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Technical Writing for Success3rd EditionDarlene Smith-Worthington, Sue Jefferson 468 solutions Technical Writing for Success3rd EditionDarlene Smith-Worthington, Sue Jefferson 468 solutions Technical Writing for Success3rd EditionDarlene Smith-Worthington, Sue Jefferson 468 solutions A health care provider recently convicted of Medicare fraud says to a nurse, Sure I overbilled. Everyone takes advantage of the government. There are too many rules to follow and I should get the money. These statements show: shame. c.superficial remorse. b.suspiciousness. d.lack of guilt feelings. D Which intervention is appropriate for an individual diagnosed with an antisocial personality disorder who frequently manipulates others? a.Refer requests and questions related to care to the case manager. b.Encourage the patient to discuss feelings of fear and inferiority. c.Provide negative reinforcement for acting-out behavior. d.Ignore, rather than confront, inappropriate behavior. a As a nurse prepares to administer medication to a patient diagnosed with a borderline personality disorder, the patient says, Just leave it on the table. Ill take it when I finish combing my hair. What is the nurses best response? a.Reinforce this assertive action by the patient. Leave the medication on the table as requested. b.Respond to the patient, Im worried that you might not take it. Ill come back later. c.Say to the patient, I must watch you take the medication. Please take it now. d. c What is an appropriate initial outcome for a patient diagnosed with a personality disorder who frequently manipulates others? The patient will: a.identify when feeling angry. b.use manipulation only to get legitimate needs met. c.acknowledge manipulative behavior when it is called to his or her attention. d.accept fulfillment of his or her requests within an hour rather than immediately. c Consider this comment to three different nurses by a patient diagnosed with an antisocial personality disorder, Another nurse said you dont do your job right. Collectively, these interactions can be assessed as: a.seductive. c.manipulative. b.detached. d.guilt-producing. c A nurse reports to the treatment team that a patient diagnosed with an antisocial personality disorder has displayed the behaviors below. This patient is detached and superficial during counseling sessions. Which behavior by the patient most clearly warrants limit setting? a.Flattering the nurse b.Lying to other patients c.Verbal abuse of another patient d.Detached superficiality during counseling c
A patient diagnosed with borderline personality disorder has a history of self-mutilation and suicide attempts. The patient reveals feelings of depression and anger with life. Which type of medication would the nurse expect to be prescribed? a.Benzodiazepine b.Mood stabilizing medication c.Monoamine oxidase inhibitor (MAOI) d.Serotonin norepinephrine reuptake inhibitor (SNRI) b A patients spouse filed charges after repeatedly being battered. The patient sarcastically says, Im sorry for what I did. I need psychiatric help. Which statement by the patient supports an antisocial personality disorder? a.I have a quick temper, but I can usually keep it under control. b.ive done some stupid things in my life, but Ive learned a lesson. c.Im feeling terrible about the way my behavior has hurt my family. d.I hit because I am tired of being nagged. My spouse deserves the beating. d What is the priority nursing diagnosis for a patient diagnosed with antisocial personality disorder who has made threats against staff, ripped art off the walls, and thrown objects? a.Risk for other-directed violence c.impaired social interaction b.Risk for self-directed violence d.Ineffective denial a When a patient diagnosed with a personality disorder uses manipulation to get needs met, the staff applies limit-setting interventions. What is the correct rationale for this action? a. It provides an outlet for feelings of anger and frustration. b. It respects the patients wishes, so assertiveness will develop. c. External controls are necessary due to failure of internal control. d. Anxiety is reduced when staff assumes responsibility for the patients behavior. c One month ago, a patient diagnosed with borderline personality disorder and a history of self-mutilation began dialectical behavior therapy. Today the patient phones to say, I feel empty and want to hurt myself. The nurse should: a. arrange for emergency inpatient hospitalization. b. send the patient to the crisis intervention unit for 8 to 12 hours. c. assist the patient to choose coping strategies for triggering situations. d. advise the patient to take an