressing her loss Correct3 Lack of sleep and the presence of symptoms of depression A primary nurse notes that a client has become jaundiced after 2 weeks of antipsychotic drug therapy. The nurse continues to administer the antipsychotic until the primary healthcare provider can be consulted. What does the nurse manager conclude about this situation? Correct1 Jaundice is sufficient reason to discontinue the antipsychotic. Which individual is coping with issues concerning dependence versus independence? 1 Infant Correct2 Toddler A nurse is teaching a group of recently hired staff members about defense mechanisms. An example given is Scarlett O'Hara, in the movie Gone with the Wind, who said, "I'll think about that tomorrow." What defense mechanism does this statement reflect? Incorrect1 Denial 2 Splitting 3 Repression A client's hands are raw and bloody from a ritual involving frequent hand washing. Which defense mechanism does the nurse identify? Correct1 Undoing A nurse working in a mental health clinic has a caseload composed of a number of individuals and families. Which members of the caseload are at the greatest risk for mental health problems? Correct1 A family with a new baby, a divorced man, and a recently retired older woman A parent of four is remanded to the psychiatric unit by the court for observation. The client was arrested and charged with abusing a 2-year-old child, who is in the pediatric intensive care unit in critical condition. The nurse approaches the client for the first time. How should the nurse anticipate that the client will likely respond? Select all that apply. Correct1 By denying beating the child Correct2 By avoiding talking about the situation Incorrect3 By asking where the other three children are 4 By expressing excessive concern for the child Correct5 By exhibiting an emotional response that is inconsistent with the degree of injury According to Erikson, a person’s adjustment to the period of senescence will depend largely on the adjustment the individual made to which earlier developmental stage? 1 Trust versus mistrust Incorrect2 Industry versus inferiority 3 Identity versus role confusion Correct4 Generativity versus stagnation During the eighth session of a therapy group, a member who talks frequently is interrupted by one who doesn't. When the interrupting person is finished talking, the one who usually contributes says, "I'm so glad that you feel like talking today." While saying this, the client sits rigidly and looks angry. How should the nurse respond? Correct1 Comment on the interrupted client's angry behavior and pleasant words. A practitioner prescribes routine checks of the client's lithium level to be performed. How many hours after the last dose of lithium should the nurse plan to obtain the blood specimen? Incorrect1 2 to 4 2 4 to 6 3 6 to 8 Correct4 8 to 12 A psychiatric unit uses a behavioral approach to determine a client's level of privileges. Which factor should a nurse use to determine whether an increase in privileges is warranted? 1 Stating that the depression is lifting Correct2 Performing hygiene activities independently Which client in a psychiatric unit needs immediate therapeutic intervention from the nurse? Incorrect1 A 25-year-old man who is mimicking the use of a machine gun in front of the nurse’s station 2 A 45-year-old man who is sitting quietly in the corner, watching the movements of other clients Correct3 A 50-year-old woman who is pacing back and forth across the dayroom and picking fights with other clients A client who was sexually assaulted and is aware of the possible legal implications decides to seek prosecution of the rapist. The nurse carefully listens and documents all assessments. This is done because with a charge of rape the burden of proof has which implication? Incorrect1 The burden of proof rests with the health team. 2 It is on the defendant to prove innocence. 3 Burden of proof must be established before the case will be heard. Correct4 The burden of proof rests with the criminal justice system in collaboration with the victim. A 17-year-old client is diagnosed with leukemia. Which statements by the teenager reflect Piaget’s cognitive processes associated with adolescence? Select all that apply. 1 "My smoking pot probably caused the leukemia." Correct2 "I’m going to do my best to fight this awful disease." Correct3 "Now I can’t go to the prom because I have this stupid disease." Incorrect4 "I know I got sick because I’ve been causing a lot of problems at home." Correct5 "This illness is serious, but with treatment I think I have a chance to get better." A young woman is brought to the emergency department by friends after being sexually assaulted. The client has a small but deep laceration on her chin, as well as contusions on her arms and legs. The client appears withdrawn but calm. Place the following nursing interventions in the appropriate order to best address the client’s immediate needs. Incorrect 1. Advise her of the potential related health risks and the treatments that are available. Incorrect 2. Talk to her in a calm, nonjudgmental manner. Incorrect 3. Encourage her to express her feelings concerning the assault. Incorrect 4. Provide care for her laceration and contusions. Incorrect 5. Provide her with clear, concise explanations of care that will be provided. The establishment of a trusting, mutually respectful nurse-client relationship is the initial focus in this particular scenario. To best minimize further trauma, the nurse will provide the client with an explanation of all care (physical contact) that will tak What action should the nurse manager take when it becomes apparent that communication between the nurse and the client is consistently superficial? 1 Assessing the client’s ability to understand the nurse’s questions Correct2 Evaluating how actively the nurse has been listening to the client A female adolescent in group therapy tells the other group members that while out on a pass she used marijuana because her boyfriend made her smoke it. What defense mechanism is the client using? 