actions are appropriate with this type of relationship? Select all that apply.
a. Identify and meet the needs and specific desires of the client.
b. Help the client explore different problem-solving techniques.
c. Encourage the practice of new coping skills.
d. Give advice to the client.
e. Exchange personal information with the client.
f. Discuss the client’s feelings with her family members.
2. A nurse knows that her initial approach to a rape victim should aim to decrease the client’s
anxiety. Which of the following interventions would be appropriate? Select all that apply.
a. Admit the client to the treatment area right away.
b. Encourage the client to undergo an examination immediately in order to get it behind her.
c. Assure the client that she’s safe in the examination room.
d. Touch the client early on so that she knows the nurse is supportive.
e. Allow a third party to be present if the client requests it.
f. Ask “what” questions to determine the type of assault.
3. A hospitalized client becomes angry and belligerent toward a nurse after speaking on the phone with
his mother. The nurse learns that the mother can’t visit as expected. Which interventions might the
nurse use to help the client deal with his displaced anger? Select all that apply.
a. Explore the client’s unmet needs.
b. Avoid the client until he apologizes.
c. Suggest that the client direct his anger at his mother.
d. Invite the client to a quiet place to talk.
e. Assist the client in identifying alternate ways of approaching the problem.
4. Electroconvulsive therapy (ECT) is an effective treatment for severe depression when which of the
following conditions are present? Select all that apply.
a. The client also has dementia.
b. The client can’t tolerate tricyclic antidepressants.
c. The client lives in a long-term care facility.
d. The client is undergoing a stressful life change.
e. The client is having acute suicidal thoughts
5. When psychiatric nurses intitiate therapeutic relationships with clients, they must be aware of
client testing behaviors. Which of the following situations demonstrate testing behaviors from a client? Select all that apply.
a. Placing the nurse in the role of parent
b. Dressing in a flamboyant or seductive manner
c. Requesting personal information from the nurse
d. Following the contract established between the nurse and client
e. Stating information to try to shock the nurse
f. Violating the nurse’s personal space
6. In the emergency department, a client reveals to the nurse a lethal plan for committing suicide and
agrees to a voluntary admission to the psychiatric unit.Which information should the nurse discuss
with the client to answer the question “How long do I have to stay here?” Select all that apply.
a. “You may leave the hospital at any time unless you’re suicidal or homicidal or unable to meet
your basic needs.”
b. “Let’s talk more after the health care team has assessed you.”
c. “Once you’ve signed the papers, you have no say.”
d. “Because you could hurt yourself, you must be safe before being discharged.”
e. “You need a lawyer to help you make that decision.”
f. “There must be a court hearing before you can leave the hospital.”
7. A nurse has developed a relationship with a client who has an addiction problem. Which actions
would indicate that the therapeutic interaction is in the working phase? Select all that apply.
a. The client discusses how the addiction has contributed to family distress.
b. The client reluctantly shares the family history of addiction.
c. The client verbalizes difficulty identifying personal strengths.
d. The client discusses the financial problems related to the addiction.
e. The client expresses uncertainty about what topic to discuss.
f. The client acknowledges the addiction’s effects on his children.
8. A nurse is caring for a client diagnosed with dysthymia.Which of the following defining characteristics are associated with this disorder? Select all that apply.
a. Insomnia or hypersomnia
b. Delusions or hallucinations
c. Suicidal thoughts
d. Onset of symptoms within a 2-week period
e. Symptoms that occur in the winter and resolve in spring
f. Appetite disturbance
9. After interviewing a client diagnosed with recurrent depression, a nurse determines the client’s
potential to commit suicide. Which of the factors listed below might contribute to the client’s risk for suicide? Select all that apply.
a. Psychomotor retardation
b. Impulsive behaviors
c. Overwhelming feelings of guilt
d. Chronic, debilitating illness
e. Decreased physical activity
f. Repression of anger
10. A physician prescribes lithium for a client diagnosed with bipolar disorder. Which of the
following topics should a nurse cover when teaching the client?