anti-anxiety medication to decrease the anxiety level. c What is the most challenging nursing intervention with patients diagnosed with personality disorders who use manipulation? a. Supporting behavioral change c. Monitoring suicide attempts b. Maintaining consistent limits d. Using aversive therapy b The history shows that a newly admitted patient is impulsive. The nurse would expect behavior characterized by: a. adherence to a strict moral code. b. manipulative, controlling strategies. c. acting without thought on urges or desires. d. postponing gratification to an appropriate time. c A patient says, I get in trouble sometimes because I make quick decisions and act on them. Select the nurses most therapeutic response. a. Lets consider the advantages of being able to stop and think before acting. b. It sounds as though youve developed some insight into your situation. c. I bet you have some interesting stories to share about overreacting. d. Its good that youre showing readiness for behavioral change. a A patient diagnosed with borderline personality disorder was hospitalized several times after self-mutilating episodes. The patient remains impulsive. Which nursing diagnosis is the initial focus of this therapy? a. Risk for self-directed violence c. Risk for injury b. Impaired skin integrity d. Powerlessness a Which statement made by a patient diagnosed with borderline personality disorder indicates the treatment plan is effective? a. I think you are the best nurse on the unit. b. Im never going to get high on drugs again. c. I felt empty and wanted to hurt myself, so I called you. d. I hate my mother. I called her today, and she wasnt home. c When preparing to interview a patient diagnosed with narcissistic personality disorder, a nurse can anticipate the assessment findings will include: a. preoccupation with minute details; perfectionist. b. charm, drama, seductiveness; seeking admiration. c. difficulty being alone; indecisive, submissiveness. d. grandiosity, self-importance, and a sense of entitlement. d For which behavior would limit setting be most essential? The patient who: a. clings to the nurse and asks for advice about inconsequential matters. b. is flirtatious and provocative with staff members of the opposite sex. c. is hypervigilant and refuses to attend unit activities. d. urges a suspicious patient to hit anyone who stares. d The nurse caring for an individual demonstrating symptoms of schizotypal personality disorder would expect assessment findings to include: a. arrogant, grandiose, and a sense of self-importance. b. attention seeking, melodramatic, and flirtatious. c. impulsive, restless, socially aggressive behavior. d. socially anxious, rambling stories, peculiar ideas. d Others describe a worker as very shy and lacking in self-confidence. This worker stays in an office cubicle all day, never coming out for breaks or lunch. Which term best describes this behavior? a. Narcissistic c. Avoidant b. Histrionic d. Paranoid c What is the priority intervention for a nurse beginning to work with a patient diagnosed with a schizotypal personality disorder? a. Respect the patients need for periods of social isolation. b. Prevent the patient from violating the nurses rights. c. Teach the patient how to select clothing for outings. d. Engage the patient in community activities. a A patient diagnosed with borderline personality disorder self-inflicted wrist lacerations after gaining new privileges on the unit. In this case, the self-mutilation may have been due to: a. an inherited disorder that manifests itself as an incapacity to tolerate stress. b. use of projective identification and splitting to bring anxiety to manageable levels. c. a constitutional inability to regulate affect, predisposing to psychic disorganization. d. fear of abandonment associated with progress toward autonomy and independence. d A patient diagnosed with borderline personality disorder has self-inflicted wrist lacerations. The health care provider prescribes daily dressing changes. The nurse performing this care should: a. maintain a stern and authoritarian affect. b. provide care in a matter-of-fact manner. c. encourage the patient to express anger. d. be very rigid and challenging. b A nurse set limits while interacting with a patient demonstrating behaviors associated with borderline personality disorder. The patient tells the nurse, You used to care about me. I thought you were wonderful. Now I can see I was wrong. Youre evil. This outburst can be assessed as: a. denial. c. defensive. b. splitting. d. reaction formation. b Which characteristic of personality disorders makes it most necessary for staff to schedule frequent team meetings in order