2. Which communication pattern is defined as

2. Which communication pattern is defined as confabulation? 1 The flow of thoughts is interrupted. 2 Imagination is used to fill in memory gaps. 3 Speech flits from one topic to another. 4 Statements are too loose to understand. 3. Which type of unit would be an appropriate placement for a client who was involuntarily admitted for a 48-hour hold due to a suicide attempt and is believed to be an elopement risk? 1 Locked 2 Unlocked 3 Assisted living 4 Nursing home 4. A client who has a history of aggressive, violent behavior becomes very angry and starts screaming at the nurse and pounding on the table. Which assessment is the priority? 1 Range of expressed anger 2 Extent of orientation to reality 3 Degree of control over the behavior 4 Level of perceived justification 5. Which is most important to ask a client whose spouse died 2 years ago and she is now exhibiting a general lack of interest, poor personal hygiene, and social isolation? 1 “How do you feel about your spouse’s death?” 2 “What do you think is causing your depressed behavior?” 3 “What can you tell me about your marital relationship?” 4 “Have you recently been thinking about suicide?” 6. Which intervention would the nurse use for a client who cries when her parents bring a birthday gift to the mental health unit, but do not stay to visit with her? 1 Limit her contact with the parents. 2 Discuss her parents’ behavior with her. 3 Distract her by engaging her in an activity. 4 Take her to the coffee shop for a birthday treat. 7. Which intervention is most important to assist a couple to cope with their feelings about the husband’s terminal illness? 1 Referring the husband to a psychotherapist for help in dealing with his anger 2 Placing the couple in a couples’ therapy group that addresses terminal illness 3 Helping the couple express to each other their feelings about his terminal illness 4 Encouraging the wife to verbalize her feelings to a therapist in individual therapy 8. A client who has been sexually assaulted says, “I should have fought back.” Which response is the most therapeutic? 1 “You’re feeling guilty about submitting, because you feel like you just gave in.” 2 “You may have submitted, but did you really have any other choice at the time?” 3 “It’s over; let’s not talk about what you could have done to prevent the assault.” 4 “Whatever action you took, it was the right action because it saved your life.” 9. While leading a group session, which action would the nurse use when occasional silence occurs? 1 Accept silence with reflection or affirmation. 2 Be willing to sit indefinitely to wait out the silence. 3 Call on specific members to talk when silence occurs. 4 Require each member to talk by going around the group. 10. Which defense mechanism is most often used by individuals who physically abuse others? 1 Repression 2 Undoing 3 Sublimation 4 Displacement 11. An older client describes the current situation and then offers information that goes further and further off the topic. Which pattern of communication is the client using? 1 Perseveration 2 Thought blocking 3 Pressured speech 4 Tangential thinking 12. Which statements by a 17-year-old client who is diagnosed with leukemia reflects Piaget’s cognitive processes associated with adolescence? Select all that apply. One, some, or all responses may be correct. 1 “My smoking pot probably caused the leukemia.” 2 “I’m going to do my best to fight this awful disease.” 3 “Now I can’t go to the prom because I have this stupid disease.” 4 “I know I got sick because I’ve been causing a lot of problems at home.” 5 “This illness is serious, but with treatment I think I have a chance to get better.” 13. During the first meeting of a therapy group, members exhibit frequent periods of silence, tense laughter, and nervous movements. Which conclusion would the nurse make? 1 The group requires an active leader who will intervene to relieve signs of obvious stress. 2 The group process is unhealthy and there is unwillingness to openly relate. 3 The members are displaying expected behaviors because relationships are not yet established. 4 The behaviors should be immediately addressed so members will not become too uncomfortable. 14. Which portion of the nervous system is primarily responsible for the clinical manifestations that occur during a crisis? 1 Central nervous system 2 Peripheral nervous system 3 Sympathetic nervous system 4 Parasympathetic nervous system 15. Which factor is most important in predicting a person’s reaction to imminent loss and grief? 1 Family interactions 2 Social support system 3 Emotional relationships 4 Earlier experiences with grief 16. Which response would the nurse use when a parent of a 13-year-old adolescent with recently diagnosed Hodgkin disease says, “I don’t want my child to know about the diagnosis”? 1 “It’s best for your child to know the diagnosis.” 