2025/2026 NR 326 Exam 1 | Questions and Answers (Complete Solutions)

2025/2026 NR 326 Exam 1 | Questions and Answers (Complete Solutions) Three years ago, Anna's dog, Lucky, her pet for 16 years, was killed by a car. Since that time, Anna has lost weight, rarely leaves her home, and talks excessively about Lucky. Anna's behavior would be considered maladaptive for which of the following reasons? a. It has been more than 3 years since Lucky died. b. Her grief is too intense over the loss of a dog. c. Her grief is interfering with her functioning. d. Cultural norms typically do not comprehend grief over the loss of a pet. Anna states that Lucky was her closest friend, and since his death, no one can ever replace the relationship they had. According to Maslow's hierarchy of needs, which level of need is not being met? a. Physiological needs b. Self-esteem needs c. Safety and security needs d. Love and belonging needs Anna's daughter notices that Anna appears to be listening to another voice when just the two of them are in a room together. When questioned, Anna admits that she hears someone telling her that she was a horrible caretaker for Lucky and did not deserve to ever have a pet. Which of the following best describes what Anna is experiencing? a. Neurosis b. Psychosis c. Depression d. Bereavement Anna, who is 72 years old, is at the age when she may have experienced several losses in a short time. What is this called? a. Bereavement overload b. Normal mourning c. Isolation d. Cultural relativity Anna has been grieving the death of Lucky for 3 years. She is unable to take care of her normal activities because she insists on visiting Lucky's grave daily. What is the most likely reason that Anna's daughter has put off seeking help for Anna? a. Women are less likely than men to seek help for emotional problems. b. Relatives often try to normalize 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." Lucky's accident occurred when he got away from Anna while they were taking a walk. He ran into the street and was hit by a car. Anna cannot remember the circumstances of his death. This is an example of what defense mechanism? a. Rationalization b. Suppression c. Denial d. Repression A client with a history of schizophrenia is brought to the emergency department by police who report that she was knocking down food displays at a grocery store and yelling that the food is all poisoned. The client reports to the nurse the she has no idea why she was brought to the emergency department because "there is nothing wrong with me." Which of these actions by the nurse demonstrates good clinical judgment? a. Instruct the police officer that this client should be incarcerated because there is nothing that can be done in an emergency department. b. Document that the client is manifesting suspicious ideation and anosognosia. c. Ask the doctor to order gastric lavage because the client reports having been poisoned. d. Instruct the client that the food is not poisoned and there is something very wrong with her. During a primary care physician appointment, a client who has been a widow for 7 years reports to the nurse that she does not want to wake up in the morning and feels there is nothing left for her. Which of these actions by the nurse is a priority? a. Listen empathically and encourage the client to find some activities to increase socialization. b. Encourage the client to discuss this with her physician. c. Assess the client for symptoms of depression and suicide risk. d. Instruct the client that grief takes a long time to resolve but that she will be feeling better soon. A client who has arrived at the health clinic for diabetic education is perspiring, wringing his hands, and states, "I'm so anxious about giving myself shots I can hardly breathe. I don't know what to do." Which of these actions by the nurse demonstrates good clinical judgment? a. Assist the client in relaxation exercises before commencing diabetes education. b. Instruct the client that it is not hard to give oneself a shot and commence teaching. c. Assess the client further for symptoms of anxiety. d. Cancel diabetic education and encourage the client to reschedule when he feels less anxious. A client who was admitted to the psychiatric unit for major depressive disorder reports to the nurse, "Ever since my daughter died by suicide 10 years ago, I can't stand to be around my friends. They just don't get it!" Which of these actions by the nurse demonstrates good clinical judgment? a. Affirm that other people cannot possibly provide adequate support in circumstances like these. b. Assist the client to explore the connection between grief and anger. c. Tell the client that her friends are doing the best they can and she should try to accept their support. d. Ask the client to describe how her daughter killed herself. The nurse 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 The nurse 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 The nurse 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 The nurse assists the physician with electroconvulsive therapy on a 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 competent, voluntary client has stated he wants to leave the hospital. The nurse hides his clothes 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 Joe is very restless and is pacing the room. 