Test Bank Essentials of Psychiatric
Nursing 2nd Edition by Mary Ann
Boyd
written by
RNstudent
www.stuvia.com
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Stuvia.com - The Marketplace to Buy and Sell your Study Material
Full Test Bank
Essentials of Psychiatric Nursing 2nd Edition Boyd Test
Bank
Test Bank Directly From The publisher, 100% Verified Answers.
COVERS ALL CHAPTERS.
Download Immediately After the Order.
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Test Generator Questions, Chapter 1, Mental Health and Mental
Disorders
Multiple Choice
1. As part of a class activity, nursing students are engaged in a small group
discussion about the epidemiology of mental illness. Which statement best explains
the importance of epidemiology in understanding the impact of mental disorders?
Epidemiology:
A) Helps promote understanding of the patterns of occurrence associated with
mental disorders.
B) Helps explain research findings about the neurophysiology that causes mental
disorders.
C) Provides a thorough theoretical explanation of why specific mental disorders
occur.
D) Predicts when a specific psychiatric client will recover from a specific mental
disorder.
Ans: A
Chapter: 1
GRAEnvironment:
DESLAB.COManagement
M
Client Needs: Safe, Effective Care
of Care
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 4
Page Number: 2
Feedback: Epidemiology is the study of patterns of disease distribution and
determinants of health within populations. It contributes to the overall understanding
of the mental health status of population groups, or aggregates, and it examines the
associations among possible factors. Epidemiology does not explain research findings
about neurophysiology, provide theoretical explanations for why specific disorders
occur, or predict recovery.
2. A nurse is working in a community mental health center that provides care to a
large population of people of Asian descent. When developing programs for this
community, which of the following would be most important for the nurse to address?
A) Public stigma
B) Self-stigma
C) Label avoidance
D) Negative life events
Ans: C
Chapter: 1
Client Needs: Psychosocial Integrity
Cognitive Level: Understand
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Integrated Process: Nursing Process
Objective: 5
Page Number: 4
Feedback: Although public stigma and self-stigma may be areas needing to be
addressed, in this cultural group, label avoidance would be most important. Label
avoidance or avoiding treatment/care so as not to be labeled mentally ill is a type of
stigma that influences why so few people with mental health problems actually
receive assistance. Asian cultures commonly have negative views of mental illness
that influence the willingness of members to seek treatment; they possibly ignore the
symptoms or refuse to seek treatment because of this stigma. Negative life events
affect anyone, not just those of the Asian culture.
3. A nursing student is assigned to care for a client diagnosed with schizophrenia.
When talking about this client in a clinical post-conference, the student would use
which terminology when referring to the client?
A) Committed client
B) Schizophrenic
C) Schizophrenic client
D) Person with schizophrenia
Ans: D
Chapter: 1
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
GRADand
ESLDocumentation
AB.COM
Integrated Process: Communication
Objective: 5
Page Number: 4
Feedback: Just as a person with diabetes should not be referred to as a “diabetic”
but rather as a “person with diabetes,” a person with a mental disorder should never
be referred to as a “schizophrenic” or “bipolar,” but rather as a “person with
schizophrenia” or a “person with bipolar disorder.” Doing so helps to counteract the
negative effects of stigma.
4. A nursing student is reviewing journal articles about major depression. One of the
articles describes the number of persons newly diagnosed with the disorder during the
past year. The student interprets this as which of the following?
A) Rate
B) Prevalence
C) Point prevalence
D) Incidence
Ans: D
Chapter: 1
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 4
Page Number: 3
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Feedback: The article is describing incidence, which refers to a rate that includes
only new cases that have occurred within a clearly defined time period. The most
common time period evaluated is 1 year. Rate reflects the proportion of cases in the
population compared with the total population. Prevalence refers to the total number
of people with the disorder within a given population at a specified time, regardless of
how long ago the disorder started. Point prevalence refers to the proportion of
individuals in the population that have a disorder at a specific point in time.
5. While working in a community mental health treatment center, the nurse
overhears one of the receptionists saying that one of the clients is “really psycho.”
Later in the day, the nurse talks with the receptionist about the comment. This action
by the nurse demonstrates an attempt to address which issue?
A) Lack of knowledge
B) Public stigma
C) Label avoidance
D) Self-stigma
Ans: B
Chapter: 1
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 5
Page Number: 4
GRADESreflects
LAB.COthe
M negative effects of
Feedback: The receptionist's statement
stigmatization, more specifically public stigma. Self-stigma reflects a person's
internalization of a negative stereotype; that is, the person with the mental illness
begins to believe that he or she is what the public thinks he or she is. Label avoidance
refers to avoiding treatment or care so as not to be labeled mentally ill. Lack of
knowledge is often the underlying theme associated with any type of stigma.
6. After educating a group of students on mental health and mental illness, the
instructor determines that the education was successful when the group identifies
which of the following as reflecting mental disorders?
A) Capacity to interact with others
B) Ability to deal with ordinary stress
C) Alteration in mood or thinking
D) Lack of impaired functioning
Ans: C
Chapter: 1
Client Needs: Psychosocial Integrity
Cognitive Level: Understand
Integrated Process: Teaching/Learning
Objective: 3
Page Number: 3
Feedback: Mental disorders are health conditions characterized by alterations in
thinking, mood, or behavior and are associated with distress or impaired functioning.
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Mental health is the emotional and psychological well-being of an individual who has
the capacity to interact with others, deal with ordinary stress, and perceive one's
surroundings realistically.
7. A nurse is preparing a presentation for a local community group about mental
disorders and plans to include how mental disorders are different from medical
disorders. Which statement would be most appropriate for the nurse to include?
A) “Mental disorders are defined by an underlying biological pathology.”
B) “Numerous laboratory tests are used to aid in the diagnosis of mental disorders.”
C) “Clusters of behaviors, thoughts, and feelings characterize mental disorders.”
D) “Manifestations of mental disorders are within normal, expected parameters.”
Ans: C
Chapter: 1
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 3
Page Number: 2
Feedback: Unlike many medical disorders, mental disorders are defined by clusters
of behaviors, thoughts, and feelings, not underlying biologic pathology. The
alterations in thoughts, behaviors, and feelings are unexpected and outside the
normal, culturally defined limits. Laboratory tests are not used in diagnosing mental
disorders.
GRADESLAB.COM
8. A psychiatric–mental health nurse is providing care for a client with a mental
disorder. The client is participating in the decision-making process. The nurse
interprets this as which component of recovery?
A) Self-direction
B) Collaborative
C) Person-centered
D) Holistic
Ans: B
Chapter: 1
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 6
Page Number: 4
Feedback: In recovery-oriented care, the person with a mental health problem
develops a partnership with a clinician to manage the illness, strengthen coping
abilities, and build resilience for life’s challenges. Being involved in decision making
helps the client transition from a dependent-driven relationship to a collaborative
recovery-oriented one. Self-direction is reflected as individuals define their own goals
and design a path to meet those goals. Individualized and person-centered is
reflected by the individual's use of his or her own unique strengths and resilience as
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
well as needs, preferences, experiences, and cultural background. Holistic involves
the whole life of the individual—mind, body, spirit, and community.
9. A nurse is explaining recovery to the family of a client diagnosed with a mental
disorder. Which statement would be most appropriate for the nurse to include about
this process?
A) “It is a step-by-step process from being ill to being well.”
B) “The client focuses mainly on the emotional aspects of their condition.”
C) “The client is helped to live a meaningful life to their fullest potential.”
D) “Although peer support is important, the self-acceptance is essential.”
Ans: C
Chapter: 1
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 6
Page Number: 4
Feedback: Recovery from mental disorders and/or substance use disorders is a
process of change through which individuals improve their health and wellness, live a
self-directed life, and strive to reach their full potential. It is a nonlinear process with
setbacks. It also is strength-based. Peer support is important, but so is respect by the
community and consumers, along with self-acceptance to ensure inclusion and
participation in all aspects of life.
GRADESLAB.COM
10. After teaching a group of nursing students on recovery, the instructor
determines that more education is needed when the group identifies which of the
following as a characteristic?
A) Self-direction in life
B) Improvement in health and wellness
C) Achievement of full potential
D) One-time change situation
Ans: D
Chapter: 1
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 6
Page Number: 4
Feedback: Recovery from mental disorders and/or substance use disorders is a
process of change through which individuals improve their health and wellness, live a
self-directed life, and strive to reach their full potential.
11. When describing the treatment of mental illness, which of the following would a
nurse identify as the primary goal?
A) Functional status
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
B) Stigma reduction
C) Stress reduction
D) Recovery
Ans: D
Chapter: 1
Client Needs: Psychosocial Integrity
Cognitive Level: Understand
Integrated Process: Nursing Process
Objective: 6
Page Number: 4
Feedback: Although reducing stigma, reducing stress, and improving functional
status are important components involved in the treatment of mental illness, recovery
is the single most important goal for individuals with mental disorders.
12. A nurse is working as part of the multidisciplinary team and developing a plan of
care for a client who is receiving recovery-oriented treatment. Which of the following
would the nurse integrate into this plan?
A) Focusing primarily on the mind
B) Limiting support from others
C) Using hope as motivation
D) Avoiding underlying trauma
Ans: C
GRADESLAB.COM
Chapter: 1
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 6
Page Number: 5
Feedback: Recovery emerges from hope: The belief that recovery is real
provides the essential and motivating message of a better future—that people can
and do overcome the internal and external challenges, barriers, and obstacles that
confront them.. Recovery is also holistic, addressing an individual's whole life,
including body, mind, spirit and community. Recovery is supported by peers and allies
and through relationships and social networks. Finally, recovery is supported by
addressing trauma, such that services and supports should be trauma-informed to
foster safety.
13. A nurse is assessing a client to evaluate the client's mental health and wellness.
Applying the eight dimensions of wellness, which of the following would the nurse
identify as reflecting emotional wellness?
A) Finding ways to expand creative abilities
B) Recognizing the need for sleep and nutrition
C) Searching for meaning in life
D) Developing skills for dealing with stress
Ans:
D
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Chapter: 1
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 1
Page Number: 2
Feedback: The emotional dimension of wellness focuses on developing skills and
strategies to cope with stress. The intellectual dimension focuses on recognizing
creative abilities and finding ways to expand one's knowledge and skills. The physical
dimension focuses on recognizing the need for physical activity, diet, sleep and
nutrition. The spiritual dimension focuses on the search for meaning and purpose in
the human experience.
14. Which of the following would be a major barrier affecting the treatment of
individuals with mental health problems?
A) Lack of a diagnostic criteria
B) Inability to obtain epidemiologic data
C) Stigma associated with mental health problems
D) Limited hope for recovery
Ans: C
Chapter: 1
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
GRADESLAB.COM
Integrated Process: Nursing Process
Objective: 3
Page Number: 3
Feedback: Stigma is one of the major treatment barriers facing individuals with
mental health problems and their families. Diagnostic criteria have been established
for mental disorders, and evidence through epidemiologic research provides valuable
information about the mental health status of population groups and associated
factors. A guiding principle of recovery is hope, the belief that recovery is real and that
the people can and do overcome the internal and external challenges, barriers and
obstacles confronting them.
15.
A)
B)
C)
D)
Which statement best reflects measures to address public stigma?
“The client with schizophrenia needs additional assistance.”
“The bipolar in room 222 is really out of control today.”
“That client down the hall is a raving maniac.”
“That hyperactive client is acting like a psycho.”
Ans: A
Chapter: 1
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 5
Page Number: 4
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Feedback: One way to reduce public stigma is to use nonstigmatizing language.
Rather than referring to the client as schizophrenic or bipolar, it is more appropriate to
say "the client with schizophrenia" or "the client with bipolar disorder." Terms such as
maniac and psycho reinforce the negative images of mental illness.
16. When assessing a client with a mental illness, the nurse determines that the
client is experiencing label avoidance when the client states which of the following?
A) “I'm at the cause of my illness.”
B) “I'll never be able to function in the world.”
C) “I'm as crazy as everybody thinks I am.”
D) “I really don't need to see anyone.”
Ans: D
Chapter: 1
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 5
Page Number: 4
Feedback: Label avoidance involves an individual not seeking treatment so as not to
be labeled as mentally ill. The statement about not really needing to see anyone
suggests label avoidance. The statements about being the cause of the illness, not
being able to function in the world, and being as crazy as everyone says reflect
self-stigma, the internalization of negative stereotypes by individuals with mental
GRADESLAB.COM
illness.
17. A nurse is describing the four dimensions of recovery to a group of new
psychiatric--mental health nurses. Which dimension is the nurse describing when
addressing relationships and social networks?
A) Health
B) Home
C) Purpose
D) Community
Ans: D
Chapter: 1
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 6
Page Number: 4
Feedback: There are four dimensions that support recovery: health (managing
disease and living in a physically and emotionally healthy way), home (a safe and
stable place to live), purpose (meaningful daily activities and independence,
resources and income), and community (relationships and social networks).
18.
A nurse is reading a journal article about epidemiologic research and mental
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
illness. Which of the following mental health conditions would the nurse expect to find
as being projected as the leading burden of disease worldwide by the year 2030?
A) Depression
B) Anxiety
C) Substance abuse
D) Anorexia nervosa
Ans: A
Chapter: 1
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 4
Page Number: 2
Feedback: Based on epidemiologic research, depression is one of the leading disease
burdens in middle- and high-income countries, such as the United States. By 2030,
depression is projected to be the leading burden worldwide.
19. Which of the following would be used to document a specific pattern of
symptoms that occurs within a community?
A) Cultural syndrome
B) Stigma
C) Wellness
D) Stereotype
GRADESLAB.COM
Ans: A
Chapter: 1
Client Needs: Psychosocial Integrity
Cognitive Level: Understand
Integrated Process: Nursing Process
Objective: 3
Page Number: 3
Feedback: A cultural syndrome refers to a specific pattern of symptoms that occurs
within a specific cultural group or community. Stigma refers to a mark of shame,
disgrace, or disapproval that results in an individual being shunned or rejected by
others. Wellness is a purposeful process of individual growth, integration of
experience, and meaningful connection with others. It reflects personally valued goals
and strengths, and results in being well and living by values.
Multiple Select
20. A psychiatric–mental health nurse is preparing a presentation about recovery for
a group of newly hired nurses at the mental health facility. Which would the nurse
identify as important concepts? (Select all that apply.)
A) Self-direction
B) Peer support
C) Respect
D) Hope
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
E)
Culturally-based
Ans: A, B, C, D
Chapter: 1
Client Needs: Psychosocial Integrity
Cognitive Level: Understand
Integrated Process: Nursing Process
Objective: 6
Page Number: 5
Feedback: Recovery is multifactorial. It encompasses self-direction, peer support,
and respect as fundamental components for recovery; hope–the catalyst of the
recovery process–is one of the most important concepts. It is through hope that
individuals and families can overcome the barriers and obstacles facing them. Culture
and cultural background in all of its diverse representations including values,
traditions, and beliefs are key in determining a person's journey and unique pathway
to recovery.
GRADESLAB.COM
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Test Generator Questions, Chapter 2, Cultural and Spiritual
Issues Related to Mental Health Care
Multiple Choice
1. When reviewing several studies about Hispanic Americans and their use of mental
health care facilities, the nurse notes that this cultural group tends to use all other
resources before seeking help from mental health professionals. Which would the
nurse identify as a reason for this belief about many mental health facilities?
A) Require periods of hospitalization
B) Do not provide 24-hour emergency services
C) Are not reimbursed by third-party payers
D) Do not accommodate their cultural needs
Ans: D
Chapter: 2
Client Needs: Psychosocial Integrity
Cognitive Level: Remember
Integrated Process: Culture & Spirituality
Objective: 2
GRADESLAB.COM
Page Number: 10
Feedback: Studies reveal that Hispanic Americans are reluctant to seek mental
health services because they believe that those services do not accommodate their
cultural needs (e.g., language, beliefs, values), cost of care, and concerns regarding
immigration status. Many instead seek help through supportive family services and
the church. Required hospitalization, lack of 24-hour emergency services, and lack of
reimbursement do not play a role.
2. A nurse is preparing a presentation about mental health problems associated with
specific cultural groups. When describing mental health problems associated with
Native Hawaiian adolescents, the nurse would address high rates of which?
A) Schizophrenia
B) Manic disorders
C) Dementia
D) Suicide
Ans: D
Chapter: 2
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 2
Page Number: 11
Feedback: Research regarding specific mental health problems in Asian cultures is
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
sparse, but various data suggest rates of suicide for Native Hawaiian adolescents are
higher than those of other adolescents in the United States.
3. A psychiatric–mental health nurse is providing care to a client who has recently
immigrated to the United States from Eastern Europe. Which of the following would be
least effective in providing culturally competent care?
A) Demonstrating a genuine interest in the client
B) Avoiding assumptions about the client’s culture
C) Learning a few key words in the native language provides quality care
D) Acquiring information about the client’s country
Ans: C
Chapter: 2
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Culture & Spirituality
Objective: 1
Page Number: 9
Feedback: Although communicating with the client in his native language may be
appropriate, speaking the same language does not guarantee shared meaning and
understanding of the client and his or her culture, a necessary component of cultural
competence. Demonstrating a genuine interest, avoiding assumptions, and acquiring
information about the client’s country are appropriate and effective actions for
providing culturally competent care.
GRADESLAB.COM
4. A psychiatric–mental health nurse is meeting with a military spouse who is Asian
American. When the client describes their spouse’s mental health problems, which
response would the nurse most likely expect?
A) “Oh, they may seem depressed, but it is just a vitamin deficiency. It runs in their
family.”
B) “I know the war messed their mind up. They’ll never be the same.”
C) “Sometimes they hallucinate that they are back in Vietnam.”
D) “They never talk to me about what is bothering them.”
Ans: A
Chapter: 2
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Culture & Spirituality
Objective: 2
Page Number: 11
Feedback: Generally, Asian cultures have a tradition of denying or disguising the
existence of mental illness. In many of these cultures, it is an embarrassment to have
a family member treated for mental illness, which may explain the extremely low
utilization of mental health services. The response about the war messing up the
spouse’s mind, or the statement about hallucinations, reflects some acknowledgment
of a mental health problem. The response about never talking about what is bothering
them also indicates some understanding of an underlying problem.
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
5. A psychiatric–mental health nurse is working with a client who is being treated for
depression. Which client statement would indicate that their spirituality is intact?
A) “My church friends came to visit me this past Sunday afternoon.”
B) “Nothing will ever be the same again; my life is not worth living.”
C) “I know I am as well off as I can be under the circumstances.”
D) “I know God must be punishing me for all my sins.”
Ans: C
Chapter: 2
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Culture & Spirituality
Objective: 4
Page Number: 14
Feedback: Perception of well-being and health in persons with severe mental illness
has been positively associated with spirituality; Answer C implies that the client has a
sense of well-being despite their depression. The statement about church friends
visiting reflects the client’s religiousness or participation in a community of people
who gather around common ways of worshiping. The statements about life not being
worth living and that God is punishing them for their sins reflect hopelessness.
6. A client is being treated for prostate cancer; his prognosis is very poor. The client
has a strong faith, and he has been active in his church for many years. He is
GRAchallenges
DESLAB.he
COfaces
M
concerned about his health and the
as his cancer progresses.
Which comment by the nurse reflects the most appropriate spiritual nursing
intervention for the client?
A) “I’ll take you to visit my church if you can get a pass.”
B) “You have to belong to the same church I do if you’re going to go to heaven.”
C) “Would you like me to bring you a guided imagery audiotape?”
D) “We can pray together if you’d like.”
Ans: D
Chapter: 2
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Caring
Objective: 4
Page Number: 14
Feedback: To carry out spiritual interventions, the nurse enters a therapeutic
relationship with the client and uses the self as a therapeutic tool. Offering to pray
with the client is the only intervention that allows the nurse to use herself as a
therapeutic tool. Prayer is an appropriate spiritual intervention in this situation
because of the client’s religious background and his need for solace and hope. The
statements about taking the client to the nurse’s church and belonging to the same
church to get to heaven focus on meeting the nurse’s need rather than the client’s
need. The statement about bringing a guided imagery audiotape, although an
appropriate spiritual intervention, would not be helpful for this client at this time
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
because of his poor prognosis and concerns about the challenges he will face.
7. A psychiatric–mental health nurse is educating a class at a community health
center on social factors associated with mental illness. When describing the influence
of poverty and effects of the downward economic spiral on mental health, which
population would the nurse identify as being the most at risk?
A) Older adults
B) Individuals with physical disabilities
C) Single-parent families
D) Homeless individuals
Ans: D
Chapter: 2
Client Needs: Psychosocial Integrity
Cognitive Level: Remember
Integrated Process: Nursing Process
Objective: 1
Page Number: 10
Feedback: Poverty affects all cultural groups and other groups such as older adults,
people with physical disabilities, individuals with psychiatric impairments, and
single-parent families. Often, those in poverty become trapped in a downward
economic spiral as tensions and stress mount. The homeless population is the group
most at risk for becoming unable to escape the spiral of poverty.
GRAstates,
DESLA“We
B.Crely
OM on our large extensive family for
8. During an assessment, the client
moral support and help, and we treat our elders with a great deal of respect. If
someone gets sick, the family takes care of them.” How should the nurse interpret this
statement?
A) Acculturation
B) Cultural identity
C) Cultural competence
D) Linguistic competence
Ans: B
Chapter: 2
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Culture & Spirituality
Objective: 2
Page Number: 9
Feedback: Everyone has a cultural identity or a set of cultural beliefs with which one
looks for standards of behavior. The client’s statements reflect their cultural identity.
Acculturation refers to the socialization process by which minority groups learn and
adopt selective aspects of the dominant culture, eventually leading to the evolvement
of a new minority culture (one that is different from the native culture and different
from the dominant culture). Cultural competence involves an adjustment or
recognition of one’s own culture in order to understand the client’s culture. Linguistic
competence is the capacity to communicate effectively and convey information that is
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
easily understood by diverse audiences.
9. Within the context of the culture of poverty, which most clearly describes why
individuals who are part of this culture become trapped in a downward economic
spiral?
A) Unemployment causes poverty; a lack of will power and motivation can, in turn,
cause unemployment in people who do not have a strong work ethic.
B) Individuals lack the finances to pay rent, so they eventually do not have an
address to use in filling out job applications.
C) Characteristics of poverty (joblessness and lack of financial independence) can, in
turn, contribute to attributes (feelings of powerlessness and low self-esteem) that
sustain poverty.
D) Poverty is passed on from generation to generation; individuals learn at an early
age that there is no way to escape living in poverty.
Ans: C
Chapter: 2
Client Needs: Psychosocial Integrity
Cognitive Level: Remember
Integrated Process: Nursing Process
Objective: 2
Page Number: 10
Feedback: Families experiencing poverty are under tremendous financial and
emotional stress, which may trigger or exacerbate mental health problems. Along
ADESLAfood
B.Cand
OM shelter for themselves and their
with the daily stressors of trying G
toRprovide
families, the lack of time, energy, and money prevents them from attending to their
psychological needs. Often, these families become trapped in a downward economic
spiral as tensions and stress mount. The inability to gain employment and the lack of
financial independence add to feelings of powerlessness and low self-esteem. Feeling
powerless and having low self-esteem have the potential to keep these individuals
from trying to find employment.
10.
A)
B)
C)
D)
The nurse has a very religious client. How should the nurse define religiousness?
Feeling of connectedness
Way of interpreting life events
Relationship with a unifying force
Community participation in common worship
Ans: D
Chapter: 2
Client Needs: Psychosocial Integrity
Cognitive Level: Remember
Integrated Process: Nursing Process
Objective: 3
Page Number: 12
Feedback: Religiousness refers to the participation in a community of people who
gather around common ways of worshiping. Spirituality refers to feelings of
connectedness with God, spirit, nature, or a unifying force, and is a way of
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
interpreting life events.
Multiple Select
11. A psychiatric–mental health nurse works in a rural mental health clinic. What
should the nurse understand impacts the use of mental health services for rural
populations? Select all that apply.
A) Limited access to care
B) Lack of available resources
C) Geographical similarities
D) Diverse cultural groups
E) Consistency in treatment approaches
Ans: A, B, D
Chapter: 2
Client Needs: Psychosocial Integrity
Cognitive Level: Remember
Integrated Process: Nursing Process
Objective: 2
Page Number: 11, 12
Feedback: All age groups in rural areas have limited access to health care. The lack
of resources is particularly problematic since most mental health services are located
in urban areas
because more people live near cities. Rural areas are also diverse in both geography
RAmental
DESLAhealth
B.COMfor those in the Deep South is
and culture. For example, accessGto
different from access for those with the same problems in the Northwest. Treatment
approaches may be accepted in one part of the country but not in another.
Multiple Choice
12. A psychiatric–mental health nurse is working on developing cultural
competence. Which would be most appropriate for the nurse to do?
A) Research information about the cultures of the population being served after
assessing the clients.
B) Recognize that one’s own culture is the predominant way of addressing a client’s
health care needs.
C) Assume that any individual of a racial or ethnic group is the same as another
individual in that group.
D) Demonstrate an appreciation of, and a genuine interest in, the individual and his
or her cultural beliefs.
Ans: D
Chapter: 2
Client Needs: Psychosocial Integrity
Cognitive Level: Understand
Integrated Process: Nursing Process
Objective: 1
Page Number: 14
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Feedback: Cultural competence requires that the nurse demonstrates a willingness
and ability to draw on community-based values, traditions, and customs, and that the
nurse values clients’ cultural beliefs. The nurse needs to demonstrate a genuine
interest in, and respect for, the individual and his or her beliefs. The nurse should
learn about the client’s country of origin and culture before assessing the client.
Cultural competence requires the nurse to adjust or recognize his or her own culture
in order to understand the client’s culture. It also requires the nurse to understand
and appreciate the cultural differences and similarities within, among, and between
groups. Nurses need to avoid assuming that all individuals of a racial or ethnic group
are the same.
13. During assessment, a client tells the nurse that he follows Buddhist beliefs. The
nurse would integrate understanding of which statement when developing the client’s
plan of care?
A) Desire is the cause of all human suffering and misery.
B) Self-indulgence is necessary to reach nirvana.
C) Present behavior is based on current unhappiness.
D) Visions can be achieved through personal meditation and contemplation.
Ans: A
Chapter: 2
Client Needs: Psychosocial Integrity
Cognitive Level: Understand
Integrated Process: Culture & Spirituality
GRADESLAB.COM
Objective: 5
Page Number: 12
Feedback: Buddhism attempts to deal with problems of human existence, such as
suffering and death, with the belief that all human suffering and misery are caused by
desire. Self-indulgence is to be avoided; good deeds and compassion facilitate the
process toward nirvana. Salvation through faith and humility reflects the beliefs of
Christianity.
14. After educating a group of students on the beliefs associated with the world’s
major religions, the instructor determines that additional teaching is needed when the
students identify which belief as associated with Confucianism?
A) People are born good.
B) People are assigned to castes.
C) Authority figures are respected.
D) Self-responsibility leads to improvement.
Ans: A
Chapter: 2
Client Needs: Psychosocial Integrity
Cognitive Level: Remember
Integrated Process: Teaching/Learning
Objective: 5
Page Number: 12
Feedback: Caste assignment reflects Hinduism. According to Confucianism, people
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
are born good; authority figures and parents are respected; and improvement is
gained through self-responsibility, introspection, and compassion for others.
15. During an interview, a client states, “God does not exist for me.” The nurse
interprets this statement as reflecting which of the following?
A) Animism
B) Agnosticism
C) Atheism
D) Polytheism
Ans: C
Chapter: 2
Client Needs: Psychosocial Integrity
Cognitive Level: Understand
Integrated Process: Culture & Spirituality
Objective: 4
Page Number: 13
Feedback: Atheism is the belief that no God exists, as “God” is defined in any current
existing culture of society. Animism reflects the belief that souls or spirits are
embodied in all beings and everything in nature. Agnosticism is the belief that
whether there is a God and spiritual world (or any ultimate reality) is unknown and
probably unknowable. Polytheism is the belief in many gods, in the basic powers of
nature.
GRADof
ESHinduism,
LAB.COMa nurse identifies the castes. The
16. After reviewing the major beliefs
nurse demonstrates understanding by identifying which caste as including priests and
intellectuals?
A) Kshatriyas
B) Vaisyas
C) Brahmans
D) Untouchables
Ans: C
Chapter: 2
Client Needs: Psychosocial Integrity
Cognitive Level: Understand
Integrated Process: Teaching/Learning
Objective: 5
Page Number: 13
Feedback: In Hinduism, all people are assigned to castes. Brahmans include priests
and intellectuals. Kshatriyas include rulers and soldiers. Vaisyas include farmers,
skilled workers, and merchants. Sudras include servants, laborers, and peasants.
Untouchables include the outcasts.
17. During an interview, a client tells the nurse that he has a feeling of a connection
to a higher power. The nurse interprets this as which of the following?
A) Spirituality
B) Self-transcendence
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
C) Cultural identity
D) Religiousness
Ans: B
Chapter: 2
Client Needs: Psychosocial Integrity
Cognitive Level: Remember
Integrated Process: Nursing Process
Objective: 3
Page Number: 12
Feedback: Self-transcendence is characterized by a feeling of connection and
mutuality to a higher power. Spirituality develops over time and is a dynamic,
conscious process, characterized by two movements of transcendence (going beyond
the limits of ordinary experiences): either deep within the self or beyond the self.
Religiousness refers to the participation in a community of people who gather around
common ways of worshiping. Cultural identity is a set of cultural beliefs with which
one looks for standards of behavior.
18. A group of nurses is preparing an in-service presentation about culture and
mental illness. When describing cultural explanations, which of the following would
the group include?
A) Suffering within a cultural group
B) Perceived causes for symptoms
C) Social factors contributing to the disorder
GRADESLAB.COM
D) Ability to communicate effectively
Ans: B
Chapter: 2
Client Needs: Psychosocial Integrity
Cognitive Level: Remember
Integrated Process: Culture & Spirituality
Objective: 2
Page Number: 9
Feedback: A cultural explanation refers to the perceived causes of the symptoms.
Cultural idiom of distress describes the suffering within a cultural group. Cultural
explanations do not describe the social factors contributing to a disorder. Linguistic
competence is the capacity to communicate effectively and convey information that is
easily understood by diverse audiences.
19. A nurse is assessing a client who has come to the health care facility for
treatment. During the assessment, the client states, “I don’t know if there is a God or
Heaven.” The nurse interprets this statement to be a reflection of:
A) Agnosticism
B) Atheism
C) Maoism
D) Scientism
Ans:
A
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Chapter: 2
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Culture & Spirituality
Objective: 5
Page Number: 13
Feedback: Agnosticism refers to the belief that whether there is a God and a spiritual
world or any ultimate reality is unknown and probably unknowable. Atheism is the
belief that no God exists because God is defined in any current existing culture of
society. Maoism reflects the faith that is centered in the leadership of the Communist
Party and all the people; the major belief goal is to move away from individual
personal desires and ambitions toward viewing and serving all people as a whole.
Scientism is the belief that values and guidance for living come from scientific
knowledge, principles, and practices; systematic study and analysis of life, rather
than superstition, lead to true understanding and practice of life.
10. The nurse is assessing an Asian American client. During the interview, the nurse
determines that the client likely follows Taoism based on which statement?
A) “Purity and balance guide all of my actions.”
B) “I strive to be in happy harmony with nature.”
C) “Nature’s powers must be respected in life.”
D) “God is worshiped out of love, not fear.”
Ans: B
GRADESLAB.COM
Chapter: 2
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Culture & Spirituality
Objective: 5
Page Number: 13
Feedback: According to Taoism, quiet and happy harmony with nature is the key
belief. Purity and balance in physical and mental life are major motivators for personal
conduct with Shintoism. Respect for the powers of nature and pleasing the spirits are
fundamental beliefs associated with animism. Worshipping God out of love, not fear,
reflects Judaism.
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Test Generator Questions, Chapter 3, Patient Rights and Legal
Issues
Multiple Choice
1. A nurse is explaining advance care directives, or "living wills," to a client and the
client's spouse. Which statement would the nurse include in the description?
A) The document tells what treatment is to be omitted if the client is unable to make
the decision.
B) It requires that the client sign the "living will" document while an attorney is
present.
C) The client's physician must act as a witness when the client signs the document.
D) An attorney draws up the papers to be given to the client and his or her family.
Ans: A
Chapter: 3
Client Needs: Safe, Effective Care Environment: Management of Care
Cognitive Level: Understand
Integrated Process: Teaching/Learning
Objective: 1
Page Number: 17
GRADorE"living
SLAB.wills,"
COM state what treatment should be
Feedback: Advance care directives,
omitted or refused if the client is unable to make those decisions. An advance care
directive requires two witnesses and notarization but does not require an attorney.
2. A psychiatric–mental health nurse determines that a client is competent when
they are able to do which action?
A) Speak coherent English
B) Communicate their choices
C) Write a “living will”
D) Comply with the medical regimen
Ans: B
Chapter: 3
Client Needs: Safe, Effective Care Environment: Management of Care
Cognitive Level: Remember
Integrated Process: Nursing Process
Objective: 3
Page Number: 19
Feedback: The client who is competent to give an informed consent should be able to
communicate choices, understand relevant information, appreciate the situation and
its consequences, and use a logical thought process to compare the risks and benefits
of treatment.
3.
A client receives a court order for commitment. Which best exemplifies the
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
concept of “least restrictive environment”?
A) Involuntary commitment to an outpatient community mental health center
B) Medication administration for sedation so the client cannot get out of bed
C) Placing the client in a locked padded room in response to threats of self-harm
D) Restraining the client with the fewest number of restraint points possible
Ans: A
Chapter: 3
Client Needs: Safe, Effective Care Environment: Management of Care
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 4
Page Number: 20
Feedback: An example of the concept of "least restrictive environment" is
involuntary commitment of a client to an outpatient mental health center. Medications
cannot be given unnecessarily, such as to keep a client in bed. An individual cannot be
restrained or locked in a room unless all other "less restrictive" interventions are
attempted first. Although clients should be physically restrained with the fewest
restraint points possible, there is no indication that this client requires restraint.
Physical restraints should be applied only after all other interventions have been used
and the client continues to be a danger to self or others.
4. A nurse is caring for a client who is hospitalized for a mental disorder. The nurse
is legally obligated to breach the client's confidentiality if the client states which of the
GRADESLAB.COM
following?
A) “I think that the federal government is spying on me.”
B) “I get really 'turned on' by your appearance.”
C) “That doctor I had today really made me angry.”
D) “When I get out of here, I'm going to kill my neighbor.”
Ans: D
Chapter: 3
Client Needs: Safe, Effective Care Environment: Management of Care
Cognitive Level: Apply
Integrated Process: Communication and Documentation
Objective: 6
Page Number: 22, 23
Feedback: When there is a judgment that the client has harmed someone or is about
to injure someone, the nurse is mandated to breach confidentiality and report this to
the authorities. The statement about killing the neighbor is an example. Thinking that
the federal government is spying on the person reflects paranoid thinking. The
statement about being "turned on" reflects manipulative behavior. The statement
about feeling angry about the doctor provides information about the client's feelings.
The nurse would be mandated to report this statement only if the client went on to say
that he or she was planning to "hurt" the doctor.
5. Which client would the nurse determine to be the most likely candidate for
involuntary commitment? The client who:
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
A) Refuses to take the prescribed medication
B) Is screaming in the street disturbing neighbors
C) Refuses to participate in the planned therapy
D) Is homeless and has been diagnosed with a mental disorder.
Ans: B
Chapter: 3
Client Needs: Safe, Effective Care Environment: Management of Care
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 4
Page Number: 21, 22
Feedback: The client who is screaming in the street is more likely to be judged as a
danger to themselves or to others. Clients have a right to refuse medications or to not
participate in therapy in many states and provinces. Being homeless or refusing
medication or therapy does not pose an immediate danger to oneself or others.
6. The nurse is providing care to a client who is hospitalized with a diagnosis of
schizophrenia. Which statement would be appropriate for the nurse to include in the
client's medical record?
A) “Client stated that they had a good night with no complaints.”
B) “Reported they are unable to sleep because he heard voices throughout the
night.”
C) “Had a typical night without incidence of insomnia or nightmares.”
GRnight;
ADESkept
LAB.
COM voices and noises.”
D) “Acted crazily throughout the
hearing
Ans: B
Chapter: 3
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Communication and Documentation
Objective: 10
Page Number: 25, 26
Feedback: The most appropriate statement to be recorded is: “Reported they are
unable to sleep because he heard voices throughout the night.” This statement clearly
depicts the client’s problem and the reason why. The nurse should avoid jargon and
stereotypical statements, such as “having a good night” or “no complaints” or acting
crazily. Only meaningful, accurate, objective descriptions of the behavior should be
used.
7. A nurse working on the psychiatric unit receives a telephone call from the
employer of one of the clients on the unit. The employer asks to be sent a copy of Mr.
Murray's latest laboratory work and psychological testing results so Mr. Murray's
medical records in employee health can be kept up-to-date. Based on the nurse's
knowledge about issues surrounding breach of confidentiality, which response would
be the most appropriate?
A) “I'm sorry; we're not allowed to give out that information about our client.”
B) “I'll have to get the client's signed consent before we can send that information to
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
you.”
C) “I am unable to acknowledge whether or not a Mr. Murray is a client on this unit.”
D) “Sure, give me your address, and I will see that the information is sent to you.”
Ans: C
Chapter: 3
Client Needs: Safe, Effective Care Environment: Management of Care
Cognitive Level: Apply
Integrated Process: Communication and Documentation
Objective: 6
Page Number: 22
Feedback: A breach of confidentiality is the release of client information without the
client's consent in the absence of legal compulsion or authorization to release
information. Acknowledging that Mr. Murray is a client on the unit would be such a
breach. Even if the nurse explains that he or she cannot give the information without
the client's consent, the explanation lets the employer know that Mr. Murray is
receiving care in a psychiatric hospital.
8. A psychiatrist informs a client that they think the client needs to participate in a
three-month outpatient aftercare program after discharge. What would protect the
client's right to request a second opinion before agreeing to this suggestion?
A) Self-determinism
B) Least restrictive environment
C) Confidentiality
GRADESLAB.COM
D) Mandates to inform
Ans: A
Chapter: 3
Client Needs: Safe, Effective Care Environment: Management of Care
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 1
Page Number: 17, 18
Feedback: The right of self-determination entitles all clients to refuse treatment, to
obtain other opinions, and to choose other forms of treatment. It is one of the basic
clients’ rights established by Title II, Public Law 99-139, outlining the Universal Bill of
Rights for Mental Health Patients. Least restrictive environment means that an
individual cannot be restricted to an institution when he or she can be successfully
treated in the community. Confidentiality is an ethical duty of nondisclosure.
“Mandates to inform” is a term referring to the legal obligation to breach
confidentiality when there is a judgment that the client has harmed, or is about to
injure, another person.
9. A nurse is preparing to administer an as-needed (PRN) medication. What would
the nurse need to keep in mind when documenting administration?
A) Reason for administration, dosage, route, and response to the medication the
first time it is administered to a client.
B) Reason for administration, dosage, route, and response to the medication every
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
time it is administered to a client.
C) Reason for administration, dosage, and route the first time it is administered to a
client.
D) Reason for administration, dosage, and route every time it is administered to a
client.
Ans: B
Chapter: 3
Client Needs: Safe, Effective Care Environment: Management of Care
Cognitive Level: Apply
Integrated Process: Communication and Documentation
Objective: 10
Page Number: 26
Feedback: Medications prescribed on a PRN basis require including a reason for
administration, dosage, route, and response to the medication. Documenting
responses is the only way to document treatment outcomes, and because the
outcome may be different each time, the response along with the reason for
administration, dosage, and route should be documented every time the PRN
medication is given.
Multiple Select
10. A nursing instructor is preparing a class discussion on the topic of
self-determinism. Which would the instructor expect to include? (Select all that
GRADESLAB.COM
apply.)
A) Personal autonomy as a key value
B) Choices based on pleasing others
C) Activities reflect personal goals
D) Right to refuse treatment
E) Lack of empowerment
Ans: A, C, D
Chapter: 3
Client Needs: Safe, Effective Care Environment: Management of Care
Cognitive Level: Understand
Integrated Process: Teaching/Learning
Objective: 1
Page Number: 16, 17
Feedback: Self-determinism is defined as being empowered or having the free will to
make moral judgments. Personal autonomy and avoidance of dependence are key
values. A self-determined individual is internally motivated to make choices based on
personal goals, not to please others or be rewarded. It is the right to choose one’s own
health-related behaviors and refuse treatment.
Multiple Choice
11. A group of nursing students is reviewing information about internal rights
protection systems. The students demonstrate understanding of this information
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
when they identify which organization as an example?
A) American Hospital Association
B) American Public Health Association
C) State mental health provider
D) The Joint Commission
Ans: C
Chapter: 3
Client Needs: Safe, Effective Care Environment: Management of Care
Cognitive Level: Remember
Integrated Process: Teaching/Learning
Objective: 2
Page Number: 18, 19
Feedback: Mental health care systems have internal rights protection systems or
mechanisms to combat any violation of their clients’ rights. Each state mental health
provider is required to establish and operate a system that protects and advocates for
the rights of individuals with mental illnesses. The American Hospital Association and
American Public Health Association serve as advocates for the rights and treatment of
mental health clients and are part of an external advocacy system. Clients’ rights are
also assured of protection by an agency’s accreditation, such as accreditation by The
Joint Commission.
12. After educating a class on competency and how it is assessed, the nursing
instructor determines the need for additional instruction when the class identifies
which ability as being evaluated?GRADESLAB.COM
A) Communication of choices
B) Understanding of relevant information
C) Appreciation for situation and consequences
D) Discussion of what is right and wrong
Ans: D
Chapter: 3
Client Needs: Safe, Effective Care Environment: Management of Care
Cognitive Level: Understand
Integrated Process: Teaching/Learning
Objective: 3
Page Number: 19
Feedback: A client who is competent is able to communicate choices, understand
relevant information, appreciate the situation and consequences, and use a logical
thought process to compare risks and benefits of treatment options. The ability to
discuss what is right and wrong is not a component assessed when determining
competency.
13. A client is involuntarily committed without a court order. The nurse understands
that the emergency, short-term hospitalization can occur for how long?
A) A maximum of 24 hours
B) 48 to 92 hours
C) three to five days
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
D)
One week
Ans: B
Chapter: 3
Client Needs: Safe, Effective Care Environment: Management of Care
Cognitive Level: Remember
Integrated Process: Nursing Process
Objective: 4
Page Number: 22
Feedback: Although commitment procedures vary among states, most have
provisions for an emergency, short-term hospitalization of 48 to 92 hours authorized
by a certified mental health provider without a court order. At the end of that period,
the individual must either agree to voluntary treatment or extended commitment
procedures are initiated.
14. A nurse is explaining the distinction between confidentiality and privacy. Which
of the following would the nurse include as reflecting privacy?
A) Part of personal life not governed by society's laws
B) Ethical duty for nondisclosure
C) Involvement of two individuals
D) Knowledge of treatment costs and benefits
Ans: A
Chapter: 3
GRAEnvironment:
DESLAB.COManagement
M
Client Needs: Safe, Effective Care
of Care
Cognitive Level: Remember
Integrated Process: Teaching/Learning
Objective: 5
Page Number: 22
Feedback: Privacy refers to that part of an individual's personal life that is not
governed by society’s laws and government intrusion. Confidentiality refers to an
ethical duty of nondisclosure. Confidentiality also involves two people: the individual
who discloses the information, and the person with whom the information is shared.
Informed consent is a legal procedure to ensure that the client knows the benefits and
costs of treatment.
15. A psychiatric–mental health client has an advance care directive on their medical
record. A clinician provides treatment that disregards the client’s directive. The
clinician would be liable for which of the following?
A) Assault
B) Battery
C) Medical battery
D) False imprisonment
Ans: C
Chapter: 3
Client Needs: Safe, Effective Care Environment: Management of Care
Cognitive Level: Understand
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Integrated Process: Nursing Process
Objective: 2
Page Number: 25
Feedback: Failure to respect a client's advance directive is considered medical
battery. Assault is the threat of unlawful force to inflict bodily injury on another.
Battery is the intentional and unpermitted contact with another. False imprisonment
is the detention or imprisonment contrary to the provision of law.
Multiple Select
16. The nurse should understand which element is required to prove negligence?
(Select all that apply.)
A) Duty to provide care
B) Proximate cause
C) Resultant damages
D) Breach of duty
E) Cause in fact
F) Evidence of simple mistake
Ans: A, B, C, D, E
Chapter: 3
Client Needs: Safe, Effective Care Environment: Management of Care
Cognitive Level: Understand
Integrated Process: Nursing Process
GRADESLAB.COM
Objective: 2
Page Number: 25
Feedback: Five elements are required to prove negligence: duty, breach of duty,
cause in fact, cause in proximity, and damages. Simple mistakes are not negligent
acts.
Multiple Choice
17. A psychiatric–mental health nurse is documenting information in a client’s
medical record. Which would be least likely to increase the nurse’s legal liability?
A) “Client reported that he was feeling better today than yesterday.”
B) “Administered haloperidol 10 mg IM stat as ordered for agitation.”
C) “Client was talking with another staff member and started screaming.”
D) “Applied restraints to all four client extremities.”
Ans: B
Chapter: 3
Client Needs: Safe, Effective Care Environment: Management of Care
Cognitive Level: Apply
Integrated Process: Communication and Documentation
Objective: 10
Page Number: 26
Feedback: The entry about medication administration is the most complete and
clear because it states the name of the medication, the dosage and route, and why it
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
was administered. The nurse should document objective data, not subjective opinion
based on what the nurse observed. The nurse would then be responsible for following
up this documentation with information about how the client responded to the
medication. The statement about the client feeling better, and the statement about
talking with a staff member and screaming are both vague and general. The
statement about applying restraints is incomplete. The statement needs to include
information about why the restraints were applied, that an order was obtained for the
restraints, and how the client responded to the restraints.
18. After educating a class of nursing students about the rights of persons receiving
mental health services, the instructor determines a need for additional instruction
when the students identify which of the following as a right?
A) Freedom from restraints or seclusion
B) Access to one’s own mental health records on request
C) An individualized written treatment plan
D) Refuse treatment during an emergency situation
Ans: D
Chapter: 3
Client Needs: Safe, Effective Care Environment: Management of Care
Cognitive Level: Remember
Integrated Process: Teaching/Learning
Objective: 2
Page Number: 17, 18
RADESLreceiving
AB.COMmental health services includes
Feedback: The Bill of Rights forGpersons
the right to be free from restraints or seclusion, access one’s own mental health care
records upon request, an individualized written treatment plan, and refuse treatment
except during an emergency situation.
Multiple Select
19. Which statement(s) made by the parent of a minor diagnosed with acute
depression, indicates an understanding of self-determination applicable for their
child? (Select all that apply.)
A)
“We will stop treatment if we think it is not working.“
B)
“What kinds of appropriate outpatient treatment is available?“
C)
“We would like a second opinon before agreeing on a voluntary admission.“
D)
“What is likely to happen if we decide not to agree to medication therapy?“
E)
“It is important that the hospitalization is over by the beginning of the school
year.“
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Ans:
A, B, C, D
Chapter: 3
Client Needs: Safe and Effective Care Environment: Management of Care
Cognitive Level: Analyze
Integrated Process: Teaching/Learning
Objective: 1
Page Number:
26
Feedback: The right of self-determination entitles all clients to refuse treatment, to
obtain other opinions, and to choose other forms of treatment. It is one of the basic
clients’ rights established by Title II, Public Law 99–139, outlining the Universal Bill of
Rights for Mental Health Patients. The decisions regarding the length of necessary
treatment are up to the treatment team, the client/guardians may refuse treatment if
they disagree.
20. The nurse is providing educational information to a client prescribed medication
therapy for the treatment of severe depression. Which statement(s) made by the
nurse demonstrates an understanding of the client’s right to provide informed
consent? (Select all that apply.)
A)
“I would really prefer to takeGR
my
doses
ADdaily
ESLA
B.COofMmedication around meal time.“
B)
“This medication can make me dizzy so I need to get up slowly from a sitting
position.“
C)
“Let’s discuss which type of antidepressant I think my provider should prescribe
for me.“
D)
“I should not stop taking my medication without first talking to my health care
provider.“
E)
“It may take several weeks of taking the medication in order to notice any positive
changes.“
Ans:
A, B, D, E
Chapter:
3
Client Needs: Safe and Effective Care Environment: Management of Care
Cognitive Level:
Analyze
Integrated Process:
Nursing Process
Objective: 3
Page Number:
19
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Feedback: A client who is competent to give informed consent should be able to
achieve the following: communicate choices, understand relevant information, and
appreciate the situation and its consequences. In this situation, deciding the
appropriateness of a particular class of antidepressant is a medical decision not a
client decision.
GRADESLAB.COM
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Test Generator Questions, Chapter 4, Ethics, Standards, and
Nursing Frameworks
Multiple Choice
1. When applying the biopsychosocial model to client care, the nurse integrates the
psychological domain when involved with which approach?
A) Behavior therapy
B) Family support
C) Nutritional therapy
D) Sleep hygiene measures
Ans: A
Chapter: 4
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 4
Page Number: 34
Feedback: Cognitive approaches, behavior therapy, and client education are all
based on the use of theories from the psychological domain. Family support involves
GRADE
SLsleep
AB.Chygiene
OM
the social domain. Nutritional therapy
and
measures address the
biologic domain.
2. A nursing instructor is describing the impact of technology and electronic health
records on psychiatric–mental health care. Which major challenge would the
instructor identify as associated with it?
A) Maintaining confidentiality
B) Establishing educational models
C) Decreasing fragmented care
D) Defining professional standards more clearly
Ans: A
Chapter: 4
Client Needs: Safe, Effective Care Environment: Management of Care
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 6
Page Number: 36
Feedback: One major challenge of new technology and electronic health records is
maintaining confidentiality and privacy. Records are now readily available and easily
accessed. Fragmented care is associated with changes in the health care delivery
system. The growing knowledge base in conjunction with disseminating and applying
this knowledge poses challenges related to education and professional standards.
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
3. A psychiatric nursing class is discussing current trends in mental health care. A
student voices the opinion that there should be equitable access to mental health care
and resources for those who live in rural areas, for those without health insurance,
and for those with very little income. The student nurse’s opinion most closely reflects
which ethical principle?
A) Nonmaleficence
B) Paternalism
C) Veracity
D) Justice
Ans: D
Chapter: 4
Client Needs: Safe, Effective Care Environment: Management of Care
Cognitive Level: Apply
Integrated Process: Communication and Documentation
Objective: 1
Page Number: 30
Feedback: Justice is the duty to treat all fairly, distributing the risks and benefits
equally. Justice becomes an issue when some portion of a population does not have
access to health care. Nonmaleficence is the duty to cause no harm, both individually
and for all. Paternalism is the belief that knowledge and education authorize
professionals to make decisions for the good of clients. Veracity is the duty to tell the
truth.
GRADESLAB.COM
4. A nurse is initiating a relationship with a new client. After meeting, the nurse
makes arrangements to visit again around lunchtime. A colleague invites the nurse to
go to the gym with them during lunch. The nurse decides to forgo the gym and talk
with the client. The nurse’s decision reflects which ethical principle?
A) Autonomy
B) Beneficence
C) Fidelity
D) Veracity
Ans: C
Chapter: 4
Client Needs: Safe, Effective Care Environment: Management of Care
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 1
Page Number: 30
Feedback: Fidelity is faithfulness to obligations and duties. It is keeping promises.
Fidelity is important in establishing trusting relationships. With autonomy, each
person has the fundamental right of self-determination. According to the principle of
beneficence, the health care provider uses knowledge of science and incorporates the
art of caring to develop an environment in which individuals achieve their maximal
health care potential. Veracity is the duty to tell the truth.
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
5. In a post-clinical conference, a group of students is engaged in a discussion with
their instructor. The instructor has the students analyze and evaluate the nursing
interventions implemented throughout the clinical experience. The students are
engaged in which activity?
A) Therapeutic use of self
B) Critical thinking
C) Interdisciplinary care
D) Planning care
Ans: B
Chapter: 4
Client Needs: Safe, Effective Care Environment: Management of Care
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 5
Page Number: 34
Feedback: Sound clinical reasoning depends on critical thinking skills and reflection.
Reflection involves continual self-evaluation through observing, monitoring, and
judging nursing behaviors with the goal of providing ideal interventions. In
therapeutic use of self, the nurse guides, teaches, and advocates for clients through
the therapeutic relationship. Interdisciplinary care involves collaboration with other
professionals. Planning care involves participation of the client for the provision of
services to the client.
GRAthe
DESfunctions
LAB.COofM psychiatric nurses. The students
6. A group of students is reviewing
demonstrate understanding of the information when they identify which as an
advanced practice level function?
A) Milieu therapy
B) Promotion of self-care
C) Psychopharmacologic interventions
D) Health promotion activities
Ans: C
Chapter: 4
Client Needs: Safe, Effective Care Environment: Management of Care
Cognitive Level: Analyze
Integrated Process: Teaching/Learning
Objective: 2
Page Number: 32
Feedback: Psychopharmacology interventions are advanced practice level functions.
Milieu therapy, self-care promotion, and health promotion are basic-level functions.
7. A nursing instructor has prepared a lecture about the scope and standards of
practice of psychiatric nurses. The instructor determines that the education was
effective when the students identify which as common to both basic and advanced
level practice of psychiatric nurses?
A) Case management
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
B) Program development
C) Clinical supervision
D) Community interventions
Ans: A
Chapter: 4
Client Needs: Safe, Effective Care Environment: Management of Care
Cognitive Level: Understand
Integrated Process: Nursing Process
Objective: 2
Page Number: 32
Feedback: Both basic and advanced level psychiatric nurses engage in case
management. Only advanced practice level psychiatric nurses engage in program
development, clinical supervision, and community interventions.
8. A nurse is working on developing ways to meet the challenge of knowledge
development. What would be most appropriate?
A) Access new information through continuing education programs.
B) Improve access to community psychiatric care for all populations.
C) Reduce the burden of mental illness by fighting stigma.
D) Provide culturally competent, high-quality nursing care.
Ans: A
Chapter: 4
GRAEnvironment:
DESLAB.COManagement
M
Client Needs: Safe, Effective Care
of Care
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 6
Page Number: 35, 36
Feedback: Accessing new information through journals, electronic databases, and
continuing education programs takes time and vigilance, but provides a sound basis
for application of new knowledge. Improving access to community psychiatric care
and reducing the burden of mental illness are ways to overcome the stigma. Providing
culturally competent, high-quality care is a means to address the challenges of the
health care delivery system.
9. A client 22 years of age with schizophrenia is refusing antipsychotic medication.
The client states, “I don't like the dopey way it makes me feel. I feel like I'm walking
underwater when I take it.” The nurse explains to them, “Your schizophrenia is caused
by a chemical imbalance in your brain, and this medication helps fix that chemical
imbalance. You need to take it so your symptoms will get better.” This conversation
reflects a conflict between which two types of ethical principles?
A) Autonomy and justice
B) Paternalism and veracity
C) Justice and nonmaleficence
D) Autonomy and beneficence
Ans:
D
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Chapter: 3
Client Needs: Safe, Effective Care Environment: Management of Care
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 1
Page Number: 30
Feedback: Ethical conflicts can occur when the client is being guided by the principle
of autonomy and the nurse by the principle of beneficence. According to the principle
of autonomy, each person has the fundamental right of self-determination. According
to the principle of beneficence, the health care provider uses knowledge of science,
and incorporates the art of caring, to develop an environment in which individuals
achieve their maximal health care potential. Justice involves a duty to treat all fairly.
Paternalism is the belief that knowledge and education authorize professionals to
make decisions for the good of the client. Veracity is the duty to tell the truth.
Nonmaleficence is the duty to cause no harm.
10. A psychiatric–mental health nurse is adhering to the standards of practice. When
engaging in clinical decision making, the nurse is integrating which concept as the
foundation?
A) Developmental issues
B) Nursing process
C) Commitment
D) Accountability
GRADESLAB.COM
Ans: B
Chapter: 4
Client Needs: Safe, Effective Care Environment: Management of Care
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 2
Page Number: 31
Feedback: Although developmental issues, commitment, and accountability are all
concepts addressed in clinical decision making, the foundation for all clinical decision
making is the nursing process.
11. A group of nursing students is reviewing the standards of professional
performance. The students demonstrate understanding when they identify which as a
standard of professional performance?
A) Prescriptive authority
B) Consultation
C) Planning
D) Collaboration
Ans: D
Chapter: 4
Client Needs: Safe, Effective Care Environment: Management of Care
Cognitive Level: Understand
Integrated Process: Teaching/Learning
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Objective: 2
Page Number: 31
Feedback: Collegiality is a standard of professional performance. Prescriptive
authority and consultation are subcategories of implementation, a standard of
practice. Planning is a standard of practice.
12. A psychiatric–mental health nurse is providing care to clients with a mental
illness and is investigating factors related to client safety, delivery of care services,
and cost effectiveness. The nurse is involved with which area of professional
performance?
A) Education
B) Quality of practice
C) Resource utilization
D) Collaboration
Ans: C
Chapter: 4
Client Needs: Safe, Effective Care Environment: Management of Care
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 2
Page Number: 32
Feedback: Resource utilization addresses factors related to safety, effectiveness,
cost, and impact of practice in planning and delivery of nursing care. Education
ADESLAB.inCO
M
involves attaining knowledge andGR
competency
current
nursing practice. Quality of
practice addresses the systematic enhancement of the quality and effectiveness of
nursing practice. Collaboration involves working together (collaborating) with clients,
family, and others in the conduct of nursing practice.
13. A psychiatric--mental health nurse is considering joining the International
Society of Psychiatric--Mental Health Nurses. The nurse understands which purpose is
an important function of the society?
A) Advocating for mental health nursing practice through liaison activities
B) Advancing psychiatric–mental health nursing practice
C) Improving mental health care for culturally diverse individuals
D) Providing a strong voice for psychiatric–mental health nurses
Ans: D
Chapter: 4
Client Needs: Safe, Effective Care Environment: Management of Care
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 3
Page Number: 33
Feedback: The purpose of the International Society of Psychiatric--Mental Health
Nurses is to unite and strengthen the presence and voice of psychiatric–mental health
nurses, and to promote quality care for individuals and families with mental health
problems. The American Nurses Association supports psychiatric–mental health
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
nursing practice through liaison activities, such as advocating for psychiatric–mental
health nurses at the national and state levels. The American Psychiatric Nurses
Association has the primary mission of advancing psychiatric–mental health nursing
practice and improving mental health care for culturally diverse individuals.
14. When applying the biopsychosocial model for a client with a mental health
problem, the nurse addresses the psychological domain when assessing which trait?
A) Sleep patterns
B) Feelings
C) Family functioning
D) Cultural groups
Ans: B
Chapter: 4
Client Needs: Safe, Effective Care Environment: Management of Care
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 4
Page Number: 34
Feedback: The psychological domain addresses thoughts, feelings, and behavior.
Sleep patterns are addressed in the biologic domain. Family functioning and cultural
groups are assessed in the social domain.
Multiple Select
RADschizophrenia
ESLAB.COM identifies several outcomes.
15. The plan of care for a clientGwith
Which outcome would the nurse identify as addressing the biologic domain? (Select all
that apply.)
A) Improving problem-solving skills
B) Promoting economic stability
C) Minimizing adverse effects of drug therapy
D) Improving nutritional status
E) Providing family education
Ans: C, D
Chapter: 4
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 4
Page Number: 33
Feedback: Biologic domain outcomes include minimizing the adverse effects of drug
therapy and improving nutritional status. Improving problem solving skills involve the
psychological domain. Promoting economic stability and providing family education
address the social domain.
Multiple Choice
16.
A nurse is engaged in exercises to develop self-awareness. The nurse is using
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
which tool?
A) Interdisciplinary care
B) Reflection
C) Plan of care
D) Clinical reasoning
Ans: B
Chapter: 4
Client Needs: Psychosocial Integrity
Cognitive Level: Understand
Integrated Process: Nursing Process
Objective: 5
Page Number: 34
Feedback: Reflection involves continual self-evaluation through observing,
monitoring, and judging nursing behaviors. Reflection skills are used in all aspects of
psychiatric nursing practice, from enhancing self-awareness and examining
nurse--client interactions to evaluation of the system of care. Interdisciplinary care
involves the collaboration with other professionals and the client in all settings. Plan of
care is the individualized plan used to direct client care. Clinical reasoning involves
critical thinking skills and reflection.
17.
Which ethical priniciple is being addressed when the nurse encourages an older,
cognitively impaired client to select the food the client will be served for dinner?
A)
B
GRADESLAB.COM
Justice
Autonomy
C)
Beneficence
D)
Nonmaleficence
Ans:
B
Chapter:
4
Client Needs: Psychosocial Integrity
Cognitive Level:
Understand
Integrated Process: Nursing Process
Objective:
1
Page Number: 29, 30
Feedback: Autonomy is the power to make one’s own decision; like selecting the
foods one will eat. Justice refers to fairness while beneficence refers to the act of doing
good. Nonmaleficence is the duty to cause no harm, both individual and for all.
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Multiple Select
18.
A nurse is researching information regarding comprehensive psychiatric nursing
care. Which nursing organization(s) serves as a source of information and leadership
in formulating policies for the care of clients with mental health concerns? (Select all
that apply.)
A)
American Nursing Association (ANA)
B)
Sigma Theta Tau International (SSTI)
C)
American Psychiatric Nurses Association (APNA)
D)
Intermational Society of Psychiatric Nursing (ISPN)
E)
The International Nurses Society on Addictions (IntNSA)
Ans:
A, C, D, E
Chapter:
4
Client Needs:
Safe and Effective Care Environment: Management of Care
Cognitive Level:
Apply
Integrated Process:
Objective:
Teaching/Learning
GRADESLAB.COM
3
Page Number:
33
Feedback: Several professional nursing organizations provide leadership in shaping
mental health care, including the ANA, the APNA, ISPN, and IntNSA. While SSTI is a
professional nursing organization, its focus is to support the learning, knowledge and
professional development of nurses.
Multiple Choice
19.
A nurse is presented with an ethical conflict when a client insists on leaving the
hospital against medical and nursing advise. This situation best demonstrates the
ethical conflict between which relevant principles?
A)
Justice vs. Paternalism
B)
Veracity vs. Autonomy
C)
Fidelity vs. Beneficence
D)
Autonomy vs. Beneficence
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Ans:
D
Chapter:
4
Client Needs:
Safe and Effective Care Environment: Management of Care
Cognitive Level:
Understand
Integrated Process:
Objective:
Teaching/Learning
1
Page Number: 29, 30
Feedback: According to the principle of autonomy, each person has the fundamental
right of self-determination. According to the principle of beneficence, the health care
provider uses knowledge of science and incorporates the art of caring to develop an
environment in which individuals achieve their maximal health care potential. These
principles can conflict when the client is being guided by the principle of autonomy and
the nurse by the principle of beneficence. Justice is the duty to treat all fairly,
distributing the risks and benefits equally. Paternalism is the belief that knowledge
and education authorize professionals to make decisions for the good of the client.
GRAD
ESLABis.faithfulness
COM
Veracity is the duty to tell the truth.
Fidelity
to obligations and duties.
It is keeping promises.
Multiple Select
20. Which task(s) will be the responsibity of the psychiatric--mental health registered
nurse working on the mental health unit? (Select all that apply.)
A)
Assuring that a newly admitted client is oriented to the milieu rules
B)
Monitoring the effectiveness of a client’s antidepressant medication
C)
Making daily care assignments for the unit’s ancillary nursing staff
D)
Conducting various psychotherapy groups and individual sessions for clients
E)
Determining the amount of self care activities each client is capable of assuming
Ans: A, B, C, E
Chapter:
4
Client Needs: Safe and Effective Care Environment: Management of Care
Cognitive Level:
Apply
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Integrated Process:
Objective:
Nursing Process
6
Page Number: 32
Feedback: Clinical activities within the scope practice for a psychiatric–mental health
registered nurse include intake screening, evaluation, and triage, provision of
therapeutic and safe environments, milieu therapy/management, promotion of
self-care activities, and administration and monitoring of psychobiologic treatment.
Conducting psychotherapy either in groups or individually is a responsibility of and
advanced practice psychiatric--mental health nurse.
GRADESLAB.COM
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Test Generator Questions, Chapter 5, Theoretical Basis of
Psychiatric Nursing
Multiple Choice
1. A group of nursing students is reviewing information about Freud’s personality
structure. The students demonstrate understanding of this information when they
identify the ability to form mutually satisfying relationships as a function of aspect?
A) Defense mechanisms
B) Unconscious
C) Id
D) Ego
Ans: D
Chapter: 5
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 2
Page Number: 41
Feedback: In Freud’s personality structure, the ability to form mutually satisfying
GRADE
LABego
.Cand
OM is formed throughout the child’s
relationships is a fundamental function
ofSthe
development. Defense mechanisms are coping styles that protect a person from
unwanted anxiety. The “unconscious” refers to feelings and thoughts outside
awareness and not remembered. The “id” is formed by unconscious desires, primitive
instincts and unstructured drives.
2. When describing the influence of Harry Stack Sullivan on psychiatric–mental
health nursing, which major concept would the instructor address?
A) Interpersonal relations
B) Harmony between the individual and society
C) Collective unconscious
D) Unconditional positive regard
Ans: A
Chapter: 5
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 2
Page Number: 42
Feedback: Harry Stack Sullivan (1892–1949), an American psychiatrist, extended
the concept of interpersonal relations to include characteristic interaction patterns.
Carl Rogers addressed the concept of unconditional positive regard. Fromm
addressed the need for harmony and understanding between the individual and
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
society. Jung addressed the collective unconscious such that individuals had both
extroverted and introverted tendencies.
3. A nursing student is to provide a class presentation about interpersonal and
psychoanalytic theories. As part of this presentation, the student is planning to
address the major way these two categories differ. Which aspect would the student
include as key to interpersonal theories?
A) Human relationships
B) Instincts
C) Drives
D) Potential for goodness
Ans: A
Chapter: 5
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 3
Page Number: 42
Feedback: Although there are similarities between psychoanalytic and interpersonal
theories, the major difference is that interpersonal theories acknowledge the
importance of individual relationships in personality development. Instincts and
drives are less important. The potential for goodness forms the basis of humanistic
theories.
GRADESLAB.COM
4. A psychiatric–mental health nurse is integrating Carl Rogers’ theory into the plan
of care for a client with a mental illness. The nurse incorporates understanding of this
theory by acknowledging that the therapist accomplishes which action?
