Summary NURS 222 Schizophrenia, Major Depressive Disorder, Narcissistic Personality Disorder, Proctor Practice, (2020/2021) West Coast University, Orange County

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1. A nurse in an alcohol treatment facility is caring for a client who states, “ My job is so stressful that the only way I can cope is to drink.” The nurse should recognize that the client is dis... playing which of the following defense mechanisms? a. Introjection b. Repression c. Rationalization d. Intellectualization A nurse is obtaining a medical history from a client who is requesting a prescription for bupropion for smoking cessation. Which of the following assessment findings in the client's history should the nurse report to the provider? e. Knee arthroplasty 1 month ago f. Hepatitis B infection g. Recent head injury (bc risk for seizures) h. Hypothyroidism A nurse is assessing a client who has histrionic personality disorder. Which of the following findings should the nurse expect? i. Lack of remorse - conduct j. Splitting of staff k. Attention-seeking - have to be the center of attention l. Identity disturbance A nurse is providing teaching to the daughter of an older adult who has obsessive compulsive disorder. Which of the following statements indicates an understanding of the teaching? m. “ I will provide my mother with detailed instructions about how to perform self care.” n. “ I will limit my mother's clothes choices when she is getting dressed.” o. “ I will wake my mother up a couple of times in the night to check on her.” p. “ I will discourage my mother from talking about her physical complaints.” 2. A nurse is caring for a client who has depression following a recent job loss. Which of the following questions should the nurse ask to assess the client's personal coping skills? a. “ Can you describe how you are feeling currently?” b. “ How does this situation affect your life?” c. “ Do you see your current situation affecting your future?” d. “ How have you dealt with similar situations in the past?” 3. A nurse is providing Crisis Intervention for a client who has who was involved in a violent mass casualty situation and the community. Which of the following actions should the nurse take during the initial session with a client? a. Identify the client’s usual coping style b. Encourage the client to display anger toward the cause of the crisis c. Tell the client that his life will soon return to normal x (false hope) d. Help the client focus on a wide variety of topics regarding the crisis 4. A nurse is planning care for a client who has acute delirium. Which of the following instructions should the nurse include in the plan? a. Reinforce the client’s orientation with a calendar. b. Teach the client assertive techniques. c. Assign the client to a different caregiver each shift. d. Refuse the client's perception of visual hallucinations 5. A nurse is assessing a child in the ED. Which of the following findings places that child at greatest risk for physical abuse? a. The child is homeschooled b. The child is 10 years old c. The child has no siblings d. The child has cystic fibrosis 6. A nurse is caring for a client who has Alzheimer's disease. Which of the following actions should the nurse take? a. Use symbols to assist a client in locating rooms b. Give complete directions before starting client care c. Provide the client with several choices for meal selection d. Seat the client at a dining table with six or more residents 7. A nurse is planning to conduct a support group for adolescents who have cancer. Which of the following actions should the nurse include during the orientation phase? a. Encourage the use of problem solving skills (working phase) b. Manage conflict within the group c. Maintain the group's focus on identified issues d. Establish a rapport with group members 8. A nurse is assessing a client who is withdrawing from heroin. Which of the following manifestations should the nurse expect? a. Bradycardia (tachycardia) b. Slurred speech (sign of intoxication) c. Hyperthermia d. Hypotension (hypertension) 9. A nurse is preparing to administer chlorpromazine hydrochloride 25 mg PO to an older adult client. Available is chlorpromazine hydrochloride syrup 10 mg/ 5 ml. How many ml should the nurse administer? ( round answer to the nearest tenth) a. 12.5 ml 10. A nurse is caring for a school-age child who has conduct disorder and is being physically aggressive toward other children on the unit. Which of the following actions should the nurse take first? a. Use a therapeutic hold technique b. Administer Risperidone c. Apply wrist restraints d. Place the child in seclusion 11. A nurse is caring for a client who has schizophrenia and is taking clozapine. Which of the following findings is a priority for the nurse to report to the provider? a. Sore throat - risk of agranulocytosis b. Heart rate 104/min c. Random blood glucose 130 mg/dL - development of Metabolic Syndrome d. Nausea 12. A nurse is caring for a client who has schizophrenia and started taking Clozapine 2 months ago. Which of the following lab results should the nurse report to the provider? a. Hgb 16 b. WBC 3,000 c. Platelets 