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 nurse reports to the supervisor that a depressed client is refusing medication to treat his heart condition and states he "would rather just die." The nurse is not sure how to intervene because, although clients have a right to refuse medication, this client may be so depressed that his behavior represents risk for suicide. Which of these actions by the supervisor is a priority? a. Tell the nurse that medication will have to be given forcibly if the client continues to refuse medication. b. Instruct the nurse that, because the client is elderly, he is unable to make this decision and medication will need to be secretly mixed in his food. c. Educate the nurse that the physician has the final say so the nurse should ask the physician what to do. d. Activate appropriate hospital resources, such as an ethics committee, so this issue can be explored further. A client on the psychiatric unit begins yelling out loud that no one is listening to him and that he is going to "blow up" soon. The orderly asks the nurse if he should go ahead and put the client in restraints for the safety of others. Which of these responses by the nurse is most appropriate? a. Educate the orderly that restraints may never be initiated without a physician's order. b. Instruct the orderly that it would be best to see if the client can be assisted to calm down by listening to his concerns. c. Instruct the orderly to put the client in restraints but make sure to assess the client every 15 minutes for issues regarding circulation, nutrition, respiration, hydration, and elimination. d. Instruct the orderly to get others to assist him in restraining the client but be aware restraints should be discontinued at the earliest possible time regardless of when a physician's order is scheduled to expire. The nurse collects the following information during the admission assessment. For which of these pieces of data should the nurse take additional action to ensure that "duty to warn" laws are followed? a. The client threatens violence toward another individual. b. The client states he wants to kill everyone that has demons. c. The client is having command hallucinations. d. The client reveals paranoid delusions about another individual. Which of these actions by the nurse demonstrates an application of the QSEN competency related to informatics? a. Learns how to effectively communicate information using electronic health records b. Provides a verbal report of client behavioral issues at shift change c. Asks the supervisor for guidelines on how to prevent lawsuits d. Reads journals to learn information about new treatments and approaches to nursing care 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 patient. b. The nurse shares the details of her divorce with the patient. c. The nurse makes arrangements to meet the patient outside of the therapeutic environment. d. The nurse shares how she dealt with a similar difficult situation. Which of the following tasks are associated with the orientation phase of relationship development? (Select all that apply.) a. Promoting the patient'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 patient from various sources e. Formulating nursing diagnoses and setting goals The nurse, who is an adult child of an alcoholic, is working with a client who abuses alcohol. The client has experienced a successful detoxification process and is beginning a rehabilitation program. He says to the nurse, "I'm not going to go to those stupid AA meetings. They don't help anything." The nurse, whose father died of complications from alcoholism, responds with anger: "Don't you even care what happens to your children?" The nurse's response is an example of which of the following? a. Transference b. Countertransference c. Self-disclosure d. A breach of professional boundaries The nurse is working with a client in the anger-management program. Which of the following identifies actions associated with the working phase of the therapeutic relationship? a. The nurse and the client work together to identify goals for developing more adaptive ways to handle anger. b. The client expresses a desire to continue in the anger management program after the goals have been met. c. The nurse reviews the client's medical record and assesses his or her personal feeling about working with a client who abused their spouse. d. The nurse assists the client in practicing various techniques to effectively manage anger and provides positive feedback when the client attempts to improve maladaptive behaviors. When there is congruence between what is felt and what is expressed, the nurse is exhibiting which of the following characteristics? a. Trust b. Respect c. Genuineness d. Empathy 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 A client who is being discharged from an inpatient hospital stay has his wife bring a box of chocolates and a bouquet of flowers for his primary nurse. He presents these gifts to the nurse, saying, "Thank you for taking care of me." What is the most appropriate 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." A client states 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 client with schizophrenia appears very watchful of others and tells the nurse, "There are infiltrators everywhere and I think they are trying to kill me." Which of these actions by the nurse would best promote development of trust with this client? a. Touch the client's shoulder and state, "I want you to feel safe here." b. State to the client, "I'm interested in hearing your thoughts. Would you like to talk more about this?" c. Ask the client, "Why would you think such a thing?" d. Tell the client, "It is an expectation that we will not talk about things that aren't real." A client is being discharged from the