Show:
Mood Disorders: Bipolar
Anxiety Disorders
Personality Disorder
Electroconvulsive Therapy
Somatoform Disorders
100
A client with bipolar I disorder is very manic and is unable to eat or sleep. Her moods hang rapidly from elated to very irritable. If this client threatens to hit a staff member or another client, which of the following verbal responses by the nurse would be most appropriate? ________________________________________________A. "We will have to restrain you immediately if you try that once more!" ________________________________________________B. "Do not hit him or me. If you are unable to control yourself, we will help you." ________________________________________________C. "Stop that right now! No one did anything to you and you have no reason to attack us." ________________________________________________D. "You know better than this. Why do you continue this behavior?"
B. "Do not hit him or me. If you are unable to control yourself, we will help you."
100
When assessing a client who states she has been dealing with instant anxiety for the past weeks, the nurse's questions should be ________________________________________________A. be open-ended. ________________________________________________B. be reasoning. ________________________________________________C. minimize the client's anxiety. ________________________________________________D. be postponed until the anxiety has subsided.
A. be open-ended.
100
A client arrived on the psychiatric unit from the emergency department. his diagnosis is personality disorder, and he exhibits manipulative behavior. As the nurse reviews the unit rules with him, the client asks "Can I go to the snack shop just one time and then I will answer whatever you ask?" What is the nurse's most appropriate response? ________________________________________________A. "Yes, but hurry, because I need to finish your assessment." ________________________________________________B. "Okay but be back in 5 minutes." ________________________________________________C. "No, you can't go." ________________________________________________D. "No, you can't go. The rules here apply to everyone."
D. "No, you can't go. The rules here apply to everyone."
100
For which of the following should the nurse monitor during or immediately following ECT therapy? (Select all that apply) ________________________________________________A. Hypotension or hypertension ________________________________________________B. Heart rate changes ________________________________________________C. Intestinal obstruction ________________________________________________D. Confusion ________________________________________________E. Nausea
A. Hypotension or hypertension B. Heart rate changes C. Confusion D. Nausea
100
A nurse is performing an assessment on a client who has many past reports of physical problems and is now reporting an inability to walk. A possible medical diagnosis is somatization disorder. Which of the following is least relevant when planning care for the client with somatization disorders? ________________________________________________A. Level of involvement and support by family and friends. ________________________________________________B. Determination of whether the client's inability to walk has a physical cause. ________________________________________________C. Client's potential for violence toward others. ________________________________________________D. Client's ability to perform self-care activities.
C. Client's potential for violence toward others
200
A lint with mania is standing with a group of clients on the mental health unit. The client is talking excitedly and at great length about a variety of topics. The nurse can see that the other clients are becoming anxious and restless but do not know what to do to stop the conversation. The most appropriate approach by the nurse is to ________________________________________________A. give honest feedback. Tell the client his behavior is annoying others. ________________________________________________B. try humor. Joke to the client that the other clients will collapse if he does not leave them alone. ________________________________________________C. set limits. Tell the client he must leave other clients alone. ________________________________________________D. use distraction. Ask the client to come to the dining room for a snack.
D. use distraction. Ask the client to come to the dining room for a snack.
200
During an assessment, a client tells the nurse that she removes her old makeup and reapplies new makeup every hour or so, because she is sure she looks horrible. This behavior is consistent with ________________________________________________A. generalized anxiety disorder. ________________________________________________B. panic disorder ________________________________________________C. obsessive-compulsive disorder. ________________________________________________D. post traumatic stress disorder
C. obsessive-compulsive disorder.
200
A nurse has denied a request from a client with borderline personality disorder. The client says "The nurse on the evening shift would never be nasty to me like you are! You are a horrible, awful person!" This is an example of ________________________________________________A. regression ________________________________________________B. splitting. ________________________________________________C. a conversion disorder. ________________________________________________D. identification.
B. splitting.
200
Which of the following is a possible indication for ECT? ________________________________________________A. Severe borderline personality disorder. ________________________________________________B. Depression and thoughts of suicide caused by the recent loss of a significant other. ________________________________________________C. Bipolar disorder with mania that has occurred six times in the past year. ________________________________________________D. Chronic paranoid schizophrenia and a moderate developmental disability.
C. Bipolar disorder with mania that has occurred six times in the past year
200
A nurse assess a client in the emergency department who says that he is suddenly unable to move his legs. Which of the following should cause the nurse to suspect that this client might be experiencing a conversion disorder? ________________________________________________A. The client is highly educated and has a high-paying job. ________________________________________________B. The client has no previous history of neurologic problems. _______________________________________________ C. The client is distressed and reports that one leg is deformed. ________________________________________________D. The client does not appear upset by the presence of symptoms.
D. The client does not appear upset by the presence of symptoms.
300
A client with bipolar I disorder is currently in an extreme manic phase. All the following nursing diagnoses apply to her situation. Which one has the highest priority? ________________________________________________A. Disturbed thought process ________________________________________________B. Risk for other- or self-directed violence _______________________________________________ C. Disturbed sleep pattern ________________________________________________D. Ineffective coping
B. Risk for other- or self-directed violence
300
An appropriate nursing intervention for a client having a panic attack is to _______________________________________________ A. teach the client relation techniques. ________________________________________________B. show the client how to change his behavior. ________________________________________________C. distract the client with a television show. ________________________________________________D. stay with the client and speak quietly.