2 “Did you know that the cure rate for Hodgkin disease is high?” 3 “Would you like someone with Hodgkin disease to talk with you?” 4 “Let’s talk about how you’re feeling about your child’s diagnosis.” 17. The home health nurse suspects that the client’s house is being used as a methamphetamine laboratory. Which observations support this conclusion? Select all that apply. One, some, or all responses may be correct. 1 Many small plastic bags 2 A strong odor of acetone 3 Many empty cold medicine bottles 4 A pot of tall plants with broad leaves 5 Jars containing crystals 18. Which defense mechanism is displayed by a male college student who is smaller than average and nonathletic but is the life of the party and a stylish dresser? 1 Introjection 2 Sublimation 3 Compensation 4 Reaction formation 19. The client phones the mental health clinic and says, “Don’t try to help me anymore. I’ve had enough, and I have a gun in front of me now.” Suddenly the call is disconnected. Which action would the nurse take? 1 Call the local clergy and request an immediate visit. 2 Call the client back and try to change his mind. 3 Call 911 and inform the dispatcher of the situation. 4 Call the family and tell them to go to the house. 20. According to Erikson’s psychosocial stages of development, which developmental conflict is a college student attempting to resolve as he struggles with indecision about an academic major? 1 Initiative versus guilt 2 Integrity versus despair 3 Industry versus inferiority 4 Identity versus role confusion 21. Which strategies would the nurse use to deal with burnout? Select all that apply. One, some, or all responses may be correct. 1 Focus on the clients’ physical and safety needs. 2 Identify personal responses to daily work stresses. 3 Change to a nursing position on a low-stress unit. 4 Attend educational programs as often as possible. 5 Seek out professional and personal support systems. 6 Leave the work at work at the end of the shift. 22. Which age group of hospitalized children will have the most difficulty with separation anxiety? 1 6 to 30 months 2 36 to 59 months 3 5 to 11 years 4 12 to 18 years 23. A client who is to undergo a mastectomy for breast cancer says, “I am worried about what I’ll look like after surgery.” Which response would the nurse use? 1 “I understand that you’d be concerned about appearance.” 2 “Try not to think about the surgery or the outcomes.” 3 “Anyone in your position would feel the same way.” 4 “Perhaps you should discuss this with your husband.” 24. A member of an opiate abuse support group states, “I just got a prescription for an opioid for my back pain.” Which response is the most therapeutic? 1 “How did you convince your health care provider to give you that prescription?” 2 “This was the wrong thing to do. Can anybody in the group explain why?” 3 “Has anybody else had chronic back pain? If so, how did you handle it?” 4 “You may not attend the group anymore because this is considered a relapse.” 25. Which goal is best for a married father of 3 children who tearfully explains that he feels upset, embarrassed, and useless after losing his job? 1 Client will limit tearfulness 2 Client will increase his self-esteem 3 Client will control feelings of sadness 4 Client will promote acceptance by others 26. A primary health care provider writes a prescription of “Restraints PRN (as needed)” for a client who has a history of violent behavior. Which action would the nurse take? 1 Ask the health care provider to specify the type of restraint in the prescription. 2 Notify the provider that PRN prescriptions for restraints are unacceptable. 3 Implement the restraint prescription when the client begins to act out. 4 Ensure that the entire staff is aware of the prescription for the restraints. 27. Which response would the nurse use for a client who appears dejected, barely responds to questions, and in a barely audible voice says, “Life is no longer worth living”? 1 “Have you been thinking about suicide?” 2 “What could be so bad to make you feel that way?” 3 “We’ll talk about your feelings after you’ve rested.” 4 “Let’s talk about something pleasant to make you feel better.” 28. Which initial response would the nurse give to a husband who is upset that his wife’s alcohol withdrawal delirium has persisted for a second day? 1 “I see that you’re worried. We’re using medication to ease your wife’s discomfort.” 2 “This is expected. I suggest that you go home because there’s nothing you can do to help.” 3 “If you’re afraid that she will die, I assure you, very few alcoholics die during detoxification.” 4 “If you are concerned that she is uncomfortable, I’m sure that she’s not in pain.” 29. When the nurse tries to bathe a young client with a spinal cord injury who has an incontinence episode he says, “Leave me alone. Having you care for me is worse than lying in this mess.” Which response is the best? 1 “Do you want me to get someone else to change you?” 2 “You shouldn’t be embarrassed; this is part of my job.” 3 “I’ll be back in a little while; why don’t you rest until then?” 4 “During the bath, I’ll start teaching you about bowel training.” 