inpatient psychiatric unit and states to his primary nurse, "Everyone abandons me and now you're probably going to abandon me, too." Which of these actions by the nurse best accomplishes termination of the therapeutic relationship? a. Discuss the boundaries of this relationship and assist the client to explore his feelings. b. Terminate the therapeutic relationship while exploring ways to remain connected as friends. c. Provide discharge medication instructions and encourage the client to follow up with his physician. d. Assure the client that he is not being abandoned and remind him that he can return to the unit in the future. A client who is angry with his psychiatrist 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 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 The environment in which 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 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 A client who has been in rehabilitation for alcohol dependence returns from a visit to his home and tells the nurse, "We were having a celebration and I did have one drink, but it really wasn't a problem." The nurse notices that his breath smells of alcohol. Which of the following responses by the nurse demonstrates a motivational interviewing style of communication? a. "You are obviously not motivated to change, so perhaps we should discuss your discharge from the treatment program." b. "You need to abstain from alcohol in order to recover, so let me talk to the doctor about the consequences of your behavior." c. "Why would you destroy everything you've worked so hard to achieve?" d. "What do you mean when you say, 'It really wasn't a problem'?" A client who has been diagnosed with schizophrenia and has been on medication for several months states, "I'm not taking that stupid medication anymore." Which of the following responses by the nurse demonstrates a motivational interviewing style of communication? a. "Don't you know that if you don't take your medication you will never recover?" b. "Why won't you cooperate with the treatment your doctor prescribed?" c. "Bill, the medication is not stupid." d. "Tell me more about why you don't want to take the medication." 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 most 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." A depressed client who has been unkempt and untidy for weeks comes to group therapy today wearing makeup and a clean dress with hair washed and combed. Which of the following responses by the nurse is most appropriate? a. "I see you have put on a clean dress and combed your hair." b. "You look wonderful today!" c. "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 client 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?" A client, who has been in the hospital for 3 weeks, has used Valium "to settle her 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 need 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. "Let's explore some things 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." A client 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." An adolescent who has just returned from group therapy 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?" 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. 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. Which of the following events would likely precipitate a crisis? (Select all that apply) a. First-time parenthood when the parents perceive they have inadequate support and education. b. Receiving a pay raise when the worker perceived they had to work very hard to accomplish their financial goals. c. A natural disaster such as a forest fire in which lives and property were lost. d. A peer or family member dies by suicide. Which of the following is a desired outcome of working with an individual who has witnessed a traumatic event and is now experiencing panic anxiety? a. The individual will experience no anxiety. b. The individual will demonstrate hope for the future. c. The individual will identify that anxiety is at a manageable level. d. The individual will verbalize the acceptance of self as worthy. The client, a firefighter who responded to an industrial explosion, lost a coworker and close friend when they entered a building that collapsed. The client reports that since this event, he has had frequent nightmares and anxiety attacks. He says to the mental health worker, "I should have died, but instead I lost my best friend!" This statement suggests that the client is experiencing: a. Spiritual distress. b. Night terrors. c. Survivor's guilt. d. Suicidal ideation A client whose home was destroyed during a tornado expresses to the nurse that she is has been having disabling anxiety and nightmares for the last 2 weeks following this disaster. The most appropriate crisis intervention 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. A teenager tells the high school nurse that her parents are drinking alcohol every day and she doesn't know what to do. Her grades are starting to drop, and she complains of feeling anxious and overwhelmed. The most appropriate nursing action in response to the client's complaint would be to: a. Facilitate 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 cope with her home situation A college student, who is an only child and attending school 500 miles away from his parents, reports to the nurse practitioner at the student health center that he has been having difficulty making decisions and will not undertake anything new without first consulting his mother. He has recently started having anxiety attacks. Which