D. stay with the client and speak quietly.
300
A client with antisocial personality disorder is admitted to a chemical dependency unit. The nurse should be alert for which of the following characteristic behaviors of the client with this type of personality disorder? (Select all that apply.) ________________________________________________A. Anxious ________________________________________________B. Indecisive ________________________________________________C. Exploitative ________________________________________________D. Submissive
C. Exploitative
300
True or False: Retrograde amnesia may be present for weeks or months after a course of ECT ends.
True: the client may experience memory loss of past events following ECT.
300
A client states that he was diagnosed with tendonitis but he is just sure the doctor is wrong and he is having a myocardial infarction. What somataform disorder does he suffer from? ________________________________________________A. Conversion disorder ________________________________________________B. Body dysmorphic disorder ________________________________________________C. Pain syndrome ________________________________________________D. Hypochondriasis
D. Hypochondriasis
400
A nurse is caring for a client who has a mood disorder that has a strong biological and genetic component. What disorder does the client most likely have? ________________________________________________A. Generalized Anxiety Disorder ________________________________________________B. Adjustment disorder with depressed mood ________________________________________________C. Posttraumatic stress disorder (PTSD) ________________________________________________D. Bipolar Disorder
D. Bipolar Disorder
400
A nurse observes a client who is pacing and wringing his hands. He says that he is sure that he and his son will die a terrible death. He has worried about this since last year. He is displaying the symptoms of ________________________________________________A. generalized anxiety disorder. ________________________________________________B. specific phobia. ________________________________________________C. post traumatic stress disorder. ________________________________________________D. obsessive-compulsive disorder.
A. generalized anxiety disorder.
400
A part-time staff nurse on a behavioral unit is stopped by a client whose treatment plan shows a nursing diagnosis of ineffective coping related to manipulation of others. When planning interventions for a manipulative client, the nurse should ________________________________________________A. give negative reinforcement for acting-out behavior. ________________________________________________B. ignore any inappropriate behavior. ________________________________________________C. encourage the client to discuss her feelings of inadequacy. ________________________________________________D. refer requests and questions related to care to the client's primary nurse.
D. refer requests and questions related to care to the client's primary nurse.
400
True or False: A course of anticonvulsant medications is typically prescribed for a client several days prior to an ECT treatment.
False: The nurse could expect that any anticonvulsant medication the client might be taking would be decreased or discontinued prior to beginning ECT treatment, because it is necessary for the client to sustain a seizure during the treatment.
400
A nurse is caring for a client who exhibits signs of somatization. Which statement is most relevant? ________________________________________________A. Clients with somatization are cognitively impaired. _______________________________________________ B. Anxiety rarely coexists with somatization. ________________________________________________C. Somatization exists when medial evidence supports the symptoms. _______________________________________________D. Clients with somatization often have lengthy medical records.
D. Clients with somatization often have lengthy medical records.
500
A client has at least on episode of mania that alters with major depression. What type of bipolar can he be diagnosed with? ________________________________________________A. Bipolar I disorder ________________________________________________B. Bipolar II disorder ________________________________________________C. Cyclothymia ________________________________________________D. Rapid Cycling
A. Bipolar I disorder
500
A client hospitalized in an acute care mental health facility ritualistically cleans the sink in her bathroom multiple times daily. The outcome identified by the treatment team is that the client should use more effective coping measures. To achieve the desired outcome the nurse should ________________________________________________A. encourage the client to work with the maintenance staff in cleaning unit bathrooms. ________________________________________________B. focus on the client's symptoms rather than on the client's feelings. ________________________________________________C. encourage the client to participate in a variety of unit activities. _______________________________________________D. encourage the client to examine negative self-perceptions.
C. encourage the client to participate in a variety of unit activities.
500
A person who evades all social situations and fears rejections is considered to have have which personality disorder? ________________________________________________A. Histrionic ________________________________________________B. Schizoid ________________________________________________C. Avoidant ________________________________________________D. Antisocial
C. Avoidant
500
Which nursing diagnosis would be most appropriate for the client who has undergone the full course of electroconvulsive therapy (ECT)? ________________________________________________A. Deficient knowledge related to memory loss ________________________________________________B. Noncompliance related to knowledge deficit ________________________________________________C. Disturbed thought processes related to adverse effects of ECT. ________________________________________________D. Fear related to the unknown.
C. Disturbed thought processes related to adverse effects of ECT.
500
A nurse is caring for a client hospitalized on numerous occasions for complaints of chest pain and fainting spells, which she contributes to her deteriorating heart condition. No relatives or friends report ever actually seeing a fainting spell. After undergoing an extensive cardiac, pulmonary, GI, and neurological work-up, she's told that all test results are completely negative. The client remains persistent in her belief that she has a serious illness. What diagnosis is appropriate for this client? ________________________________________________A. Exhibitionism ________________________________________________B. Somatoform disorder ________________________________________________C. Degenerative Dementia ________________________________________________D. Echolalia
B. Somatoform disorder