A homeless patient diagnosed with a serious mental illness became suspicious and delusional. Depot antipsychotic medication began, and housing was obtained in a local shelter. One month later, which statement by the patient indicates significant improvement?
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Question 2 of 81
A victim of partner abuse, parent of one child, describes the partner as someone who is easily frustrated and more likely to be abusive after experiencing an event in which the most recent episodes of violence were related to feeling 'upset' over a job loss. What type of therapy would provide the greatest help to the abuser?
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Question 3 of 81
A 91-year-old female client with dementia is being seen by the home health nurse. Both she and her husband, who is 92 years old, were very active until her dementia became debilitating. Since that time, the client does not recognize her husband or children, forgets how to eat and dress, and wanders about the house day and night. Her husband wants to keep her at home to care for her, but the nurse notices that he is increasingly tired with each visit. What is the nurse's priority intervention for the nursing diagnosis of caregiver role strain?
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Question 4 of 81
Which of the following is a characteristic of bulimia nervosa?
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Question 5 of 81
Which nursing strategy leads patients to respond more positively to limit setting?
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Question 6 of 81
A person who is the caregiver of a parent with early-to-middle-stage Alzheimer disease is concerned about possible episodes of incontinence. What strategy should the nurse suggest?
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Question 7 of 81
The family of a patient with schizophrenia who has been stable for a year reports to the community mental health nurse that the patient reports feeling tense and having difficulty concentrating. He sleeps only 3 to 4 hours nightly and has begun to talk about creatures called 'volmers' hiding in the warehouse where he works and undoing his work each night. This information most likely suggests:
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Question 8 of 81
A man, aged 84 years, was stopped for going through a red light in a small town where he lives. He told the officer, 'It wasn't there yesterday.' He was unable to tell the officer his address and demonstrated labile mood, seeming pleasant one minute and angry the next. The officer took the man home to discuss his condition with the family and found that he has been wandering around the neighborhood, sometimes taking tools from people's garages, saying they belong to him. The family reluctantly agreed that he should go to the emergency department. What cardinal sign of Alzheimer's disease does this patient demonstrate?
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Question 9 of 81
Which theory of etiology of Alzheimer's disease, suggested by current research, might the nurse use to help a family understand that this disorder is not of psychosocial origin? Alzheimer's disease is associated with:
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Question 10 of 81
The main focus of medical management for anorexia is to:
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Question 11 of 81
A 35-year-old woman who is being interviewed by the advanced practice nurse indicates that she has few friends, fears criticism from others, and withholds information about her thoughts and feelings because she anticipates a negative reaction. Based on these data, the nurse suspects that Sarah may later be diagnosed as having:
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Question 12 of 81
Which characteristics are most likely in a sexual perpetrator? Select all that apply.
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Question 13 of 81
Which of the following is a characteristic behavior in patients with anorexia nervosa?
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Question 14 of 81
A client displays disorganized thinking, difficult-to-follow speech, and silly, inappropriate affect. The client isolates himself from other clients and staff, ignores unit activities, and often seems to be listening and responding to unseen stimuli. This client's behavior most closely conforms to the characteristic behavior of:
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Question 15 of 81
A patient is currently in an abusive relationship with the father of her only child and tells a nurse that her partner 'is really sorry for hitting me and wants to come back and be part of the family again.' The nurse should provide which intervention?
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Question 16 of 81
Because there is considerable overlap among the types of schizophrenia, and because patterns of behavior shift over time, many patients are simply classified as suffering from schizophrenia
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Question 17 of 81
A patient, aged 77 years, has Alzheimer's disease. She goes to day care during the week and is otherwise cared for by her daughter and grandchildren. The nurse at the day care center noticed multiple bruises on the patient's palms, elbows, and buttocks. When the daughter arrived to pick her up, the nurse discussed her observations. The daughter became defensive and said that her mother was very difficult to manage. She stated, "My mother is not my mother anymore. She is confused, and she wanders all night. We have to watch her constantly. Last night I fell asleep, and she fell down the stairs. Sometimes she cannot recognize me and accuses me of trying to poison her. I can't concentrate at work, and it's wrecking the family. Sometimes I just cannot bear it."Â Which nursing diagnosis would be most important to address for this family?