nursing action is most appropriate in response to this client's maturational crisis? a. Suggest that he move to a college closer to home. b. Help him to explore unresolved dependency issues. c. Help him find someone in the college town from whom he could seek assistance rather than calling his mother regularly. d. Recommend that the college physician prescribe an antianxiety medication for him. A client is brought to the emergency department by her college roommate and appears to be emotionless. The client reports that she was raped at a party earlier that evening. Which of these actions by the nurse is a priority? a. Ask the client if she would like to shower before she is examined. b. Confront the client about her apparent lack of emotion and ask if this was consensual sex. c. Affirm the client for seeking help and ask her to describe what happened. d. Ask the roommate if the client is typically so emotionless. A client is admitted to the inpatient psychiatric unit after a suicide attempt. He reports that he has a history of depression but he became acutely suicidal after he recently lost his job. Which of these nursing actions is a priority in response to this client's psychiatric crisis? a. Assess why the client lost his job. b. Ensure that the client remains safe and free from further self-injury. c. Explore career interests and other job opportunities. d. Assess for substance use disorder. Your spouse says, "You're crazy to think about going to college! You're not smart enough to handle the studies along with everything else." 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): "I'll just go anyway and keep it a secret." 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!" 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." 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?" A spouse comes home from work and angrily 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 intentionally takes a long time to cook the meal. b. "I'm tired, too. 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!" 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 client on the psychiatric unit approaches the nurse, strokes the nurse's arm, and says, "Why don't you be a sweetie and get me some pain medication." Which of these actions by the nurse demonstrates the best clinical judgment? a. Ignore the client's behavior and assess pain level. b. Inform the client that patronizing attitudes are not the best way to get more pain medication. c. Tell the client that this behavior is not appropriate and clarify unit rules and policies regarding touching others. d. Tell the client, "If you call me sweetie or touch me one more time I will call security and have you restrained." A client tells the nurse, "I know I need to communicate more assertively, but I don't really know how." Which of these is the best response by the nurse? a. Inform the client that you will make a referral to an advanced practice nurse because generalist nurses are not within their scope of practice to teach assertiveness skills. b. Affirm that the client must know how to communicate assertively because they just did communicate their needs. c. Instruct the client that as long as they use "I" statements their communication will be assertive. d. Ask the client to further describe their concerns and offer to provide education in assertiveness skills. During a client education group on assertiveness skills, a client asks a question while some other group members are carrying on a separate conversation, appearing not to listen. The client states, "When you appear not to be listening, I feel disrespected. I need for the group to listen to my question." How should the nurse respond to this event? a. Reinforce that the client used assertive communication to express their needs and support that respect for other group members includes not having private conversations during the group. b. Tell the client to ask the question again and speak louder. c. Instruct the client that no one is being disrespectful but their low self-esteem may be influencing their perception. d. Terminate the group and offer to talk with the client privately about their questions. A nurse is approached by a mental health technician who states, "I need for you to do 15-minute checks on my clients because I've got too many other things to do." This has been a regular occurrence with the mental health technician, and other staff members have complained that this worker is "just being lazy." Which of these is the best response by the nurse? a. Commend the technician for using good "I" communication. b. Instruct the technician that his peers think he is just being lazy. c. Reinforce to the technician that everyone is busy. d. State to the technician the expectation that he will complete his assigned duties. A physician approaches the nurse, yelling loudly and stating, "You must be the stupidest person to ever get out of nursing school. I said I wanted vital signs on this client every 4 hours and there are no recordings of temperatures. Do I need to teach you what vital signs are?" Which of these is the best response by the nurse? a. "Yes, doctor, I know what vital signs are." b. "I will try to find the information you are looking for, but I don't appreciate your belittling comments. I need for you to treat me with respect." c. "If you weren't so stupid you would know that the temperatures are recorded on a separate graph in the electronic health record." d. "I'm not doing a thing for you until you treat me with respect." A new client on the psychiatric unit is 35 years