OCD
Neurobiological theories
Treatment settings
Psychosocial theories and therapy
Miscellaneous
100

A client with obsessive-compulsive disorder tells the nurse, "I never thought I'd be able to survive the feeling of leaving a room without going back through the door eight times, but I just did it with my therapist!" This client's treatment most likely included: 

  • thought stopping.
  •  progressive relaxation.
  •  exposure and response prevention.
  •  cue cards.

exposure and response prevention.

100

A nurse is aware that the likelihood a client will be in adherence with psychotropic medications is affected by what? 

  • The number of other medications the client is taking.
  •  A history of taking these types of medications.
  •  Receiving education and information about the medication.
  •  The support the client has at home for taking medications.

Receiving education and information about the medication.

100

Which type of setting is used for clients who continue to need supervision but not long-term admission? 

  • Partial (day) hospitalization
  •  Voluntary commitment
  •  Nursing home
  •  Acute care
  • Partial (day) hospitalization
100

The nurse is working with a client seeking treatment for bulimia and determines that cognitive restructuring will help build the client's self-esteem. Which best describes the goals of cognitive restructuring? 

  • Use adaptive defense mechanisms
  •  Change distorted thinking and the subsequent behaviors
  •  Avoid negative self-talk
  •  Find a sounding board for identifying and discussing feelings

Change distorted thinking and the subsequent behaviors

100

The nurse is demonstrating countertransference with a client with which behavior? 

  • maintaining a professional demeanor with the client
  •  explaining to the client that it is normal for the client to feel attachment
  •  relating to the client because the client resembles a favorite cousin
  •  discussing the client’s behavior with a family member

relating to the client because the client resembles a favorite cousin

200

Which statement made by the nurse to the family of a client diagnosed with obsessive-compulsive disorder (OCD) demonstrates the best general understanding of the chronic nature of the disorder and its management? 

  • "It's important to know that the symptoms will intensify during periods of stress."
  •  "There are several comorbid conditions that can develop from the anxiety."
  •  "OCD often lasts well into adulthood."
  •  "The symptoms will require lifelong medication therapy."
  • "It's important to know that the symptoms will intensify during periods of stress."
200

Benzodiazepines increase which neurotransmitter function? 

  • Acetylcholine
  •  Norepinephrine
  • GABA
  •  Serotonin
  • GABA
200

The nurse works for a psychiatric–mental health facility that utilizes traditional milieu therapy. Which stage of milieu therapy allows for control and limitation of maladaptive behaviors including yelling and screaming? 

  • Containment
  •  Validation
  •  Structure
  •  Involvement

Structure

200

A client is undergoing individual psychotherapy. The client is yelling at the therapist because of a fight with the client's spouse about their children several years ago. In this instance, the client is exhibiting which response? 

  • Parataxis
  • Transference  
  •  Resistance
  •  Countertransference
  • Transference  
200

An instructor is teaching a class about the use of cognitive therapies in psychiatric nursing. Which statement made by a student identifies a need for further instruction? 

  • Lengths of stay for clients in inpatient settings are becoming shorter each year."
  •  "The context of practice has changed considerably over the years for psychiatric nurses."
  •  "Solution-focused approaches have been effective with hospitalized people experiencing delusions."
  •  "Lengths of stay for clients in inpatient settings are becoming longer each year."

Lengths of stay for clients in inpatient settings are becoming longer each year."

300

The nurse is providing education to a client prescribed clomipramine to help with obsessive-compulsive disorder. Which statement by the client indicates the teaching was effective? 

  • "I should be feeling better in a week once I am on the medication."
  •  "I may have a risk of suicidal thoughts with the medication."
  •  "I will not feel sleepy as a side effect of the medication."
  •  "I should take the medication on an empty stomach.

"I may have a risk of suicidal thoughts with the medication."

300

Antipsychotics function by blocking receptors of which neurotransmitter? 

  • GABA
  •  Acetylcholine
  •  Dopamine
  •  Serotonin

Dopamine

300

A client will soon be completing a course of inpatient treatment for the treatment of schizophrenia. At what point should the care team review the client's eligibility for additional services, coverage, and programs in the community? 