300,000 d. Potassium 4.2 13. A nurse is performing a Mental Status Examination for a client who has schizophrenia. The nurse should recognize that which of the following actions requires the client to think abstractly? a. Determine the meaning of a proverb b. Count by adding sevens consecutively c. Explain what to do if he misses the bus d. Name the last three presidents of the United States of America 14. A nurse in a Center Rehab unit is caring for a client who has a traumatic brain injury. To which of the following members of the clients interprofessional team to the nurse prefer the client in order to help him learn how to use eating utensils? a. Physical therapist b. Neuro psychiatrist c. Social worker d. Occupational therapist 15. A charge nurse is orienting a newly licensed nurse and observes the newly licensed nurse imitating her behaviors. The nurse should recognize this Behavior as which of the following defense mechanisms? a. Suppression b. Identification c. Compensation d. Reaction formation 16. A nurse is leading a grief support group for bereaved clients. which of the following statements should the nurse report to the provider as an indication of clinical depression? a. “ It's been a long time before I'm happy again.” b. “ I don't feel anything but numbness anymore.” c. “ I feel like I'm angry at the whole world right now.” d. “ I don't know how I could cope if I didn't have my family’s support.” 17. A nurse is reviewing lab values for a client who has bipolar disorder and a prescription for lithium. The nurse should identify that which of the following lab results places the risk for lithium toxicity? a. Chloride 98 b. Sodium 130 c. Potassium 5.0 d. Calcium 9.0 18. A nurse in an inpatient mental health facility is assessing a client who has schizophrenia and is taking haloperidol. Which of the following findings is a nurse's priority? a. Insomnia b. Urinary hesitancy c. High fever d. Headache 19. A nurse is developing a plan of care for school-age child who has ADHD. Which of the following interventions should the nurse include in the plan? a. Administer olanzapine - antipsychotic/schizo/bipolar b. Encourage thought stopping techniques - OCD c. Provide a stimulating environment - when do we ever? d. Institute consequences for deliberate behaviors 20. A nurse is planning care for a client who has bipolar disorder. The client reports not sleeping for 3 days and is exhibiting a euphoric mood. The nurse should identify which of the following as a priority intervention? a. Secure a client's valuable possessions b. Limit loud noises in a client's environment c. Provide high calorie snacks to the client d. Encourage the client to participate in structured solitary activities 21. A nurse is providing teaching for the family of a client who has dementia. Which of the following should the nurse include in the teaching as a contributing factor for the disorder? a. Alcohol use disorder (substance abuse leads to dementia in old ppl) b. Dehydration c. Change in environment- d. Hypotension 22. A nurse is caring for a client in the emergency department who states that she was beaten and sexually assaulted by her partner. After a rapid assessment, which of the following actions should the nurse take first? a. Conduct a pregnancy test b. Offer prophylactic medication to prevent STIs c. Request a mental health consultation for the client d. Provide a trained advocate to stay with the client 23. A nurse is caring for a client who has bipolar disorder and is experiencing a manic episode. Which of the following actions should the nurse take? a. Place a client in a group therapy session b. Rotate staff members who work with the client c. Distract the client w increased environmental stimuli d. Encourage the client to participate in physical activities 24. A nurse in a mental health facility is caring for a client. Which of the following actions should the nurse take during the working phase of the nurse client relationship? a. Summarize his goals and objectives b. Address confidentiality c. Promote problem solving skills d. Establish a participation contract 25. A nurse is assessing the boundaries of a client's family. One of the family members says to the client, “ I know exactly what you're thinking right now.” The nurse should recognize that the family member is displaying which of the following types of family boundaries? a. Enmeshed b. Clear c. Rigid d. Inconsistent 26. A nurse is reviewing the lab results of an adolescent who has anorexia nervosa. which of the following findings should the nurse expect? a. Hgb 10 g/dL (anemia) b. Potassium 3.7 mEq/L c. Blood glucose 100 mg/dL d. T4 11 mcg/dL [ 4-12 ] 27. A nurse is providing behavioral therapy for a client who has OCD. The client repeatedly checks that the doors are locked at night. Which of the following instructions should the nurse give the client when using thought stopping technique? a. “Keep a journal of how often you check the locks each.” b. “Ask a family member to check the locks for you at night.” c. “Focus on abdominal breathing whenever you go to check the locks.” d. “Snapping rubber band on your wrist when you think about checking the locks.” 