old. Theoretically, in which level of psychosocial development (according to Erikson) would you expect this client to be? a. Intimacy vs. isolation b. Generativity vs. self-absorption c. Trust vs. mistrust d. Autonomy vs. shame and doubt A client who has been diagnosed with schizophrenia refuses to eat and tells the nurse he knew he was "being poisoned." According to Erikson's theory, in what developmental stage is this client? a. Intimacy vs. isolation b. Generativity vs. self-absorption c. Trust vs. mistrust d. Autonomy vs. shame and doubt A psychiatric client diagnosed with borderline personality disorder has just been hospitalized for threatening suicide. According to Mahler's theory, the client did not receive the critical "emotional refueling" required during the rapprochement phase of development. What are the consequences of this deficiency? a. She has not yet learned to delay gratification. b. She does not feel guilt about wrongdoings to others. c. She is unable to trust others. d. She has internalized rage and fears of abandonment. A client on a chemical dependence treatment unit walks into the dayroom where other clients are watching a program on TV, picks up the remote, and changes the channel, stating, "That's a stupid program! I want to watch something else!" In what stage of development is John fixed according to Sullivan's interpersonal theory? a. Juvenile. He is learning to form satisfactory peer relationships. b. Childhood. He has not learned to delay gratification. c. Early adolescence. He is struggling to form an identity. d. Late adolescence. He is working to develop a lasting relationship. A client with antisocial personality disorder says to the nurse, "I'm not crazy. I'm just fun-loving. I believe in looking out for myself. Who cares what anyone thinks? If it feels good, do it!" Which of the following describes the psychoanalytical structure of this client's personality? a. Weak id, strong ego, weak superego b. Strong id, weak ego, weak superego c. Weak id, weak ego, punitive superego d. Strong id, weak ego, punitive superego A client with antisocial personality disorder feels no guilt about violating the rights of others. He does as he pleases without thought to possible consequences. In which of Peplau's stages of development would you place this client? a. Learning to count on others b. Learning to delay gratification c. Identifying oneself d. Developing skills in participation A client has been admitted with a diagnosis of schizophrenia. On the psychiatric unit he appears very anxious, paces back and forth, and darts his head from side to side in a continuous scanning of the area. He has refused to eat, making a barely audible comment related to "being poisoned." In planning care for Danny, which of the following would be the primary focus for nursing? a. To decrease anxiety and develop trust b. To set limits on his behavior c. To ensure that he gets to group therapy d. To attend to his hygiene needs The nurse has just admitted a client to the psychiatric unit with major depressive disorder. The client states, "I just need someone to talk to right now about all these feelings I'm having." Which of Peplau's identified nursing roles would be best for the nurse to assume at this point? a. Surrogate b. Resource person c. Counselor d. Technical expert A client has been admitted to the psychiatric unit and states to the nurse, "I've never been on a psych unit before, what am I supposed to do now?" Which of Peplau's identified nursing roles would be most appropriate for the nurse to assume at this point? a. Resource person b. Counselor c. Surrogate d. Technical expert A client admitted to the psychiatric unit has just been ordered electroconvulsive therapy and states she's not sure what it does but that it sounds "pretty scary." Which of Peplau's identified nursing roles would be most appropriate for the nurse to assume at this point? a. Counselor b. Technical expert c. Surrogate d. Stranger A client is admitted to the psychiatric unit with depression. Which of these activities by the nurse is a priority? a. Assess the client's risk for suicide. b. Establish a care plan that includes suicide precautions. c. Contact the physician for orders. d. Orient the client to unit activities. The nurse is transferring a client to a different unit and is providing a transfer report to the nurse that will be receiving this client. The receiving nurse asks what medications this client received within the last 2 hours. Which source should the nurse use to convey this information? a. Handwritten notes from a shift change report. b. Memory of what was given to the client earlier. c. The electronic health record. d. All of the above. Which of the following nursing diagnoses would be the priority diagnosis for the client described in question 7? a. Social isolation b. Disturbed body image c. Low self-esteem d. Imbalanced nutrition: Less than body requirements A 15-year-old female client is admitted to the adolescent psychiatric unit with a diagnosis of anorexia nervosa. She is 5 feet 5 inches tall and weighs 82 pounds. She was selected to join the cheerleading squad for the fall but states that she is not as good as the others on the squad. The treatment team has identified the following problems: refusal to eat, occasional purging, refusing to interact with staff and peers, and fear of failure. Which of the following nursing diagnoses would be appropriate for this client? (Select all that apply.) a. Social isolation b. Disturbed body image c. Low self-esteem d. Imbalanced nutrition: Less than body requirements