A) Provides validation of the terminology used during the session
B) Focuses on the client’s instinctual drives
C) Recognizes an understanding of the client’s basic needs
D) Develops unconditional positive regard for the client
Ans: D
Chapter: 5
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 2
Page Number: 43
Feedback: Carl Rogers advocated that the therapist develop unconditional positive
regard for the client (i.e., a nonjudgmental caring for the client). Genuineness of the
therapist was also an important factor. Rogers did not address validation, instinctual
drives, and basic needs.
5. A nurse is demonstrating behaviors that the treatment team is attempting to get
the client to develop. The nurse is integrating which theory?
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
A) Erikson’s model of psychosocial development
B) Albert Bandura’s social cognitive theory
C) Skinner’s operant conditioning
D) Freud’s psychoanalytic model
Ans: B
Chapter: 5
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 1
Page Number: 45
Feedback: Bandura developed his ideas after being concerned about violence on
television contributing to aggression in children. He believes that important behaviors
are learned by internalizing behaviors of others. His initial contribution was identifying
the process of modeling: pervasive imitation, or one person trying to be similar to
another. Erickson identified eight stages of psychosocial development. Skinner
proposed that if a behavior is reinforced or rewarded, the behavior will probably be
repeated. Freud’s psychoanalytic model identified the human mind as composed of
conscious and unconscious mental processes.
6. An instructor is preparing a class discussion on the various theoretical models
used in psychiatric–mental health nursing. When describing cognitive theories, which
statement should the instructor include? The theories attempt to:
RADESprocesses
LAB.COMand effects on behavior.”
A) “Explain development of theGmental
B) “Describe how people learn and act.”
C) “Link internal thought processes with behavior.”
D) “Explain normal human growth and development.”
Ans: C
Chapter: 5
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 1
Page Number: 45
Feedback: Cognitive theories attempt to link internal thought processes with human
behavior. Psychodynamic theories attempt to explain mental processes and how they
affect behavior. Behavioral theories attempt to describe how people learn and act.
Developmental theories attempt to explain normal human growth and development
over time.
7. A nurse is integrating the Neuman systems model while caring for a client with a
mood disorder. The nurse should focus on which aspect of the client?
A) Behaviors
B) Relationships
C) Self-care activities
D) Stressors
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Ans: D
Chapter: 5
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 4
Page Number: 54
Feedback: The Neuman systems model focuses on the client system interacting with
the environment. She was one of the first psychiatric nurses to include the concept of
stressors in understanding nursing care. Behaviors, relationships, and self-care
activities would not be addressed.
8. The nurse is integrating Peplau’s model when providing care to a client with a
mental illness. What would the nurse identify as a key component?
A) Suffering
B) Anxiety
C) Self-care
D) Nonverbal behaviors
Ans: B
Chapter: 5
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
GRADESLAB.COM
Integrated Process: Nursing Process
Objective: 1
Page Number: 51, 52
Feedback: Anxiety is a key concept of Peplau’s model. According to her, anxiety is
the energy that arises when expectations that are present are not met. If anxiety is
not recognized, it continues to rise and escalates toward panic. Orem focused on
self-care.
9. A group of nursing students is reviewing information about the various nursing
theorists and their application to psychiatric–mental health nursing. The students
demonstrate understanding when they identify which theorist as responsible for
developing the theory of cultural care diversity and universality?
A) Madeleine Leininger
B) Sister Calista Roy
C) Hildegard Peplau
D) Dorothea Orem
Ans: A
Chapter: 5
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 4
Page Number: 50
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Feedback: The nurse–anthropologist who developed the theory of cultural care
diversity and universality is Madeleine Leininger. Calista Roy developed an adaptation
model. Hildegard Peplau focused on the nurse–client relationship and emphasized the
power of empathy. Dorothea Orem developed the self-care deficit nursing theory.
10. A nurse needs to teach a client about discharge medications. The client is
exhibiting signs of moderate anxiety about the upcoming discharge. Based on
Peplau’s views regarding anxiety, the nurse would expect to implement the education
plan at which time?
A) When the client’s anxiety stabilizes at its current level
B) When the client’s anxiety decreases to a mild level
C) When the client is completely free of anxiety
D) When the client’s anxiety escalates to the panic level
Ans: B
Chapter: 5
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 3
Page Number: 52
Feedback: Mild anxiety is useful for learning; therefore, it would be appropriate to
begin educating the client when their anxiety decreases to a mild level. Severe
anxiety interferes with learning. Anxiety should be relieved as much as possible, but
RADthe
ESclient
LAB.would
COM become completely free of
it would be unrealistic to expect G
that
anxiety.
11. A nursing instructor is integrating Piaget’s theory of cognitive development into
the discussion of learning and mental health issues affecting adolescents. The
instructor would identify this age group as in which stage?
A) Concrete operations
B) Preoperational
C) Formal operations
D) Sensorimotor
Ans: C
Chapter: 5
Client Needs: Health Promotion and Maintenance
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 2
Page Number: 47, 48
Feedback: Adolescents are in the formal operations stage of development.
School-age children are in the concrete operations stage. Children between the ages
of 2 to 7 years are in the preoperational stage of cognitive development. Infants and
toddlers to age 2 years are in the sensorimotor stage.
12.
While working with an older client, the nurse begins to think that the client
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
reminds them of their grandparent, and responds as if they were the grandchild. The
nurse is developing which behavior?
A) Empathy
B) Transference
C) Countertransference
D) Modeling
Ans: C
Chapter: 5
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 3
Page Number: 41
Feedback: The nurse, upon feeling that the client reminds them of their
grandparent, is developing countertransference; that is, the nurse is developing an
attachment to the client, treating the client as a grandparent. Empathy refers to the
ability to feel what the client is feeling. Transference is the displacement of the
thoughts, feelings, and behaviors originally associated with a significant other from
childhood onto a person in a current therapeutic relationship. Modeling is pervasive
imitation, or one person trying to be similar to another.
13. A psychiatric–mental health nurse is working on an inpatient unit that uses a
privilege system. The nurse understands that this intervention integrates which group
GRADESLAB.COM
of theories?
A) Behavioral
B) Developmental
C) Humanistic
D) Cognitive
Ans: A
Chapter: 5
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 3
Page Number: 43, 46, 48
Feedback: Interventions such as privilege systems and token economies are
interventions based on behavioral theories. Understanding childhood and adolescent
experiences, and their manifestations as adult problems would reflect developmental
theories. Exploring personal capabilities to develop self-worth would reflect
humanistic theories. Focusing on thought processes and how they relate to behavior
would reflect cognitive theories.
Multiple Select
14. A group of nursing students is reviewing the various theories that form the basis
for psychiatric–mental health nursing. The students demonstrate understanding of
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
these theories when they identify which theorist as addressing female development?
(Select all that apply.)
A) Maslow
B) Gilligan
C) Bandura
D) Miller
E) Thorndike
Ans: B, D
Chapter: 5
Client Needs: Health Promotion and Maintenance
Cognitive Level: Analyze
Integrated Process: Teaching/Learning
Objective: 3
Page Number: 48
Feedback: Both Gilligan and Miller addressed female development, identifying that
females develop differently from males. Maslow focused on a hierarchy of needs;
Bandura focused on learning through internalization of behaviors of others; Thorndike
focused on reinforcement of positive behavior as important for learning.
15. When describing the major concepts of Jean Watson’s theory to a group of
nursing students, component(s) would the nurse expect to include? (Select all that
apply.)
A) Freedom
GRADESLAB.COM
B) Paradox
C) Caritas Process
D) Rhythmicity
E) Caritas field
F) Mystery
Ans: C, E
Chapter: 5
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 4
Page Number: 52, 53
Feedback: Jean Watson’s theory contains three foundational concepts:
transpersonal caring, clinical Caritas process (original 10 carative processes), and
Caritas field. Freedom, paradox, rhythmicity, and mystery are associated with Parse’s
theory of humanbecoming.
Multiple Choice
16. A nurse is applying King’s model to a nurse–client interaction by identifying
which outcome?
A) Transaction
B) Adaptation
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
C) Transpersonal caring
D) Self-system
Ans: A
Chapter: 5
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 4
Page Number: 54
Feedback: According to King’s theory, the outcome of the interaction within the
nurse–client relationship is a transaction, defined as the transfer of value between two
or more people. Adaptation is associated with Roy’s model. Transpersonal caring is
associated with Watson. Self-system is associated with Peplau.
17. The nurse is assessing a young adult and determines that the individual has
achieved successful resolution of the previous stage of growth and development,
evidenced by demonstrating which concepts?
A) Drive and hope
B) Direction and purpose
C) Devotion and fidelity
D) Production and care
Ans: C
GRADESLAB.COM
Chapter: 5
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 1
Page Number: 46
Feedback: According to Erickson’s Eight Stages of Man, the young adult would have
successfully developed identity— achieving the outcome of devotion and
fidelity—during adolescence, the stage before young adulthood. A young adult is
experiencing a current developmental conflict of intimacy versus isolation, with the
ultimate long-term outcome of achieving affiliation and love. Drive and hope are the
long-term outcomes of infancy. Direction and purpose are the long-term outcomes of
preschool stage. Production and care are the long-term outcomes of adulthood, which
the young adult has yet to reach.
18. The nurse is assessing a client with anxiety and observes the client yelling and
screaming. The nurse, integrating Peplau’s theory, interprets this behavior as which
behavioral cue?
A) Panic behaviors
B) Relief behaviors
C) Empathetic linkage
D) Social distance
Ans:
B
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Chapter: 5
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 3
Page Number: 51, 52
Feedback: According to Peplau, behavioral cues related to the levels of anxiety are
“relief behaviors.” Panic is the most severe form of anxiety manifested by an inability
to function. Empathetic linkage is the ability to feel in oneself the feelings experienced
by another person. Social distance is a concept associated with formal and informal
support systems. It is the degree to which the values of the formal support
organization and primary group members differ.
19. The nurse is watching a video that depicts a client and therapist interacting. The
client is asked to say whatever comes to their mind. The nurse identifies this as which
approach?
A) Dream work
B) Free associations
C) Gestalt therapy
D) Classical conditioning
Ans: B
Chapter: 5
Client Needs: Psychosocial Integrity
GRADESLAB.COM
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 1
Page Number: 41
Feedback: The video is depicting free associations, as described by Freud, in which a
person verbalizes spontaneous, uncensored words of whatever comes to mind.
Dream work refers to the interpretation of dreams as part of psychoanalysis. Gestalt
therapy involves individual and group exercises to bring unmet needs into awareness.
Classical conditioning refers to behavior that occurs in response to a stimulus.
20. A nurse is developing a plan of care integrating Maslow’s hierarchy of needs.
What should the nurse identify as the priority?
A) Basic needs
B) Predictable social environment
C) Acceptance from family
D) Positive self-image
Ans: A
Chapter: 5
Client Needs: Health Promotion and Maintenance
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 3
Page Number: 43
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Feedback: According to Maslow’s hierarchy, physiologic and survival needs such as
food and shelter are the priorities. These are followed by safety and security needs
(predictable social environment), love and belonging needs (acceptance from family),
and esteem needs (positive self-image).
GRADESLAB.COM
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Test Generator Questions, Chapter 6, Biologic Foundations of
Psychiatric Nursing
Multiple Choice
1. A nurse is teaching a medication class to a group of psychiatric clients. One of
them asks, “why am I having so much more trouble learning now that I am 60 than I
did when I was younger?” Which concept would the nurse integrate into the response?
A) The extrapyramidal motor system
B) The amygdala
C) Neuroplasticity
D) Psychoneuroimmunology
Ans: C
Chapter: 6
Client Needs: Physiological Integrity: Physiological Adaptation
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 1
Page Number: 63--65
Feedback: Neuroplasticity is the brain’s ability to change structure and function to
GRADenvironment
ESLAB.COM
compensate for a changing neuronal
(Mohr & Mohr, 2001). With age,
brains become less plastic, which explains why it is easier to learn a second language
at the age of 5 years than at 55 years. The extrapyramidal motor system controls
muscle tone, common reflexes, and automatic voluntary motor function. The
amygdale provides an emotional component to memory and is involved in modulating
aggression and sexuality. Psychoneuroimmunology involves the connection between
the immune system and stress.
2. Which area of the brain would a nursing instructor identify when describing its
involvement with verbal language function, including areas for both receptive and
expressive speech?
A) Right hemisphere
B) Parietal lobe
C) Occipital lobe
D) Left hemisphere
Ans: D
Chapter: 6
Client Needs: Physiological Integrity: Physiological Adaptation
Cognitive Level: Understand
Integrated Process: Teaching/Learning
Objective: 2
Page Number: 58, 59
Feedback: The area of the brain involved with verbal language function, including
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
areas for both receptive and expressive speech, is the left hemisphere. The right
hemisphere provides input into receptive nonverbal communication, spatial
orientation, and recognition. The parietal lobe is involved with coordinating visual and
somatosensory information. The occipital lobe is primarily involved with vision.
3. A nurse is developing a plan of care for a client experiencing expressive aphasia.
The nurse incorporates knowledge that the client most likely has sustained damage to
which area of the brain?
A) The postcentral gyrus
B) Broca area
C) Basal ganglia
D) The hippocampus
Ans: B
Chapter: 6
Client Needs: Physiological Integrity: Physiological Adaptation
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 2
Page Number: 59
Feedback: The frontal lobe also contains Broca area, which controls the motor
function of speech. Damage to Broca area produces expressive aphasia, or difficulty
with the motor movements of speech. The postcentral gyrus, immediately behind the
central sulcus, contains the primary somatosensory area. The basal ganglia are
GRare
ADassociated
ESLAB.COwith
M the learning and programming
involved with motor functions and
of behavior/activities that are repetitive and that, done over time, become automatic.
The hippocampus is involved in storing information, especially the emotions attached
to a memory.
4. The nurse is caring for an older adult who has experienced damage to the frontal
lobe after an automobile accident. The nurse anticipates that the client will have
difficulty with which function?
A) Smell
B) Concept formation
C) Receptive speech
D) Hearing
Ans: B
Chapter: 6
Client Needs: Physiological Integrity: Physiological Adaptation
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 2
Page Number: 59
Feedback: Working memory is an important aspect of frontal lobe function. The
nurse can anticipate that the client will have difficulty with concept formation, insight,
judgment, and reasoning. The temporal lobes contain the primary auditory and
olfactory areas. Wernicke area, located at the posterior aspect of the superior
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
temporal gyrus, is primarily responsible for receptive speech.
5. The nurse is caring for a client who has experienced damage to the parietal lobes
of the brain. The nurse anticipates that the client will have difficulty with which
activity?
A) Perceiving sensory input
B) Calculating a math problem
C) Seeing objects in front of him
D) Speaking fluently
Ans: B
Chapter: 6
Client Needs: Physiological Integrity: Physiological Adaptation
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 2
Page Number: 59, 60
Feedback: The client who has experienced damage to the parietal lobes of the brain
most likely will be unable to calculate a math problem. Damage to this area produces
complex sensory deficits. The parietal lobes contribute to the ability to recognize
objects by touch, calculate, write, draw, and organize spatial stimuli. Damage to the
occipital lobe would lead to difficulty in vision, color vision, object and facial
recognition, and the ability to perceive objects in motion. The frontal lobe, specifically
Broca area, would be involved if the client had difficulty speaking fluently.
GRADESLAB.COM
6. A client has been diagnosed with memory dysfunction associated with Alzheimer
disease. The nurse determines that damage to the client’s brain includes deterioration
of temporal lobe structures and the nerves of which structure?
A) Basal ganglia
B) Limbic system
C) Frontal lobe
D) Hippocampus
Ans: D
Chapter: 6
Client Needs: Physiological Integrity: Physiological Adaptation
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 2
Page Number: 61
Feedback: Deterioration of the nerves of the hippocampus and other related
temporal lobe structures are associated with Alzheimer disease. The basal ganglia are
involved with motor functions; the frontal lobe contains the primary motor area,
Broca area (for speech), personality, and working memory. The limbic system
modulates basic emotions, needs, drives, and instinct.
7. The nurse is caring for a hospitalized client who has a disorder of the
hypothalamus. When developing the client’s plan of care, in which area would the
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
nurse anticipate a problem?
A) Sleep
B) Constipation
C) Speech
D) Motor activity
Ans: A
Chapter: 6
Client Needs: Physiological Integrity: Physiological Adaptation
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 1
Page Number: 61
Feedback: Disorders of the hypothalamus produce common psychiatric symptoms
such as sleep and appetite problems. The hypothalamus is not involved with bowel
elimination, speech, or motor activity.
8. A client who is scheduled to undergo a sleep-deprivation electroencephalogram
(EEG) in the morning is experiencing moderate anxiety about the procedure. Based on
an understanding of this test, which action would the nurse avoid?
A) Explaining in depth what to expect during the upcoming procedure
B) Administering a benzodiazepine medication prescribed for anxiety
C) Taking a thorough history of the client’s use of prescribed and illicit drugs
D) Giving the client a noncaffeinated beverage of his or her choice
GRADESLAB.COM
Ans: B
Chapter: 6
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 3
Page Number: 77
Feedback: If a sleep-deprivation EEG is to be done, caffeine or other stimulants that
might assist the client in staying awake should be withheld because they may change
the EEG patterns. In addition, many medications change the wave patterns on an
EEG. For example, the benzodiazepine class of drugs increases the rapid and fast beta
activity. Therefore, benzodiazepines should be avoided. Noncaffeinated beverages
would be allowed. Explaining about the procedure would help to alleviate the client's
anxiety. A thorough history about prescribed drug use would be important because it
may reveal medications that could change the EEG wave patterns.
9. A nurse knows that chronobiology influences depression. Which statement is true
regarding the relation between chronobiology and depression?
A) The exact location of genes leads to identifying the gene responsible for causing
depression.
B) A break in the corpus callosum blocks information exchange between the right
and left hemispheres.
C) Damage to the posterior areas of the parietal lobe leads to altered discriminative
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
sensory function.
D) Internal and external triggers can elicit biologic rhythm changes indicative of
clinical depression.
Ans: D
Chapter: 6
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 1
Page Number: 76
Feedback: Chronobiology involves the study and measure of time structures or
biologic rhythms. Zeitgebers are specific events that function as time givers or
synchronizers and that set biologic rhythms. Some theorists think that psychiatric
disorders may result from one or more biologic rhythm dysfunctions. For example,
depression may be, in part, a phase advance disorder, including early morning
awakening and a decreased time of onset of REM sleep.
10. When describing the various neurotransmitters, which chemical would the nurse
identify as the primary cholinergic neurotransmitter?
A) Dopamine
B) Acetylcholine
C) Norepinephrine
D) Serotonin
GRADESLAB.COM
Ans: B
Chapter: 6
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 4
Page Number: 67
Feedback: Acetylcholine is the primary cholinergic neurotransmitter. Biogenic
amines include dopamine, norepinephrine, and serotonin.
11. A nurse is giving a presentation to colleagues about the actions of
neurotransmitters. The nurse correctly identifies which chemical as a neuropeptide?
A) Melatonin
B) Serotonin
C) Glutamate
D) Gamma-aminobutyric acid
Ans: A
Chapter: 6
Client Needs: Psychosocial Integrity
Cognitive Level: Understand
Integrated Process: Teaching/Learning
Objective: 4
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Page Number: 68, 69
Feedback: Melatonin is classified as a neuropeptide. Serotonin is classified as a
biogenic amine. Glutamate and gamma-aminobutyric acid are amino acids.
12. The nurse is assessing a client experiencing anxiety and observes increased
sweating and goose flesh. The nurse understands that these are the result of which
substance?
A) Acetylcholine
B) Norepinephrine
C) Serotonin
D) Histamine
Ans: B
Chapter: 6
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 1
Page Number: 63
Feedback: The sympathetic response associated with anxiety that leads to
piloerection and sweating results from norepinephrine. Acetylcholine has no effect on
the pilomotor muscles and sweat glands. Serotonin plays a role in the control of
appetite, sleep, and mood states. Histamine controls gastric secretions and smooth
muscle of the gastrointestinal tract.
GRofAcare
DESLfor
ABa.client
COM diagnosed with schizophrenia.
13. A nurse is developing a plan
The nurse integrates knowledge of this disorder, identifying which neurotransmitter
as being primarily involved?
A) Acetylcholine
B) Dopamine
C) Norepinephrine
D) Serotonin
Ans: B
Chapter: 6
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 4
Page Number: 69
Feedback: Abnormally high activity of dopamine has been associated with
schizophrenia. Loss of cholinergic neurons is associated with Alzheimer disease.
Decreased norepinephrine is associated with depression; excessive norepinephrine is
associated with manic symptoms. Increased serotonin is associated with mania;
decreased serotonin is associated with depression and insomnia.
14. A group of students is reviewing information about neurotransmitter subtypes.
The group demonstrates understanding of the information when they identify which
neurotransmitter as having muscarinic and nicotinic receptors?
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
A) Serotonin
B) Gamma-aminobutyric acid (GABA)
C) Dopamine
D) Acetylcholine
Ans: D
Chapter: 6
Client Needs: Psychosocial Integrity
Cognitive Level: Understand
Integrated Process: Teaching/Learning
Objective: 4
Page Number: 72
Feedback: The receptors for acetylcholine are muscarinic and nicotinic receptors.
Serotonin receptors are grouped in families such as 5-HT1A, 5-HT1B, and so on.
Specific receptors for GABA are named A, B, and C. Dopamine receptors are named
D1, D2, D3, and so on.
15. A nurse is involved in gathering information about the inheritance of mental
disorders using population genetics. Which aspect of inheritance would the nurse be
least likely to be evaluating?
A) Concordance rates of twins
B) Occurrence in first-degree relatives
C) Risk factor analysis
D) Adoption studies
GRADESLAB.COM
Ans: C
Chapter: 6
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 5
Page Number: 73, 74
Feedback: Risk factor analysis is evaluated when determining genetic susceptibility,
that is, predicting who is more likely to experience psychiatric disorders or certain
conditions. Population genetics evaluates family studies that analyze the occurrence
of a disorder in first-degree relatives; twin studies that analyze the presence (or
absences) of the disorder in pairs of twins using concordance rates; and adoption
studies that compare the risk developing in offspring raised in different environments.
Multiple Select
16. A nurse is reading a journal article about psychoneuroimmunology. Which
information would the nurse most likely find? (Select all that apply.)
A) Neurotoxin’s role in receptor site damage
B) Hypothalamic--pituitary--thyroid axis disruption
C) Static activity of natural killer cells in response to stress
D) Hypothalamic damage leading to immune dysfunction
E) Interruption in the typical circadian rhythm cycle
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Ans: A, B, D
Chapter: 6
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 6
Page Number: 74, 75
Feedback: Psychoneuroimmunology addresses possible explanations for the
development of psychiatric disorders based on the interaction of the neurologic,
endocrine, and immune systems.
Areas addressed include immune dysregulation caused by neurotoxins affecting the
brain tissue at locations such as receptor sites; disruption of the hypothalamic–
pituitary–thyroid axis feedback system; and immune system dysfunction resulting
from damage to the hypothalamus, hippocampus, or pituitary gland. Another area
being studies is the role of natural killer cell function, which shows that natural killer
cell activity varies in response to many emotional, cognitive, and physiologic
stressors.
Multiple Choice
17. A client is scheduled for a challenge test. Which information would the nurse
include when explaining this test to the client?
A) Intravenous administration of a substance to induce symptoms
GRAscalp
DESLfor
ABmonitoring
.COM
B) Application of electrodes to the
C) Evaluation of electrical impulses recorded on graph paper
D) Exposure to a flashing strobe light to elicit abnormal activity
Ans: A
Chapter: 6
Client Needs: Physiological Integrity: Reduction of Risk Potential
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 1
Page Number: 77
Feedback: A challenge test is usually conducted by intravenously administering a
chemical known to produce a specific set of psychiatric symptoms. Applications of
electrodes for monitoring, and evaluation of electrical impulses recorded on graph
paper, are involved with an electroencephalogram (EEG). Using a flashing strobe light
may be used to gather additional information when an EEG is done.
18. A client with depression tells the nurse that they are to “have a test that involves
the recording of an electroencephalogram (EEG) throughout the night.” The nurse
most likely identifies this as which test?
A) Sleep deprivation EEG
B) Polysomnography
C) Evoked potentials
D) Functional magnetic resonance imaging
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Ans: B
Chapter: 6
Client Needs: Physiological Integrity: Reduction of Risk Potential
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 1
Page Number: 77
Feedback: Polysomnography is a special procedure that involves recording the EEG
throughout a night of sleep. A sleep deprivation EEG involves keeping a client awake
the night before the EEG evaluation. Evoked potentials measure changes in electrical
activity of the brain as a response to a given stimulus. Functional magnetic resonance
imaging creates images of changes in blood flow.
19. A nurse is explaining the role of serotonin to a client with a psychiatric disorder.
The client demonstrates a need for additional teaching when they identify which
disorder as being associated with its dysfunction?
A) Depression
B) Mania
C) Panic disorder
D) Schizophrenia
Ans: D
Chapter: 6
GRADEPhysiological
SLAB.COM Adaptation
Client Needs: Physiological Integrity:
Cognitive Level: Analyze
Integrated Process: Teaching/Learning
Objective: 4
Page Number: 69, 70
Feedback: Schizophrenia is associated with abnormally high activity of dopamine,
not serotonin. Whereas depression and insomnia have been associated with
decreased levels of 5-HT, mania has been associated with increased 5-HT. Some of
the most well-known antidepressant medications, such as Prozac and Zoloft, function
by raising serotonin levels within certain areas of the CNS.
20. When describing neuronal transmission, an instructor describes the area where
the electrical intracellular signal becomes a chemical one. The instructor is describing
which anatomical location?
A) Soma
B) Synaptic cleft
C) Terminal
D) Receptor site
Ans: B
Chapter: 6
Client Needs: Physiological Integrity: Physiological Adaptation
Cognitive Level: Apply
Integrated Process: Teaching/Learning
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Objective: 3
Page Number: 66
Feedback: The synaptic cleft, a junction between one nerve and another, is the
space where the electrical intracellular signal becomes a chemical intracellular signal.
The soma is the neuron’s cell body. Terminal is the end of the axon. Receptor site is
the area of the postsynaptic membrane that accepts the released neurotransmitter.
GRADESLAB.COM
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
1. The nurse is planning care for a group of clients using the recovery model. Which
client(s) would be appropriate for the nurse to include? Select all that apply.
A. A client with a history of personality disorder.
B. A client recovering from an opioid overdose.
C. A client diagnosed with Alzheimer disease
D. A client with an eating disorder.
E. A client with erectyle disfunction.
Answer: A, B, D
Rationale: The recovery model was initially applied to clients with substance use
disorders and then expanded to include clients with mental health disorders as well.
Therefore, the nurse should include the clients who have mental health disorders
which would be, opioid overdose, personality disorder, and an eating disorder.
Alzheimer disease and erectyle disfunction would not be appropriate diagnosis for
the recovery model.
Question format: Multiple Select
Chapter 7: Recovery Framework for Mental Health Nursing
Cognitive Level: Understand
Client Needs: Safe, Effective Care Environment: Management of Care
Reference: e-1
2. The nurse is developing the plan of care for a client with suicidal ideations using
GRAshould
DESLAthe
B.nurse
COM take?
person-centered care. Which action
A. Ask if the client would feel more safe having inpatient care or making a 24-hour
safe contract.
B. Ask if the client understands what the Baker Act is.
C. Teach the client about the benefits of a newly prescribed antidepressant
medication.
D. Teach the client about the need for one-to-one care.
Answer: A
Rationale: Person-centered care actively involves the client in the client's own care.
This allows the client to be educated about treatment options and the disorder, so
the client can make educated decisions about the care. The nurse should ask the
client about safety and if the client would rather check into inpatient care in order
to stay safe or if the client wants to make a contract to promise not to hurt oneself
for the next 24-hours. The other options do not allow the client to participate in
decision making, but rather tell the client about treatment the client will receive
without the client's input.
Question format: Multiple Choice
Chapter 7: Recovery Framework for Mental Health Nursing
Cognitive Level: Apply
Client Needs: Safe, Effective Care Environment: Management of Care
Reference: e-1, e-2
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
3. The nurse is caring for a client who has a history of several re-admissions for
nonadherance to medications. Which action by the nurse would best help the client
with medication adherance?
A. Using a person-centered approach.
B. Gaining the client's trust before informing the client about the plan of care.
C. Asking why the client failed to adhere to the medication regimen.
D. Including a support person from home in the client's plan of care.
Answer: A
Rationale: The nurse should try a person-centered approach to help the client
achieve medication adherance after discharge. Including a support person could be
helpful, if the client prefers that, and it would be part of person-centered approach
to ask the client about the preferences. It may be a good idea to assess what the
reasons were for failed medication adherance in the past, but asking the client why
may cause the client to feel defensive and would not be the best action. Gaining
trust and establishing a therapeutic nurse-client relationship is also important and
part of the person-centered approach. However, the nurse should not then go
ahead and create a plan of care without the client's input.
Question format: Multiple Choice
Chapter 7: Recovery Framework for Mental Health Nursing
Cognitive Level: Apply
Client Needs: Psychosocial Integrity: Psychosocial Integrity
Reference: e-1, e-2
GRADESLAB.COM
4. The charge nurse is talking with another nurse who states, "I feel like my client
has no interest in his or her care and does not care that I am trying to help." Which
response should the charge nurse make?
A. "A lot of clients behave that way, but you cannot take it personally."
B. "Do you want me to assign another nurse to the client?"
C. "Have you tried to establish a therapeutic relationship with the client?"
D. "Clients often behave that way when they are in pain."
Answer: C
Rationale: The charge nurse should ask if the nurse has tried to establish a
therapeutic relationship with the client yet. Establishing this relationship helps with
a feeling of connectedness for the client and promotes behavior changes needed to
improve health and well-being. The other options dismiss the nurse's concerns or
make assumptions about the client.
Question format: Multiple Choice
Chapter 7: Recovery Framework for Mental Health Nursing
Cognitive Level: Apply
Client Needs: Psychosocial Integrity: Psychosocial Integrity
Reference: e-2
5. The nurse is caring for a client who wants to actively participate in the plan of
care. Which action should the nurse take?
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
A. Discuss the informed choice model with the client.
B. Include the concept of empowerment when planning the client's care.
C. Use the shared decision-making model when planning the client's care.
D. Discuss the paternalistic model with the client.
Answer: C
Rationale: The nurse should include use of the shared decision-making model when
planning the client's care because this approach allows the individual to be an
active participant in planning care. The paternalistic model does not allow active
participation, it is based on the nurse/health care provider making choices that
person feels are best for the client. The informed choice model allows the client to
choose after the nurse/health care provider provides evidence of treatments and
care and offers options to the client. However, this is not a collaborative effort, the
client makes all the choices alone based on the information provided.
Empowerment is a concept that is used to support clients not to collaboratively plan
care with the client.
Question format: Multiple Choice
Chapter 7: Recovery Framework for Mental Health Nursing
Cognitive Level: Apply
Client Needs: Safe, Effective Care Environment: Management of Care
Reference: e-2
6. The nurse is planning short-term goals for a client to improve the client's selfGRA
DESLaction
AB.CO
esteem and treatment compliance.
Which
byM the nurse would assist the
client to achieve these goals?
A. Using shared decision-making model to plan the client's care.
B. Using the informed choice model to plan the client's care.
C. Referring the client for peer support after discharge.
D. Assisting the client in finding employment after discharge.
Answer: A
Rationale: The nurse should use the shared decision-making model when planning
care with the client because the benefits of this model include improving selfesteem and treatment compliance. The informed choice model allows the client to
make decisions based on information presented, but this model does not contribute
to improved self-esteem and treatment compliance. Referring the client and
assisting the client with peer support and employment after discharge will not
contribute to increased self-esteem and treatment compliance while the client is
hospitalized.
Question format: Multiple Choice
Chapter 7: Recovery Framework for Mental Health Nursing
Cognitive Level: Apply
Client Needs: Safe, Effective Care Environment: Management of Care
Reference: e-2
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
7. The nurse is caring for a client who was homeless and is being treated for mental
illness. The nurse has requested a referral for a social worker to assist in
establishing housing for the client after discharge. The nurse understands that
housing is essential for which goal?
A. To teach the client to maintain independence
B. To reduce the client's risk of committing crimes
C. To prevent the client from future re-admissions
D. To establish the first level of Maslow's hierarchy of needs
Answer: D
Rationale: The first level of Maslow's hierarchy of needs is safety and security which
refers to having consistent safe sheltering, like housing. Having housing could
possibly contribute to maintaining independence, avoiding criminal acts and
decreasing the need for future re-admissions. However, housing is not essential for
those outcomes like it is to meet the needs of safety and security with Maslow's
hierarchy.
Question format: Multiple Choice
Chapter 7: Recovery Framework for Mental Health Nursing
Cognitive Level: Understand
Client Needs: Safe, Effective Care Environment: Management of Care
Reference: e-3
8. The nurse is talking with a client at a follow-up visit. The client has been
RADESLfor
ABmore
.COMthan 1 year. The client asks,
recovering from a substance useGdisorder
"How do I become a peer support specialist, so I can help others recover?" Which
response(s) should the nurse make? Select all that apply.
A. "You must become certified in specific competencies."
B. "Peer support specialists must have recovered from at least one relapse."
C. "Peer support specialists are volunteers."
D. "You would need to be comfortable with managing crisis."
E. "You must be willing to share your own stories and experiences with others."
Answer: A, C, D, E
Rationale: All of the options except experiencing at least one relapse are related to
competencies for peer workers in behavior health services and the role of the peer
support person.
Question format: Multiple Select
Chapter 7: Recovery Framework for Mental Health Nursing
Cognitive Level: Understand
Client Needs: Physiological Integrity: Physiological Adaptation
Reference: e-3, e-4
9. The nurse is caring for a client who is receiving the five-stage process for
homeless rehabilitation. Which statement by the client would indicate the client is in
the transition to the intensive care stage?
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
A. "I am learning to redirect my anger, so I can prevent overreacting when I am
upset."
B. "I am ready to stop using drugs, but I need help with getting into a rehabilitation
facility."
C. "I have adjusted to living in the half-way house and sharing responsibilities."
D. "I will always be seen as a failure to my siblings."
Answer: B
Rationale: The nurse should recognize stage 2: transition to intensive care when
the client admits wanting help and needubg resources to get that help. Stating that
the client's siblings will always see the client as a failure implies self-stigma. Talking
about adjusting in a half-way house and taking responsibility are related to stage 5:
ongoing rehabilitation. Learning to redirect anger to prevent overreacting is related
to stage 3: intensive treatment.
Question format: Multiple Choice
Chapter 7: Recovery Framework for Mental Health Nursing
Cognitive Level: Apply
Client Needs: Psychosocial Integrity: Psychosocial Integrity
Reference: e-5
10. The nurse is caring for a client who was admitted with severe depression and
the client's sibling states, "Can you just stop being so dramatic and snap out of
this." Which response by the nurse would be most appropriate?
GRADEhow
SLAB
.COM
A. "Would you be willing to understand
depression
works in the brain?"
B. "You should probably leave the room for awhile."
C. "People cannot just snap in and out of feeling sad."
D. "Do you understand that depression is a disease?"
Answer: A
Rationale: The most appropriate response would be asking if the sibling is willing to
be educated about depression. Telling the sibling to leave may not be what the
client wants. Telling the sibling the client cannot snap in and out or that depression
is a disease does not really give the sibling an understanding of why the client feels
sad. Educating people is a way the nurse can advocate for the client and would be
the best response.
Question format: Multiple Choice
Chapter 7: Recovery Framework for Mental Health Nursing
Cognitive Level: Apply
Client Needs: Safe, Effective Care Environment: Management of Care
Reference: e-5
11. The nurse is assessing a client in the emergency department who appears
disheveled and anorexic and is malodorous. The client states, "I do not need your
help, I am doing just fine on my own with all my stuff. Besides nobody wants to
give a crazy person a job or apartment." Which action(s) should the nurse take?
Select all that apply.
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
A. Discuss implementing a paternalistic model of care with the health care provider.
B. Focus on implementing person-centered care.
C. Assist the client with receiving "Housing First" benefits.
D. Establish a therapeutic nurse–client relationship.
E. Document self-stigma as a barrier to the client's recovery.
Answer: B, C, D, E
Rationale: The nurse should recognize that this client is homeless, has a lack of
services, possibly has mental health issues and is self-stigmatizing. The client is not
ready for stage 2 of the five-stage process in homeless rehabilitation because the
nurse has not yet established stage 1, which would be a trusting relationship with
the client. The nurse should also recognize that this client indicates independence is
important and so Housing First would be beneficial to the client in establishing
independence in a safe environment. Person-centered care would be more
beneficial for this client, so the client can participate in health care decisions. The
paternalistic model would mean the nurse and health care provider would make
decisions for the client that they felt were best.
Question format: Multiple Select
Chapter 7: Recovery Framework for Mental Health Nursing
Cognitive Level: Apply
Client Needs: Psychosocial Integrity: Psychosocial Integrity
Reference: e-1, e-5
GRfor
ADrisk
ESLfactors
AB.COassociated
M
12. The nurse is screening clients
with limited or no
access to health care. Which client should the nurse identify as having the highest
risk?
A. The 5-year-old child who lives in the city and requires treatment for leukemia.
B. The 10-year-old child who lives on a farm and requires treatment for depression.
C. The 23-year-old client who is a veteran and requires treatment for posttraumatic stress disorder (PTSD).
D. The 20-year-old client who is homeless and requires treatment for diabetes
mellitus.
Answer: B
Rationale: The nurse should identify the child who lives on a farm and has
depression as having the highest risk for limited or no access to health care. People
who live in rural areas and especially children with mental health needs have higher
risks of limited to no access for care. Even the client who is homeless would be able
to access care for diabetes through many services that are offerred. The veteran
could receive government assisted care, and the child with leukemia could also
receive free care through facilities like the Shriner's hospital.
Question format: Multiple Choice
Chapter 7: Recovery Framework for Mental Health Nursing
Cognitive Level: Analyze
Client Needs: Health Promotion and Maintenance: Health Promotion and
Maintenance
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Reference: e-5
13. The nurse is discussing empowerment with a group of people at a community
health fair. Which idea(s) should the nurse include in the discussion? Select all that
apply.
A. A needle exchange program for individuals with substance use disorder.
B. Building a basketball court near the park.
C. Developing a support group at a church for clients with addiction.
D. Lobbying for building a movie theater in town.
E. Providing a free education program for families of clients with mental health
disorders.
Answer: A, B, C, E
Rationale: The nurse should include all of the ideas except lobbying for a movie
theater. Empowerment is related to supporting communities to take control of their
own health needs, not social needs, like a theater. A needle exchange program
allows for self-management. A basketball court encourages healthy behaviors. A
support group can contribute to well-being, and free education for families can help
promote positive mental health and decrease stigma.
Question format: Multiple Select
Chapter 7: Recovery Framework for Mental Health Nursing
Cognitive Level: Apply
Client Needs: Health Promotion and Maintenance: Health Promotion and
GRADESLAB.COM
Maintenance
Reference: e-2
14. The nurse is developing the care plan for a client with a substance use disorder
using person-centered care. Which intervention(s) should the nurse include in the
client's plan of care? Select all that apply.
A. Refer the client for inpatient therapy.
B. Determine if the client would prefer to have family members involved in the
plan.
C. Assess the client's willingness to participate in recovering.
D. Provide the client with a list of a support groups available in the community.
E. Educate the client about how addiction works in the body.
Answer: B, C, D
Rationale: The nurse using person-centered care should focus on health needs and
expectations instead of the disease. Educating the client about how addiction works
in the body and referring the client for inpatient care are not actions that
encompass person-centered care. Providing a list of support groups, assessing the
client's willingness to change and providing the client the choice to include the
client's family are actions that support the concept of person-centered care.
Question format: Multiple Select
Chapter 7: Recovery Framework for Mental Health Nursing
Cognitive Level: Apply
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Client Needs: Safe, Effective Care Environment: Management of Care
Reference: e-1, e-2
15. The nurse is leading a support group on the mental health unit. Which action
should the nurse take first?
A. Empower each client to share as much or as little as desired within the group.
B. Promote comfort by allowing each client to find a place to sit that makes the
client comfortable with in the room.
C. Establish a connection by greeting each client by name and thanking each for
joining the group.
D. Encourage each client to invite a peer support person to come with him or her to
the group sessions.
Answer: C
Rationale: The nurse should first establish a therapeutic nurse–client relationship by
trying to establish trust and a connection with the clients. Person-centered care is
built on a strong nurse–client relationship. Greeting each client by name and
thanking him or her for joining the group can give each client a sense of importance
and belongingness. The other options would be appropriate to do after establishing
a connection.
Question format: Multiple Choice
Chapter 7: Recovery Framework for Mental Health Nursing
Cognitive Level: Analyze
GRADPsychosocial
ESLAB.COM
Client Needs: Psychosocial Integrity:
Integrity
Reference: e-1, e-2
16. The nurse is discharging a client from inpatient mental health treatment to a
halfway house and has referred a peer support specialist to assist the client. Which
has the nurse demonstrated?
A. Stigma resilience
B. Shared decision-making model
C. Stage 4 of the five-stage process in homeless rehabilitation
D. Stage 3 of the five-stage process in homeless rehabilitation
Answer: C
Rationale: The nurse has demonstrated stage 4 of the five-stage process in
homeless rehabilitation, which is transition from intensive care to ongoing
rehabilitation. Stage 3 of this model is intensive treatment. Stigma resilience is a
characteristic of a client that demonstrates the ability to overcome challenges that
threaten stabiliity, viability or development. The shared decision-making model
occurs moreso at the beginning of treatment not at discharge. Although the client
and caregivers may have made shared-decisions about the client's discharge, there
is no evidence in the scenario to show that shared decision-making was used.
Question format: Multiple Choice
Chapter 7: Recovery Framework for Mental Health Nursing
Cognitive Level: Understand
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Client Needs: Safe, Effective Care Environment: Management of Care
Reference: e-5
17. The nurse is caring for a group of clients at a substance use disorder treatment
facility. Which statement would indicate a client is experiencing self-stigma?
A. "Everytime I am outside getting fresh air I can feel people who are walking by
just staring at me. I almost did not come back in."
B. "I cannot wait to prove to my family that I am not using drugs anymore, but I
know they are just going to see me as an addict forever."
C. "I understand that I need to find a new group of friends, because my friends will
keep offerring me drugs instead of helping me stay off of them."
D. "How do I get my coworkers to understand that I have a disease and it is not a
choice? Their whispers make me want to leave work and find drugs."
Answer: D
Rationale: The client statement about wanting to leave work and use drugs because
of the coworkers' whispering is an indication of self-stigma. The client is
internalizing the coworkers' opinions and it increases the client's symptoms of
wanting to use drugs. The other statements are indications that the client is
overcoming other people's opinions.
Question format: Multiple Choice
Chapter 7: Recovery Framework for Mental Health Nursing
Cognitive Level: Apply
GREnvironment:
ADESLAB.CManagement
OM
Client Needs: Safe, Effective Care
of Care
Reference: e-5
18. The nurse is caring for a client with depression who was admitted for a
substance use disorder. The nurse is using recovery oriented nursing care. Which
goal would be the most appropriate for the client's care?
A. To prevent re-admission
B. To have the client achieve stigma resilience
C. To empower the client to maintain recovery
D. To provide person-centered care
Answer: C
Rationale: The most appropriate goal would be to empower the client to maintain
recovery. Using person-centered care would assist with achieving the goal and with
achieving stigma resilience. If the client can maintain the goal of recovery than that
would prevent r-eadmission.
Question format: Multiple Choice
Chapter 7: Recovery Framework for Mental Health Nursing
Cognitive Level: Apply
Client Needs: Safe, Effective Care Environment: Management of Care
Reference: e-1
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
19. The nurse is explaining the concept of the shared decision-making model to the
spouse of a client who was involuntarily admitted for a substance use disorder. The
spouse states, "Is it really a good idea to let my spouse help make decisions since
this is involuntary and the decisions my spouse made to begin with is why we are
here?" Which response would be most appropriate by the nurse?
A. "Your spouse still has rights, and this model can help improve the success of
recovery."
B. "You can make decisions for your spouse, if you become the conservator."
C. "Do you think your spouse will try to make bad choices for treatment options,
because your spouse has an addiction problem?"
D. "The health care provider has the final say in the treatment, so your spouse will
get the care needed."
Answer: A
Rationale: The best response by the nurse is to advocate for the client, explaining
that the client has rights even if the client was admitted involuntarily. Also,
explaining that the model can improve the client's success with recovery helps the
spouse understand that this would be the best plan. The other options do not
advocate for the client and/or are incorrect. The health care provider does not have
the "final say," but rather the decisions are made together to facilitate the best plan
of care for the client.
Question format: Multiple Choice
Chapter 7: Recovery Framework for Mental Health Nursing
GRADESLAB.COM
Cognitive Level: Analyze
Client Needs: Safe, Effective Care Environment: Management of Care
Reference: e-2
20. The nurse at a local clinic is caring for the following clients. Which client should
the nurse recognize as being homeless and unsheltered?
A. The client who sleeps in a friend's car at night.
B. The client sleeping in a sleeping bag under a tree in the park.
C. The client who looks for coins at the beach all day and sleeps on a bench in the
pavillion.
D. The client who sleeps in a tent during the day and at night digs through trash
cans for food.
Answer: B
Rationale: The nurse should recognize the client sleeping under a tree in the park
has unsheltered homelessness. The other clients all have some type of roof over
them to protect them from rain or snow while they sleep. A tree would not be
considered shelter.
Question format: Multiple Choice
Chapter 7: Recovery Framework for Mental Health Nursing
Cognitive Level: Understand
Client Needs: Psychosocial Integrity: Psychosocial Integrity
Reference: e-4, e-5
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Test Generator Questions, Chapter 8, Therapeutic
Communication
Multiple Choice
1. When engaged in therapeutic communication with a client who has a mental
disorder, what is most important for the nurse to keep in mind?
A) The nurse should self-disclose when indicated.
B) The client is the primary focus of the interaction.
C) The nurse should have an empathetic relationship with the client.
D) The client’s conversations should be recorded.
Ans: B
Chapter: 8
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 2
Page Number: 83
Feedback: A fundamental principle of therapeutic communication is that the client
must be the focus of the interaction. Self-disclosure should be avoided. Empathy is
GRas
ADthe
ESnurse
LAB.C
OM
important and develops over time
receives
information from the client
with an open, nonjudgmental acceptance. The nurse communicates this
understanding of the experience so that the client feels understood. Conversations
with clients should be kept confidential.
2. A hospitalized client diagnosed with depression asks the nurse, “Should I go home
this weekend?” Which response by the nurse uses the technique of reflection?
A) “Should you go home for the weekend?”
B) “Home means what to you?”
C) “It sounds as if you don't want to go home this weekend.”
D) “I doubt that you really should go home this weekend.”
Ans: A
Chapter: 8
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Communication and Documentation
Objective: 4
Page Number: 86
Feedback: Reflection is used when the client wants the nurse’s approval or
judgment. The statement by the nurse that uses reflection is, “Should you go home
for the weekend?” This allows the client the opportunity to discuss the matter further.
The question: “Home means what to you?” seeks clarification. The question: “It
sounds as if you don't want to go home this weekend” reflects the technique of
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
interpretation. The question: “I doubt that you really should go home” offers the
nurse’s opinion and is judgmental.
3. A client who is hospitalized with depression tells the nurse, “I don't want to take
the medication because I'm afraid I'll become suicidal.” Which response by the nurse
would be most appropriate?
A) “Have you ever thought about hurting yourself?”
B) “It's important that you take this medication.”
C) “I agree with you. I wouldn't want to take this medication either.”
D) “Another client took that medication, and he really felt better.”
Ans: A
Chapter: 8
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Communication and Documentation
Objective: 4
Page Number: 88
Feedback: The nurse’s best response is, “Have you ever had feelings of hurting
yourself?” This response seeks to clarify the client’s statement about hurting
themselves and opens the door to allow a therapeutic discussion, since clients with
depression may have suicidal thoughts. Telling the client to take the medication,
agreeing with the client, or giving advice will block the therapeutic communication.
RAthe
DEnurse
SLAB.
COM why they are hospitalized. The
4. A psychiatric client is talkingGto
about
client begins to discuss their relationship with their same-sex partner. The client
describes the things in their relationship that cause discomfort, and the client asks the
nurse, “Should I break up with my partner?” Which response by the nurse would be
most effective in building rapport between the client and nurse?
A) “Of course you should; being gay is just not natural.”
B) “Yes, I think you should pursue building a relationship with someone of the
opposite sex.”
C) “It sounds like you're beginning to be uncomfortable in this relationship.”
D) “You need to focus on yourself rather than the relationship right now.”
Ans: C
Chapter: 8
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Caring
Objective: 4
Page Number: 82
Feedback: Nurses establish rapport through interpersonal warmth, a nonjudgmental
attitude, and a demonstration of understanding. The response about the relationship
becoming uncomfortable reflects both a nonjudgmental attitude and understanding.
Telling the client that being gay is unnatural, or telling the client to pursue a
relationship with someone of the opposite sex, reflects the nurse’s beliefs, gives
advice, and is judgmental. Telling the client to focus on themselves ignores the client’s
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
concern.
5. A nurse engaged in an interaction with a client recognizes body space zones.
Which description best explains an individual’s personal zone?
A) Beginning at the boundary of the intimate zone and ending at the social zone
B) Extending outward from the border to the public zone
C) Surrounding and protecting an individual from others, especially outsiders
D) The most distant boundary that can be used for recognizing intruders
Ans: A
Chapter: 8
Client Needs: Psychosocial Integrity
Cognitive Level: Understand
Integrated Process: Nursing Process
Objective: 6
Page Number: 88, 89
Feedback: The four zones are intimate, personal, social, and public. The personal
zone begins at the boundary of the intimate zone and ends at the social zone. The
intimate zone varies widely in different cultures. The social zone begins at the end of
the personal zone and ends at the public zone. The public zone begins at the end of
the social zone and extends outward.
6. While providing care to a client with a mental disorder, the client asks the nurse,
“Does mental illness run in your family?” Which response by the nurse would be most
GRADESLAB.COM
inappropriate?
A) “Mental illnesses do run in families, and I've had a lot of experience caring for
people with mental illness.”
B) “It sounds like you are concerned that there may be a family connection to your
current problem?”
C) “Yes, it does. I have a sister who was diagnosed several years ago with severe
major depression.”
D) “Mental illness can be family related. Let's focus the discussion on you and how
you're doing today.”
Ans: C
Chapter: 8
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 2
Page Number: 84
Feedback: The statement about the nurse’s sister suffering from depression is
inappropriate because it involves self-disclosure that serves no therapeutic purpose.
In addition, it ignores the underlying concern of the client’s statement---mental
illnesses and family. The statements about having experience dealing with mental
illnesses, sounding concerned about a family connection, and focusing the discussion
on the client serve to redirect the interaction back to the client.
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
7. A nurse is providing training to a new nurse on the team and is describing the
nurse–client relationship. What does the nurse emphasize as being crucial for
establishing and maintaining the relationship?
A) Rapport
B) Empathy
C) Self-awareness
D) Values
Ans: C
Chapter: 8
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 1
Page Number: 81, 82
Feedback: Self-awareness is crucial for the nurse–client relationship. Without it,
nurses will find it impossible to establish and maintain therapeutic relationships with
clients. Although rapport and empathy are important considerations for the nurse–
client relationship, self-awareness is key. Values are inherent in the nurse and the
nurse must be self-aware of his or her own values.
8. A nurse is giving a presentation to colleagues about verbal communication. The
audience demonstrates understanding of the information when they identify which
component as the first in the process?
GRADESLAB.COM
A) Formulation of an idea
B) Message encoding
C) Transmission of message
D) Message reception
Ans: A
Chapter: 8
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 2
Page Number: 83
Feedback: With verbal communication, typically the person formulates an idea,
encodes a message, and then transmits the message with emotion. The message is
then received and decoded, and a response is made.
9. A nurse responds to a client’s statement with silence, because the nurse knows
that this technique is used primarily for what reason?
A) To allow the nurse to determine an appropriate response
B) To permit the client to gather his or her thoughts
C) To encourage self-reflection by the nurse
D) To demonstrate passive listening
Ans:
B
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Chapter: 8
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 3
Page Number: 86
Feedback: By maintaining silence, the nurse allows the client to gather his or her
thoughts and to proceed at his or her own pace. Silence may help the nurse determine
an appropriate response or engage in self-reflection, but it is more directed on
allowing the client to focus. Silence does not reflect passive listening. Passive listening
involves sitting quietly and letting the client talk, rambling without focusing, or
guiding the thought process.
Multiple Select
10. A nurse is preparing a presentation on therapeutic and nontherapeutic
techniques of communication. The nurse should select which techniques to
demonstrate as therapeutic? (Select all that apply.)
A) Confrontation
B) Open-ended statements
C) Reflection
D) Reassurance
E) Agreement
F) Challenges
GRADESLAB.COM
Ans: A, B, C
Chapter: 8
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Teaching/Learning
Objective: 4
Page Number: 85, 86
Feedback: Therapeutic communication techniques include confrontation,
open-ended statements, and reflection. Reassurance, agreement, and challenges are
techniques that inhibit communication.
Multiple Choice
11. When communicating with a client, how should the nurse convey positive body
language?
A) Sit erect with back against the chair
B) Cross the arms over the chest
C) Sit at the client’s eye level
D) Keep the feet on the floor with the legs crossed
Ans: C
Chapter: 8
Client Needs:
Psychosocial Integrity
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 2
Page Number: 84
Feedback: Positive body language includes sitting at the same eye level as the client
with a relaxed posture, leaning slightly forward with the arms and legs uncrossed.
12. During an interview, a client tells the nurse that they were recently let go from
their job. As the interaction continues, the client states, “I was really overqualified for
that position anyway. It was definitely below my area of expertise.” The nurse
interprets this information as reflecting which mechanism?
A) Denial
B) Intellectualization
C) Projection
D) Passive aggression
Ans: B
Chapter: 8
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 5
Page Number: 90
Feedback: The client is attempting to use abstract thinking or make generalizations
GRassociated
ADESLABwith
.COM
to control or minimize his feelings
the loss of his job. Refusing to
acknowledge the painful aspect—for example, “I really didn't want that job”—would
reflect denial. With projection, an individual falsely attributes to another person his or
her own acceptable feelings, thoughts, or impulses. Passive aggression reflects a
façade of overt compliance that masks covert resistance, resentment, or hostility.
Multiple Select
13. A nurse is engaged in active listening. Which techniques would the nurse use?
(Select all that apply.)
A) Changing the subject to gather more information
B) Responding indirectly to statements
C) Using open-ended statements
D) Concentrating on what the client says
E) Allowing the client to talk as he wishes
Ans: B, C, D
Chapter: 8
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 3
Page Number: 85
Feedback: Through active listening, the nurse focuses on what the client is saying to
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
interpret and respond to the message objectively. While listening, the nurse
concentrates only on what the client is saying and on the underlying meaning. The
nurse usually responds indirectly, using techniques such as open-ended statements,
reflection, and questions that elicit additional responses from the client. Changing the
subject is avoided. Allowing the client to talk as he wishes reflects passive listening,
which does not foster a therapeutic relationship.
Multiple Choice
14. A nurse is discussing defense mechanisms with a client. The nurse determines
that the client understands the concept when the client makes what statement?
A) “Most defense mechanisms are considered to be maladaptive, regardless of the
situation.”
B) “Defense mechanisms help mediate a person’s response to emotional conflicts
and external stressors.”
C) “Use of defense mechanisms indicates that the person’s mental state is
dysfunctional.”
D) “Persistent use of defense mechanisms commonly enhances a person’s quality of
life.”
Ans: B
Chapter: 8
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
GRADESLAB.COM
Integrated Process: Teaching/Learning
Objective: 7
Page Number: 89
Feedback: Defense mechanisms (also known as coping styles) are defined in the
Diagnostic and Statistical Manual of Mental Disorders-5 as mechanisms that mediate
the [client’s] reaction to emotional conflicts and to external stressors. Some defense
mechanisms (e.g., projection, splitting, acting out) are almost invariably
maladaptive. Others (e.g., suppression, denial) may be either maladaptive or
adaptive, depending on their severity, their inflexibility, and the context in which they
occur. While defense mechanisms might seem to indicate the existence of problematic
mental state, this is not true. Healthy individuals in many different contexts use
defense mechanisms. As with some other mental illnesses, the use of defense
mechanisms becomes maladaptive when its persistent use reduces the client’s quality
of life. The degree to which a particular defense mechanism is maladaptive varies.
15. During a training session, a group of nurses are role-playing situations in order
to practice using therapeutic communication techniques. Which would the nurses
identify as verbal communication?
A) Emotion underlying the words
B) Gestures
C) Body language
D) Expressions
Ans:
A
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Chapter: 8
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Communication and Documentation
Objective: 2
Page Number: 82, 83
Feedback: Verbal communication, which is principally achieved by spoken words,
includes the underlying emotion, context, and connotation of what is actually said.
Nonverbal communication includes gestures, expressions, and body language.
Multiple Select
16. Which statement(s) made by a nurse whose family immigrated to the United
States 4 years ago demonstrates an effective process of personal self-awareness?
(Select all that apply.)
A. “Living through the stress of adjusting to a new country has taught me patience
and empathy.”
B. “I work very hard at seeing all my clients as individuals not members of a group.”
C. “I realize that not everyone is comfortable with my Muslim heritage.”
D. “Meditation is a very effective stress management technique.”
GRADES
LABto
.Clive.”
OM
E. “Today’s world is a difficult, stressful
place
Ans: A, B, C
Chapter: 8
Client Needs:
Psychosocial Integrity
Cognitive Level:
Analyze
Integrated Process:
Culture and Spirituality
Objective: 1
Page Number:
81
Feedback: “Self-awareness is the process of understanding one’s own beliefs,
thoughts, motivations, biases, and limitations, and recognizing how they affect
others. The options that focus on “I” and personal experiences are reflective of
self-awareness while meditation and a stressful environment are more general in
mature and not necessary based on an understanding of self.
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
17. A nurse is working with a client diagnosed with chronic depression. Which
statement(s) made by the nurse demonstrates compliance with the basic principles of
therapeutic communication? (Select all that apply.)
A. “Our talks are confidential unless what you share poses a danger to you or
someone else.”
B. “Tell me more about what you mean when you call your partner abusive.”
C. “I have been depressed before and found medication to be most helpful.”
D. “It is very hard to help you when you miss our sessions so often.”
E. “My divorce was the most painful thing I have ever experience.”
Ans:
A, B
Chapter: 8
Client Needs:
Psychosocial Integrity
Cognitive Level:
Apply
Integrated Process: Communication and Documentation
Objective: 4
Page Number: 82
GRADESLAB.COM
Feedback: Principles of therapeutic communication include maintaining client
confidentiality unless there is a danger present and clarifying information the client
has presented. The focus on the interaction should be the client, not the personal
feelings or experiences of the nurse. The nurse should avoid being judgmental about
the client or the client’s behavior.
Multiple Choice
18. Which component of a conversation between the nurse and a client being
prepared for surgery is the best example of decoding and validation of the message?
A. The nurse asks, “Is there anything I can get for you?”
B. The client states, “I am OK; I do not need anything.”
C. The nurse responds to the client, “While you say everything is alright, you seem
anxious.”
D. The client responds to the nurse, “Maybe a little; I have never had any kind of
surgery before.”
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Ans:
C
Chapter: 8
Client Needs:
Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Communication and Documentation
Objective: 2
Page Number: 83
Feedback: The client formulates an idea, encodes that message (puts ideas into
words), and then transmits the message with emotion. The client’s words and their
underlying emotional tone and connotation communicate the individual’s needs and
emotional problems. The nurse receives the message, decodes it (interprets the
message, including its feelings, connotation, and context), and then responds to the
client. Validation is essential to ensure that the nurse has received the information
accurately. While offering or declining services involves addressing needs neither
option demonstrates validation as effectively as further exploring the verbal and
nonverbal responses of the client. The client’s response to the nurse’s inquiry
GRADESvalidation
LAB.COMeffectively, because the client
regarding anxiety does not demonstrate
minimizes the anxiety.
19. Which nursing response would likely inhibit communication and be nontherapeutic
in helping the client achieve treatment goals related to improving poor self-esteem?
A. “I cannot promise things will improve, but I can assure you we are here to support
you.”
B. “If you are serious about getting better you need to get a job and support yourself.”
C. “Life presents everyone with challenges that we need to work at overcoming.”
D. “All people have good qualities and you certainly have talents to be proud of.”
Ans: B
Chapter: 8
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Communication and Documentation
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Objective: 4
Page Number: 87
Feedback: Ineffective communication techniques include giving advice that attempts
to solve the individual’s identified problem. The remaining options offer support and
guidance and avoid making inappropriate assurances.
20. When attempting to discuss the feelings associated with an impending divorce, a
client begins crying after stating,“I will never be able to get over this failure.” Which
statement made by the nurse will most likely support the client’s ability to adopt a
more positive view of the divorce?
A.“I agree that you are never the same after a divorce.”
B. “Let’s talk about what is making you feel so hopeless.”
C. “Many people experience these feelings; things will improve.”
D. “Let’s talk about this later after you have a change to compose yourself.”
Ans: B
GRADESLAB.COM
Chapter: 8
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Communication and Documentation
Objective: 3
Page Number: 87
Feedback: Talking about the feelings is appropriate and likely to encourage a positive
change of view. Agreeing denies the client the opportunity to change his or her point
of view, because it has been validated by the nurse. The nurse should not provide
assurance that may not be attainable nor should attention to the client’s needs be
postponed.
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Test Generator Questions, Chapter 9: The Nurse--Patient
Relationship
1. A client is talking to the nurse about the recent death of the client’s
grandmother. The client is sad and crying. The nurse remembers feeling sad when
the nurse’s own grandmother died the previous summer. The nurse puts a hand on
the client’s shoulder and says, “This must be very difficult for you.” What indicates
that the nurse is demonstrating empathy?
A) The nurse’s response reflects an attempt to communicate understanding of the
client’s feelings.
B) The nurse’s response and use of reassuring touch reinforce the nurse’s concern
for the client.
C) The nurse demonstrates understanding of how the client feels because of her
own grandmother’s death.
D) The nurse’s statement expresses compassion and kindness toward the client.
Ans: A
Chapter: 9
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
GRADand
ESLDocumentation
AB.COM
Integrated Process: Communication
Objective: 1
Page Number: 96, 97
Feedback: Empathy involves the nurse receiving information from the client with
open, nonjudgmental acceptance. The nurse should communicate this
understanding of the experience and feelings so the client feels understood. It is
not necessary for the nurse to have had the same experience, but the nurse needs
to imagine how having the experience feels to the client. Sympathy is the
expression of compassion and kindness.
2. The nurse is in the orientation phase of the nurse–client relationship with a
client diagnosed with a mental disorder. When interviewing the client during this
first encounter, which information is most important for the nurse to obtain about
the client?
A) Known allergies
B) Recent hospitalizations
C) Perception of the problem
D) Family history
Ans: C
Chapter: 9
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Objective: 3
Page Number: 97, 98
Feedback: Although information about allergies, hospitalizations, and family history
are important in the orientation phase, it is most important for the nurse to ask the
client with a mental disorder about the nature of the problem from the client’s
perspective. Some clients deny that a problem exists; other clients may have
misperceptions about the problem.
3. Termination takes place during the resolution phase of a nurse–client
relationship. During the termination process, a client brings up resolved problems
and presents them as new issues toward which to work. The nurse interprets the
client’s action as indicating what feeling in the client?
A) Anger that the nurse is abandoning him
B) Wish for additional therapy
C) Belief that the therapy was ineffective
D) Wish to prolong the nurse–client relationship
Ans: D
Chapter: 9
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Communication and Documentation
Objective: 3
Page Number: 99
GRADEwith
SLAmental
B.COMdisorders to bring up resolved
Feedback: It is not unusual for clients
problems and present them as new issues during the resolution phase. The client is
most likely attempting to prolong the nurse–client relationship. The client may be
experiencing anxiety about the relationship ending. Anger typically would be
demonstrated toward the nurse or displaced onto others rather than through the
use of bringing up resolved problems. The client’s actions do not indicate that
additional therapy is needed, or that the therapy was ineffective.
4. When engaged in a nontherapeutic relationship, which action would the nurse
identify as occurring first?
A) Failure to recognize the client as a person with a need
B) Client avoiding the nurse
C) The nurse being perceived as rude
D) Client feeling hopeless and frustrated
Ans: A
Chapter: 9
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Communication and Documentation
Objective: 4
Page Number: 99, 100
Feedback: In a nontherapeutic relationship, the withholding phase occurs first, in
which the nurse fails to recognize that the client is a person with an illness or health
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
needs. The client avoiding the nurse and the nurse being perceived as rude are
characteristics of the avoiding and ignoring phase. Feelings of client hopelessness
and frustration characterize the end phase of “struggling with and making sense of
. . . .”
Multiple Select
5. The nurse is engaged in a therapeutic nurse–client relationship. The relationship
is in the working phase. With which steps would the client be involved? (Select all
that apply.)
A) Beginning to identify a need
B) Testing new ways for problem solving
C) Testing the relationship
D) Discussing problems related to needs
E) Examining personal issues
Ans: B, D, E
Chapter: 9
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 3
Page Number: 98
Feedback: During the working phase, the client discusses problems underlying the
RAthe
DESrelationship
LAB.COM to examine personal issues,
needs, uses the emotional safetyGof
and tests new ways of solving problems. Identifying a need and testing the
relationship typically occur during the orientation phase of the relationship.
6. The nurse knows that rapport has been established when the client begins to do
what action?
(Select all that apply.)
A) Tries to isolate himself or herself from others in the group.
B) Acknowledge that they wish to keep many topics off limit and private.
C) Develop a sense of sharing.
D) Display decreased anxiety and feels comfortable in the presence of the nurse.
E) Begin speaking with a more rapid repetitive speech.
Ans: C, D
Chapter: 9
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 2
Page Number: 96
Feedback: When rapport develops, a client feels comfortable with the nurse and
finds self-disclosure easier. The nurse also feels comfortable and recognizes that an
interpersonal bond or alliance is developing. All of these factors—comfort, sense of
sharing, and decreased anxiety—are important in establishing and building the
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
nurse–client relationship. The other distractors are signs that the client is distrustful
of the therapeutic relationship.
7. Which actions indicate that the relationship between nurse and client may be
moving outside the professional boundaries? (Select all that apply.)
