Quiz 2: 75 Questions

Comprehensive Mental Health and Psychiatric Nursing NCLEX Practice

Quiz #2: 75 Questions

• Question

Which nursing intervention is best for facilitating communication with a psychiatric client who speaks a foreign language?

• Rely on nonverbal communication
• Select symbolic pictures as aids
• Speak in universal phrases
• Use the services of an interpreter - correct answerD. Use the services of an

interpreter

• Question

The nurse explains to a mental health care technician that a client's obsessive- compulsive behaviors are related to an unconscious conflict between id impulses and the superego (or conscience). On which of the following theories does the nurse base this statement?

• Behavioral theory
• Cognitive theory
• Interpersonal theory
• Psychoanalytic theory - correct answerD. Psychoanalytic theory

• Question

The nurse observes a client pacing in the hall. Which statement by the nurse may help the client recognize his anxiety?

• "I guess you're worried about something, aren't you?
• "Can I get you some medication to help calm you?"
• "Have you been pacing for a long time?"
• "I notice that you're pacing. How are you feeling?" - correct answerD. "I notice that

you're pacing. How are you feeling?"

• Question

A client with obsessive-compulsive disorder is hospitalized in an inpatient unit. Which nursing response is most therapeutic?

• Accepting the client's obsessive-compulsive behaviors.
• Challenging the client's obsessive-compulsive behaviors.
• Preventing the client's obsessive-compulsive behaviors.
• Rejecting the client's obsessive-compulsive behaviors. - correct answerA. Accepting

the client's obsessive-compulsive behaviors.

• Question

A 45-year-old woman with a history of depression tells a nurse in her doctor's office that she has difficulty with sexual arousal and is fearful that her husband will have an affair.

Which of the following factors would the nurse identify as least significant in contributing to the client's sexual difficulty?

• Education and work history
• Medication used
• Physical health status
• Quality of spousal relationship - correct answerA. Education and work history

• Question

Which nursing intervention is most appropriate for a client with anorexia nervosa during initial hospitalization on a behavioral therapy unit?

• Emphasize the importance of good nutrition to establish normal weight.
• Ignore the client's mealtime behavior and focus instead on issues of dependence and

independence.

• Help establish a plan using privileges and restrictions based on compliance with

refeeding.

• Teach the client information about the long-term physical consequence of anorexia. -

correct answerC. Help establish a plan using privileges and restrictions based on compliance with refeeding.

• Question

A nurse is evaluating therapy with the family of a client with anorexia nervosa. Which of the following would indicate that the therapy was successful?

• The parents reinforce increased decision making by the client.
• The parents clearly verbalize their expectations for the client.
• The client verbalizes that family meals are now enjoyable.
• The client tells her parents about feelings of low self-esteem. - correct answerA. The

parents reinforce increased decision making by the client.

• Question

The nurse is working with a client with a somatoform disorder. Which client outcome goal would the nurse most likely establish in this situation?

• The client will recognize signs and symptoms of physical illness.
• The client will cope with physical illness.
• The client will take prescribed medications.
• The client will express anxiety verbally rather than through physical symptoms. -

correct answerD. The client will express anxiety verbally rather than through physical symptoms.

• Question

Which method would a nurse use to determine a client's potential risk for suicide?

• Wait for the client to bring up the subject of suicide.
• Observe the client's behavior for cues of suicide ideation.
• Question the client directly about suicidal thoughts.
• Question the client about future plans. - correct answerC. Question the client directly

about suicidal thoughts.

• Question

A client with a bipolar disorder exhibits manic behavior. The nursing diagnosis is Disturbed thought processes related to difficulty concentrating, secondary to flight of ideas. Which of the following outcome criteria would indicate improvement in the client?

• The client verbalizes feelings directly during treatment.
• The client verbalizes a positive "self" statement.
• The client speaks in coherent sentences.
• The client reports feelings calmer. - correct answerC. The client speaks in coherent

sentences.

• Question

A client tells a nurse. "Everyone would be better off if I wasn't alive." Which nursing diagnosis would be made based on this statement?

• Disturbed thought processes
• Ineffective coping
• Risk for self-directed violence
• Impaired social interaction - correct answerC. Risk for self-directed violence

• Question

Which information is the most essential in the initial teaching session for the family of a young adult recently diagnosed with schizophrenia?

• Symptoms of this disease imbalance in the brain.
• Genetic history is an important factor related to the development of schizophrenia.
• Schizophrenia is a serious disease affecting every aspect of a person's functioning.
• The distressing symptoms of this disorder can respond to treatment with

medications. - correct answerD. The distressing symptoms of this disorder can respond to treatment with medications.

• Question

A nurse is working with a client who has schizophrenia, paranoid type. Which of the following outcomes related to the client's delusional perceptions would the nurse establish?

• The client will demonstrate realistic interpretation of daily events in the unit.
• The client will perform daily hygiene and grooming without assistance.
• The client will take prescribed medications without difficulty.
• The client will participate in unit activities. - correct answerA. The client will

demonstrate realistic interpretation of daily events in the unit.

• Question

A client with bipolar disorder, manic type, exhibits extreme excitement, delusional thinking, and command hallucinations. Which of the following is the priority nursing diagnosis?

• Anxiety
• Impaired social interaction
• Disturbed sensory-perceptual alteration (auditory)
• Risk for other-directed violence - correct answerD. Risk for other-directed violence

• Question

A client who abuses alcohol and cocaine tells a nurse that he only uses substances because of his stressful marriage and difficult job. Which defense mechanisms is this client using?

• Displacement
• Projection
• Rationalization
• Sublimation - correct answerC. Rationalization

• Question

An 11-year-old child diagnosed with conduct disorder is admitted to the psychiatric unit for treatment. Which of the following behaviors would the nurse assess?

• Restlessness, short attention span, hyperactivity.
• Physical aggressiveness, low-stress tolerance, disregard for the rights of others.
• Deterioration in social functioning, excessive anxiety, and worry, bizarre behavior.
• Sadness, poor appetite and sleeplessness, loss of interest in activities. - correct

answerB. Physical aggressiveness, low-stress tolerance, disregard for the rights of others.

• Question

The nurse understands that if a client continues to be dependent on heroin throughout

her pregnancy, her baby will be at high risk for:A. Mental retardation

• Mental retardation
• Heroin dependence
• Addiction in adulthood
• Psychological disturbances - correct answerB. Heroin dependence

• Question

The emergency department nurse is assigned to provide care for a victim of a sexual assault. When following legal and agency guidelines, which intervention is most important?

• Determine the assailant's identity
• Preserve the client's privacy
• Identify the extent of an injury
• Ensure an unbroken chain of evidence - correct answerD. Ensure an unbroken chain

of evidence

• Question

Which factor is least important in the decision regarding whether a victim of family violence can safely remain in the home?

• The availability of appropriate community shelters.
• The non-abusing caretaker's ability to intervene on the client's behalf.
• The client's possible response to relocation.
• The family's socioeconomic status. - correct answerD. The family's socioeconomic

status.