1. Nurse Rhea outcome criteria would be appropriate for a child diagnosed with oppositional defiant disorder?
a. Accept responsibility for own behaviors
b. Be able to verbalize own needs and assert rights
c. Set firm and consistent limits with the client
d. Allow the child to establish his own limits and boundaries
2. The definition of nihilistic delusions is:
a. A false belief about the functioning of the body
b. Belief that the body is deformed or defective in a specific way
c. False ideas about the self, others, or the world
d. The inability to carry out motor activities
3. A client in an acute care setting tells nurse Gio, “I don’t think I can face going home tomorrow.” The nurse replies, “Do you want to talk more about it?” The nurse is using which of the following techniques?
a. Presenting reality
b. Making observations
4. Nurse Ritchel is leading group therapy with psychiatric clients. During the working phase, what should the nurse do?
a. Explain the purposes and goals of the group
b. Offer advice to help resolve conflicts
c. Encourage group cohesiveness
d. Encourage a discussion of feelings of loss regarding termination of the group
5. A 20-year-old female’s pregnancy is confirmed at a clinic. She says her husband will be excited but is concerned because she herself isn’t excited. She fears this may mean she’ll be a bad mother. Nurse Linda should respond by:
a. Referring her to counseling
b. Telling her such feelings are normal in the beginning of pregnancy
c. Exploring her feelings
d. Recommending she talk her feelings over with her husband
6. A male client is admitted with a diagnosis of schizotypal personality disorder. Which signs would this client exhibit during social situations?
a. Aggressive behavior
b. Paranoid thoughts
c. Emotional affect
d. Independence needs
7. During a group therapy session in the psychiatric unit, a client constantly interrupts with impulsive behavior and exaggerated stories that cast her as a hero or princess. She also manipulates the group with attention-seeking behaviors, such as sexual comments and angry outbursts. Nurse Lindsay realizes that these behaviors are typical of:
a. Paranoid personality disorder
b. Avoidant personality disorder
c. Histrionic personality disorder
d. Borderline personality disorder
8. A female client undergoes a total laryngectomy and tracheostomy formation. On discharge, nurse Aimee should give which instruction to the client and family?
a. “Clean the tracheostomy tube with alcohol and water.”
b. “Family members should continue to talk to the client.”
c. “Oral intake of fluids should be limited for 1 week only.”
d. “Limit the amount of protein in the diet.”
9. An 16-year-old boy is admitted to the facility after acting out his aggressions inappropriately at school. Predisposing factors to the expression of aggression include:
a. Violence on television
b. Passive parents
c. An internal locus of control
d. A single-parent family
10. Nurse Kim is working with a client who abuses alcohol. Which of the following facts should the nurse communicate to the client?
a. Abstinence is the basis for successful treatment
b. Attendance at Alcoholics Anonymous meetings every day will cure alcoholism
c. For treatment to be successful, family members must participate
d. An occasional social drink is acceptable behavior for the alcoholic
11. A man at a pizza parlor verbally confronts the waiter for lack of attentiveness. Later, in the back room, the waiter spits on the man’s pizza. This is an example of a behavior typical of which disorder?
12. Which of the following groups of characteristics would nurse Tracy expect to see in the client with schizophrenia?
a. Loose associations, grandiose delusions, and auditory hallucinations
b. Periods of hyperactivity and irritability alternating with depression
c. Delusions of jealousy and persecution, paranoia, and mistrust
d. Sadness, apathy, feelings of worthlessness, anorexia, and weight loss
13. A client has approached nurse Joyce asking for advice on how to deal with his alcohol addiction. The nurse should tell the client that the only effective treatment for alcoholism is:
b. Total abstinence
c. Alcoholics Anonymous (AA)
d. Aversion therapy
14. While looking out the window, a client with schizophrenia remarks, “That school across the street has creatures in it that are waiting for me.” Which of the following terms best describes what the creatures represent?