to address the patients needs and maintain a therapeutic milieu? a. Ability to achieve true intimacy b. Flexibility and adaptability to stress c. Ability to provoke interpersonal conflict d. Inability to develop trusting relationships c A nursing diagnosis appropriate to consider for a patient diagnosed with any of the personality disorders is: a. noncompliance. c. disturbed personal identity. b. impaired social interaction. d. diversional activity deficit. b A new psychiatric technician says, Schizophreniaschizotypal! Whats the difference? The nurses response should include which information? a. A patient diagnosed with schizophrenia is not usually overtly psychotic. b. In schizotypal personality disorder, the patient remains psychotic much longer. c. With schizotypal personality disorder, the person can be made aware of misinterpretations of reality. d. Schizotypal personality disorder causes more frequent and more prolonged hospitalizations than schizophrenia. c Personality traits most likely to be documented regarding a patient demonstrating characteristics of an obsessive-compulsive personality disorder are: a. affable, generous. c. suspicious, holds grudges. b. perfectionist, inflexible. d. dramatic speech, impulsive. b A nurse determines desired outcomes for a patient diagnosed with schizotypal personality disorder. Select the best outcome. The patient will: a. adhere willingly to unit norms. b. report decreased incidence of self-mutilative thoughts. c. demonstrate fewer attempts at splitting or manipulating staff. d. demonstrate ability to introduce self to a stranger in a social situation. d A patient says, The other nurses wont give me my medication early, but you know what its like to be in pain and dont let your patients suffer. Could you get me my pill now? I wont tell anyone. Which response by the nurse would be most therapeutic? a. Im not comfortable doing that, and then ignore subsequent requests for early medication. b. I understand that you have pain, but giving medicine too soon would not be safe. c. Ill have to check with your doctor about that; I will get back to you after I do. d. It would be unsafe to give the medicine early; none of us will do that. b A nurse plans care for an individual diagnosed with antisocial personality disorder. Which characteristic behaviors will the nurse expect? Select all that apply. a. Reclusive behavior b. Callous attitude c. Perfectionism d. Aggression e. Clinginess f. Anxiety b,d For which patients diagnosed with personality disorders would a family history of similar problems be most likely? Select all that apply. a. Obsessive-compulsive b. Antisocial c. Borderline d. Schizotypal e. Narcissistic a,b,c,d An older adult patient takes multiple medications daily. Over 2 days, the patient developed confusion, slurred speech, an unsteady gait, and fluctuating levels of orientation. These findings are most characteristic of: a. delirium. c. amnestic syndrome. b. dementia. d. Alzheimers disease. a A patient with fluctuating levels of awareness, confusion, and disturbed orientation shouts, Bugs are crawling on my legs. Get them off! Which problem is the patient experiencing? a. Aphasia c. Tactile hallucinations b. Dystonia d. Mnemonic disturbance c A patient with fluctuating levels of consciousness, disturbed orientation, and perceptual alteration begs, Someone get these bugs off me. What is the nurses best response? a. No bugs are on your legs. You are having hallucinations. b. I will have someone stay here and brush off the bugs for you. c. Try to relax. The crawling sensation will go away sooner if you can relax. d. I dont see any bugs, but I can tell you are frightened. I will stay with you. d What is the priority nursing diagnosis for a patient with fluctuating levels of consciousness, disturbed orientation, and visual and tactile hallucinations? a. Risk for injury related to altered cerebral function, fluctuating levels of consciousness, disturbed orientation, and misperception of the environment b. Bathing/hygiene self-care deficit related to cerebral dysfunction, as evidenced by confusion and inability to perform personal hygiene tasks c. Disturbed thought processes related to medication intoxication, as evidenced by confusion, disorientation, and hallucinations d. Fear related to sensory perceptual alterations as evidenced by visual and tactile hallucinations a What is the priority intervention for a patient diagnosed with delirium who has fluctuating levels of consciousness, disturbed orientation, and perceptual alterations? a. Distraction using sensory stimulation c. Avoidance of physical contact b. Careful observation and supervision d. Activation of the bed alarm b A patient