A) Client brings the nurse a baked item for their lunch.
B) Nurse is spending more time with the client than the others in the group.
C) Nurse objectively listens and contributes to the team meeting about behaviors
the client is displaying.
D) Nurse tells a friend that the nurse is the only one that truly understands this
client.
E) Nurse informs their supervisor that the client asked the nurse to “keep a secret
from the rest of the staff.”
Ans: A, B, D
Chapter: 9
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 4
Page Number: 97
Feedback: Indicators that the relationship may be moving outside the professional
boundaries are gift giving on either party’s part, spending more time than usual
with a particular client, strenuously defending or explaining the client’s behavior in
team meetings, the nurse feeling that he or she is the only one who truly
GRADESor
LAfrequently
B.COM thinking about the client
understands the client, keeping secrets,
outside of the work situation.
8. Which item should the nurse discuss with the client about the clients’
responsibilities during the first meeting? (Select all that apply.)
A) Attendance is expected for each session.
B) Participation is expected during each session.
C) How to make-up sessions if they don’t feel like attending meetings.
D) If they feel anxious, they should take additional antianxiety medications.
E) Should be able to focus on the topics and not interrupt others during the
session.
Ans: A, B, C
Chapter: 9
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 3
Page Number: 98
Feedback: The client is responsible for attending agreed-upon sessions, interacting
during the sessions, and participating in the nurse--client relationship. The nurse
should also explain clearly to the client meeting times, handling of missed sessions,
and the estimated length of the relationship.
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Multiple Choice
9. Which response would be considered “usual or expected” during the first few
sessions?
A) Showing up late for the first session.
B) Being confrontational with nurse and other group members.
C) Rambling due to nervousness.
D) Bragging about sexual conquests.
Ans: C
Chapter: 9
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 3
Page Number: 98
Feedback: The client is usually nervous and insecure during the first few sessions
and may exhibit behavior reflective of these emotions, such as rambling. Showing
up late, being confrontational, and bragging are nontherapeutic ways to not
participate in the session.
10. Which behavior would be considered a “testing behavior” that usually happens
during the “honeymoon phase” of the relationship?
A) Talking nonstop and monopolizing the conversation.
RAD
ESparticipating
LAB.COM in the discussion.
B) Sitting away from the group G
and
not
C) Accusing the nurse of being too controlling during the session.
D) Expressing anger and accusing the nurse of breaking confidentiality.
Ans: D
Chapter: 9
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 3
Page Number: 98
Feedback: This first part of the orientation phase, called the “honeymoon phase,”
is usually pleasant. However, the therapeutic team typically hits rough spots before
completing this phase. The client begins to test the relationship to become
convinced that the nurse will really accept him or her. Typical “testing behaviors”
include forgetting a scheduled session or being late. Clients may also express anger
at something a nurse says or accuse the nurse of breaking confidentiality.
Multiple Select
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
11. During the termination phase, a client begins to raise old problems that have
already been resolved. What are the most appropriate responses by the nurse?
(Select all that apply.)
A) Immediately stop the client and inform them that the nurse is running the
session.
B) Get angry at the client and ask them to leave the session.
C) Reassure the client that they already covered these issues.
D) Review with the client the learned methods to control the problems.
E) Do not acknowledge this issue and continue on with the session as planned.
Ans: C, D
Chapter: 9
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 3
Page Number: 99
Feedback: A typical termination behavior is raising old problems that have already
been resolved. The nurse may feel frustrated if clients in the termination phase
present resolved problems as if they were new. The clients are attempting to
prolong the relationship and avoid its ending. Nurses should avoid addressing these
problems. Instead, they should reassure clients that they already covered those
issues and learned methods to control them.
Multiple Choice
GRADESLAB.COM
12.How might a client respond in a nontherapeutic relationship?
A) Go to the supervisor and ask to be placed in another group.
B) Get angry and start attacking the nurse.
C) Leave the unit and not be available for the scheduled meeting.
D) Ask the nurse to talk about her relationships outside of work.
Ans: C
Chapter: 9
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 4
Page Number: 99
Feedback: In a nontherapeutic relationship, the nurse and client both feel very
frustrated and keep varying their approach with each other in an attempt to
establish a meaningful relationship. Eventually, the frustration becomes so great
that the pair gives up on each other and moves to a phase of mutual withdrawal.
The client will leave the unit or otherwise be unavailable during scheduled meeting
times. If a meeting does occur, the nurse will try to keep it short, thinking, “What’s
the point—we just cover the same old ground anyway.” The client will attempt to
keep it superficial and stay on safe topics.
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Multiple Select
13.What actions usually occur during the middle phase of a deteriorating
relationship? (Select all that apply.)
A) The client trying to avoid the nurse.
B) The nurse trying to smother the client with attention.
C) The client begins to break as many rules as possible.
D) The nurse ignores and avoids the client’s requests for help.
E) The client feels frustrated and hopeless.
Ans: A, D
Chapter: 9
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 4
Page Number: 100, 101
Feedback: The middle phase of a deteriorating relationship consists of two
subphases: avoiding and ignoring. The client begins to avoid the nurse and
perceives that the nurse is avoiding him or her. The client abides by the rules and
because he or she does not want to cause problems. The nurse is perceived as rude
and condescending. The nurse ignores and avoids the client’s requests for help; in
turn, the client becomes more anxious, frustrated, and fearful. The end phase is
named struggling with and making sense of. In the final phase of a nontherapeutic
GRADEas
SLaAresult
B.COM
the client feels hopeless and frustrated
of the lack of support received by
the nurse.
14.Which features appear when motivational interviewing is being used? (Select all
that apply.)
A) Eliciting and strengthening client change talk
B) Negotiating change plans
C) Firming up client commitment
D) Trying to “stick to the plan” without adapting to the moment
E) Utilizing feedback at the very last session
Ans: A, B, C
Chapter: 9
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 5
Page Number: 101
Feedback: Eight identified features of motivational interviewing (MI) that should
appear in every application of this technique include “openness to collaboration with
clients’ own expertise; proficiency in client centered counseling, including accurate
empathy; recognition of key aspects of client speech that guides the practice of MI;
eliciting and strengthening client change talk; rolling with resistance; negotiating
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
change plans; consolidating client commitment, and; switching flexibly between MI
and other intervention styles.”
Multiple Select
15. Which client statement(s) best supports that the nurse--client relationship has
acheived a therapeutic rapport? (Select all that apply.)
A) “I do not feel so alone with this problem anymore.”
B) “I enjoy the time we spend together.”
C) “Nurses are really good people.”
D) “I feel that you understand me.”
E) “It is really hard being sick.”
Answer: A, D
Chapter: 9
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
GRADESLAB.COM
Integrated Process: Nursing Process
Objective: 2
Page Number: 96
Feedback: Rapport is the development of interpersonal harmony characterized by
understanding and respect, and is important in developing a trusting, therapeutic
relationship. When rapport develops, a client feels comfortable with the nurse and
finds self-disclosure easier. Establishing rapport helps lessen feelings of being
alone. While the other options present positive feelings about nurses in general and
spending time with the nurse, none express the concepts of understanding and not
feeling isolated. The option related to the client’s feelings related to being sick
demonstrates a sense of isolation.
Multiple Choice
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
16. The nurse is providing care to a client who recently lost a long-time domestic
partner. Which statement best demonstrates the nurse’s desire to develop empathy
with the client?
A) “I am so sorry to hear about the terrible loss of your parner.”
B) “Please let me know what I can do to help with the loss of your partner.”
C) “Losing a partner must be the most difficult things you have ever experienced.”
D) “Please talk with me about how losing your partner has affected you personally.”
Ans: D
Chapter: 9
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Communication and Documentation
Objective: 2
Page Number: 97, 98
Feedback: Empathy is the ability to experience, in the present, a situation as
RADThe
ESLnurse
AB.Cdoes
OM not actually need to have had
another did at some time in the G
past.
the experience for oneself but must be able to imagine the feelings associated with
it. For empathy to develop, there must be a “giving of self” to the other individual,
demonstrated by the request to talk about how the loss of a partner has affected
the client. Expressing sorrow is a demonstration of sympathy not empathy. The
nurse should not assume how the loss has affected the client. Offering help is
appropriate but does not suggest a true interest in the client’s feelings as does the
asking the client to discuss those feelings.
17. The nurse has been providing regular care to a client diagnosed with an
anxiety-related disorder for the past 2 weeks. Which statement made by the nurse
suggests a possible professional boundary issue?
A) “I am going to rearrange my schelude today so we can spend more time
talking.”
B) “We can meet at 2:30 PM today to practice stress management techniques.”
C) “It would be helpful if your family attended your next session with me.”
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
D) “It is good to see you smiling today.”
Ans: A
Chapter: 9
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 2
Page Number: 97
Feedback: Maintaining professional boundaries may be more difficult in an ongoing
therapeutic relationship. Indicators that the relationship may be moving outside of
professional boundaries are gift giving on either party’s part, providing the client
with a personal phone number, or spending more time than usual with a particular
client. None of the other options present with behaviors or attitudes that breech the
criteria for professional boundaries.
Multiple Select
GRADESLAB.COM
18. The nurse is providing care for a group of clients diagnosed with and being
treated for anxiety and depression. Which nursing statement(s) identifies an action
associated with the orientation phase of the nurse--client relationship? (Select all
that apply.)
A) “Today we will spend time working on relaxation techniques.”
B) “We will meet each Monday and Wednesday at 11:30 AM for 45 minutes.”
C) “Our main goal is to discuss the things that tend to trigger your symptoms.”
D) “So you feel that your relationship with your siblings causes your depression.”
E) “I am the nurse who will be working with you; please come to me with your
concerns.”
Ans: B, C, E
Chapter: 9
Client Needs: Psychosocial Integrity
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 3
Page Number: 97
Feedback: The orientation phase begins when the nurse and patient meet and ends
when the patient begins to identify problems to be examined. Introductions,
expectations, and rapport building are focused on during this phase. Discussion and
work on specific client issues occur in the working phase of the relationship.
Multiple Choice
19. A client accused the nurse of “really not caring” and has is now consistently 10
minutes late for sessions. To best perserve the nurse--client relationship, how
should the nurse respond?
A) The nurse continues to arrive for the session at the agreed upon time.
B) The nurse tells the client, “I do care and I am surprised you think I do not.”
C) The nurse asks the client, “What can I do to prove I really do care about you?”
GRADESLAB.COM
D) The nurse reschedules the sessions to start 10 minutes later than originally
agreed upon.
Ans: A
Chapter: 9
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 3
Page Number: 98
Feedback: The first part of the orientation phase, also called the “honeymoon
phase,” is usually pleasant but the client usually begins to test the relationship to
be convinced that the nurse will really accept him or her. Typical “testing
behaviors” include forgetting a scheduled session or being late for appointments.
Clients may also express anger at something a nurse says or may accuse the nurse
of breaking confidentiality. If the nurse simply accepts the behavior and continues
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
to be available and consistent with the client, these behaviors usually subside.
Testing needs to be understood as a normal way that human beings develop trust.
Neither rescheduling the time of the sessions nor demonstrating such personal
responses to the client’s claim will help preserve the nurse--client relationship.
Multiple Select
20. The nurse has been conducting a group for clients diagnosed with anxiety and
depression. Which event(s) best demonstrates that a specific nurse--client
relationship is experiencing mutual withdrawal? (Select all that apply.)
A) The client consistently changes focus of the sessions‘ discussions.
B) The nurse frequently shortens the length of the scheduled sessions.
C) The client has family members plan visits during the time sessions are
scheluded.
D) The client reverts to “safe topics” rather than discuss issues previously
identified as important.
E) The nurse schedules sessions for late in the shift and frequently gets “too busy”
and cancels.
GRADESLAB.COM
Ans: A, B, C, D, E
Chapter 9
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 4
Page Number: 99
Feedback: In a nontherapeutic relationship, the nurse and client both feel very
frustrated and eventually, the frustration becomes so great that the pair gives up
on each other and moves onto a phase of mutual withdrawal. The nurse may
schedule seeing this client at the end of the shift and “run out of time” so that the
meeting never happens. The client will leave the unit, or otherwise be unavailable
during scheduled meeting times. If a meeting does occur, the nurse will try to keep
it short, thinking, “What is the point—we just cover the same old ground anyway.”
The client will attempt to keep it superficial and stay on safe topics. The client will
attempt to find focus by frequently changing topics. When that is unsuccessful, the
mutual withdrawal will likely occur.
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Test Generator Questions, Chapter 10, The Psychiatric--Mental
Health Nursing Process
Multiple Choice
1.
for
A)
B)
C)
D)
Which question would be most helpful in beginning an initial assessment interview
a client who has just been admitted to a psychiatric inpatient unit?
“Have you had any previous psychiatric admissions?”
“What brings you into the hospital today?”
“Have you had any thoughts about trying to harm yourself?”
“How would you describe your relationship with your spouse?”
Ans: B
Chapter: 10
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 2
Page Number: 105, 107
Feedback: Open-ended questions are most helpful when beginning the interview
because they allow the nurse to observe how the client responds verbally and
GRADand
ESLinterest
AB.COin
M the person’s well-being, which
nonverbally. They also convey caring
helps to establish rapport. Asking about previous hospitalization, thoughts of
self-harm, and spousal relationship would be questions asked later in the assessment.
2. A client is being admitted to the psychiatric unit. The client explains their reason
for seeking admission, describing how their 32-year-old son recently died of a heart
attack. Which response by the nurse would enhance the effectiveness of this
interview?
A) “How is your spouse handling your son's death?”
B) “Do you have any other living children that can help you cope with this loss?”
C) “This must be a very difficult time for you.”
D) “I know exactly how you're feeling; my 23-year-old son died unexpectedly last
year.”
Ans: C
Chapter: 10
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 2
Page Number: 107
Feedback: This statement reflects empathy, which is one of the nursing behaviors
that can enhance the effectiveness of an assessment interview. The focus needs to be
on the client. Therefore, asking about his wife or other children would be less
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
appropriate. Telling the client how the nurse feels is inappropriate use of
self-disclosure.
3. A client was admitted to the hospital after attempting suicide attempt after a
daughter’s death in an automobile accident. During the assessment interview, the
client begins to describe their daughter. The client’s voice trembles and they begin
crying. Then the client smiles superficially at the nurse and states, “I'll get over this.
I think all I need to do is stay overnight. I'll be as good as new by tomorrow.” Which
response by the nurse would be most appropriate?
A) “Tell me about your daughter. How would you describe the relationship you had
with her?”
B) “I'm sure you are right; a good night’s rest should make a big difference.”
C) “As good as new?”
D) “You made a serious attempt on your life; you will not be ready to go home by
tomorrow.”
Ans: D
Chapter: 10
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 2
Page Number: 107
Feedback: The response about making a serious attempt at suicide and not being
GRADESLthe
AB.client’s
COM unrealistic assumption and
ready to go home by tomorrow addresses
presents him or her with the reality of his or her situation. Presenting reality is one of
the assessment interview behaviors that enhances the effectiveness of an assessment
interview. Asking the client to tell the nurse about the daughter changes the subject
and focus of the client’s statement. Telling the client that they are right is false
reassurance. The response, “As good as new?”, although a reflective and clarifying
statement, shifts the focus of the interaction.
4. After assessing a client, the nurse noted the following: “He was tearful, he tried to
kill himself before coming into the hospital, he had no immediate plan for another
suicide attempt, he was unable to concentrate, and he reported having trouble
sleeping and having little or no appetite.” The nurse also noted that the client’s
appearance was unkempt, that he spoke in a low monotone, and that he was unable
to establish and maintain eye contact. Based on this information, which nursing
diagnosis would be the most appropriate?
A) Ineffective Role Performance
B) Risk for Infection
C) Risk for Suicide
D) Risk for Self-Mutilation
Ans: C
Chapter: 10
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Integrated Process: Nursing Process
Objective: 3
Page Number: 114
Feedback: The client’s history of a recent suicide attempt in conjunction with his
signs of depression, such as difficulty sleeping, lack of appetite, and inability to
concentrate, put him at risk for suicide. The information described in the nurse’s
observations does not support ineffective role performance, infection, or
self-mutilation.
5. A staff nurse on a psychiatric unit knows that clients often have trouble sleeping
because of their psychiatric conditions. Which psychiatric nursing intervention reflects
a way to appropriately address this problem?
A) Limiting amounts of evening snacks and beverages
B) Involving clients in a volleyball game immediately before bedtime
C) Enforcing the rule that all clients be in bed with lights out by 10:30 PM
D) Encouraging clients to take short naps in the afternoons
Ans: A
Chapter: 10
Client Needs: Physiological Integrity: Basic Care and Comfort
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 5
Page Number: 118
RADafternoon
ESLAB.CorOMevening, eating lightly before
Feedback: Avoiding naps in theGlate
retiring, and limiting fluid intake before retiring are nonpharmacologic sleep
interventions that should be tried before administering sleep medications because of
side effects associated with many of the pharmacologic sleep interventions.
6. The nurse is determining the success of a client’s plan of care by evaluating
outcome indicators. What is a positive outcome for a client with schizophrenia who
has been experiencing numerous hallucinations?
A) On the day of discharge, the client reports they are only hearing two voices today.
B) During the initial assessment, the nurse observes the client talking to themselves
throughout the interview phase.
C) At the initial interview, the client is unable or unwilling to answer all questions, at
times just staring off in space.
D) After intense therapy sessions and medication readjustment, the client reports
they are no longer hearing voices.
Ans: D
Chapter: 10
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 4
Page Number: 117
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Feedback: The nurse usually determines outcome indicators during the assessment
process. Outcomes can be expressed in terms of the client’s actual responses (no
longer reports hearing voices) or the status of a nursing diagnosis at a point in time
after implementation of nursing interventions.
7. A nurse is educating a client on how to relax before bedtime. The nurse
determines that the education was effective on the basis of which action by the client?
A) Discusses feelings about not being able to fall asleep
B) Reports feeling rested upon awakening in the morning within 3 days
C) Requests sleeping medication each night before bedtime
D) Is able to sleep for short intervals throughout the night
Ans: B
Chapter: 10
Client Needs: Physiological Integrity: Basic Care and Comfort
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 4
Page Number: 118
Feedback: An appropriate outcome statement for the client is that the client reports,
within 3 days, of feeling rested upon awakening in the morning. The outcome is
measurable and has a specified time frame for achievement. Requesting sleeping
medication indicates that the relaxation techniques have not been helpful. Discussing
feelings is part of the assessment data and would reflect a nursing diagnosis related to
anxiety or ineffective coping. Sleeping for short intervals indicates some progression
GRADeffectiveness.
ESLAB.COM
toward the goal but does not indicate
8. A migrant worker is brought to the emergency department because of an injury,
and it soon becomes evident that the client cannot speak English. A nurse on duty
offers to find an interpreter so the client can communicate with the medical staff. The
nurse’s offer is an example of which type of nursing intervention?
A) Milieu therapy
B) Conflict resolution
C) Cultural brokering
D) Structured interaction
Ans: C
Chapter: 10
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 5
Page Number: 120, 121
Feedback: Cultural brokering is the act of bridging, linking, or mediating messages,
instructions, and belief systems between groups of people of differing cultural
systems to reduce conflict or produce change. In this instance, the nurse intended to
produce a change in the quality of care provided to the client. Milieu therapy provides
a stable and coherent social organization to facilitate an individual’s treatment.
Conflict resolution involves helping clients resolve disagreements or disputes with
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
family, friends, or other clients. Structured interaction, a milieu concept, is the
purposeful interaction that allows clients to interact with others in a useful way.
9. A home health nurse is making a home visit to a psychiatric client who was
recently discharged from a mental health unit. During the visit, the nurse plans on
clarifying with the client the date and time of the next home visit. During which stage
would the nurse discuss the next home visit with the client?
A) Closure stage
B) Service implementation
C) Greeting stage
D) Focus establishment
Ans: A
Chapter: 10
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 5
Page Number: 125, 126
Feedback: Closure is the last phase, the end of the home visit. It is a time to
summarize and clarify important points. The nurse should also schedule any
additional visits and reiterate client expectations between visits. The greeting phase
establishes the communication process and atmosphere for the visit. The focus of the
visit is accomplished next. The third phase, implementation of service, uses most of
RADESL
B.Cvisit.
OM
the visit time and addresses the G
purpose
ofAthe
10. The nurse is reviewing the assessment data of a client diagnosed with a mental
illness. The client is to be prescribed medication to treat the illness. The nurse
identifies changes in which laboratory values as being the least significant?
A) Hemoglobin
B) Alanine aminotransferase (ALT)
C) Blood urea nitrogen (BUN)
D) Serum creatinine
Ans: A
Chapter: 10
Client Needs: Physiological Integrity: Reduction of Risk Potential
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 2
Page Number: 107, 108
Feedback: Hepatic, renal, or urinary abnormalities, such as ALT, BUN, and creatinine
levels, are important to note because these systems metabolize or excrete many
psychiatric medications. Changes in hemoglobin levels, such as a decrease, suggest
anemia but would have little effect on medication being prescribed.
Multiple Select
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
11. A nurse is performing a biopsychosocial assessment of a client with depression.
Which factors should the nurse assess as part of the psychological domain? (Select all
that apply.)
A) Abstract reasoning
B) Medication use
C) Mood
D) Orientation
E) Self-care
Ans: A, C, D
Chapter: 10
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 2
Page Number: 110--112
Feedback: Assessment of the psychological domain would include abstract
reasoning, mood, and orientation. Medication use and self-care would be assessed as
part of the biologic domain.
Multiple Choice
12. During assessment, the nurse asks a client to explain what the following means:
“A penny saved is a penny earned.” What is the nurse assessing?
GRADESLAB.COM
A) Affect
B) Attention
C) Concentration
D) Abstract reasoning
Ans: D
Chapter: 10
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 2
Page Number: 112
Feedback: When assessing abstract reasoning and comprehension, the client is
given a proverb such as “a penny saved is a penny earned” and asked to interpret it.
Affect is assessed by observing the client’s outward expression of emotion. Attention
and concentration are assessed by having a client subtract a specific number from a
starting number and work backward, or asking a client to spell “world” backward.
Multiple Select
13. The nurse is reviewing a drawing that a client completed as a self-portrait. The
nurse observes that the drawing lacks arms and feet. What does the nurse interpret
this to indicate in the client? (Select all that apply.)
A) Low self-esteem
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
B) Powerlessness
C) Insecurity
D) Inadequacy
Ans: B, D
Chapter: 10
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 2
Page Number: 113
Feedback: Powerlessness and feelings of inadequacy are expressed through lack of
head, mouth, arms, feet, or eyes. Low self-esteem is expressed by small size, lack of
color variation, and sparse details. A lack of symmetry (placement of figure parts or
entire drawings off center) represents feelings of insecurity and inadequacy.
Multiple Choice
14. Which statement by a client would support a nursing diagnosis of chronic low
self-esteem?
A) “I feel so ugly.”
B) “No one wants to date me.”
C) “I'm so fat, like a cow.”
D) “I never do anything right.”
GRADESLAB.COM
Ans: D
Chapter: 10
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 3
Page Number: 114
Feedback: Statements reflecting a negative self-esteem such as: “I'm a worthless
person” and “I never do anything right” would help to support a nursing diagnosis of
chronic low self-esteem. Statements such as feeling ugly or fat, or that dating seems
untenable reflect a negative body image.
15. A nurse is assessing a client’s spirituality. Which question is most appropriate to
ask?
A) “Have you ever tried to harm yourself?”
B) “How important is your family to you?”
C) “How do you define good and evil?”
D) “What gives your life meaning?”
Ans: D
Chapter: 10
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Integrated Process: Nursing Process
Objective: 2
Page Number: 116
Feedback: Spirituality refers to a unifying force of a person that is unique to each
individual. Thus, asking a client about what gives meaning to his or her life addresses
this area. Asking about self-harm provides information about suicidal ideation. Asking
about the importance of family provides information about the social system of the
family. Asking about how the client defines good and evil reflects the client’s cultural
beliefs.
16. A nurse is assisting a client in using simple relaxation techniques. Which action
would the nurse do first?
A) Have the client assume a relaxed position.
B) Advise the client to let the sensations happen.
C) Ensure a quiet, nondisruptive environment.
D) Instruct the client to take an initial slow, deep breath.
Ans: C
Chapter: 10
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 5
Page Number: 119
RADES
LAB.COM
Feedback: When implementingGsimple
relaxation
techniques, it would be most
important to ensure that the environment is quiet and not a distraction, with the lights
dimmed and a comfortable temperature. Have the client assume a relaxed position,
instructing him or her to relax and let the sensations happen. Using a low tone of voice
with a slow, rhythmic pacing of the words, the nurse would instruct the client to take
an initial slow, deep breath.
17. A group of nurses are reviewing information about counseling interventions. A
newer nurse in the group demonstrates a need for additional review when they
identify counseling interventions as involving which elements?
A) Specific, time-limited intervention
B) Focus on coping improvement
C) Goal of regaining functional abilities
D) Prevention of disability
Ans: C
Chapter: 10
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 5
Page Number: 120
Feedback: Psychotherapy, not counseling interventions, is a long-term approach
aimed at improving or helping clients regain previous health status and functional
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
abilities. Counseling interventions are specific, time-limited interactions that focus on
improving coping abilities, reinforcing healthy behaviors, fostering positive
interactions, or preventing illness or disability.
18. A client is engaged in bibliotherapy and begins to express his feelings because he
closely associates his experience with that provided by the reading material. The
nurse interprets this as which action?
A) Insight
B) Catharsis
C) Anxiety reduction
D) Problem solving
Ans: B
Chapter: 10
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 5
Page Number: 121
Feedback: Catharsis is the expression of feelings stimulated by parallel experiences.
Insight involves increased self-awareness and understanding as the reader explores
personal meaning from what is read. Anxiety reduction involves a decreased concern
about a diagnosed problem and treatment based on self-help written materials.
Problem solving involves the development of solutions to problems in the literature
GRAconflicts.
DESLAB.COM
from practical ideas about resolving
19. A nurse is explaining milieu therapy to a client. The nurse determines that
additional education is needed when the client identifies which action as a key concept
of milieu therapy?
A) Structure interaction
B) Open communication
C) Validation
D) De-escalation
Ans: D
Chapter: 10
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 5
Page Number: 124
Feedback: The key concepts of milieu therapy include containment, validation,
structured interaction, and open communication. De-escalation is used to provide
client safety and is an interactive process of calming and redirecting a client who
demonstrates potential for violence toward himself or others.
20. The nurse is assessing a client's immediate and short-term memory. Which
action would be most appropriate?
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
A) Questioning the client about an event that has occurred within the past several
months.
B) Giving the client a simple scenario and having him identify what would be the best
response.
C) Giving the client three words and asking him to recite them now and then in 5
minutes.
D) Asking the client to tell the nurse the date, time, and current location.
Ans: C
Chapter: 10
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 2
Page Number: 11.
Feedback: To check immediate and short-term memory, the nurse gives the client
three unrelated words to remember and asks him or her to recite them immediately
and at 5-minute and 15-minute intervals. To test recent memory, the nurse may
question about a holiday or world event within the past few months. Giving the client
a scenario and asking him or her for the best response evaluates judgment. Asking
the client about the date, time, and current location evaluates orientation.
GRADESLAB.COM
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Test Generator Questions, Chapter 11, Psychopharmacology,
Dietary Supplements, and Biologic Interventions
Multiple Choice
1. A nurse is performing an admission assessment. The client reports that it has
been taking larger and larger amounts of medication to get the desired effect. Based
on this information, the nurse interprets this as suggesting which effect?
A) Desensitization
B) Tolerance
C) Therapeutic index
D) Toxicity
Ans: B
Chapter: 11
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 2
Page Number: 134
GRdecrease
ADESLAin
B.the
COM
Feedback: Tolerance is a gradual
action of a drug at a given dose or
concentration in the blood. This decrease may take days or weeks to develop and
results in loss of therapeutic effect of a drug, necessitating an increase in medication
to achieve the desired effect. Desensitization is a rapid decrease in drug effects that
may develop in a few minutes of exposure to a drug. Toxicity generally refers to the
point at which concentrations of the drug in the bloodstream are high enough to
become harmful or poisonous to the body. Individuals vary widely in their responses
to medications. Some clients experience adverse reactions more easily than others.
The therapeutic index is the ratio of the maximum nontoxic dose to the minimum
effective dose. A high therapeutic index means that there is a large range between the
dose at which the drug begins to take effect and a dose that would be toxic to the
body.
2. An older adult complaining of anxiety is prescribed diazepam (Valium) by a health
care provider. The physician asks the office nurse to explain the problematic side
effects of this medication to the client. Which instruction is most important for the
nurse to emphasize about this drug?
A) “You may experience minor urine incontinence from time to time.”
B) “You may find that you have temporary memory disturbances.”
C) “You need to use this medication cautiously because it can cause dependence.”
D) “You may feel dizzy and be prone to falls after taking this medication.”
Ans: D
Chapter:
11
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Client Needs: Physiological Integrity: Reduction of Risk Potential
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 2
Page Number: 153
Feedback: Diazepam (Valium) is a benzodiazepine and may cause incontinence,
memory disturbances, and dizziness in older adults. However, the risk for falls
because of dizziness is a major concern, and this information needs to be emphasized
with the client.
3. A nurse is caring for a psychiatric client who is receiving an antacid that contains
aluminum salts. Which action by the nurse is most appropriate?
A) Give the antacid 1 hour before the antipsychotic medication
B) Give the antacid at the same time as the antipsychotic medication
C) Administer the antacid 1 hour after the antipsychotic medication
D) Administer the antacid just before the client goes to sleep
Ans: A
Chapter: 11
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 7
Page Number: 134
RADESLA
B.Cdecrease
OM
Feedback: Antacids containing G
aluminum
salts
the absorption of most
antipsychotic drugs; thus, antacids must be given at least 1 hour before
administration or 2 hours afterward.
4. A client is prescribed medication for a psychiatric disorder. After 3 days, the client
reports being constipated. Which instruction should the nurse give the client?
A) “You need to eat more high-protein foods such as meat and peanut butter.”
B) “You need to eat more fruits and vegetables and drink more water.”
C) “Ask your psychiatrist to prescribe a stool softener for you.”
D) “This side effect should disappear within a week or so.”
Ans: B
Chapter: 11
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 7
Page Number: 130
Feedback: The nurse should instruct the client to increase fiber and fluid intake. A
mild laxative, exercise, and fiber supplement also may help the client’s constipation.
High-protein foods would have no effect on constipation. Stool softeners may be
appropriate if an increase in fiber and fluids is ineffective. The side effect will not
necessarily disappear.
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
5. The nurse is caring for a 70-year-old client with a psychiatric disorder who has
been prescribed a number of medications. When educating the client on the
medications, which explanation would be most appropriate?
A) “Your stomach empties more quickly as you age; therefore, you may feel the
effect of your medications almost immediately.”
B) “Your entire GI system speeds up, so your medications are digested much more
quickly. Therefore, it is important that you not drive after you take your medications.”
C) “Because of your age and related changes in liver functioning, you may have
medication levels in your system with the potential to be toxic.”
D) “Because of age-related circulation changes, your body will be able to deliver
therapeutic doses of your medication to select body sites more quickly.”
Ans: C
Chapter: 11
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 7
Page Number: 137
Feedback: The activity of hepatic enzymes also slows with age. As a result, the
ability of the liver to metabolize medications may slow to as much as a fourfold
decrease between the ages of 20 and 70 years. Thus, the client is at increased risk for
toxicity. Gastric pH increases, and gastric emptying and motility decrease, which can
influence the absorption.
GRADESLAB.COM
6. During the stabilization phase of drug therapy for a client who is hospitalized with
a psychiatric disorder, which action would be most appropriate?
A) Discussing the timing of tapering the medication
B) Instructing the client about relapse prevention
C) Determining if the medication is losing its effect
D) Assessing the client for target symptoms and side effects
Ans: D
Chapter: 11
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 7
Page Number: 138
Feedback: During stabilization, the medication dosage is adjusted or titrated to
achieve the maximum amount of improvement with a minimum of side effects.
Psychiatric–mental health nurses assess target symptoms, looking for changes or
improvements and side effects. Education about relapse prevention and target
symptoms and assessing if the medication is losing its effect occur during the
maintenance phase. Tapering occurs during the discontinuation phase.
7. A client has been prescribed clozapine for treatment of schizophrenia. Which
statement should the nurse include in the education plan for this client and family?
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
A) “You may experience hypertension while taking this medication.”
B) “One of the side effects of this medication is breast engorgement.”
C) “People taking this medication often experience dermatitis.”
D) “You may experience noticeable weight gain while taking this medication.”
Ans: D
Chapter: 11
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 7
Page Number: 141
Feedback: Weight gain is a common side effect of the atypical antipsychotics,
particularly clozapine and olanzapine (Zyprexa), which can cause a weight gain of up
to 20 pounds within 1 year. Orthostatic hypotension may occur with this drug. Breast
engorgement would be more likely with typical antipsychotics. Photosensitivity, not
dermatitis, is associated with antipsychotic use.
8. A client who has been taking clozapine for 6 weeks visits the clinic reporting fever,
sore throat, and mouth sores. The nurse notifies the client’s physician because the
nurse suspects which condition?
A) Severe anemia
B) Neuroleptic malignant syndrome
C) Encephalitis
GRADESLAB.COM
D) Agranulocytosis
Ans: D
Chapter: 11
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 2
Page Number: 141
Feedback: High fever, sore throat, and mouth sores are indicative of infection
secondary to agranulocytosis, which has been associated with clozapine. The
medication can suppress the bone marrow and cause a significant decrease in white
blood cells. The client’s signs and symptoms do not suggest anemia, neuroleptic
malignant syndrome, or encephalitis.
9. A hospitalized client who has been taking an antipsychotic medication for 2 weeks
begins pacing and walking throughout the unit. The client tells the nurse that he or
she “cannot sit still.” The nurse documents this finding as which condition?
A) Akinesia
B) Dystonia
C) Pseudoparkinsonism
D) Akathisia
Ans:
D
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Chapter: 11
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Analyze
Integrated Process: Communication and Documentation
Objective: 1
Page Number: 142
Feedback: The client’s inability to “sit still” and his or her frequent pacing are termed
“akathisia,” an extrapyramidal effect of the antipsychotic medication. Akinesia is
slowed movements. Dystonia involves involuntary muscle spasms that lead to
abnormal postures, especially of the head and neck muscles. Pseudoparkinsonism
includes rigidity, slowed movements, and tremor.
10. The nurse observes an adult client who has been taking antipsychotic
medications for 8 months. The client is smacking their lips and blinking their eyes
rapidly. The nurse also observes a protruding tongue. Which action by the nurse
would be most appropriate?
A) Ask whether the client has been experiencing side effects.
B) Contact the client’s physician for a different medication order.
C) Document the client’s symptoms of tardive dyskinesia.
D) Instruct the client to begin tapering off the medication.
Ans: C
Chapter: 11
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
GRADESLAB.COM
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 2
Page Number: 144
Feedback: The nurse should document the symptoms of tardive dyskinesia, a
chronic syndrome caused by long-term use. Asking the client whether they have been
experiencing side effects would be inappropriate because the client is already
exhibiting signs. Contacting the physician for a different medication implies that these
effects can be reversed. Tardive dyskinesia is typically irreversible. It is not within the
nurse’s scope of practice to instruct the client to begin to taper the drug.
11. A nurse is working as part of a team involved with the testing of a new
psychiatric medication. The drug is currently being used in multiple clinical trials at
various different sites. The nurse is engaged in which phase of testing?
A) Phase I
B) Phase II
C) Phase III
D) Phase IV
Ans: C
Chapter: 11
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Apply
Integrated Process: Nursing Process
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Objective: 3
Page Number: 129
Feedback: Phase III of new drug testing involves extensive clinical trials conducted
at multiple sites throughout the country with large numbers of clients. This phase
concludes with a new drug application being submitted to the U.S. Food and Drug
Administration (FDA). Phase I testing defines the range of dosages tolerated in
healthy individuals. Phase II testing studies the effects of the drug in a limited number
of persons with the disorder, and defines the range of clinically effective dosage.
Phase IV involves drug studies that continue after FDA approval to detect new or rare
adverse reactions and potentially new indications.
12. A nursing instructor is educating a class on the pharmacodynamics of psychiatric
medications. The instructor determines that additional education is needed when the
students identify which site of action?
A) Receptor
B) Ion channels
C) Neurotransmitters
D) Enzymes
Ans: C
Chapter: 11
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Apply
Integrated Process: Teaching/Learning
GRADESLAB.COM
Objective: 4
Page Number: 129, 130
Feedback: Psychiatric medications primarily target the central nervous system at
the cellular synaptic level at four sites: receptors, ion channels, enzymes, and carrier
proteins. Receptors respond to neurotransmitters, but neurotransmitters are not a
site of action of the medication.
13. A nurse is reviewing information about a psychiatric medication that describes
the amount of the drug that actually reaches systemic circulation unchanged. The
nurse identifies this as which action?
A) First-pass effect
B) Bioavailability
C) Solubility
D) Biotransformation
Ans: B
Chapter: 11
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 5
Page Number: 134
Feedback: Bioavailability describes the amount of the drug that actually reaches the
systemic circulation unchanged. First-pass effect refers to the metabolism that a drug
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
undergoes within the gastrointestinal wall or liver before reaching the rest of the
body. Solubility refers to the ability of the medication to cross a membrane.
Biotransformation or metabolism is the process by which the drug is altered and
broken down into small substances known as metabolites.
14. A client receiving an antipsychotic agent develops acute extrapyramidal
symptoms. Which response by the nurse is most appropriate?
A) “These symptoms are not real; the medication makes your brain think they are
real.”
B) “You have developed an allergy to the medication, so we need to change it.”
C) “These are the results of the drug that can be treated; your illness is not getting
worse.”
D) “The sunlight together with the medication has caused these symptoms; just stay
indoors.”
Ans: C
Chapter: 11
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Apply
Integrated Process: Caring
Objective: 2
Page Number: 142
Feedback: Individuals with acute extrapyramidal symptoms need frequent
reassurance that this is not a worsening of their psychiatric condition, but instead is a
GRADEThey
SLABalso
.COneed
M validation that what they are
treatable side effect of the medication.
experiencing is real, and that the nurse is concerned and will be responsive to changes
in these symptoms. Extrapyramidal symptoms are not indicative of an allergy.
Photosensitivity occurs with antipsychotic agents and sunlight.
15. A group of nursing students are reviewing information related to drug therapy
for mood disorders. The students demonstrate understanding of the information when
they identify which agent as the gold standard for treating bipolar disorder?
A) Carbamazepine
B) Lithium
C) Valproate
D) Lamotrigine
Ans: B
Chapter: 11
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Understand
Integrated Process: Teaching/Learning
Objective: 6
Page Number: 144
Feedback: Although carbamazepine, valproate, and lamotrigine are anticonvulsants
used to treat clients with mood disorders, lithium is considered the gold standard.
16.
A nurse administers a prescribed dose of lithium at 8 PM. The nurse should
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
schedule a specimen to be obtained for a blood level at which time?
A) 10 PM
B) 12 AM
C) 4 AM
D) 8 AM
Ans: D
Chapter: 11
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 7
Page Number: 145
Feedback: Blood levels should be monitored 12 hours after the last dose of
medication.
Multiple Select
17. A nurse is preparing a continuing education presentation for a group of
psychiatric–mental health nurses about various psychopharmacologic agents. The
nurse is planning to discuss selective serotonin reuptake inhibitors. Which agents
should the nurse include? (Select all that apply.)
A) Fluoxetine
B) Duloxetine
GRADESLAB.COM
C) Sertraline
D) Venlafaxine
E) Bupropion
F) Amoxapine
Ans: A, C
Chapter: 11
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 6
Page Number: 148
Feedback: Selective serotonin reuptake inhibitors include fluoxetine and sertraline.
Duloxetine and venlafaxine are serotonin norepinephrine reuptake inhibitors.
Bupropion is a norepinephrine--dopamine reuptake inhibitor. Amoxapine is a tricyclic
antidepressant.
Multiple Choice
18. A client is brought to the emergency department by their brother, who reports
that the client became very agitated and “started hallucinating.” Further assessment
reveals tachycardia, incoordination, vomiting, and diarrhea. The brother states that
the client is taking paroxetine for depression. Which condition should the nurse most
likely suspect?
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
A) Neuroleptic malignant syndrome
B) Acute dystonic reaction
C) Serotonin syndrome
D) Hypothyroidism
Ans: C
Chapter: 11
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 2
Page Number: 147
Feedback: The client’s symptoms, along with the use of paroxetine (a selective
serotonin reuptake inhibitor [SSRI]) suggest serotonin syndrome. Neuroleptic
malignant syndrome and acute dystonic reaction would be seen with antipsychotics.
Hypothyroidism may result from lithium use.
19. After teaching a client who is prescribed imipramine about the drug, the nurse
determines that the education was effective when the client makes what statement?
A) “I need to be careful because the drug can make me sleepy.”
B) “I don’t have to worry about getting dizzy when I get up from lying down.”
C) “I might notice some excess saliva in my mouth at different times.”
D) “I need to avoid foods with fiber because diarrhea can occur.”
GRADESLAB.COM
Ans: A
Chapter: 11
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Analyze
Integrated Process: Teaching/Learning
Objective: 2
Page Number: 133, 149
Feedback: Imipramine is a tricyclic antidepressant and is associated with sedation,
orthostatic hypertension, and anticholinergic effects such as dry mouth and
constipation. The client needs to be careful with activities because the drug is
sedating. The client should change positions slowly to minimize orthostatic
hypotension. Sugarless candies, good oral hygiene, and frequent rinsing of the mouth
are helpful to combat dry mouth. A high-fiber intake would be appropriate to decrease
possible constipation.
20. A client with depression asks the nurse about possible herbal supplements.
Which supplement should the nurse identify as being commonly used?
A) Valerian
B) St. John’s wort
C) Kava
D) Melatonin
Ans: B
Chapter:
11
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Understand
Integrated Process: Teaching/Learning
Objective: 8
Page Number: 156, 157
Feedback: St. John’s wort is an herbal supplement commonly used for depression.
Valerian is a common ingredient in products promoted for insomnia and nervousness.
Kava is used to reduce anxiety. Melatonin is used to treat insomnia and prevent jet
lag.
Multiple Select
21. A nurse is preparing a client for electroconvulsive therapy. Which actions should
the nurse include in the client’s plan of care? (Select all that apply.)
A) Ensuring that there is a signed informed consent on the client’s chart
B) Telling the client he can have fluids but no food before the procedure
C) Alerting the client to the possibility of confusion after the treatment
D) Informing the client that he can leave his dentures in place for the treatment
E) Ensuring that the client is closely supervised for at least the first 12 hours
afterward
Ans: A, C, E
Chapter: 11
Client Needs: Physiological Integrity: Reduction of Risk Potential
GRADESLAB.COM
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 8
Page Number: 158
Feedback: For the client undergoing electroconvulsive therapy, an informed consent
is necessary. The client should have nothing by mouth after midnight of the evening
before the procedure. The client needs to be alerted to the fact that his dentures will
be removed, that he may experience some confusion after the procedure, that he will
be closely supervised for at least the first 12 hours afterward, and that he will receive
continued observation for 48 hours after treatment.
Multiple Choice
22. The nurse is reviewing the medical records of several clients receiving
antipsychotic agents. Which factors, if noted, should the nurse identify as placing a
client at greater risk for tardive dyskinesia?
A) Male sex
B) Age 30 to 45 years
C) History of depression
D) Short duration of treatment
Ans: C
Chapter: 11
Client Needs:
Physiological Integrity: Reduction of Risk Potential
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 7
Page Number: 144
Feedback: Risk factors for tardive dyskinesia include age older than 50 years;
female sex; affective disorders, particularly depression; brain damage or dysfunction;
increased duration of treatment; standard antipsychotic medication; and possibly
higher doses of antipsychotic agents.
23. A client is experiencing hallucinations and delusions. The nurse expects the
physician to order which class of drug?
A) Mood stabilizer
B) Antipsychotic
C) Antianxiety agent
D) Stimulant
Ans: B
Chapter: 11
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 6
Page Number: 139
Feedback: Antipsychotic agents are indicated for the treatment of schizophrenia,
GRAsymptoms
DESLAB.of
COpsychosis,
M
mania, and autism and to treat the
such as hallucinations,
delusions, bizarre behavior, disorganized thinking, and agitation. Mood stabilizers are
indicated to treat mania in clients with bipolar disorders. Antianxiety agents are used
to anxiety disorders. Stimulants are used to treat narcolepsy and attention deficit
hyperactivity disorders.
24.
the
A)
B)
C)
D)
After educating a client who is receiving phenelzine, the nurse determines that
education was successful when the client states the need to avoid what food?
Fresh cottage cheese
Cooked sliced ham
Tap beers
Soy milk
Ans: C
Chapter: 11
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Analyze
Integrated Process: Teaching/Learning
Objective: 7
Page Number: 151
Feedback: Phenelzine is a monoamine oxidase inhibitor. The client needs to avoid
foods high in tyramine such as tap beers, matured and aged cheeses, air-dried, aged,
and fermented meats, broad bean pods, concentrated yeast extract, sauerkraut, and
soy sauce.
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Multiple Select
25. A nurse is discussing with a client the types of drugs that can be used to treat
psychiatric disorder. The nurse identifies which drugs as examples of antianxiety
medications? (Select all that apply.)
A) Selegiline
B) Lorazepam
C) Buspirone
D) Zolpidem
E) Methylphenidate
Ans: B, C
Chapter: 11
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Understand
Integrated Process: Teaching/Learning
Objective: 6
Page Number: 151
Feedback: Examples of antianxiety agents include lorazepam and buspirone.
Selegiline is a monoamine oxidase inhibitor antidepressant; zolpidem is a hypnotic;
methylphenidate is a stimulant.
GRADESLAB.COM
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Test Generator Questions, Chapter 12, Group Interventions
Multiple Choice
1. The nurse is preparing to form a group in an inpatient psychiatric setting for
clients who have experienced trauma. In addition to the group leader, the nurse
would anticipate including how many clients?
A) Three or four
B) Five or six
C) Seven or eight
D) Nine or 10
Ans: C
Chapter: 12
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 3
Page Number: 165
Feedback: An ideal size for a small group is seven to eight clients. Clients with
challenging behaviors should be carefully screened and assigned to smaller groups.
Small groups (usually no more than
eight
become more cohesive,
GRAseven
DESLtoAB
.COmembers)
M
are less likely to form subgroups, and can provide a richer interpersonal experience
than large groups. Even though small groups cannot easily withstand the loss of
members, they are ideal for clients who are highly motivated to deal with complex
emotional problems (e.g., sexual abuse, eating disorders, or trauma) or for those who
have cognitive dysfunction and require a more focused group environment with
minimal distractions.
2. While participating in a group therapy session, one group member consistently
asks for clarification of the topic the group is discussing. The nurse leading the group
interprets this behavior as reflecting which group role?
A) Coordinator
B) Recorder
C) Information seeker
D) Standard setter
Ans: C
Chapter: 12
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 2
Page Number: 170
Feedback: For any group to be successful, it must have members who assume task
roles. The task role of information seeker is one in which the group member asks for
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
clarification. The coordinator shows or clarifies the relationships among various ideas
and suggestions. The recorder writes suggestions, keeps minutes, and serves as the
group memory. The standard setter expresses the standards for the group to achieve.
3. While leading a small group, the nurse sets up the ground rules at the beginning
of the first meeting. One of the rules established is that the group will always start at
the specified time, rather than waiting until everyone has arrived in order to begin.
Which rule does this reflect?
A) Group norms
B) Group cohesion
C) Group think
D) Group process
Ans: A
Chapter: 12
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 1
Page Number: 167, 170
Feedback: Norms establish acceptable group behaviors and encourage conformity of
behavior among group members. Group cohesion is the closeness or sticking together
of the group. Group think is the tendency of group members to avoid conflict and
adopt a normative pattern of thinking that is often consistent with the ideas of the
GRA
DESLAB.Cand
OM culmination of the
group leader. Group process is the
development
session-to-session interactions of the members that move the group toward its goals.
4. The nurse has begun group counseling sessions for several hospitalized clients in
the psychiatric facility. Which action would be most effective for the nurse to do to
promote group cohesiveness?
A) Use team-building exercises
B) Encourage task completion by members
C) Spend time with each member individually
D) Be consistent with the group themes
Ans: A
Chapter: 12
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 3
Page Number: 172
Feedback: To encourage group cohesiveness, the nurse should use team-building
exercises or encourage socialization with minimal supervision. Task completion helps
to promote achievement of the group’s work but does not necessarily foster group
cohesiveness. Spending time with each member may be important to facilitate
communication and develop a relationship, but this would not promote group
cohesiveness. Each group develops its own group themes.
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
5. In an initial group therapy session, the nurse observes that one group member
continually tries to monopolize the conversation. The nurse interprets this behavior as
reflecting which feeling in the client?
A) Anxiety
B) Anger
C) Rebellion
D) Fear
Ans: A
Chapter: 12
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 2
Page Number: 170
Feedback: When one group member continually tries to monopolize the
conversation in an initial session, the client is most likely experiencing anxiety. The
monopolizer does not reflect anger, rebellion, or fear.
6. The nurse is leading a small group of hospitalized clients diagnosed with
psychiatric disorders. One group member has asked for advice and often agrees with
suggestions by other group members but then adds, “Yes, but . . .” to every
suggestion offered. Which response by the nurse would be most appropriate?
ADbetter
ESLAB
COMjoined a different group.”
A) “Things would probably workGR
out
if .you
B) “Do you realize you say, ‘Yes, but . . .’ to every suggestion the group has for you?”
C) “I suggest you stop and think about why you always respond to suggestions with
‘Yes, but . . .’”
D) “What solution do you think would work best for you?”
Ans: D
Chapter: 12
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Communication and Documentation
Objective: 3
Page Number: 170, 171
Feedback: With a client who agrees initially then continually says, “Yes, but . . .,” the
nurse should encourage that person to formulate his or her own solutions. The leader
can serve as a role model of the problem-solving behavior for the other members and
encourage them to let the member develop a solution that would work specifically for
him or her. Telling the client to join a different group is demeaning and does not
address the client’s problem. Asking the client if he or she realizes the response, or
telling the client to stop and think about why, could be threatening to the client’s
self-esteem.
7. A client has been placed in an anger management group because he has trouble
controlling his angry outbursts. The nurse interprets this type of group as an example
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
of which of the following?
A) Psychotherapy
B) Self-help
C) Psychoeducation
D) Supportive therapy
Ans: C
Chapter: 12
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 4
Page Number: 172, 173
Feedback: Learning how to manage a medication regimen or control angry outbursts
is often the aim of teaching (psychoeducation) groups. Psychoeducation groups are
formally planned, and members are purposefully selected so that the focus of the
group will help them work on a specific problem or knowledge deficit. Psychotherapy
groups treat individuals’ emotional problems and can be implemented from various
theoretic perspectives, including psychoanalytic, behavioral, and cognitive. These
groups focus on examining emotions and helping individuals face their life situations.
Self-help groups are led by people who are concerned about coping with a specific
problem or life crisis. These groups do not explore psychodynamic issues in depth.
Supportive therapy groups are usually less intense than psychotherapy groups and
focus on helping individuals cope with their illnesses and problems.
GRADESLAB.COM
8. A nurse is leading a group in which members are encouraged to discuss their
feelings and emotions. The group session is just starting when a client stomps into the
room, slams his notebook down on a table, and sits down. His affect is one of anger
and hostility. Which response by the nurse would be most appropriate?
A) Keep the focus elsewhere so the client’s anger has time to de-escalate.
B) Suggest the client make a private counseling appointment to address any anger
issues.
C) Ask the client to leave the group until the client is calmer.
D) Encourage the client to discuss the anger with the group.
Ans: D
Chapter: 12
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 3
Page Number: 170
Feedback: An effective group leader recognizes the effects of an individual’s mood
on the total group. Thus, an effective leader would realize that the client’s intense
anger could set the emotional tone of the entire group. If the purpose of the group is
to deal with emotions, then choosing to discuss the member’s problem at the
beginning of the session would help limit the intense anger to the one person
experiencing it. Keeping the focus off the client or asking the client to leave could
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
disrupt the functioning of the group because the client’s emotions can affect the entire
group. Suggesting the client make a private counseling appointment may be
appropriate later, after discussing the client’s problem at the beginning of the session.
9. A nurse is leading a group on an adolescent psychiatric unit. A new member’s
accent and way of dressing set the client apart from the others, and it is obvious that
the group dislikes this client. During the group session, the nurse has the members
draw an emotion they are feeling and then present their drawings to the group. What
would be the most effective way to address the group’s dislike for the new member?
A) Skip the when it is the client’s turn to present a drawing.
B) Let the client talk last so the others will not have time to make fun of him or her.
C) Compliment the client when the client presents.
D) Demand that each member of the group explain why they dislike the client.
Ans: C
Chapter: 12
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 3
Page Number: 171
Feedback: In some groups, members clearly dislike one particular member. This
situation can be challenging for the leader because it can result in considerable
tension and conflict. This person could become the group’s scapegoat. The group
GR
ADplacing
ESLABthe
.Cperson
OM
leader may have made a mistake
by
in this particular group, and
another group may be a better match. One solution may be to move the person to a
better-matched group. Whether the person stays or leaves, the group leader must
stay neutral and avoid displaying negative verbal/nonverbal behaviors that indicate
that there is dislike for this specific member (or that indicate displeasure with the
other members for their behavior). Often, the group leader can manage the situation
by showing respect for the disliked member and acknowledging his or her
contribution. Skipping the client nonverbally indicates negative feelings. Allowing the
client to talk last isolates the client from the group. Demanding that the other group
members tell why they dislike the client would demonstrate displeasure with the rest
of the group for their behavior.
10. A nurse is educating a client about the different types of group. The client
demonstrates understanding of the nurse’s teaching when they identify which
characteristic of a self-help group that differentiates it from a supportive therapy
group?
A) The group is led by a professional.
B) The group is led by a consumer.
C) There is no identified leader.
D) The group is focused on a specific problem.
Ans: B
Chapter: 12
Client Needs:
Psychosocial Integrity
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 4
Page Number: 173
Feedback: Self-help groups are led by people who are concerned about coping with
a specific problem or life crisis. These groups do not explore psychodynamic issues in
depth. Professionals usually do not attend these groups or serve as consultants.
Psychiatric nurses lead supportive therapy groups. Both types of groups focus on a
specific problem.
11. A nurse is preparing to lead an older adult group. What should the nurse need to
keep in mind when leading this group?
A) Focus the group in order to promote learning of new information
B) Keep the pace of the group meetings slow
C) Discourage the use of life-review strategies
D) Teach entirely new methods for coping
Ans: B
Chapter: 12
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Caring
Objective: 5
Page Number: 174
GRADadult
ESLAgroups,
B.COMthe nurse needs to slow the pace
Feedback: When working with older
of the group meetings and place greater emphasis on using wisdom and experience,
rather than learning new information. The nurse should also encourage the group to
use life-review strategies such as autobiography and reminiscence. When teaching
new skills, the nurse should place them within the context of previous attempts to
resolve issues and problems.
12. A nurse is preparing to take over from a colleague the leadership of an open
group. Which group will the nurse soon be leading?
A) Outpatient smoking cessation group
B) Community clinic psychoeducation group
C) Ambulatory psychotherapy group
D) Inpatient anger management group
Ans: D
Chapter: 12
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 1
Page Number: 165
Feedback: Because the length of client hospitalization is relatively short, open
groups are typical on inpatient units, such as an inpatient anger management group.
Closed groups are more typical of outpatient groups that have a sequential
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
curriculum, or psychotherapy groups. Examples include outpatient smoking
cessation, psychotherapy, and psychoeducation groups.
13. A nurse is deciding about the size of a group. Why would the nurse determine
that a large group would be best?
A) Transference and countertransference issues will be moderate to minimal.
B) Group cohesiveness will be strong with greater interpersonal experiences.
C) The number of potential interactions and relationships is limited.
D) The group is effective for dealing with a specific issue.
Ans: D
Chapter: 12
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 3
Page Number: 165
Feedback: Large groups (more than 8 to 10 members) are effective for specific
problems or issues, such as smoking cessation or medication information, and are
often used in the workplace. Usually transference and countertransference issues do
not develop in large groups. Group cohesiveness is less in larger groups. Larger
groups also can be challenging because of the increased number of potential
interactions and relationships that can form.
Multiple Select
GRADESLAB.COM
14. A nurse is acting as the leader of a newly formed group that is in the beginning
stage of development. Which action would the nurse expect to do? (Select all that
apply.)
A) Develop rapport with the group members
B) Anticipate members testing one another
C) Work with members to develop norms
D) Promote sharing of feelings
E) Facilitate verbal and nonverbal communication
Ans: A, B
Chapter: 12
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 3
Page Number: 166, 167
Feedback: In the beginning stage of development, the nurse acknowledges each
member; constructs a working environment; develops rapport with the members;
begins to build a therapeutic relationship; and clarifies outcomes, processes, and
skills related to the group’s purpose. Members also begin to test whether they can
trust one another and the leader. Working to develop norms, promoting sharing of
feelings, and facilitating communication occur during the working phase.
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
15. After educating a client about the formal and informal roles of group members,
the nurse determines that the education was successful when the client identifies
which position as a formal role? (Select all that apply.)
A) Coordinator
B) Leader
C) Member
D) Harmonizer
E) Information seeker
Ans: B, C
Chapter: 12
Client Needs: Psychosocial Integrity
Cognitive Level: Understand
Integrated Process: Teaching/Learning
Objective: 2
Page Number: 170
Feedback: Formal group roles include the leader and each member. Coordinator and
information seeker, which are task roles, and harmonizer, which is a maintenance
role, are considered informal roles.
Multiple Choice
16. While leading a group, a nurse leader says to a client, “This is the fourth time
GRADwe
EShave
LAB.talked
COM about child abuse. Is something
that you’ve changed the subject when
going on?” The nurse is using which technique?
A) Support
B) Confrontation
C) Summarizing
D) Clarification
Ans: B
Chapter: 12
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Communication and Documentation
Objective: 3
Page Number: 168
Feedback: The nurse’s statement reflects confrontation, which helps individuals
learn something about themselves, helps reduce some form of disruptive behavior,
and helps members deal more openly and directly with one another. Support would be
reflected in statements such as, “We really appreciate your sharing that experience
with us.” Summarizing would be reflected in statements such as, “So far we’ve
discussed problems with . . .” Clarification would be reflected in statements such as,
“What I heard you say was that you were feeling very angry right now. Is that
correct?”
17.
During a group session, one of the members states, “Let's keep this discussion
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
going so that everyone can participate, but let's keep the time each person speaks to
about 3 minutes.” The leader interprets this member as acting in which role?
A) Group observer
B) Gatekeeper
C) Encourager
D) Energizer
Ans: B
Chapter: 12
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 2
Page Number: 171
Feedback: The statement reflects the role of the gatekeeper, who attempts to keep
communication channels open by encouraging or facilitating the participation of
others or proposes regulation of the flow of communication through limiting time. The
group observer keeps records of various aspects of the group processes and
interprets data to the group. The encourager praises, agrees with, and accepts the
contributions of others. The energizer attempts to stimulate the group to action or
decision.
Multiple Select
GRADdetermines
ESLAB.COthat
M several of the group members
18. When leading a group, the nurse
have assumed roles that may be interfering with the group’s function. Which roles
might be involved? (Select all that apply.)
A) Self-confessor
B) Follower
C) Dominator
D) Elaborator
E) Playboy
F) Compromiser
Ans: A, C, E
Chapter: 12
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 2
Page Number: 171
Feedback: The roles of self-confessor, dominator, and playboy are individual roles
that members play to meet personal needs. These roles have nothing to do with the
group’s purpose or cohesion and can detract from the group’s functioning. If
individual roles predominate, the group may be ineffective. Follower and compromiser
are maintenance roles. Elaborator is a task role.
19.
A nurse is giving a presentation about group psychotherapy. When reviewing the
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
factors through which therapeutic changes occur in this type of therapy, which items
should the nurse include? (Select all that apply.)
A) Altruism
B) Catharsis
C) Repressed behavior
D) Universality
E) Hopelessness
Ans: A, B, D
Chapter: 12
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Teaching/Learning
Objective: 4
Page Number: 173
Feedback: Yalom described 11 primary factors through which therapeutic changes
occur in group psychotherapy. These include altruism, catharsis, imitative behavior,
universality, and instillation of hope.
20. A psychiatric–mental health nurse is preparing to lead a medication group.
Which characteristics would be most important for the nurse to assess? (Select all that
apply.)
A) Cognitive abilities
B) Medication knowledge
GRADESLAB.COM
C) Reading skills
D) Writing abilities
E) Use of a specific medication
Ans: A, B, C, D
Chapter: 12
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 5
Page Number: 174, 175
Feedback: When planning a medication group, the nurse should assess a member's
medication knowledge to determine what the individual would like to learn. People
with mental illnesses may have difficulty remembering new information, so
assessment of cognitive abilities is important. Assessing attention span, memory, and
problem-solving skills gives valuable information that nurses can use in designing the
group. The nurse should determine the member's reading and writing skills to select
effective client education materials. Although an ideal group is one in which all
members use the same medication, in reality, this situation is rare, and usually the
group members are using various medications.
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Test Generator Questions, Chapter 13, Stress and Mental Health
Multiple Choice
1. A nurse is performing an assessment interview with a client. The client tells the
nurse that he has a type A personality. Based on the nurse’s interpretation, the nurse
would expect which behavior by the client?
A) Appearing relaxed and easy going throughout the interview
B) Wanting the interview to be over as quickly as possible
C) Being pleased with the overall pace of the interview
D) Speaking slowly, requiring time to consider his answers
Ans: B
Chapter: 13
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 1
Page Number: 182
Feedback: The nurse can anticipate that the client will be competitive, aggressive,
and impatient because these characteristics signify the type A personality. People
with type B personalities do not G
exhibit
and generally are more
RADEthese
SLABbehaviors
.COM
relaxed, easy going, and easily satisfied. They have an accepting attitude about trivial
mistakes and use a problem-solving approach to major problems. People with type C
personalities are described as having difficulty expressing emotion, and being
introverted, respectful, conforming, compliant, and eager to please and avoid conflict.
They respond to stress with depression and hopelessness. A person with a type D
(distressed) personality is indicated when he or she experiences increased negative
emotions (depression) and pessimism, and does not share emotions.
2. A nurse is assessing a client and the client’s social networks. When evaluating this
area, the nurse integrates knowledge that which component is important?
A) Blood relationships
B) Bonding with one another
C) Reciprocity
D) Emotional support
Ans: C
Chapter: 13
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 2
Page Number: 182
Feedback: Social networks provide opportunities for give and take. Network
members both provide and receive support, aid, services, and information.
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Reciprocity is particularly important because most friendships do not last without the
give and take of support and services. A person who is always on the receiving end
eventually becomes isolated from others. Emotional support and bonding may occur
in a social network but this is not a key component. Blood relationships are unrelated
to social networks.
3. A client visits the clinic and tells the nurse about being under a great deal of stress
on the job for the past month. Applying the factors that determine the stress
response, which question would be most appropriate for the nurse to ask?
A) “What effect is the stress having on your job performance?”
B) “How would you describe the social network within your family?”
C) “What is the specific event that you find most stressful?”
D) “When did you first become aware of experiencing this stress?”
Ans: A
Chapter: 13
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 5
Page Number: 180
Feedback: A given event or situation may be extremely stressful to one person but
not to another. The more important or meaningful the outcome, the more vulnerable
the person is to stress. Appraisal is the process in which all aspects are
GRADEand
SLAresources
B.COM are balanced with personal
considered—the demands, constraints,
goals and beliefs. Asking about the social network, the specific event, or first
becoming aware reflects the person–environment relationship, which is determined
by the significance of the event.
4. The nurse is caring for a client with chronic stress because of job loss and financial
difficulties. When evaluating the client’s assessment findings, the nurse would
anticipate finding an elevated antibody titer to which type of virus?
A) Herpes simplex viruses
B) Herpes zoster viruses
C) Acquired immune deficiency viruses
D) Influenza viruses
Ans: A
Chapter: 13
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 5
Page Number: 179
Feedback: Research has shown that antibody titers to Epstein--Barr and herpes
simplex viruses are elevated in stressed populations.
5.
The nurse is caring for a client who has been under severe stress while caring for
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
an elderly parent, who is in the advanced stages of Alzheimer disease. The nurse
explains that the client is adapting to the stress that the client is experiencing because
of which of the following?
A) Ability to survive in the midst of severe stress
B) Acceptance of others’ help in caring for the parent
C) Success at being able to solve problems
D) Capability in setting reasonable personal goals
Ans: A
Chapter: 13
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Caring
Objective: 4
Page Number: 186
Feedback: Adaptation can be conceptualized as a person’s capacity to survive and
flourish. Adaptation, or lack of it, affects three important areas: health, psychological
well-being, and social functioning. A period of stress may compromise any or all of
these areas. If a person copes successfully with stress, he or she returns to a previous
level of adaptation. Successful coping results in an improvement in health, well-being,
and social functioning. Accepting help, solving problems, and setting reasonable goals
are means for achieving adaptation.
6. The nurse is preparing to care for a client under severe stress, caused by her
GRAdiagnosed
DESLAB.with
COM leukemia. When assessing the
caregiver duties for her elderly aunt
client’s emotional state, which question would the nurse ask first?
A) “Let's talk about what you have been feeling.”
B) “Tell me about your depressed moods.”
C) “How long have you been caring for your aunt?”
D) “Are you feeling overwhelmed by caring for your aunt?”
Ans: A
Chapter: 13
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 5
Page Number: 187
Feedback: Using therapeutic communication techniques, a person’s emotional state
is assessed in a nurse–client interview. By beginning the interview with a statement
such as, “Let’s talk about what you have been feeling,” the nurse can elicit the feelings
that the person has been experiencing. Identifying the person’s emotions can be
helpful in assessing the intensity of the stress being experienced. Asking about
depressed moods or feeling overwhelmed does not allow the client to verbalize her
feelings. Asking how long the client has been caring for her aunt provides no
information about what the client is feeling.
7.
A client has come to the clinic to discuss the stress the client is experiencing
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
because of failing two exams at school. Initially, the client described the failures as
“the worst thing that has ever happened to me,” and stated, “There is absolutely
nothing I can do to pass this course now.” In response to questions, the nurse finds
out there are three more equally weighted exams scheduled for this course. The nurse
and client collaborate and decide to use interventions to facilitate emotion-focused
coping. Which additional comment from the client would the nurse identify as
providing support for this decision?
