The nurse is reviewing the chart of a client diagnosed with Generalized Anxiety Disorder (GAD). Which client statement, indicating a core characteristic of GAD, should the nurse expect to find documented?
A. "I am absolutely terrified of spiders and avoid the garage."
B. "I constantly anticipate the worst outcome in everyday situations."
C. "The intrusive thoughts are terrible, but the hand washing makes them stop."
D. "I intentionally exaggerate my symptoms to receive attention from the staff."
B. "I constantly anticipate the worst outcome in everyday situations."
A client presents to the emergency department with an acute onset (24-48 hours) of fluctuating confusion and altered mental status. The nurse recognizes this presentation as a hallmark characteristic of which disorder?
A. Alzheimer's Disease
B. Dementia
C. Lewy Body Dementia
D. Delirium
D. Delirium
The nurse is assessing a client for Major Depressive Disorder (MDD). Which classic symptom should the nurse expect to find?
A. Euphoria
B. Anhedonia
C. Hyperactivity
D. Flight of Ideas
B. Anhedonia
A client is in crisis, displaying intense emotional responses and erratic behavior, which includes making threats to harm others. What is the nurse's first and highest priority intervention?
A. Call the client's family.
B. Safety
C. Teach coping strategies.
D. Provide a relaxation technique.
B. Safety
A client with Major Depressive Disorder (MDD) states, "I just want this all to end." What is the nurse's priority next action?
A. Document the statement in the client's chart.
B. Initiate therapeutic communication by asking, "Tell me more about the problems that are important to you?".
C. Ask the client, "Do you have a plan?".
D. Tell the client to practice relaxation techniques.
C. Ask the client, "Do you have a plan?".
A client is experiencing an intense, sudden onset of fear, chest tightness, shortness of breath, and a rapid heart rate. What is the priority nursing intervention for this client?
A. Instruct the client to try guided imagery.
B. Leave the client alone in a quiet room to de-escalate.
C. Stay with the client and provide calming reassurance.
D. Encourage the client to verbalize their feelings immediately.
C. Stay with the client and provide calming reassurance.
The nurse is caring for a client with Alzheimer's Dementia who is having difficulty with tasks like brushing their teeth and getting dressed, despite having the physical ability. The nurse documents this symptom as:
A. Agnosia
B. Confabulation
C. Apraxia
D. Aphasia
C. Apraxia
A client is prescribed an SSRI for a depressive disorder. What is the most critical education point the nurse must emphasize regarding this medication?
A. SSRIs have a Black Box Warning (BBW) for increased suicidal ideation.
B. The medication works immediately to relieve all depressive symptoms.
C. The client should stop taking the medication if they experience nausea.
D. It is safe to take with alcohol to enhance the sedative effect.
A. SSRIs have a Black Box Warning (BBW) for increased suicidal ideation.
The nurse is implementing care for a client with Generalized Anxiety Disorder (GAD). Which environment-related intervention is most therapeutic?
A. Introduce multiple new stimuli to distract the client.
B. Provide a calm and quiet environment with minimal stressors.
C. Encourage the client to practice avoidance behaviors.
D. Engage the client in a loud group activity immediately.
B. Provide a calm and quiet environment with minimal stressors.
A nurse is teaching a client about a newly prescribed SSRI. Which instruction is correct regarding the effectiveness of the medication?
A. The client should expect to feel better within 72 hours.
B. Improvement typically takes 4 to 6 weeks to show.
C. The medication should be adjusted early if side effects occur.
D. Taking the medication with alcohol will enhance its effectiveness
B. Improvement typically takes 4 to 6 weeks to show.
Which client statement is most indicative of Post-Traumatic Stress Disorder (PTSD) symptoms following a traumatic event?
A. "I can't seem to stop scrubbing my hands."
B. "My worry about my family is excessive and uncontrollable."
C. "I frequently have nightmares and feel irritable."
D. "I am intensely afraid of heights, so I avoid tall buildings."
C. "I frequently have nightmares and feel irritable."
Which nursing intervention is essential when caring for a client with delirium?
A. Restrain the client to prevent injury.
B. Provide complex, multi-step instructions.
C. Monitor the client frequently to maintain safety.
D. Assume the cause is psychological and begin therapy.
C. Monitor the client frequently to maintain safety.
A client has been diagnosed with a chronic, low-level depressive mood that has lasted for at least two years. The nurse documents this as:
A. Major Depressive Disorder (MDD)
B. Premenstrual Dysphoric Disorder (PMDD)
C. Seasonal Affective Disorder (SAD)
D. Persistent Depressive Disorder (PDD)
D. Persistent Depressive Disorder (PDD)
When using therapeutic communication with a client with moderate-stage dementia, the nurse should:
A. Argue with the client when they state something factually incorrect.
B. Offer simple, step-by-step guidance to promote independence.
C. Challenge the client's feelings and redirect the topic away from the past.
D. Use complex, lengthy sentences to fully explain tasks.
B. Offer simple, step-by-step guidance to promote independence.
Which statement accurately describes Factitious Disorder?