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Question 18 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.' Since admission, the client remains delusional, shouts obscenities, and demonstrates loosely associated thoughts. Based on these data, the nurse should develop a nursing diagnosis of:
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Question 19 of 81
The client has been taking lithium and fluoxetine (Prozac) for almost a week. During today's assessment, the nurse notes a temperature of 39°C, muscle rigidity, and confusion. The client's signs and symptoms suggest:
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Question 20 of 81
A nurse is planning care for a patient with anorexia nervosa. What is the priority intervention?
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Question 21 of 81
According to the map showing deaths resulting from poor air quality worldwide, which regions of the world have the poorest air quality?
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Question 22 of 81
A nurse planning teaching for a parent group concerned with preventing family violence can discuss the fact that exposure to violence in the media:
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Question 23 of 81
The home care nurse assessed a client with a history of dementia who had a herniorrhaphy at an ambulatory surgical center the previous day. The client lives in a senior retirement community and has no close family. The nurse assesses mild dysphasia. The client cannot remember why he has a bandage. He thinks he is in the army and that it is 1950. Appropriate planning for the client should include:
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Question 24 of 81
What is the priority nursing intervention when caring for a patient with bulimia nervosa who has a history of purging?
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Question 25 of 81
Disorders which are characterised by serious abnormalities in the developmental process, fall under the heading of pervasive developmental disorders (PDD) and are usually associated with impairment in several areas of development. From early infancy, some children will exhibit a spectrum of developmental impairments and delays that include which of the following?
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Question 26 of 81
The nurse who assesses a patient previously diagnosed as having paranoid personality disorder is most likely to describe the patient as:
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Question 27 of 81
An infant develops jaundice 6 hours after birth. Which one of the following is the most likely diagnosis?
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Question 28 of 81
The nurse has been working with a patient diagnosed with schizophrenia who experiences auditory hallucinations. The patient relates, 'When I first heard the voices they said nice things about me. Lately, they've changed and they say bad things.' What information has the least impact on therapeutic patient care at this point in the hospitalization?
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Question 29 of 81
A 10-year-old boy is diagnosed with gender dysphoria. Which assessment finding would the nurse expect?
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Question 30 of 81
In a sad voice, an elderly patient tells the nurse of the recent deaths of a spouse and close friend. The patient has no other family and only a few acquaintances in the community. The nurses priority is to determine whether which nursing diagnosis applies to this patient?
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Question 31 of 81
The client lives so completely in a world of her own that she does not eat, drink, or bathe regularly. She is considered to be:
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Question 32 of 81
In the OB follow-up clinic, your patient, who is 4 weeks post-delivery, tells you she is sleeping for long hours, wants to avoid taking care of the baby, and wishes she had never had the baby. What would be your first response?
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Question 33 of 81
A patient has recently been under significant stress and worked long hours. At home, the patient watches television and eats until going to bed. The patient is too tired to exercise and has gained 25 pounds in 1 month. A desired outcome for the patient is to recognize anxiety that precedes binge eating and reduce it. Which intervention addresses the outcome?
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Question 34 of 81
A client with a personality disorder asks the nurse, 'Is it true I have an inherited brain disorder?' The nurse replies, knowing that:
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Question 35 of 81
Hearing voices that are not really there would be called a(n)
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Question 36 of 81
Police bring a 63-year-old woman to the emergency room, reporting that her behavior is disorganized and disruptive, that her speech makes little sense, and that she does not seem able to take care of herself. The woman has had elective surgeries at the hospital previously and was seen in the ER last week after a fall; records show no history of similar symptoms or mental illness. The ER physician speaks with the patient but does not examine her medically, diagnoses her with schizophrenia, and orders admission to the inpatient psychiatric unit. Which response by the nurse would be most appropriate?
