The medical records of a patient diagnosed with schizophrenia state that the patient has cognitive dysfunction. From this statement, the nurse can expect to see evidence of:
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Question 2 of 81
An individual is brought by ambulance to the emergency room. The patient's roommate reports that the patient was weak and confused on awakening and began "rambling and talking crazy"Â about 3 hours ago. A nurse notes that the patient's skin is flushed and dry. When transferred to a bed, the patient strikes out at the staff and shouts, "You're not going to kill me!"Â The most likely analysis of this behavior is:
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Question 3 of 81
Which finding is most indicative of refeeding syndrome in a patient with anorexia nervosa?
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Question 4 of 81
A victim of physical abuse by her domestic partner is being treated for a broken humerus. Which indicator for the outcome of Abuse protection is most important to achieve before the patient leaves the emergency department?
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Question 5 of 81
Major concerns of the elderly living alone in their home are: (Name 1)
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Question 6 of 81
What is the most effective intervention to address the disturbed body image in patients with anorexia nervosa?
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Question 7 of 81
A short-term goal for a patient with Alzheimer disease is:
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Question 8 of 81
A mother discusses her concerns about genetic transmission of schizophrenia with the nurse saying, 'My son is a fraternal twin. He has been diagnosed with schizophrenia. Will my other son develop schizophrenia, too?' The response that is both sensitive and shows understanding of the genetic component is:
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Question 9 of 81
The nursing approach that will minimize power struggles between the client with an eating disorder and the nurse is best characterized as:
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Question 10 of 81
A student transfers from a hometown college to a university 200 miles away after breaking up with her boyfriend of 2 years. She was slow to make friends at the university. The history shows a close relationship with her mother and sister. She began eating large quantities when she felt sad, and then she induced vomiting. When the student's schoolwork declined, she sought help from the university health clinic. During the initial interview, what priority issue should the nurse address?
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Question 11 of 81
The expected outcome for a patient with a nursing diagnosis of disturbed thought processes is:
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Question 12 of 81
Which stage of Piaget's theory marks the onset of logical thinking?
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Question 13 of 81
A patient with mania has not eaten or slept for 3 days. Which nursing diagnosis has priority?
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Question 14 of 81
An elderly female client on the mental unit suddenly becomes upset because she can't remember where she is and she says, 'I can't think straight.' The staff has never witnessed this behavior in the client, and this type of complaint is not documented in the nursing history. What is the client most likely experiencing?
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Question 15 of 81
The antisocial personality
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Question 16 of 81
A nurse monitors a patient with anorexia nervosa for complications of refeeding. Which assessment is most important?
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Question 17 of 81
A patient with the diagnosis of schizophrenia, disorganized type, approaches the nurse and says, "It's beat, it's eat. No room for doom." The nurse can correctly assess this verbalization as:
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Question 18 of 81
A person who has an extreme lack of self-confidence and who allows others to run his or her life is said to have a(n) personality
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Question 19 of 81
Which of the following best describes a social gambler
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Question 20 of 81
A child, age 5, was admitted to the children's unit, having been sexually abused by an acquaintance of her family. The child refuses to talk and participate in unit activities, choosing to stay in her room with her stuffed animals. Which therapeutic intervention will best help the child release pent-up feelings about the abuse?
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Question 21 of 81
Why did the risk of acquiring disease decrease for people living in cities since the 1850's?
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Question 22 of 81
A patient with Alzheimer's disease has been determined to have a dressing/grooming self-care deficit. Which intervention(s) would be appropriate for this nursing diagnosis? Select all that apply.
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Question 23 of 81
A nurse is working with a patient with bulimia nervosa. Which outcome would indicate successful intervention?
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Question 24 of 81
A patient was abducted and raped at gunpoint by an unknown assailant. Which nursing interventions are appropriate while caring for the patient in the emergency department? Select all that apply.
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Question 25 of 81
The client interprets the proverb 'A rolling stone gathers no moss' as 'As long as the rock keeps moving, it won't turn green.' This is an example of:
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Question 26 of 81
A client, age 42, has been battered by her husband since they were married 8 years ago. Until this hospitalization for major depression, she had avoided dealing with her situation, but she now expresses a desire to deal with the problem. The attacks are occurring more often. Which outcome is realistic for the client?
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Question 27 of 81
Which is the most appropriate response when a patient with bulimia nervosa expresses feelings of shame about their purging behaviors?
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Question 28 of 81
A nurse is caring for a patient with bulimia nervosa. What is a priority assessment for this patient?
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Question 29 of 81
A physical therapist recently convicted of multiple counts of Medicare fraud is brought to the emergency department after taking an overdose of sedatives. He tells the nurse, 'Sure I overbilled. Why not? Everybody takes advantage of the government. They have too many rules. No one can abide by all of them.' These statements can be assessed as showing:
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Question 30 of 81
A 28-year-old female client was admitted 3 days ago after she ran nude through the streets, shouting that she was the 'Queen of Hearts.' The client has remained delusional since admission. An initial expected outcome would be that the client will:
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Question 31 of 81
A client with catatonic schizophrenia has been posturing, standing with his left arm upraised and his right foot off the floor. For the most part, he ignores attempts at nursing intervention but will occasionally walk, sit, or lie down for a few minutes. The client eats standing up if the nurse brings a tray to the room. The priority nursing order would be to:
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Question 32 of 81
A male patient diagnosed with paranoid schizophrenia typically relates effectively with female staff but angrily tells the male nurse, 'You act like a homosexual. None of the men trust you or want to be around you.' The nurse, who is heterosexual, is perplexed by the patient's statements and discusses the event with his mentor. Which explanation most likely underlies the patient's behavior?
