Questions And Answers
A nurse is caring for a group of clients. For which of the following situations should the nurse
complete an incident report? Correct Answers: A client was administered one-half of the prescribed
dose of medication
A nurse is caring for a group of clients. Which of the following findings is the nurse required to report?
Correct Answers: A client who has borderline personality disorder threatened to harm their roommate
A nurse is caring for a client who has borderline personality disorder. Which of the following goals is
the priority when planning care for this client? Correct Answers: The client will refrain from self-
mutilation
A nurse is discussing the home care of a client who has advanced Alzheimer's disease with he
client's partner, who is planning to go out of town for several days. Which of the following resources
should the nurse recommended to the caregiver? Correct Answers: Respite care
A nurse is caring for an older adult client who has dementia and has wandered into the day room
looking for their deceased partner. Which of the following actions should the nurse take? Correct
Answers: Talk with the client about activities they enjoyed with their partner
A nurse is admitting a client who has schizophrenia to an acute care setting. When the nurse
questions the client regarding their admission, the client states, "I'm red, in the head, and I'm going to
bed!" The nurse should document the client's speech pattern as which of the following? Correct
Answers: Clang association
A nurse is assessing a client who has schizophrenia. Which of the following findings should the nurse
document as a negative symptom of this disorder? Correct Answers: Anhedonia
A nurse is delegating client care tasks to a licensed practical nurse (LPN) and an assistive personnel.
Which of the following tasks should the nurse assign to the LPN? Correct Answers: Change the
dressing of a client who has borderline personality disorder and superficial self-inflicted wounds
A nurse is assessing a school-age child who has conduct disorder. Which of the following
characteristics should the nurse expect the child to demonstrate? Correct Answers: Aggression
toward animals
A nurse in a mental health clinic is planning car for a client who has a new prescription for
olanzapine. Which of the following interventions should the nurse identify as the priority? Correct
Answers: Instruct the client to avoid driving during initial therapy
A nurse is caring for a client who has a history of substance use disorder and was involuntarily
admitted to a mental health facility. When the nurse attempt to administer oral lorazepam, the client
refuses to take the medication and becomes physically aggressive. Which of the following actions
should the nurse take? Correct Answers: Do not administer the lorazepam
, A nurse is caring for a client who has schizophrenia and is experiencing psychosis. The nurse should
identify that which of the following findings indicates a potential psychiatric emergency? Correct
Answers: The client reports command hallucinations
A nurse is assessing a client who has borderline personality disorder. Which of the following findings
should the nurse expect? Correct Answers: Emotional lability
While observing group therapy, a nurse recognizes that a client is behaving in a way suggestive of
dependent personality disorder. Which of the following behaviors is consistent with this condition?
Correct Answers: The client needs excessive external input to make everyday decisions
A home health nurse is assessing an older adult client whose sibling is the primary caregiver. Which
of the following findings should the nurse identify as a possible indicator of neglect? Correct Answers:
Inappropriate dress
A nurse is establishing a therapeutic relationship with a client who has antisocial personality disorder.
Which of the following strategies should the nurse use when communicating with this client? Correct
Answers: Set realistic limits on the clients behavior
A nurse in the emergency department is caring for a client who has alcohol toxicity and is
unresponsive. Which of the following interventions should the nurse take? Correct Answers: Gather
supplies for endotracheal intubation
A nurse is preparing to administer chlorpromazine 0.55 mg/kg PO to an adolescent who weighs 110
lb. Available is chlorpromazine syrup 10 mg/ 5 ml. How many ml should the nurse administer?
Correct Answers: 14
A nurse is planning care for a client who is experiencing acute mania. Which of the following
interventions should the nurse include in the plan to promote sleep? Correct Answers: Encourage
frequent rest periods throughout the day
A nurse is reviewing routine laboratory values for several clients who re taking lithium carbonate.
Which of the following clients should the nurse assess further for findings indicating lithium toxicity?
Correct Answers: A client who has a sodium level of 128 meq/L
A nurse is admitting a female client who has anorexia nervosa. Which of the following manifestations
should the nurse expect during the admission assessment? Correct Answers: Orthostatic
hypotension
A nurse in a community health center is counseling a family of two parents and two children. Which of
the following statements by a family member indicates manipulative behavior? Correct Answers: "If
you do my homework for me, I won't bother to for the rest of the day."
A charge nurse is preparing an educational session for a group of newly licensed nurses to review
client rights under the law. Which of the following statements should the nurse make? Correct
Answers: "In the event a client threatens to harm others, medications can be administered without
consent"
A client who has paranoid schizophrenia is attending a treatment planning conference with a family
member. During the discussion of the medication adherence portion of the plan, a nurse notices that