1 Denial Incorrect2 Undoing Correct3 Projection An older adult with a chronic degenerative disease progresses to the stage at which self-care is no longer possible, and admission to a long-term care facility becomes necessary. What is the major developmental conflict for this client, according to Erikson? Incorrect1 Intimacy versus isolation Correct2 Ego integrity versus despair The nurse’s role in maintaining or promoting the health of the older adult should be based on which principle? 1 Some physiologic changes that occur as a result of aging are reversible. Incorrect2 Thoughts of impending death are common and depressing to most older adults. 3 Older adults can better accept the dependent state that chronic illness often causes. Correct4 There is a strong correlation between successful retirement and maintaining health. A client with bipolar disorder has been admitted for alcohol detoxification, and laboratory tests are performed. Which results should prompt the nurse to notify the admitting health care provider? Select all that apply. 1 Hemocrit: 47% Correct2 Prothrombin time: 13.9 seconds Correct3 Serum albumin: 2.9 g/dL (29 g/L) Incorrect4 Lithium level: 1.2 mEq/L (1.2 mmol/L) 5 Serum sodium: 140 mEq/L (140 mmol/L) Correct6 Blood urea nitrogen: 25 mg/dL (9.0 mmol/L A nurse begins terminating the consistent one-to-one relationship with a client who is soon to be discharged. How might the nurse expect the client to respond to the termination of their relationship? Correct1 Grief The home care nurse visits a child in whom failure to thrive has been diagnosed and makes observations that lead the nurse to suspect that the house is being used as a methamphetamine laboratory. Which observations support this conclusion? Select all that apply. Correct1 Many small plastic bags Correct2 A strong odor of acetone Correct3 Many empty cold medicine bottles 4 A pot of tall plants with broad leaves Correct5 Jars containing bright-yellow crystals The parents of an autistic child begin family therapy with a nurse therapist. The father states that the family members wish to share their religious beliefs with the therapist. What should the nurse do? Incorrect1 Limit the father's discussion of religion. 2 Include the mutual discussion of religious beliefs. 3 Invite the family's religious leader to a therapy session. Correct4 Encourage family discussion of their religion in the sessions. What is the best initial approach to take with a self-accusatory, guilt-ridden client? 1 Contradict the client's persecutory delusions. Correct2 Accept the client's statements as the client's beliefs A nurse in the mental health clinic is counseling a client with the diagnosis of depression. During the counseling session the client says, "Things always seem the same. They never change." The nurse suspects that the client is feeling hopeless. For what indication of hopelessness should the nurse assess the client? Correct1 Outbursts of ange An 8-year-old child is found to have oppositional defiant disorder. What behavior noted by the nurse supports this diagnosis? Incorrect1 Easily distracted Correct2 Argues with adults Which client assessment does the nurse determine is inconsistent with the diagnosis of anorexia nervosa, restricting type? Correct1 Engages in episodes of purging What should the nurse teach parents about childhood depression? Correct1 May appear as acting-out behavior The nurse is interviewing a female adolescent with anorexia nervosa who is malnourished and severely underweight. Which statement leads the nurse to conclude that the client is experiencing secondary gains from her behavior? 1 "I'm as big as a house." 2 "I get straight A's in school." Correct3 "My mother keeps trying to get me to eat." A client with a long history of alcohol abuse who has been hospitalized for 1 week tells the nurse, "I feel much better and probably won't need any more treatment." What does the nurse conclude when evaluating the client's progress? 1 The client has accepted the illness and now must use willpower to resist alcohol. Incorrect2 The client will probably not use alcohol again as long as the client's family remains supportive. Correct3 The client's lack of insight into the emotional aspects of the illness indicates the need for continued supervision. A nurse in a mental health unit of the emergency department of a hospital frequently cares for adolescents who attempt suicide. What is important for the nurse to remember about adolescent suicide behavior? 1 Boys account for more attempts than do girls. 2 Girls use more dramatic methods than do boys. Incorrect3 Girls talk more about suicide before attempting it. Correct4 Boys are more likely to use lethal methods than are girls. A 42-year-old adult with a long history of alcohol abuse seeks help in one of the local hospitals. What does the nurse consider to be the major underlying factor for success in a client’s alcohol treatment program? 1 Family Correct2 Motivation A nurse is working with clients with a variety of eating disorders. Which characteristic unique to bulimia nervosa differentiates this disorder from anorexia nervosa? 1 The client is obese and attempting to lose weight. Correct2 The client behaves appropriately and looks normal. A nurse is discussing plans with a client who has decided to withdraw from alcohol. What should the nurse recommend as one of the mosteffective treatments for alcoholism? Incorrect1 Daily administration of disulfiram 2 Individual or group psychotherapy 3 Admission to an alcoholic unit in a hospital Correct4 Active membership in Alcoholics Anonymous A severely depressed male client responds to therapy and with the help of the staff begins to set some daily objectives. Which behavior mostindicates improvement in this client? 1 Staying clear of people who make him anxious Correct2 Talking with at least one person on the unit daily A client with recurrent episodes of depression comes to the mental health clinic for a routine follow-up visit. The nurse suspects that the client is at increased risk for suicide. What is a contributing factor to the client's risk for suicide? Incorrect1 Psychomotor retardation 2 Decreased physical activity 3 Deliberate thoughtful behavior Correct4 Overwhelming feelings of guilt A client who is to begin a physical therapy regimen after orthopedic surgery expresses anxiety about starting this new therapy. Why does the nurse respond that some of this apprehension can be an asset? 1 Slow physiological function Correct2 Increase alertness to the env