A) “You’ve got to figure out something for me to do to get me out of this situation!”
B) “This is a waste of time because absolutely nothing you or I can do will make it
any better.”
C) “I overreacted; surely together we can figure out something for me to do.”
D) “This is the worst thing that could ever happen to me. I’m nothing but a failure.”
Ans: C
Chapter: 13
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 7
Page Number: 187, 188
Feedback: In an assessment interview, the nurse can determine whether the person
uses problem-focused or emotion-focused coping strategies effectively.
Emotion-focused coping is effective when the person has inaccurately assessed the
situation. Coping corrects the false interpretation. Recognizing an overreaction
GRof
ADmore
ESLAaccurately
B.COM assessing the situation and is
indicates that the client is capable
able to begin viewing the predicament as a challenge, which will lessen the impact of
the stress on the client’s mental health. The statements about figuring out something,
that this is a waste of time, and that this is the worst thing that could ever happen do
not reflect emotion-focused coping.
8. A nurse is reviewing the assessment findings of several clients. Which client would
the nurse identify as having a type D personality?
A) A client who threatens the receptionist in the emergency department with bodily
harm if a doctor does not see the client right away
B) A client who sits quietly reading in a waiting room before seeing a doctor for an
annual physical
C) A quiet teen who drinks a six pack of beer because of peer pressure
D) A client who reacts negatively to almost everything but never discusses feelings
with anyone
Ans: D
Chapter: 13
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 5
Page Number: 182
Feedback: Persons with type D or distressed personalities experience increased
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
negative emotions, but do not share their emotions. People with type A personalities
are characterized as competitive, aggressive, ambitious, impatient, alert, tense, and
restless. Persons with type B personalities do not exhibit these behaviors and
generally are more relaxed, easy going, and easily satisfied. They have an accepting
attitude about trivial mistakes and use a problem-solving approach to major
problems. People with type C personalities are described as having difficulty
expressing emotion and being introverted, respectful, conforming, compliant, eager
to please and avoid conflict. They respond to stress with depression and
hopelessness.
9. A client is talking to the nurse about a friendship with another person. The client
comments, “That person is always there for me, and I am always there for her. We
help each other out; sometimes she’s helping me, and sometimes I am helping her.”
The nurse interprets these statements about the client’s social network as reflecting
which of the following?
A) Denseness
B) Reciprocity
C) Social support
D) Constraints
Ans: B
Chapter: 13
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
GRADESLAB.COM
Integrated Process: Nursing Process
Objective: 4
Page Number: 182
Feedback: The client is describing reciprocity, opportunities for give and take.
Network members both provide and receive support, aid, services, and information.
Reciprocity is particularly important because most friendships do not last without the
give and take of support and services. Denseness is the size the network and the
interconnectedness of the individuals in that network. Social support refers to the
positive interpersonal interactions that occur as part of a dynamic process that is in
constant flux. Constraints are personal and environmental limitations.
10. After interviewing a client about social supports, the nurse determines that the
client is experiencing emotional support from these social supports based on which
statement?
A) “I’m glad I have someone that I can talk to.”
B) “The person who cut my lawn was great!”
C) “I received a small community grant for groceries.”
D) “The senior center gave me a booklet about my medications.”
Ans: A
Chapter: 13
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Nursing Process
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Objective: 2
Page Number: 183
Feedback: Emotional support from social support is evidenced by attachment,
reassurance, and being able to rely on and confide in a person. The statement about
having someone to talk to reflects this. The statements about cutting the lawn and the
grant for groceries reflect tangible support. The statement about the medication
booklet reflects informational support.
11. A nurse is assessing a client and uses the Recent Life Changes Questionnaire as
part of the assessment. The nurse determines that the client has experienced major
life crisis when which score is attained?
A) 150
B) 250
C) 350
D) 450
Ans: D
Chapter: 13
Client Needs: Psychosocial Integrity
Cognitive Level: Understand
Integrated Process: Nursing Process
Objective: 2
Page Number: 184
Feedback: A score of over 400 on the Recent Life Changes Questionnaire indicates
GRisAindicated
DESLAB.by
COaMscore between 250 and 400.
major life crisis. A minor life crisis
12. A nurse is reviewing the events associated with the fight-or-flight response. The
nurse knows that which effect results from sympathetic nervous stimulation?
A) Hypoglycemia
B) Tachycardia
C) Hypotension
D) Hypercoagulability
Ans: B
Chapter: 13
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 3
Page Number: 178
Feedback: With the “fight-or-flight” response, the sympathetic nervous system is
activated, leading to an increase in heart rate, blood pressure, and blood sugar.
Hyperactivation of the hemostatic and coagulation systems, leading to
hypercoagulability to prevent excessive bleeding from wounds, also occurs, but it is
not related to sympathetic nervous system activation.
13. During an interview, the client states, “I feel so guilty, and I’m so ashamed of
what I did.” The nurse interprets this as which emotion?
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
A) Negative emotion
B) Positive emotion
C) Borderline emotion
D) Nonemotion
Ans: A
Chapter: 13
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 5
Page Number: 15.
Feedback: Negative emotions occur when there is a threat to, delay in, or thwarting
of a goal or a conflict between goals; these emotions include anger, fright, anxiety,
guilt, shame, sadness, envy, jealousy, and disgust. Positive emotions occur when
there is movement toward, or attainment of, a goal; examples include happiness,
pride, relief, and love. Borderline emotions are somewhat ambiguous and include
hope, compassion, empathy, sympathy, and contentment. Nonemotions connote
emotional reactions but are too ambiguous to fit into any of the preceding categories;
these include confidence, awe, confusion, and excitement.
14. A nurse is giving a client information about emotional responses to stress. The
client demonstrates understanding of the information by identifying which emotion as
associated with being moved by another’s suffering and wanting to help?
GRADESLAB.COM
A) Relief
B) Hope
C) Compassion
D) Love
Ans: C
Chapter: 13
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 5
Page Number: 185
Feedback: Compassion reflects being moved by another’s suffering and wanting to
help. Relief is reflected as a distressing goal-incongruent condition that has changed
for the better or gone away. Hope reflects fearing the worst but yearning for better.
Love reflects desiring or participating in affection, usually (but not necessarily)
reciprocated.
15. A nurse has completed an assessment of a client who is experiencing significant
stress. The assessment revealed intense anger and acting-out behaviors, along with
statements of negative emotions. Which nursing diagnosis would be most
appropriate?
A) Disturbed Thought Processes
B) Low Self-esteem
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
C) Hopelessness
D) Ineffective Coping
Ans: D
Chapter: 13
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 6
Page Number: 186
Feedback: The assessment information supports the nursing diagnosis of Ineffective
Coping. There is no information related to problems with thought processes. Low
Self-esteem may be a problem, but there is no information to support this diagnosis.
The client also may be experiencing Hopelessness, but the situation does not support
this.
Multiple Select
16. A nurse is conducting an assessment of a client’s social network. What questions
should the nurse ask? (Select all that apply.)
A) “How big is your network of contacts?”
B) “What gives you the best advice?”
C) “Who is responsible for providing the support?”
D) “Do any of the members know one another?”
RADEbe
SLhelpful?”
AB.COM
E) “What services do you think Gmight
Ans: A, B, C, D
Chapter: 13
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 4
Page Number: 188
Feedback: When assessing a client’s social network, questions should address the
following: the size and extent of the client's social network, both relatives and
nonrelatives, professional and nonprofessional, and how long known; functions that
the network serves (e.g., intimacy, social integration, nurturance, reassurance of
worth, guidance and advice, access to new contacts); degree of reciprocity between
the client and other network members (i.e., who provides support to the client and
who the client supports); and the degree of interconnectedness (i.e., how many of the
network members know one another and are in contact).
Multiple Choice
17. After educating a group of students on appraisal and the stress response, the
instructor determines that additional education is needed when the students identify
which element as part of the secondary appraisal?
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
A) Relevance of the goal
B) Consistency of goal with values
C) Personal commitment
D) Outcome explanation
Ans: D
Chapter: 13
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 2
Page Number: 181
Feedback: In a secondary appraisal, the person explains the outcome of events.
During primary appraisal of a goal, the person determines whether (1) the goal is
relevant, (2) the goal is consistent with his or her values and beliefs, and (3) a
personal commitment is present.
18. When describing the concept of allostatic load to a group of students, which of
the following would the instructor identify as abnormal, indicative of the overall
changes of the biologic regulatory system?
A) Nuclear imaging studies
B) Laboratory test results
C) Bone radiographs
D) Cardiac studies
GRADESLAB.COM
Ans: B
Chapter: 13
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 3
Page Number: 5.
Feedback: As wear and tear on the brain and body occurs, there is a corresponding
increase in the number of abnormal biologic parameters called allostatic load (AL)
(Fig. 13.1). AL is measured by the cumulative changes of the biologic regulatory
systems as indicated by abnormal laboratory values. Nuclear imaging studies, bone
radiographs, and cardiac studies are not used to measure allostatic load.
Multiple Select
19. A nurse is providing an in-service presentation on coping and adaptation. Which
information would the nurse most likely include? (Select all that apply.)
A) Most coping strategies are similar in their approach.
B) Coping when effective leads to adaptation.
C) Reappraisal occurs simultaneously with coping.
D) The same coping strategy is used in each situation.
E) Coping is a deliberate and planned effort to manage stress.
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Ans: B, E
Chapter: 13
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 6
Page Number: 184, 185
Feedback: Coping is a deliberate, planned, and psychological effort to manage
stressful demands. Positive coping leads to adaptation. No singular coping strategy is
best for all situations. Coping strategies work best in particular situations. Over time,
these strategies become automatic and develop into patterns for each person.
Hopefully, the strategies are effective.
Multiple Select
20. The nurse is suggesting interventions to a group focused on stress management.
What intervention(s) is relevant for the management of stress through
implementation of positive coping strategies? (Select all that apply.)
A)
Identifying situations that present with risks for personal stress
B)
Role playing various coping skills to help manage stressful situations
C)
Attending a group that focuses on introducing stress reducing techniques
D)
GRADEStoLA
B.Cmanage
OM
Inquiring about medication therapy
help
person stress responses
E)
Implementing the coping mechanisms of denial and repression to eliminate daily
stress
Ans: A, B, C
Chapter: 13
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 6
Page Number: 186
Feedback: The goals for those who are at high risk for stress are to recognize the
potential for stressful situations and strengthen positive coping skills through
education and practice. It is unrealistic and not necessary to strive to eliminate all
stress but rather to focus primarily on ways to minimize not eliminate and manage the
risks naturally without first relying on medication therapy.
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Test Generator Questions, Chapter 14, Management of Anger,
Aggression, and Violence
Multiple Choice
1. The nurse is caring for an older client in a residential care facility. The client has
been extremely irritable the entire day. When modifying the client’s plan of care,
which snack is appropriate to offer the client in order to decrease the irritability?
A) Chocolate candy bar
B) Handful of raisins
C) Granola bar
D) Glass of milk
Ans: D
Chapter: 14
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 8
Page Number: 200
GRADpoor
ESLAdietary
B.COMhabits (e.g., indigent clients,
Feedback: Clients with longstanding
clients with alcoholism) often have deficiencies of thiamine and niacin. Increased
irritability, disorientation, and paranoia may result. Low serotonin levels are also
associated with irritability. Assessing overall dietary intake is relevant, particularly
noting good tryptophan sources, such as wheat, flour, corn, milk, and eggs.
2. The nurse is assessing a client on an inpatient psychiatric unit. Which aspect of
the client’s history should the nurse identify as the strongest indicator of risk for
violence?
A) Panic disorder
B) Problematic anxiety
C) Somatoform disorder
D) Previous episodes of rage
Ans: D
Chapter: 14
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 3
Page Number: 199
Feedback: The client’s history of violent behavior is probably the most important
predictor of potential for violence. Important markers include previous episodes of
rage and violent behavior, escalating irritability, intruding angry thoughts, and fear of
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
losing control. History of other psychiatric disorders would be less of a concern.
3. A son brings his father to the clinic and tells the nurse that his father has begun to
act strangely in the past few days, with unprovoked outbursts of anger. After the
incidents, the father expresses remorse for his outburst. The son says, “I’ve never
seen him act this way.” Which question is most appropriate for the nurse to ask next?
A) “Does your father have a history of an anxiety disorder, such as panic disorder?”
B) “Has your father exhibited previous problems expressing anger appropriately?”
C) “Has your father suffered any traumatic injury to his brain recently?”
D) “Has your father injured the back of his head or neck in the past week?”
Ans: C
Chapter: 14
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 3
Page Number: 197, 198
Feedback: Asking about injury to the brain would be most appropriate, because the
brain structures most frequently associated with aggressive behavior are the limbic
system and cerebral cortex. Clients with a history of damage to the cerebral cortex
are more likely to exhibit increased impulsivity, decreased inhibition, and decreased
judgment than are those who have not experienced such damage. Schizophrenia and
substance abuse are also associated with violent behavior. Asking about previous
GRADESto
LAknow
B.CObut
M would not be the priority.
problems with anger would be important
Additionally, the son states that the father has never done this before. Injury to the
back of the head or neck is not associated with aggression.
4. The nurse is caring for an older adult client who has no history of violence but is
agitated and appears ready to strike out at a staff member. The nurse would assess
the client for which condition?
A) Panic disorder
B) Epilepsy
C) Bipolar disorder
D) Sensory losses
Ans: D
Chapter: 14
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 8
Page Number: 199
Feedback: The nurse should assess the client for sensory losses. Impaired
communication (including hearing loss and reduced visual acuity), disorientation, and
depression have been found to be consistently associated with aggressive behavior
among nursing home residents with dementia. Panic disorder, epilepsy, and bipolar
disorder are unrelated to agitation in older adults.
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
5. The nurse is working with a potentially violent client in a community clinic. What
action should the nurse take to minimize personal risk?
A) Use protective devices
B) Stay close to a door
C) Keep the door closed to ensure privacy
D) Wear expensive jewelry to distract the client
Ans: B
Chapter: 14
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 5 & 8
Page Number: 203
Feedback: The nurse can take a position near the door so immediate access to an
exit is available in case the client becomes violent. Protective devices would be
inappropriate. Closing the door would be unsafe. The nurse should remove or not
wear accessories such as jewelry that could be used to harm the nurse.
6. The nurse is caring for a family of an older adult with dementia who is living in
their home. The nurse has instructed the family about how to decrease the client’s
agitation. The nurse determines that the family has understood the instructions when
they make what statement?
A) “Restraints can help reduce my father’s agitation.”
RAbedroom
DESLAB.
COMme so I can watch him more
B) “I should place my father in G
the
with
closely.”
C) “It’s important that he gets out shopping with us.”
D) “If I simplify our home environment, my father may be less agitated.”
Ans: D
Chapter: 14
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Teaching/Learning
Objective: 8
Page Number: 200
Feedback: The nurse determines that the family has understood the nurse’s
instructions when they say, “If we simplify our home environment, my father may be
less agitated.” The goal is to reduce environmental stimuli and adapt the environment
to the client. Restraints are used only as a last resort. Continuous surveillance is
unrealistic. Taking the client out shopping would add to the already intense and highly
confusing stimulation.
7. A nurse is presenting to a group of colleagues about the relationships between
anger, aggression, and violence. Which statement by the nurse would be most
appropriate to include?
A) “Anger, aggression, and violence are points along a continuum.”
B) “The terms used to describe anger are very precise.”
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
C) “Anger is a knee-jerk reaction to external events.”
D) “Women experience anger as frequently as men do.”
Ans: D
Chapter: 14
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 1
Page Number: 193
Feedback: Women experience anger as frequently as men do, but societal
constraints may inhibit their expression of it. Anger, aggression, and violence should
not be viewed as a continuum because one does not necessarily lead to another.
Language related to anger is imprecise and confusing. People can choose to slow
down their reactions and to think and behave differently in response to events;
therefore, anger is not a knee-jerk reaction to external events.
8. A group of new graduate nurses is reviewing information about maladaptive
anger. The nurses demonstrate a need for additional review when they identify which
physical condition as being linked to suppressed anger?
A) Coronary heart disease
B) Arthritis
C) Hypertension
D) Breast cancer
GRADESLAB.COM
Ans: A
Chapter: 14
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Teaching/Learning
Objective: 1
Page Number: 193
Feedback: Suppressed anger is related to arthritis, breast and colorectal cancer, and
hypertension. Excessive, outwardly directed anger is linked to coronary heart disease,
reduced left ventricular ejection fraction, and myocardial infarction.
9. While interviewing a client, a nurse asks, “What do you do when you get angry?”
Which client response indicates to the nurse that the client engages in anger
suppression?
A) “I’ve been known to fly off the handle when I’m angry.”
B) “People say I withdraw and pout about the problem.”
C) “I usually approach the person directly to talk about it.”
D) “I try to discuss how I’m feeling about it with a close friend.”
Ans: B
Chapter: 14
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Integrated Process: Nursing Process
Objective: 1
Page Number: 194
Feedback: Anger suppression is characterized by acting as though nothing has
happened; withdrawing from people; and sulking, pouting, or ruminating. Unhealthy,
outward anger expression is characterized by flying off the handle or expressing anger
in an attacking or blaming way, yelling, or using profanity. Approaching a person
directly to talk about it, or discussing how the person feels with a close friend, reflects
constructive anger discussion.
10. The plan of care for a client with anger includes behavioral interventions. Which
intervention is the nurse be likely to find?
A) Self-monitoring of cues
B) Anger management
C) Relaxation training
D) Response disruption
Ans: B
Chapter: 14
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 2
Page Number: 196, 197
DESLAB.COM
Feedback: Anger management G
isRaApsychoeducational
intervention. Behavioral
treatment of anger involves avoidance of provoking stimuli, self-monitoring regarding
cues of anger arousal, stimulus control, response disruption, and guided practice of
more effective anger behaviors. Relaxation training is often introduced early in the
treatment because it strengthens the therapeutic alliance, and convinces clients that
they can indeed learn to calm themselves when they are angry.
Multiple Select
11. When assessing a client experiencing aggression, the nurse applies the general
aggression model. Which factors would the nurse assess as the person factors?
(Select all that apply.)
A) Client’s personality traits
B) Insult initiating the behavior
C) Previous behavior patterns
D) Shouting by the client
E) Client’s mood
F) Client’s gender
Ans: A, F
Chapter: 14
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Objective: 4
Page Number: 199
Feedback: The person factors include characteristics such as gender, personality
traits, beliefs and attitudes, values, goals, and behavior patterns. Situational factors
include the actual provocation (insults, slights, verbal and physical aggression,
interference with achieving goals) and cues that trigger memories of similar
situations. Cognition includes hostile thoughts and scripts (previous behavior patterns
and responses to similar episodes). Mood, emotion, and expressive motor responses
(automatic reactions to specific emotions) represent the affect component. Arousal
can be physiologic, psychological, or both.
12. A nurse is presenting an in-service program about aggression and violence to a
group of newly hired nurses who will be working in an inpatient psychiatric facility.
When describing characteristics that may predict the risk for violence and aggression
in clients, which of the following would the nurse include? (Select all that apply.)
A)
B)
C)
D)
E)
Age
Intimidating stare
Raised voice
Gender
Demanding comment
Ans: B, C, E
Chapter: 14
GRADESLAB.COM
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 3
Page Number: 199
Feedback: The age, gender, and race of clients are not good predictors, but several
research reports suggest that particular characteristics are predictive of violent
behaviors. Usually, but not always, there are some observable precursors to
aggression and violence: staring or glaring in an intimating manner, raising voice tone
or volume, making sarcastic or demanding comments, and pacing.
13. A unit in an inpatient psychiatric facility is experiencing an increase in violence
episodes by clients. A group of nurses working on this unit is developing a plan to
address this issue. When developing this plan, which problem areas are the nurses
most likely to address? (Select all that apply.)
A) Inconsistent unit activities
B) Medication power struggles
C) Empathetic staff response
D) Clearly set boundaries
E) Little client participation in treatment plan
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Ans: A, B, E
Chapter: 14
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 3, 5
Page Number: 200
Feedback: Areas that may contribute to violence in inpatient units include a lack of
meaningful and predictable ward activities, power struggles related to medications,
failure of the staff to listen or be empathetic, boundary violations, and a lack of client
control over treatment plan.
14. After working with a client who has a history of violent behavior to identify
possible clues that suggest the behavior is escalating, the nurse and client develop a
plan for prevention. Which strategies will the nurse be most likely to include? (Select
all that apply.)
A) Counting to 10
B) Taking slow, deep breaths
C) Playing loud music
D) Taking a voluntary time out
Ans: A, B, D
Chapter: 14
GRADESLAB.COM
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 8
Page Number: 202
Feedback: Turning up the music loudly would add additional stimulation, which
could contribute to increasing the stress and stimulation of the situation. Rather, the
suggestion would be to listen to quiet music or read. Counting to 10, taking slow deep
breaths, and taking a voluntary time out would be appropriate.
Multiple Choice
15. A nurse is leading an anger management group in the inpatient program. A client
says, “I'm feeling really tense, and I'm fidgety today.” What is the nurse's most
appropriate response to the client's comment?
A)
Explore what is underlying the client's physical and emotional state
B) Encourage the client to engage in a relaxation exercise prior to joining the group
the the rest of the session
C)
Ask the client if the client feels triggered by another client in the group
D)
Ask another client in the group to respond to the client's comment
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Ans: A
Chapter: 14
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 5
Page Number: 195
Feedback: Identifying the feelings reduces the frustration. Attempt to discover the
concern and respond with empathy, interest, and willingness to help. Encourage the
client to describe and clarify the client's experience using open-ended questions to
increase the client's awareness of problematic feelings and what triggers them.
16. While talking with a client who has been experiencing aggression and intense
anger, the nurse identifies that the client feels isolated and anxious. Which statement
by the nurse is most appropriate?
A) “This must be scary for you.”
B) “Once you relax, things will improve.”
C) “I really understand how you feel."”
D) “If you calm down, I can help you.”
Ans: A
Chapter: 14
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
GRADESLAB.COM
Integrated Process: Nursing Process
Objective: 7
Page Number: 201
Feedback: The most appropriate response would be to acknowledge and validate the
client’s feelings, perhaps by stating that this must be scary for him. In doing so, the
nurse helps the client feel understood and supported. The statements about relaxing
and calming down do not address the client’s underlying feelings. Telling the client
that the nurse really understands is nontherapeutic because only the client can truly
know what he or she is feeling.
17. An advanced practice psychiatric nurse is preparing to conduct a support group
for psychiatric–mental health nurses who have been assaulted by clients. Which of the
following would the nurse need to keep in mind with this group?
A) Nurses experience a conflict between the role of caregiver and victim.
B) Nurses who are victims often go on to prosecute the client attackers.
C) Nurses actively express the feelings associated with client assaults.
D) Nurses as victims of client assaults rarely experience guilt or shame.
Ans: A
Chapter: 14
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 6
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Page Number:
204
Feedback: Because of their role as caregivers, nurses may suppress the normal
range of feelings after an assault, believing that it is wrong to experience strong
feelings of anger and fear in this situation. This belief may relate to the conflict nurses
experience in having to care for clients who have hurt them. The conflict is between
one’s professional role as a caregiver and one’s own needs as an assault victim.
Nurses seldom prosecute their attackers. Feelings of guilt and shame are common.
18. After teaching a class about the General Aggression Model, the nurse determines
that additional education is needed when the class identifies which of the following as
an interactive component of the model?
A) Cognition
B) Affect
C) Arousal
D) Rewards
Ans: D
Chapter: 14
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 4
Page Number: 198, 199
GRAModel
DESLA(GAM)
B.COis
M a framework that accounts for
Feedback: The General Aggression
the interaction of cognition, affect, and arousal during an aggressive episode.
Cognition includes hostile thoughts and scripts (previous behavior patterns and
responses to similar episodes). Mood, emotion, and expressive motor responses
(automatic reactions to specific emotions) represent the affect component. Arousal
can be physiologic, psychological, or both. In Bandura’s social learning theory, he
focuses on the role of learning and rewards in the expression of aggression and
violence.
19. A nurse is reading a journal article about anger and violence. Which condition
does the nurse expect to see as being linked to excessive, outwardly directed anger?
A) Myocardial infarction
B) Hypertension
C) Arthritis
D) Chronic pain
Ans: A
Chapter: 14
Client Needs: Physiological Integrity: Reduction of Risk Potential
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 3
Page Number: 193
Feedback: Maladaptive anger (excessive, outwardly directed anger or suppressed
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
anger) is linked to psychiatric conditions, such as depression (Perugi, Fornaro, &
Akiskal, 2011), as well as a plethora of medical conditions. For example, excessive,
outwardly directed anger is linked to coronary heart disease (Ketterer et al., 2011)
and myocardial infarction (Mostofsky, Maclure, Tofler, Muller, & Mittleman, 2013).
Suppressed anger is related to arthritis, breast and colorectal cancer, chronic pain,
and hypertension (Burns, Quartana, & Bruehl, 2011; Thomas, 2009). Furthermore,
suppressed anger was a predictor of early mortality for both men and women in a
large 17-year study (Potpara & Lip, 2011).
Multiple Select
20. When assessing a client's anger, which element is important for the nurse to
determine? (Select all that apply.)
A) How the person expresses the anger
B) Problems at work due to the anger
C) Frequency of the anger episodes
D) Evidence of coping techniques
E) The intensity of the anger, outwardly or inwardly
Ans: A, B, C, D, E
Chapter: 14
Client Needs: Safe and Effective Care Environment: Management of Care
Cognitive Level: Apply
Integrated Process: Nursing Process
GRADESLAB.COM
Objective: 8
Page Number: 195
Feedback: The manner of anger expression is not the only important aspect of
assessment. The difficulty in regulating the frequency and intensity of anger must also
be assessed, along with the extent to which anger is creating problems in work or
intimate relationships. The nurse should also assess for the presence or absence of
coping techniques such as calming or diffusion through vigorous exercise.
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Test Generator Questions, Chapter 15, Crisis, Loss, Grief
Response, Bereavement, and Disaster Management
Multiple Choice
1. The nurse is assessing a 35-year-old client who is seeking assistance at a local
community counseling center. Which statement made by the client would indicate
that the client is experiencing a crisis?
A) “I’m so upset; my spouse has never left me like this before.”
B) “I’m confused and hurt; I have lost my best friend and my lover.”
C) “I don’t understand; I can’t seem to function like I usually do.”
D) “No matter what I do, I am still overcome by these sad feelings.”
Ans: C
Chapter: 15
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 1
Page Number: 208
Feedback: Crisis occurs when there is a perceived challenge or threat that
GRADESLto
ABcope
.COeffectively
M
overwhelms the capacity of the individual
with the event. Life is
disrupted, and unexpected emotional (e.g., depression) and biologic (e.g., nausea,
vomiting, diarrhea, headaches) responses occur. Functioning is severely impaired.
Although feelings of upset, confusion, hurt, and sadness may occur with a crisis, the
key component is impaired functioning.
2. A client’s 5-year-old poodle ran in front of a car and was killed. The client
continues to be upset by the pet’s death and exclaims to a community counseling
center nurse that “My Precious meant the world to me, and now my world will never
be the same!” If the nurse were to determine that the client is experiencing a crisis,
which type of crisis is it most likely to be?
A) Maturational
B) Situational
C) Traumatic
D) Developmental
Ans: B
Chapter: 15
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 1
Page Number: 210
Feedback: A situational crisis occurs whenever a specific stressful event threatens a
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
person’s biopsychosocial integrity and results in some degree of psychological
disequilibrium. The pet’s death caused the client to experience a degree of
psychological disequilibrium. A developmental or maturational crisis is one involving
normal growth and development. A traumatic crisis is initiated by unexpected,
unusual events that affect an individual or multitude of people.
3. A 62-year-old client has lost an 87-year-old father a week ago. The hospice nurse
is making a follow-up visit to determine how the client is handling the father’s death.
Which statement made by the client indicates to the hospice nurse that client is in the
acute mourning stage of bereavement?
A) “I keep thinking about my father; I have trouble believing he’s dead. I feel guilty
because I didn’t go to the nursing home to visit him last week!”
B) “I’ve been grieving my father; losing him is a tremendous loss, but I have to get
on with my life.”
C) “My father was a saint. I am so angry at God for taking him away! I’m crying all
the time; I haven’t been able to work for days.”
D) “I’m going to spend the weekend with my children; they understand what I’ve
been going through, and I can relax around them.”
Ans: C
Chapter: 15
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Nursing Process
GRADESLAB.COM
Objective: 3
Page Number: 212, 213
Feedback: The fact that the client is crying all the time, feeling angry for much of the
time, missing work, and idealizing his father are all indicators of the acute mourning
stage of bereavement. This stage is characterized by intense feeling states, social
withdrawal, and identification with the deceased person. The statement about having
trouble believing he is dead suggests the shock stage. The statement about grieving
but having to get on with life suggests the beginning of the resolution stage, as does
the statement about spending the weekend with the children to relax.
4. A 25-year-old legal secretary is seeking counseling because of a recent
unexpected job loss. Which question would be most appropriate for the nurse to use
in assessing the client’s response to this loss?
A) “What happened to cause you to lose your job?”
B) “How did you feel immediately after being told you no longer had a job?”
C) “How do you expect yourself to be able to handle this situation?”
D) “How have you responded to previous stressful situations?”
Ans: D
Chapter: 15
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 4
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Page Number: 214, 219
Feedback: Individual responses to a crisis can be best understood by assessing the
usual responses of the person to stressful events. The response to the crisis will also
depend on the meaning of the event to the person. Asking about the cause of job loss,
immediate feelings, and how the person expects to handle the situation do not
address the client’s response to the job loss.
5. An individual is seeking employment as a nurse in a crisis center. The interviewer
asks the job candidate what the candidate would ask someone who called the crisis
hotline in order to determine whether the caller is experiencing a crisis. Which
response would be most appropriate?
A) “To what extent are you involved in a crisis situation?”
B) “Tell me about what you are experiencing and what it means to you.”
C) “How would you rate your level of functioning on a scale from 1 to 10?”
D) “Why do you think you are in a crisis situation?”
Ans: B
Chapter: 15
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 4
Page Number: 213, 214
Feedback: The response to the crisis will also depend on the meaning of the event to
GRADES
LABthey
.COM
the victim. Telling someone to describe
what
are experiencing and what that
experience means to them elicits more information than asking a person to quantify
the extent of the crisis. Asking someone “Why” tends to put an individual on the
defensive because the question implies that the individual needs to “justify” his or her
perception. Asking about the extent of the crisis would be difficult for the person to
answer. In addition, it already assumes that the client is in crisis. Rating the level of
functioning would be important information to ask later, after establishing what the
client is experiencing.
6. A Red Cross nurse is working with tornado victims. The nurse is interviewing a
client whose house was totally destroyed during the night by the tornado. The client’s
cat died as a result of the tornado. Which statement by the client does the nurse
expect to hear?
A) “I don't know. I can’t feel anything right now. Nothing seems real.”
B) “Devastated. . . . I just feel totally devastated. I don't know how I can go on
living.”
C) “I just want my insurance man to get here so I can file a claim. Everything I had
is gone.”
D) “I always thought my cat would die peacefully in my arms. Now I’ll never be able
to hold her again.”
Ans: A
Chapter: 15
Client Needs:
Psychosocial Integrity
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 5
Page Number: 213
Feedback: In the beginning of the crisis, the victim may report the feeling of
numbness and shock. The reality of the client’s loss has not had sufficient time to “sink
in.” When it does, the client will experience intense emotions regarding the loss.
7. A nurse is part of team working with hurricane victims. One of the victims is
staying in a temporary shelter provided by the Red Cross. To determine the extent to
which this victim can cognitively cope with his situation and how much support he
needs, which question would be most appropriate for the nurse to ask?
A) “What kind of help do you need from us?”
B) “What are your thoughts about what you will do during the next few days?”
C) “How are you feeling about all that you have gone through?”
D) “Are you feeling guilty because you survived and some of your neighbors did
not?”
Ans: B
Chapter: 15
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 4
GRADESLAB.COM
Page Number: 213
Feedback: By assessing the victim’s ability to solve problems, the nurse can
evaluate whether the victim can cognitively cope with the crisis situation and
determine the kind and amount of support needed. At this point in time, the client
may not be able to identify the type of help he needs or what he will be doing for the
next few days. Asking about feeling guilty is inappropriate. Additionally, this is a
closed-ended question that does not allow the victim to explore what he is feeling.
8. A family has just lost their home in a fire. An on-call nurse from a community
counseling center has been called in to the emergency department to help them with
this traumatic event. Which action would the nurse identify as the priority for this
family?
A) Arranging for follow-up therapy to deal with the crisis
B) Completing a family genogram to determine family patterns
C) Assessing the impact of the loss on their lifestyle
D) Arranging for emergency shelter and food supplies
Ans: D
Chapter: 15
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 4
Page Number: 214
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Feedback: Safety interventions to protect people in crisis from harm should include
preventing the individuals from committing suicide or homicide, arranging for food
and shelter (if needed), and mobilizing social support. Additionally, the priorities of
physical needs surpass those of psychosocial needs. After the individual’s safety
needs are met, the nurse can address the psychosocial aspects of the crisis.
9. A nurse is explaining to a new nurse on the team about how to respond to
individuals who are in the midst of a disaster. Which statement would be most
appropriate to include about initial nursing interventions for such individuals?
A) “You should ask them to give you a brief medical history so their physical needs
can be met.”
B) “Focus on safety needs and provide simple, clear instructions to help them
function effectively.”
C) “Help them determine what their long-term goals will be so they can maintain a
sense of hope.”
D) “Try to redirect their attention away from the problems at hand so you can
decrease their anxiety.”
Ans: B
Chapter: 15
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 4
GRADESLAB.COM
Page Number: 220
Feedback: When responding to a disaster, the nurse would follow the ABCs of
psychological first aid: arousal, behavior, and cognition. Thus, the first area to
address is arousal. When arousal is present, the intervention goal is to decrease
excitement by providing safety, comfort, and consolation. When abnormal or
irrational behavior is present, survivors should be assisted to function more
effectively in the disaster. If cognitive disorientation occurs, reality testing and clear
information should be provided. In the initial phases, the nurse should assist the
victim in focusing on the reality of problems that are immediate, with specific goals
that are consistent with available resources and with the culture/lifestyle of the
victim.
10. A nurse is working as part of a community disaster response team. When
responding to a community disaster, the nurse integrates understanding of
individuals’ responses, anticipating which of the following?
A) People can become aggressive and violent when their basic needs are threatened.
B) People involved in the disaster will always put the welfare of others before their
own.
C) Losses incurred during the disaster have little, if any, long-term effect on victims.
D) The psychological distress associated with disasters is felt immediately.
Ans: A
Chapter: 15
Client Needs:
Psychosocial Integrity
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 6
Page Number: 219
Feedback: In a disaster, shelter, money, and food may not be available. The
absence of basic human needs such as food, a place to live, or immediate
transportation quickly becomes a priority that may precipitate acts of violence.
Additionally, the victims may experience economic distress because of job loss and
loss of other resources. This may ultimately lead to psychological distress, potential
acts of aggression, and other mental health problems. Long-term mental health
consequences are evident in most disasters.
11. A nurse is reviewing with new graduate nurse’s information about the types of
crisis. The new nurses demonstrate understanding of the information when they
identify which event as a developmental crisis?
A) Going away to college
B) Obtaining a job promotion
C) Loss of a pet
D) Earthquake
Ans: A
Chapter: 15
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
GRADESLAB.COM
Integrated Process: Teaching/Learning
Objective: 1
Page Number: 209, 210
Feedback: A developmental crisis is one that occurs with normal growth and
development, such as going away to college. Obtaining a job promotion or loss of a
pet is an example of a situational crisis. An earthquake is an example of a traumatic
crisis.
12. As part of a community program on crisis prevention, a nurse is describing the
phases of crisis. Which event would the nurse identify as occurring first?
A) Person has a problem that doesn’t “fit” with their usual problem-solving methods
B) Trial and error attempts to alleviate the problem
C) Automatic relief behaviors take over as the “fight-or-flight” hormones dissipate
D) Person has serious personality disorganization
Ans: A
Chapter: 15
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Teaching/Learning
Objective: 1
Page Number: 208, 209
Feedback: A crisis occurs in phases as identified by psychiatrist Gerald Caplan. A
crisis occurs when a person faces a problem that cannot be solved by customary
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
problem-solving methods. When the usual problem-solving methods no longer work,
a person’s life balance or equilibrium is upset, and the person uses trial and error to
solve the problem. These attempts fail, and the anxiety rises to severe or panic levels,
whereby the person then adopts automatic relief behaviors. When these fail, anxiety
overwhelms the person and leads to serious personality disorganization, which signals
the person is in crisis.
13. A nurse is assessing the parents of a 6-year-old child who has died from
leukemia. The nurse is integrating the dual process model for the assessment. Which
action would the nurse identify as reflecting the parents’ loss-oriented coping?
A) Engaging in new activities
B) Denying the grief
C) Developing new relationships
D) Thinking about the lost child
Ans: D
Chapter: 15
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 3
Page Number: 211
Feedback: According to the dual process model, the person adjusts to the loss by
oscillating between loss-orientated coping (in which there is preoccupation with the
GRabout
ADESL
ABlost
.COchild)
M
deceased person, such as thinking
the
and restoration-oriented
coping (in which the bereaved person is preoccupied with stressful events as a result
of the death, such as financial issues, new identity as a widow, etc.). Engaging in new
activities, denying the grief, and developing new relationships reflect
restoration-oriented coping.
14. A nurse is describing uncomplicated grief during a presentation. Which
statement should the nurse include in the presentation?
A) Uncomplicated grief differs from normal grief because it lasts longer.
B) Most bereaved persons experience uncomplicated grief.
C) Uncomplicated grief is primarily loss associated with death.
D) This type of grief is less painful and disruptive than normal grief.
Ans: B
Chapter: 15
Client Needs: Psychosocial Integrity
Cognitive Level: Understand
Integrated Process: Teaching/Learning
Objective: 2
Page Number: 211
Feedback: Most bereaved people experience normal or uncomplicated grief after the
loss of a loved one. Uncomplicated grief is painful and disruptive. It can be applied to
situations other than loss because of death.
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Multiple Select
15. Assessment of a client indicates complicated grief. Which statements would the
nurse identify as supporting this reaction? (Select all that apply.)
A) “It’s been two months, and I still want my son back.”
B) “I still wait for him to come right through the door every day.”
C) “I’m really struggling with trusting anybody anymore.”
D) “I wish I could go back to the days before he died.”
E) “Life seems so empty now that he’s gone. What will I do?”
Ans: B, C, D, E
Chapter: 15
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 2
Page Number: 212
Feedback: Complicated grief, which occurs in about 10% to 20% of bereaved
persons, is characterized by the person being frozen or stuck in a state of chronic
mourning. They feel bitter over their loss and wish that their lives could revert to the
time when they were together. In addition, the person experiences an intense longing
and yearning for the deceased for more than 6 months. Additionally, the person may
have trouble accepting the death, an inability to trust others since the death,
excessive bitterness related to the death, and feeling that life is meaningless without
GRADESLAB.COM
the deceased person.
16. A client is experiencing traumatic grief resulting from the suicide of a family
member. In addition to the usual emotions experienced with bereavement and grief,
which of the following will the person most likely exhibit? (Select all that apply.)
A) Acceptance of the loss
B) Sense of rejection
C) Disgust
D) Stigmatization
E) Self-blame
Ans: B, D, E
Chapter: 15
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 2
Page Number: 209, 211, 212
Feedback: Bereavement of family members for those who committed suicide seems
to differ from bereavement related to other sudden deaths. Common experiences
during the bereavement process of family members who committed suicide include
stigmatization, shame, guilt, and a sense of rejection. The bereaved person may
experience self-blame for contributing to the family member’s death. Acceptance and
disgust are least likely.
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Multiple Choice
17. After educating a client about crisis, the nurse determines that the education
was successful when the client makes which statement?
A) “Crisis triggers maladaptive responses”
B) “Crisis is a time-limited event”
C) “Chronic crisis is a real situation”
D) “Events causing a crisis are similar for everyone”
Ans: B
Chapter: 15
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 1
Page Number: 208
Feedback: Crisis is a time-limited event (usually no more than 4 to 6 weeks) that
triggers adaptive or nonadaptive responses to maturational, situational, or traumatic
experiences. By definition, there is no such thing as a chronic crisis. People who live in
constant turmoil are not in crisis but in chaos. Although the feelings associated with a
crisis are similar, the precipitating event and circumstances are unusual or rare,
perceived as a threat and specific to the individual.
GRADcare
ESLA
.COM of a disaster that occurred
18. The nurse is providing follow-up
toBvictims
several months ago. Assessment of which condition would lead the nurse to suspect
that the victims are experiencing possible aftereffects of the disaster?
A) Tachycardia
B) Profuse perspiration
C) Unexplained gastrointestinal disturbance
D) Tremors
Ans: C
Chapter: 15
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 6
Page Number: 219
Feedback: Unexplained physical symptoms such as headache, fatigue, pain, chest
pain, and gastrointestinal disturbances have been reported in the aftermath of a
disaster in both traumatized and nontraumatized populations. Tachycardia, profuse
perspiration, and tremors or shakiness are more typically assessed in the period
immediately after the disaster.
Multiple Select
19.
A nurse is working with a client who is in crisis. Which actions by the nurse would
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
be
A)
B)
C)
D)
appropriate? (Select all that apply.)
Support the client’s cultural beliefs about expressing feelings.
Encourage the client to focus on one aspect at a time.
Provide the client with an understanding that everything will be okay.
Explain information clearly to clarify any misconceptions or myths.
Ans: A, B, D
Chapter: 15
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Caring
Objective: 4
Page Number: 214
Feedback: The nurse should focus on what the information means to the client.
Supporting the client’s cultural beliefs about expressing his or her feelings,
encouraging the client to focus on one thing at a time, and explaining information
clearly are appropriate. Telling the client that everything will be okay is false
reassurance and blocks communication.
Multiple Choice
20. A nurse is reviewing information about grief and bereavement with the family of
a client who recently died. Which statement by the nurse provides appropriate
information?
GRADinterchangeably
ESLAB.COM as responses to loss.
A) Grief and bereavement are used
B) Bereavement is the process of mourning and grief is the emotional reaction.
C) Grief involves confronting the stress, but bereavement helps avoid the stresses.
D) Bereavement is influenced by culture, but grief is not.
Ans: B
Chapter: 15
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 2
Page Number: 210
Feedback: Grief is an intense, emotional reaction to the loss of a loved one. The
reaction is a biopsychosocial response that often includes spontaneous expression of
pain, sadness, and desolation. Bereavement is the process of mourning and coping
with the loss of a loved one. It begins immediately after the loss, but it can last
months or years. Individual differences and cultural practices influence grieving and
bereavement.
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Test Generator Questions, Chapter 16, Suicide Prevention:
Screening, Assessment, and Intervention
Multiple Choice
1. The nurse is caring for a group of hospitalized clients with various psychiatric
diagnoses. The nurse identifies which client as having the greatest risk for a suicide
attempt?
A) Man with bipolar I disorder
B) Woman with acute stress disorder
C) Man with major depressive disorder
D) Woman with somatoform disorder
Ans: C
Chapter: 16
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 3
Page Number: 226, 227
GRADE
SLAB.COrate
M than women. For men, suicide
Feedback: Men have a higher suicide
completion
occurs at a rate of 24.79 per 100,000, whereas in women it is 7.16 per 100,000. White
men complete 78% of all suicides; 56% of these deaths are by firearms. Men are
more likely to use means that have a higher rate of success, such as firearms and
hanging. Most suicide deaths occur in men with a psychiatric disorder, primarily
depression, in many cases complicated by substance abuse.
2. The nurse is reviewing the electronic health records of several clients diagnosed
with major depression. The nurse identifies which client as most likely to commit
suicide?
A) Divorced man
B) Widowed man
C) Woman living with a roommate
D) Married woman
Ans: B
Chapter: 16
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 3
Page Number: 228
Feedback: The nurse determines that the client most likely to commit suicide is the
client who is widowed. Single, older men living in a rural area have high rates of
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
suicide. Unmarried, unsociable men between the ages of 42 and 77 years with
minimal social networks and no close relatives have a significantly increased risk for
committing suicide. Women are less likely to complete a suicide but are more likely to
attempt suicide. Marriage has been identified as a protective factor for mental
disorders in older adults.
3. A family member of an adolescent who has expressed a desire to commit suicide
asks the nurse, “What might predict the possibility of future suicide attempts?” Which
element would the nurse include in the response?
A) Unemployment
B) Death of a spouse
C) Previous suicide attempt
D) Polydrug use
Ans: C
Chapter: 16
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 4
Page Number: 232
Feedback: Although factors such as unemployment, death of a spouse, and polydrug
use can contribute to depression and suicidal ideation, one of the best predictors for
suicide in adolescence is a previous attempt.
GRADESLAB.COM
4. A nurse is completing an admission assessment of a young adult client who has a
history of depression, and who was brought to the hospital by a friend. In response to
the nurse’s question regarding suicidal ideation, the client discloses that they often
think about attempting suicide. Which question is appropriate for the nurse to ask?
A) “What does your friend think about your desire to kill yourself?”
B) “What are your spiritual beliefs about suicide?”
C) “What will killing yourself accomplish?”
D) “What thoughts have you had about how you would kill yourself?”
Ans: D
Chapter: 16
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 6
Page Number: 232
Feedback: Assessing for risk includes determining the seriousness of the suicidal
ideation, degree of hopelessness, disorders, previous attempt, suicide planning and
implementation, and availability and lethality of the suicide method. Risk assessment
also includes the client’s resources, including coping skills and social supports, that
can be used to counter suicidal impulses.
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
5. The nurse is caring for a 30-year-old white man whose wife recently died. The
client has been diagnosed with clinical depression and is demonstrating insufficient
coping skills. Which action by the nurse would be most important?
A) Refer the client for long-term psychotherapy.
B) Determine the client’s risk of psychosis.
C) Determine whether anyone in the client’s family has had depression.
D) Ask the client whether he is thinking about killing himself.
Ans: D
Chapter: 16
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 6
Page Number: 231, 232
Feedback: The nurse should first ask if the client is thinking about killing himself,
because statistics show that in young, recently widowed white men between the ages
of 20 and 34 years, the suicide risk is 17 times higher than that of married men in that
same age group. Social isolation and access to firearms play important roles in this
group. Information related to psychosis, psychotherapy, or family history would be
less of a priority at this time.
6. The nurse is providing a presentation for a group of health professionals about
suicide. Which would the nurse address as a major contributing factor to the rising
GRADESLAB.COM
suicide rate among men?
A) Substance abuse
B) Media influences
C) Lack of conflict resolution skills
D) Parenting practices
Ans: A
Chapter: 16
Client Needs: Psychosocial Integrity
Cognitive Level: Remember
Integrated Process: Teaching/Learning
Objective: 3
Page Number: 226
Feedback: Substance abuse, aggression, hopelessness, emotion-focused coping,
social isolation, and lack of purpose in life have been associated with suicidal behavior
in men. In addition, 56% of suicide deaths among men involve firearms. The media,
lack of conflict resolution skills, and parenting practices can play a role, but are not
considered major factors.
7. A nurse has just completed a suicide risk assessment of a widowed client, 76
years of age. In addition to documenting the presence or absence of suicidal thoughts,
a suicide plan, and the client’s available means, the nurse would also document which
information?
A) Use of substances 6 hours before the assessment
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
B) Speech patterns
C) Availability of support resources
D) Amount of sleep in past 24 hours
Ans: A
Chapter: 16
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Communication and Documentation
Objective: 7
Page Number: 235
Feedback: The nurse should document the presence or absence of suicidal thoughts,
intent, plan, and available means to illustrate current and ongoing suicide risk. If the
client denies any suicidal ideation, it is important that the denial is documented.
Documentation must include any use of drugs, alcohol, or prescription medications by
the client during the 6 hours before the assessment. It should include the use of
antidepressants that are especially lethal (e.g., tricyclics), as well as any medication
that might impair the client’s judgment (e.g., a sleep medication). Notes should
reflect the level of the client’s judgment and ability to be a partner in treatment.
8. A client was admitted to the psychiatric unit 3 days ago because of suicidal
ideation. The client’s suicidal risk has lessened considerably, and the client currently
denies having any desire to perform suicide. In addition, the client is able to identify
reasons to be alive. Which nursing intervention is appropriate?
GRwith
ADESthe
LAclient
B.COduring
M
A) Assigning nursing staff to stay
this suicidal crisis
B) Developing a personal plan for managing suicidal thoughts when they occur
C) Advising the client to consider electroconvulsive therapy treatments
D) Administering psychotropic drugs that decrease the client’s serotonin levels
Ans: B
Chapter: 16
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 6
Page Number: 234
Feedback: The client's immediate suicidal crisis has subsided, and it is now
appropriate for the nurse to focus on working with the client on symptom
management. Preventing suicidal behavior requires that clients develop crisis
management strategies, generate solutions to difficult life circumstances other than
suicide, engage in effective interpersonal interactions, and maintain hope. The nurse
can help the client develop a written plan that can be used as a blueprint for action
when the client feels like he is losing control. The plan should include strategies that
the client can use to self-soothe; friends and family members who could be called
(including multiple phone numbers where they can be reached); self-help groups and
services such as suicide hotlines; and professional resources, including emergency
departments and outpatient emergency psychiatric services. Medications that
increase serotonin levels may be prescribed. The role of electroconvulsive therapy to
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
decrease suicidal behavior is under investigation.
9. A nurse is presenting a discussion for a local community group about suicide.
Which comment from an audience member indicates the need to clarify the
information?
A) “Warning signs about the person's intention often occur.”
B) “People who are suicidal are undecided about living or dying.”
C) “Asking about suicide, may put the idea in people’s heads.”
D) “People who talk about suicide need to be taken seriously.”
Ans: C
Chapter: 16
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Teaching/Learning
Objective: 34
Page Number: 224
Feedback: The comment about asking a client about suicide will put the idea in the
person’s head is a myth that requires clarification. It is important to ask the question
so that the nurse understand the person’s thoughts and intentions. Warning signs,
indecision about living and dying, and taking individuals seriously when they discuss
suicide are accurate facts.
GRADinformation
ESLAB.COabout
M
10. A group of nurses are reviewing
suicide and associated
concepts. The group demonstrates understanding of the information when they define
which term as the probability that a person will successfully complete suicide?
A) Parasuicide
B) Suicidal ideation
C) Suicidality
D) Lethality
Ans: D
Chapter: 16
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 4
Page Number: 224
Feedback: Lethality refers to the probability that a person will successfully complete
suicide. Parasuicide is a voluntary, apparent attempt at suicide, commonly called a
suicidal gesture, in which the aim is not death (e.g., taking a sublethal drug). The
term suicidality refers to all suicide-related behaviors and thoughts of completing or
attempting suicide, and suicide ideation. Suicidal ideation is thinking about and
planning one’s own death.
11. After presenting to a group on factors that enhance the risk of suicide, the nurse
determines the need for additional education when the group identifies which item as
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
a risk factor?
A) Family member committing suicide
B) Cautiousness
C) Delusions
D) Loss
Ans: B
Chapter: 16
Client Needs: Psychosocial Integrity
Cognitive Level: Remember
Integrated Process: Teaching/Learning
Objective: 4
Page Number: 225, 226
Feedback: Impulsivity, rather than cautiousness, enhances suicide risk. Other
factors include a family member having completed suicide, psychotic thoughts such as
delusions, and loss.
Multiple Select
12. A client comes to the clinic for an evaluation of headache, fatigue, and an overall
feeling of sadness. When assessing the client, which statement by the client would
alert the nurse to suspect possible suicide? (Select all that apply.)
A) “I've been drinking about three or four more beers every night.”
B) “I’ve been going out with my friends about once or twice a week.”
GRADtoES
.COMall the time.”
C) “I’m so tired that all I ever want
doLA
isBsleep
D) “Most times, I feel like I’m trapped with no way out.”
E) “I’m looking for a new job because my job is so stressful.”
Ans: A, C, D
Chapter: 16
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 5
Page Number: 230
Feedback: Warning signs for suicide include increased substance use (drinking three
or four more beers every night), an inability to sleep or sleeping all the time, and
feeling trapped. Social isolation or withdrawal (rather than going out with friends or
looking for a new job) would suggest suicide.
13. The nurse determines that a client is at imminent risk for suicide. Which
priorities are most appropriate to include in the client’s plan of care? (Select all that
apply.)
A) Listening intently and nonjudgmentally
B) Validating the client’s feelings and experience
C) Instituting strict restriction on the client’s activity
D) Using cognitive interventions to foster hope
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Ans: A, B, D
Chapter: 16
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 6
Page Number: 232
Feedback: There are three urgent priorities for care of a person who is at imminent
risk for suicide: (1) reconnecting the client to other people and instilling hope, (2)
restoring emotional stability and reducing suicidal behavior, and (3) ensuring safety.
Reconnecting the client interpersonally includes listening intently and without
judgment to the client’s thoughts and feelings, and validating the client’s experience
and suffering. This intervention directly challenges the client’s belief that no one
cares. Using cognitive interventions can help the client to regain hope. Restricting a
client’s activity can be very upsetting. Rather, the nurse should reduce the client’s
stress while ensuring safety by intruding as little as possible on the client’s exercise of
free will.
Multiple Choice
14. A client who has attempted suicide has an underlying diagnosis of depression.
Which of the following would the nurse anticipate being ordered for the client?
A) Selective serotonin reuptake inhibitor
B) Mood stabilizer
GRADESLAB.COM
C) Tricyclic antidepressant
D) Atypical antipsychotic
Ans: A
Chapter: 16
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 6
Page Number: 233
Feedback: Medication management focuses on treating the underlying psychiatric
disorder. For depression, a nonlethal antidepressant (e.g., selective serotonin
reuptake inhibitor) usually will be prescribed. For clients with schizophrenia and
schizoaffective disorder, antipsychotics may be used; however, only clozapine, an
atypical antipsychotic, has been shown to be effective.
15. The nurse is working with a client who will be signing a commitment to treatment
statement. After teaching the client about this statement, the nurse determines the
need for additional instruction when the client makes which statement?
A) “Signing this statement means that I will not commit suicide.”
B) “I am agreeing to get emergency treatment if I have suicidal thoughts.”
C) “I will be open and honest about my feelings about treatment.”
D) “I am agreeing to participate in the necessary treatment for my condition.”
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Ans: A
Chapter: 16
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 6
Page Number: 234
Feedback: Clients are usually ambivalent about wanting to die. The commitment to
treatment statement (CTS) directly addresses ambivalence about treatment by
asking the client to make a commitment to treatment. Different from the no-suicide
contract, the CTS does not restrict the client’s rights regarding the option of suicide.
Instead, the client agrees to engage in treatment and access emergency service if
needed. Underlying the CTS is the expectation that the client will communicate openly
and honestly about all aspects of treatment, including suicide. This commitment is
written and signed by the client.
16. A nurse is performing an assessment of a client with suicidal ideation. Which
question should the nurse ask to determine the degree of planning?
A) “How seriously do you want to die?”
B) “Have you attempted suicide before?”
C) “Could you stop yourself from killing yourself?”
D) “How much do the thoughts distress you?”
Ans: C
GRADESLAB.COM
Chapter: 16
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 6
Page Number: 232
Feedback: The question about stopping oneself from suicide reflects the degree of
planning. Asking the client about how seriously he wants to die and about previous
attempts of suicide reflect the client’s intent to die. Asking about how much the
thoughts are distressing reflects the severity of the ideation.
17. A nurse determines that a client has poor social skills that have interfered with
their ability to engage others, which has contributed to the client’s feelings of
purposelessness, hopelessness, and withdrawal. Which recommendation is most
important for the nurse to make in order to help the client begin to develop social
skills?
A) Self-help group
B) Recovery group
C) Interpersonal nurse–client relationship
D) Limit setting
Ans: C
Chapter: 16
Client Needs:
Psychosocial Integrity
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Cognitive Level: Understand
Integrated Process: Nursing Process
Objective: 6
Page Number: 234, 235
Feedback: Poor social skills may interfere with the client’s ability to engage others.
The nurse should assess the client’s social capability early in treatment and make
necessary provisions for social skills training. The interpersonal relationship with the
nurse is an ideal place to begin shaping social behaviors that will help the client
establish a social network that will sustain him during periods of discouragement or
crisis. Thereafter, participation in support networks such as recovery groups,
clubhouses, drop-in centers, self-help groups, or other therapeutic social engagement
will help the client become connected to others.
18. After educating a group of new nurses on various concepts involving suicide, the
nurse determines that the education was successful when the new nurses provide
which definition for the term parasuicide?
A) Voluntary act of killing oneself
B) All suicide-related behaviors and suicidal thoughts
C) Nonfatal act with the intent to die
D) Voluntary attempt without death as the aim
Ans: D
Chapter: 16
Client Needs: Psychosocial Integrity
GRADESLAB.COM
Cognitive Level: Remember
Integrated Process: Teaching/Learning
Objective: 2
Page Number: 224
Feedback: Parasuicide is a voluntary, apparent attempt at suicide, commonly called
a suicidal gesture, in which the aim is not death. Suicide is the voluntary act of killing
oneself. It is a fatal, self-inflicted destructive act with explicit or inferred intent to die.
Suicidality is all suicide-related behaviors and thoughts of completing or attempting
suicide and suicide ideation. A suicide attempt is a nonfatal, self-inflicted destructive
act with explicit or implicit intent to die.
19.
and
A)
B)
C)
D)
A nurse is with an adolescent who tells the nurse that there is nothing to live for
that the client just wishes to be dead. Which nursing action is appropriate?
Telling the client’s psychiatrist of the client’s suicidal ideation
Staying with the client to explore more of the client’s thoughts about suicide
Putting the client in seclusion with a staff assigned to watch the client at all times
Ascertaining the client’s beliefs about what happens when you die
Ans: B
Chapter: 16
Client Needs: Psychosocial Integrity
Cognitive Level: Understand
Integrated Process: Nursing Process
Objective: 6
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Page Number: 230
Feedback: A true psychiatric emergency exists when an individual presents with one
or more symptoms associated with imminent risk for suicidal behavior. The first
priority is to provide for the client’s safety while initiating the least restrictive care
possible. Staying with the client and further exploring his or her thoughts about
suicide will enhance safety and allow the nurse to more thoroughly understand the
extent of the client’s suicidal risk. It would not be appropriate to leave the client alone
while the nurse goes to talk with the psychiatrist. Seclusion would be used only as a
last resort because it is not the least restrictive environment. Determining the client’s
beliefs about death would be a topic to be addressed much later in the process.
Multiple Select
20. A nurse has discussed suicide prevention information with a client suffering with
moderately severe acute depression. Which client statement(s) demonstrates that
the implementation of effective suicide prevention education has occurred? (Select all
that apply.)
A. “My brother has been there for me and I am so grateful.”
B. “I have got some hope now that medication seems to be working.”
C. “It is sad when committing suicide seems to be your only option.”
D. “It felt good being able to help
GRmy
ADmom
ESLAwith
B.Cthe
OM house repair she needed done.”
E. “Going to the support group has certainly given my a lot if information about
depression.”
Ans: A, B, D, E
Chapter: 16
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 7
Page Number: 234
Feedback: When teaching the client and family about suicide and its prevention, the
following topics should be discussed and the client should be evaluated for
understanding and achievement of the related goals: Importance of emotional
connections to family and friends, importance of instilling hope, self-validation, and
information about treatment of underlying psychiatric conditions. The only
inappropriate option fails to present with alternative behaviors for suicidal thoughts
and/or actions.
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Test Generator Questions, Chapter 17, Mental Health Care for
Survivors of Violence
Multiple Choice
1. The nurse is talking to a client who is a survivor of intimate partner violence. The
client believes that their spouse has the characteristics of an antisocial personality
disorder. The client also informs the nurse that the spouse has an extensive criminal
record. The nurse interprets this information and suspects that the client’s spouse
would most likely demonstrate which behavior?
A) A risk for aggressive and assaultive violence toward people within and outside of
the family
B) Intermittent remorse for the violence and abuse committed
C) Symptoms of depression along with feelings of inadequacy
D) Purposefully remaining socially isolated from people other than those in the
family
Ans: A
Chapter: 17
Client Needs: Psychosocial Integrity
GRADESLAB.COM
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 3
Page Number: 240
Feedback: Evidence suggests that when people with borderline personality disorder
are distressed, they are predisposed to interpret social situations as threatening and
to respond with emotional dysregulation, verbal attacks, and physical violence.
People who meet the diagnostic criteria of antisocial personality disorder, have an
extensive history of criminal behavior, and who are generally violent are also more
likely to be both aggressive and assaultive. These perpetrators have a heightened
sensitivity to emotional displays that predispose them to interpret social situations as
threatening, and to respond with emotional dysregulation, verbal attacks, and
physical violence.
2. The nurse is caring for a young adult in the mental health clinic. The client tells the
nurse about the physical neglect that the client experienced as a child. The nurse
should assess the client for symptoms of which condition?
A) Major depression
B) Schizophrenia
C) Narcissistic personality disorder
D) Panic disorder
Ans: A
Chapter:
17
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 1
Page Number: 254
Feedback: An important outcome of nursing intervention with survivors is
appropriate treatment of any disorder resulting from abuse like acute stress disorder,
PTSD, anxiety disorders, dissociative identity disorder (DID), major depression, or
substance abuse.
3. The emergency department nurse is assessing a client with traumatic injuries. To
assess whether or not the client’s injuries have resulted from abuse, which question
would be most appropriate for the nurse to ask the client?
A) “Is your partner being mean to you?”
B) “Why do you think your spouse has beaten you?”
C) “It looks like someone has hurt you. Tell me about it.”
D) “Can you describe the person who did this to you?”
Ans: C
Chapter: 17
Client Needs: Psychosocial Integrity
Cognitive Level: Remember
Integrated Process: Nursing Process
Objective: 5
GRADESLAB.COM
Page Number: 252
Feedback: The nurse should say to the client, “It looks like someone has hurt you.
Tell me about it.” This is an open-ended statement and allows the client to verbalize
her thoughts and feelings. Asking if the partner is being mean or asking why the client
thinks the spouse has beaten him or her already assumes that the client has been
abused. Asking about the person who did this would be ineffective because survivors
of violence are unlikely to disclose sensitive information unless they perceive the
nurse to be trustworthy and nonjudgmental. Additionally, this question is a closed
question that does not allow the client to verbalize her thoughts and feelings openly.
4. A client has been admitted to the inpatient psychiatric facility with a diagnosis of
posttraumatic stress disorder after a history of violence by the client’s significant
other. During the initial assessment interview, which assessment would be the
priority?
A) Nutritional status
B) Hydration status
C) Sleep patterns
D) Suicide risk
Ans: D
Chapter: 17
Client Needs: Psychosocial Integrity
Cognitive Level: Understand
Integrated Process: Nursing Process
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Objective: 5
Page Number: 245
Feedback: The first, and most important, assessment conducted is a lethality
assessment that determines whether the survivor is in danger for his or her life, either
from homicide or suicide and, if children are in the home, whether they are in danger.
Then the physiologic areas such as nutrition, hydration, and sleep areas can be
assessed.
5. The nurse is caring for a family in which the elderly mother has been a victim of
abuse and neglect by her son, 48 years of age. Which is important for the nurse to
keep in mind before interviewing the family?
A) A top nursing priority would be to legally remove the son from the home.
B) The main focus of the nurse’s actions should be on improving the elderly mother’s
self-esteem.
C) The nurse must allow the older adult mother to decide whether she wants to leave
the situation.
D) Placement of the older adult woman in a nursing home within the community is
crucial.
Ans: C
Chapter: 17
Client Needs: Psychosocial Integrity
Cognitive Level: Understand
Integrated Process: Nursing Process
GRADESLAB.COM
Objective: 3
Page Number: 245
Feedback: Removing children and older adults from their families or caregivers often
is necessary to ensure immediate safety. If the home of an abused or neglected child
or older adult cannot be made safe, the nurse must facilitate other professionals
involved in placing the child or older adult in a foster home or nursing home. Still,
intervening in cases of elder abuse is not a clear-cut issue. When an older adult’s
decision making is not impaired (competence is the legal term), he or she must be
allowed an appropriate degree of autonomy in deciding how to manage the problem,
even if the choice is to remain in the abusive situation. Forcing someone to do
something against his or her wishes is in itself a form of victimization and denies
autonomous decision making.
6. A nurse is working with a client who is anticipating the possibility of leaving an
abusive relationship. In helping the client make the decision to leave or to stay in the
abusive situation, which is appropriate for the nurse to do?
A) Ensure that the client can effectively describe the behaviors inherent in each
phase of the cycle of domestic violence.
B) Inform the client that if she leaves the abusive situation, there is a possibility her
partner will attempt to murder her.
C) Assist the client in finding a new apartment and a new job so she will be safe after
she leaves her current situation.
D) Suggest that the client legally change her name and move out of state so she will
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
be safe from future harm.
Ans: B
Chapter: 17
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 5
Page Number: 253
Feedback: Survivors must understand the cycle of violence and the danger of
homicide that increases as violence escalates, or when the survivor attempts to leave
the relationship. Although survivors also need information about resources (e.g.,
shelters for battered women), legal services, government benefits, and support
networks, the nurse needs to first discuss the possibility of the perpetrator’s reaction
and the possibility of extreme violence leading to death.
7. The school nurse is aware that a student has requested “Tylenol” three times
during the past week because his “back hurts.” The nurse has noticed that he often
wears long-sleeved sweaters and sweatshirts, even in warm weather. The nurse
suspects that the student may be the victim of physical abuse. The nurse is preparing
to ask the child about his ongoing backache. Which would the nurse anticipate the
child reporting if the child was indeed being abused?
A) Explain that his father is beating him on a regular basis.
RADESLofAB
.COMor fear of retaliation.
B) Be reluctant to report abuseGbecause
shame
C) Give the same reason the client’s sister would give were she asked to explain the
injuries.
D) Carefully explain that the client’s mother provides discipline because she loves
the client.
Ans: B
Chapter: 17
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 1
Page Number: 246
Feedback: Most survivors do not report violence to health care workers without
specifically being asked about it. Survivors may be reluctant to report abuse because
of shame and fear of retaliation, especially if the victim depends on the abuser as
caregiver. In addition, children may fear they will not be believed.
8. A nurse is presenting a program to a church group about domestic violence.
During the presentation, a member of the audience asks the nurse to explain what
“intergenerational transmission of violence” means because he has seen that phrase
used in the media. Which response by the nurse is most appropriate?