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Question 37 of 81
A client who is diagnosed with schizoid personality disorder is isolative, does not speak to her peers, and sits through the community meeting without speaking. Her mother describes her as shy and having few friends. Which would be an appropriate nursing diagnosis for this client?
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Question 38 of 81
Which neurological deficit(s) would the nurse be most likely to encounter when assessing a patient diagnosed with schizophrenia?
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Question 39 of 81
A nurse plans an educational program for staff of a home health agency specializing in care of the elderly. Which topic is the highest priority to include?
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Question 40 of 81
A nurse works a rape telephone hotline. Communication should focus on:
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Question 41 of 81
The risk for developing the condition is about 50% only if both parents were carriers of the gene that predisposes the condition to their offspring.
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Question 42 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 43 of 81
A community mental health nurse is assigned to investigate the frequent school absences of an 11-year-old child. The nurse finds the child home alone, caring for his 1- and 3-year-old siblings. The house is cluttered and dirty, and both parents are at work. The child tells the nurse that whenever his mother is called to work at her part-time job, he must watch the kids because the family cannot afford a babysitter. Based on the information obtained thus far, what preliminary assessment can be made?
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Question 44 of 81
Most individuals with Alzheimer's disease are cared for in:
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Question 45 of 81
The average age for onset of anorexia nervosa is:
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Question 46 of 81
A patient diagnosed with schizophrenia has had multiple relapses. The patient usually responds quickly to antipsychotic medication but soon discontinues the medication. Discharge plans include follow-up at the mental health center, group home placement, and a psychosocial day program. Which strategy should apply as the patient transitions from hospital to community?
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Question 47 of 81
A patient has not come out of her room for breakfast. The nurse finds the patient moving restlessly about her room in a disorganized manner. The patient is talking to herself, and her verbal responses to the nurse are nonsensical and suggest disorientation. The nurse notices that the patient's skin is hot and dry, and her pupils are somewhat dilated. All these symptoms are significant departures from the patient's recent presentation. The patient is likely experiencing ______, and the nurse should ______.
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Question 48 of 81
Which of these is a sign of delayed mental development in toddlers?
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Question 49 of 81
A nurse and social worker co-lead a reminiscence group for eight elite-old adults. Which activity is appropriate to include in the group?
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Question 50 of 81
A young patient diagnosed with schizophrenia is standing naked after showering and appears to be both dazed and indecisive. The nursing intervention that will be most helpful to promote dressing would be:
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Question 51 of 81
Schizophrenia is most commonly found in
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Question 52 of 81
A depressed patient who is taking a tricyclic antidepressant tells the nurse, "I don't think I can keep taking these pills. They make me very dizzy, especially when I stand up." The best nursing response is:
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Question 53 of 81
A patient states that unit staff members have been avoiding them since an attempt to self-mutilate. The psychiatric-mental health nurse's most appropriate response is to:
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Question 54 of 81
A 14-year-old female comes into clinic for a medical certificate once a week for multiple complaints of chest pain and abdominal pain. The complaints are non-specific, and her physical examination is normal. She is quiet with poor eye contact. She states the pain is worse on school days. Her mother is concerned that her daughter is being bullied but won't talk to her. Her mother is also worried that her complaints represent an undiagnosed medical condition. The next best step in management is:
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Question 55 of 81
A woman tells the nurse, 'My partner is frustrated with me. I don't have any natural lubrication when we have sex.' What type of sexual disorder is evident?