Select all that apply.
a. Potential for addiction
b. Signs and symptoms of drug toxicity
c. Potential for tardive dyskinesia
d. Importance of a low-tyramine diet
e. Need to consistently monitor blood levels
f. Amount of time that may be needed for mood changes to occur
11. A nurse is assessing a client for dementia. What history findings would the nurse expect to learn
while talking with the client and her family? Select all that apply.
a. The progression of symptoms has been slow.
b. The client admits to feelings of sadness.
c. The client acts apathetic and pessimistic.
d. The family can’t determine when the symptoms first appeared.
e. The client has been exhibiting basic personality changes.
f. The client has great difficulty paying attention to others.
12.A 40-year-old executive who was unexpectedly laid off from work 2 days earlier complains of fatigue
and an inability to cope. He admits drinking excessively over the previous 48 hours. This behavior is
an example of:
a)alcoholism.
b)a manic episode.
c)situational crisis.
d)depression
13.The family of an older adult wants their mother to have counseling for depression. During the
initial nursing assessment, the client denies the need for counseling. Which of the following comments
by the client supports the fact that the client may not need counseling?
a)"My doctor just put me on an antidepressant, and I'll be fine in a week or so."
b)"My daughter sent me here. She's mad because I don't have the energy to take care of my grandkids."
c)"Since I've gotten over the death of my husband, I've had more energy and been more active than
before he died."
d)"My son got worried because I made this silly comment about wanting to be with my husband in
heaven."
14.A client with a tentative diagnosis of psychosis is admitted to the psychiatric unit. A physician
orders the phenothiazine thioridazine 50 mg by mouth three times per day. Phenothiazines differ from
central nervous system (CNS) depressants in their sedative effects by producing:
a)deeper sleep than CNS depressants.
b)greater sedation than CNS depressants.
c)a calming effect from which the client is easily aroused.
d)more prolonged sedative effects, making the client more difficult to arouse.
15.Family members of a client with bipolar disorder tell a nurse that they are concerned that the
client is becoming manic. The nurse knows that the manic phase is marked by:
a)flight of ideas and inflated self-esteem.
b)increased sleep and greater distractibility.
c)decreased self-esteem and increased physical restlessness.
d)obsession with following rules and maintaining order
16.A client is irritable and hostile. He becomes agitated and verbally lashes out when his personal
needs are not immediately met by the staff. When the client's request for a pass is refused by the
primary care provider, he utters a stream of profanities. Which of the following statements best
describes the client's behavior?
a)The client's anger is not intended personally.
b)The client's anger is a reliable sign of serious pathology.
c)The client's anger is an intended attack on the primary care provider's skills
d)The client's anger is a sign that his condition is improving
17.The major goal of therapy in crisis intervention is to:
a)withdraw from the stress.
b)resolve the immediate problem.
c)decrease anxiety.
d)provide documentation of events
18.A nurse is instructing a client with bipolar disorder on proper use of lithium carbonate
(Eskalith), the drug's adverse effects, and symptoms of lithium toxicity. Which client statement
indicates that additional teaching is required?
a)"I can still eat my favorite salty foods."
b)"When my moods fluctuate, I'll increase my dose of lithium."
c)"A good blood level of the drug means the drug concentration has stabilized."
d)"Eating too much watermelon will affect my lithium level."
19.At an outpatient visit 3 months after discharge from the hospital, a client says he has stopped his
olanzapine (Zyprexa) even though it controls his symptoms of schizophrenia better than other
medications. "I have gained 20 lb already. I can't stand any more." Which response by the nurse is
most appropriate?
a)"I don't think you look fat, why do you think so?"
b)"I can help you with a diet and exercise plan to keep your weight down."
c)"You can be switched to another medicine."
d)"Your weight gain will level off if you stay on the medication 3 more months."
20.The nurse should assess the client who is taking risperidone (Risperdal) 1 mg, orally twice a day for:
a)Insomnia.
b)Headache.
c)Anxiety.
d)Orthostatic hypotension
Answer And Reason
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