A) “People who are violent are that way because of the various neurochemical
imbalances in their brains.”
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
B) “People who grow up in violent home situations tend to be involved in domestic
violence situations as an adult.”
C) “Recent research has identified a gene that is responsible for transmission of a
risk for violent behavior that is passed on from generation to generation.”
D) “Domestic violence seems to skip every other generation when it is traced in
families.”
Ans: B
Chapter: 17
Client Needs: Psychosocial Integrity
Cognitive Level: Understand
Integrated Process: Teaching/Learning
Objective: 2
Page Number: 243
Feedback: Violent families create an atmosphere of tension, fear, intimidation, and
tremendous confusion about intimate relationships. Children in violent homes often
learn violent behavior as an approved and legitimate way to solve problems,
especially within intimate relationships. Social learning or intergenerational
transmission of violence theory posits that children who witness violence in their
homes often perpetuate violent behavior in their families as adults. Moreover,
children who grow up in violent homes learn to accept violence and expect it in their
own adult relationships. Neurochemical imbalances, genetics, or skipping generations
are unrelated to this theory.
GRADESLAB.COM
9. A nurse is assessing a survivor of intimate partner violence. During the interview,
the nurse determines that the survivor’s partner is using power and control over the
client through coercion and threats. Which client statement would lead the nurse to
suspect this?
A) “He always tells me that the abuse never happened.”
B) “He tells me who I can and cannot see.”
C) “He tells me that he’ll tell child services I’m a bad parent.”
D) “He acts like he’s the master of his castle and I’m his servant.”
Ans: C
Chapter: 17
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 1
Page Number: 241
Feedback: The statement about telling child services that the client is a bad parent
reflects coercion and threats. The statement about the abuse never happening
reflects power and control through minimizing, denying, and blaming. The statement
about whom the client can and cannot see reflects power and control through the use
of isolation. The statement about the partner being the master of his castle reflects
power and control through the use of the male privilege.
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
10. A nurse is reviewing information about intimate partner violence (IPV). The
nurse demonstrates understanding of this topic when the nurse identifies which
information?
A) Men are more likely to be seriously injured even though more women are typically
victims.
B) Victims in same-sex couples often receive less support.
C) IPV in same-sex couples occurs less frequently as compared with heterosexual
relationships.
D) The reactions to IPV are similar in male and female victims.
Ans: B
Chapter: 17
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Teaching/Learning
Objective: 1
Page Number: e-16, 240
Feedback: Nonheterosexual couples experience IPV at rates similar to heterosexual
couples, but victims often receive less support as a result of social stigma associated
with nontraditional relationships. Nearly one in four women and one in nine men are
victims of IPV at some point in their lives. Women are much more likely than men to
be seriously injured as a result of IPV and to require medical treatment. The reaction
to IPV may differ by gender.
GRADESLAB.COM
11. A group of newly hired nurses is receiving training about the types of abuse. The
nurses demonstrate understanding of the information when they identify a pattern of
repeated unwanted contact, attention, and harassment that often increases in
frequency as which crime?
A) Rape
B) Stalking
C) Sexual assault
D) Intimate partner violence
Ans: B
Chapter: 17
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 1
Page Number: e-18, 242
Feedback: Stalking is a pattern of repeated unwanted contact, attention, and
harassment that often increases in frequency. Stalkers harass and terrorize their
victims through behavior that causes fear or substantial emotional distress. Stalking
may include such behaviors as following someone, showing up at the person’s home
or workplace, vandalizing property, using technology to track or harass someone, or
sending unwanted gifts.. Rape is a crime of violence. Sexual assault is any form of
nonconsenting sexual activity. Intimate partner violence occurs on a continuum and
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
can involve the other types of violence listed here.
12. A nurse is assessing a client who is a survivor of abuse. Which form of evaluation
is appropriate to use when conducting a lethality assessment?
A) Danger Assessment Screen
B) Abuse Assessment Screen
C) Burgess-Partner Abuse Scale
D) Beck Depression Inventory
Ans: A
Chapter: 17
Client Needs: Psychosocial Integrity
Cognitive Level: Understand
Integrated Process: Nursing Process
Objective: 5
Page Number: 245
Feedback: The Danger Assessment Screen developed by Jacquelyn Campbell and
colleagues is a useful tool for assessing the risk that either the adult survivor or
perpetrator will commit homicide. It would be appropriate to use when conducting a
lethality assessment. The Abuse Assessment Screen and Burgess-Partner Abuse
Scale are appropriate tools to use to screen for violence and abuse. The Beck
Depression Inventory is used to screen for depression.
13. A nurse is interviewing a client who is a survivor of abuse. The client is telling the
GRADEWhich
SLABstatement
.COM
nurse about how the violence occurred.
would the nurse interpret as
reflecting phase 3 of the cycle of violence?
A) “He threw me against the wall and started punching my face.”
B) “He yells at me for not having dinner waiting for him when he comes home.”
C) “He calls me stupid and incompetent, asking himself why he ever married me.”
D) “He tells me that he is sorry and that he will never hit me again.”
Ans: D
Chapter: 17
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 2
Page Number: 244
Feedback: During phase 3 of the cycle, the perpetrator becomes kind, contrite, and
loving, begging for forgiveness and promising never to inflict abuse again. The actual
violence occurs in phase 2. Yelling at the client for not having dinner ready and calling
her stupid and incompetent reflect phase 1, or tension building.
14. A nurse is developing a safety plan with a client who is a survivor of violence.
Which aspect of the plan would the nurse address first?
A) Devising an escape route
B) Recognizing the signs of danger
C) Identifying a safe place to hide
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
D)
Identifying a signal to indicate it is safe to leave
Ans: B
Chapter: 17
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Teaching/Learning
Objective: 5
Page Number: 251
Feedback: One of the most important teaching goals is to help survivors develop a
safety plan. The first step in developing such a plan is helping the survivor recognize
the signs of danger. Changes in tone of voice, use of alcohol and other drugs (AOD),
and increased criticism may indicate that the perpetrator is losing control. Detecting
early warning signs helps survivors to escape before battering begins. The next step
is to devise an escape route. This involves mapping the house and identifying where
the battering usually occurs and what exits are available. The survivor needs to have
a bag packed and hidden, but readily accessible, containing what is needed to get
away. If children are involved, the adult survivor should make arrangements to get
them out safely. That might include arranging a signal to indicate when it is safe for
them to leave the house and to meet at a prearranged place. A safety plan for a child
or dependent older adult might include safe places to hide and important telephone
numbers, including 911, police and fire departments, and other family members and
friends.
GRADESLAB.COM
Multiple Select
15. An adolescent client has recently ended a physically and emotionaly abusive
initimate relationship. What nursing assessment question(s) will help identify a
commonly associated comorbid mental health problem? (Select all that apply.)
A)
“How much alcohol do you drink in an average week?”
B)
“Do you ever have thoughts of hurting or killing yourself?”
C)
“Are your teachers satisfied with the grades you earn in school?”
D)
“How would you alter your eating habits in order to lose wieght?”
E)
“Has anyone every told you that you had a problem with your temper?”
Ans: A, B, C, D
Chapter: 17
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Nursing Process
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Objective: 1
Page Number: 240
Feedback: Adolescents who experience violence in intimate relationships are more
likely to develop problems such as depression with consideration of suicide, substance
use disorders including alcohol use disorder, eating disorders resulting in weight loss,
and poor school performance. While not impossible, anger management issues are
not as commonly associated with this client’s situation.
Multiple Choice
16. The nurse provides care to individuals who have been sexually assaulted during
their childhood. Which characteristic is most commonly noted by the nurse during an
assessment of such clients?
A)
Overly self-confident
B)
Unusually aggressive
C)
Overly social
D)
Too trustful
GRADESLAB.COM
Ans: B
Chapter: 17
Client Needs: Psychosocial Integrity
Cognitive Level: Understand
Integrated Process: Assessment
Objective: 1
Page Number: 242
Feedback: A child who is a survivor of prolonged sexual abuse will develop low
self-esteem, as well as developing feelings of worthlessness, and become socially
withdrawn, distrustful, or suicidal. Other characteristics of children who have been
sexually abused include becoming unusually aggressive.
17. Which assessment finding should cause the nurse the greatest concern regarding
the possible abuse of an older adult client?
A)
Has lost weight since breaking an ankle
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
B)
Has developed a urinary tract infection
C)
Sends money every month to each adult child
D)
Often cries, mourning the recent death of a beloved pet
Ans: C
Chapter: 17
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 1
Page Number: 242
Feedback: Older adults may be victims of physical, psychological, or sexual abuse.
The most common type of elder abuse is financial abuse, in which older adults may be
manipulated by family or caregivers to give up control of their money. While all
options could be explained by non-abusing situations, the option regarding money is
the most troublesome and should be researched further to confirm the lack of possible
GRADESLAB.COM
financial abuse.
18. A client has been in a physically abusive relationship for more than a decade.
Which statement best demonstrates that the client understands of how fear can
influence a reluctance to leave such a relationship?
A)
“My partner would hunt me down and kill me for sure.”
B)
“The kids love my partner and my partner has been a good parent to them.”
C)
“I do not have a job or anyway to support myself and my kids.”
D)
“No one would believe me if I tell them how terrible life has been.”
Ans: A
Chapter: 17
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 3
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Page Number: 244, 245
Feedback: Leaving an abusive relationship is a process that can be quite complex.
Fear is one of the most important factors in deciding whether to leave or to stay in a
violent relationship. Victims recognize the valid concern that leaving may not stop the
violence. If victims attempt to leave or actually do leave the relationship, perpetrators
often escalate their violence, stalk their partners, and may even kill them, which
makes leaving the time of greatest risk in intimate partner violence. While all the
options present reasons to stay, the most compelling is fear of future violence and
possible death.
Multiple Select
19. A person found quilty of physically abusing a domestic partner is offered
participation in a rehabilitation program as part of the sentencing process. What
information should the nurse provide the individual in order to make an informed
decision about accepting the offer? (Select all that apply.)
A)
The program will likely last between 36 weeks and 5 years.
B)
No contact with the abused partner and/or children will be allowed.
C)
The participant is responsible for paying a fee to cover program expences.
D)
If alcohol is a factor, sobriety during the entire period of the program is
GRADESLAB.COM
mandatory.
E)
When applicable, random drug testing is a criteria of the program’s acceptance.
Ans:
A, D, E
Chapter: 17
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 6
Page Number: 254
Feedback: Programs meet weekly for an extended period of time, often 36 to 48
weeks. Some programs advocate longer programs, believing that chronic offenders
require from 1 to 5 years of treatment to change abusive behavior. When applicable,
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
intervention programs may require abusers to undergo substance use treatment
concurrently, so clients are required to remain sober and to submit to random drug
testing. States vary on requiring that treatment programs for abusers contact
partners and there is usually no fee if the program is mandated by the court.
20. The nurse is providing care to client who is currently in a sexually abusive
relationship. To best manage the development of additional comorbid disorders, what
question(s) should the nurse ask this client? (Select all that apply.)
A)
“What community resources related to HIV and pregnancy are you aware of?”
B)
“What are the early symptoms of posttraumatic stress disorder (PTSD)?”
C)
“Are you aware of self-defense strategies to physically protect oneself?”
D)
“Do you have a safety and escape plan in place?”
E)
“What do you do to avoid angering your abuser?”
Ans: A, B, D
Chapter: 17
GRADESLAB.COM
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Communication and Documentation
Objective: 5
Page Number: 253
Feedback: Information should focus on effective safety and health promotion
interventions including relevant health screenings, early symptom identification, and
safety plans. Physical self-defense strategies may be acquired but they are an
established method of assuring safety in abusive situations. The anger is
unpredictable, unavoidable, and outside the control of the abused.
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Test Generator Questions, Chapter 18, Anxiety Disorders:
Nursing Care of Patients With Anxiety, Phobia, and Panic
Multiple Choice
1. The nurse is planning a presentation to a community group on the topic of anxiety
disorders. Which statement would the nurse include when describing panic disorder?
A) Individuals may believe they are having a heart attack when a panic attack
occurs.
B) People with panic attacks often have fewer attacks if they also have agoraphobia.
C) Typically, individuals experience this disorder after the age of 30 years.
D) Persons rarely have an underlying comorbid condition of depression.
Ans: A
Chapter: 18
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 4
Page Number: 261, 262
GRA
ESLAdisorder
B.COMmay believe they are having a
Feedback: Clients diagnosed with
aD
panic
heart attack when a panic attack occurs. Panic disorder peaks during the teenage
years and does not usually manifest after the age of 30 years. Individuals with panic
disorder (with or without agoraphobia) experience recurrent and unexpected panic
attacks.
2. A client comes to the emergency department because he thinks he is having a
heart attack. Further assessment determines that the client is not having a heart
attack but is having a panic attack. When beginning to interview the client, which
question would be most appropriate for the nurse to use?
A) “Are you feeling much better now that you are lying down?”
B) “What did you experience just before and during the attack?”
C) “Do you think you will be able to drive home?”
D) “What do you think caused you to feel this way?”
Ans: B
Chapter: 18
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 5
Page Number: 261, 262
Feedback: After it has been determined that the client does not have other medical
problems, the nurse should assess for the characteristic symptoms of panic attack,
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
focusing the questions on what the client was experiencing just before and during the
attack. Asking the client if he feels better provides no information for the nurse and
lying down may or may not be effective. Asking the client if he thinks he can drive
home is a question that can be asked much later in the interview, after the attack
subsides and the client is stable. Asking the client about what caused the attack is
inappropriate because numerous stimuli, both external and internal, can provoke an
attack. Most clients will not be able to identify a specific cause. The focus of care is on
the characteristics of the attack.
3. A client with a panic disorder has been prescribed a benzodiazepine medication.
Which risk would the nurse emphasize as being associated with using this medication?
A) Dietary restrictions
B) Withdrawal symptoms
C) Agitation
D) Fecal impaction
Ans: B
Chapter: 18
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 5
Page Number: 272
Feedback: Although benzodiazepines are well tolerated and tremendously useful in
GRADESthey
LAB.
COMthe risks of physical dependence
treating intensely distressed individuals,
carry
and withdrawal symptoms with discontinuation. Dietary restrictions are not necessary
with benzodiazepines. Sedation, rather than agitation, occurs with this class of drugs.
Fecal impaction is not associated with benzodiazepines.
4. A client is diagnosed with panic disorder. The client hasn’t left the house in more
than a month because the client is afraid of being attacked. The client visited the
mental health clinic today only because a family member came along. Which nursing
diagnosis would be a priority for this client?
A) Powerlessness related to symptoms of anxiety
B) Decisional Conflict related to fear of leaving the house
C) Ineffective Family Coping related to symptoms of anxiety
D) Social Isolation related to fear of recurrence of anxiety symptoms
Ans: D
Chapter: 18
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 5
Page Number: 269, 277
Feedback: The priority nursing diagnosis for the client is Social Isolation related to
fear of recurrence of anxiety symptoms. The client’s fear has led the client to avoid
leaving the house. Powerlessness would be reflected in statements addressing
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
feelings related to loss of control. Decisional Conflict would be reflected in statements
about which way to act. Ineffective Family Coping would be reflected in statements
about the family, and their inability to address or deal with the client's condition.
5. The nurse has instructed a client with panic disorder about how to use the
technique of positive self-talk. The nurse determines that the client has understood
the instructions when the client verbalizes which statement to use during an
impending panic attack?
A) “I am feeling very nervous right now.”
B) “I can handle this anxiety; it will be over shortly.”
C) “I am taking medication to eliminate these symptoms.”
D) “Relax your muscles, relax your muscles.”
Ans: B
Chapter: 18
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 5
Page Number: 274
Feedback: An example of positive self-talk is when the client says, “This is only
anxiety; it will be over shortly.” These types of positive statements can give the
individual a focal point and reduce fear when panic symptoms begin.
GRADwith
ESLpanic
AB.Cdisorder
OM
6. A client who has been diagnosed
visits the clinic and
experiences a panic attack. The client tells the nurse, “I’m so nervous. My hands are
shaking, and I’m sweating. I feel as if I’m having a stroke right now.” What would be
the priority intervention at this time?
A) Stay with the client while remaining calm
B) Move the client to a safe environment
C) Tell the client that the attack will soon pass
D) Teach the client deep breathing techniques to calm her
Ans: A
Chapter: 18
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 5
Page Number: 276
Feedback: The first nursing intervention should be to stay with the client while
remaining calm. A calm presence will help to relax the client. The nurse should use
short sentences to provide clear directions and then assist the client to an
environment with minimal stimuli. The client experiencing panic is unable to process
information, so telling the client that the attack will soon pass would be ineffective.
Educating the client on deep breathing techniques would be appropriate later, after
the panic subsides and the client is amenable to hearing and processing information.
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
7. A nurse who has worked with a client diagnosed with generalized anxiety disorder
(GAD) when he was an inpatient on the psychiatric unit sees the client in the waiting
room of the outpatient psychiatric clinic. The client tells the nurse how things have
been going since he was discharged. The nurse determines that the client's therapy
has been effective when the client makes which statement?
A) “I am still experiencing quite a bit of stress at home and at work; things are
different at home than they were in the hospital.”
B) “When my mother-in-law comes over now, I go out to my workshop and work on
one of my projects.”
C) “I’m still drinking coffee; I can’t quit after drinking it all these years.”
D) “I’ve learned having a beer after I get home from work helps me relax.”
Ans: B
Chapter: 18
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 6
Page Number: 274
Feedback: Evaluation should focus on the individual’s ability and skills in using
techniques that control anxiety, such as relaxation, positive self-talk, and stress
management. Reducing personal and environmental stress (e.g., removing himself
from his mother-in-law's company) can indicate success, as can incorporating
practices that foster relaxation into daily routines. Although alcohol is relaxing for this
GRADESLand
AB.encouraging
COM
client, it has the potential for dependency,
its routine use should be
avoided. The statement about stress and things being different at home indicate that
the client is still experiencing anxiety. Caffeine is a stimulant and should be avoided.
8. The nurse is caring for a client who is being treated in the emergency department
for a panic attack. Which nursing intervention would be most appropriate?
A) Demonstrate empathy for the client by trying to mimic the client’s state of
anxiety.
B) Tell the client that you must leave to go report his symptoms to the psychiatrist
on duty.
C) Tell the client this is an acute exacerbation with a positive prognosis and low
morbidity.
D) Stay with the client, emphasizing that he is safe and that you will remain with
him.
Ans: D
Chapter: 18
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 5
Page Number: 276
Feedback: It is important to stay with the client and remain calm to help relax the
client. Trying to mimic the client’s symptoms would further add to the client’s anxiety
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
level. It is also important to stress that you will stay with the client and that the client
is safe. The nurse should use clear, concise directions and short sentences. Medical
jargon, such as telling the client this is an acute exacerbation with a positive
prognosis, should be avoided.
9. A nurse determines that a client who is experiencing anxiety is using relief
behaviors. The nurse determines that the client is experiencing which degree of
anxiety?
A) Mild
B) Moderate
C) Severe
D) Panic
Ans: C
Chapter: 18
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 2
Page Number: 258
Feedback: A client experiencing severe anxiety typically uses relief behaviors. With
mild anxiety, the client is able to recognize and name anxiety easily. With moderate
anxiety, the client is usually able to state that he or she is anxious. With panic, the
client is perplexed and self-absorbed.
GRADESLAB.COM
10. A group of new nurses is reviewing information about anxiety disorders in
preparation for their first day on the job. The nurses demonstrate understanding of
the material when they make what statement?
A) Anxiety disorders rank second to depression in psychiatric illnesses being treated.
B) Women experience anxiety disorders more often than do men.
C) Most anxiety disorders tend to be short term with individuals achieving full
recovery.
D) Anxiety disorders are more common in children than in adolescents.
Ans: B
Chapter: 18
Client Needs: Psychosocial Integrity
Cognitive Level: Understand
Integrated Process: Nursing Process
Objective: 3
Page Number: 261
Feedback: Women experience anxiety disorders more often than do men by a 2:1
ratio. Anxiety disorders are the most common of the psychiatric illnesses treated by
health care providers. They tend to be chronic and persistent illnesses with full
recovery more likely among those who do not have other mental or physical illnesses.
Anxiety disorders are the most common condition of adolescents, with one in three
having an anxiety disorder.
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
11. During an interview with a nurse, the client reports an intense fear of spiders,
stating, “I can’t be near them. I get so upset. I start to sweat and hyperventilate if I
see one.” The nurse documents this as what finding?
A) Algophobia
B) Entomophobia
C) Arachnophobia
D) Cynophobia
Ans: C
Chapter: 18
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 1
Page Number: 278
Feedback: The client is describing arachnophobia, a fear of spiders. Algophobia is a
fear of pain, entomophobia is a fear of insects, and cynophobia is a fear of dogs.
Multiple Select
12. When caring for a client with panic disorder, the nurse knows that which
neurotransmitters are implicated in this disorder? (Select all that apply.)
A) Dopamine
B) Serotonin
GRADESLAB.COM
C) Norepinephrine
D) Gamma-aminobutyric acid (GABA)
E) Acetylcholine (Ach)
Ans: B, C, D
Chapter: 18
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Teaching/Learning
Objective: 4
Page Number: 263, 264
Feedback: Biologic theories suggest involvement of serotonin, norepinephrine, and
GABA as playing a role in panic disorder. Neither dopamine nor acetylcholine is
associated with this condition.
Multiple Choice
13. A nurse is preparing an in-service presentation about panic disorders and
associated theories related to the cause. When describing the cognitive behavioral
concepts associated with panic disorders, which issue would the nurse expect to
address?
A) Personal losses
B) Conditioned response
C) Early separation
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
D)
Dysfunctional family communication
Ans: B
Chapter: 18
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 4
Page Number: 264
Feedback: Learning theory underlies most cognitive behavioral explanations of
panic disorder with classic conditioning and interoceptive conditioning as the basis.
Classic conditioning theory
suggests that one learns a fear response by linking an adverse or fear-provoking
event, such as a car accident, with a previously neutral event, such as crossing a
bridge. One becomes conditioned to associate fear with crossing a bridge. Personal
losses and separation reflect psychodynamic theories. Families affected by panic
disorder have difficulty with overall communication, reflecting the family response to
the disorder.
14. A nurse is developing the plan of care for a client with panic disorder that will
include pharmacologic therapy. Which medication does the nurse most likely expect
to administer?
A) Benzodiazepine
B) Selective serotonin reuptake inhibitor (SSRI)
RADESLAB.COM
C) Monoamine oxidase inhibitorG(MAOI)
D) Tricyclic antidepressant (TCA)
Ans: B
Chapter: 18
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 5
Page Number: 271
Feedback: Although all of the agents can be used to treat panic disorder, SSRIs are
recommended as the first drug option for treatment. Benzodiazepines (antianxiety
agents) are used only for short periods of time. MAOIs are reserved for clients who do
not respond to SSRIs or serotonin–norepinephrine reuptake inhibitors (SNRIs). The
use of tricyclic antidepressants is declining.
Multiple Select
15. A client with panic disorder who has been prescribed sertraline in conjunction
with alprazolam comes to the clinic for a follow-up. The client states, “I stopped taking
the alprazolam about two days ago. I was feeling really sleepy and tired.” Which
symptom would alert the nurse to suspect possible withdrawal? (Select all that apply.)
A) Apprehension
B) Irritability
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
C) Dry, flushed skin
D) Weight gain
E) Muscle flaccidity
Ans: A, B
Chapter: 18
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 5
Page Number: 273
Feedback: Symptoms associated with withdrawal of benzodiazepine therapy are
more likely to occur after high doses and long-term therapy. They can also occur after
short-term therapy. Withdrawal symptoms manifest in several ways, including
psychological (apprehension, irritability, agitation).
Multiple Choice
16. A nurse is providing to a client information about the etiology of generalized
anxiety disorder (GAD). The client demonstrates understanding of this information
when they identify which item as representing the basis for this disorder?
A) Inaccurate environmental danger assessment
B) Exposure to multiple stressful life events
C) Kindling caused by overstimulation
GRAwork
DESLorABsimple
.COMfamily life.
D) Intense worry and stress about
Ans: D
Chapter: 18
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Teaching/Learning
Objective: 4
Page Number: 277
Feedback: Adults with GAD often worry about matters such as their job, household
finances, health of family members, or simple matters (e.g., household chores or
being late for appointments). The intensity of the worry fluctuates, and stress tends to
intensify the worry and anxiety symptoms. Cognitive behavioral theory regarding the
etiology of GAD proposes that the disorder results from inaccurate assessment of
perceived environmental dangers. Although there are no specific sociocultural
theories related to the development of GAD, a high-stress lifestyle and multiple
stressful life events may be contributors. Kindling results from overstimulation or
repeated stimulation of nerve cells by environmental stressors.
Multiple Select
17. A nurse is explaining to a client the signs and symptoms associated with anxiety.
The client demonstrates an understanding of the information when they identify which
symptoms as cognitive symptoms? (Select all that apply.)
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
A)
B)
C)
D)
E)
F)
Edginess
Feelings of unreality
Difficulty concentrating
Tunnel vision
Apprehensiveness
Speech dysfluency
Ans: B, C, D
Chapter: 18
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 1
Page Number: 258, 259
Feedback: Cognitive symptoms include feelings of unreality, difficulty
concentrating, and tunnel vision. Edginess and apprehensiveness are affective
symptoms. Speech dysfluency is a behavioral symptom.
18. A nurse is preparing a presentation about social anxiety disorder. Which
information will the nurse include when describing a person with this condition?
(Select all that apply.)
A) Fear that others will judge them negatively
B) Openly speak up in crowds to reduce fear
C) Are insensitive to other’s criticism
GRof
ADtheir
ESLown
AB.strengths
COM
D) Demonstrate a distorted view
E) Exaggerate personal flaws
Ans: A, D, E
Chapter: 18
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 1
Page Number: 278
Feedback: People with social anxiety disorder fear that others will scrutinize their
behavior and judge them negatively. They often do not speak up in crowds out of fear
of embarrassment. They go to great lengths to avoid feared situations. If avoidance is
not possible, they suffer through the situation with visible anxiety. People with social
anxiety disorder appear to be highly sensitive to disapproval or criticism, tend to
evaluate themselves negatively, have poor self-esteem, and a distorted view of their
personal strengths and weaknesses. They may magnify their personal flaws and
underrate their talents.
Multiple Choice
19.A nurse was confronted by pharmacy staff about a medication error that was
detected in the automated dispensing device. The medication administered to a
client receiving palliative care may have caused an earlier demise because the
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
A)
B)
C)
D)
medication decreases the client’s respiratory rate significantly when given at the
administered dose. Which of the following statements by the nurse displays the
use of rationalization?
“Thank you for pointing this error out. I will fill out an incident report
immediately.”
“Please don’t tell my supervisor. She will put me on probation if she knows this
information.”
“I didn’t think I needed to disclose this error since the client is going to die
anyway.”
“Are you sure I made this error? I can’t recall this incident.”
Ans: C
Chapter: 18
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 1
Page Number: 260
Feedback: Rationalization is when one avoids anxiety by explaining an unacceptable
or disappointing behavior or feeling in a logical, rationale way. May protect
self-esteem and
self-concept. Suppression reduces anxiety by intentionally avoiding thinking about
disturbing problems, wishes, feelings or experiences. Useful in many situations such
as test taking situations. Denial avoids feelings associated with recognizing a
GRADESLAB.COM
problem.
Multiple Select
20.If a client is experiencing “moderate” anxiety, which clinical manifestations will the
nurse observe? (Select all that apply.)
A) Can sustain attention on a particular focus.
B) Verbally states, “For some reason, I am feeling anxious now.”
C) Flights of ideas and confusion noted.
D) Because of inadequacy of observed data, they make distorted inferences.
E) May pace, run, or fight violently if asked to perform a task they do not want to
perform.
Ans: A, B
Chapter: 18
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 2
Page Number: 258
Feedback: With “moderate” anxiety, the client sees, hears, and grasps less than
previously. The client can attend to more if directed to do so. They are able to sustain
attention on a particular focus; selectively inattentive to contents outside the focal
area. Usually able to state, “I am anxious now.” With severe anxiety, Inferences
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
drawn may be distorted because of inadequacy of observed data. With panic, the
client has feelings of unreality, flights of ideas or confusion, and fear. They often
repeat a detail. Many relief behaviors used automatically (without thought). The
enormous energy produced by panic must be used and may be mobilized as rage. May
pace, run, or fight violently.
GRADESLAB.COM
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Test Generator Questions, Chapter 19, Trauma- and StressorRelated Disorders: Nursing Care of Persons With Posttraumatic
Stress and Other Trauma-Related Disorders
Multiple Select
1. The nurse is assessing a client with posttraumatic stress disorder (PTSD). Which
symptoms would the nurse categorize as reflecting intrusion? (Select all that
apply.)
A) Irritability
B) Difficulty sleeping
C) Flashbacks
D) Acting as if the event is reoccurring
E) Dissociation
Ans: B, C, D, E
Chapter: 19
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Nursing Process
GRADESLAB.COM
Objective: 4
Page Number: 284
Feedback: Intrusion is reflected by flashbacks and nightmares as well as altered
memory function. Intrusive symptoms also include dissociative reactions (feeling or
acting as if the event is reoccurring). Irritability and difficulty sleeping reflect
hyperarousal. Dissociation reflects avoidance and numbing.
2. A client is admitted to the inpatient adult psychology unit with posttraumatic
stress disorder (PTSD). During the assessment, what events would the nurse
consider to be causes of psychological trauma? (Select all that apply.)
A) Experienced abuse from a former partner.
B) Was raped while walking home from work one evening.
C) Lost their mother with whom they had very close to relationship.
D) Had a car accident where they suffered head trauma.
E) Regularly cuts their wrists as a form of self-inflected trauma.
Ans: A, B, C, D, E
Chapter: 19
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 4
Page Number: 282, 283
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Feedback: Harassment, embarrassment, child abuse, sexual abuse, employment
discrimination, police brutality, bullying, and domestic violence are examples of
events that can lead to psychological trauma. Family violence, loss of family
members, acts of terrorism and natural disasters are all traumatic events. Physical
trauma may result from bodily injury resulting from an accident, self-inflicted
damage, or violence perpetrated by others. Automobile accidents are a major
threat to adolescents. Self-inflicted physical trauma is often associated with mental
disorders.
3. Which statement is accurate with regard to resilience in clients who have
experienced PTSD? (Select all that apply.)
A) The stronger the resilience, the less likely the person will develop maladaptive
behaviors.
B) When one is feeling out of control in one’s life, resilience is no longer possible.
C) As positive self-concept increases, resilience will also increase over time.
D) Everyone who experiences a traumatic event can develop resilience.
E) Only those with supportive family can develop resilience.
Ans: A, C
Chapter: 19
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
GRADESLAB.COM
Objective: 2
Page Number: 283
Feedback: The stronger the resilience, the less likely the individual will experience
reactions that lead to maladaptive behaviors and outcomes. An important mental
health promotion nursing strategy is enhancing resilience, especially for persons
with mental and/or substance abuse problems. Resilience develops in association
with a positive self-concept and self-worth, a feeling of being in control of one’s life,
and a feeling of power. Resilience is acquired over time, Positive family and
community support also play a role in developing resilience.
Multiple Choice
4. An abused child has been placed in a loving foster home. The foster parents
express concern when the child has not developed a positive attachment after
living in their home for the past 9 months. The case manager concludes that the
child has developed which condition?
A) Acute stress disorder
B) Adjustment disorder
C) Disinhibited social engagement disorder
D) Reactive attachment disorder
Ans: D
Chapter: 19
Client Needs: Psychosocial Integrity
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 4
Page Number: 293
Feedback: Reactive attachment disorder (children) is defined as an inability to
develop positive attachments to caregivers because of prior social neglect. Acute
stress disorder is when the child develops symptoms of PTSD 3-7 days after the
traumatic event. Adjustment disorder is when the child develops emotional
symptoms in response to a stressful event that doesn’t meet the criteria of PTSD.
Disinhibited social engagement disorder is when the child is inappropriate and
overly familiar with strangers.
Multiple Select
5. When presenting about PTSD to a community group, the nurse gives examples
of traumatic events that may precede PTSD. Which events does the nurse
include? (Select all that apply.)
A) Personal assault by a family member
B) Military combat mission where there were casualties
C) Surviving an EF 4 tornado
D) Falling off a playground swing
E) Urinary incontinence due to prolapsed bladder
Ans: A, B, C
GRADESLAB.COM
Chapter: 19
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 4
Page Number: 284
Feedback: Examples of traumatic events are violent personal assault, rape, military
combat, natural disasters, terrorist attacks, being taken hostage, incarceration as a
prisoner of war, torture, an automobile accident, or being diagnosed with a lifethreatening illness. Falling off a swing is not necessarily a trauma, but a typical
accident common among children. Prolapsed bladder is not a traumatic event and
can be easily corrected with various surgical procedures.
Multiple Choice
6. Which symptom leads the nurse to suspect the young child is experiencing
PTSD?
A) Becomes disrespectful of authority figures
B) Feel guilty that they could not save their friends during an attack at their school
C) Having thoughts of revenge toward boys who were bullying him at school.
D) Acts out the scary event during playtime
Ans: D
Chapter: 19
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 4
Page Number: 284
Feedback: PTSD symptoms in children include bedwetting after they had learned
how to use a toilet; forgetting how or being unable to talk; acting out the scary
event during playtime; and being unusually clingy with a parent or other adult. All
of the other distractors are symptoms seen in the adolescent client.
Multiple Select
7. In PTSD, which signs/symptoms could be classified as intrusive? (Select all that
apply.)
A) When the client re-experiences a traumatic image
B) No longer dream during REM sleep
C) Have feelings that the event is reoccurring
D) Complain of excessive sleeping, usually 12 hours/day or more
E) Feel like they are suspended in outer space and can’t find their way home
Ans: A, C
Chapter: 19
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
GRADESLAB.COM
Integrated Process: Nursing Process
Objective: 4
Page Number: 284
Feedback: Often the intrusive thoughts are associated with cues that symbolize or
resemble the original event. Sometimes, the traumatic images, thoughts, or
perceptions are re-experienced. Nightmares are common. Intrusive symptoms also
include dissociative reactions (i.e., feeling or acting as if the event is reoccurring).
Sleeping is difficult. Terrifying flashbacks and nightmares often include fragments of
traumatic events exactly as they happened.
Multiple Choice
8. Which statement made by a client diagnosed with PTSD leads the nurse to
believe the client is experiencing dissociative symptoms?
A) “It’s like I’m having flashbacks every time I fall asleep.”
B) “I describe my feelings like I’m having an out-of-body experience.”
C) “Loud noises always make me a little jittery now.”
D) “I feel guilty that I survived the attack and my friend didn’t.”
Ans: B
Chapter: 19
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Communication and Documentation
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Objective: 9
Page Number: 284
Feedback: Dissociation is a disruption in the normally occurring linkages among
subjective awareness, feelings, thoughts, behavior, and memories. A person who
dissociates is making him- or herself “disappear.” That is, the person has the
feeling of leaving his or her body and observing what happens to it from a distance.
During trauma, dissociation enables a person to observe the event while
experiencing no pain or only limited pain and to protect him- or herself from
awareness of the full impact of the traumatic event. Flashbacks are common with
PTSD; Loud noises associated with the trauma cause flashbacks. Guilt is common
for survivors.
Multiple Select
9. Which common manifestations following a traumatic experience would the nurse
identify in a client experiencing physiologic hyperarousal? (Select all that apply.)
A) Frequent urination
B) Startles easily
C) Overreacts to others
D) Avoids places associated with the event
E) Has vivid dreams
Ans: B, C
Chapter: 19
GRADESLAB.COM
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 4
Page Number: 285
Feedback: After a traumatic experience, the stress system seems to go on
permanent alert, as if the danger might return at any time. In this state of
physiologic hyperarousal, the traumatized person is hypervigilant for signs of
danger, startles easily, reacts irritably to small annoyances, and sleeps poorly. The
state of hyperarousal causes the affected individual to be irritable and overreacts to
others which cause others to avoid the person. Frequent urination and vivid dreams
are not associated with PTSD. Avoiding places associated with the trauma is
common but not associated with hyperarousal.
Multiple Choice
10. A client with PTSD asks the nurse about this eye movement, desensitization,
and reprocessing (EMDR) treatment. How would the nurse most appropriately
explain this treatment?
A) Takes a long time because you have to have counseling sessions a minimum of
twice/week.
B) Guides the client through images of the trauma, allowing for progressive
desensitization.
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
C) Blocks the trauma from appearing in their psychological frame using carefully
placed electrical stimuli.
D) Helps the client understand why recovering from the trauma is difficult, but
gives them new ways of coping.
Ans: B
Chapter: 19
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 6
Page Number: 287
Feedback: EDMR is a process of reviewing and visualizing disturbing memories of
traumatic or distressing experiences to reduce the long-term impact of the events.
The client is guided through images of the trauma, allowing for progressive
desensitization. Under deep relaxation, the client maintains an image of the
traumatic event while focusing on the lateral movement of the clinician’s finger.
This recent approach has been successful in minimizing the fear response and
avoidance pattern of those with PTSD. Counseling, blocking trauma via electrical
stimuli, and using cognitive processing therapy are not a part of EDMR, but are
separating possible treatment plans.
Ordering
GRADE
SLaAclient
B.COwith
M PTSD in order of priority,
11. Place these nursing interventions
for
with #1 being the highest priority, followed by #4 being the least priority.
A) Ensure that the client’s physical needs are met.
B) Have the client identify the original trauma that started the PTSD.
C) Establish suicidal/aggressive safety measures.
D) Begin intensive one-on-one counseling.
Ans: A; C; B; D
Chapter: 19
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 6
Page Number: 288
Feedback: After the physical health needs are met and suicidal/aggressive safety
measures are established, the mental health nursing assessment targets specific
areas. These include identification of the original trauma, specific physical
symptoms, and the emotional and behavioral consequences of the client’s PTSD.
Multiple Choice
12. A client with PTSD has begun to stay out late every night and “party” with their
friends. When family members ask about when the client is going to return to
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
A)
B)
C)
D)
work, they become extremely irritated and verbally lashes out, saying some
very hurtful things. What would be the priority NANDA for this client?
Risk of relocation stress syndrome
Ineffective activity planning
Anxiety
Ineffective impulse control
Ans: D
Chapter: 19
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 6
Page Number: 289
Feedback: Depending on the trauma, posttrauma syndrome, rape trauma
syndrome, risk for suicide, anxiety, defensive coping, hopelessness, ineffective
impulse control and powerlessness, are examples of nursing diagnoses generated
by assessment of a person with PTSD.
Multiple Select
13. A client with PTSD has been prescribed sertraline (Zoloft). While educating this
client about possible side effects, the nurse should stress that they need to call
their health care provider if they experience which signs/symptoms? (Select all
GRADESLAB.COM
that apply.)
A) Fatigue
B) Constipation
C) Dry eyes
D) Muscle twitching
E) Tachycardia [heart racing]
Ans: D, E
Chapter: 19
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 6
Page Number: 291
Feedback: Client/family should be taught to notify the health care provider if severe
agitation, hallucinations, coordination problems, muscle twitching, racing heartbeat,
high or low blood pressure, muscle rigidity, sweating or fever, nausea, vomiting,
diarrhea occur.
Multiple Choice
14. When explaining dissociative disorders to a client, what feature of these
disorders would the nurse describe?
A) Total amnesia of the events that caused the disorder
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
B) Overuse of sedatives like alcohol
C) Failure to integrate identity, memory, and consciousness
D) Disinhibited social engagement, being overly friendly with strangers.
Ans: C
Chapter: 19
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 9
Page Number: 293
Feedback: The essential feature of these disorders involves a failure to integrate
identity, memory, and consciousness. That is, unwanted intrusive thoughts disrupt
one’s contact with the here and now or memories that are normally accessible are
lost. These disorders are closely related to the trauma- and stressor-related
disorders but are categorized separately.
15. Which statement is accurate regarding PTSD and children?
A) The risk of developing PTSD following leukemia treatment is about the same as
all children of the same age.
B) Best practices demonstrate that adolescents who have PTSD are at increased
risk of drug abuse.
C) In the family unit where one child is diagnosed with cancer, all the children in
the household are at increased risk for developing PTSD.
GRADchildhood
ESLAB.Cwere
OM more likely to be diagnosed
D) Children who were abused during
with obsessive compulsive disorder rather than PTSD.
Ans: B
Chapter: 19
Client Needs: Physiological Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 1
Page Number: 285, 286
Feedback: For adolescents, PTSD was associated with an increased risk of drug use.
Childhood cancer survivors have been found to have four times the risk of
developing PTSD as their siblings. Similarly, high rates of PTSD have been reported
among clients with alcohol and drug dependence who have experienced childhood
abuse.
16.When explaining behavioral sensitization to a group of nursing students in their
mental health rotation, the best explanation would be:
A) With repeated re-experiencing of the traumatic event, PTSD symptoms become
more easily triggered with time.
B) After combat exposure the client has little or no reaction when a car backfires
on the road.
C) The sensitized person will no longer react to later, milder stressors similar to
their initial exposure.
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
D) The symptoms associated to the stressor will correlate to a decrease in
dopamine activity.
Ans: A
Chapter: 19
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 6
Page Number: 286
Feedback: Behavioral sensitization may be one mechanism underlying the
hyperarousal seen in PTSD. This phenomenon, sometimes referred to as kindling,
occurs after exposure to severe, uncontrollable stressors. The sensitized person
reacts with a magnified stress response to later, milder stressors. Research shows
that traumatic exposure can alter neurotransmitter connectivity in the frontal areas
resulting in severe reaction to a minor stressor. This finding would account for the
fact that some individuals with PTSD experience intense fear, anxiety, and panic in
response to minor stimuli. One example of behavioral sensitization is that PTSD
after combat exposure is more likely to develop in veterans who are survivors of
childhood abuse than in those who have not experienced prior trauma.
17. A PTSD client who is having recurring nightmares may be prescribed which
medication (as an off-label use) to treat the nightmares and improve sleep?
A) Lorazepam, benzodiazepines
B) Prazosin, an alpha1 inhibitor GRADESLAB.COM
C) Metoprolol, a β-adrenergic blocking agent
D) Zolpidem, a sedative
Ans: B
Chapter: 19
Client Needs: Physiological Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 6
Page Number: 287
Feedback: The selective serotonin reuptake inhibitors (SSRIs), benzodiazepines,
and β-blockers have been shown to be effective in reducing the symptoms of PTSD.
Recently, off-label use of prazosin, an alpha1 inhibitor, has been shown to be
effective in treating nightmares and improving sleep in PTSD clients.
Multiple Select
18. To promote sleep hygiene, the nurse should encourage the PTSD client to
incorporate which strategies into their routine? (Select all that apply.)
A) Go to bed at a regular time nightly
B) Sleep in during the mornings when one had a restless night of sleep
C) Avoid drinking alcohol
D) Enjoy a cup of caffeinated tea in the mid-afternoon if one gets sleepy
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
E) Exercise within 2 hours of bedtime will make you tired and you will fall to sleep
faster
Ans: A, C
Chapter: 19
Client Needs: Physiological Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 7
Page Number: 291
Feedback: Some persons with PTSD find that they cannot sleep in their bed, but
can sleep in a chair. Some of the following strategies may be helpful: (1) Establish
and maintain a regular bedtime and rising time; (2) Avoid naps; (3) Abstain from
alcohol. Although alcohol may assist with sleep onset, an alerting effect occurs
when it wears off; (4) Refrain from caffeine after midafternoon. Avoid nicotine
before bedtime and during the night. Caffeine and nicotine are strong stimulants
and cause fragmented sleep; and, (5) Exercise regularly, avoiding the 3 hours
before bedtime.
19. When giving a community lecture about PTSD for clients and their families, the
nurse will include which topics for discussion? (Select all that apply.)
A) Daily use of a sedative to assist with rest and sleep.
B) Try to identify triggers that lead to re-experiencing trauma.
C) Finding people who can assist with watching the client during stressful periods.
GRifAone
DESdoes
LABnot
.COhelp.
M
D) Try various treatment options
E) Do not discuss smoking cessation techniques if the client is stressed.
Ans: B, D
Chapter: 19
Client Needs: Physiological Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 6
Page Number: 292
Feedback: When caring for a person with a PTSD, be sure to include the following
topic areas in the teaching plan:
Identification of individual triggers and cues that lead to re-experiencing
trauma
Safety plans for stressful periods
Recovery plans that focus on personal strengths
Risk factors for reoccurrence of symptoms
Various treatment options: if one does not help, others exist
Avoid substances such as alcohol and drugs
Nutrition
Exercise
Sleep hygiene
Follow-up appointments
Community services
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
20. A client diagnosed with posttraumatic stress disorder (PTSD) has been
encouraged to engage in exposure therapy. What education should the nurse
provide to help the client prepare to effectively engage in this treatment? (Select all
that apply.)
A) Therapy will help you face and control fear by controlled expose to the trauma.
B) Physically revisiting the site where the traumatic event will be helpful for you,
when possible.
C) Writing down or journaling the details of the trauma will be therapuetic.
D) Therapy will teach how trauma has changed personally held thoughts and
beliefs.
E) Therapy will help you reframe the traumatic experience in a more realistic
manner.
Ans: A, B, C
Chapter: 19
Client Needs: Psychological Integrity
GRADESLAB.COM
Cognitive Level: Understand
Client Needs: Psychological Integrity
Integrated Process: Teaching/Learning
Objective: 8
Page Number: 287
Feedback: Psychotherapeutic approaches to the treatment of clients with
posttraumatic stress disorder include exposure therapy, which helps people face
and control their fear by exposing them to the trauma in a safe way. Strategies
include mental imagery, writing, or visits to the place where the event happened.
Cognitive restructuring helps people make sense of the bad memories by reframing
their experiences in a more realistic way. Cognitive processing therapy helps people
understand how traumatic experiences changed thoughts and beliefs and influenced
current feelings and behaviors.
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Test Generator Questions, Chapter 20, Obsessive--Compulsive
and Related Disorders: Nursing Care of Persons With
Obsessions and Compulsions
Multiple Choice
1. A client with obsessive--compulsive disorder has been taking fluoxetine for 1
month. The client tells the nurse, “These pills are making me sick. I think I’m
getting a brain tumor because of the headaches.” Which response by the nurse
would be most appropriate?
A) “Let’s talk about how often you have been performing the rituals lately.”
B) “Tell me how many times you have washed your hands today.”
C) “Have you been practicing your deep breathing and relaxation exercises?”
D) “These medications have side effects that can cause increased headaches.”
Ans: D
Chapter: 20
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Communication and Documentation
Objective: 5
GRADESLAB.COM
Page Number: 304
Feedback: Individuals with obsessive--compulsive disorder need frequent
reassurance that the side effects are a common response to the medication and
that they are not becoming ill. Ignoring the client’s concerns will only increase the
client’s anxiety.
Multiple Select
2. A client is diagnosed with obsessive--compulsive disorder (OCD) and is to
receive medication therapy. Which of agents might the nurse expect to be
prescribed? (Select all that apply.)
A) Clomipramine
B) Lithium
C) Sertraline
D) Fluvoxamine
E) Paroxetine
F) Alprazolam
Ans: A, C, D, E
Chapter: 20
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Apply
Integrated Process: Nursing Process
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Objective: 5
Page Number: 303, 304, 307
Feedback: The SSRIs and TCAs are considered to be the most effective treatment
agents used for OCD. Clomipramine was the first drug to produce significant
advances in treating people with OCD. Other medications have proved effective,
including sertraline, fluoxetine, fluvoxamine, and paroxetine. Lithium is used to
treat bipolar disorder. Alprazolam may be used to treat panic disorder.
Multiple Choice
3. A client diagnosed with obsessive--compulsive disorder comes to the clinic with
their spouse. During the visit, the spouse states that the client is “always checking
and rechecking to make sure that all of the appliances are turned off before we go
out. It’s nerve-wracking. We can never get out of the house on time. Isn’t checking
once enough?” An understanding of which aspect of this disorder would the nurse
need to incorporate into the response?
A) The client is attempting to exert control over the situation.
B) The client performs the ritual to relieve anxiety temporarily.
C) The client’s behavior reflects a need for safety.
D) The client is attempting to use thought stopping to decrease her behavior.
Ans: B
Chapter: 20
Client Needs: Psychosocial Integrity
GRADESLAB.COM
Cognitive Level: Apply
Integrated Process: Communication and Documentation
Objective: 1
Page Number: 297
Feedback: The nurse needs to explain to the client’s spouse that the compulsion is
done to relieve anxiety temporarily. The compulsion is necessary, not pleasurable,
and if not performed, anxiety and distress increase. The compulsion is an anxiety
response, not a means to control the situation or promote safety. Thought stopping
is a mechanism used to control obsessions.
4. Parents visit the clinic with their teenager to discuss the teen’s skin picking.
Many bleeding wounds and various stages of scabs located up and down both of
the teenager’s arms. The parents are very upset about this behavior and want it
to stop. What condition does the health care provider documents?
A) Body dysmorphic disorder
B) Disrupted family dynamics
C) Excoriation disorder
D) Control dysfunction
Ans: C
Chapter: 20
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Objective: 6
Page Number: 297
Feedback: Excoriation disorder (skin picking) is the inability to stop recurrent
picking at skin for emotional release or anxiety release. Body dysmorphic disorder
is a preoccupation with slight or imagined physical defects that are not apparent to
others. There is not enough information to diagnose disrupted family dynamics or
control issues within the family unit.
5. A client explains to the health care provider that a cleaning ritual must be
completed every day. If something disrupts this cleaning schedule, what effect
does the client experience?
A) Depression
B) Extreme anxiety
C) Aggression to the point of lashing out
D) Isolation from others
Ans: B
Chapter: 20
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 3
Page Number: 297
Feedback: Obsessions create tremendous anxiety; individuals perform compulsions
GRIfAD
EScompensatory
LAB.COM ritual is not performed, the
to relieve the anxiety temporarily.
the
person feels increased anxiety and distress. Compulsions are necessary, not
pleasurable. They are often recognized as odd or strange to the individual. Initially,
attempts are made to resist the compulsive behavior, but eventually, resistance
fails, and the repetitive behaviors are incorporated into daily routines. Depression,
aggression, and isolation are not usual response to this behavior.
6. What symptoms might parents notice in their child who is exhibiting obsessive-compulsive disorder (OCD)?
A) Is failing classes due to lack of concentration
B) Spending excessive amount of time in their room
C) Frequently “stares off into space”
D) Is jittery and nervous all the time
Ans: A
Chapter: 20
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 3
Page Number: 298
Feedback: Because children subscribe to myths, superstition, and magical thinking,
obsessive and ritualistic behaviors may go unnoticed. Behaviors such as touching
every third tree, avoiding cracks in the sidewalk, or consistently verbalizing fears of
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
losing a parent in an accident may have some underlying pathology but are
common behaviors in childhood. Typically, parents notice that a child’s grades
begin to fall as a result of decreased concentration and great amounts of time spent
performing rituals. Isolating themselves, staring off into space, and being nervous
could be considered normal behavior at certain developmental ages.
7. While providing in-serve training on the psychodynamic theory behind OCD
symptoms, the nurse mentions reaction formation. Which statement is
characteristic of this theory?
A) When parents are too harsh during potty training, the child may feel dirty and
ashamed. Then the child may deliberately soil his or her clothes as an act of
rebellion.
B) Fear in individuals with OCD will trigger a fear associated with unwashed hands
that are very unlikely to cause real harm. However, they keep washing their
hands frequently.
C) Compulsions are rewarded by immediate reduction of distress or anxiety.
Clients carrying out the compulsive rituals but never get to test out their faulty
thinking that there is not a dire consequence if they make a mistake.
D) Clients report their symptoms. Such report is retrospective and so may not be
accurately recalled and yields subjective data vulnerable to bias and distortion.
Ans: A
Chapter: 20
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
GRADESLAB.COM
Integrated Process: Teaching/Learning
Objective: 4
Page Number: 300
Feedback: The psychodynamic theory hypothesizes that OCD symptoms and
character traits arise from three unconscious defense mechanisms: isolation,
undoing and reaction formation. The answer is an example of reaction formation
(behavior and consciously stated attitudes that oppose underlying impulses).
Distractors B and C are based on behavioral explanation, while distractor D is based
on cognitive theory.
Multiple Select
8. When the client with extremely severe OCD is no longer responding to intensive
drug therapy or behavioral therapy, what other treatment options should the
nurse prepare to educate the client/family about? (Select all that apply.)
A) Stereotactic surgical procedures
B) Deep brain stimulation with electrical current
C) Biofeedback techniques
D) Service and companion dogs
E) Hypnotherapy
Ans: A, B
Chapter: 20
Client Needs: Psychosocial Integrity
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Cognitive Level: Analyze
Integrated Process: Teaching/Learning
Objective: 5
Page Number: 302
Feedback: Psychosurgery is sometimes used to treat extremely severe OCD that
has not responded to prolonged and intensive drug treatment, behavioral therapy,
or a combination of the two. Modern stereotactic surgical techniques that produce
lesions of the cingulum bundle (a bundle of connective tissue) or anterior limb of
the internal capsule (a region near the thalamus and part of the circuit connecting
to the cortex) may bring about substantial clinical benefit in some individuals
without causing significant morbidity. Other treatment options include radiotherapy
and deep brain stimulation in which electrical current is applied through an
electrode inserted into the brain. Biofeedback is helpful when relaxation is needed.
Service animals and hypnotherapy are useful treatments for clients with PTSD.
Multiple Choice
9. When planning for a client with OCD who has been admitted for severe
exacerbation of symptoms, the nursing care should prioritize which intervention?
A) Giving medications in a timely fashion to maintain steady blood levels.
B) Starting all group sessions on time and incorporating all group members into
the discussion.
C) Assessing the client for suicide risk since they may also have a major
depression.
GRADobsessions
ESLAB.Cinvolve
OM
D) Discussing with the client if their
self-mutilation acts like
pulling their hair.
Ans: C
Chapter: 20
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Communication and Documentation
Objective: 5
Page Number: 302
Feedback: Assessing for suicidal thoughts is always the priority. The person may
feel a sense of hopelessness and helplessness and may contemplate suicide to end
the suffering. An additional risk for suicide is created by the high probability of
major depression, which often accompanies OCD. Clients may feel a need to punish
themselves for their intrusive thoughts (e.g., religious coupled with sexual
obsessions). Some persons have aggressive obsessions, so that external limits may
have to be imposed for the protection of others. All clients should expect
medications to be given on time and group sessions to start when posted time
arrives.
10. What is the most appropriate technique for the nurse to use while assessing a
client with OCD at admission?
A) Simple questions with Yes/No responses
B) Short questions that require one or two sentences to answer
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
C) Stopping the client and getting them to focus on the topic when they start to
ramble
D) Calm, nonauthoritarian approach with patience and active listening
Ans: D
Chapter: 20
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Communication and Documentation
Objective: 5
Page Number: 303
Feedback: Establishing a therapeutic relationship with a person with OCD requires
patience and active listening. The individual may go to great lengths to explain
some minute aspect of her or his life. It is important not to interrupt or rush these
explanations. Being unable to finish thoughts increases the client’s anxiety and
frustration. The nurse should interact with the individual in a calm, nonauthoritarian
fashion without exhibiting any disapproval of the client or the client’s behaviors
while demonstrating empathy about the distress that the disorder has caused. The
other responses would only heighten the client’s anxiety.
11. While planning care for a child who has excoriation disorder, what would the
priority NANDA be?
A) Hopelessness
B) Dysfunctional family processes
C) Ineffective role performance GRADESLAB.COM
D) Impaired skin integrity
Ans: D
Chapter: 20
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 6
Page Number: 307, 308
Feedback: The nursing diagnoses applied to clients with OCD can run the gamut
from the primary diagnosis of Anxiety to other physiologic disturbances of the
compulsion, such as Impaired Skin Integrity, which may result from continuous
hand washing or picking at the skin.
12.When using cognitive restructuring for the OCD client, the nurse teaches the
client to monitor automatic thoughts and recognize the connection between
thoughts, emotional response and behavior. What is the client’s goal with this
technique?
A) Decrease their compulsive actions by 50%.
B) Analyze their thoughts as incongruent with reality.
C) Improve their sleeping patterns.
D) Build time in their daily schedule to perform the compulsion without
interruption.
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Ans: B
Chapter: 20
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 5
Page Number: 305
Feedback: With cognitive restructuring, the client is taught to monitor automatic
thoughts and then to recognize the connection between thoughts, emotional
response, and behaviors. The distorted thoughts are examined and tested by foror-against evidence presented by the therapist, which helps the individual to
realistically assess the likelihood that the feared event will happen if the compulsive
behavior is not performed. The person begins to analyze his or her thoughts as
incongruent with reality. For example, even if the alarm clock is not checked 30
times before going to bed, it will still go off in the morning, and the person will not
be disciplined for tardiness at work. Maybe it needs to be checked only once or
twice. There is no research to support that the actions will decrease 50%.
Relaxation techniques assist with improving sleep pattern.
13. What action would a client diagnosed with body dysmorphic disorder (BDD)
primarily focus on?
A) Raising money to surgically repair their body part so that everything will return
to “normal.”
RApinpoint
DESLAB
.COM
B) Researching their family treeGto
when
their body part became
defective.
C) Real or imagined defects in appearance like having a “long” nose.
D) Analyze why others think the client looks fine and should just get on with life.
Ans: C
Chapter: 20
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 6
Page Number: 307, 308
Feedback: Individuals with body dysmorphic disorder (BDD) focus on real (but
slight) or imagined defects in appearance, such as a large nose, thinning hair, or
small genitals. Preoccupation with the perceived defect causes significant distress
and interferes with their ability to function socially. They feel so self-conscious that
they avoid work or public situations. Some fear that their “ugly” body part will
malfunction. Surgical correction of the problem by a plastic surgeon or a
dermatologist does not correct their preoccupation and distress. BDD is an
extremely debilitating disorder and can significantly impair an individual’s quality of
life.
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
14. A child has to verbalize their thoughts using 3 syllables at a time, pause, and
then state another 3 syllables. If they are not allowed to do this, they get
frustrated and angry. What is this behavior known as?
A) Obsession with the number 3
B) Tradition that started when they were learning to formulate words
C) Magical thinking performance
D) Ritual behavior common in childhood
Ans: D
Chapter: 20
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 4
Page Number: 298
Feedback: Rituals are common compulsions in which objects must be in a certain
order, motor activities are performed in a rigid fashion, or things are arranged in
perfect symmetry. A ritual consumes a great deal of time to complete even the
simplest task. Some individuals experience discontent, rather than anxiety, when
things are not symmetrical or perfect. Behaviors such as touching every third tree,
avoiding cracks in the sidewalk, or consistently verbalizing fears of losing a parent
in an accident may have some underlying pathology but are common behaviors in
childhood.
GROCD,
ADESthe
LABnurse
.COMknows that the obsession or
15.In order to rule a behavior and
compulsion must have which characteristic?
A) Be their primary thought process throughout the entire day.
B) Cause considerable anguish if not performed first thing in the morning.
C) Take up more than one hour/day and cause stress to the individual.
D) Convince the individual that their obsessive thoughts are true.
Ans: C
Chapter: 20
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 3
Page Number: 298
Feedback: OCD is diagnosed when recurrent obsessions or compulsions (or both)
take up more than one hour a day or cause considerable stress to the individual.
These obsessions or compulsions are not caused by substance or medication use or
other disorders. Some individuals recognize that these obsessions or compulsions
are excessive and unrealistic; others have limited insight and are unsure whether
the obsessive thoughts are true, but continue to have the thoughts and feel
compelled to perform the actions. Another group of individuals are convinced that
their
obsessive thoughts are true. These thoughts and compulsive behaviors are stressful
and interfere with normal daily routines.
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Multiple Select
16. A client has been diagnosed with OCD. While further assessing this individual,
the nurse should be aware of which of the other mental health disorders that
may be associated with OCD? (Select all that apply.)
A) Depression
B) Bipolar disease
C) Mood disorder
D) Schizophrenia
E) Psychosis
Ans: A, B, C
Chapter: 20
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 5
Page Number: 299
Feedback: It is estimated that one third of persons with OCD experience depression
because of OCD’s effects on their lifestyle. Bipolar, cyclothymic, panic, mood,
eating, and impulse control disorders also commonly occur in those with OCD. A
significant number of older depressed persons have OCD. Schizophrenia and
psychosis are not comorbidities for OCD.
Multiple Choice
GRADESLAB.COM
17. When prescribing an antidepressant for the treatment of an adolescent with
OCD, a higher dose is usually ordered by the health care provider. When
educating the client/family, the health care provider should warn them about
safety due to an increased risk for which effect?
A) Nightmares
B) Sleepwalking
C) Amnesia
D) Suicidality
Ans: D
Chapter: 20
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 5
Page Number: 305
Feedback: All antidepressants have a black box warning for suicidality in children,
adolescents, and young adults. This is the highest priority that must be assessed
frequently. These medications often take several weeks or months to relieve
compulsions and may take even longer to decrease obsessions. One of the older
antidepressants, clomipramine, is commonly used in the treatment of OCD.
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
18. New research by Singh & Jones (2013) found that clients diagnosed with
hoarding may benefit from what intervention?
A) Increased dose of an antianxiety medication regularly.
B) Using a “buddy” system where members support each other outside the group.
C) Daily visits from a social worker trained to perform hypnosis.
D) Waste treatment companies stopping by to offer their services at a reduced
rate.
Ans: B
Chapter: 20
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 6
Page Number: 47
Feedback: Using group processes, the group members became supportive of each
other when undertaking changes. The group developed a buddy system where
members supported each other outside the group. Through using the visual
methods, the individuals were able to distance themselves from the problem and
decrease the feeling of being overwhelmed. They were able to be more objective
and develop an action plan. Medication, daily visits and having trash companies
visit would not be helpful for these clients and may make the problem worse.
Multiple Select
GRADESLAB.COM
19. The nurse is working with a client diagnosed with compulsive hoarding
syndrome. Which client statement(s) suggests successful implementation of
strategies introduced by cognitive behavioral therapy (CBT)? (Select all that apply.)
A) “I was not raised to live like this; I do not like hoarding.”
B) “I know my kids are ashamed to bring friends home but I cannot help it.”
C) “I keep reminding myself what life would be like if all the clutter was gone.”
D) “I know my child’s allergies would be so much less of a problem if the house
was clean.”
E) “I feel so overwhelmed when I think about getting rid of some of the clutter in
the house.”
Ans: C, D, E
Chapter: 20
Client Needs: Psychological Integrity
Cognitive Level: Analyze
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Integrated Process: Communication and Documentation
Objective: 6
Page Number: 308
Feedback: CBT is a talking therapy that can help manage problems by changing the
way the client thinks and behaves. It is most commonly used to treat anxiety and
depression but can be useful for other mental and physical health problems
including hoarding. Helpful interventions include photographing cluttered areas in
the home and determining what the client would like to overcome, imagining life
without all of the clutter, and identifying how life and relationships are affected by
the problem. This exercise helps the client recognize the problem and what to do
about it. Through using the visual methods, the client is able to distance oneself
from the problem and decrease the feeling of being overwhelmed. Most individuals
with is disorder were not raised to live this way and they generally dislike and are
ashamed of the state of their environment, so these comments are not related to
effective therapy.
GRAbody
DESLdysmorphic
AB.COM disorder (BDD). Which
20. A teen has been diagnosed with
assessment question(s) demonstrates the nurse‘s effective understanding of
comorbid coexisting psychiatric disorders associated with this disorder? (Select all
that apply.)
A) “Do you generally feel hopeful about your life?”
B) “Would you consider yourself to be more anxious than your friends?”
C) “Do you ever find yourself thinking about or planning to end your life?”
D) “How do you handle yourself when someone or something makes you angry?”
E) “Would you say that you rely a lot on rituals to help manage fears or anxiety?”
Ans: A, B, C
Chapter: 20
Client Needs: Psychological Integrity
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 6
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Page Number: 307
Feedback: Individuals with BDD focus on real (but slight) or imagined defects in
appearance. Preoccupation with the perceived defect causes significant distress and
interferes with the ability to function socially. These clients feel so self-conscious
that they avoid work or public situations, which can significantly impair an
individual’s quality of life. Sixty percent of the clients with BDD also have an anxiety
disorder and the risk of depression, suicide ideation, and suicide is high. While
anxiety is a factor, obsessive–compulsive rituals are not generally associated with
BDD. A client may present with anger management problems, but this is not
generally considered to be related to BDD.
GRADESLAB.COM
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Test Generator Questions, Chapter 21, Depression: Nursing
Care of Persons With Depressive Moods and Suicidal Behavior
Multiple Choice
1. The nurse is making a home visit to an adult client who is diagnosed with
persistent depressive disorder. When developing this client’s plan of care, which of the
following would the nurse need to keep in mind?
A) The client’s symptoms of major depression disorder have lasted for 2 years.
B) The client’s condition is considered to be of a shorter duration.
C) The client typically experiences an elevated mood.
D) The client experiences symptoms that are intermittent.
Ans: A
Chapter: 21
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 8
Page Number: 330
GRADEPsychiatric
SLAB.COM
Feedback: According to the American
Association, persistent depressive
disorder (or dysthymic disorder) is a long duration mood disorder that has a lower
intensity of depressive symptomatology. The condition is persistent and the client
typically has a depressed mood for most of the day.
2. A client has been diagnosed with major depression. The client reports that he
often wakes up during the night and has trouble returning to sleep. The nurse
interprets this finding as suggesting which of the following?
A) Initial insomnia
B) Terminal insomnia
C) Hypersomnia
D) Middle insomnia
Ans: D
Chapter: 21
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 3
Page Number: 318
Feedback: The most common sleep disturbance associated with major depression is
insomnia which is categorized according to three categories: initial insomnia
(difficulty falling asleep), middle insomnia (waking up during the night and having
difficulty returning to sleep), and terminal insomnia (waking too early and being
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
unable to return to sleep). Less frequently, the sleep disturbance is hypersomnia
(prolonged sleep episodes at night or increased daytime sleep).
3. The nurse is caring for a client in the outpatient setting who has been diagnosed
with a depressive disorder. Before the client is given a prescription for a tricyclic
antidepressant, assessment for which of the following would be most important?
A) Suicide
B) Hypersomnia
C) Cardiac dysrhythmias
D) Erectile dysfunction
Ans: A
Chapter: 21
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 5
Page Number: 326
Feedback: Tricyclic antidepressants (TCAs) should not be prescribed for clients at
risk for suicide because lethal doses are only three to five times the therapeutic dose,
and more than 1 g of a TCA is often toxic and may be fatal. Death may result from
cardiac dysrhythmias, hypotension, or uncontrollable seizures. Hypersomnia may be
a symptom of depression for which the client is receiving medication therapy.