diagnosed with delirium is experiencing perceptual alterations. Which environmental adjustment should the nurse make for this patient? a. Provide a well-lit room without glare or shadows. Limit noise and stimulation. b. Maintain soft lighting day and night. Keep a radio on low volume continuously. c. Light the room brightly day and night. Awaken the patient hourly to assess mental status. d. Keep the patient by the nurses desk while awake. Provide rest periods in a room with a television on. a Which assessment finding would be likely for a patient experiencing a hallucination? The patient: a. looks at shadows on a wall and says, I see scary faces. b. states, I feel bugs crawling on my legs and biting me. c. reports telepathic messages from the television. d. speaks in rhymes. b Consider these health problems: Lewy body disease, frontal-temporal lobar degeneration, and Huntingtons disease. Which term unifies these problems? a. Cyclothymia c. Delirium b. Dementia d. Amnesia b Which medication prescribed to patients diagnosed with Alzheimers disease antagonizes N-Methyl-D-Aspartate (NMDA) channels rather than cholinesterase? a. Donepezil (Aricept) c. Memantine (Namenda) b. Rivastigmine (Exelon) d. Galantamine (Razadyne c An older adult was stopped by police for driving through a red light. When asked for a drivers license, the adult hands the police officer a pair of sunglasses. What sign of dementia is evident? a. Aphasia c. Agnosia b. Apraxia d. Anhedonia c An older adult drove to a nearby store but was unable to remember how to get home or state an address. When police intervened, they found that this adult was wearing a heavy coat and hat, even though it was July. Which stage of Alzheimers disease is evident? a. Preclinical Alzheimers disease c. Moderately severe cognitive decline b. Mild cognitive decline d. Severe cognitive decline c Consider these diagnostic findings: apolipoprotein E (apoE) malfunction, neurofibrillary tangles, neuronal degeneration in the hippocampus, and brain atrophy. Which health problem corresponds to these diagnostic findings? a. Huntingtons disease c. Parkinsons disease b. Alzheimers disease d. Vascular dementia b A patient with stage 3 Alzheimers disease tires easily and prefers to stay home rather than attend social activities. The spouse does the grocery shopping because the patient cannot remember what to buy. Which nursing diagnosis applies at this time? a. Self-care deficit c. Caregiver role strain b. Impaired memory d. Adult failure to thrive b A patient has progressive memory deficits associated with dementia. Which nursing intervention would best help the individual function in the environment? a. Assist the patient to perform simple tasks by giving step-by-step directions. b. Reduce frustration by performing activities of daily living for the patient. c. Stimulate intellectual function by discussing new topics with the patient. d. Read one story from the newspaper to the patient every day. a Two patients in a residential care facility have dementia. One shouts to the other, Move along, youre blocking the road. The other patient turns, shakes a fist, and shouts, Youre trying to steal my car. What is the nurses best action? a. Administer one dose of an antipsychotic medication to both patients. b. Reinforce reality. Say to the patients, Walk along in the hall. This is not a traffic intersection. c. Separate and distract the patients. Take one to the day room and the other to an activities area. d. Step between the two patients and say, Please quiet down. We do not allow violence here. c An older adult patient in the intensive care unit has visual and auditory illusions. Which intervention will be most helpful? a. Using the patients glasses and hearing aids b. Placing personally meaningful objects in view c. Placing large clocks and calendars on the wall d. Assuring that the room is brightly lit but very quiet at all times a A patient diagnosed with Alzheimers disease calls the fire department saying, My smoke detectors are going off. Firefighters investigate and discover that the patient misinterpreted the telephone ringing. Which problem is this patient experiencing? a. Hyperorality c. Apraxia b. Aphasia d. Agnosia d During morning care, a nurse asks a patient diagnosed with dementia, How was your night? The patient replies, It was lovely. I went out to dinner and a movie with my friend. Which term applies to the patients response? a. Sundown syndrome c. Perseveration b. Confabulation d. Delirium b A nurse counsels the family of a patient diagnosed with Alzheimers disease who lives at home and wanders at night. Which action is most important for the nurse to recommend to enhance safety? a. Apply a