28. A nurse in a mental health facility is assessing a client for suicide risk factors using the SAD PERSONS scale. Which of the following findings should indicate a risk for suicide? a. The client is married b. The client is female c. The client is 50 years old d. The client has diabetes mellitus 29. A nurse is assessing a newly admitted client who has schizophrenia and takes thioridazine. Which of the following findings should the nurse document as an adverse effect of the medication? a. Waxy flexibility b. Contractions of the jaw (dystonia) c. Incongruent affect d. Anhedonia 30. A nurse is assisting with obtaining informed consent for a client who has been declared legally incompetent. Which of the following actions should the nurse take? a. Explain implied consent to the client’s family b. Contact the facility social worker to obtain the consent c. Request that the client’s guardian sign the consent d. Ask the charge nurse to obtain informed consent 31. A nurse is providing teaching for school-age child And its parent regarding a new prescription for risperidone. Which of the following statements for the parent indicates an understanding of the teaching? a. “ I should expect my son to develop hand tremors.” (expected AE) b. “ I'll provide a low sodium diet for my son.” c. “ I should contact my doctor if my son urinates excessively.” (anticholinergic) d. “ I will make sure my son takes the last dose of the day by 4 p.m..” (IM once every 2 weeks) 32. A nurse is assessing a client who requests bupropion for smoking cessation. Which of the following findings in the client's history should the nurse recognize as a contraindication for taking this medication? a. Anemia b. Asthma (plus allergies/resp problems) c. Migraines d. Seizures 33. A nurse is evaluating the medication response of a client who takes Naltrexone for the treatment of alcohol use disorder. The nurse should identify that which of the following is a therapeutic effect of this medication? a. Blocks aldehyde dehydrogenase b. Reduces substance craving c. Decreases the likelihood of seizures d. Prevents anxiety of abstinence 34. A nurse is teaching a client who has major depressive disorder about electroconvulsive therapy. Which of the following information should the nurse include? a. “This therapy will stimulate the vagus nerve to improve your mood.” b. “You might experience confusion for a few hours after treatment.” c. “This therapy works as a cure for major depressive disorders.” d. “You will be awake and alert during the procedure.” 35. A nurse is teaching about Benztropine to a client has schizophrenia. Which of the following should the nurse include in the teaching? a. “Benztropine helps alleviate your hallucinations.” b. “This medication is given to help with extrapyramidal side effects” c. “Benztropine is used to counteract your tachycardia” d. “This medication is given to help with your depression.” 36. A nurse is caring for a client who has a lithium level of 0.8 mEq/L. Which of the following actions should the nurse take? a. Administer the next dose of lithium [ Normal: 0.6 - 1.2 ] b. Withhold the next dose of lithium c. Repeat the lithium level test d. Recommended low sodium diet 37. A nurse is caring for a client who is involuntarily admitted for major depressive disorder and refuses to take a prescribed anti-anxiety medication. Which of the following actions should the nurse take? a. Inform the client that he does not have the right to refuse the medication b. Implement consequences until the client takes the medications c. Administer to medication to the client via IM injection d. Offer the client that medication at the next scheduled dose time 38. A nurse is creating a plan of care for a client who has anorexia nervosa. Which of the following interventions should the nurse include in the plan? a. Weigh the client twice per day (3x daily for the first week) b. Prepare the client for electroconvulsive therapy c. Encourage the client to participate in Family Therapy d. Set a weight gain goal of 2.2 kg (5lb) per week [ 2 or 3 lb/week ] 39. A nurse is planning care for 3 year old child who has autism spectrum disorder which the following findings should the nurse expect? a. Readily initiates conversation b. Strong relationship with siblings and peers c. Attachment to objects that spin d. Enjoys imaginative play 40. A nurse is providing teaching to the caregiver of an older adult client who has Alzheimer's disease and is being cared for at home. The client wanders at night and has a history of previous falls. Which of the following instructions should the nurse include in the teaching? SATA a. Place the client in a reclining chair b. Encourage physical activity prior to bedtime c. Install sensor devices on outside doors d. Position the mattress on the floor e. Put locks up top of doors 41. A nurse is planning care for a client who has experienced intimate partner abuse. The nurse should identify which of the following outcomes as a priority? a. The client identifies support systems b. The client develops a safety plan c. The client joins a support group d. The client identifies techniques to reduce her stress 42. A nurse is reviewing the medical records of four