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Question 33 of 81
What is the most important aspect of refeeding for a patient with anorexia nervosa?
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Question 34 of 81
The nurse at the clinic is interviewing a patient who offers a number of vague somatic complaints that might not ordinarily prompt a visit to a caregiver: fatigue, back pain, headaches, and sleep disturbance. The patient seems tense, and after having spoken of the symptoms, seems reluctant to provide more information and is in a hurry to leave. The nurse can best serve the patient by:
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Question 35 of 81
What environmental conditions should the nurse arrange for a patient with delirium and altered perceptions of their environment?
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Question 36 of 81
Which of the following should the nurse use as a basis for explaining the etiology of Alzheimer's disease to the family of a client with this disease?
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Question 37 of 81
What is the most important aspect of nursing care for patients with anorexia nervosa during refeeding?
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Question 38 of 81
Suicidal tendency is most commonly seen with
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Question 39 of 81
An elderly patient brings a bag of medications to the clinic. The nurse finds a bottle labeled Ativan and one labeled lorazepam, both of which are to be taken BID. There are also bottles labeled hydrochlorothiazide, Inderal, and rofecoxib, each to be taken once daily. Which conclusion is accurate?
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Question 40 of 81
A man who regularly experiences premature ejaculation tells the nurse, 'I feel like such a failure. It's so awful for both me and my partner.' Select the nurse's most therapeutic response.
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Question 41 of 81
Which of the following can potentially be diagnostic at the clinic?
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Question 42 of 81
A patient diagnosed with dementia associated with excessive alcohol use is shown a pencil, a nickel, and a safety pin and asked to repeat the names of each. Later when asked to identify the same three items the patient is unable to do so. The nurse assesses this as:
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Question 43 of 81
The mother of a teen with an eating disorder tells the nurse, 'Our family is pretty well-adjusted. It's hard for me to imagine what we could have done to have this happen.' The nurse can promote more complete understanding of the etiology of eating disorders by mentioning that young women are also influenced by:
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Question 44 of 81
Persons who are excessively narcissistic, dependent, or antisocial are characterized as having
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Question 45 of 81
Which of the following criteria can be used to define intellectual disabilities?
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Question 46 of 81
Which behavior would the nurse expect to observe in a person who commits psychic rape?
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Question 47 of 81
A novice nurse tells the assigned mentor, 'I admitted a patient today who has several bizarre delusions. I wanted to tell the patient that the ideas and conclusions simply are not logical. What do you think will happen if I do?' Which reply by the mentor is best?
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Question 48 of 81
A psychiatric technician mentions to the nurse, 'All these clients with Axis II problems! It makes me wonder how so many mothers could have been such poor parents and messed up their kids so badly!' The response by the nurse that helps put the development of personality disorders into perspective is:
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Question 49 of 81
The persistent eating of nonfood items such as clay, laundry starch, insects, leaves, or pebbles that lasts for longer than 1 month is called:
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Question 50 of 81
CT scans of the brains of some young schizophrenics show than normal
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Question 51 of 81
The nurse performs a functional assessment of a client upon admission to a home health service. The purpose of this assessment is to determine the client's:
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Question 52 of 81
Inappropriate, life-threatening or challenging behaviours may be inadvertently maintained by reinforcement from others in the environment. Which of the following is a process that can be carried out in order to help identify the factors maintaining the behaviour?
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Question 53 of 81
Asking the husband to leave is likely to increase the client's anxiety and alter test results. Testing in the more familiar, comfortable surroundings of the home will yield more reliable results.
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Question 54 of 81
A nurse is caring for a patient with anorexia nervosa who is refusing to eat. What should the nurse do first?
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Question 55 of 81
After a rape victim visited a rape crisis counselor weekly for 8 weeks, which finding best demonstrates that reorganization was successful?
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Question 56 of 81
A patient is being discharged after spending six days in the hospital due to depression with suicidal ideation. The psychiatric-mental health nurse knows that an important outcome has been met when the patient states,:
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Question 57 of 81
Which nursing diagnosis is more relevant for a patient with anorexia nervosa who restricts intake and is 20% below normal weight than for a 130-pound patient with bulimia nervosa who purges?