Assessment of cardiac dysrhythmias or erectile dysfunction would not be as important
as the client’s risk for suicide. GRADESLAB.COM
4. The nurse is caring for a client with major depression. The client tells the nurse,
“I’m just not sure that life is worth living.” The nurse documents which nursing
diagnosis as the priority?
A) Self-esteem, Low, related to depressive episode
B) Hopelessness related to symptoms of depression
C) Anxiety related to lack of energy for self-care activities
D) Thought Processes, Disturbed, related to memory loss and depression
Ans: B
Chapter: 21
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 5
Page Number: 320
Feedback: The priority nursing diagnosis is Hopelessness related to symptoms of
depression. There is no evidence to suggest Low Self-Esteem, Anxiety, or Disturbed
Thought Processes.
5. A client is prescribed phenelzine (Nardil) to treat her depression. The client is at a
local café for lunch with a friend. Which item on the menu should the client avoid
ordering?
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
A) Roast beef, mashed potatoes, and gravy
B) A Cobb salad with blue cheese and Roquefort salad dressing
C) Scrambled eggs, toast, and grape jelly
D) Medium-well steak, French fries, and broccoli
Ans: B
Chapter: 21
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Evaluate
Integrated Process: Nursing Process
Objective: 5
Page Number: 325, 326
Feedback: Phenelzine is a monoamine oxidase inhibitor (MAOI). If coadministered
with food or other substances containing tyramine (e.g., aged cheese, beer, red
wine), MAOIs can trigger a hypertensive crisis that may be life threatening. The blue
cheese is aged, and the Roquefort salad dressing contains aged cheese.
6. A client is hospitalized on a psychiatric unit after a suicide attempt and has been
diagnosed with depression. The client has been consistently depressed. When
assessing the client, which information alerts the nurse that the client’s suicidal risk
has worsened?
A) The client feels more depressed than ever.
B) The client is lethargic, remaining isolated from other clients.
C) The client feels better after more interaction with other clients.
RADESof
LAdepression
B.COM remain the same.
D) The client’s energy level andGdegree
Ans: C
Chapter: 21
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 3
Page Number: 329
Feedback: During the depths of depression, clients may not have the energy to
complete a suicide. As clients begin to feel better and have increased energy, they
may be at a greater risk for suicide. If a previously depressed client appears to
become energized overnight, he or she may have made a decision to commit suicide
and thus may be relieved that the decision is finally made. The nurse may
misinterpret the mood improvement as a positive move toward recovery; however,
this client may be very intent on suicide. These individuals should be carefully
monitored to maintain their safety.
Multiple Select
7. A nurse is reviewing information about the epidemiology of depressive disorders
in preparation for a presentation. The nurse demonstrates understanding of the
information when they identify which possible risk factors? (Select all that apply.)
A) History of substance abuse as a teenager
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
B) Little social support
C) Inadequate coping skills
D) Prior episode of anxiety disorder
E) Concomitant medical illnesses
Ans: B, C, E
Chapter: 21
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 2
Page Number: 313
Feedback: Generally agreed-upon risk factors for depression include a prior episode
of depression, family history of depressive disorder, lack of social support, lack of
coping abilities, presence of life and environmental stressors, current substance use
or abuse, and medical comorbidity.
8. A nurse is preparing a community presentation about major depression. Which
statements would the nurse expect to include? (Select all that apply.)
A) Depression in children is manifested in the same manner as in adults.
B) The risk for suicide is especially high during midadolescence.
C) Response to treatment in older adults is slower than that for younger adults.
D) People older than age 65 years have the lowest suicide rates of any age group.
E) Episodes of depression tend to occur more frequently over time.
GRoften
ADEStreated
LAB.Cin
OMthe primary care setting.
F) Depressive disorders are most
Ans: B, C, E, F
Chapter: 21
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 2
Page Number: 312
Feedback: Children with depressive disorders have similar symptoms to those seen
in adults, with a few exceptions. They are more likely to have anxiety symptoms, less
interaction with peers, and an irritable, rather than sad, mood. The risk of suicide
peaks during the midadolescent years. The response to treatment in older adults is
slower than in younger adults. People older than age 65 years have the highest
suicide rates of any age group. With time, episodes of depression tend to occur more
frequently, become more severe, and are of a longer duration. Depressive disorders
are so widespread that they are mostly diagnosed and treated in the primary care
setting.
Multiple Choice
9. After reviewing with a group of new-hire nurses the neurobiologic theories of
depression, the nurse determines the need for additional education when the new
nurses identify which neurotransmitter as playing a role?
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
A) Gamma-aminobutyric acid (GABA)
B) Norepinephrine
C) Serotonin
D) Dopamine
Ans: A
Chapter: 21
Client Needs: Psychosocial Integrity
Cognitive Level: Understand
Integrated Process: Teaching/Learning
Objective: 4
Page Number: 315
Feedback: According to the neurobiologic theories, major depression is caused by a
deficiency or dysregulation in central nervous system concentrations of the
neurotransmitters norepinephrine, dopamine, and serotonin, or in their receptor
functions. GABA has not been implicated.
10. A nurse is preparing to assess a middle-aged client who was brought to the
emergency department by his spouse. The spouse reports that the client has been
“extremely depressed lately.” When assessing this client, which assessment would be
the priority?
A) Changes in sleeping patterns
B) Thoughts of self-harm
C) Appetite changes
GRADESLAB.COM
D) Level of fatigue
Ans: B
Chapter: 21
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 3
Page Number: 317, 318, 320
Feedback: Although appetite and weight changes, sleep disturbances, decreased
energy, and fatigue are important indicators for the severity of depression, identifying
the possibility of self-harm (suicide) is always a priority in clients who are depressed.
11. A client with depression is prescribed fluoxetine. On a return visit to the clinic,
the nurse finds out that the client has started taking St. John’s wort to feel better. The
nurse assesses the client for which condition?
A) Water intoxication
B) Increased depressive symptoms
C) Serotonin syndrome
D) Hypertensive crisis
Ans: C
Chapter: 21
Client Needs:
Physiological Integrity: Pharmacological and Parenteral Therapies
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 5
Page Number: 326
Feedback: Fluoxetine is a selective serotonin reuptake inhibitor that when combined
with St. John’s wort can lead to serotonin syndrome. Water intoxication is possible
with mood stabilizers such as lithium. The combination of fluoxetine and St. John’s
wort leads to an increase in intrasynaptic serotonin. Thus, a potential for toxicity is
present. Hypertensive crisis occurs when MAOIs are taken with tyramine-rich foods.
12. A client comes to the emergency department reporting a severe pounding
headache in the temples and a stiff neck. The client is flushed and diaphoretic, and has
a racing pulse. The client is taking selegiline to treat depression. Which question by
the nurse would be most important to ask at this time?
A) “When did you last have blood drawn to check your drug level?”
B) “What have you had to eat or drink today?”
C) “Are you having any chest pain?”
D) “Do you use any herbal remedies?”
Ans: B
Chapter: 21
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Analyze
Integrated Process: Nursing Process
GRADESLAB.COM
Objective: 5
Page Number: 325, 326
Feedback: The client is exhibiting signs of a hypertensive crisis, which can occur
when a client is receiving MAOI therapy (selegiline) and ingests food or other
substances that contain tyramine. Thus, the nurse should ask what the client has had
to eat or drink. Drug levels are used to monitor tricyclic antidepressants. Asking about
chest pain would be appropriate after obtaining information related to what the client
has ingested. Herbal remedies can interact with medications, but this information
would be obtained after determining if the client has ingested foods and fluids
containing tyramine.
Multiple Select
13. The nurse is developing an education plan for a client who is prescribed
escitalopram. Which side effects would the nurse include in this plan? (Select all that
apply.)
A) Weight gain
B) Decreased sexual interest
C) Somnolence
D) Blurred vision
E) Urinary retention
F) Dry mouth
Ans:
A, B, C, F
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Chapter: 21
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 5
Page Number: 323, 324
Feedback: Escitalopram is an SSRI. Common side effects include weight gain,
diminished sexual interest and performance, headaches, gastrointestinal symptoms,
somnolence, dry mouth and agitation. Blurred vision and urinary retention are more
commonly associated with tricyclic antidepressants.
14. The nurse is preparing a client for treatment with repetitive transcranial
magnetic stimulation. When educating the client about this procedure, which
statement would the nurse include? (Select all that apply.)
A) “You will receive a short-acting anesthetic to relax you.”
B) “You will be awake and alert during the procedure.”
C) “You can resume your normal activities right after the treatment.”
D) “We will need to shave your scalp at the area where the magnet is placed.”
E) “You might feel a moderate amount of stinging at the site.”
Ans: B, C
Chapter: 21
Client Needs: Physiological Integrity: Reduction of Risk Potential
Cognitive Level: Apply
GRADESLAB.COM
Integrated Process: Teaching/Learning
Objective: 5
Page Number: 327, 328
Feedback: With this procedure, the client is awake, reclining in a special chair, and
can resume normal activities immediately after the procedure. Because anesthesia is
not required, there are no risks associated with sedation. The pulses, similar in type
and strength to a magnetic resonance imaging machine, easily pass through the hair,
skin, and skull, requiring much less electricity than electroconvulsive therapy. Thus,
shaving the scalp is unnecessary, and it is highly unlikely that the client would
experience stinging at the site.
Multiple Choice
15. When assessing a client with depression, the client states, “I just feel so sad and
hopeless. I just don’t care anymore. I don’t even enjoy doing the crossword puzzles
like I used to.” The nurse documents this finding as indicative of condition?
A) Dysthymic disorder
B) Anhedonia
C) Delusion
D) Psychosis
Ans: B
Chapter: 21
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Integrated Process: Nursing Process
Objective: 3
Page Number: 318
Feedback: The client’s statements reflect anhedonia, a loss of interest or pleasures
such that the client does not experience any enjoyment in activities that were
previously considered pleasurable. Dysthymic disorder is a milder but more chronic
depression. Delusion is manifested as false, fixed beliefs. Psychosis is a state in which
a person experiences symptoms such as hallucinations, delusions, or disorganized
thoughts, speech, or behavior.
16. The plan of care for a client diagnosed with depression includes cognitive
interventions. The nurse expects to assist with which technique?
A) Social skills training
B) Activity scheduling
C) Thought stopping
D) Interpersonal therapy
Ans: C
Chapter: 21
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 5
Page Number: 328
GRAinclude
DESLAmeasures
B.COM such as thought stopping and
Feedback: Cognitive interventions
positive self-talk. Social skills training and activity scheduling are behavioral
interventions. Interpersonal therapy is used to recognize, explore, and resolve the
interpersonal losses, role confusion and transitions, social isolation, and deficits in
social skills.
17. A nurse is preparing a presentation for family members of clients who have been
diagnosed with depression. When describing the family response to depression, which
information should the nurse include?
A) Family members typically can understand how disabling depression can be.
B) Depression in one family member affects the entire family.
C) Abuse of the depressed person is a rare occurrence in families.
D) Families of women older than 55 years of age with depression experience the
majority of problems.
Ans: B
Chapter: 21
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 5
Page Number: 316
Feedback: Depression in one member affects the whole family. Spouses, children,
parents, siblings, and friends experience frustration, guilt, and anger when the family
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
member is immobilized and cannot function. It is often hard for others to understand
the depth of the mood and how disabling it can be. The lack of understanding and
difficulty of living with a depressed person can lead to abuse. Women between the
ages of 18 and 45 years constitute the majority of those experiencing depression, and
thus their families experience the majority of problems.
18. The nurse is reviewing the medical record of a client diagnosed with depression
and notes that the client has been prescribed mirtazapine. The nurse identifies this
agent as being in which drug category?
A) Selective serotonin reuptake inhibitor
B) Cyclic antidepressant
C) Norepinephrine dopamine reuptake inhibitor
D) Alpha-2 antagonist
Ans: D
Chapter: 21
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Understand
Integrated Process: Teaching/Learning
Objective: 5
Page Number: 323, 324
Feedback: Mirtazapine is an alpha-2 antagonist. Escitalopram, fluoxetine, and
sertraline are selective serotonin reuptake inhibitors. Amitriptyline, imipramine, and
amoxapine are examples of tricyclic antidepressants. Bupropion is a norepinephrine
GRADESLAB.COM
dopamine reuptake inhibitor.
19. A 34-year-old client with depression is admitted to an inpatient psychiatric unit.
The nurse enters her room and initiates interaction with the client. When talking with
the client, which approach would be least appropriate?
A) Quiet and empathetic manner
B) Animated and cheerful manner
C) Matter-of-fact manner
D) Respectful, direct manner
Ans: B
Chapter: 21
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Communication and Documentation
Objective: 5
Page Number: 328
Feedback: When communicating with clients who are depressed, the nurse should
never use an overly enthusiastic approach. This approach can lead to irritation and
block communication. Clients should be encouraged to set realistic goals to reconnect
with their families and communities.
20.Following a change in job position, the minister asks a congregant how the
congregant likes his new job. The client states, “Oh everything is great. I can really
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
A)
B)
C)
D)
see myself going far in this new position.” However, the congregant’s voice was
monotone and their face was nearly absent of affective expression. How does the
minister describe the congregant’s facial expression?
Inappropriate
Blunted
Flat
Constricted
Ans: C
Chapter: 21
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Communication and Documentation
Objective: 5
Page Number: 312
Feedback: Several terms are used to describe affect, including the following:
Flat: absent or nearly absent affective expression; Inappropriate: discordant affective
expression accompanying the content of speech or ideation; Blunted: significantly
reduced intensity of emotional expression; Restricted or constricted: mildly reduced
in the range and intensity of emotional expression
GRADESLAB.COM
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Test Generator Questions, Chapter 22, Bipolar Disorders:
Nursing Care of Persons With Mood Lability
Multiple Choice
1. A client asks the nurse whether he needs to alter any of his activities because he
is taking lithium carbonate. Which responses would be most appropriate?
A) “Increase your salt intake if an activity causes you to perspire heavily.”
B) “Wear sunscreen when you are going to be outdoors in the summer.”
C) “Drink less fluid than usual now that you are taking this drug.”
D) “No changes are necessary for strenuous activities you do outdoors.”
Ans: A
Chapter: 22
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 5
Page Number: 343, 348
Feedback: If body fluid decreases significantly because of a hot climate, strenuous
ADESreduction
LAB.COMin fluid intake, then lithium levels
exercise, vomiting, diarrhea, or aGR
drastic
can rise sharply, causing an increase in side effects with progression to lethal lithium
toxicity. Clients should increase salt intake during periods of perspiration, increased
exercise, and dehydration.
2. The nurse is assessing a client with bipolar disorder who is experiencing mania.
The client states, “I’m just so beautiful. Everyone just stops and stares at how
gorgeous I am. Men constantly want to have sex with me.” The nurse interprets these
statements as indicative of which type of mood?
A) Irritable
B) Elevated
C) Expansive
D) Euphoric
Ans: C
Chapter: 22
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 3
Page Number: 335
Feedback: The client’s statements reflect an expansive mood, which is characterized
by lack of restraint in expressing feelings; an overvalued sense of self-importance;
and a constant and indiscriminate enthusiasm for interpersonal, sexual, or
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
occupational interactions. An irritable mood is characterized by easy annoyance and
provocation to anger, particularly when wishes are challenged or thwarted. An
elevated mood can be expressed as euphoria (exaggerated feelings of well-being) or
elation (feeling “high,” “ecstatic,” “on top of the world,” or “up in the clouds”).
3. The nurse is reviewing the medical record of a client with bipolar disorder. The
nurse would most likely expect to find a history of which condition?
A) Panic disorder
B) Schizophrenia
C) Delusional disorder
D) Posttraumatic stress disorder
Ans: A
Chapter: 22
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 1
Page Number: 336, 337
Feedback: The two most common comorbid conditions associated with bipolar
disorder are anxiety disorders (panic disorder and social phobia are most prevalent)
and substance use, most commonly alcohol and marijuana. Schizophrenia and
delusional disorder are not associated comorbidities. Although posttraumatic stress
disorder is an anxiety disorder, it is not as common as panic disorder and social
GRADESLAB.COM
phobia.
4. A nurse is developing a presentation for families who have members that have
been diagnosed with bipolar disorders. When describing this condition to the group,
which information would the nurse most likely include?
A) As the person ages, the episodes tend to decrease over time.
B) Environmental stressors are a key cause of these disorders.
C) The risk for suicide is high with either depression or mania.
D) Risk-taking behaviors are more common with a depressive episode.
Ans: C
Chapter: 22
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 5
Page Number: 338
Feedback: The risk of suicide is always present for those having a depressive or
manic episode. During a depressive episode, the client may feel that life is not worth
living. During a manic episode, the client may believe that he or she has supernatural
powers, such as the ability to fly. As clients recover from a manic episode, they may
be so devastated by the consequences of their impulsive behavior and poor judgment
that suicide seems like the only option. Manic or depressive episodes tend to
accelerate over time, with each episode leaving a trace and increasing the person’s
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
vulnerability (or sensitizing the person to have another episode with less stimulation).
Environmental conditions contribute to the timing of an episode of the illness but are
not a cause of the illness. During a manic episode, poor judgment and impulsivity lead
to risk-taking behaviors.
Multiple Select
5. A client is to receive lithium therapy as part of the treatment plan for bipolar
disorder. When reviewing the client’s medication history, which agents would alert the
nurse to the possibility that a decrease in lithium dosage may be needed? (Select all
that apply.)
A) Lisinopril
B) Hydrochlorothiazide
C) Indomethacin
D) Caffeine
E) Aspirin
Ans: A, B, C
Chapter: 22
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 5
Page Number: 343, 344
GRAhydrochlorothiazide,
DESLAB.COM
Feedback: Drugs such as lisinopril,
and indomethacin increase
serum lithium levels and as such might necessitate a dosage reduction of the lithium.
Caffeine increases lithium excretion, so the drug dosage may need to be increased.
Aspirin, unlike other NSAIDs, does not decrease renal clearance of lithium or increase
serum lithium levels.
Multiple Choice
6. A client with bipolar disorder is receiving divalproex sodium as part of the
treatment plan. When monitoring the client’s blood level for this drug, which level
would alert the nurse to the need to change the dosage?
A) 30 ng/mL
B) 55 ng/mL
C) 75 ng/mL
D) 115 ng/mL
Ans: A
Chapter: 22
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 5
Page Number: 344
Feedback: Optimal blood levels appear to be in the range of 50 to 150 ng/mL. Thus,
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
anything outside this range would indicate the need for a change in drug dosage.
7. A client with bipolar disorder, having experienced a depressive episode, is
prescribed lamotrigine. After educating the client on this medication, the nurse
determines that the education was successful when the client makes which
statement?
A) “I need to notify my physician if I develop a skin rash.”
B) “I need to have my blood tested about once a month.”
C) “I have to watch how much salt I use every day.”
D) “This drug can affect my liver function.”
Ans: A
Chapter: 22
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Analyze
Integrated Process: Teaching/Learning
Objective: 5
Page Number: 346
Feedback: Lamotrigine has a boxed warning for skin rash, which should be reported
immediately if it develops. In most cases, the rash is benign, but it is not possible to
predict whether the rash is benign or serious (Stevens--Johnson syndrome). Blood
testing is needed for other mood stabilizers such as lithium, divalproex, and
carbamazepine. Salt is a concern with lithium therapy. Liver function can be affected
by carbamazepine.
GRADESLAB.COM
8. A nurse is preparing to administer medications to a client with bipolar disorder
who is experiencing acute mania. Which action by the nurse is most appropriate?
A) Tell the client firmly that he or she must take the medication.
B) Allow the client to participate in the treatment decision.
C) Restrain the client before administering the medication.
D) Notify the physician about the client’s refusal of the medication.
Ans: B
Chapter: 22
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 5
Page Number: 347
Feedback: Even during the most acute episodes, it is important for clients to have a
sense of empowerment and participation in treatment. Therefore, the nurse would
allow the client to participate in treatment decisions. Telling the client firmly that he or
she must take the medication or restraining the client would be inappropriate.
Notifying the physician would be appropriate only if the client continued to refuse to
take the medication after being allowed to participate in the decisions.
9. A client who is receiving lithium comes to the clinic for an evaluation. During the
visit, the client reports a fine hand tremor. Which action by the nurse would be most
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
appropriate?
A) Immediately obtain a specimen to determine the client’s blood drug level.
B) Suggest that the client take the medication with meals or snacks.
C) Assist the client in minimizing exposure to stressors.
D) Encourage the client to elevate the affected hand on a pillow.
Ans: C
Chapter: 22
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 5
Page Number: 345
Feedback: Fine hand tremor is a side effect of lithium therapy that can worsen with
anxiety and intentional movement. Therefore, the nurse would provide support and
reassurance, and encourage the client to minimize his or her exposure to stressors.
The nurse would notify the prescriber if the tremor interferes with the client’s work
and if compliance will be an issue. There is no need to obtain a drug level because this
tremor is not an indication of toxicity. Taking the medication with meals or snacks
would be helpful if the client was experiencing diarrhea, nausea, or abdominal
discomfort. Elevating the hand on a pillow would have no effect on the tremor.
Elevating would be appropriate for edema of the hands or feet.
10. A client’s blood level of carbamazepine is increased. When reviewing the client’s
GRADwould
ESLAalert
B.COthe
M nurse to a possible interaction?
medication history, which medication
A) Phenobarbital
B) Primidone
C) Phenytoin
D) Diltiazem
Ans: D
Chapter: 22
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 5
Page Number: 346
Feedback: Diltiazem interacts with carbamazepine, causing increased
carbamazepine levels. Phenobarbital, primidone, and phenytoin interact with
carbamazepine, leading to decreased carbamazepine levels.
Multiple Select
11. A client is brought to the emergency department by a brother. The client has a
history of bipolar disorder and is taking valproate. The brother reports that he
watched the client take the medication about 2 hours ago. He stated, “A little while
ago, he got very disoriented and agitated.” The nurse suspects toxicity based on
assessment of which symptoms? (Select all that apply.)
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
A)
B)
C)
D)
E)
Tachypnea
Bradycardia
Hypotension
Dizziness
Respiratory depression.
Ans: C, D, E
Chapter: 22
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 5
Page Number: 345
Feedback: Both valproate and carbamazepine may be lethal if high doses are
ingested. Toxic symptoms appear in 1 to 3 hours and include neuromuscular
disturbances, dizziness, stupor, agitation, disorientation, nystagmus, urinary
retention, nausea and vomiting, tachycardia, hypotension or hypertension,
cardiovascular shock, coma, and respiratory depression.
12. A client with bipolar disorder has a lithium drug level of 1.2 mEq/L. Which effect
would the nurse expect to assess? (Select all that apply.)
A) Metallic taste
B) Ataxia
C) Diarrhea
GRADESLAB.COM
D) Slurred speech
E) Fasciculations
F) Muscle weakness
Ans: A, C, F
Chapter: 22
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 5
Page Number: 345
Feedback: Manifestations associated with a lithium level less than 1.5 mEq/L include
a metallic taste in the mouth, diarrhea or loose stools, and muscular weakness or
fatigue. Ataxia and slurred speech are associated with lithium blood levels between
1.5 and 2.5 mEq/L. Fasciculation is associated with a lithium blood level over 2.5
mEq/L.
13. The nurse is preparing an education plan for the family of a client who has been
diagnosed with bipolar disorder. After teaching them about potential indicators for
relapse, the nurse determines that the education was effective when the family
identifies which characteristic as suggesting mania? (Select all that apply.)
A) Avoiding people
B) Sleeping more than usual
C) Talking faster than usual
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
D) Being hungry all the time
E) Reading several books at once
Ans: C, D, E
Chapter: 22
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Teaching/Learning
Objective: 5
Page Number: 349
Feedback: Indicators of possible mania include reading several books or newspapers
at once, talking faster than usual, feeling irritable, and being hungry all the time.
Avoiding people and sleeping more than usual would suggest depression.
Multiple Choice
14. A client with bipolar disorder has had a history of multiple episodes and states,
“I’m so frustrated with what’s happened because of these episodes.” Which technique
should the nurse encourage to help support this client’s recovery?
A) Codependence
B) Hope
C) Self-control
D) Independent decision making
GRADESLAB.COM
Ans: B
Chapter: 22
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 5
Page Number: 339, 341
Feedback: Emphasizing the recovery concept of hope will support the person who
has had multiple episodes and is frustrated with the impact of several episodes.
Recovery is promoted through engaging the client in partnership and empowering the
person to make decisions in setting overall goals of care. Shared decision making has
been shown to improve outcomes.
15. A client receiving lithium therapy has a plasma blood level of 2.2 mEq/L. Which
effect does the nurse expect to assess?
A) Slurred speech
B) Fine resting hand tremor
C) Loose stools
D) Muscular weakness
Ans: A
Chapter: 22
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Analyze
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Integrated Process: Nursing Process
Objective: 5
Page Number: 345
Feedback: A plasma lithium level of 2.2 mEq/L indicates moderate toxicity, which
would be evidenced by slurred speech, lack of coordination, mild to moderate ataxia,
and severe diarrhea. A fine resting hand tremor, loose stools, and muscular weakness
are mild side effects which are seen with plasma levels less than 1.5 mEq/L.
16. When caring for a client with mania, which effect would the nurse most likely
assess?
A) Unusual self-confidence
B) Slow, repetitive speech
C) Logical thinking
D) Narrowed focus
Ans: A
Chapter: 22
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 3
Page Number: 334, 335
Feedback: Mania is easily recognized by the cognitive changes that occur. Elevated
self-esteem is expressed as grandiosity (exaggerating personal importance) and may
GRAtoDE
SLAB.Cdelusions.
OM
range from unusual self-confidence
grandiose
Speech is pressured; the
person is more talkative than usual and at times is difficult to interrupt. There is often
a flight of ideas (illogical connections between thoughts) or racing thoughts.
Distractibility increases.
17. A client with mania is exhibiting signs of a manic episode manifested by an
elevated mood. Which characteristic does the nurse expect to assess?
A) Feelings of being on top of the world
B) Lack of restraint with feelings
C) Overvalued sense of self-importance
D) Indiscriminate enthusiasm for interactions
Ans: A
Chapter: 22
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 3
Page Number: 335
Feedback: An elevated mood can be expressed as euphoria (exaggerated feelings of
well-being) or elation (feeling high, ecstatic, on top of the world, or up in the clouds).
An expansive mood is characterized by lack of restraint in expressing feelings; an
overvalued sense of self-importance; and a constant and indiscriminate enthusiasm
for interpersonal, sexual, or occupational interactions.
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Multiple Select
18. A client is diagnosed with bipolar I disorder. When assessing the client, the nurse
would be alert for signs of which other comorbidities? (Select all that apply.)
A) Panic disorder
B) Social phobia
C) Antisocial personality disorder
D) Delirium
E) Somatoform disorder
Ans: A, B
Chapter: 22
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 9
Page Number: 336, 337
Feedback: Although any disorder may occur with bipolar disorder, the two most
common comorbid conditions are anxiety disorders (panic disorder and social phobia
are the most prevalent) and substance use (most commonly alcohol and marijuana).
Individuals with a comorbid anxiety disorder are more likely to experience a more
severe course. A history of substance use further complicates the course of illness,
and results in less chance for remission and poorer treatment compliance.
Multiple Choice
GRADESLAB.COM
19. After educating a client’s family on the etiology of bipolar disorders, the nurse
determines that the education was successful when the family describes the kindling
theory as involving what?
A) A dysregulation in the circadian rhythm, leading to sleep disturbance
B) A single gene or sequence of genes causing pathologic changes
C) Exposure to repetitive subthreshold stressors at vulnerable times
D) “Wear and tear” on the body from mood episodes leading to increased problems
Ans: C
Chapter: 22
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 4
Page Number: 337
Feedback: The kindling theory posits that as genetically predisposed individuals
experience repetitive, subthreshold stressors at vulnerable times, mood symptoms of
increasing intensity and duration occur. Eventually, a full-blown depressive or manic
episode erupts. Each episode leaves a trace and increases the person’s vulnerability,
or sensitizes the person to have another episode with less stimulation. Chronobiologic
theories suggest that circadian dysregulation underlies the sleep--wake disturbances
of bipolar disorder. Research related to genetic factors suggests that bipolar disorder
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
is highly heritable, although no one gene or sequence of genes is responsible for the
pathology of bipolar disorders. The allostatic load (or “wear and tear” on the body
model) bipolar disorder is viewed as a disorder where the allostatic load increases as
the number of mood episodes increases, leading to an increase in physical and mental
health problems.
Multiple Select
20. A client with bipolar disorder is prescribed lithium. The nurse is reviewing the
client’s medication history for drugs that could interact with lithium. The nurse would
monitor the client’s serum lithium levels closely for toxicity if the client’s history
included which medications? (Select all that apply.)
A) Captopril
B) Fluoxetine
C) Hydrochlorothiazide
D) Mannitol
E) Isosorbide
Ans: A, B, C
Chapter: 22
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 5
GRADESLAB.COM
Page Number: 344
Feedback: Medications such as captopril, fluoxetine and hydrochlorothiazide
increase serum lithium levels, placing the client at increased risk for lithium toxicity.
Mannitol and isosorbide increase renal excretion of lithium, thus decreasing lithium
levels.
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Test Generator Questions, Chapter 23, Schizophrenia and
Related Disorders: Nursing Care of Persons With Thought
Disorders
Multiple Choice
1. The nurse is caring for a client in an inpatient mental health setting. The nurse
notices that when conversing with other clients, the client repeats what they are
saying word for word. The nurse interprets this finding and documents it as which
condition?
A) Echopraxia
B) Neologisms
C) Tangentiality
D) Echolalia
Ans: D
Chapter: 23
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
GRADESLAB.COM
Objective: 1
Page Number: 358
Feedback: The nurse should document the client’s speech pattern as echolalia, or
parrot-like and inappropriate repetition of another’s words. Echopraxia refers to an
involuntary imitation of another person’s movements or gestures. Neologisms are
made-up words that have no common meaning and are not recognized. Tangentiality
is a disorganized thinking pattern in which the topic of conversation changes to an
entirely different topic; the change is a logical progression but causes a permanent
detour from the original focus.
2. While caring for a hospitalized client with schizophrenia, the nurse observes the
client listening to the radio. The client tells the nurse that the radio commentator is
speaking directly to the client. The nurse interprets this finding as which type of
thinking?
A) Autistic
B) Concrete
C) Referential
D) Illusional
Ans: C
Chapter: 23
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Integrated Process: Nursing Process
Objective: 1
Page Number: 358
Feedback: The client is exhibiting referential thinking, that is, the belief that neutral
stimuli, such as the radio, have special meaning to that person, such that the radio is
talking directly to the client. Autistic thinking involves restriction of thinking to the
literal and immediate, so that the individual has private rules of logic and reasoning
that make no sense to anyone else. Concrete thinking reflects a lack of abstraction in
thinking with the inability to understand punch lines, metaphors, and analogies.
Illusional thinking occurs when a person misperceives or exaggerates stimuli that
actually exist in the external environment.
3. A client has been diagnosed with schizophrenia. Assessment reveals that the
client lives alone. The client has disheveled clothing, uncombed and matted hair, and
a strange body odor. During an interview, the client’s family voices a desire for the
client to live with them upon being discharged. Based on the assessment findings,
which nursing diagnosis would be the priority?
A) Ineffective Role Performance related to symptoms of schizophrenia
B) Social Isolation related to auditory hallucinations
C) Dysfunctional Family Processes related to psychosis
D) Bathing Self-Care Deficit related to symptoms of schizophrenia
Ans: D
Chapter: 23
GRADESLAB.COM
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 4
Page Number: 370
Feedback: The negative symptom of avolition may be so profound that simple
activities of daily living, such as dressing, bathing, or combing hair, may not get done.
Therefore, a priority nursing diagnosis for the client is [Bathing] Self-Care Deficit
related to the symptoms of schizophrenia. The family’s desire in caring for the client
does not support a nursing diagnosis of Dysfunctional Family Processes. There is no
evidence of Ineffective Role Performance or Social Isolation at this time.
4. The nurse is caring for an older adult client who has been taking an antipsychotic
medication for 1 week. The nurse observes that the client has muscle rigidity that
resembles Parkinson disease and notifies the health care provider. Which agent would
the nurse expect the provider to prescribe?
A) Anticholinergic
B) Anxiolytic
C) Benzodiazepine
D) Beta-blocker
Ans: A
Chapter: 23
Client Needs:
Physiological Integrity: Pharmacological and Parenteral Therapies
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 5
Page Number: 374, 376
Feedback: Unless the client develops akathisia, the health care provider will likely
order an anticholinergic medication such as benztropine (Cogentin) to increase the
acetylcholine. An anxiolytic, benzodiazepine, or beta-blocker would not be used.
5. The nurse is caring for a hospitalized client who has schizophrenia. The client has
been taking antipsychotic medications for 1 week when the nurse observes that the
client’s eyes are fixed on the ceiling. The nurse interprets this finding as which
condition?
A) Akathisia
B) Oculogyric crisis
C) Retrocollis
D) Tardive dyskinesia
Ans: B
Chapter: 23
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 5
Page Number: 374
GRADthe
ESLclient’s
AB.COhealth
M
Feedback: The nurse should contact
care provider because the
client is exhibiting a dystonic reaction termed oculogyric crisis in which the muscles
that control eye movements tense and pull the eyeball so that the client is looking
toward the ceiling. Akathisia is manifested by restlessness, with clients often
reporting that they feel driven to keep moving. Retrocollis involves the neck muscle,
causing the head to be pulled back. Tardive dyskinesia involves abnormal, involuntary
movements that are constant.
6. A hospitalized client with schizophrenia is receiving antipsychotic medications.
While assessing the client, the nurse identifies signs and symptoms of a dystonic
reaction. Which agent would the nurse expect to administer?
A) Diphenhydramine (Benadryl)
B) Propranolol (Inderal)
C) Risperidone (Risperdal)
D) Aripiprazole (Abilify)
Ans: A
Chapter: 23
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 5
Page Number: 375, 376
Feedback: For dystonic reactions, the drug of choice is benztropine mesylate
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
(Cogentin) or diphenhydramine (Benadryl). Propranolol could be used to treat
akathisia. Risperidone and aripiprazole are antipsychotic agents used to treat
schizophrenia.
7. The nurse is caring for a client who has been receiving chlorpromazine to treat
schizophrenia for the past year. It would be essential for the nurse to monitor the
client for which effect?
A) Weight loss
B) Torticollis
C) Hypoglycemia
D) Tardive dyskinesia
Ans: D
Chapter: 23
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 5
Page Number: 376
Feedback: Tardive dyskinesia is late-appearing, abnormal involuntary movements.
Therefore, it is essential that the nurse monitor the client for tardive dyskinesia at this
time. Weight gain (not weight loss) and new onset of diabetes (hyperglycemia), would
be possible side effects of an antipsychotic. Torticollis, a dystonic reaction, would
occur early in antipsychotic drug treatment.
GRADESLAB.COM
8. A client hospitalized for treatment of schizophrenia has been receiving olanzapine
(Zyprexa) for the past 2 months. The nurse would be alert for which effect?
A) Weight loss
B) Hypertension
C) Diarrhea
D) Diabetes
Ans: D
Chapter: 23
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 5
Page Number: 373, 377
Feedback: The nurse should monitor the client for symptoms of diabetes, which has
been associated with second-generation antipsychotics like olanzapine and clozapine.
Weight gain and hypotension are common side effects. Constipation is more common
with antipsychotic therapy because of the anticholinergic effects.
9. The nurse is caring for a client who has been taking clozapine (Clozaril) for 2
weeks. The client tells the nurse, “My throat is sore, and I feel weak.” The nurse
assesses the client’s vital signs and finds that the client has a fever. The nurse notifies
the health care provider, expecting an order to obtain which laboratory test?
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
A) A white blood cell count
B) Liver function studies
C) Serum potassium level
D) Serum sodium level
Ans: A
Chapter: 23
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 5
Page Number: 378
Feedback: Clients who are taking clozapine are at risk for developing
agranulocytosis; therefore, they should have their white blood cells and granulocytes
monitored while on this medication. An immediate evaluation of blood cell status is
necessary when symptoms of infection are present. Liver function studies, serum
potassium, and serum sodium levels would not be necessary based on the
assessment findings.
10. A client is being released from the inpatient psychiatric unit with a diagnosis of
schizophrenia and treatment with antipsychotic medications. After teaching the client
and family about managing the disorder, the nurse determines that the education was
effective when they state which symptom should be reported immediately?
A) Elevated temperature
GRADESLAB.COM
B) Tremor
C) Decreased blood pressure
D) Weight gain
Ans: A
Chapter: 23
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 5
Page Number: 378
Feedback: Clients receiving antipsychotic therapy need to be alerted to the potential
for complications, including neuroleptic malignant syndrome, a life-threatening
condition that can occur with antipsychotic agents. This syndrome is manifested by
severe muscle rigidity and elevated temperature that can rapidly accelerate. The
nurse should instruct the client to seek immediate care if an elevated temperature
develops. Tremor also should be reported, but this is not a life-threatening
manifestation. Decreased blood pressure and weight gain can occur with
antipsychotic agents, but these are not life threatening.
11. A nurse is preparing an in-service program about schizophrenia for a group of
psychiatric–mental health nurses. Which element would the nurse include as a major
reason for relapse?
A) Lack of family support
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
B) Accessibility to community resources
C) Nonadherence to prescribed medications
D) Stigmatization of mental illness
Ans: C
Chapter: 23
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 6
Page Number: 356
Feedback: Although lack of family or social support, accessibility to community
resources, and stigmatization are factors that can contribute to relapse, one of the
major reasons for relapse is failure to follow the medication regimen.
12. While assessing a client with schizophrenia, the client states, “Everywhere I
turn, the government is watching me because I know too much. They are afraid that
I might go public with the information about all those conspiracies.” The nurse
interprets this statement as indicating which type of delusion?
A) Grandiose
B) Nihilistic
C) Persecutory
D) Somatic
GRADESLAB.COM
Ans: C
Chapter: 23
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 1
Page Number: 358
Feedback: Persecutory delusions involve the belief that one is being watched,
ridiculed, harmed, or plotted against. Grandiose delusions involve the belief that one
has exceptional powers, wealth, skill, influence, or destiny. Nihilistic delusions involve
the belief that one is dead or a calamity is impending. Somatic delusions involve
beliefs about abnormalities in bodily functions or structures.
13. The nurse is interviewing a client with schizophrenia when the client begins to
say, “Kite, night, right, height, fright.” What term would the nurse use to document
this action?
A) Clang association
B) Stilted language
C) Verbigeration
D) Neologisms
Ans: A
Chapter: 23
Client Needs:
Psychosocial Integrity
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 1
Page Number: 358, 359
Feedback: The client is manifesting clang association, which is the repetition of
words or phrases that are similar in sound, but in no other way connected. Stilted
language is the use of overly and inappropriate artificial formal language.
Verbigeration is the purposeless repetition of words or phrases. Neologisms are words
that are made up that have no common meaning and are not recognized.
14. A nurse is providing care to a client just recently diagnosed with schizophrenia
during an inpatient hospital stay. Throughout the day, the nurse observes the client
drinking from the water fountain frequently and carrying cans of soda and bottles of
water around. Upon entering the client’s room, the nurse sees numerous empty cups
that had been filled with liquid on a table and in the trash can. The room has an odor
of urine. What condition does the nurse suspect?
A) Risk for unstable blood glucose level related to diabetes
B) Disturbed fluid and electrolyte balance
C) Tardive dyskinesia
D) Orthostatic hypotension
Ans: B
Chapter: 23
Client Needs: Psychosocial Integrity
GRADESLAB.COM
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 1
Page Number: 373
Feedback: Some persons with schizophrenia develop disturbed fluid and electrolyte
balance. Nurses should observe for polydipsia (frequently drinking an excessive
amount of fluids) or frequent incontinence. These individuals are obsessed with
drinking water and compulsively consume fluids. Because of urgency and
incontinence, especially at nighttime, the client’s clothing and room may smell of
urine. Diabetes would be manifested by changes in glucose levels and possibly weight
loss [due to polydipsia]. Tardive dyskinesia would be indicated by involuntary
movements; this condition is a late-appearing side effect of antipsychotic agents.
Orthostatic hypotension would be suggested by changes in blood pressure, and
dizziness upon position changes.
15. During an in-service training, a group of nurses is reviewing the various theories
related to the etiology of schizophrenia. The nurses identify which neurotransmitter as
being responsible for hallucinations and delusions?
A) Dopamine
B) Serotonin
C) Norepinephrine
D) Gamma-aminobutyric acid (GABA)
Ans:
A
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Chapter: 23
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 2
Page Number: 362, 364
Feedback: Although research is demonstrating that schizophrenia does not result
from dysregulation of a single neurotransmitter or biogenic amine (such as serotonin,
norepinephrine, or dopamine), positive symptoms of schizophrenia, specifically
hallucinations and delusions, are thought to be caused by dopamine hyperactivity in
the mesolimbic tract. Researchers are also hypothesizing a role for GABA but have yet
to identify any specific information.
16. After educating a client on antipsychotic agents, the nurse determines that the
education was successful when the client identifies which medication as an example of
a second-generation antipsychotic agent?
A) Fluphenazine (Prolixin)
B) Thiothixene (Navane)
C) Quetiapine (Seroquel)
D) Chlorpromazine (Thorazine)
Ans: C
Chapter: 23
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Understand GRADESLAB.COM
Integrated Process: Teaching/Learning
Objective: 5
Page Number: 373
Feedback: Quetiapine is an example of a second-generation antipsychotic agent.
Fluphenazine, thiothixene, and chlorpromazine are examples of first-generation
antipsychotic agents.
17.
FBI
A)
B)
C)
D)
A client with schizophrenia tells the nurse, “I’m being watched constantly by the
because of my job.” Which response by the nurse would be most appropriate?
“Tell me more about how you are being watched.”
“It must be frightening to feel like you're always been watched.”
“You're not being watched; it's all in your mind.”
“You are experiencing a delusion because of your illness.”
Ans: B
Chapter: 23
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Caring
Objective: 3
Page Number: 381
Feedback: When interacting with a client who is experiencing delusions, the nurse
must remember that these experiences are real for the client. Based on the client’s
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
statement, the nurse should focus on the feelings that are generated by the delusion,
such as acknowledging how frightening it must be to feel constantly watched. The
nurse should not focus on the delusion itself (such as by asking the client to tell the
nurse more about being watched). Telling the client that he or she is not being
watched, that it is all in his or her mind, or that the client is experiencing a delusion
would be inappropriate because these statements tell the person that his or her
experiences are not real.
Multiple Select
18. A nurse is working in a community setting with a group of clients diagnosed with
schizophrenia. Which actions would the nurse prioritize? (Select all that apply)
A) Improving the quality of life
B) Instilling hope
C) Managing psychosis
D) Preventing relapse
E) Occupational training
Ans: A, B, D, E
Chapter: 23
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 6
GRADESLAB.COM
Page Number: 385
Feedback: In the community, the priorities of care are preventing relapse,
maintaining psychosocial functioning, engaging in psychoeducation, improving the
quality of life, occupational training and supported employment, and instilling hope.
Managing psychosis would be a priority for the client with acute symptoms of
schizophrenia requiring emergency or inpatient focused care.
Multiple Choice
19. A client with schizophrenia is prescribed clozapine because other medications
have been ineffective. After educating the client and family about the drug, the nurse
determines that the education was successful when they make which statement?
A) “The client needs to have an electrocardiogram periodically when taking this
drug.”
B) “We’ll need to make sure that the client’s blood count is checked at least weekly.”
C) “Toxic levels of the drug might develop if the client smokes cigarettes.”
D) “We need to watch to make sure that the client doesn’t lose too much weight.”
Ans: B
Chapter: 23
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 5
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Page Number: 378
Feedback: Clozapine is associated with agranulocytosis, so clients taking clozapine
should have regular blood tests. White blood cell and granulocyte counts should be
measured before treatment is initiated, and at least weekly or twice weekly after
treatment begins. Although cardiac dysrhythmias can occur, they are more likely to
occur with ziprasidone. Cigarette smoking can lower the concentration of clozapine,
thus necessitating a higher dose of this medication. Clozapine is associated with
weight gain, not weight loss.
20. In order to promote recovery, which information would be most important for
the nurse to keep in mind when establishing the nurse--client relationship with a client
who has schizophrenia?
A) The relationship typically develops over a short period of time.
B) Decisions about care are the responsibility of interdisciplinary team.
C) Short, time-limited interactions are best for the client experiencing psychosis.
D) Typically, clients with schizophrenia readily engage in a therapeutic relationship.
Ans: C
Chapter: 23
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Communication and Documentation
Objective: 3
Page Number: 372
GRschizophrenia
ADESLAB.COtakes
M time, and short, time-limited
Feedback: Engaging a client with
interactions are best for a client who is experiencing psychosis. Consistency in
interactions and follow-through helps to establish trust. Relationships should be built
on the recovery paradigm that focuses on individualizing treatment and care that is
person centered and allows for self-direction. Clients with schizophrenia are often
reluctant to engage in any relationship.
21. A nurse is developing an education plan for a client with schizophrenia. Which
method would the nurse use to be most effective?
A) Engaging the client with trial-and-error learning
B) Having the client write down information after directly being given the correct
information
C) Asking the client questions that encourage the client to guess at the correct
answer
D) Using visual aids that are very colorful and full of descriptive graphic images
Ans: B
Chapter: 23
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 4
Page Number: 382
Feedback: Evidence indicates that people with schizophrenia may learn best in an
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
errorless learning environment in which they are directly given correct information
and then encouraged to write it down. Asking questions that encourage guessing is
not as effective in helping them retain information. Trial-and-error learning also is
avoided. Visual aids can supplement verbal information, but these aids should have
simple information stated in simple language. Overcrowding the visual material or
incorporating images that draw attention away from important content should be
avoided.
22. Assessment of a client with schizophrenia reveals that the client is hearing voices
that say people are staring, and that the client is seeing illusions. When developing
the plan of care for this client, which nursing diagnosis would be appropriate?
A) Disturbed thought processes
B) Risk for self-directed violence
C) Disturbed sensory perception
D) Ineffective coping
Ans: C
Chapter: 23
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 4
Page Number: 367
Feedback: The most appropriate nursing diagnosis would be disturbed sensory
GRADEand
SLAillusions.
B.COM Disturbed thought processes
perception related to his hallucinations
would be appropriate for delusions, confusion, and disorganized thinking. Risk for
self-directed violence would be appropriate if the client verbalized that the voices
were telling him or her to self-harm. Although ineffective coping could apply, there is
nothing to support this nursing diagnosis.
23. A nurse is preparing a presentation about schizophrenia and outcomes focusing
on recovery for families of clients with schizophrenia. Which main goal would the
nurse include?
A) Continuity of care
B) Shorter inpatient stays
C) Immediate crisis stabilization
D) Social engagement
Ans: A
Chapter: 23
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 6
Page Number: 385
Feedback: Outcome research has shown that schizophrenia can be successfully
treated and managed. Continuity of care has been identified as a major goal of
recovery for clients with schizophrenia because they are at risk for becoming lost to
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
services if left alone after discharge. Although inpatient hospitalizations are brief and
focus on client stabilization, and crisis management is key to emergency care, and
decreased social isolation through social engagement are all important, they are not
considered major goals for recovery.
Multiple Select
24. After assessing a client with schizophrenia, the nurse suspects that the client is
experiencing an anticholinergic crisis. Which symptoms would the nurse most likely
have assessed? (Select all that apply.)
A) Dilated, reactive pupils
B) Blurred vision
C) Ataxia
D) Coherent speech
E) Facial pallor
F) Disorientation
Ans: B, C, F
Chapter: 23
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 5
Page Number: 380
GRADESLABcrisis
.COMinclude dilated, unreactive pupils,
Feedback: Manifestations of anticholinergic
blurred vision, ataxia, incoherent speech, facial flushing, and disorientation.
Multiple Choice
25. A client who has a major depressive episode tells the nurse that, for the past 2
weeks, the client has been hearing voices and at times thinks that they are being
followed. History reveals that the client had these alternating symptoms before. The
client also has experienced time with neither of these symptoms and has been able to
function adequately. The nurse interprets these findings as suggesting which
condition?
A) Paranoid schizophrenia
B) Undifferentiated schizophrenia
C) Brief psychotic disorder
D) Schizoaffective disorder
Ans: D
Chapter: 23
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 7
Page Number: 385
Feedback: Schizoaffective disorder is characterized by intervals of intense
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
symptoms between quiescent periods. At times, there are symptoms of
schizophrenia, and at other times, there appears to be a mood disorder. Because the
symptoms alternate with quiet periods, schizophrenia, either paranoid or
undifferentiated, would not apply. A brief psychotic episode involves symptoms of at
least one day but less than 1 month, and the onset is sudden. The client generally
experiences emotional turmoil or overwhelming confusion and rapid intense shifts of
affect.
26.
The
A)
B)
C)
D)
The nurse is caring for a client who was diagnosed with schizoaffective disorder.
nurse develops a plan of care to address which priority?
Suicide
Aggression
Substance abuse
Eating disorder
Ans: A
Chapter: 23
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 4
Page Number: 385, 386
Feedback: One of the characteristics that distinguish schizoaffective disorder from
schizophrenia is that clients with schizoaffective disorder are extremely susceptible to
RADbe
ESassociated
LAB.COMwith substance abuse, but this
suicide. Schizoaffective disorder G
may
would not be the priority. Aggression and eating disorder are not commonly
associated with schizoaffective disorder.
27. The nurse is caring for a client diagnosed with a delusional disorder. While
assessing this client, which element would the nurse expect to find?
A) History of chronic major depression
B) Consistently disrupting behavior patterns
C) Verbalization of bizarre delusions
D) Living with one or more delusions for a period of time
Ans: D
Chapter: 23
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 7
Page Number: 386
Feedback: Clients usually live with delusions for years, rarely receiving psychiatric
treatment unless their delusion relates to their health or they act on the basis of their
delusion and violate the law or social rules. The person often behaves in a normal
manner except when focusing on the delusion. A person with delusional disorder does
not have other psychiatric disorders. If mood episodes occur with this disorder, the
duration of the mood episode is relatively brief in comparison. Behavior is remarkably
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
normal except when the client focuses on the delusion. Delusional disorder involves
the presence of nonbizarre delusions.
28. The nurse is preparing to interview a client who has a delusional disorder. Which
aspect of this disorder does the nurse expect?
A) Cognitive impairment
B) Normal behavior
C) Labile affect
D) Evidence of motor symptoms
Ans: B
Chapter: 23
Client Needs: Psychosocial Integrity
Cognitive Level: Understand
Integrated Process: Nursing Process
Objective: 7
Page Number: 386
Feedback: Behavior is remarkably normal except when the client focuses on the
delusion. At that time, thinking, attitudes, and mood may change abruptly.
Personality does not usually change, but the client is gradually and progressively
involved with the delusional concern. Cognition is not impaired, and motor symptoms
are not evident.
29. The nurse is preparing to document information obtained from a client
GRADwho
ESLisAexperiencing
B.COM
diagnosed with a delusional disorder
somatic delusions. Which
characteristic would the nurse document?
A) Disorientation
B) Reduced attention span
C) Above average intelligence
D) Body issues
Ans: D
Chapter: 23
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 7
Page Number: 386
Feedback: Clients usually live with delusions for years, rarely receiving psychiatric
treatment unless their delusion relates to their health (somatic delusion). Clients with
delusional disorder show few, if any, psychological deficits. These clients
characteristically have average or marginally low intelligence. Mental status generally
is not affected. Thinking, orientation, affect, attention, memory, perception, and
personality are generally intact.
30. A client with schizoaffective disorder is prescribed clozapine to treat symptoms.
Which instructions would the nurse provide?
A) “Keep a record of how often and how long you experience the side effect of dry
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
mouth.”
B) “Monitor your urinary output and notify your doctor if your urine changes color.”
C) “Keep an eye on your weight, and if you gain weight rapidly, notify your doctor.”
D) “If you experience any drowsiness, discontinue taking this medication.”
Ans: C
Chapter: 23
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 5
Page Number: 375
Feedback: The client should be cautioned to notify the health care provider if rapid
weight gain occurs, because this may be indicative of excessive fluid retention. Dry
mouth and sedation, common side effects of any antipsychotic agent, do not require
the client to notify the health care provider. Urinary changes are not associated with
clozapine use. Although clozapine is associated with an increased risk of infection, it
would be important to notify the provider if the client’s urine odor becomes foul,
possibly suggesting a urinary tract infection.
31. While interviewing a client diagnosed with a delusional disorder, the client
states, “I have this really strange odor coming out of my mouth. I stop to brush my
teeth almost every hour and then rinse with mouthwash every half hour to get rid of
this smell. I’ve seen so many doctors, and they can’t tell me what’s wrong.” The nurse
RAreflecting
DESLABwhich
.COM type of delusion?
interprets the client’s statement G
as
A) Erotomanic
B) Grandiose
C) Somatic
D) Jealous
Ans: C
Chapter: 23
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 7
Page Number: 358, 367
Feedback: The client’s statements reflect a somatic delusion, which involves bodily
functions or sensations. Those with somatic delusions use excessive health care
resources and often go through elaborate rituals to cleanse themselves or their
surroundings. Erotomanic delusions focus on the belief that the client is loved
intensely by a “loved object,” who is usually married, of a higher economic status, or
otherwise unattainable. With grandiose delusions, the client is convinced that he or
she has a great unrecognized talent or has made an important discovery. Jealous
delusions focus on the unfaithfulness or infidelity of a spouse or lover.
Multiple Choice
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
32. When obtaining a client’s history, the nurse determines that the client has been
experiencing delusions and hallucinations for the past 3 months, which has caused
some problems with the ability to function at work. The client also is exhibiting
catatonic excitement, echopraxia, loose associations, and pressured speech. Which
condition does the nurse suspect?
A) Schizophrenia
B) Schizoaffective disorder
C) Brief psychotic disorder
D) Schizophreniform disorder
Ans: D
Chapter: 23
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 7
Page Number: 386
Feedback: The essential features of schizophreniform disorder are identical to those
of criteria A for schizophrenia (delusions, hallucinations, disorganized speech, grossly
disorganized or catatonic behavior, negative symptoms), with the exception of the
duration of the illness, which can be less than 6 months but with symptoms present
for at least 1 month. Schizophrenia would be as described, but the symptoms must
persist for at least 6 months. In brief psychotic disorder, the length of the episode is
at least one day but less than 1 month. With schizoaffective disorder, the client must
RADEwhen
SLABthere
.COMis a major depressive, manic, or
have an uninterrupted period of G
illness
mixed episode along with two of the following symptoms of schizophrenia: delusions,
hallucinations, disorganized speech, disorganized or catatonic behavior, or negative
symptoms.
33. A nurse is presenting information about psychotic disorders to a client’s family.
The family demonstrates a need for more discussion when they make which
statement about schizophreniform disorder?
A) The duration of the illness is usually less than 6 months.
B) Symptoms must be present for at least 1 month for the diagnosis.
C) The majority of individuals with the disorder recover completely.
D) The individual experiences hallucinations and/or delusions
Ans: C
Chapter: 23
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 7
Page Number: 386
Feedback: The essential features of schizophreniform disorder are identical to those
of criteria A for schizophrenia (delusions, hallucinations, disorganized speech, grossly
disorganized or catatonic behavior, negative symptoms), with the exception of the
duration of the illness, which can be less than 6 months. Symptoms must be present
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
for at least 1 month to be classified as a schizophreniform disorder. About one third of
the individuals recover, with the other two thirds developing schizophrenia.
GRADESLAB.COM
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Test Generator Questions, Chapter 24, Personality and
Impulse-Control Disorders: Nursing Care of Persons With
Personality and Impulse-Control Disorders
Multiple Choice
1. The nurse is assessing a client who is diagnosed with borderline personality
disorder. Which statement by the client indicates the client is at risk for self-injurious
behavior?
A) “I have felt so down lately. I don’t enjoy doing anything anymore.”
B) “I do what I do because others tell me to do so.”
C) “When I feel extremely anxious, it is like my mind goes somewhere else.”
D) “It is almost as if as soon as I think of doing something, I immediately do it.”
Ans: A
Chapter: 24
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 2
Page Number: 396, 397
GRADESLAB.COM
Feedback: Self-harm behavior is more likely to occur when the individual with
borderline personality disorder is depressed; has highly unstable interpersonal
relationships; and is paranoid, hypervigilant, and resentful. The statement about
doing what others tell him to do reflects an unstable self-image. Going somewhere
else reflects dissociation. Doing something upon immediately thinking about it reflects
impulsivity.
2. A client with borderline personality disorder has been admitted to the inpatient
unit because of cutting. The client’s sister is visiting, and she asks the nurse to explain
why the client sometimes does this. Which response by the nurse would be
appropriate?
A) “Sometimes the self-injurious behavior is undertaken to relieve stress.
B) “Self-injurious behavior often calms and sedates people with this diagnosis.”
C) “Sometimes they do it to avoid the onslaught of delusional thinking.”
D) “The self-mutilation often slows the mood swings your sibling experiences.”
Ans: A
Chapter: 24
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Communication and Documentation
Objective: 2
Page Number: 397
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Feedback: Clients with borderline personality disorder are impulsive and may
respond to stress by harming themselves. Self-harm is an effort to self-soothe by
activating endogenous endorphins to provide comfort. The behavior is not sedating or
calming, and it is not used to prevent delusional thinking or mood swings.
3. The nurse has explained some of the biologic theories of causation to a client
diagnosed with borderline personality disorder, and the client’s family. The nurse
determines that the client and family have understood the instructions when they
make which statement?
A) “The disorder may be caused by increased serotonin activity.”
B) “The disorder is caused by decreased dopamine activity in my brain.”
C) “A frontal lobe dysfunction may be causing this condition.”
D) “A decrease in hormonal substances increases the risk for this illness.”
Ans: C
Chapter: 24
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 3
Page Number: 397
Feedback: Associated brain dysfunction occurs in the limbic system or frontal lobe
and increases impulsive behaviors, parasuicidal behaviors, and mood disturbances.
GRAD
ESL
AB.COM as well as hormones, have not
Neurotransmitters such as serotonin
and
dopamine,
been implicated in the cause.
4. The nurse is assessing a client who has borderline personality disorder. Which
should be given priority during the assessment?
A) Nutrition patterns
B) Personal hygiene practices
C) Physical functioning
D) Somatic issues
Ans: A
Chapter: 24
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 2
Page Number: 399, 400
Feedback: Because of the comorbidity of borderline personality disorder (BPD) and
eating disorders and substance abuse, a nutritional assessment may be needed.
Individuals with BPD are usually able to maintain personal hygiene and physical
functioning.
5. A client diagnosed with borderline personality disorder tells the nurse that they
“frequently space out.” Which response by the nurse is appropriate?
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
A) “Do you feel stressed most of the time?”
B) “Does this frighten you when it happens?”
C) “What’s happening around you when this occurs?”
D) “Do you feel as if you are out of your body?”
Ans: C
Chapter: 24
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 5
Page Number: 401
Feedback: To determine a pattern for the client’s coping skills, it is important to ask
the client what is happening in the environment when dissociation occurs. In addition,
this is the only question that is open ended; therefore, it will elicit more information
than a closed-ended question would.
6. The nurse is caring for a client diagnosed with borderline personality disorder. The
nurse has instructed the client about using the communication triad. The nurse
determines that the client has understood this technique when the client makes which
statement?
A) “I should start by stating my feelings as an “I’ statement.”
B) “Maybe I should start by describing the situation that has me upset.”
C) “I should first tell the other person what I’d like to be different about the
GRADESLAB.COM
situation.”
D) “I should begin by telling the other person what has triggered my emotion.”
Ans: A
Chapter: 24
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Communication and Documentation
Objective: 5
Page Number: 407
Feedback: The client should begin with an “I” statement and the identification of
feelings. Many want to begin with the condition. If the client begins with the condition,
the statement becomes accusatory and is likely to evoke defensiveness. The “I”
statement is followed by a nonjudgmental statement of the emotional trigger, then
followed by what the person would like differently or what would restore comfort to
the situation.
7. A client with borderline personality disorder tells the nurse, “I’m afraid to get on a
train because it will probably wreck.” Which response by the nurse would be
appropriate?
A) “Have you had a bad experience riding a train?”
B) “What are the chances of that actually happening?”
C) “Now you know that won't happen.”
D) “Have you thought about going by automobile?”
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Ans: B
Chapter: 24
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 6
Page Number: 405
Feedback: The nurse should challenge the client’s dysfunctional thinking by
encouraging the client to think about the event or situation in a different way,
providing the client with a different perspective to consider. Although asking about a
previous bad experience may help shed some light on the situation, the client with
borderline personality disorder has dysfunctional thinking, and this needs to be
addressed. Telling the client that he or she knows it won’t happen or suggesting the
client travel by car does not address the client’s underlying pattern of thinking.
Multiple Select
8. A nurse is preparing an in-service presentation on personality disorders and
characteristics. Which terms should the nurse include to differentiate personality
disorders from normal personality? (Select all that apply.)
A) Inflexible
B) Short term
C) Pervasive
GRADESLAB.COM
D) Unstable over time
E) Distressing
Ans: A, C, D, E
Chapter: 24
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 1
Page Number: 392
Feedback: Personality disorder refers to abnormal, inflexible behavior patterns that
are pervasive, of long duration, unstable over time, traced to an onset in adolescence
or early adulthood, deviate from acceptable cultural norms, and lead to distress or
impairment.
9. A nurse is explaining to a client, possible risk factors for development of
borderline personality disorder. The client demonstrates understanding of the
information when they identify which characteristics as a risk factor? (Select all that
apply.)
A) Childhood sexual abuse
B) Parental loss
C) Substance abuse
D) Family history
E) Genetics
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Ans: A, B
Chapter: 24
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 1
Page Number: 397
Feedback: Various studies show that physical abuse and sexual abuse appear to be
significant risk factors for borderline personality disorder. Other studies cite parental
loss and separation. Substance abuse, family history, and genetics have not been
implicated.
Multiple Choice
10. A nurse is assessing a client with borderline personality disorder. Which question
would be appropriate to assess the client’s level of impulsivity?
A) “What things bother you and what things make you feel happy?”
B) “Have you ever felt sorry after acting as you did on the spur of the moment?”
C) How do you view other people around you?”
D) “Have you ever felt like you were separated from your body?”
Ans: B
Chapter: 24
GRADESLAB.COM
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 2
Page Number: 401
Feedback: To assess impulsivity, the nurse would ask the client if he or she ever felt
sorry for acting on the spur of the moment. Asking about things bothering the client
provides information about the client’s mood. Asking about how the client views other
people provides information about the client’s cognition and possible dichotomous
thinking. Asking about feeling separated from the body provides information about
dissociation.
11. As part of a client’s treatment plan for borderline personality disorder, the client
is engaged in dialectical behavior therapy. As part of the therapy, the client is learning
how to control and change behavior in response to events. The nurse identifies the
client as learning which type of skills?
A) Emotion regulation skills
B) Mindfulness skills
C) Distress tolerance skills
D) Self-management skills
Ans: D
Chapter: 24
Client Needs:
Psychosocial Integrity
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 6
Page Number: 399
Feedback: Self-management skills focus on helping clients learn how to control,
manage, or change their behavior, thoughts, or emotional responses to events.
Emotion regulation skills are taught to manage intense, labile moods and involve
helping the client label and analyze the context of the emotion, as well as developing
strategies to reduce emotional vulnerability. Teaching individuals to observe and
describe emotions without judging or blocking them helps clients experience emotions
without stimulating secondary feelings that may cause more distress. Mindfulness
skills are the psychological and behavioral versions of meditation skills usually taught
in Eastern spiritual practice; they are used to help the person improve observation,
description, and participation skills by learning to focus the mind and awareness on
the current moment’s activity. Distress tolerance skills involve helping the individual
tolerate and accept distress as a part of normal life.
Multiple Select
12. A client with borderline personality disorder has difficulty maintaining the
boundaries of the professional relationship. Which actions by the nurse would be most
effective? (Select all that apply.)
A) Punish the client with seclusion for violating established boundaries.
B) Respond to the client’s arrogance in a neutral, nonconfrontational manner.
GRADinES
LAtherapeutic
B.COM
C) Discuss the purpose of the limits
the
relationship.
D) State the parameters of the limits and boundaries clearly.
E) Ensure that any established limits are maintained consistently.
Ans: B, C, D, E
Chapter: 24
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 4, 5
Page Number: 36.
Feedback: When setting limits to maintain boundaries, the nurse must state the
limits and consequences for violating them clearly, and ensure that they are
consistently maintained. In addition, the nurse must respond to a client’s arrogance in
a neutral manner that avoids confrontation and a power struggle. The nurse also
should discuss the purpose of the limits in the therapeutic relationship and confront
violations in a nonpunitive way.
13. A nurse is engaged in role-playing with a client with borderline personality
disorder in order to assist the client in learning how to communicate effectively. Which
technique would the nurse encourage the client to use? (Select all that apply.)
A) “Me” statements
B) Validating perceptions with others
C) Paraphrasing before responding
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
D) Listening passively
E) Compromising
Ans: B, C, E
Chapter: 24
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 5
Page Number: 407
Feedback: The nurse would teach the client basic communication approaches, such
as making “I” statements, paraphrasing what the other party says before responding,
checking the accuracy of perceptions with others, compromising and seeking common
ground, listening actively, and offering and accepting reactions.
14. When describing the characteristics associated with borderline personality
disorder (BPD), which would the nurse most likely include? (Select all that apply.)
A) Difficulty regulating moods
B) Over-inflated self-identity
C) Problems with interpersonal relationships
D) Thinking that is delusional-based
E) Impulsive behavior
Ans: A, C, E
GRADESLAB.COM
Chapter: 24
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 2
Page Number: 395
Feedback: People with BPD have problems regulating their moods, developing a
self-identity, maintaining interpersonal relationships, maintaining reality-based
thinking, and avoiding impulsive or destructive behavior.
15. When assessing a client with borderline personality disorder (BPD), which
characteristics would the nurse expect to assess? (Select all that apply.)