clients. Which of the following findings should the nurse identify as a risk factor for violent Behavior? a. Schizoid personality disorder b. Dysrhythmic disorder c. Alcohol intoxication? d. Long-term isolation 43. A nurse is reviewing the lab report of a client who is taking carbamazepine for bipolar disorder. Which of the following lab results should the nurse report to the provider? a. Urine specific gravity 1.029 b. Platelets 90,000/mm3 c. Urine pH 5.6 d. RBC 4.7/mm3 44. A nurse is speaking with a client. Which of the following responses by the nurse demonstrates the communication technique of reflection? a. “I would like to sit with you for a while.” b. “Can you tell me what is happening now?” c. “You feel upset when this happens?” d. “Let's work together to try to solve your problem” 45. A nurse is counseling an adult client whose parent just died. The client states, “My son is four, and I don't know how he'll react when he finds out that his Grandpa died.” The nurse should inform the client that the preschool age child, commonly has which of the following concepts of death? a. Death is contagious and can cause other people he loves to die b. Death create an interest in the physical aspects of dying c. Death is a part of life that eventually happens to everyone d. Death is not permanent and the loved one may come back to life 46. A nurse in a mental health facility is making plans for a client's discharge. Which of the following interdisciplinary team members should the nurse contact to assist a client with housing placement? a. Social worker b. Clinical nurse specialists c. Occupational therapist d. Recreational therapist 47. A nurse is caring for a client who reports that he's angry with his partner because she thinks he's just trying to gain attention. When the nurse attempts to talk to the client he becomes angry and tells the nurse to leave. Which of the following defense mechanisms is a client demonstrating? a. Rationalization b. Compensation c. Denial d. Displacement 48. A nurse is assessing a client who recently started antidepressant therapy for the treatment of major depressive disorder. Which of the following findings indicates the client is in an increased risk for suicide? a. Increased energy b. Unkempt appearance c. Hypersomnia d. Psychomotor retardation 49. A nurse and a mental health facility is caring for a client who has borderline personality disorder. Which of the following findings should the nurse expect? a. Self-mutilation b. Pacing back and forth c. Disorganized speech d. Preoccupation with details 50. A nurse is caring for a client who exhibits excessive compliance passivity and self-denial. The nurse should recognize that these findings are associated with which of the following personality disorders? a. Dependent b. Histrionic c. Paranoid d. Borderline 51. A nurse is giving presentation about intimate partner abuse for community group. Which of the following statements by group member indicates an understanding of the teaching? a. Survivors of abuse often feel guilty b. As abuse continues victims become more determined to be independent c. The honeymoon stage and violence usually gets longer overtime d. Abusers often have high self-esteem 52. A nurse is caring for a client who has post-traumatic stress disorder related to military service, which of the following actions should the nurse take? a. Address the client in an authoritative manner b. Assign the same staff to care for the client each day c. Limit the amount of time spent with the client d. Encourage the client to suppress feelings of trauma 53. A nurse is caring for a client who has major depressive disorder. After discussing the treatment with his partner, the client verbally agrees to electroconvulsive therapy but will not sign the consent form. Which the following actions should the nurse take? a. Inform the client about the risks of refusing ECT b. Cancel the scheduled ECT procedure (must be signed) c. Proceed with preparation for ECT based on implied consent d. Request of the client’s partner sign the consent form 54. A nurse is developing a behavioral contract with a client who has antisocial personality disorder. Which of the following should the nurse include in the contract? a. Use bargaining skills for Behavioral consequences b. Use projection during group therapy c. Decrease the number of verbal outbursts d. Increase self-esteem 55. A nurse is caring for a group of clients on a mental health unit. For which of the following clients is a nurse considered a mandated reporter to the appropriate agency? a. A client reports that he enjoy smoking marijuana on weekends b. A client reports that she took $20 from the cash register and where she works c. A client who reports lying to his provider about having suicidal ideation d. A client reports that her partner tied their children to a bed as punishment 56. A nurse is creating a plan of care for a client who has major depressive disorder. Which of the following interventions should the nurse include in the plan? a. Encourage physical activity for the client during the day b. Keep a bright light on in the client room at night c. Identify and schedule alternative group activities for