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    Exam Review

    1. A nurse is planning care for a client newly admitted with major depressive disorder. Which of the following actions should the nurse plan to take?
      A)Ask the client to create her own schedule of daily activities.
      B)Teach the client to use passive communication when interacting with others.
      C)Limit the client's involvement in unit activities.
      D)Determine the client's need for assistance with grooming.
    2. A nurse is caring for a client who has bipolar disorder and is experiencing acute mania. The client is doing calisthenics in the client dining room during lunchtime instead of eating. Which of the following statements should the nurse make?
      A)"You will need to leave the dining room right now and go somewhere else to exercise."
      B)"We need you to decide what activities you will do today."
      C)"You are already too thin and exercise is not good for you. Go sit down somewhere and eat something."
      D)"Come with me. Here is a milkshake to drink."
    3. A nurse is making a home visit for a 16-year old adolescent who attempted suicide. Which of the following behaviors should alert the nurse that the adolescent still has suicidal intent?
      A)Stating that he wants to be with his peers more than with his parents.
      B)Preferring to eat his meals while watching TV.
      C)Telling his parents that he doesn't want to talk about the suicide attempt.
      D)Planning to give his CD collection to his girlfriend.
    4. A nurse is caring for a client who reports an upset stomach after taking chlorpromazine. Which of the following responses should the nurse make?
      A)"Drink a glass of milk with each dose of your medication."
      B)"Lie down for 30 minutes after each dose to help prevent stomach upset."
      C)"Taking the medication on an empty stomach will decrease your stomach upset."
      D)"Talk to your provider about decreasing your dose of medication."
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    Exam Review

    1. A nurse is providing discharge teaching to a client who has bipolar disorder and will be discharged with a prescription for lithium. The nurse should teach the client that which of the following factors puts her at risk for lithium toxicity?
      A)The client drinks 2 liters of liquids daily.
      B)The client eats foods high in tyramine.
      C)The client eats 2 to 3 gm of sodium-containing foods daily.
      D)The client runs 4 miles outdoors every afternoon.
    2. A nurse is caring for a client who has generalized anxiety disorder and is taking buspirone. Which of the following adverse effects should the nurse report to the provider?
      A)Discolored urine
      B)Decreased appetite
      C)Hallucinations
      D)Sweating
    3. A nurse is planning care for a client who is scheduled to receive electroconvulsive therapy (ECT). Which of the following medications should the nurse anticipate administering prior to the procedure?
      A)Atropine
      B)Diphenhydramine
      C)Fluoxetine
      D)Epinephrine
    4. A nurse is planning care for a client who has generalized anxiety disorder. Which of the following intervention should the nurse implement to promote relaxation?
      A)Encourage the client to identify his positive qualities.
      B)Help the client to identify his previous accomplishments.
      C)Assist the client in practicing meditation.
      D)Recognize the client's spiritual preferences.
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    Exam Review

    1. A nurse is collecting a health history on a client who has a diagnosis of Wernicke-Korsakoff syndrome. Which of the following is an expected finding?
      A)Personal history of alcohol use disorder.
      B)Current rehabilitation for opiate addiction.
      C)Undergoing current treatment for HIV.
      D)Family history of Alzheimer's disease.
    2. A nurse is caring for a client who has delusional behavior and states, "I can't go to group therapy today. I am expecting a high level official to visit me!" The nurse responds, "I understand, but it is time for group therapy and we expect everyone to attend. Let's walk over together." For which of the following reasons is the nurse's response considered therapeutic?
      A)It uses reflection when talking with the client.
      B)It demonstrates empathy towards the client.
      C)It clearly articulates what is expected of the client.
      D)It sets limits on the client's manipulative behavior.
    3. A nurse is caring for an adolescent client who has a new diagnosis of schizophrenia. The client's parents are tearful and express feelings of guilt. Which of the following statements should the nurse make?
      A)"You said that you feel guilty about your daughter's diagnosis. Let's talk about what is causing you to feel this way."
      B)"Your provider has explained the causes of schizophrenia. Why do you feel guilty about your daughter's diagnosis?"
      C)Tm sure your daughter's diagnosis is very difficult to deal with, but everything will be all right once she receives the proper treatment."
      D)"You should not feel guilty about your daughter's diagnosis. Schizophrenia is unpreventable."
    4. A nurse is reviewing the medical record of a client who performs self-injury. Which of the following information should the nurse identify as placing the client at risk for self-harm behaviors?
      A)The client has a parent who has dependent personality disorder.
      B)The client has borderline personality disorder.
      C)The client has a history of bulimia nervosa.
      D)The client recently received a promotion at work.
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    Exam Review