A) Freely shares feelings with others
B) Control necessary for a relationship
C) Fear of rejection
D) Exaggerated sense of self
E) Self-injurious behavior
Ans: B, C, E
Chapter: 24
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 2
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Page Number: 396
Feedback: People with BPD have an extreme fear of abandonment as well as a
history of unstable, insecure attachments. These individuals, who already are
intensely emotional and have a poor sense of self, feel estranged from others and
inadequate in the face of perceived social standards. Intense shame and self-hate
follow. These feelings often result in self-injurious behaviors, such as wrist cutting,
self-burnings, or head banging. People with BPD use elaborate strategies to structure
interactions. That is, they restrict their relationships to ones in which they feel in
control. They distance themselves from groups when feeling anxious (which is most of
the time) and rarely use their social support system. Even if they are married or have
a supportive extended family, they are reluctant to share their feelings. They do not
want to burden anyone; they fear rejection and assume that people are tired of
hearing them repeat the same issues.
Multiple Choice
16. Which client statement accurately reflects the cognitive dysfunction associated
with borderline personality disorder?
A) “I was a total failure at my new job.”
B) “Sometimes things are not always clear cut.”
C) “At least some good came out of my trying.”
D) “You need to look at things in perspective.”
Ans: A
GRADESLAB.COM
Chapter: 24
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 2
Page Number: 396
Feedback: People with BPD have dichotomous thinking. Cognitively, they evaluate
experiences, people, and objects in terms of mutually exclusive categories (e.g., good
or bad, success or failure, trustworthy or deceitful), which results in extreme
interpretations of events that would normally be viewed as including both positive and
negative aspects. The statement about being a total failure is an example.
17. A nurse is reviewing the medical record of a client diagnosed with borderline
personality disorder. Which element would the nurse identify as one of the strongest
risk factors for this disorder?
A) Abuse as a child
B) Parental alcohol abuse
C) Poverty
D) History of depression
Ans: A
Chapter: 24
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Integrated Process: Nursing Process
Objective: 1
Page Number: 397
Feedback: Childhood sexual abuse, which more commonly affects girls, is one of the
strongest risk factors for BPD. Various studies show that physical and sexual abuse
appear to be significant risk factors for BPD. Other studies cite parental loss and
separation. Parental alcohol abuse, poverty or a history of depression have not been
linked to BPD.
18. A client with borderline personality disorder (BPD) tells the nurse, “You are good
but the nurse on the afternoon shift is bad. The doctor is bad, too, but the therapist is
good.” The nurse interprets this statement as reflecting which function?
A) Splitting
B) Identity diffusion
C) Dissociation
D) Cognitive schema
Ans: A
Chapter: 24
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 2
GRADESLAB.COM
Page Number: 399
Feedback: Clients with BPD view the world in absolutes; nurses and other treatment
team members are alternately categorized as all good or all bad. This defense is called
splitting, and presents clinicians with a challenge to work openly with each other, as
well as the client, until the issue can be resolved through team meetings and clinical
supervision. Identity diffusion occurs when a person lacks aspects of personal identity
or when personal identity is poorly developed. Dissociation is a cognitive dysfunction
reflected as thinking, feeling or behaving outside a person’s awareness. Cognitive
schema refers to patterns of thoughts that determine how a person interprets events.
19. The nurse is preparing to assess a client with a paranoid personality trait. The
nurse integrates knowledge of this condition, anticipating that the client most likely
have what type of affect and behavior?
A) Angry and hostile
B) Flirtatious and seductive
C) Fearful and anxious
D) Friendly and open
Ans: A
Chapter: 24
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 2
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Page Number: 392
Feedback: People with paranoid personality traits are unforgiving and hold grudges;
their typical emotional responses are anger and hostility. They distance themselves
from others and are outwardly argumentative and abrasive; internally, they feel
powerless, fearful, and vulnerable. Other hallmark features of paranoid personality
disorder are persistent ideas of self-importance and the tendency to be rigid and
controlled. Thus, the client would not be flirtatious, seductive, fearful, anxious,
friendly, or open.
20. The nurse is caring for a client with schizoid personality trait. When developing
the plan of care for the client, which intervention would the nurse most likely include?
A) Social skills training
B) Anger management training
C) Relaxation techniques
D) Coping skills training
Ans: A
Chapter: 24
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 4
Page Number: 9.
RADschizoid
ESLABpersonality
.COM
Feedback: Because individuals G
with
trait often lack customary
social skills, social skills training is useful in enhancing their ability to relate in
interpersonal situations. The primary focus is to increase the client’s ability to feel
pleasure. The nurse balances interventions between encouraging enough social
activity and too much activity, which prevents the individual from retreating to a
fantasy world that becomes intolerable. Anger management, relaxation techniques,
and coping skills are not appropriate for a client with schizoid personality trait.
Multiple Select
21. A nurse is preparing a training plan for a group of new nurses about antisocial
personality disorder. Which terms would the nurse include as words used to describe
the behaviors associated with this condition? (Select all that apply.)
A) Psychopath
B) Manipulator
C) Criminality
D) Sociopath
E) Psychotic
Ans: A, D
Chapter: 24
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Teaching/Learning
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Objective: 2
Page Number: 408
Feedback: The terms psychopath and sociopath are often used to describe the
behaviors of antisocial personality disorder. Although individuals with this disorder are
self-serving, exploitive, and engage in acts that are grounds for arrest, the terms
manipulator and criminality are not commonly used. Psychotic refers to behaviors in
which there are disturbed thought processes.
22. A nurse is reading a journal article about the various theories associated with the
development of antisocial personality disorder. The article mentions difficult
temperament as a possible theory. The nurse demonstrates understanding of this
concept when identifying which key behaviors as associated with a difficult
temperament? (Select all that apply.)
A) Aggression
B) Inattention
C) Hyperactivity
D) Impulsivity
E) Depression
F) Paranoia
Ans: A, B, C, D
Chapter: 24
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
GRADESLAB.COM
Integrated Process: Nursing Process
Objective: 3
Page Number: 409, 410
Feedback: A difficult temperament is characterized by withdrawal from stimuli, low
adaptability, and intense emotional reactions. Four key behaviors are present in a
difficult temperament: aggression, inattention, hyperactivity, and impulsivity.
Depression and paranoia are not components of a difficult temperament.
23. A nurse is developing a plan of care for a client diagnosed with an antisocial
personality disorder who has been admitted to the inpatient psychiatric unit. Which
items would the nurse most likely include? (Select all that apply.)
A) Developing a therapeutic relationship
B) Bargaining about the unit rules
C) Holding the client responsible for behavior
D) Discouraging client from discussing thoughts
E) Using a firm, lecture-like approach for teaching
Ans: A, C
Chapter: 24
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 4
Page Number: 411
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Feedback: The nurse should develop a therapeutic relationship, although it may be
difficult because individuals do not attach to others. The nurse should hold the client
responsible for behavior, avoid arguing or bargaining about unit rules, encourage the
client to recognize and discuss thoughts, and use a direct approach to teaching. A
lecture-like approach can lead to resentment by the client.
Multiple Choice
24. A nurse is working with the family of a client who has been diagnosed with
antisocial personality disorder. Which information would be most important for the
nurse to focus on when teaching the family about this disorder?
A) Anger management
B) Boundary setting
C) Medication therapy
D) Self-responsibility
Ans: B
Chapter: 24
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 5
Page Number: 413
GRADEwith
SLAantisocial
B.COM personality disorder usually
Feedback: Family members of clients
need help in establishing boundaries. Because there is a long-term pattern of
interaction in which family members feel responsible for the client’s antisocial
behavior, these patterns need to be interrupted. Anger management and
self-responsibility are appropriate for the client, not the family. Medication therapy is
usually not prescribed unless the client has another disorder.
25. A nurse is assigned to care for a client with antisocial personality disorder. The
nurse knows that which information about this disorder is true?
A) The disorder occurs more frequently in women.
B) The individual must be at least 18 years of age.
C) The disorder is found primarily in Asian individuals.
D) Alcohol abuse disorder rarely accompanies this disorder.
Ans: B
Chapter: 24
Client Needs: Psychosocial Integrity
Cognitive Level: Understand
Integrated Process: Teaching/Learning
Objective: 2
Page Number: 408
Feedback: To be diagnosed with antisocial personality disorder, the individual must
be at least 18 years of age and must have exhibited one or more childhood behavioral
characteristics of conduct disorder before the age of 15 years. The disorder occurs
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
more frequently in men and crosses all cultures and ethnicities. This personality
disorder is strongly associated with alcohol and drug abuse.
26. A nurse is providing care to a client with antisocial personality disorder. As part
of the plan of care, the client is to participate in a problem-solving group. The nurse
understands that this intervention is effective based on which rationale?
A) It requires the client to develop attachments.
B) It sets up specific boundaries for the client.
C) It helps reinforce self-responsibility.
D) It avoids confrontation about dysfunctional patterns.
Ans: C
Chapter: 24
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 5
Page Number: 412, 413
Feedback: Problem-solving groups that focus on identifying a problem and
developing a variety of alternative solutions are especially helpful for the client with
antisocial personality disorder. This is because client self-responsibility is reinforced
when clients remind each other of the better alternatives. In addition, clients are likely
to confront each other with dysfunctional schemas or thinking patterns. Groups that
focus on developing empathy would foster attachment. Although groups typically
GRAthis
DES
AB.the
COprimary
M
have specific rules and boundaries,
isLnot
focus of problem-solving
groups.
27. The nurse is reviewing the medical record of a client diagnosed with antisocial
personality disorder. The nurse notes that the client has had numerous episodes
involving irritability, aggressiveness, and impulsivity, and has exhibited callousness
toward others. Based on this information, which nursing diagnosis would the nurse
identify as a priority?
A) Risk for Other-Directed Violence
B) Risk for Self-Injury
C) Risk for Suicide
D) Risk for Self-Directed Violence
Ans: A
Chapter: 24
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 4
Page Number: 410
Feedback: Although they can be interpersonally charming, these clients can become
verbally and physically abusive if their expectations are not met. Protection of other
clients and staff from manipulative and sometimes abusive behavior is a priority.
Thus, a nursing diagnosis of Risk for Other-Directed Violence would be a priority.
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Clients with antisocial personality disorder are less likely to engage in self-injury or
self-violence; rather, they are more likely to strike out at those who are perceived to
be interfering with their immediate gratification. Risk for Suicide would be a priority if
the client was also experiencing depression.
Multiple Select
28. A client is brought into the emergency department because of reports from the
neighbors that the client was acting strangely. The nurse assesses the client and
suspects schizotypal personality disorder based on assessment of which symptoms?
(Select all that apply.)
A) Magical beliefs
B) Hallucinations
C) Paranoia
D) Avoidance of eye contact
E) Meticulous dress
Ans: A, B, C, D
Chapter: 24
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 2
Page Number: 394
GRADESpersonality
LAB.COM disorder exhibits magical beliefs
Feedback: The person with schizotypal
and perceptual alterations that are similar to hallucinations but not hallucinations.
They also exhibit paranoia and avoid eye contact. Typically, the client has an unkempt
manner of dress that does not quite fit together with clothing that is stained or ill
fitting.
29. A nurse is assessing a client diagnosed with avoidant personality disorder. Which
characteristics would the nurse most likely expect to find? (Select all that apply.)
A) Shyness
B) Feelings of inadequacy
C) Feelings of superiority
D) Perfectionism
E) Detail oriented
Ans: A, B
Chapter: 24
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 7
Page Number: 416
Feedback: Individuals with avoidant personality disorder appear timid, shy, and
hesitant; fear criticism; and feel inadequate and inferior. These individuals are
extremely sensitive to negative comments and disapproval, and appraise situations
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
more negatively than others do. Individuals with obsessive--compulsive personality
disorder exhibit perfectionism and an intense involvement in details such that they
have difficulty making decisions and completing tasks.
Multiple Choice
30. A nurse is interviewing a client and suspects that the client may have narcissistic
personality disorder. Which client statement would help support the nurse’s
suspicions?
A) “I have a very important position in life; everyone I know wants to be like me.”
B) “My spouse is poisoning my food so I’ll die and they’ll get my life insurance
money.”
C) “I like to work alone because then I can let my thoughts wander.”
D) “I’m always the life of the party, making new friends all the time.”
Ans: A
Chapter: 24
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 7
Page Number: 415
GRADESpersonality
LAB.COMdisorder are grandiose, have an
Feedback: Individuals with narcissistic
inexhaustible need for admiration, and lack empathy. These individuals believe that
they are superior, special, or unique, and that others should recognize them in this
way. The statement about having a very important position in life and everyone
wanting to be like the client reflects this personality trait. The statement about
poisoning the food reflects paranoid personality traits. The statement about working
alone suggests schizoid personality traits. The statement about being the life of the
party suggests histrionic personality traits.
31. A nurse is developing an education plan for a client with an impulse-control
disorder. The nurse is planning to explain the emotional aspects associated with the
behavior as part of the plan. Which feeling would the nurse describe as occurring first
before the individual commits the act?
A) Remorse
B) Tension
C) Regret
D) Pleasure
Ans: B
Chapter: 24
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Teaching/Learning
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Objective: 7
Page Number: 418
Feedback: Tension increases before the individual commits the act, and excitement
or gratification occurs at the time the act is committed. The release of tension is
perceived as pleasurable, but remorse and regret usually follow the act.
32. A nurse is describing histrionic personality disorder to a group of new nurses.
Which term would the nurse most likely use?
A) Attention-seeking
B) Psychopath
C) Sociopath
D) Lacking empathy
Ans: A
Chapter: 24
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 7
Page Number: 413
Feedback: A person with a histrionic personality disorder is often described as
attention seeking, excitable, and emotional. Psychopath and sociopath are terms
used to describe the behavior of a person with antisocial personality disorder. Lacking
RAperson
DESLA
B.CaOnarcissistic
M
empathy is a term that describesGa
with
personality disorder.
33. A nurse is working with the parents of a child with a conduct disorder and
teaching them how to use “time out.” Which statement by the parents indicates that
they have understood the information?
A) “We should put our child in a chair in the corner of the room, away from all to
see.”
B) “The time starts as soon as the child begins the behavior.”
C) “We should keep the child in time out for about five minutes.”
D) “Our child needs to explain why they are going to time out before the time out
begins.”
Ans: C
Chapter: 24
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 6
Page Number: 420
Feedback: Typically the time duration for a “time out” is 5 minutes for children 5
years of age and older. The chair should be located away from general activity but
within view. The time starts once the child is sitting quietly in the designated spot.
Once the time out is complete, the child is asked to recount why he or she was given
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
the time out.
34. After reviewing information about different personality disorders, a group of
nurses identifies which characteristics as associated with schizoid personality
disorder?
A) Introverted
B) Overly friendly
C) Highly social
D) Exuberant
Ans: A
Chapter: 24
Client Needs: Psychosocial Integrity
Cognitive Level: Understand
Integrated Process: Teaching/Learning
Objective: 7
Page Number: 393
Feedback: People with schizoid personality disorder are characterized as being
expressively impassive and interpersonally unengaged (Millon, 2011). They tend to
be unable to experience the joyful and pleasurable aspects of life. They are
introverted and reclusive and clinically appear distant, aloof, apathetic, and
emotionally detached. Typically lifelong loners, they have difficulty making friends,
seem uninterested in social activities, and appear to gain little satisfaction in personal
GRADESLAB.COM
relationships.
Multiple Select
35. A nurse is conducting an in-service program on personality disorders. When
describing obsessive--compulsive personality disorder, which characteristics will the
nurse most likely include? (Select all that apply.)
A) Preoccupation with control
B) Inability to delay rewards
C) Strict attention to rules
D) Difficulty with decision making
E) Relationships primarily formal and polite
Ans: A, C, D, E
Chapter: 24
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 7
Page Number: 417
Feedback: Individuals with obsessive--compulsive personality disorder demonstrate
a pervasive pattern of preoccupation with orderliness, perfectionism, and control.
They also have the ability to delay rewards and maintain control by careful attention
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
to rules. Perfectionists are prone to repetition and have difficulty making decisions.
They can be overly conscientious about morality and ethics and value polite, formal,
and correct interpersonal relationships.
Multiple Choice
36. A nurse is reviewing the medical record of an individual diagnosed with antisocial
personality disorder. Which characteristic would the nurse identify as having
increased the person’s risk for this condition?
A) Conduct disorder at age 12
B) History of childhood ADHD
C) Hispanic American cultural background
D) Female gender with alcohol use disorder
Ans: B
Chapter: 24
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 1
Page Number: 408, 409
Feedback: There is an increased likelihood of developing adult ASPD if there was an
early onset of conduct disorder (before age 10 years) as well as accompanying
childhood attention deficit hyperactivity disorder (ADHD). Males with alcohol use
GRA
DESLclinics,
AB.COprisons,
M
disorder and those from substance
abuse
or other forensic settings
have the highest rates. In the 2001 to 2002 National Epidemiologic Survey on Alcohol
and Related Conditions (n = 43,093), the odds of ASPD were greater among Native
Americans and lower among Asians, compared with white men and women.
Multiple Select
37. A nurse is assessing a client who is reported to have a difficult temperament.
Which behaviors would the nurse expect to assess? (Select all that apply.)
A) Aggression
B) Inattention
C) Hypoactivity
D) Impulsivity
E) Talkativeness
Ans: A, B, D
Chapter: 24
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 3
Page Number: 410
Feedback: According to Psychosocial Theories, a difficult temperament is
characterized by withdrawal from stimuli, low adaptability, and intense emotional
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
reactions. Four key behaviors are present in a difficult temperament: aggression,
inattention, hyperactivity, and impulsivity. Talkativeness would not apply.
Multiple Choice
38. A nurse is working with a client diagnosed with antisocial personality disorder.
The nurse needs to keep in mind which information about the therapeutic
relationship?
A) The goal is to alleviate dysfunctional thinking.
B) The relationship initially is superficial due to lack of client commitment.
C) The client uses the relationship to change the problem behavior.
D) The client continuously focuses on new topics during the relationship.
Ans: B
Chapter: 24
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 5
Page Number: 411
Feedback: Therapeutic relationships are difficult to establish because these
individuals do not attach to others and are often unable to use the relationship to
change behavior. The goal of the therapeutic relationship is to identify dysfunctional
thinking patterns and develop new problem-solving behaviors. After the first few
RADEmay
SLAbelieve
B.COMthat the relationship has a good
meetings with these clients, the G
nurse
start, but in reality, a superficial alliance is usually formed. Additional sessions reveal
the lack of client commitment to the relationship. These clients begin to revisit topics
discussed in previous sessions or lose interest in trying to work on problems.
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Test Generator Questions, Chapter 25, Addiction and
Substance-Related Disorders: Nursing Care of Persons With
Alcohol and Drug Use
Multiple Choice
1. A client has been prescribed naltrexone (Trexan) for treatment of alcohol
dependence. The nurse has explained the drug’s purpose to the client. The nurse
determines that the client has understood the instructions when the client identifies
which information about the drug?
A) Causes itching if alcohol is consumed
B) Produces the euphoria of alcohol
C) Reduces the appeal of alcohol
D) Improves appetite and nutritional status
Ans: C
Chapter: 25
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Analyze
Integrated Process: Nursing Process
GRADESLAB.COM
Objective: 2
Page Number: 432
Feedback: Naltrexone’s effect is unknown. Reports from successfully treated clients
suggest three kinds of effects: (1) can reduce craving (the urge or desire to drink), (2)
can help maintain abstinence, and (3) can interfere with the tendency to want to drink
more if a recovering client slips and has a drink.
2.
the
A)
B)
C)
D)
An adolescent client reports occasionally “sniffing airplane glue.” When discussing
results of long-term use of inhalants, which effects would the nurse include?
Tremors and CNS arousal
Enhanced normal heart rhythms
Enhanced attention on focus and memory
Brain damage and cognitive abnormalities
Ans: D
Chapter: 25
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 1
Page Number: 441
Feedback: Long-term inhalant use is linked to widespread brain damage and
cognitive abnormalities that can range from mild impairment to severe dementia.
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Tremors, CNS arousal, and cardiac changes are not associated with long-term
inhalant use. Intoxication can lead to cardiac arrest.
3. A client is committed to trying to quit smoking. When educating the client on
smoking cessation, which information would the nurse include?
A) Success usually involves more than one type of intervention.
B) Relapse is fairly rare within the first year of quitting.
C) Ear acupressure is a highly proven method for quitting.
D) The drug, varenicline is widely used in clients with psychiatric disorders.
Ans: A
Chapter: 25
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 2
Page Number: 436
Feedback: Successful smoking cessation usually requires more than one type of
intervention, including social support and education. Recent research has shown that
nicotine addiction is extremely powerful and is at least as strong as addictions to other
drugs, such as heroin and cocaine; 70% of those who quit relapse within 1 year.
Auricular therapy, or ear acupressure, is being studied as a potential adjunctive
treatment for nicotine addiction. Varenicline tartrate (Chantix) reduces the craving
and rewarding effects of nicotine by preventing nicotine from accessing one of the
GRAD
ESLnicotine
AB.COdependence,
M
acetylcholine receptor sites involved
with
but it can cause
depression and related psychiatric symptoms in some people. This side effect limits its
usefulness for people with psychiatric disorders.
Multiple Select
4. The nurse is monitoring a client who is withdrawing from chronic alcohol use.
Which findings should the nurse document as evidence that the client is experiencing
stage 1 of alcohol withdrawal syndrome? (Select all that apply.)
A) Slight diaphoresis
B) Hand tremors
C) Intermittent confusion
D) Heart rate of 135 beats/min
E) Normal blood pressure
Ans: A, B, D, E
Chapter: 25
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 1
Page Number: 430
Feedback: A person in stage 1 of alcohol withdrawal syndrome exhibits slight
diaphoresis, hand tremors, no confusion, elevated heart rate, and normal or slightly
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
elevated blood pressure. A heart rate of 135 beats/min indicates stage 3 or severe
alcohol withdrawal syndrome.
Multiple Choice
5. A client is being treated for chronic alcoholism, the nurse notes the client is
wearing a stethoscope and asks the client where the stethoscope came from. The
client gives a rambling response that the nurse knows is not accurate. The nurse
suspects that the client may be experiencing which condition?
A) Wernicke syndrome
B) Delirium tremens
C) Korsakoff’s amnestic syndrome
D) Malignant hyperthermia
Ans: C
Chapter: 25
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 1
Page Number: 432
Feedback: Korsakoff’s amnestic syndrome, is associated with alcoholism, involves
the heart and the vascular and nervous systems, but the primary problem is acquiring
new information and retrieving memories. Symptoms include amnesia, confabulation,
GRADscenario
ESLAB.toCO
M
(i.e., telling a plausible but imagined
compensate
for memory loss),
attention deficit, disorientation, and vision impairment. Wernicke encephalopathy, a
degenerative brain disorder caused by thiamine deficiency, is characterized by vision
impairment, ataxia, hypotension, confusion, and coma. Delirium tremens is an acute
withdrawal syndrome characterized by autonomic hyperarousal, disorientation,
hallucinations, and tremors. Malignant hyperthermia is characterized by a sharp
increase in body temperature leading to muscle breakdown, kidney and
cardiovascular failure, and death.
6. A nurse is using motivational therapy with a client suffering from alcoholism. The
client, who is unwilling to consider changing the drinking behavior, emphatically
states, “I am not an alcoholic; you can’t make me stop drinking.” Which response by
the nurse would be most appropriate?
A) “You have to stop drinking and driving. You could kill someone.”
B) “You’re right. You are not an alcoholic.”
C) “You should consider what you are doing to your marital relationship.”
D) “You're the only one who can make yourself stop drinking.”
Ans: D
Chapter: 25
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 2
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Page Number: 445
Feedback: The acronym FRAMES summarizes elements of brief interventions with
clients using motivational interviewing. The nurse should emphasize both the client’s
freedom to choose to change as well as the client’s responsibility to change. Telling
the client to stop drinking and driving is confrontational and not therapeutic in this
situation; telling the client to think about the effects of the drinking on the client’s is
inappropriate because the client has yet to acknowledge that he or she has a problem.
Telling the client that they are not an alcoholic only reinforces the client’s denial.
7. A nurse is working with a client who is addicted to heroin. The nurse engages in
harm reduction by educating the client about which intervention?
A) Needle exchange programs
B) Problem solving
C) Healthy coping skills
D) Proper use of naltrexone (Trexan)
Ans: A
Chapter: 25
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 3
Page Number: 450
Feedback: Harm reduction initiatives range from widely accepted designated driver
GRADsuch
ESLA
COM of condoms in schools, safe
campaigns to controversial initiatives
asB.
provision
injection rooms, needle exchange programs, and heroin maintenance programs.
Problem solving, coping skills, and naltrexone would not be considered
harm-reduction interventions.
8. A client arrives at the emergency department by ambulance. The client is
unconscious, with slow respirations and pinpoint pupils. The friend who came with the
client reports that the client had just “shot up” heroin and became unconscious. Which
medication would the nurse most likely expect to administer?
A) Naloxone
B) Naltrexone
C) Bupropion
D) Varenicline
Ans: A
Chapter: 25
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 3
Page Number: 439
Feedback: Naloxone (Narcan), an opioid antagonist, is given to reverse respiratory
depression, sedation, and hypertension. Naltrexone is used to treat alcohol
dependence. Bupropion and varenicline are used to promote smoking cessation.
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Multiple Select
9. A client who used to drink about six cups of coffee and several diet cola drinks per
day reports to the nurse, “I just cut down my coffee and soda intake to one per day.”
Which assessment findings would the nurse expect? (Select all that apply.)
A) Headache
B) Fatigue
C) Yawning
D) Flushing
E) Diuresis
Ans: A, B, C
Chapter: 25
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 1
Page Number: 437
Feedback: The client’s decreased intake of caffeine could lead to caffeine
withdrawal, manifested by headache, drowsiness, fatigue, craving, impaired
psychomotor performance, difficulty concentrating, yawning, and nausea. Flushing
and diuresis would be characteristic of caffeine overdose.
10. During a presentation to a teen group in the community, a nurse reviews
GRare
ADEabused.
SLAB.The
COMteenagers demonstrate
information about substances that
understanding of the information when they identify which chemicals as stimulants?
(Select all that apply.)
A) Alcohol
B) Cocaine
C) Heroin
D) Nicotine
E) Phencyclidine
Ans: B, D
Chapter: 25
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Teaching/Learning
Objective: 1
Page Number: 434--436
Feedback: Stimulants include cocaine and nicotine. Alcohol is a depressant. Heroin
is an opioid derivative that depresses the central nervous system. Phencyclidine is
classified as a hallucinogen.
Multiple Choice
11. A client is receiving methadone maintenance therapy. After teaching the client
about this treatment, the nurse determines that the education was successful when
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
the
A)
B)
C)
D)
client makes which statement?
“I can have a glass of wine with dinner if I choose.”
“I should eat small frequent meals if I get nauseated.”
“I should take the drug on an empty stomach.”
“I might experience diarrhea with this drug.”
Ans: B
Chapter: 25
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Analyze
Integrated Process: Teaching/Learning
Objective: 3
Page Number: 440
Feedback: A client receiving methadone maintenance therapy may experience
nausea. Therefore, the client should eat small, frequent meals to treat the nausea and
loss of appetite, and take the drug with food and lie quietly to minimize the nausea.
Alcohol should be avoided. Constipation may occur, necessitating the use of a mild
laxative.
12. A client with a history of alcohol abuse is participating in a 12-step Alcoholics
Anonymous (AA) program. The nurse determines that the client is at step 2 based on
what statement by the client?
A) “I’ve admitted to myself and others the wrongdoings I’ve done.”
B) “I realize that there is a higher power that can help me.”
GRADover
ESLAalcohol.”
B.COM
C) “I know now that I am powerless
D) “I am making amends to all those that I've harmed.”
Ans: B
Chapter: 25
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 3
Page Number: 450
Feedback: Coming to believe that a power greater than oneself could help restore
sanity reflects the second step of AA. Admitting to one’s self and others about
wrongdoings reflects step 5 of AA. Admitting powerlessness over alcohol is step 1.
Making amends is part of step 9.
13. A nurse is preparing an in-service program about substance abuse. Which
information would the nurse include in the presentation when discussing possible
contributors to the development of substance abuse?
A) Mixed self-esteem
B) Genetic predisposition
C) Dysfunctional family
D) Peer influence
Ans:
B
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Chapter: 25
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 1
Page Number: 427
Feedback:
Substance abuse encompasses the body, the mind, and society’s
influence. Human and animal studies confirm a genetic predisposition for drinking
behaviors and self-administering mind-altering drugs, but as yet no precise genetic
marker has been established. Temperament, self-concept, age, motivation for
change, social consequences for problematic behaviors, parental and family
relationships and peer pressure all contribute to expression of substance abuse—a
chronic and progressive disorder. Dysfunctional family and peer influence reflect
social etiologies.
14. A client is brought into the emergency department after a motor vehicle
collision. The client’s blood alcohol level (BAL) is 0.10 mg%. What assessment
findings does the nurse attribute to this BAL?
A) Difficulty with coordination
B) Stupor
C) Emotional lability
D) Ataxia
Ans: A
GRADESLAB.COM
Chapter: 25
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 2
Page Number: 429
Feedback: A BAL of 0.10 mg% would be manifested by difficulty driving and
coordinating movements. Ataxia and emotional lability would be associated with a
BAL of 0.20 mg%. Stupor would be associated with a BAL of 0.30 mg%.
15. A client with a history of opioid abuse is exhibiting manifestations of moderate
withdrawal. Which assessment findings will the nurse document as evidence of
moderate withdrawal?
A) Rhinorrhea
B) Lacrimation
C) Dilated pupils
D) Dysphoria
Ans: C
Chapter: 25
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 1
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Page Number: 439
Feedback: With moderate opioid withdrawal, pupils are dilated. Rhinorrhea,
lacrimation, and dysphoria are noted with mild withdrawal.
16. A nurse is implementing a brief intervention with a client who is abusing alcohol.
What action will the nurse perform?
A) Asking the client questions about alcohol use
B) Negotiating a conversation with the client to reduce use
C) Pointing out the inconsistencies in thoughts, feelings, and action
D) Helping the client change the way he thinks about a situation
Ans: B
Chapter: 25
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 3
Page Number: 447
Feedback: Brief intervention involves a negotiated conversation between the nurse
and the client that is designed to reduce the substance use. Asking the client
questions about substance use refers to screening. Pointing out inconsistencies
reflects confrontation. Helping the client change his or her way of thinking reflects a
cognitive approach.
Multiple Select
GRADESLAB.COM
17. A client with a history of substance abuse is involved in a skills training group.
What activities will the nurse facilitate to help the client develop intrapersonal coping
skills? (Select all that apply.)
A) Substance refusal skills
B) Problem solving
C) Anger awareness
D) Emergency planning
E) Social support networking
Ans: B, C, D
Chapter: 25
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Teaching/Learning
Objective: 2
Page Number: 450
Feedback: Topics included in skills training groups addressing intrapersonal issues
include problem solving, awareness and management of anger, and planning for
emergencies. Substance refusal skills and social support networking would be skills
addressing interpersonal issues.
18.
A client is brought to the emergency department after having overdosed on
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
cocaine. When assessing the client, which conditions would the nurse document as
evidence of cocaine overdose? (Select all that apply.)
A) Euphoria
B) Seizures
C) Cardiac arrhythmia
D) Paranoia
E) Insomnia
Ans: B, C
Chapter: 25
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 1
Page Number: 428
Feedback: Manifestations of cocaine overdose include cardiac dysrhythmias or
arrest, increased or lowered blood pressure, respiratory depression, chest pain,
vomiting, seizures, psychosis, confusion, dyskinesia, dystonia, and coma. Euphoria,
paranoia, and insomnia are effects of cocaine.
Multiple Choice
19. A client is prescribed disulfiram as part of an alcohol treatment program to
prevent relapse. The client asks the nurse, “How will this drug help me?” Which
GRADESLAB.COM
response by the nurse is most appropriate?
A) “It will help to cure your alcoholism.”
B) “It can help to prevent you from drinking.”
C) “It makes the withdrawal symptoms less troublesome.”
D) “It helps to clear the alcohol out of your body.”
Ans: B
Chapter: 25
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 2
Page Number: 432
Feedback: Disulfiram (Antabuse) is not a treatment or cure for alcoholism, but it can
be used as adjunct therapy to help deter some individuals from drinking while using
other treatment modalities to teach new skills on coping with altering abuse
behaviors. Disulfiram plus even small amounts of alcohol produces adverse effects.
Disulfiram does not affect withdrawal symptoms and does not promote alcohol
elimination from the body.
20. A nurse has a reasonable suspicion that another member of the nursing staff
suffers from substance use disorder that is resulting in impaired care practices. What
action should the nurse take to protect both the clients and staff member?
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
A)
Ask the nurse to explain the reason for the suspicious behavior
B)
Report the suspicion as required by the state’s nurse practice act
C)
File a formal complaint with the facility’s Chief Nursing Officer
D)
Threaten to report the staff member if they do not immediately resign
Ans: B
Chapter: 25
Client Needs: Safe and Effective Care Environment: Management of Care
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 2
Page Number: 451
Feedback: A nurse is just as susceptible to addiction as any other individual but
additional risk factors exist such as access and availability of drugs, training in the
administration and injection of drugs, and a familiarity with and a frequency of
administering drugs. To protect clients’ safety and maintain the standards of the
profession, many states have mandatory reporting laws. According to the nurse
practice acts, any nurse who knows of any health care provider’s incompetent,
RADESthat
LABinformation
.COM
unethical, or illegal practice mustGreport
through proper channels. A
formal complaint to a facility administrator is not sufficient in this situation. Neither of
the remaining options would be acceptable since neither involves reporting as
required.
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Test Generator Questions, Chapter 26, Eating Disorders:
Nursing Care of Persons With Eating and Weight-Related
Disorders
Multiple Choice
1. While caring for a client with anorexia nervosa, the nurse anticipates that the
client would have difficulty making which of the following comments?
A) “I'm mad at you because you won’t let me go on a pass unless I gain weight!”
B) “I need to have everything in its place and perfect.”
C) “If I gain a pound, I’ll just keep gaining weight.”
D) “I am very involved in preparing my food and counting calories.”
Ans: A
Chapter: 26
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 8
Page Number: 456, 463
Feedback: Most clients with anorexia
avoid
GRADEnervosa
SLAB.C
OM conflict and have difficulty
expressing negative emotions, such as anger. Perfectionism and a drive for thinness
are key for a client with anorexia. The behavior of clients with anorexia becomes
organized around food-related activities such as preparing food, counting calories,
and reading cookbooks.
2. A nurse is performing an admission assessment for an adolescent girl with an
eating disorder who is being admitted to the psychiatric unit. Which statement would
the nurse interpret as likely to support the client’s diagnosis?
A) “My father was always very thin.”
B) “I’ve never really liked myself.”
C) “I have a lot of confidence in myself.”
D) “I feel really close to my parents and my brother.”
Ans: B
Chapter: 26
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 1
Page Number: 463
Feedback: Individuals with eating disorders are usually struggling with their
self-concept. It is important to determine their self-concept and self-esteem. In many
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
instances, these individuals appear to be very competent, but when queried about
their views, they often feel that they are not good enough and will describe their
perceived faults in great detail. A father’s body type has little impact on the
development of this disorder. Families of individuals with anorexia are often labeled as
overprotective, enmeshed, unable to resolve conflicts, and rigid related to
boundaries. Thus, a close relationship would not be associated with this disorder.
3. A client with bulimia nervosa is being treated at an outpatient clinic and is
prescribed a selective serotonin reuptake inhibitor (SSRI). Which instruction would
the nurse include when teaching the client about the prescribed medication?
A) Closely monitor your fluid intake while taking this medication.
B) Stop taking this medication if it causes weight gain.
C) Expect menstrual irregularities, particularly if they’ve occurred previously.
D) Note that the drug may take up to 4 weeks to get a full effect.
Ans: D
Chapter: 26
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 9
Page Number: 465
Feedback: The client needs to be aware that the drug may take up to 4 weeks for the
GR
DESmeantime,
LAB.COM the client should monitor weight
client to get the drug’s full effect.
InAthe
loss caused by drug-induced nausea and vomiting. Because the client has a diagnosis
of bulimia nervosa, the intake of medication must be monitored for possible purging
after administration. Monitoring fluid intake and menstrual irregularities are not
associated with this group of medications.
4. The nurse is caring for several hospitalized clients with anorexia nervosa. The
nurse would be especially alert for which of the following if noted in the clients’
histories?
A) Paranoia
B) Primary insomnia
C) Depression
D) Aggression
Ans: C
Chapter: 26
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 1
Page Number: 458
Feedback: Depression is common in individuals with anorexia nervosa, and these
individuals are at risk to attempt suicide. Paranoia and insomnia are not comorbid
conditions associated with anorexia nervosa. Clients with anorexia nervosa have
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
difficulty expressing anger, so aggression would be unlikely.
5. The nurse is preparing to discharge a client who has been hospitalized with
anorexia nervosa. Which of the following would the nurse include in the education
plan?
A) Knowing the calorie content of numerous foods
B) Learning strategies to control impulses
C) Describing physiologic consequences of anorexia nervosa
D) Setting realistic goals
Ans: D
Chapter: 26
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 10
Page Number: 464
Feedback: Because these clients tend to be perfectionist and set unrealistic goals for
themselves, the nurse should educate the client about realistic and attainable goal
setting. Other topics such as weight monitoring, resources, and effects of restrictive
eating should be included in the nurse’s educational plan.
6. A client with bulimia nervosa is scheduled for a visit to the clinic. When assessing
this client, which of the following would the nurse expect to find?
GRADESLAB.COM
A) Impulsivity
B) Panic
C) Hyperactivity
D) Delusions
Ans: A
Chapter: 26
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 1
Page Number: 471
Feedback: Clients with bulimia often demonstrate impulsivity. Situations that
produce feelings of being overwhelmed and powerless need to be explored, as does
the client’s ability to set boundaries, control impulsivity, and maintain quality
relationships. These underlying issues precipitate binge eating. Panic, hyperactivity,
and delusions are not associated with bulimia nervosa.
7. The nurse is planning to explain the purpose of the behavioral therapy technique
of self-monitoring to a client with bulimia nervosa. The nurse would emphasize
keeping a diary to record which of the following?
A) Feelings of hunger
B) Efforts at distraction
C) Environmental stimuli
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
D)
Rigid rules about eating
Ans: C
Chapter: 26
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 10
Page Number: 471
Feedback: Self-monitoring is accomplished using a diary in which the client records
binges and purges, precipitating emotions, and environmental cues. Emotional and
environmental cues are identified, and alternative responses are suggested, tried,
and reinforced. When a cue or stimulus leads to a dysfunctional or unhealthy
response, the response can be eliminated or an alternate, healthier response to the
cue can be substituted, tried, and then reinforced.
8. A psychiatric–mental health nurse working in the community is planning an
educational program for fifth and sixth grade teachers. Which of the following would
the nurse include?
A) Discussion of strategies the teachers can use to counteract the role media plays in
encouraging eating disorders
B) Emphasis on the need for teachers to focus their prevention efforts on female
students
C) Stressing the need to allow students to eat without undue attention or
GRADESLAB.
COM
supervision, in order to prevent inadvertently
influencing
eating patterns
D) Clarification that peer pressure is not typically problematic in children who are in
the fifth and sixth grades
Ans: A
Chapter: 26
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 9
Page Number: 467, 468
Feedback: Counteracting the influence of media should be stressed; both boys and
girls are at risk for developing eating disorders. Other preventive educational
strategies include the need to improve self-esteem and the importance of peer
pressure’s influence on eating and weight.
9. The nurse is initiating a group for adolescent girls diagnosed with anorexia
nervosa. Many of the clients in the group are irritable and resent having to attend.
One of them comments, “This is a stupid waste of time!” Which response by the nurse
would be most appropriate?
A) “If you feel that way, then you can just leave.”
B) “You sound irritated; tell me about what is bothering you.”
C) “You were assigned to this group by your therapist, so you must participate.”
D) “Sit down and be quiet; your peers would appreciate some peace and quiet.”
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Ans: B
Chapter: 26
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Communication and Documentation
Objective: 7
Page Number: 471
Feedback: A nonjudgmental, accepting approach is best when working with clients
with anorexia. This response is nonjudgmental and accepting; it also gives the client
feedback about how the client is perceived by others and conveys that the nurse is
interested in what the client is feeling. It is best to avoid a power struggle over control
issues. Telling the client to leave or to sit down and be quiet is nontherapeutic.
Multiple Select
10. An adolescent is brought to the emergency department by her parents because
they were concerned about their daughter’s appearance. The client appears
emaciated and pale. The parents tell the nurse that the client has been diagnosed with
anorexia nervosa. A history, physical examination, and laboratory testing are
completed. Which of the following would lead the nurse to suspect that the client will
be admitted to the hospital? (Select all that apply.)
A) Blood pressure of 110/60 mm Hg
B) Elevated serum potassium level
GRlevel
ADESLAB.COM
C) Decreased serum magnesium
D) Heart rate of 40 beats/min
E) Statements of being “hopeless”
Ans: C, D, E
Chapter: 26
Client Needs: Physiological Integrity: Reduction of Risk Potential
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 7
Page Number: 461
Feedback: Indicators for hospitalization include a heart rate near 40 beats/min,
blood pressure less than 80/50 mm Hg, decreased serum potassium levels, decreased
serum magnesium levels, and severe depression and risk for suicide.
11. A group of nursing students is reviewing the similarities and differences between
bulimia nervosa and binge-eating disorder. The students demonstrate understanding
when they identify which characteristics as specific to binge-eating disorder? (Select
all that apply.)
A) Clients typically are obese.
B) Clients refrain from purging behaviors.
C) Binge eating periods are shorter.
D) Clients engage in overexercising.
E) Feelings of guilt do not occur after binging.
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Ans: A, B
Chapter: 26
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Teaching/Learning
Objective: 3
Page Number: 474
Feedback: Binge-eating disorder (BED) is seen in a number of studies that have
uncovered a group of individuals who binge in the same way as those with bulimia
nervosa, but who do not purge or compensate for binges through other behaviors
(such as overexercising). Individuals with BED also differ from those with other eating
disorders in that most of them are obese. In addition, investigators have shown that
individuals with BED have lower dietary restraint and are higher in weight than those
with bulimia nervosa. Binge-eating episodes are not shorter. Feelings of guilt occur
with both bulimia nervosa and binge-eating disorder.
12. A nursing instructor is reviewing the various theories related to anorexia
nervosa. Which theories would the instructor include when describing theories related
to the biologic domain? (Select all that apply.)
A) Genetic vulnerability
B) Separation–individuation
C) Role pressures
D) Pursuit of thinness
E) Decreased serotonin activityGRADESLAB.COM
Ans: A, E
Chapter: 26
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 2
Page Number: 458, 459
Feedback: Theories related to the biologic domain include increased genetic
vulnerability, and blunted serotonergic functioning. Separation–individuation and role
pressures reflect psychological theories. Pursuit of thinness reflects social theories.
13. A nurse is preparing a presentation for a local middle school health class about
eating disorders as a means for prevention and early detection. Which of the following
would the nurse incorporate into the presentation as being common to both anorexia
nervosa and bulimia nervosa? (Select all that apply.)
A) Body dissatisfaction
B) Feelings of control
C) Obsessiveness
D) Boundary problems
E) Sexuality fears
F) Cognitive distortions
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Ans: A, C, F
Chapter: 26
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 1
Page Number: 455
Feedback: Characteristics common to both anorexia and bulimia nervosa include
body dissatisfaction, powerlessness (lack of control), obsessiveness, and cognitive
distortions. Boundary problems are associated with bulimia nervosa. Sexuality fears
are associated with anorexia nervosa.
Multiple Choice
14. A nurse is reviewing the plan of care for a client with anorexia nervosa and notes
a behavioral plan for increasing weight. The nurse correlates this intervention with
which nursing diagnosis?
A) Disturbed Body Image
B) Anxiety
C) Imbalanced Nutrition: Less Than Body Requirements
D) Ineffective Coping
Ans: C
GRADESLAB.COM
Chapter: 26
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 7
Page Number: 464
Feedback: A behavioral plan for increasing weight is part of a refeeding program that
is instituted for a nursing diagnosis of Imbalanced Nutrition: Less Than Body
Requirements. Interventions for Disturbed Body Image and Anxiety involve
addressing interoceptive awareness, helping clients understand their feelings, and
initiating interpersonal therapy. Interventions for Ineffective Coping would address
integrating the clients back into school, renewing friendships and relationships, and
promoting participation in family therapy.
15. A nurse is interviewing a client diagnosed with bulimia nervosa about her family
and her relationship with her mother. Which statement by the client would the nurse
least likely associate with bulimia nervosa?
A) “My mother is my confidante for everything.”
B) “My mother’s happiness depends on me.”
C) “My family basically has very few rules.”
D) “My mother and I are close but not joined at the hip.”
Ans:
D
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Chapter: 26
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 6
Page Number: 460
Feedback: The statement about being close but not joined at the hip is not reflective
of a family associated with bulimia. The families of individuals who experience bulimia
nervosa are reported to be chaotic, with few rules and unclear boundaries. Often,
there is an overly close or enmeshed relationship between the daughter and mother.
Daughters may relate that their mother is their “best friend.” The boundaries are
blurred in that the mother may interact with the daughter as a confidante, and this
unhealthy relating further impedes the separation–individuation process. The
daughters often feel guilty about separation and responsible for their mother’s
happiness and emotional well-being.
16. A nurse is developing a plan of care for a client newly diagnosed with bulimia
nervosa. Which of the following would the nurse expect to implement in conjunction
with pharmacologic therapy?
A) Behavioral therapy
B) Cognitive behavioral therapy
C) Interpersonal therapy
D) Family therapy
GRADESLAB.COM
Ans: B
Chapter: 26
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 10
Page Number: 470
Feedback: Although behavioral, interpersonal, and family therapy may be used, the
combination of cognitive behavioral therapy and pharmacologic interventions is best
for producing an initial decrease in symptoms.
17. While talking with a client with an eating disorder, the client states, “I’ve gained
two pounds, so I’ll be up by 100 pounds soon.” The nurse interprets this as which of
the following?
A) Magnification
B) Selective abstraction
C) Overgeneralization
D) Dichotomous thinking
Ans: D
Chapter: 26
Client Needs: Psychosocial Integrity
Cognitive Level: Understand
Integrated Process: Nursing Process
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Objective: 5
Page Number: 466
Feedback: The client’s statement reflects dichotomous, or all-or-none, thinking.
Magnification reflects overemphasizing, such as, “I binged last night, so I can’t go out
with anyone tonight.” Selective abstraction reflects a narrow focus, such as, “I can
only be happy 10 pounds lighter.” Overgeneralization reflects taking an idea and
expanding it, such as, “I didn’t eat anything yesterday, and I did okay, so not eating
for a week won’t hurt me.”
18. When describing the characteristic similarities and differences between anorexia
nervosa and bulimia nervosa, which of the following would the nurse identify as
specific to bulimia?
A) Boundary problems
B) Low self-esteem
C) Perfectionism
D) Obsessiveness
Ans: A
Chapter: 26
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 1
Page Number: 455
RAspecific
DESLAto
B.bulimia
COM nervosa. Low self-esteem,
Feedback: Boundary problems G
are
perfectionism and obsessiveness are characteristics of both disorders.
Multiple Select
19. A client diagnosed with an eating disorder is to be hospitalized. When reviewing
the client’s medical record, which of the following would the nurse expect to find?
(Select all that apply.)
A) Blood pressure, 100/60 mm Hg
B) Hypokalemia
C) Hyperphosphatemia
D) Heart rate, 44 beats/min
E) Suicidal ideation
Ans: B, D, E
Chapter: 26
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 1
Page Number: 461
Feedback: Criteria for hospitalization for eating disorders includes acute weight loss,
less than 85% below ideal; temperature less than 36.1ºC; heart rate near 40
beats/min; hypokalemia; hypophosphatemia; hypomagnesemia; poor motivation to
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
recover; blood pressure less than 80/50 mm Hg; risk for suicide; severe depression;
failure to comply with treatment; and inadequate response to treatment at another
level of care.
20. A nurse is conducting a class for a group of adolescents about eating disorders.
One of the adolescents asks, “What can I do if I think my friend has an eating
disorder?” Which response by the nurse would be most appropriate? (Select all that
apply.)
A) “Confront your friend and say, ‘You have an eating disorder.’”
B) “Try reaching out to an adult if your friend refuses help.”
C) “Frequently ask your friend about how many calories she or he is eating.”
D) “Try to talk about other things besides food and weight”
E) “If your friend won’t eat, be strong and force him or her to eat.”
Ans: B, D
Chapter: 26
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 10
Page Number: 467
Feedback: Helpful strategies for family and friends of individuals with eating
disorders include telling the person of the concern and offering assistance; suggesting
RADESLout
ABto
.Can
OMadult if the person refuses to seek
to seek help from a professional; G
reaching
help; not discussing weight or the number of calories being consumed; talking about
other things besides food; and avoiding power struggles (not forcing the person to
eat).
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Test Generator Questions, Chapter 27, Somatic Symptom and
Related Disorders: Management of Somatic Problems
Multiple Choice
1. A client is admitted to the mental health unit with a diagnosis of factitious
disorder. When reviewing the client’s history, which of the following would the nurse
most likely find?
A) Intentional self-injurious behavior
B) Pain to achieve a self-serving goal
C) Malingering to avoid work
D) Parents who were restrictive
Ans: A
Chapter: 27
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 1
Page Number: 489
GRdisorder
ADESLAintentionally
B.COM
Feedback: Clients with factitious
cause an illness or injury to
receive the attention of health care workers. Pain for a self-serving goal, malingering,
or restrictive parents are not associated with factitious disorder.
2. While assessing a client thought to have a factitious disorder, the nurse asks the
client to describe when they felt nurtured as a child. Which response would the nurse
interpret as supporting the client’s diagnosis?
A) “I never felt nurtured or loved when I was growing up.”
B) “The only time I felt loved and appreciated was when I made the honor roll at
school.”
C) “The only time I ever felt loved was when I was sick enough to miss school.”
D) “I felt loved and accepted when my parent apologized for spanking me so hard.”
Ans: C
Chapter: 27
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 1
Page Number: 490
Feedback: Individuals who are diagnosed with factitious disorders are thought to
have often been abused as children and to have received nurturance only during times
of illness. As a result, they try to recreate illness or injury in a desperate attempt to
receive love and attention.
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Multiple Select
3. A nursing instructor is preparing a class about functional neurologic symptoms.
Which of the following would the instructor most likely include as an assessment
finding? (Select all that apply.)
A) Difficulty swallowing
B) Spasticity
C) Urinary frequency
D) Aphonia
E) Blindness
Ans: A, D, E
Chapter: 27
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 3
Page Number: 489
Feedback: Clients with functional neurologic symptoms (conversion disorder) have
neurologic symptoms including impaired coordination or balance, paralysis, aphonia
(inability to produce sound), difficulty swallowing or a sensation of a lump in the
throat, and urinary retention. They also may have loss of touch, vision problems,
blindness, deafness, and hallucinations.
Multiple Choice
GRADESLAB.COM
4. A client is admitted to the mental health unit because they were found trying to
inject diluted feces into their hospitalized child’s intravenous line. The client has a
history of similar attempts of harming the child. The nurse would most likely suspect
which of the following?
A) Schizoid personality traits
B) Factitious disorder imposed on another
C) Functional neurologic symptoms
D) Borderline personality disorder
Ans: B
Chapter: 27
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 3
Page Number: 491
Feedback: A rare but dramatic disorder, factitious disorder imposed on another
(previously factitious disorder by proxy or Münchausen's by proxy), involves a person
who inflicts injury on another person. It is commonly a mother who inflicts injuries on
her child to gain the attention of the health care provider through her child’s injuries.
The client’s history does not reflect manifestations of schizoid personality traits or
borderline personality disorder. Functional neurologic symptoms involve severe
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
emotional distress or unconscious conflict expressed through physical symptoms.
5. After educating a group of nurses about somatic symptom disorder, the instructor
determines that the education was successful when the group identifies which of the
following as a characteristic?
A) Symptoms that remain relatively static
B) Manifestations highly variable
C) Symptoms that are easily manageable
D) Reports of overall health as good
Ans: B
Chapter: 27
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Teaching/Learning
Objective: 1
Page Number: 478
Feedback: Somatic symptom disorder is one of the most difficult disorders to
manage because the symptoms tend to change, are diffuse and complex, and
vary/move from one body system to another. For example, initially there may be
gastrointestinal (nausea, vomiting, diarrhea) and neurologic (headache, backache)
symptoms that change to musculoskeletal (aching legs) and sexual issues (pain in the
abdomen, pain during intercourse). The physical symptoms may last for 6 to 9
months. Individuals with SSD perceive themselves as being sicker than the sick and
RApoor.
DESLAB.COM
report all aspects of their health G
as
6. A client with somatic symptom disorder is complaining of significant pain in the
joints. When providing care to this client, which of the following would be most
important for the nurse to keep in mind?
A) Opioid analgesics are the primary mode of therapy.
B) The client’s experience of pain is real.
C) Complementary therapies are usually of little benefit.
D) Outcomes need to reflect the biologic aspects of the pain.
Ans: B
Chapter: 27
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 1
Page Number: 482
Feedback: Even though there is no medical explanation for the pain, the client’s pain
is real and has serious psychosocial implications. Aggressive pharmacologic treatment
of the symptoms must be avoided. Nonpharmacologic strategies, including
complementary and alternative treatments, should be used to assist in pain relief.
Outcomes developed need to avoid focusing on the biologic aspects of the disorder
and instead help the client overcome the pain through biopsychosocial approaches.
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
7. A client has made multiple visits to the clinic. The nurse suspects that the client
may be experiencing somatic symptom disorder based on which of the following?
A) Expressions of concern about psychological problems
B) Indications their parents were always in good health
C) Reports of changing symptoms to different body systems
D) Evidence of a need for social support from her friends
Ans: C
Chapter: 27
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 1
Page Number: 478
Feedback: SSD is one of the most difficult disorders to manage because the
symptoms tend to change, are diffuse and complex, and vary/move from one body
system to another. For example, initially there may be gastrointestinal (nausea,
vomiting, diarrhea) and neurologic (headache, backache) symptoms that change to
musculoskeletal (aching legs) and sexual issues (pain in the abdomen, pain during
intercourse). The physical symptoms may last for 6 to 9 months. Individuals with SSD
perceive themselves as being sicker than the sick and report all aspects of their health
as poor. Many eventually become disabled and cannot work. They typically visit health
care providers multiple times per month and quickly become frustrated because their
primary health care providers do not appreciate their level of suffering, and are unable
GRAD
ESLAB.for
COtheir
M extreme discomfort.
to validate that a particular problem
accounts
8. A nurse is reviewing the medical history of a client diagnosed with somatic
symptom disorder. Which of the following would the nurse expect to find as a
comorbid condition?
A) Depression
B) Bipolar disorder
C) Thought disorder
D) Sleep disorder
Ans: A
Chapter: 27
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 1
Page Number: 479
Feedback: Somatic symptoms disorder frequently coexists with other psychiatric
disorders, most commonly depression and anxiety. Others include panic disorder,
mania, social phobia, obsessive--compulsive disorder (OCD), psychotic disorders, and
personality disorders. Older adults are particularly high risk for comorbid depression.
9. The nurse is assessing a client for somatic symptom disorder. Which client
statement would the nurse interpret as most likely supporting this diagnosis?
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
A) “It’s like my foot is asleep all the time; I can’t feel anything that touches my foot.”
B) “I’m losing weight no matter what or how much I eat.”
C) “I am always in pain; there is nothing I can do to relieve it.”
D) “It seems like I am always having diarrhea at the most inconvenient times.”
Ans: C
Chapter: 27
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 1
Page Number: 478
Feedback: With somatic symptom disorder, the client may complain of various
symptoms. However, pain is the most common complaint.
10. A client with somatic symptom disorder also has anxiety. Which of the following
would the nurse expect to be prescribed?
A) Monoamine oxidase inhibitor (MAOI)
B) Selective serotonin reuptake inhibitor (SSRI)
C) Tricyclic antidepressant
D) Atypical antipsychotic
Ans: B
Chapter: 27
GRADEPharmacological
SLAB.COM
Client Needs: Physiological Integrity:
and Parenteral Therapies
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 5
Page Number: 486
Feedback: For the client with somatic symptom disorder and anxiety, SSRIs are
used, in a higher dose than prescribed for depression to relieve and manage the
symptoms. Phenelzine (Nardil) is one of the monoamine oxidase inhibitors (MAOIs)
that has been effective in treating not just depression, but also the chronic pain and
headaches common in people with SSD. TCAs and atypical antipsychotics would not
be used.
11. The nurse is caring for a client with somatic symptom disorder. When assessing
this client, the nurse would be especially alert for symptoms of which of the following?
A) Depression
B) Avoidant personality disorder
C) Delirium
D) Bipolar disorder
Ans: A
Chapter: 27
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Objective: 3
Page Number: 479
Feedback: Somatic symptom disorder frequently coexists with other psychiatric
disorders, most commonly depression and anxiety. Other less common comorbidities
include panic disorder, mania, social phobia, obsessive-compulsive disorder,
psychotic disorders, and personality disorders.
12. A nursing instructor is describing somatic symptom disorder to a group of
nursing students. The instructor determines that the education was successful when
the students state which of the following?
A) The disorder typically is diagnosed in men.
B) The first symptom usually appears during adolescence.
C) The disorder commonly occurs with substance abuse.
D) Highly educated individuals often develop this disorder.
Ans: B
Chapter: 27
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 1
Page Number: 479
Feedback: Complex somatic symptom disorder typically has an onset before age 30
years, with the first symptom often appearing during adolescence. The disorder is
RADoccurs
ESLAmost
B.COoften
M with depression and anxiety.
diagnosed more often in women G
and
Epidemiologic studies reveal that the disorder occurs primarily in nonwhite, less
educated women, particularly those with lower socioeconomic status and high
emotional stress.
13. The husband of a client diagnosed with somatic symptom disorder asks the
nurse, “What causes this condition?” Which response by the nurse would be most
accurate?
A) “There is definitely an underlying genetic link for this disorder.”
B) “Your wife is experiencing chronic stress that causes hypoarousal.”
C) “The symptoms reflect an emotion that your wife cannot verbalize.”
D) “The symptoms reflect an internal preoccupation with events.”
Ans: C
Chapter: 27
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Caring
Objective: 1
Page Number: 480
Feedback: Somatic symptom disorder has been explained as a form of social or
emotional communication, meaning that the body symptoms express an emotion that
cannot be verbalized by the individual. Although there is some evidence to support a
genetic component, the exact transmission mechanism is unclear. In individuals with
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
this disorder, chronic activation of the HPA axis indicates a hyperarousal condition
from chronic stress. Additionally, the personality trait alexithymia is associated with
somatic symptoms. These individuals have difficulty identifying and expressing their
emotions, have a preoccupation with external events, and are described as concrete
thinkers.
14. The nurse is preparing to interview a client diagnosed with somatic symptom
disorder. The nurse anticipates that the client will most likely exhibit which of the
following?
A) No facial expression during the interview
B) Intermittent nodding and glancing at the clock on the wall
C) Altered mental status
D) Rapidly changing moods during the interview
Ans: D
Chapter: 27
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 3
Page Number: 483
Feedback: The individual’s mood is usually labile, often shifting from extremely
excited or anxious to being depressed and hopeless. Response to physical symptoms
is usually magnified. The client’s mental status is usually normal, and cognition is not
impaired but may be distorted. GRADESLAB.COM
15. A client with pain who has been diagnosed with somatic symptom disorder and
depression is prescribed medication therapy to treat both the pain and the symptoms
of depression. When educating the client about the medication, which of the following
would the nurse emphasize?
A) Use of sunscreen when exposed to bright sunlight
B) Limiting of the amount of water ingested
C) Avoiding foods such as aged cheeses
D) Stopping the medication if no change after 1 week.
Ans: C
Chapter: 27
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 5
Page Number: 492
Feedback: The client most likely is prescribed phenelzine (Nardil), a monoamine
oxidase inhibitor (MAOI) that has been effective in treating not just clients with
depression but also the chronic pain and headaches common in people with complex
somatic symptom disorder. Clients who take phenelzine (Nardil) should avoid foods
high in tyramine (e.g., aged cheese) to prevent a hypertensive crisis. Photosensitivity
is not associated with the use of MAOIs. Water intake needs to be monitored when
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
lithium is used. Clients should also be encouraged to give the medications enough
time to be effective because many medications require up to 6 weeks before the client
has a response or a relief of symptoms.
Multiple Select
16. A nurse is providing care for a client who has somatic symptom disorder and is
exhibiting anxiety about having a severe illness. Which of the following would be
appropriate for the nurse to do? (Select all that apply.)
A) Listen closely to the client’s report of symptoms.
B) Ignore the client’s report of symptoms and make a professional nursing
assessment.
C) Acknowledge that what the client is saying may be real.
D) Encourage the client to write down symptoms in a journal.
E) Review the symptom pattern with the client.
Ans: A, C, D, E
Chapter: 27
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 5
Page Number: 487
Feedback: Nursing management should include listening to the client’s report of
RAacknowledging
DESLAB.COMthat the fears may be real, asking
symptoms and fears, validating itGby
the client to monitor symptoms in a journal, and encouraging the client to bring the
journal to the next visit. By actually seeing the symptom pattern, it is possible to
continue to educate the client and assess for significant symptoms.
Multiple Choice
17. A nurse is evaluating the outcomes for a client diagnosed with somatic symptom
disorder. Which of the following would the nurse most likely identify as interfering
with achievement?
A) Outcomes were stated in realistic terms
B) Outcomes addressed overall issues
C) Outcomes indicated small successes
D) Outcomes identified specific behaviors
Ans: B
Chapter: 27
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 3
Page Number: 488
Feedback: Recovery outcomes for clients with somatic symptom disorder should be
realistic. Because this is a lifelong disorder, small successes should be expected.
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Specific outcomes also should be identified, so that the small successes can be
measured, such as gradually increasing social contact. Over time, there should be a
gradual reduction in the number of health care providers the individual contacts, and
a slight improvement in the ability to cope with stresses.
18. A nurse is working with a client diagnosed with somatic symptom disorder.
Which of the following would the nurse identify as the most difficult aspect of
providing care to this client?
A) Managing the client’s pain
B) Relieving the client’s anxiety
C) Developing the therapeutic relationship
D) Monitoring the client’s treatment program
Ans: C
Chapter: 27
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 5
Page Number: 484
Feedback: Although managing the client’s symptoms can be challenging, and
anxiety may be present to add to the challenges, the most difficult aspect is
developing a sound, positive nurse--client relationship. However, this relationship is
crucial, for without it, the nurse is just one more provider who fails to meet the client’s
GRADESLrequires
AB.COMtime and patience.
expectations. Developing this relationship
19. The nurse is assisting in planning a series of group therapy sessions with several
female clients diagnosed with somatic symptom disorder. The nurse plans to focus the
sessions on which of the following as a priority?
A) Causes of medical illnesses
B) Positive self-talk
C) Side effects of medications
D) Assertiveness skills
Ans: D
Chapter: 27
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 5
Page Number: 488
Feedback: Because most of the clients are women, participation in groups that
address feminist issues should be encouraged to strengthen their assertiveness skills
and improve their generally low self-esteem. Group sessions focusing on the causes of
medical illnesses, and positive self-talk would be inappropriate. Medication therapy is
not specifically recommended for people with this disorder unless they have comorbid
disorders such as depression or anxiety.
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
20. A client disagnosed with a conversion disorder repeatedly reports abdominal
symptoms to the nursing staff. What response provided by the nurse managing the
client‘s care will best meet the client’s needs therapuetically?
A)
Ignoring the reports but documenting the symptoms
B)
Distracting the client with offers to include the client in group activities
C)
Recognizing the symptoms but not providing the client the opportunity to dwell
on them
D)
Reminding the client that the tests were all negative and that the symptoms are
just imaginary
Ans: C
Chapter: 27
Client Needs: Psychological Integrity
Cognitive Level: Apply
Client Needs: Psychological Integrity
Integrated Process: Caring
GRADESLAB.COM
Objective: 1
Page Number: 489
Feedback: Conversion disorder is a psychiatric condition in which severe emotional
distress or unconscious conflict is expressed through physical symptoms. The
symptoms, different from those with an organic basis, do not follow a neurologic
course but rather follow the person’s own perceived conceptualization of the problem.
It is important to understand that the symptoms are real for the client and should
never be ignored. In approaching the client, rather than using distraction, the nurse
treats conversion symptoms as real symptoms that may have distressing
psychological aspects. Acknowledging the symptoms, even when the diagnostic tests
fail to confirm them physically, helps the client deal with them.
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Test Generator Questions, Chapter 28, Sleep–Wake Disorders:
Nursing Care of Persons with Insomnia and Sleep Problems
Multiple Choice
1. The nurse is assessing the sleep patterns of a female client age 70 years with a
mental disorder. Based on the knowledge of circadian rhythms and the influence of
age, which of the following would the nurse anticipate that the client would report
about her sleep pattern?
A) “When I was younger, I didn’t notice any differences in how I felt in the morning
or evening.”
B) “Now it seems like I have difficulty falling asleep or maintaining sleep even when
circumstances are adequate for sleep.”
C) “When I worked days, I’d always have trouble feeling sleepy in the morning.”
D) “When I was younger, the amount of sleep I got didn’t seem to matter.”
Ans: B
Chapter: 28
Client Needs: Physiological Integrity: Basic Care and Comfort
Cognitive Level: Apply
Integrated Process: Nursing Process
GRADESLAB.COM
Objective: 1
Page Number: e-14
Feedback: Insomnia has a greater prevalence among older people and among
divorced, separated, and widowed adults. Increasing age, female sex, and comorbid
disorders (e.g., medical, mental disorders, and substance use) are all risks for
developing insomnia disorder.
2. A student nurse is preparing a nursing care plan for a client who has insomnia and
is experiencing sleep deprivation. Which nursing diagnosis would the nurse most
likely identify as reflecting a priority care issue?
A) Risk for Injury
B) Ineffective Coping
C) Deficient Knowledge
D) Anxiety
Ans: A
Chapter: 28
Client Needs: Safe and Effective Care Environment: Safety and Infection Control
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 4
Page Number: e-14
Feedback: Safety is a priority for people with insomnia. Sleep deprivation can lead to
accidents, falls, and injuries, especially in older clients. Sedating medication could
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
potentially increase falls.
3. A client who is receiving counseling at a community health center has complained
during the last three weekly sessions about being unable to sleep. The nurse
interviews the family members to determine the effect of the client’s problem on
them. Which response would the nurse most likely expect to hear?
A) “It really hasn’t seemed to be a problem for us.”