30. According to Erikson’s developmental psychosocial theory, which is expected by 20 years of age? 1 Having the capacity for love and a commitment to work 2 Being creative and productive and having concern for others 3 Having a coherent sense of self and planning to accomplish future goals 4 Accepting the worth, integrity, and uniqueness of one’s past and present life 1. Which signs and symptoms support the conclusion that the client has been abusing high-dose cocaine for a prolonged time? Select all that apply. One, some, or all responses may be correct. 1 Sadness 2 Euphoria 3 Loss of appetite 4 Impaired judgment 5 Psychomotor retardation 2. Which clinical manifestations would the nurse expect when assessing a client with schizophrenia? Select all that apply. One, some, or all responses may be correct. 1 Paranoid behaviors 2 Loose associations 3 Inappropriate affect 4 Feelings of depression 5 Flashbacks 3. A 17-year-old girl is being treated in the acute care psychiatric unit. Her mother comes and leaves a gift for her but says, “I’m too busy to visit today.” Which type of communication is the mother displaying? 1 Giving false reassurance 2 Congruent communication 3 Double-bind message 4 Seeking validation 4. Which questions will the nurse ask to assess for the vegetative signs of clinical depression? Select all that apply. One, some, or all responses may be correct. 1 “Have you experienced any changes in libido?” 2 “Are you having any constipation?” 3 “Have you noticed a change in your appetite?” 4 “Are you having urinary retention?” 5 “Have you noticed a change in your sleeping patterns?” 6 “Are you feeling sad or blue?” 5. Which statement by the nurse accurately describes the DSM-5 criteria for conduct disorder? Select all that apply. One, some, or all responses may be correct. 1 “The client often initiates fights.” 2 “Others’ basic rights are violated.” 3 “Three of 15 criteria must be present.” 4 “One criterion must be present in the past 6 months.” 5 “The behavior has caused the child to be suspended from school.” 6 “In adolescent onset, there are no symptoms before 10 years of age.” 6. A teenager recently committed suicide. Which behaviors indicate to the school nurse that another student may be considering suicide? Select all that apply. One, some, or all responses may be correct. 1 Withdrawing from friends 2 Giving away prized possessions 3 Memorializing the dead teenager 4 Talking excessively about the event 5 Becoming involved in student activities 7. Which interventions would the nurse include in the plan of care for a client with depression who is at risk for self-directed violence? Select all that apply. One, some, or all responses may be correct. 1 Provide safe outlets for energy. 2 Make rounds every 15 minutes. 3 Assign a room next to the nurses’ station. 4 Reduce stimulation by dimming the lights. 5 Promote the discussion of negative thoughts. 8. Which behavior is characteristic of oppositional defiant disorder? 1 Difficulty with focus 2 Argues with adults 3 Lies to obtain favors 4 Initiates physical fights 9. For a child with attention-deficit/hyperactivity disorder (ADHD), which behaviors are expected? Select all that apply. One, some, or all responses may be correct. 1 Impulsiveness 2 Excessive talking 3 Spitefulness and vindictiveness 4 Deliberate annoyance of others 5 Playing video games for hours on end 6 Failure to follow through or finish tasks 10. Which would be the nurse’s priority when caring for a schizophrenic client exhibiting signs of impaired judgment, paranoia, and agitation? 1 Protecting other clients 2 Placing the client in seclusion 3 Giving antipsychotic medication 4 Talking to the client in a calm manner 11. For a postsurgical client, which data suggest acute alcohol withdrawal? Select all that apply. One, some, or all responses may be correct. 1 Tremors in both hands make it difficult for the client to hold a cup. 2 Systolic blood pressure has dropped 6 points over the past 6 hours. 3 The client is falling asleep while talking on the telephone to family. 4 The client’s bed linens and pajamas had to be changed during the night because of diaphoresis. 5 The client who has been cooperative becomes verbally abusive and irritable. 12. A 13-year-old student reports, “I worry about my parents because I don’t want them to get a divorce. I can’t stop worrying; I can’t sleep; I’m always tired, and my grades have dropped.” Which condition is the student experiencing? 1 Panic disorder 2 Separation anxiety 3 Generalized anxiety 4 Acute stress disorder 13. Which characteristic would the nurse consider when attempting to assess the defense mechanisms of an older adult client with neurocognitive disorder due to vascular impairment? 1 Avoids the use of any defense mechanisms 2 Uses one method of defense for every situation 3 Makes exaggerated use of old, familiar mechanisms 4 Attempts to develop new defense mechanisms for the current situation 14. Which intervention would the nurse add to the plan of care for a client with bipolar disorder who is using pressured speech and has stopped eating and sleeping? Select all that apply. One, some, or all responses may be correct. 