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Question 56 of 81
An individual accompanied by a friend was brought by ambulance to the emergency room. A nurse notes that the patient's skin is flushed and dry. Further assessment reveals the patient has not voided or ingested food or fluid in 18 hours. Temperature, pulse, blood pressure, and respirations are elevated, and sensorium alternates between clouded and clear. The physician diagnoses fever of unknown origin. Because the patient is restless and agitated, the plan is to make an effort to orally hydrate before attempting to start an IV line. The intervention most likely to be effective will be:
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Question 57 of 81
A client with schizophrenia tells the nurse as they sit in the day room, 'I hear voices telling me bad things.' The most therapeutic response the nurse can make is:
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Question 58 of 81
When assessing the elderly for depression, the nurse may find that a depressed person over 70 years of age without a medical diagnosis, may have the following symptoms of depression (Select one tha does not apply):
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Question 59 of 81
The nurse is administering haloperidol (Haldol) to a client experiencing delusions and hallucinations associated with schizophrenia. The nurse can expect symptom abatement as a result of the drug's action to:
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Question 60 of 81
Which statement by a parent of a teen with anorexia nervosa suggests a need for further education?
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Question 61 of 81
The first step in the creation of a therapeutic alliance between a nurse and a patient with a maladaptive response to eating regulation is:
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Question 62 of 81
Which nursing intervention will assist a client being treated in the Emergency Department for extensive soft tissue injuries to disclose an experience of domestic violence?
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Question 63 of 81
Which of the following is an example of a Specific Learning Disability?
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Question 64 of 81
Behaviorists would say that self-defeating behaviors are maintained by immediate reinforcement in the form of
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Question 65 of 81
A type of delusion in which a patient claims that her genitals have disappeared without her knowledge is called
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Question 66 of 81
What would be an expected outcome for a patient with anorexia nervosa undergoing treatment?
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Question 67 of 81
A client who is hospitalized with anorexia nervosa states during a one-to-one session with the nurse, 'I'm freaking out. I'm losing it.' Which nurse response would be most therapeutic at this time?
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Question 68 of 81
A boy with a conduct disorder diagnosis would be most likely to have which symptom?
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Question 69 of 81
Which of the following is not a psychiatric condition commonly associated with oppositional behaviour in children?
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Question 70 of 81
The intervention that would be most appropriate of a male client develops orthostatic hypotension while taking amitriptyline (Elavil) is
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Question 71 of 81
In DSM-IV-TR intellectual disabilities are divided into a number of degrees of severity, depending primarily on the range of IQ score provided by the sufferer. One of these is Moderate Mental Retardation, represented by an IQ score between:
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Question 72 of 81
A patient receiving risperidone (Risperdal) reports severe muscle stiffness midmorning. During lunch he has difficulty swallowing food and speaking, and when vital signs are taken 30 minutes later, he is noted to be stuporous and diaphoretic, with a temperature of 38.8° C, pulse of 110 beats/min, and blood pressure of 150/90 mm Hg. The nurse should suspect _____ and should _____.
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Question 73 of 81
The wife of a client newly diagnosed with paranoid schizophrenia asks the nurse, 'My husband was well adjusted until a month ago, and then, after a lot of work stress, he got sick. What can I expect? Will he be this sick for the rest of his life?' What information can the nurse provide about prognosis?
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Question 74 of 81
A nurse finds a patient with anorexia nervosa vigorously exercising before gaining the agreed-upon weekly weight. Select the nurse's best comment.
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Question 75 of 81
Which of the following is a common emotional response for patients with anorexia nervosa?
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Question 76 of 81
Which nursing diagnosis is most appropriate for a patient with bulimia nervosa who engages in frequent purging behaviors?
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Question 77 of 81
For which behavior(s) would limit setting be most essential?
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Question 78 of 81
A priority measure to teach a client who purges is:
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Question 79 of 81
A patient with bipolar disorder, mania, relapsed after discontinuing lithium. The health care provider prescribes lithium 600 mg BID and olanzapine (Zyprexa) 10 mg BID. What is the rationale for addition of olanzapine to the lithium regime? It will:
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Question 80 of 81
When making a distinction as to whether an elderly patient has confusion related to delirium or another problem, what information would be of particular value?
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Question 81 of 81
It is a primary dementia that is incurable, irreversible, and fatal. It is caused by the accumulation of amyloid protein in the neurons, resulting in senile plaques.
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