1. When a depressed client becomes more active and there is evidence that her mood has lifted, an appropriate goal to add to the nursing care plan is to
a. Encourage her to go home for the weekend.
b. Move her to a room with three other clients.
c. Begin to explore the reasons she became depressed.
d. Monitor her whereabouts at all times.
2. One day the nurse overhears a client with the diagnosis of schizophrenia talking to herself. She is saying, “The mazukas are coming. The mazukas are coming.” Her use of the word mazuka is most likely
a. An example of associative looseness.
b. A manifestation of dyslexia.
c. A neologism.
d. Flight of ideas.
3. Persons with personality disorders tend to be manip ulators. Which principle is it important for the nurse to know in planning the care of a person with this diagnosis?
a. The nurse should appeal to the client’s sense of loyalty in adhering to the rules of the community.
b. When the client’s manipulations are not successful, anxiety will increase.
c. The establishment of a nurse-client relationship will decrease the client’s manipulations.
d. The nurse should allow manipulation so as to not raise the client’s anxiety.
4. The best explanation for the term depersonalization, as seen in schizophrenics, is
a. A flight from reality related to oneself or the environment.
b. A mechanism seen in chronic schizophrenia.
c. The client cannot tolerate personal relationships.
d. The client personalizes all threats and uses projection.
5. A 16 year old is hospitalized for adolescent adjustment problems. After assessing her, the nurse’s first objective is to establish a nurse-client relationship. The next day, the nurse is late for the appointment. Knowing that the client has difficulty assuming responsibility for her own behavior, the nurse would like to use this situation as an opportunity for role modeling. The most appropriate statement the nurse could make is
a. “Oh, you are here. I thought we’d be arriving at the same time.”
b. “What do you mean you are angry with me? I bet you keep people waiting.”
c. “Thank goodness you are still here; I just had a flat tire.”
d. “I’m late. I apologize.”
6. A client has the diagnosis of cognitive disorder-Alzheimer’s disease. The client is constantly making up stories that are untrue. This characteristic of the disease is called
b. Memory loss.
7. A 60-year-old male client has been admitted to the psychiatric unit, with symptoms ranging from fatigue, an inability to concentrate, an inability to complete everyday tasks, to refusal to care for himself and preferring to sleep all day. One of the first interventions should be aimed at
a. Talking to his wife for cues to help him.
b. Encouraging him to join activities on the unit.
c. Developing a structured routine for him to follow.
d. Developing a good nursing care plan.
8. The treatment in crisis intervention centers is specifically intended to help clients
a. Make long-range plans for the future.
b. Return to prior levels of functioning.
c. Accept their illness.
d. Understand the dynamics underlying symptoms.
9. A female client has just received the diagnosis of hypochondriasis. This client continually focuses on gastrointestinal problems and constantly rings for a nurse to meet her every demand. The best nursing approach is to
a. Assign various staff members to work with the client so no staff member will become negative.
b. Anticipate the client’s demands and spend time with her even though she does not demand it.
c. Ignore the demands because the nurse knows it is not necessary to respond.
d. Provide for the client’s basic needs, but do not respond to her every demand, which reinforces secondary gains.
10. A nurse observes a client sitting alone in her room crying. As the nurse approaches her, the client states, “I’m feeling sad. I don’t want to talk now.” The nurse’s best response would be
a. “It will help you feel better if you talk about it.”
b. “Sometimes it helps to talk.”
c. “I’ll stay with you a few minutes.”
d. “I’ll come back when you feel like talking.”
11. When the nurse is talking with a schizophrenic client, she suddenly says, “I’m frightened, do you hear that? Terrible things.” Which initial response by the nurse would be most appropriate?
a. “Who is saying terrible things to you.”
b. “I don’t hear anything, but you do seem frightened.”
c. “I don’t hear anything.”
d. “What is someone saying to you?”
12. When assessing a client for possible suicide, an important clue would be if the client
a. Is hostile and sarcastic to the staff.
b. Begins to talk about leaving the hospital.
c. Identifies with problems expressed by other clients.
d. Seems satisfied and detached.
13. A depressed client refuses to get out of bed, go to activities, or participate in any of the unit’s programs. The most appropriate nursing action is to
a. Tell her the rules of the unit are that no client can remain in bed.
b. Suggest she better get out of bed or she will go hungry later.
c. Allow her to remain in bed until she feels ready to join the other clients.
d. Tell her that the nurse will assist her out of bed and help her to dress.
14. A client is suffering from post-traumatic stress disorder following a rape by an unknown assailant. One of the primary goals of nursing care for this client would be to
a. Establish a safe, supportive environment.
b. Discuss the client’s nightmares and reactions.
c. Control aggressive behavior.
d. Deal with the client’s anxiety.
15. A client has the diagnosis of manic episode. Her disruptive behavior on the unit has been increasingly annoying to the other clients. One intervention by the nurse might be to
a. Set limits on the client’s behavior and be consistent in approach.
b. Ignore the client’s behavior, realizing it is consistent with her illness.
c. Tell the client she is annoying others and confine her to her room.
d. Make a rigid, structured plan that the client will have to follow.