1 Limiting caffeine intake 2 Giving olanzapine as prescribed 3 Providing soft music at bedtime 4 Maintaining a record of intake and output 5 Monitoring blood pressure every 30 minutes 6 Offering a high-calorie, high-protein drink every hour 15. A client reports decreased appetite, insomnia, anhedonia, and feelings of worthlessness. His job performance and relationships have been affected. Which is the most important to assist the health care provider in determining the diagnosis of this mood disorder? 1 “Are you taking any prescribed medications?” 2 “Is there a family history of mental illness?” 3 “Are you having suicidal thoughts?” 4 “When did the symptoms first start?” 16. Within a few hours of alcohol withdrawal, the nurse would assess the client for the presence of which clinical manifestations? Select all that apply. One, some, or all responses may be correct. 1 Agitation 2 Tremulousness 3 Yawning 4 Convulsions 5 Profuse diaphoresis 18. Which descriptions would the nurse expect to hear from a client describing experiences of panic? Select all that apply. One, some, or all responses may be correct. 1 Severe withdrawal 2 Hallucinations or delusions 3 A decreased need for sleep 4 Being more talkative than usual or feeling pressure to keep talking 5 Flight of ideas or the subjective experience that thoughts are racing 6 Feeling unreal (depersonalization) or that the world is unreal (derealization) 19. Which behavior typifies generalized anxiety disorder? 1 Inability to stop washing hands because hospital is dirty 2 Detachment while telling nurse about a traumatic event 3 Anxiety over interpersonal relationships, finances, and health 4 High level of anxiety when riding the hospital elevator 20. Which nursing intervention is most important for preventing injury to a client preparing to undergo electroconvulsive therapy (ECT) treatment? 1 Obtain baseline vital signs. 2 Evaluate swallowing ability. 3 Implement seizure precautions. 4 Determine use of benzodiazepines. 21. A client with paranoid schizophrenia shouts at the nurse, “You’re the one who made my lover leave me.” Which conclusion would the nurse make? 1 The client is disoriented and confused. 2 The client is actively hallucinating. 3 The client feels a sense of vulnerability. 4 The client needs to have limits set. 22. At which age are the signs of autism initially evident? 1 1 to 3 months 2 6 months 3 2 years 4 6 years 23. Which clinical manifestations would the nurse observe in a client with opioid withdrawal? Select all that apply. One, some, or all responses may be correct. 1 Muscle twitching 2 Runny nose 3 Tachycardia 4 Flulike symptoms 5 Pinpoint pupils 24. Which characteristics are likely to be demonstrated by a client with a diagnosis of schizophrenia? Select all that apply. One, some, or all responses may be correct. 1 Hallucinations 2 Low self-esteem 3 Concrete thinking 4 Apathy 5 Blunted affect 6 Intact reality testing 25. Which comorbid disorder is most commonly associated with generalized anxiety disorder (GAD)? 1 Post-traumatic stress disorder 2 Major depressive disorder 3 Histrionic personality disorder 4 Primary hyperinsomnia 26. Which signs and symptoms would the nurse observe in clients with anorexia nervosa? Select all that apply. One, some, or all responses may be correct. 1 Cachexia 2 Purging 3 Diarrhea 4 Hypertension 5 Lanugo 27. Which behaviors are observed in children with autism? Select all that apply. One, some, or all responses may be correct. 1 Imitates others 2 Engages in cooperative play 3 Avoids eye-to-eye contact 4 Seeks physical contact 5 Performs repetitive activities 6 Prefers children rather than adults 28. A client with a personality disorder alternately clings to the nurse and then distances him- or herself. Which interpretation would the nurse make about the client’s fears? 1 Client fears embarrassment and shame 2 Client fears losing self-esteem and respect 3 Client fears abandonment and rejection 4 Client fears interdependence and connection 29. Which characteristic unique to bulimia nervosa differentiates this disorder from anorexia nervosa? 1 The client is obese and always tries different or extreme diets. 2 The client has near-ideal weight and behavior can seem normal. 3 The client has a distorted body image and thinks of self as fat. 4 The client is struggling with dependence versus independence. 30. In distinguishing between dementia and delirium, which factors are unique to delirium? Select all that apply. One, some, or all responses may be correct. 1 Slurred speech 2 Lability of mood 3 Long-term memory loss 4 Visual or tactile hallucinations 5 Insidious deterioration of cognition 6 A fluctuating level of consciousness SCIENCE HEALTH SCIENCE NURSING NUR 3290

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