B) “There’s been little change in how they get along with other family members.”
C) “The not sleeping has really had a positive effect on us all.”
D) “It’s been exhausting living with them these past few weeks.”
Ans: D
Chapter: 28
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 2
Page Number: e-14
Feedback: Living with a family member with insomnia is challenging. Irritability,
complaints of sleeplessness, and chronic fatigue interfere with quality interpersonal
relationships. It would be highly unlikely that things are not problematic or that the
effects of the insomnia would be positive.
4. The nurse is discussing strategies to enhance sleep with a client who is
RAD
ESLAB.would
COM be most appropriate for the
experiencing insomnia. Which ofGthe
following
nurse to suggest?
A) “Eat right before you go to bed, as long as it is something rich that will make you
sleepy.”
B) “Try exercising a bit right before your bedtime so you will feel tired and sleepy.”
C) “Drinking a warm cup of tea right before bedtime will help to relax you.”
D) “Establish a regular time for going to bed and getting up in the morning.”
Ans: D
Chapter: 28
Client Needs: Physiological Integrity: Basic Care and Comfort
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 6
Page Number: e-17
Feedback: Routines are important, especially when preparing the body to sleep.
Therefore, establishing and maintaining a regular time for bedtime and awakening is
appropriate. Clients with insomnia should be counseled not to eat anything heavy for
several hours before retiring. Spicy foods, alcohol, and caffeine should be avoided.
Additionally, exercise promotes sleep, but regular exercise should be planned for 3
hours before bedtime.
5. A nurse is working with a psychiatric client who was admitted to the inpatient
facility and is being discharged. The client asks the nurse what he should do when he
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
goes home to promote getting adequate sleep. Which response by the nurse would be
most appropriate?
A) “Go to bed at the same time every night and watch a television show that relaxes
you.”
B) “Save your bedroom for sleeping; that means no work and no TV in the
bedroom.”
C) “Why don’t you ask your psychiatrist for a prescription for a sleeping pill?”
D) “Make sure to keep the bedroom warm and toasty.”
Ans: B
Chapter: 28
Client Needs: Physiological Integrity: Basic Care and Comfort
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 4
Page Number: e-17
Feedback: The nurse can help the client develop bedtime rituals and good sleep
hygiene. Bedtime should be at a regular hour, and the bedroom should be conducive
to sleep. Preferably, the bedroom should not be a place where the individual watches
television or does work-related activities. The bedroom should be viewed as a room
for sleeping and sex, and the environment should be cool, with minimal lighting.
6. A client with a mental disorder is being discharged from the inpatient unit. During
the hospital stay, the client eventually was able to get an adequate night’s sleep even
GRchronic
ADESLinsomnia
AB.COM over the years. The client’s
though the client had experienced
spouse asks the nurse what the family can do in the home environment to promote
healthy sleep. Which response by the nurse would be most appropriate?
A) “It is basically up to your spouse to focus on promoting their own sleep.”
B) “You might consider a glass of wine about 30 minutes before they are ready to go
to bed.”
C) “Remember to keep stimulating activities at a minimum before he goes to bed.”
D) “Give them a spicy snack with a warm cup of tea at night before bedtime.”
Ans: C
Chapter: 28
Client Needs: Physiological Integrity: Basic Care and Comfort
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 4
Page Number: e-19
Feedback: Family and friends should be encouraged to support the new habits that
the client is trying to establish. Avoiding stimulating activities and engaging in
relaxing activities before bedtime are crucial, and family and friends can help create
an environment conducive to sleep. Alcohol, spicy foods, and caffeine should be
avoided.
7. A client has been admitted to the psychiatric unit with a diagnosis of narcolepsy.
Which client statement would the nurse interpret as reflecting this condition?
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
A) “Sometimes I fall asleep when I’m driving my car home from work.”
B) “I often have brief periods of intense excitement when going to sleep, and my
legs won’t hold still.”
C) “I lie there and worry all night, and it keeps me awake. I just can’t relax.”
D) “I think my sleep pattern is messed up because I took sleeping pills when I was
younger.”
Ans: A
Chapter: 28
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 2
Page Number: e-20
Feedback: The overwhelming urge to sleep is the primary symptom of narcolepsy.
This irresistible urge to sleep occurs at any time of the day, regardless of the amount
of sleep the client has had. Falling asleep often occurs in inappropriate situations,
such as while driving a car or reading a newspaper. These sleep episodes are usually
short, lasting 5 to 20 minutes, but may last up to an hour if sleep is not interrupted.
Individuals with narcolepsy may experience sleep attacks and report frequent
dreaming. They usually feel alert after a sleep attack, only to fall asleep
unintentionally again several hours later. Excitement with leg restlessness, worrying,
an inability to relax, and the use of sleeping pills are not associated with narcolepsy.
GRAdiagnosed
DESLAB.with
COMinsomnia. When developing an
8. A nurse is working with a client
education plan for the client, which sleep promotion intervention would the nurse
implement first?
A) Encouraging the client to stop smoking
B) Instructing the client to keep regular bedtimes and rising times
C) Encouraging the client to take frequent naps
D) Administering prescribed sleep medications
Ans: B
Chapter: 28
Client Needs: Physiological Integrity: Basic Care and Comfort
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 4
Page Number: e-16
Feedback: Nonpharmacologic, health-promoting interventions are the first choice
before administering pharmacologic agents. Sleep hygiene strategies, such as
keeping regular times for going to bed and rising, are effective and should be
encouraged. The goal is to normalize sleep patterns to improve well-being.
9. The sleep history of a client experiencing sleep problems reveals that the client
ingests a significant amount of caffeine each day. When reviewing the effect of
caffeine on sleep with the client, which of the following would the nurse incorporate
into the discussion as a caffeine effect?
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
A) Decreased sleep latency
B) Increased total sleep time
C) Decreased REM sleep
D) Increased slow-wave sleep
Ans: C
Chapter: 28
Client Needs: Physiological Integrity: Basic Care and Comfort
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 3
Page Number: e-16
Feedback: Caffeine causes increased sleep latency, decreased total sleep time, and
decreased REM sleep. It does not affect slow-wave sleep.
10. A client with insomnia is taught to avoid watching television, eating, and doing
work in the bedroom. Which technique is being used?
A) Sleep restriction
B) Relaxation training
C) Cognitive behavior therapy
D) Stimulus control
Ans: D
Chapter: 28
GRADESLAB.COM
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 4
Page Number: e-19
Feedback: Stimulus control is a technique used when the bedroom environment no
longer provides cues for sleep, but has become the cue for wakefulness. Clients are
instructed to avoid behaviors in the bedroom that are incompatible with sleep,
including watching television, doing homework, and eating. This allows the bedroom
to be reestablished as a stimulus for sleep. Clients often increase their time in bed to
provide more opportunity for sleep, resulting in fragmented sleep and irregular sleep
schedules. With sleep restriction, clients are instructed to spend less time in bed and
to avoid napping. Relaxation training involves the use of progressive relaxation,
autogenic training, and biofeedback to relieve physical or emotional distress
impacting sleep. Cognitive behavior therapy identifies the maladaptive behavior,
bringing the distortions to the client’s attention and extinguishing the association
between effort to sleep and increased arousals.
11. A client with insomnia is prescribed zolpidem. When describing the action of this
medication to the client, the nurse would incorporate information related to the
medication’s effect on which of the following?
A) GABA
B) Serotonin
C) Dopamine
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
D)
Norepinephrine
Ans: A
Chapter: 28
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 4
Page Number: e-17
Feedback: Zolpidem is a benzodiazepine receptor agonist that exerts its effects by
facilitating GABA effects. Serotonin, dopamine, and norepinephrine are not involved.
12. A group of nursing students is reviewing the various agents used to treat
insomnia. The students demonstrate an understanding of the information when they
identify which agent as a melatonin receptor agonist?
A) Trazodone
B) Estazolam
C) Mirtazapine
D) Ramelteon
Ans: D
Chapter: 28
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Analyze
GRADESLAB.COM
Integrated Process: Teaching/Learning
Objective: 4
Page Number: e-17, e-18
Feedback: Ramelteon is a melatonin receptor agonist. Trazodone and mirtazapine
are sedating antidepressants. Estazolam is a benzodiazepine classified as a
benzodiazepine receptor agonist.
Multiple Select
13. A nursing instructor is describing the prevalence of sleep--wake disorders as
being greater in individuals with mental health disorders. Which disorders would the
instructor include as being associated with sleep--wake disorders? (Select all that
apply.)
A) Depression
B) Borderline personality disorder
C) Schizophrenia
D) Posttraumatic stress disorder
E) Anxiety
Ans: A, D
Chapter: 28
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Teaching/Learning
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Objective: 1
Page Number: e-9
Feedback: Sleep--wake disorders occur independently of the diagnosis of other
mental disorders, but they are also seen in people with mental disorders. For
example, a core feature of posttraumatic stress disorder (PTSD) is sleep disturbance.
Insomnia often increases the risk for relapse of the mental disorder. Documented
comorbid conditions include cardiovascular disorders, diabetes, musculoskeletal
disorders, respiratory disorders, digestive disorders, pain conditions, and mental
disorders including depression, PTSD, and other sleep disorders such as sleep apnea,
and restless legs syndrome (RLS). OSA is not associated with borderline personality
disorder or schizophrenia.
14. After teaching a class about circadian rhythm disorders, a nursing instructor
determines that the education was successful when the class identifies which of the
following as a subtype identified in the DSM-5? (Select all that apply.)
A) Delayed sleep phase
B) Nightmare
C) Sleep terror
D) Shift work type
E) Jet lag type
Ans: A, D
Chapter: 28
Client Needs: Psychosocial Integrity
GRADESLAB.COM
Cognitive Level: Analyze
Integrated Process: Teaching/Learning
Objective: 2
Page Number: e-23
Feedback: According to the DSM-5, subtypes of circadian rhythm disorders include a
delayed sleep phase and shift work type. Although jet lag type is a circadian rhythm
sleep--wake disorder, it is not included in the DSM-5. Nightmare and sleep terror are
separate disorders.
Multiple Choice
15. A nurse is interviewing a client about their sleep patterns. The client tells the
nurse that they go to bed about 11 PM and usually falls asleep by 11:15 PM. The nurse
identifies this time period as which of the following?
A) Sleep latency
B) Sleep architecture
C) Sleep efficiency
D) Slow-wave sleep
Ans: A
Chapter: 28
Client Needs: Physiological Integrity: Basic Care and Comfort
Cognitive Level: Apply
Integrated Process: Nursing Process
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Objective: 3
Page Number: e-10
Feedback: Sleep latency is the time period measured from lights out, or bedtime, to
initiation of sleep. Sleep architecture is the pattern of non–rapid eye movement
(NREM) and rapid eye movement (REM) that are in approximately a 90- to
110-minute cycle. Sleep occurs in stages, and the timing of sleep is regulated by
circadian rhythms. Sleep efficiency is the ratio of total sleep time to time in bed.
Slow-wave sleep is the deepest state of sleep occurring during stages 3 and 4 of
non--rapid eye movement (NREM) sleep.
16. What characteristic will the nurse note regarding a client who is experiencing
dysfunctional slow-wave sleep?
A)
Easy arousal
B)
Generally feeling “unrested”
C)
Electroencephalogram shows K complexes
D)
Alpha rhythm is gradually being replaced by theta rhythm
Ans: B
Chapter: 28
Client Needs: Physiological Integrity:
GRADBasic
ESLACare
B.Cand
OM Comfort
Cognitive Level: Understand
Integrated Process: Nursing Process
Objective: 1
Page Number: e-12
Feedback: Slow-wave sleep, or the deepest state of sleep, characterizes stages 3 and
4. Slow-wave sleep is believed to have a restorative function. Light sleep is
characteristic of stages 1 and 2, in which the person is easily aroused. During stages
1 and 2, an electroencephalogram (EEG) shows an alpha rhythm gradually being
replaced by a theta rhythm. Sleep spindles or “k complexes” occur in stage 2.
17. A client with a history of both managed posttraumatic stress disorder (PTSD) and
type 2 diabetes now presents with new reports of insomnia. Considering the most
urgent, immediate risk for a client, what will the nurse assess for regularly?
A) The relapse of PTSD symptoms
B) The conversion of type 2 to type 1 diabetes
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
C) The symptoms associated with early onset dementia
D) The development of obessive--compulsive disorder (OCD)
Ans: A
Chapter: 28
Client Needs: Physiological Integrity: Reduction of Risk Potential
Cognitive Level: Apply
Client Needs: Physiological Integrity: Reduction of Risk Potential
Integrated Process: Nursing Process
Objective: 3
Page Number: e-14
Feedback: Sleep–wake disorders occur independently of the diagnosis of other mental
disorders, but they are also seen in people with mental disorders such as PTSD and
depression. Insomnia often increases the risk for relapse of the mental disorder but
there is no research to support that it will trigger the onset of a new mental health
disorder. Type 2 diabetes will not convert to the type 1 form of the disorder.
GRADESLAB.COM
18. The nurse is assessing a client reporting the symptoms associated with insomnia.
What assessment question demonstrates the nurse’s understanding of mental health
issues often related to the development of insomnia?
A)
“Are you afraid for your personal safety?”
B)
“Would you consider yourself as being depressed?”
C)
“Can you hear or see things others cannot hear or see?”
D)
“Do you engage in compulsive hand washing or other ritualistic behaviors?”
Ans: B
Chapter: 28
Client Needs: Physiological Integrity: Basic Care and Comfort
Cognitive Level: Analyze
Client Needs: Physiological Integrity: Basic Care and Comfort
Integrated Process: Nursing Process
Objective: 3
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Page Number: e-14
Feedback: Many factors affect sleep, but one of the major reasons for insomnia is
depression, which accounts for most cases. Asking if the client considers oneself as
being depressed will assess for this condition. There is no currently accepted
correlation between paranoid (Are you afraid for your personal safety?),
hallucinations (Can you hear or see things others cannot hear or see?) or compulsive
(Do you engage in compulsive hand washing or other ritualistic behaviors?) behaviors
with the development of insomnia.
Multiple Select
19. The nurse is conducting an assessment of a client reporting difficulty falling
asleep. Which statement(s) made by the client would be most relevant to supporting
a mental health-related diagnosis of a sleep disorder? (Select all that apply.)
A)
“I am awake at least 4 to 5 times a night.”
B)
“Both my parents where fitful sleepers as well.”
C)
“I work shifts and so my sleep routine varies.”
D)
“An afternoon nap is not a luxury but rather a necessity.”
E)
“It is like I never feel rested regardless of when I go to bed.”
GRADESLAB.COM
Ans:
A, C, D, E
Chapter: 28
Client Needs: Physiological Integrity: Basic Care and Comfort
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 6
Page Number: e-15
Feedback: Insomnia is affected by sleep schedule (bedtime and rise time), difficulty
falling asleep or maintaining sleep, quality of sleep, and existence of daytime
sleepiness. A family history is not a common factor in the presence of insomnia.
Multiple Choice
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
20. An older adult client with a history of cirrhosis of the liver, depression, and
insomnia is to be started on ramelteon therapy. What initial action should the nurse
take in response to this prescription?
A)
Placing the client on falls precautions
B)
Notifying the health care provider of the client’s hepatic impairment
C)
Determining what antidepressant medication the client is currently taking
D)
Instructing the client to take the daily dose of the medication 30 minutes prior to
bedtime
Ans: B
Chapter: 28
Client Needs: Physiological Integrity: Reduction of Risk Potential
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 6
Page Number: e-18
GRA
DEinsomnia
SLAB.Ccharacterized
OM
Feedback: Ramelteon is prescribed
for
by difficulty with sleep
onset. The initial action in this situation is to notify the prescriber of the client’s
impaired hepatic function. Ramelteon should not be used by clients with severe
hepatic impairment nor should it be used in combination with the antidepressant
fluvoxamine. It should be taken at 30 minutes before bedtime and is often responsible
for dizziness. The client’s hepatic status makes all the other options secondary in
importance.
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Test Generator Questions, Chapter 29, Sexual Disorders:
Nursing Care of Persons With Sexual Dysfunction and
Paraphilias
Multiple Choice
1. A group of nursing students is reviewing information about sexual development.
The students demonstrate understanding of the information when they describe
biosexual identity as which of the following?
A) Conviction of belonging to the male or female gender
B) Outward expression of gender
C) Sexual attraction to opposite, same, or both sexes
D) Anatomic and physiologic state of being male or female
Ans: D
Chapter: 29
Client Needs: Psychosocial Integrity
Cognitive Level: Remember
Integrated Process: Teaching/Learning
Objective: 1
Page Number: 496
GRADESLAB.COM
Feedback: Whereas biosexual identity refers to the anatomic and physiologic state
of being male or female, gender identity is the conviction of belonging to the male or
female gender. Both biosexual and gender identities result from genetic and
intrauterine hormonal influences, not learned behavior. Sex role identity (or gender
role) is the outward expression of gender, including behaviors, feelings, and attitudes.
Sexual orientation is a person’s sexual attraction to those of the opposite sex
(heterosexual), same sex (homosexual), or both sexes (bisexual).
2. When describing the events associated with determining the sex of a fetus, which
would the nurse include in the discussion?
A) Genes on the Y chromosome
B) Formation of ovaries
C) Rising testosterone levels
D) Neurochemical inhibition
Ans: A
Chapter: 29
Client Needs: Health Promotion and Maintenance
Cognitive Level: Remember
Integrated Process: Teaching/Learning
Objective: 1
Page Number: 496
Feedback: As a result of the sex-determining genes on the Y chromosome,
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
testosterone is present in male fetuses, and by weeks 6 to 12, is responsible for the
formation of the penis, prostate, and scrotum. The formation of ovaries in the female
depends on the absence of this male hormone. After the male sex organs are formed,
testosterone levels temporarily rise, causing a permanent sexual organization of the
brain that is different than that in females. Testosterone is also elevated during the
first 3 months after birth, causing the brain structures and circuits to be fixed for the
rest of a boy’s life. These structural differences are thought to be the basis of sex
differences that are reflected in behavior from birth.
Multiple Select
3. A nurse is preparing a presentation for a local senior group about sexuality and
sexual behaviors in older adults. Which would the nurse need to address? (Select all
that apply.)
A) Decreased vaginal lubrication
B) Decreased amount of sperm
C) Enhanced clitoral response
D) Thickening of vaginal mucosa
E) Increased ejaculation time
Ans: A, B, E
Chapter: 29
Client Needs: Health Promotion and Maintenance
Cognitive Level: Remember
GRADESLAB.COM
Integrated Process: Teaching/Learning
Objective: 2
Page Number: 497
Feedback: In women, estrogen deficiency during menopause affects the sexual
system by causing a gradual thinning of the vaginal mucosa, decreasing elasticity of
muscles and orgasmic force, and increasing breast involution (sagging of breast
tissue). Vaginal lubrication decreases, which may cause dyspareunia (pain during
intercourse). In some, an increase in time is required to lubricate the vulvovaginal
areas and to strengthen clitoral response. In men, decreasing testosterone production
is responsible for sexual changes. The amount and viability of sperm decrease,
erections become less firm, and more direct sexual stimulation is needed. The
testicles begin to decrease in elasticity and size, ejaculation time increases, and the
force of ejaculation decreases. Spermatogenesis decreases and seminal fluid is less
voluminous and viscous.
Multiple Choice
4.
the
A)
B)
C)
D)
A nurse provides education for a preadolescent client. Which mechanism would
nurse discuss as controlling arousal?
Sympathetic nervous system
Endocrine system
Parasympathetic nervous system
Central nervous system
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Ans: C
Chapter: 29
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 2
Page Number: 497
Feedback: In healthy adults, the sex drive is integrated through the central nervous
system with the autonomic nervous system governing extragenital changes
(increased respiration and heart rate). The parasympathetic nervous system largely
controls arousal, and the sympathetic nervous system controls orgasmic discharge.
Sexual stimulation brings about a total-body response with dramatic changes seen in
the genitals and breasts. Sex hormones, particularly androgen, influence desire in
both genders, but less is known about hormonal influence in women. That the higher
centers of the brain apparently mediate the lower reflex response centers supports
the relationship between cognitive and affective states and sexual function.
5. A nurse is preparing a client education plan about the sexual response cycle and
is integrating the theoretical model described by Masters and Johnson. Which would
the nurse describe as occurring first?
A) Erotic feelings
B) Penile erection
C) Vaginal lubrication
D) Increased muscle tension
GRADESLAB.COM
Ans: A
Chapter: 29
Client Needs: Health Promotion and Maintenance
Cognitive Level: Remember
Integrated Process: Teaching/Learning
Objective: 2
Page Number: 498
Feedback: According to Masters and Johnson, the first phase of the sexual response
cycle is excitement. During this phase, erotic feelings occur in both genders, which
lead to penile erection in the man and vaginal lubrication in the woman. Sexual
pleasures and increased muscle tension occur in the second phase, the plateau phase.
6. A female client is diagnosed with female orgasmic disorder and is receiving
treatment by a qualified sex therapist. The client and her partner are being taught
sensate focus. Which would the couple be required to do first?
A) Have sexual intercourse
B) Engage in genital touching
C) Participate in nongenital contact
D) Use masturbation
Ans: C
Chapter: 29
Client Needs:
Psychosocial Integrity
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Cognitive Level: Remember
Integrated Process: Teaching/Learning
Objective: 2
Page Number: 500
Feedback: Sensate focus is a method for partners to learn what each finds arousing
and to learn to communicate those preferences. It begins with nongenital contact and
gradually includes genital touch and sexual intercourse.
Multiple Select
7. A nurse is reviewing the health record of a client with a sexual dysfunction. Which
of the following would the nurse identify as a possible contributing factor if noted in
the client’s history? (Select all that apply.)
A) Antihypertensive therapy
B) Diabetes
C) Peptic ulcer disease
D) Appendectomy at age 15 years
E) Occasional alcohol use
Ans: A, B
Chapter: 29
Client Needs: Psychosocial Integrity
Cognitive Level: Remember
Integrated Process: Nursing Process
GRADESLAB.COM
Objective: 5
Page Number: 500
Feedback: A careful medication history is important because so many medications
have a negative effect on sexual performance. Antihypertensives are one example.
Adults with chronic medical illnesses and disabilities who have problems with
sensation, movement, body structure, fertility, energy, or negative self-image should
be asked about the impact of the medical problems on their sexual function. Diabetes
is associated with a gradual impotence in about half of men, and orgasmic dysfunction
in about one third of women. Peptic ulcer disease, appendectomy at age 15 years, and
occasional alcohol use would not be contributing factors. However, chronic alcohol
abuse is a contributing factor.
Multiple Choice
8. A nurse identifies the nursing diagnosis of Ineffective Sexuality Patterns based on
which client-reported assessments?
A) The sexual problem is causing dissatisfaction for the client.
B) The client has experienced a change in sexual functioning.
C) The client is feeling inadequacy related to the sexual problem.
D) The client believes that sexual activity is unrewarding.
Ans: B
Chapter: 29
Client Needs:
Psychosocial Integrity
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 4
Page Number: 499
Feedback: Ineffective Sexuality Patterns is used as the nursing diagnosis if the
person is at risk for, or has already experienced, a change in sexual functioning.
Sexual dysfunction refers to problematic sexual function that the individual perceives
as unsatisfying, unrewarding, or inadequate, and for which nursing can intervene.
9. A client has been admitted to the inpatient psychiatric facility as part of a
court-ordered program. The client was arrested numerous times over the past several
months for exposing his genitals and masturbating in public in front of an elementary
school. The nurse interprets this behavior as reflecting which condition?
A) Frotteurism
B) Exhibitionism
C) Sexual masochism
D) Voyeurism
Ans: B
Chapter: 29
Client Needs: Psychosocial Integrity
Cognitive Level: Remember
Integrated Process: Nursing Process
Objective: 4
GRADESLAB.COM
Page Number: 507
Feedback: With exhibitionism, the behavior involves exposing one’s genitals to
strangers, with occasional masturbation. Frotteurism involves sexually arousing
urges, fantasies, and behaviors that occur when touching or rubbing one’s genitals
against the breasts, genitals, or thighs of a nonconsenting person. Sexual masochism
involves the act of being humiliated, beaten, bound, or made to suffer. Voyeurism
behavior involves “peeping” at unsuspecting people who are nude, undressing, or
engaged in sexual activity for the purpose of sexual excitement.
10. A group of students is reviewing medications used to treat erectile dysfunction.
The students demonstrate understanding of the information when they identify which
of the following as being administered by injection?
A) Tadalafil
B) Papaverine
C) Alprostadil
D) Vardenafil
Ans: B
Chapter: 29
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Remember
Integrated Process: Teaching/Learning
Objective: 5
Page Number: 504, 505
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Feedback: Papaverine is injected directly into the corpus cavernosum to increase
arterial flow of blood. Tadalafil and vardenafil are PDE5 inhibitors that are taken
orally. Alprostadil is used in a microsuppository form inserted into the urethra with a
special applicator.
11. A nursing instructor is preparing a class discussion about sexual disorders.
Which would the instructor include when describing gender dysphoria?
A) It typically involves same-sex identification.
B) The individual experiences a strong desire to be of the opposite gender.
C) Recurrent, intense sexual urges lead to significant distress.
D) Changes in sexual desire and response are key characteristics.
Ans: B
Chapter: 29
Client Needs: Psychosocial Integrity
Cognitive Level: Remember
Integrated Process: Teaching/Learning
Objective: 4
Page Number: 506
Feedback: Gender dysphoria is the term used to describe an incongruence between
an individual’s experienced/expressed gender and assigned gender. These individuals
have a strong desire to be of the other gender. In boys (assigned gender), there is a
strong preference for cross-dressing or simulating female attire. In girls (assigned
GRADfor
ESwearing
LAB.COtypical
M
gender), there is a strong preference
masculine clothing and a
strong resistance to the wearing of typical female clothing. Paraphilias involve
recurrent, intense sexual urges, fantasies, or behaviors involving unusual objects,
activities, or situations. Sexual dysfunctions are characterized by alterations in sexual
desire and response, and by emotional and interpersonal distress.
12. After educating a group of students on sexual disorders in women, the instructor
determines that the education was successful when the students identify which as
most common?
A) Female orgasmic disorder
B) Sexual interest/arousal disorder
C) Genito-pelvic pain/penetration disorder
D) Paraphilia
Ans: A
Chapter: 29
Client Needs: Psychosocial Integrity
Cognitive Level: Remember
Integrated Process: Nursing Process
Objective: 4
Page Number: 499
Feedback: Female orgasmic disorder is among the most commonly occurring sexual
disorders in women. Other disorders occur, but are less common.
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
13. A client diagnosed with an ejaculatory disorder is receiving treatment using
sensate focus. The nurse understands that this treatment focuses on which of the
following
A) Learning new ejaculatory control responses
B) Partners learn what each finds arousing and to communicate those preferences
C) Resolving underlying issues
D) Gaining knowledge about the arousal-orgasm mechanism
Ans: B
Chapter: 29
Client Needs: Psychosocial Integrity
Cognitive Level: Remember
Integrated Process: Nursing Process
Objective: 4
Page Number: 500
Feedback: Sensate focus is a method for partners to learn what each finds
arousing and to learn to communicate those preferences. It begins with nongenital
contact and gradually includes genital touch and sexual intercourse. The squeeze
technique is used to help the person learn new ejaculatory control responses.
Counseling or psychotherapy focuses on helping the individual become aware of, and
resolve, personal, sexual and relationship issues. Education focuses on increasing the
person’s knowledge of arousal-orgasm mechanism.
14.
A)
B)
C)
D)
Which is considered the treatment of choice for erectile dysfunction?
Microsuppository alprostadil GRADESLAB.COM
Intracavernosal pharmacotherapy
PDE5 inhibitors
Penile prosthesis
Ans: C
Chapter: 29
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Remember
Integrated Process: Nursing Process
Objective: 4
Page Number: 504
Feedback: Although intracavernosal pharmacotherapy, alprostadil in
microsuppository form, and penile prosthesis can be used to treat erectile
dysfunction, the treatment of choice is the use of PDE5 inhibitors.
15. During the health history, a client reports that she experiences pain during
sexual intercourse. The nurse documents this as which of the following?
A) Dyspareunia
B) Anorgasmia
C) Vaginismus
D) Paraphilia
Ans:
A
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Chapter: 29
Client Needs: Psychosocial Integrity
Cognitive Level: Remember
Integrated Process: Communication and Documentation
Objective: 4
Page Number: 506
Feedback: Dyspareunia is a term used to describe the genital pain associated with
sexual intercourse. Anorgasmia refers to the inability to achieve an orgasm.
Vaginismus refers to the spastic, involuntary constriction of the perineal and outer
vaginal muscles. Paraphilias are characterized by recurrent, intense sexual urges,
fantasies or behaviors involving unusual objects, activities, or situations.
16. A client is brought to the emergency department by law enforcement because
numerous individuals on the street reported that the client was exposing the naked
body to people as they were walking by. The nurse interprets this as suggesting which
condition?
A) Fetishism
B) Frotteurism
C) Exhibitionism
D) Voyeurism
Ans: C
Chapter: 29
Client Needs: Psychosocial Integrity
GRADESLAB.COM
Cognitive Level: Remember
Integrated Process: Nursing Process
Objective: 4
Page Number: 507
Feedback: The behavior of exhibitionism involves exposing one’s genitals to
strangers, with occasional masturbation. With fetishism, an object such as women’s
undergarments or foot apparel is used for sexual arousal. With frotteurism, sexually
arousing urges, fantasies, and behaviors occur when touching or rubbing one’s
genitals against the breasts, genitals, or thighs of a nonconsenting person. Voyeurism
involves peeping, for the purpose of sexual excitement, at unsuspecting people who
are nude, undressing, or engaged in sexual activity.
17. After educating a group of students on sexual maturation, the instructor
determines that the education was successful when the students identify which as
referring to the anatomic and physiologic state of being male or female?
A) Biosexual identity
B) Gender identity
C) Sex role identity
D) Sexual orientation
Ans: A
Chapter: 29
Client Needs: Health Promotion and Maintenance
Cognitive Level: Remember
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Integrated Process: Teaching/Learning
Objective: 1
Page Number: 496
Feedback: Sexual maturation encompasses four areas: biosexual identity, gender
identity, sex role identity, and sexual orientation. Whereas biosexual identity refers to
the anatomic and physiologic state of being male or female, gender identity is the
conviction of belonging to a male or female gender. Both biosexual and gender
identities result from genetic and intrauterine hormonal influences, not learned
behavior. Sex role identity (or gender role) is the outward expression of gender,
including behaviors, feelings, and attitudes. Sexual orientation refers to a person’s
sexual attraction to those of the opposite sex (heterosexual), same sex
(homosexual), or both sexes (bisexual).
18. A nurse is preparing a class for a group of parents about sexuality and sexual
behaviors in children. Which would the nurse include as typical behavior of children
between the ages of 10 to 12 years?
A) Touching one’s genitals at home
B) Standing extremely close to others
C) Trying to look at persons when nude
D) Looking at nudity on television or the internet
Ans: D
Chapter: 29
Client Needs: Health Promotion and Maintenance
GRADESLAB.COM
Cognitive Level: Remember
Integrated Process: Teaching/Learning
Objective: 1
Page Number: 496
Feedback: Typically, boys and girls ages 6 to 9 years often touch genitals at home,
stand too close to others, and try to look at persons when they are nude. In contrast,
children age 10 to 12 years, who are actually more interested in (and know more
about) sex, limit their behavior to looking at nudity in magazines, television, and the
internet.
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Test Generator Questions, Chapter 30, Mental Health Disorders
of Childhood and Adolescence
Multiple Choice
1. The school nurse is caring for a child 7 years of age who has demonstrated a
significantly lower-than-average score for mental age on standardized tests in
reading. However, the child’s IQ scores were within the average range. The nurse
interprets this information as suggesting which condition?
A) Communication disorder
B) Attention deficit hyperactivity disorder
C) Asperger syndrome
D) Dyslexia
Ans: D
Chapter: 30
Client Needs: Psychosocial Integrity
Cognitive Level: Understand
Integrated Process: Nursing Process
Objective: 3
Page Number: 527
GRAthe
DESchild
LABis
.Cexhibiting
OM
Feedback: The nurse suspects that
symptoms of dyslexia or a
reading disability, which is considered a learning disorder. A communication disorder
involves speech or language impairments. Attention deficit hyperactivity disorder
involves a persistent pattern of inattention, hyperactivity, and impulsiveness.
Asperger syndrome is characterized by severe and sustained impairment in social
interaction and restricted, repetitive patterns of behavior, interests, and activities in
conjunction with age-appropriate language and intelligence.
2. The nurse is counseling a parent whose child has a communication disorder.
Which would the nurse emphasize when educating the parent on this disorder?
A) Providing the child with nonverbal activities
B) Initiating conversations with the child frequently
C) Stopping the child’s conversation if stuttering begins
D) Asking the physician for medication to improve the child’s speech
Ans: B
Chapter: 30
Client Needs: Psychosocial Integrity
Cognitive Level: Understand
Integrated Process: Nursing Process
Objective: 3
Page Number: 527, 528
Feedback: For the child with a communication disorder, the interventions focus on
fostering social and communication skills and making referrals for specific speech or
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
language therapy. Modeling appropriate communication in spontaneous situations
with the child can be a useful intervention for some children. Nonverbal activities or
stopping the child if stuttering begins would not foster the development of
communication skills. Medication therapy is not used for communication disorders.
3. A nurse is assessing a child who is suspected of having attention deficit
hyperactivity disorder. Which would the nurse identify as reflecting impulsiveness in
the child?
A) Inability to wait his turn
B) Restlessness
C) Difficulty completing a task
D) Risk-taking behavior
Ans: D
Chapter: 30
Client Needs: Psychosocial Integrity
Cognitive Level: Remember
Integrated Process: Nursing Process
Objective: 4
Page Number: 517
Feedback: Impulsiveness is the tendency to act on urges, notions, or desires without
adequately considering the consequences. This is manifested by risk-taking behaviors
and use of poor judgment, often leading to more than the usual bumps, lumps, and
bruises. The inability to wait his turn and restlessness reflect hyperactivity. Difficulty
GRADESLAB.COM
completing a task reflects inattention.
4. The nurse is preparing to initiate a behavioral treatment program for a child with
encopresis. Which would the nurse implement first?
A) Administration of mineral oil
B) Bowel cleansing
C) Low-fiber diet
D) Toilet sitting after each meal
Ans: B
Chapter: 30
Client Needs: Physiological Integrity: Basic Care and Comfort
Cognitive Level: Understand
Integrated Process: Nursing Process
Objective: 8
Page Number: 530
Feedback: Before initiating behavioral treatment, cleaning out the bowel is usually
necessary in many cases. The bowel catharsis is usually followed by administration of
mineral oil, which is often continued during the bowel retraining program. A high-fiber
diet is often recommended. The behavioral treatment program follows, which involves
daily sitting on the toilet for a predetermined period after each meal.
5. A nurse is assessing a girl age 8 years with a mood disorder. Which would the
nurse expect to assess?
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
A) Statement from the child that she feels sad
B) Behavioral problems
C) Recurrent obsessions
D) Ritualistic behavior
Ans: B
Chapter: 30
Client Needs: Psychosocial Integrity
Cognitive Level: Understand
Integrated Process: Nursing Process
Objective: 7
Page Number: 528
Feedback: Children with mood disorders may not spontaneously express their
feelings (sadness, irritability) and are more likely to show their suffering through their
behavior. These children may act out their feelings rather than discuss them. Thus,
behavior problems may accompany depression. Recurrent obsessions and ritualistic
behavior would suggest obsessive--compulsive disorder.
6. A nurse is reviewing medications used to treat attention deficit hyperactivity
disorder. The nurse identifies methylphenidate as which class of medication?
A) Selective serotonin reuptake inhibitor
B) Psychostimulant
C) Noradrenergic reuptake inhibitor
D) Alpha agonist
GRADESLAB.COM
Ans: B
Chapter: 30
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Remember
Integrated Process: Teaching/Learning
Objective: 4
Page Number: 520, 521
Feedback: Methylphenidate is a psychostimulant. Fluoxetine is an example of a
selective serotonin reuptake inhibitor. Atomoxetine is a noradrenergic reuptake
inhibitor. Alpha agonists include guanfacine and clonidine.
7. The nurse educates a client’s parents about cognitive impairment and adaptive
behavior. The nurse determines that additional education is needed when the parent
identifies which type of skill as being involved with adaptive behavior?
A) Intellectual skill
B) Conceptual skill
C) Social skill
D) Practical skill
Ans: A
Chapter: 30
Client Needs: Psychosocial Integrity
Cognitive Level: Remember
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Integrated Process: Teaching/Learning
Objective: 1
Page Number: 512
Feedback: Adaptive behavior is composed of three skill types: conceptual skills
(language and literacy, money, time, number concepts, and self-direction); social
skills (interpersonal skills, social responsibility, self-esteem, gullibility, social problem
solving, and the ability to follow rules and obey laws and to avoid being victimized);
and practical skills (activities of daily living, occupational skills, health care, travel and
transportation, schedules and routines, safety, use of money, use of telephone).
8. The mother of a child with autism spectrum disorder tells the nurse that her child
has few playmates. She states, “He has real trouble interacting with other children
and when there is a change in his routine, he throws a tantrum.” Based on this
information, the nurse identifies which nursing diagnosis?
A) Self-Care Deficits related to repeated tantrums
B) Risk for Injury related to autism spectrum disorder
C) Compromised Family Coping related to having a child with autism spectrum
disorder
D) Social Isolation related to poor social skills
Ans: D
Chapter: 30
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
GRADESLAB.COM
Integrated Process: Nursing Process
Objective: 3
Page Number: 515
Feedback: Based on the mother’s comments, the priority nursing diagnosis is Social
Isolation related to poor social skills of the child. This nursing diagnosis is
substantiated by the mother’s statement that the child has few playmates and has
difficulty interacting with other children. There is no information provided to suggest
a Self-Care Deficit or Risk for Injury. Statements about the family’s issues with the
child and his disorder would support a nursing diagnosis of Compromised Family
Coping.
9. A child with autism spectrum disorder engages in a repetitive rocking behavior
that does not pose a threat to the child’s safety. When educating the child’s family on
managing this behavior, which would be appropriate for the nurse to suggest?
A) Ignore it
B) Redirect the child
C) Use positive reinforcement
D) Pad the area around the child
Ans: A
Chapter: 30
Client Needs: Psychosocial Integrity
Cognitive Level: Understand
Integrated Process: Teaching/Learning
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Objective: 3
Page Number: 516
Feedback: Managing the repetitive behaviors of these children depends on the
specific behavior and its effects on others or the environment. If the behavior, such as
rocking, has no negative effects, ignoring it may be the best approach. If the
behavior, such as head banging, is unacceptable, redirecting the child and using
positive reinforcement are recommended. In some cases, especially in severely
delayed children, these strategies may not work, and environmental alterations and
perhaps protective headgear are needed.
10. The nurse is caring for a family with a child who has autism spectrum disorder.
When developing the education plan for the parents, which would the nurse include?
A) The child is at higher risk for seizure disorder
B) The child’s IQ will typically be higher than that of other children
C) Dyslexia also may be a comorbid condition
D) A structured physical environment is important for the child
Ans: D
Chapter: 30
Client Needs: Psychosocial Integrity
Cognitive Level: Understand
Integrated Process: Teaching/Learning
Objective: 3
Page Number: 516
GRADto
ESthe
LAB
.COM of a child with autism spectrum
Feedback: The nurse should explain
parents
disorder that a structured physical environment will most likely be important. Keeping
furniture, dishes, and toys in the same place helps ease anxiety and fosters secure
feelings. The nurse should identify the child’s specific needs for structure in the
physical environment, and record what occurs when the physical environment is
changed. Approximately 25% of children with autism spectrum disorder have seizure
disorders, and about 50% have intellectual disability. Dyslexia is associated with a
learning disorder.
11. The nurse is counseling a family whose child age 4 years has mild intellectual
disability. The nurse is working with the family on realistic long-term goals. Which is
appropriate?
A) Locating suitable residential placement for the child
B) Finding a foster home for the child
C) Having the child function independently as an adult
D) Preventing the onset of psychiatric disorders in the child
Ans: C
Chapter: 30
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 3
Page Number: 513
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Feedback: The long-term goal for this family and child is to have the child function
independently as an adult. Independence may be delayed but is not impossible.
Multiple Select
12. A nurse is preparing an education session for parents of children with autism
spectrum disorder. When describing problems associated with communication, which
of the following would the nurse most likely include as common? (Select all that
apply.)
A) Repetition of words or phrases
B) Abstract interpretation of language
C) Early language development
D) Reversal of pronouns
E) Abnormal intonation
Ans: A, D, E
Chapter: 30
Client Needs: Psychosocial Integrity
Cognitive Level: Remember
Integrated Process: Nursing Process
Objective: 3
Page Number: 513
Feedback: The impairment in communication is severe and affects both verbal and
GRAwith
DESautism
LAB.Cspectrum
OM
nonverbal communication. Children
disorder may manifest
delayed and deviant language development, as evidenced by echolalia (repetition of
words or phrases spoken by others) and a tendency to be extremely concrete in
interpretation of language. Pronoun reversals and abnormal intonation are also
common.
Multiple Choice
13. A child diagnosed with autism spectrum disorder is hospitalized in an inpatient
mental health unit. When developing the plan of care for this child, which is important
for the nurse to include?
A) Ensuring that a variety of caregivers are available for the child
B) Providing a consistent, structured environment with predictable routines
C) Allowing the child frequent visits off the unit to provide stimulation
D) Sending the child to the “time out” area if the child repeats phrases continually
Ans: B
Chapter: 30
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 3
Page Number: 516
Feedback: When children with autism spectrum disorder are hospitalized, a
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
consistent, structured environment with predictable routines for activities, mealtimes,
and bedtimes (termed “milieu management”) is necessary for successful treatment.
Changes in routine, including numerous caregivers, stimulation, or “time-out” may
provoke disorganization in the child, leading to emotional disequilibrium and
explosive behavior. The safety of the inpatient unit offers an opportunity to try
behavioral strategies, such as rewards for managing transitions. Time-out would be
appropriate for aggressive or assaultive behavior.
Multiple Select
14. A child is prescribed atomoxetine to treat ADHD. When educating the child and
parents about common side effects, which does the nurse include? (Select all that
apply.)
A) Headache
B) Abdominal pain
C) Decreased appetite
D) Nervousness
E) Dyskinesias
Ans: A, B, C
Chapter: 30
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Remember
Integrated Process: Teaching/Learning
GRADESLAB.COM
Objective: 4
Page Number: 521
Feedback: Common side effects of atomoxetine include headache, abdominal pain,
decreased appetite, vomiting, somnolence, and nausea. Nervousness and dyskinesias
are associated with methylphenidate.
Multiple Choice
15. The mother of a child age 4 years with autism spectrum disorder tells the nurse
that the child rocks continuously, but “that she doesn’t hurt herself.” Which will the
nurse suggest?
A) Ignore the behavior.
B) Tell the child to stop.
C) Hold the child until she stops rocking.
D) Put the child in time-out for 4 minutes.
Ans: A
Chapter: 30
Client Needs: Psychosocial Integrity
Cognitive Level: Understand
Integrated Process: Nursing Process
Objective: 3
Page Number: 516
Feedback: Managing the repetitive behaviors depends on the specific behavior and
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
its effect on others and the environment. Because the rocking has no negative effects,
ignoring it may be the best approach. If the behavior is unacceptable, redirecting the
child and using positive reinforcement are recommended.
16. The parent of an adolescent diagnosed with Tourette disorder shares with the
nurse that the tics have gotten more frequent with longer duration since the child has
started elementary school. The parent asks that the dose of the prescribed
antipsychotic medication be increased to help manage the tics more effectively. What
response should the nurse provide to address the parent’s concern?
A. “It sounds as if we need to introduce some form of stress management
techniques.”
B. “Maybe it is time to discontinue the original medication and prescribe something
new.”
C. “Increasing the medication will trigger some very serious cardiac focused side
effects.”
D. “Increasing the dose will most likely result in the lessening of the therapeutic
effectiveness.”
GRADESLAB.COM
Ans: D
Chapter: 30
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 5
Page Number: 523
Feedback: Attempts to eradicate all tics by increasing the dosages of these
antipsychotics almost certainly will result in diminishing therapeutic returns and
additional side effects. The most frequently encountered side effects include
drowsiness, dulled thinking, muscle stiffness, akathisia, increased appetite and
weight gain, and acute dystonic reactions. Cardiac side effects are not generally
associated with increased doses of this classification of medications.
Multiple Select
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
17. The nurse is interviewing the parents of a child being treated for Tourette
syndrome. Which assessment question(s) is relevant when evaluating this child?
(Select all that apply.)
A)
“Have teachers ever mentioned your child having difficulty in class?”
B)
“Does your child have difficult concentrating on tasks or problems?”
C)
“Would you describe your child as a worrier?”
D)
“Are ritual behaviors important to your child?”
E)
“Is your child easily angered?”
Ans: A, B, C, D
Chapter: 30
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 5
Page Number: 523
GRADES
LAB.COM
Feedback: Some children with Tourette
syndrome
have attention deficient
hyperactivity disorder, and a substantial percentage have symptoms of the
anxiety-based disorder obsessive--compulsive disorder. Therefore, in addition to
inquiring about tics, the nurse should assess the child’s overall development, activity
level, and capacity to concentrate and persist with a single task, as well as explore
repetitive habits and recurring worries. Anger and aggression are not generally
associated with Tourette syndrome.
18. The nurse is providing medication education to an adult client who has recently
been prescribed methylphenidate. Which statement(s) made by the client suggests
that the education has been effective? (Select all that apply.)
A) “I will be asked periodically to stop taking the medication for short periods?”
B) “This medication is not safe for me to take if I start feeling really anxious again.”
C) “My primary health care provider needs to know if my appetite starts to decrease.”
D) “It is important that my blood pressure be monitored closely while taking this
medication.”
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
E) “I need to stop smoking because nicotine decreases the therapeutic effect of this
medication.”
Ans: A, B, C, D
Chapter: 30
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Analyze
Integrated Process: Teaching/Learning
Objective: 4
Page Number: 521
Feedback: Methylphenidate therapy can result in anorexia and increased blood
pressure. The drug is discontinued periodically to assess the client’s condition and
evaluate the effectiveness of the medication. A contraindication for this therapy
includes marked anxiety. Although nicotine use has health-related risks, it is not
known to affect the effectiveness of this medication.
GRADinformation
ESLAB.COto
M the parents of a child diagnosed
19. The nurse is providing educational
with a chronic mental health disorder. Which statement(s) made by a parent reflects
common emotions demonstrated by parents dealing with this challenge? (Select all
that apply.)
A)
“All we ever wanted was a healthy, happy child.”
B)
“We did everything right; we do not deserve this.”
C)
“No one else in our family has ever had this sort of challenge.”
D)
“I should have taken better care of myself during my pregnancy.”
E)
“My child will certainly outgrow these problems especially with the right care.”
Ans: A, B, D, E
Chapter: 30
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Caring
Objective: 3
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Page Number: 516
Feedback: Parents may manifest denial, grief, guilt, and anger at various points as
they adjust to their child’s condition. The nurse can offer parents the opportunity to
express their frustrations and disappointments and can be alert for indications that
parents are in need of additional assistance, such as parent support groups or respite
care. Expressing a possible lack of meaningful help from family is a concern rather
than any emotion mentioned above.
Multiple Choice
20. The nurse is assessing a child being evaluated for a diagnosis of an autism
spectrum disorder. Which example of dysfunctional communication is the nurse likely
to observe?
A)
When the nurse uses the phase, “tell me about,” the child repeats the phrase
rather than responding appropriately, mimicking the words and phrases spoken by
others.
B)
The child clearly prefers using sign language rather than the spoken word to
GRADESLAB.COM
communicate.
C)
Regularly responds to questions using a jumble of words that lack true meaning.
D)
Communicates using a vocabulary that centers on shrieks and clicking sounds.
Ans: A
Chapter: 30
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 1
Page Number: 513
Feedback: In a child with an autism spectrum disorder, impairment in communication
is severe and affects both verbal and nonverbal communication. Children with an
autism spectrum disorder may manifest delayed and deviant language development,
as evidenced by echolalia (repetition of words or phrases spoken by others). Sign
language, word salad, and alternate sounds are not associated with communication
methods generally used by those diagnosed on the autism spectrum.
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Test Generator Questions, Chapter 31, Mental Health Disorders
of Older Adults
Multiple Choice
1. While caring for a client age 88 years suspected of having dementia, the nurse
assesses the client for a common delusional thought. Which of the following would the
nurse interpret as a common delusion?
A) “I am the king of the universe.”
B) “Creatures are living in my closet.”
C) “The government has people following me.”
D) “My roommate keeps stealing my clothes.”
Ans: D
Chapter: 31
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 1
Page Number: 545
Feedback: Common delusional or suspicious thoughts for clients with dementia
GRADE“This
SLABis.C
OMmy house,” and “My relative is an
include “People are stealing my things,”
not
imposter.”
2. The nurse is assessing a client age 78 years who lives alone in their own home. To
assess the client’s instrumental activities of daily living, which question would be most
appropriate to ask?
A) “How often do you bathe or shower?”
B) “How many times do you change clothes during the day?”
C) “How often do you cook meals for yourself?”
D) “How often do you go to the store to buy groceries?”
Ans: D
Chapter: 31
Client Needs: Health Promotion and Maintenance
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 1
Page Number: 543
Feedback: Instrumental activities of daily living are part of the functional status
assessment of older adults. These activities include shopping, talking on the
telephone, and driving or using other transportation. Bathing, showering, dressing,
and cooking are examples of activities of daily living.
3.
A nurse is providing an in-service educational program for beginning nurses
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
regarding mental health assessment needs of the older adult. One of the topics
addressed is the importance of interviewing family members in addition to the older
adult client. The nurse tells the audience that family members are sometimes able to
give a more accurate history than the client can if the client has memory impairment.
The nurse also emphasizes that interviewing family members provides which of the
following?
A) A more accurate picture of the social support resources available
B) Evaluation of the family’s ability to effectively care for the older client
C) Determination of the extent of the client’s memory impairment
D) A much needed period of respite and support for the family members
Ans: B
Chapter: 31
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 3
Page Number: 537
Feedback: By interviewing family members, the nurse expands the scope of the
client assessment. Moreover, the nurse has an opportunity to evaluate the caregivers
themselves to determine whether they can care for the client adequately and how
they are coping with the situation.
RADESLAB
.COdementia
M
4. Assessment of an older adultGdiagnosed
with
with Lewy bodies reveals
that the client is receiving psychiatric medications. The client states, “I get dizzy
periodically and have trouble walking.” Which of the following should the nurse do
first?
A) Assess for development of orthostatic hypotension.
B) Instruct the client to stop taking the psychiatric medications.
C) Interview the client’s family about the client’s coping skills and current stress
level.
D) Suggest the client periodically use an alcohol-based mouthwash several times a
day.
Ans: A
Chapter: 31
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 3
Page Number: 556
Feedback: Many psychiatric medications affect blood pressure. Generally, these
medications may cause orthostatic hypotension, which can lead to dizziness, an
unsteady gait, and falls. A baseline blood pressure is needed to effectively monitor
medication side effects. Telling the client to stop taking the medications is
inappropriate. Asking family members about the client’s coping skills and stress level
would provide no information about the client’s complaints. Using a nonalcohol-based
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
mouthwash would be appropriate for combating dry mouth.
5. A group of nursing students is reviewing information about age-related changes
occurring in cognition and intellectual performance. The students demonstrate
understanding of the concepts when they identify which of the following as a cognitive
change for a client diagnosed with delirium?
A) Orientation to time
B) Inability to recognize familiar objects
C) Diminished executive functioning
D) Restricted judgment
Ans: B
Chapter: 31
Client Needs: Health Promotion and Maintenance
Cognitive Level: Analyze
Integrated Process: Teaching/Learning
Objective: 3
Page Number: 535
Feedback: Impaired consciousness is the key diagnostic criterion for delirium. The
client becomes less aware of his or her environment and loses the ability to focus,
sustain, and shift attention. Cognitive changes include problems with memory,
orientation, and language. The client may not know where he or she is, may not
recognize familiar objects, or may be unable to carry on a conversation. This problem
developed during a short period.GRADESLAB.COM
6. The nurse is assessing a client who has received a tentative diagnosis of delirium.
The nurse is explaining to the family about the major cause of the client’s condition.
Which statement by the nurse would be most appropriate?
A) “Basically, this diagnosis is based on the client’s inability to talk normally.”
B) “Your report of gradually developing confusion over time was the basis for the
diagnosis.”
C) “Their diagnosis is primarily based on the rapid onset of their change in
consciousness.”
D) “The client’s exposure to an infectious agent led us to determine the diagnosis.”
Ans: C
Chapter: 31
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 1
Page Number: 535
Feedback: The key diagnostic indicator for delirium is impaired consciousness, which
is usually sudden in onset. Although infection may be an underlying cause, and other
cognitive changes may occur such as problems in memory, orientation, and language,
impaired consciousness developing over a short period is key.
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
Multiple Select
7. As part of a follow-up home visit to a client age 80 years who has had surgery, the
nurse discusses the client’s risk for delirium with his family members. Which of the
following would the nurse include as placing the client at increased risk? (Select all
that apply.)
A) Urinary tract infection
B) Hypertension
C) Acute stress
D) Bone fractures
E) Dehydration
F) Electrolyte balance
Ans: A, C, D, E
Chapter: 31
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 3
Page Number: 536
Feedback: Risk factors associated with delirium include infection, advanced age,
hypotension, acute or chronic stress, bone fractures, and electrolyte or metabolic
imbalances, such as dehydration and hyponatremia.
GRADESLAB.COM
Multiple Choice
8 The nurse is caring for a client diagnosed with delirium who has been brought for
treatment by his son. While taking the client’s history, which question would be most
appropriate for the nurse to ask the client’s son?
A) “Has your father taken any medications recently?”
B) “Are you aware of your father falling or injuring his head in any way?”
C) “Has your father had a recent stroke?”
D) “Has your father experienced any major losses recently?”
Ans: A
Chapter: 31
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 1
Page Number: 535, 536
Feedback: Delirium is typically caused by medications, urinary or upper respiratory
tract infections, fluid and electrolyte imbalances, and metabolic disturbances.
Therefore, questioning the son about the client’s medication use would be most
appropriate. Head injury or stroke may lead to changes in consciousness but not
delirium. Although acute or chronic stress may be a risk factor for the development of
delirium, this would not be the most appropriate question to ask at this time.
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
9. The nurse makes a home visit to a family caring for a client with Alzheimer
disease. The client’s wife tells the nurse that she hasn’t been out of the house for more
than 2 weeks because her sister has been unable to help care for her husband. Which
nursing diagnosis would the nurse identify as the priority?
A) Ineffective Family Coping related to care of a client with Alzheimer disease
B) Risk for Activity Intolerance related to Alzheimer disease
C) Caregiver Role Strain related to social isolation
D) Powerlessness related to seclusion and long-term care of client
Ans: C
Chapter: 31
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 3
Page Number: 543
Feedback: Although Family Coping, Activity Intolerance, and Powerlessness may be
issues, the priority nursing diagnosis is Caregiver Role Strain related to social
isolation, as evidenced by the wife’s statement of not being out of the house for 2
weeks. The nurse should assist the client’s wife in obtaining respite care if it is
available.
10. A daughter brings her mother, who has Alzheimer disease, to the clinic. The
GRADEinhibitor
SLAB.Cmedication
OM
client has been taking a cholinesterase
for 1 month. When
assessing the client, the nurse would be alert for the possibility of which side effect?
A) Gastrointestinal distress
B) Mild headache
C) Muscle tics
D) Blurred vision
Ans: 3
Chapter: 31
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 3
Page Number: 548
Feedback: The most frequent side effects from cholinesterase inhibitors include
gastrointestinal distress, such as nausea, vomiting, and diarrhea. Other side effects
include constipation, ataxia, insomnia, and skin rashes.
11. A son brings his mother to the clinic for an evaluation. The son’s mother has
moderate Alzheimer disease without delirium. The nurse assesses the client for which
of the following as the priority?
A) Hearing deficits
B) Mania
C) Strange verbalizations
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
D)
Catastrophic reactions
Ans: D
Chapter: 31
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 3
Page Number: 546
Feedback: Catastrophic reactions are overreactions, or extreme anxiety reactions,
to everyday situations. As the disease progresses, the client may exhibit catastrophic
responses such as night awakening, wandering, agitation, and panic.
12. A client is admitted to the hospital with dementia related to Parkinson disease.
The client is being treated for a fractured tibia from a recent fall. The nurse should
assess the client’s history for use of which type of medication?
A) Anticholinergics
B) Dopamine agonists
C) Anxiolytics
D) Benzodiazepines
Ans: A
Chapter: 31
Client Needs: Psychosocial Integrity
GRADESLAB.COM
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 3
Page Number: 537
Feedback: Medical treatment of people with Parkinson disease typically involves
anticholinergics and dopamine agonists. In clients with dementia caused by Parkinson
disease, anticholinergic medications are likely to increase cognitive impairment.
13. While the nurse is caring for a hospitalized client in the advanced stages of
Alzheimer disease, the client begins to have a catastrophic reaction to feeding
themselves. Which of the following should the nurse do first?
A) Remain calm and reassuring
B) Restrain the client temporarily
C) Draw the curtains to darken the room
D) Offer to feed the client
Ans: A
Chapter: 31
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 3
Page Number: 552
Feedback: During a catastrophic reaction, the nurse should remain calm, minimize
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
environmental distractions (quiet the environment), get the client’s attention, and
softly assure the client that he or she is safe. Give information slowly, clearly, and
simply, one step at a time, letting the client know that the nurse understands the fear
or other emotional response, such as anger or anxiety.
14. While reviewing the medical record of a client with moderate dementia of the
Alzheimer type, the nurse notes that the client has been receiving memantine. The
nurse identifies this drug as which type?
A) Atypical antipsychotic
B) Cholinesterase inhibitor
C) NMDA receptor antagonist
D) Benzodiazepine
Ans: C
Chapter: 31
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 3
Page Number: 548, 549
Feedback: Memantine is classified as an NMDA receptor antagonist that has been
shown to improve cognition and activities of daily living in clients with moderate to
severe symptoms of dementia. Risperidone, olanzapine, and quetiapine are examples
of atypical antipsychotics. Galantamine, donepezil, rivastigmine, and tacrine are
cholinesterase inhibitors. Clonazepam, alprazolam, and lorazepam are examples of
GRADESLAB.COM
benzodiazepines.
15. A group of nursing students is reviewing information about delirium and
dementia. The students demonstrate a need for additional review when they identify
which of the following as characteristics of dementia?
A) Fluctuating changes within a 24-hour period
B) Possible hallucinations
C) Normal psychomotor activity
D) Globally impaired cognition
Ans: A
Chapter: 31
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 1
Page Number: 536
.
Feedback: With dementia, the client’s cognition is stable throughout a 24-hour
period, but with delirium, the client’s cognition fluctuates. Hallucinations are possible
with dementia. Psychomotor activity is normal, and cognition is globally impaired with
dementia.
Multiple Select
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
16. A client is brought to the emergency department by his wife. The wife states that
over the past few hours, the client has become disoriented and confused. “He didn't
know where he was and didn't seem to recognize me or be able to carry on a coherent
conversation.” The nurse suspects delirium. When reviewing the client's medication
history with the wife, which of the following medications would alert the nurse to a
potential cause? (Select all that apply.)
A) Propranolol
B) Acetaminophen
C) Diphenhydramine
D) Verapamil
E) Quinidine
Ans: A, C, E
Chapter: 31
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 3
Page Number: 537
Feedback: Drugs associated with delirium include propranolol, diphenhydramine,
and quinidine. Special attention should be given to combinations of these medications
because drug interactions can cause delirium. Acetaminophen and verapamil are not
typically associated with delirium.
GRADESLAB.COM
Multiple Choice
17. A nurse is assessing a client diagnosed with Alzheimer disease. As part of the
assessment, the nurse asks the client to identify common objects. The nurse is
assessing for which of the following?
A) Aphasia
B) Apraxia
C) Agnosia
D) Executive functioning
Ans: C
Chapter: 31
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 3
Page Number: 540
Feedback: Agnosia is the failure to recognize or identify objects despite intact
sensory function. Aphasia is alterations in language ability. Apraxia is the impaired
ability to execute motor activities despite intact motor functioning. Executive
functioning is the ability to think abstractly, plan, initiate, sequence, monitor, and
stop complex behavior.
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
18. A nursing instructor is preparing a presentation on the etiology of Alzheimer
disease. When discussing the role of neurotransmitters in the course of the disease,
which of the following would the instructor most likely emphasize?
A) Serotonin
B) Acetylcholine
C) Dopamine
D) Norepinephrine
Ans: B
Chapter: 31
Client Needs: Physiological Integrity: Physiological Adaptation
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 2
Page Number: 541
Feedback: Acetylcholine is a major neurotransmitter involved with Alzheimer
disease (AD). Cell loss in the nucleus basalis leads to deficits in the synthesis of
cortical acetylcholine, but the number of ACh receptors is relatively unchanged. The
reduced ACh is related to a decrease in choline acetyltransferase (a critical enzyme in
the synthesis of ACh), especially in the forebrain. That is, there are fewer enzymes
available to synthesize ACh, which leads to a reduction in cholinergic activity. Other
neurotransmitters that are affected include norepinephrine and serotonin.
Deficiencies in norepinephrine are associated with a loss of cells in the locus ceruleus,
and neuronal loss in the raphe nuclei leads to a loss of serotonergic activity. Dopamine
GRADESLAB.COM
is not involved with AD.
19. When assessing a client with dementia, the nurse identifies that the client is
experiencing hallucinations. Based on the nurse’s understanding of this disorder,
which type of hallucination would the nurse expect as most common?
A) Auditory
B) Visual
C) Gustatory
D) Olfactory
Ans: B
Chapter: 31
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 1
Page Number: 536, 545
Feedback: Hallucinations occur frequently in dementia and are usually visual or
tactile (they can also be auditory, gustatory, or olfactory). Visual, rather than
auditory, hallucinations are the most common in people with dementia.
20. A nurse is talking with the husband of a female client diagnosed with Alzheimer
disease. During the conversation, the husband tells the nurse that “she often begins
to scream and curse for no apparent reason.” The nurse interprets this as which of the
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
following?
A) Hypersexuality
B) Disinhibition
C) Hypervocalization
D) Apathy
Ans: C
Chapter: 31
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 1
Page Number: 546
Feedback: The husband is describing hypervocalization, which involves screams,
cursing, moaning, groaning, and verbal repetitiveness, which reflect aberrant motor
behavior. Hypersexuality is manifested by inappropriate and socially unacceptable
sexual behavior, in which the client begins talking and behaving in ways that are
uncharacteristic of premorbid behavior. Disinhibition is acting on thoughts and
feelings without exercising appropriate social judgment, such as removing clothes in
public or walking into a room naked because the client was unable to find clothes.
Apathy is the inability or unwillingness to become involved with one’s environment,
which leads to withdrawal from the environment and a gradual loss of empathy for
others.
GRADESstudents
LAB.COon
M Alzheimer disease and
21. After educating a group of nursing
appropriate nursing care, the instructor determines that the education was successful
when the students identify which of the following as the foundation for providing care
to the client and family?
A) Therapeutic relationship
B) Medication therapy
C) Injury prevention
D) Functional independence
Ans: A
Chapter: 31
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Teaching/Learning
Objective: 3
Page Number: 549
Feedback: The therapeutic relationship is the basis for interventions for the client
and family with dementia. Care of the client entails a long-term relationship needing
much support and expert nursing care. Interventions should be delivered within the
relationship context. Medication therapy, injury prevention, and promoting
independent functioning within the limits of the disorder are important components of
care, but the therapeutic relationship is critical.
22.
A nurse is providing care to a client with Alzheimer disease who is exhibiting
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
suspiciousness and delusional thinking. Which of the following would be most
important for the nurse to do with this client?
A) Tell the client that they are experiencing delusions
B) Confront the client about their distorted thinking
C) Correct the client’s interpretation of the situation
D) Determine the trigger for the distorted thinking
Ans: D
Chapter: 31
Client Needs: Psychosocial Integrity
Cognitive Level: Apply
Integrated Process: Nursing Process
Objective: 3
Page Number: 545, 550
Feedback: Suspiciousness and delusional thinking must be addressed to be certain
that they do not endanger the client or others. Often, delusions are verbalized when
clients are placed in situations they cannot master cognitively. The principle of
nonconfrontation is most important in dealing with suspiciousness and delusion
formation. No efforts should be made to ease the client’s suspicions directly, or to
correct delusions. Rather, efforts should be directed at determining the circumstances
that trigger suspicion or delusion formation, and creating a means of avoiding these
situations.
23. A client with Alzheimer disease is admitted to the acute care facility for
GRADEreveals
SLAB.that
COMthe client is anxious. When
treatment of an infection. Assessment
developing the client’s plan of care, which of the following would be least appropriate
for the nurse to include?
A) Frequently provide reality orientation
B) Simplify the client's routines
C) Limit the number of choices to be made
D) Establish predictable routines
Ans: A
Chapter: 31
Client Needs: Psychosocial Integrity
Cognitive Level: Analyze
Integrated Process: Nursing Process
Objective: 3
Page Number: 552
Feedback: The threshold for stress is progressively lowered in people with Alzheimer
disease and other progressive dementias. A healthy person frequently uses cognitive
coping strategies when under stress, but a person with dementia can no longer use
many of these strategies. Commonly used therapeutic approaches may exacerbate
anxiety in a client with dementia. For example, reality orientation is usually an
effective intervention for acutely confused clients. Reality orientation is
contraindicated in those with dementia because it is possible that the client's
disoriented behavior or language has inherent meaning. If the disoriented behavior or
language is continuously neglected or corrected, the client's sense of isolation and
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Test Bank for Essentials Stuvia.com
of Psychiatric
2nd
Edition
- The MarketplaceNursing
to Buy and Sell
your Study
Material Boyd (Test Bank PDF Files)
anxiety may increase. Effective nursing interventions include simplifying routines,
making routines as consistent and predictable as possible, reducing the number of
choices the client must make, identifying areas in which control can be maintained,
and creating an environment in which the client feels safe.
GRADESLAB.COM
WWW.NURSYLAB.COM
GARDESLAB.COM
Downloaded by: zankiamb5511 | zankiamb5511@students.pgcc.edu
Distribution of this document is illegal
Powered by TCPDF (www.tcpdf.org)