    1. A nurse is discussing the use of mechanical restraints with a newly licensed nurse. Which of the following situations should the nurse include as an indication for placing a client in mechanical restraints?
      A)Discipline for throwing objects at staff
      B)Punishment for verbally abusing other clients
      C)Coercion to take prescribed medications
      D)Self-destructive behavior despite alternative interventions
    2. A nurse is caring for a client who has major depressive disorder and is scheduled for electroconvulsive therapy (ECT). The client's spouse asks the nurse about the possible side effects of the ECT. Which of the following responses should the nurse make?
      A)"The most common side effects are directly related to the use of anesthesia."
      B)"The main side effects are temporary, and may include mild confusion, a headache, and short-term memory loss."
      C)"Some clients have been known to have a myocardial infarction, but we will monitor your spouse closely to be certain this does not happen."
      D)"Most clients have no adverse effects to this treatment, but muscle cramping may result from the induced seizure."
    3. A nurse in an acute mental health facility is caring for a client who jumps out of her chair and begins to shout angrily at the clients around her. Which of the following actions should the nurse take first?
      A)Offer the client a PRN antianxiety medication..
      B)Escort the client to an unlocked seclusion room.
      C)Call for assistance to place the client in restraints.
      D)Speak to the client calmly, giving simple directions.
    4. A nurse in a mental health clinic is assessing a client who was brought in by her adult daughter stating that her mother has not been able to leave her home for weeks because she is afraid to be outdoors alone. The nurse should anticipate planning care for managing which of the following phobias?
      A)Mysophobia
      B)Xenophobia
      C)Agoraphobia
      D)Acrophobia
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    Exam Review

    1. A nurse is caring for a client who has a history of alcohol use disorder and has been hospitalized for detoxification. The nurse enters the room an finds the client shouting in a terrified voice, "Get these bugs off of me!" Which of the following responses by the nurse is appropriate?
      A)"I'm sure that the bugs you see will not harm you."
      B)"I don't see any bugs, but you seem very frightened."
      C)"I do not see anything. This is part of the withdrawal process."
      D)"Tell me more about the bugs that you see in your room."
    2. A nurse is caring for a client who has major depressive disorder and was prescribed citalopram 2 weeks ago with a planned dosage increase 1 week ago. The client reports having an improved appetite, but still feels very depressed and is still having trouble sleeping. Which of the following actions should the nurse take?
      A)Speak to the provider about adding an MAOI to the current medication regimen.
      B)Tell the client that the provider will need to change citalopram to a different medication.
      C)Explain that antidepressants often take several weeks to be fully effective.
      D)Recommend a sleep study be done on the client.
    3. A nurse overhears a client who has schizophrenia talking to herself. The client keeps stating. "The flakalas are here. The flakalas are here." The nurse correctly recognizes the client's use of the word flakalas as an example of which of the following alterations in speech?
      A)Clang association
      B)Echolalia
      C)Word salad
      D)Neologism
    4. A nurse is caring for a client who has bipolar disorder and is taking lithium. The client reports blurred vision and ataxia. Which of the following actions should the nurse take?
      A)Administer the next dose as prescribed.
      B)Withhold the medication.
      C)Prepare to administer propranolol.
      D)Plan to administer levothyroxine.
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    Exam Review

    1. A nurse in an acute mental health unit is admitting a client who has bipolar disorder. Which of the following findings supports the admitting diagnosis of acute mania?
      A)The client's spouse reports that client has recently gained weight.
      B)The client reports that voices are telling him to write a novel.
      C)The client responds to questions with disorganized speech.
      D)The client is dressed in all black.
    2. A nurse is caring for a client who has autism spectrum disorder. Which of the following findings should the nurse expect?
      A)Ambivalence.
      B)Echolalia
      C)Expressive affect
      D)Associative looseness
    3. A nurse notices that a client who has moderate anxiety is pacing the hall and mumbling As the nurse approaches the client, he states, "I am at the end of my rope. I don't think I can take any more bad news." Which of the following responses should the nurse make?
      A)"Providers usually recommend relaxation exercises for clients who are as upset as you are."
      B)"Come with me to an area where we can talk without interruption."
      C)"Most clients with anxiety issues benefit from lying down."
      D)"An antianxiety pill works best for situations like this.
    4. A nurse is caring for an adolescent client who has conduct disorder. The client reports that she has received five speeding tickets in the past 6 months. Which of the following interventions should the nurse take?
      A)Inform the client that she cannot drink and drive.
      B)Call the local police and alert them to the client's car license plate number and the make and model of her car.
      C)Make a contract with the client not to drive over the speed limit.
      D)Ask the client to "hand over the keys" to you, and tell her that now she must use a cab or other public transportation until your next session.
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