medical alert bracelet to the patient. b. Place locks at the tops of doors. c. Discourage daytime napping. d. Obtain a bed with side rails. b Goals of care for an older adult patient diagnosed with delirium caused by fever and dehydration will focus on: a. returning to premorbid levels of function. b. identifying stressors negatively affecting self. c. demonstrating motor responses to noxious stimuli. d. exerting control over responses to perceptual distortions. a An older adult with moderately severe dementia forgets where the bathroom is and has episodes of incontinence. Which intervention should the nurse suggest to the patients family? a. Label the bathroom door. b. Take the older adult to the bathroom hourly. c. Place the older adult in disposable adult briefs. d. Limit the intake of oral fluids to 1000 ml per day. a A older patient diagnosed with severe, late-stage dementia no longer recognizes family members. The family asks how long it will be before this patient recognizes them when they visit. What is the nurses best reply? a. Your family member will never again be able to identify you. b. I think that is a question the health care provider should answer. c. One never knows. Consciousness fluctuates in persons with dementia. d. It is disappointing when someone you love no longer recognizes you. d A patient with severe dementia no longer recognizes family members and becomes anxious and agitated when they attempt reorientation. Which alternative could the nurse suggest to the family members? a. Wear large name tags. b. Focus interaction on familiar topics. c. Frequently repeat the reorientation strategies. d. Place large clocks and calendars strategically. b What is the priority need for a patient with late-stage dementia? a. Promotion of self-care activities b. Meaningful verbal communication c. Preventing the patient from wandering d. Maintenance of nutrition and hydration d An older adult is prescribed digoxin (Lanoxin) and hydrochlorothiazide daily as well as lorazepam (Ativan) as needed for anxiety. Over 2 days, the patient developed confusion, slurred speech, an unsteady gait, and fluctuating levels of orientation. What is the most likely reason for the patients change in mental status? a. Drug actions and interactions c. Hypotensive episodes b. Benzodiazepine withdrawal d. Renal failure a A hospitalized patient diagnosed with delirium misinterprets reality, while a patient diagnosed with dementia wanders about the home. Which outcome is the priority in both scenarios? The patients will: a. remain safe in the environment. c. communicate verbally. b. participate actively in self-care. d. acknowledge reality. a An elderly patient is admitted with delirium secondary to a urinary tract infection. The family asks whether the patient will ever recover. Select the nurses best response. a. The health care provider is the best person to answer your question. b. The confusion will probably get better as we treat the infection. c. Unfortunately, delirium is a progressively disabling disorder. d. I will be glad to contact the chaplain to talk with you. b An elderly person presents with symptoms of delirium. The family reports, Everything was fine until yesterday. What is the most important assessment information for the nurse to gather? a. A list of all medications the person currently takes b. Whether the person has experienced any recent losses c. Whether the person has ingested aged or fermented foods d. The persons recent personality characteristics and changes a A nurse gives anticipatory guidance to the family of a patient diagnosed with stage 3, mild cognitive decline Alzheimers disease. Which problem common to that stage should the nurse address? a. Violent outbursts c. Communication deficits b. Emotional disinhibition d. Inability to feed or bathe self c A patient diagnosed with moderately severe Alzheimers disease has a self-care deficit of dressing and grooming. Designate appropriate interventions to include in the patients plan of care. Select all that apply. a. Provide clothing with elastic and hook-and-loop closures. b. Label clothing with the patients name and name of the item. c. Administer anti-anxiety medication before bathing and dressing. d. Provide necessary items and direct the patient to proceed independently. e. If the patient resists dressing, use distraction and try again after a short interval. a,b,e Which assessment findings would the nurse expect in a patient experiencing delirium? Select all that apply. a. Impaired level of consciousness b. Disorientation to place, time c. Wandering attention d. Apathy e. Agnosia a,b,c Which nursing diagnoses are most applicable for a patient diagnosed with severe Alzheimers