the client d. Discourage the client from expressing feelings of anger 57. A nurse is caring for a client who has a new diagnosis of bulimia nervosa. Which of the following diagnostic procedures should the nurse anticipate the provider to prescribe during the medical evaluation? a. Chest x-ray b. ECG (pg 104) c. Liver function test d. Coagulation studies 58. A nurse at a community mental health clinic is caring for a group of clients. The nurse should encourage participation and cognitive behavioral family therapy in response to which of the following client statements? a. I want each of my family members to be more aware of each other's feelings b. I want to learn how to change the way I reacted to problems within my family ? c. I want to understand why my past experiences are affecting my family relationships d. I want to improve my family's understanding of each other's boundaries 59. A nurse is teaching the parent of a school-age child who has ADHD and a prescription for atomoxetine 40 mg daily. Which of the following information should the nurse include in the teaching? a. Administer medication before the child goes to school in the morning (pg 147) b. Crush the medication and mix it with 120ml / 4oz of juice c. Therapeutic effects will occur within 24 hours of starting treatment d. Expect the child to gain weight while taking this medication 60. A nurse is caring for a client who has been taking valproic acid. Which of the following is an expected outcome of the med? a. The client has decreased anxiety b. The client reports improved short-term memory c. The client reports absence of auditory hallucination d. The client has decreased euphoric mood - mood stabilizer for bipolar 61. An older adult client is brought to the mental health clinic by her daughter. The daughter reports that her mother is not eating and seems uninterested in routine activities. The daughter states, “I am so worried that my mother is depressed.” Which of the following responses should the nurse make? a. Tell me the reasons you think your mother is depressed b. You shouldn't worry about this, because depressive disorder is easily treated c. Everyone gets depressed from time to time d. Older adults are usually diagnosed with depressive disorder as they age 62. A nurse is assessing a client who is experiencing alcohol withdrawal period for which of the following findings should the nurse anticipate administration of lorazepam? a. Afebrile b. Bradycardia c. Hypertension ( lightheadedness, delirium, seizures, muscle twitching) i. Tremors, diaphoresis, anxiety, insomnia d. Stupor i. Benzodiazepine: prevention and tx of acute withdrawal sx 63. A nurse is advising an Assistive Personnel on the care of a client who has major depressive disorder. The AP states that he is irritated by the client’s depression. Which of the following statements by the nurse is appropriate? a. Please don't take what the clients said seriously when she's depressed b. I'll change your assignment to someone who doesn't have depressive disorder c. It's important that the client feels safe verbalizing how she's feeling d. Everybody feels that way about this client, so don't worry about it 64. A nurse is caring for a client who suddenly directs profanities at her, then abruptly hangs his head and says, “Please forgive me, I'm not sure what came over me I don't know why I said those things.” The nurse interprets this behavior as which of the following? a. Neologism - making up words b. Confabulation - making up stories/AD pts c. Emotional lability - (exaggerated changes in mood) d. Flight of ideas - associative looseness / sentences that don’t make sense 65. A school nurse is caring for an adolescent client whose teacher reports changes in school performance and withdrawal from interaction with classmates. Which of the following interventions is the nurse’s priority at this time? a. Suggest the client joins a support group b. Contact the adolescents parents c. Ask the adolescent if he is considering hurting himself d. Determine when the adolescents change in behavior began 66. A nurse in a provider's office is assessing a school-age child who has a spiral fracture. The parent of the child provides different accounts of the cause of the injury. Which of the following actions should the nurse take first? a. Ask the child how the injury occurred b. Request that the parent leave the room while interviewing the child c. Report suspected abuse to Child Protective Services d. Determine immediate safety needs of the child 67. A nurse in the emergency department is assessing a client who has major depressive disorder. Which of the following actions should the nurse take? EXHIBIT a. Administered Dantrolene IV bolus to the client i. For neuroleptic syndrome (EPS) 1. Induces muscle relaxation b. Ask the client if she has eaten foods containing tyramine i. If on MAOI (Phenelzine) = hypertensive crisis c. Give regular insulin Sub-Q to the client d. Prepare the client for electroconvulsive therapy i. For major depressive disorders ii. Psychotic manifestations iii. Client who is suicidal iv. Acute manic eps / bipolar v. Schizophrenia [Show More]

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