a. Anxiety attack
15. Nurse Vince is trying to establish rapport with a newly admitted client. Which technique blocks effective communication with a client?
a. Using silence
b. Asking open-ended questions
c. Giving advice
16. The parents of a 2 year old child arrive at a hospital to visit their child. The child is in the playroom when the parents arrive. When the parents enter the playroom, the child does not readily approach the parents. Nurse Rey interprets this behavior as indicating that:
a. The child is withdrawn
b. This is a normal pattern
c. The child is self-centered
d. The child has adjusted to the hospital setting
17. Nurse Danny is preparing a plan of care for a client who is a Jehovah’s Witness. The client has been told that surgery is necessary. The nurse considers the client’s religious preferences in developing the plan of care and documents that:
a. Faith healing is practiced primarily
b. Medication administration is not allowed
c. Surgery is prohibited in this religious group
d. The administration of blood and blood products is forbidden
18. Lou, a home care nurse is visiting an older female client whose husband died 6 months ago. Which behavior by the client indicates ineffective coping?
a. Neglecting her personal grooming
b. Looking at old snapshots of her family
c. Participating in a senior citizens’ program
d. Visiting her husband’s grave once a month
19. Wendy, an ambulatory care nurse is discussing preoperative procedures with a Chinese-American client who is scheduled for surgery the following week. During the discussion, the client continually smiles and nods the head. The nurse interprets this nonverbal behavior as:
a. Reflecting a cultural value
b. An acceptance of the treatment
c. The client is agreeable to the required procedures
d. The client understands the preoperative procedures
20. Faith, A hospice nurse visits a client dying of ovarian cancer. During the visit, the client expresses that “If I can just live long enough to attend my daughter’s graduation, I’ll be ready to die.” Which phase of coping is this client experiencing?
21. Lester, a nursing student is discussing cultural diversity issues in a clinical conference when a nursing instructor asks the student to describe ethnocentrism. Which statement by the student indicates a lack of understanding of the issue of ethnocentrism?
a. “It is a tendency to view one’s own ways as best.”
b. “It is acting in a manner that is superior to other cultures.”
c. It is imposing one’s beliefs on individuals from another culture.”
d. “It is believing that one’s own way is the only acceptable way.”
22. A male client who has developed severe pulmonary edema would most likely exhibit which of the following?
a. Mild anxiety
b. Slight anxiety
c. Extreme anxiety
d. Moderate anxiety
23. Karen, a nurse educator asks a student to list the five categories of complementary and alternative medicine (CAM), developed by the National Center for Complementary and Alternative Medicine (NCCAM), to a group of nursing students. Which of the following, if stated by the nursing student, would indicate an understanding of the five categories of CAM?
a. Herbology, hydrotherapy, acupuncture, nutrition, and chiropractic care
b. Mind-body medicine, traditional Chinese medicine, homeopathy, naturopathy, and healing touch
c. Biologically based practices, body-based practices, magnetic therapy, massage therapy, and Trager body work
d. Whole medical systems, mind-body medicine, biologically based practices, manipulative and body-based practices, and energy medicine
24. Nurse Gretchen is bathing a hospitalized Native American client of the Navajo culture and notes that the client avoids eye contact during the procedure. The nurse makes which interpretation about the client’s behavior?
a. The client is depressed
b. The client is displaying disrespectful mannerisms
c. The client is displaying behavior that is a common cultural action
d. The client is humiliated because of the cared for by someone else.
25. Claudine, a nurse educator is providing in-service education to the nursing staff regarding trans-cultural nursing care when a staff member asks the nurse educator to describe the concept of acculturation. The appropriate response is which of the following?
a. “It is a subjective perspective of the person’s heritage and a sense of belonging to a group.”
b. “It is a group of individuals in a society who are culturally distinct and have a unique identity.”
c. “It is a process of learning a different culture to adapt to a new of changing environment.”
d. “It is a group that shares some of the characteristics of the larger population group of which it is a part.”