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Question 58 of 81
A patient diagnosed with schizophrenia has been rehospitalized after a relapse. A priority intervention in designing a discharge plan to prevent relapses will be:
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Question 59 of 81
A patient tells the nurse that his sexual functioning is normal when his wife wears short, red camisole-style nightgowns. He states, 'Without the red teddies, I am not interested in sex.' The nurse can assess this as consistent with
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Question 60 of 81
A nurse is caring for a patient who has a maladaptive response to eating regulation. The patient tells the nurse, 'I know my parents are already upset, but I need to lose another 10 pounds to be at an ideal weight.' This statement suggests that the best treatment setting for this patient would be:
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Question 61 of 81
A client with undifferentiated schizophrenia is readmitted for an acute exacerbation of the disorder. The goal of hospitalization is symptom stabilization. The nurse has documented that, in addition to experiencing auditory hallucinations, the client seems uninterested in activities, has difficulty completing tasks, seems forgetful, and seems puzzled by information and directions given by staff. The nurse's plans for intervention will be effective if these behaviors are attributed to:
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Question 62 of 81
When a psychiatric technician questions the nurse about comorbidity of eating disorders, which Axis I disorder would the nurse say is most commonly seen in clients with bulimia and anorexia nervosa?
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Question 63 of 81
A 67-year-old woman recently noticed a non-painful lump in the right breast (see image). Which one of the following is the most likely diagnosis?
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Question 64 of 81
A patient with swelling and a laceration above the right eye states, 'I don't know what caused me to fall and cut my head on the door frame in my bedroom. I'm lucky my spouse was home to take me to the hospital.' The patient's spouse appears nervous but smiles when mentioning that the patient is 'so clumsy at times.' Which nursing intervention should the nurse give priority attention to when addressing this patient's needs?
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Question 65 of 81
When a patient with a personality disorder uses manipulation as a way of getting needs met, the staff agree to use limit setting as an intervention. How does limit setting work to reduce manipulation?
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Question 66 of 81
An outpatient diagnosed with schizophrenia attends programming at a community mental health center. The patient says, I threw away the pills because they keep me from hearing God. Which response by the nurse would most likely to benefit this patient?
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Question 67 of 81
A Hispanic woman comes to the mental health center at the urging of her adult children. The patient has lost 5 pounds since her husband's death 6 months ago and says, "My husband comes to visit me in the night but I cannot understand what he says." How should the nurse analyze this situation? The patient is:
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Question 68 of 81
An 85-year-old client with dementia has a nursing diagnosis of Self-care deficit: bathing, hygiene. She lives at home and has not bathed for a month. Her 67-year-old daughter states that she thinks her mother may have forgotten how to take a shower. An appropriate outcome would be that the client will:
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Question 69 of 81
A patient with schizophrenia has received typical (first-generation) antipsychotics for a year. His hallucinations are less intrusive, but he remains apathetic, has poverty of thought, cannot work, and is socially isolated. To address these symptoms, the nurse might consult the prescribing health care provider to suggest a change to:
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Question 70 of 81
Which of the following is not a common characteristic of oppositional behaviour?
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Question 71 of 81
You are caring for a 13-year-old boy with a diagnosis of conduct disorder. Which of the following would you be most likely to expect given this diagnosis?
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Question 72 of 81
The main reasons that childhood obesity rates are higher among the areas of the highest poverty are
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Question 73 of 81
A physically frail elderly patient with mild cognitive impairments needs services of a facility that can provide supervision and safety as well as recreation and social interaction. The family cares for this patient during the evening and night. Which type of facility should the nurse suggest to meet this patients needs?
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Question 74 of 81
A 79-year-old white male tells a nurse, 'I have felt very sad lately. I do not have much to live for. My family and friends are all dead, and my own health is failing.' The nurse should analyze this comment as
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Question 75 of 81
True paranoids are rarely treated or admitted to hospitals because
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Question 76 of 81
A catatonic patient admitted in a stuporous condition begins to demonstrate increased motor activity. During his assessment, the psychiatrist raises the patient's arm above his head and releases it. The patient maintains the position his arm was placed in, immobile in that position for 15 minutes, moving only when the nurse gently lowers his arm. What symptom is demonstrated by this assessment technique?
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Question 77 of 81
A patient living independently had command hallucinations to shout warnings to neighbors. After a short hospitalization, the patient was prohibited from returning to the apartment. The landlord said, 'You cause too much trouble.' What problem is the patient experiencing?
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Question 78 of 81
A nurse is caring for a patient with bulimia nervosa. Which intervention should the nurse prioritize?
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Question 79 of 81
A worker is characterized by her co-workers as 'painfully shy' and lacking in self-confidence. Her co-workers say she stays in her cubicle all day, never coming out for breaks or lunch. One day after falling on the ice in the parking lot, she goes to the nurse's office, where she apologizes for falling and mentions that she hopes the company will not fire her for being so clumsy. Which nursing approach or response would be most therapeutic?
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Question 80 of 81
A 27-year-old woman diagnosed with borderline personality disorder displays a labile affect, impulsivity, frequent angry outbursts, and difficulty tolerating her angry feelings without self-injury. A priority nursing diagnosis for this client is:
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Question 81 of 81
A patient with schizophrenia is admitted to the psychiatric unit in an acutely disturbed, violent state. He is given several doses of haloperidol (Haldol) and becomes calm and approachable. During rounds the nurse notices the patient has his head rotated to one side in a stiffly fixed position. His lower jaw is thrust forward and he appears severely anxious. The patient has ______, and the nurse should ______.
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