  • When the client and/or client's family advocates for such a review
  •  Once the client experiences an exacerbation of symptoms
  •  When requested by the client's health maintenance organization (HMO)
  •  Upon admission to the inpatient setting

Upon admission to the inpatient setting

300

Which concept states that if a certain behavior is rewarded with praise, the behavior will probably be repeated? 

  •  modeling
  •  behaviorism
  •  self-efficacy
  • operant conditioning
  • operant conditioning
300

When a therapist is interviewing a client diagnosed with depression, the client's feelings toward the client's parents as a child are being directed at the therapist. This is an example of: 

  •  countertransference.
  •  psychoanalysis.
  •  object relations.
  • transference.
  • transference.
400

The nurse is teaching a client with obsessive-compulsive disorder about cognitive restructuring. Which client statement best demonstrates effectiveness of teaching? 

  • "I may not always have harmful germs on my hands.”
  •  "I should wash my hands with lukewarm water only.”
  •  “I never need to wash my hands again.”
  •  "I can wash my hands as long as I put lotion on them.”
  • "I may not always have harmful germs on my hands.”
400

Benzodiazepines and buspirone are included in which therapeutic category? 

  • Mood stabilizers
  •  Antipsychotics
  • Anxiolytics
  •  Antidepressants
  • Anxiolytics
400

The nurse is caring for a group of clients in a residential treatment facility. While the intensive outpatient programs promote education in the areas of stress management and relapse prevention, the residential treatment facility emphasizes what? 

  • Nutritional therapies
  •  Drug abuse prevention
  •  Ensuring a sustainable living situation
  •  Spiritual aspects of care

Ensuring a sustainable living situation

400

A client refuses to talk to anyone about the recent death of the client's mother. Which defense mechanism is this client using? 

  • Suppression
  •  Displacement
  •  Sublimation
  •  Intellectualization
  • Suppression
400

A basic function of psychiatric nurses is to implement a group that focuses on helping individuals coping with their illness. This refers to ... 

  • an interactive group.
  •  a cognitive behavior therapy group.
  •  a supportive therapy group.
  •  a psychoeducational group.

a supportive therapy group.

500

A nurse is providing care to several clients with obsessive-compulsive disorder. Which client would the nurse identify as most likely to benefit from psychosurgery? 

  •  a client who has pulled out most of her hair and compulsively pulls on her eyelashes
  •  a client who picks at her skin compulsively and has frequently caused herself to bleed
  •  a client who has filled many of the rooms in his home with items that his family deems “trash”
  •  a client whose obsessive-compulsive disorder consumes most of the day’s waking hours
  •  a client with severe obsessive compulsive disorder who has not responded to conservative treatment

a client with severe obsessive compulsive disorder who has not responded to conservative treatment

500

A client receives the first dose of fluphenazine. The next day, during the follow-up appointment, the nurse finds the client is confused and mute, and the client's temperature is 103°F. The client also presents with rigidity and diaphoresis. The nurse should investigate further for which condition? 

  • Neuroleptic malignant syndrome
  •  Parkinsonism
  •  Serotonin syndrome
  •  Heatstroke
  • Neuroleptic malignant syndrome
500

The nurse is conducting an admission assessment on a client in a forensic setting. Which is a priority care issue? 

  •  Risk assessment
  •  Conditional release plan
  •  Discussion of crimes
  •  Recovery oriented care

Risk assessment

500

Two staff nurses in a psychiatric emergency department are being considered for a promotion that will be announced via memo on a unit bulletin board. They work in a collaborative team environment, have been colleagues for 15 years, and socialize outside work. Nurse A hears from a third colleague that Nurse B was promoted. Nurse A responds, “I knew I’d never get the job. The nurse manager hates me.” Nurse A is most likely demonstrating: 

  • denial.
  •  projection.
  •  reaction formation.
  •  compensation.

projection.

500

A nurse is leading a group. During the session, the nurse observes the members testing each other to see if they can trust each other. The nurse leader also notes that the members are testing the nurse, too. The nurse interprets this behavior as characteristic of which phase? 

  • Termination
  • Beginning
  •  Intermittent
  •  Working
  • Beginning