A. It is characterized by the chronic, non-intentional experience of physical symptoms.
B. The client is excessively preoccupied with the fear of having a serious illness.
C. It involves the intentional production or exaggeration of symptoms to gain attention.
D. It is a disorder where the physical symptoms are volitional and ill-intended by the client.
C. It involves the intentional production or exaggeration of symptoms to gain attention.
A client with Obsessive-Compulsive Disorder (OCD) frequently performs a ritual of checking locks. What is the appropriate initial nursing intervention?
A. Implement a restriction on the compulsive behavior immediately.
B. Allow the compulsive behavior to occur unless it poses a safety risk.
C. Assign a staff member to stop the client every time they start checking the locks.
D. Tell the client to use deep breathing instead of performing the compulsion.
B. Allow the compulsive behavior to occur unless it poses a safety risk.
A client with Lewy Body Dementia is experiencing visual hallucinations. Which intervention demonstrates a reality-based approach for this client?
A. Correcting the client by stating, "There is no one there."
B. Administering an antipsychotic and leaving the room.
C. Distracting the client by focusing on real people and situations.
D. Encouraging the client to ignore the hallucination.
C. Distracting the client by focusing on real people and situations.
Cognitive Behavioral Therapy (CBT) for a client with depression focuses primarily on which therapeutic goal?
A. Exploring childhood trauma as the root cause of all symptoms.
B. Focusing on identifying and changing negative thought patterns.
C. Achieving complete freedom from any negative emotions.
D. Providing a weekly, unstructured social support system.
B. Focusing on identifying and changing negative thought patterns.
Which intervention is essential for a client with Post-Traumatic Stress Disorder (PTSD) who struggles with concentration and irritability?
A. Obtain the client's verbal permission before any procedures requiring touch.
B. Instruct the client to increase their consumption of alcohol.
C. Discuss the traumatic event in detail immediately upon admission.
D. Disregard the client's need for autonomy regarding their care.
A. Obtain the client's verbal permission before any procedures requiring touch.
A client with Somatic Symptom Disorder (SSD) reports severe back pain. The most therapeutic nursing intervention is to:
A. Confront the client that the pain is "all in their head."
B. Immediately obtain an order for strong opioid pain medication.
C. Acknowledge the physical symptom while exploring potential emotional triggers.
D. Dismiss the client's symptom because medical tests were negative.
C. Acknowledge the physical symptom while exploring potential emotional triggers.
A nurse is discharging a client with a new diagnosis of a specific phobia. Which teaching point is the most important for the nurse to include in the discharge plan?
A. The phobia will likely disappear with positive thinking alone.
B. Medications will eliminate the need for continued therapy.
C. Exploring the underlying feelings that cause the irrational fear is an important part of treatment.
D. Exposure to the feared stimulus should be sudden and without warning to desensitize the client quickly.
C. Exploring the underlying feelings that cause the irrational fear is an important part of treatment.
A nurse is providing education on Donepezil (Aricept) to the family of a client newly diagnosed with Alzheimer's disease. The nurse should include which teaching point about this medication?
A. It is typically prescribed for severe stages of the disease.
B. It works by decreasing the level of acetylcholine.
C. It can slow the cognitive decline but does not stop the disease progression.
D. It is an NMDA receptor antagonist that regulates glutamate activity.
C. It can slow the cognitive decline but does not stop the disease progression.
A client with a history of a suicide attempt who has been taking an SSRI for one month reports an increase in mood and energy. What is the nurse's priority action?
A. Congratulate the client on the medication's success.
B. Decrease the client's constant observation level.
C. Recognize this as a concerning sign and increase monitoring for suicidal ideation.
D. Encourage the client to immediately return to work and social activities.
C. Recognize this as a concerning sign and increase monitoring for suicidal ideation.
The client with Major Depressive Disorder (MDD) is refusing to participate in the scheduled structured group therapy. What is the nurse's best response?
A. "I will come back in an hour to give you time to change your mind."
B. "Group therapy is a key intervention for social support and coping skills in MDD."
C. "You must attend this group or you will be placed on observation."
D. "I see you are sad; I will let you skip the group today."
B. "Group therapy is a key intervention for social support and coping skills in MDD."
A client reports experiencing symptoms of fatigue, sadness, and difficulty concentrating that occur specifically during the late fall and winter months but resolve in the spring. The nurse recognizes that this client is likely experiencing which condition?
A. Persistent Depressive Disorder (PDD)
B. Major Depressive Disorder (MDD)
C. Premenstrual Dysphoric Disorder (PMDD)
D. Seasonal Affective Disorder (SAD)
D. Seasonal Affective Disorder (SAD)