disease? Select all that apply. a. Acute confusion b. Anticipatory grieving c. Urinary incontinence d. Disturbed sleep pattern e. Risk for caregiver role strain c,d,e Over the past year, a woman has cooked gourmet meals for her family but eats only tiny servings. This person wears layered loose clothing. Her current weight is 95 pounds, a loss of 35 pounds. Which medical diagnosis is most likely? a. Binge eating b. Bulimia nervosa c. Anorexia nervosa d. Eating disorder not otherwise specified c Disturbed body image is a nursing diagnosis established for a patient diagnosed with an eating disorder. Which outcome indicator is most appropriate to monitor? a. Weight, muscle, and fat congruence with height, frame, age, and sex b. Calorie intake is within required parameters of treatment plan c. Weight reaches established normal range for the patient d. Patient expresses satisfaction with body appearance d A patient referred to the eating disorders clinic has lost 35 pounds during the past 3 months. To assess eating patterns, the nurse should ask the patient: a. Do you often feel fat? b. Who plans the family meals? c. What do you eat in a typical day? d. What do you think about your present weight? c A patient diagnosed with anorexia nervosa virtually stopped eating 5 months ago and lost 25% of body weight. A nurse asks, Describe what you think about your present weight and how you look. Which response by the patient is most consistent with the diagnosis? a. I am fat and ugly. b. What I think about myself is my business. c. Im grossly underweight, but thats what I want. d. Im a few pounds overweight, but I can live with it. a A patient was diagnosed with anorexia nervosa. The history shows the patient virtually stopped eating 5 months ago and lost 25% of body weight. The serum potassium is currently 2.7 mg/dL. Which nursing diagnosis applies? a. Adult failure to thrive related to abuse of laxatives as evidenced by electrolyte imbalances and weight loss b. Disturbed energy field related to physical exertion in excess of energy produced through caloric intake as evidenced by weight loss and hyperkalemia c. Ineffective health maintenance related to self-induced vomiting as evidenced by swollen parotid glands and hyperkalemia d. Imbalanced nutrition: less than body requirements related to reduced oral intake as evidenced by loss of 25% of body weight and hypokalemia d Outpatient treatment is planned for a patient diagnosed with anorexia nervosa. Select the most important desired outcome related to the nursing diagnosis Imbalanced nutrition: less than body requirements. Within 1 week, the patient will: a. weigh self accurately using balanced scales. b. limit exercise to less than 2 hours daily. c. select clothing that fits properly. d. gain 1 to 2 pounds. d Which nursing intervention has the highest priority as a patient diagnosed with anorexia nervosa begins to gain weight? a. Assess for depression and anxiety. b. Observe for adverse effects of refeeding. c. Communicate empathy for the patients feelings. d. Help the patient balance energy expenditures with caloric intake. b a. Because severe anxiety concerning eating is expected, objective and subjective data may be unreliable. b. Patient involvement in decision making increases sense of control and promotes compliance with treatment. c. Because of increased risk of physical problems with refeeding, the patients permission is needed. d. A team approach to planning the diet ensures that physical and emotional needs will be met. b The nursing care plan for a patient diagnosed with anorexia nervosa includes the intervention monitor for complications of refeeding. Which system should a nurse closely monitor for dysfunction? a. Renal c. Integumentary b. Endocrine d. Cardiovascular d A psychiatric clinical nurse specialist uses cognitive-behavioral therapy for a patient diagnosed with anorexia nervosa. Which statement by the staff nurse supports this type of therapy? a. What are your feelings about not eating foods that you prepare? b. You seem to feel much better about yourself when you eat something. c. It must be difficult to talk about private matters to someone you just met. d. Being thin doesnt seem to solve your problems. You are thin now but still unhappy. d An appropriate intervention for a patient diagnosed with bulimia nervosa who binges and purges is to teach the patient: a. to eat a small meal after purging. b. not to skip meals or restrict food. c. to increase oral intake after 4 PM daily. d. the value of reading journal entries aloud to others. b A nurse provides care for an adolescent patient diagnosed with an eating disorder. Which behavior by this nurse indicates that additional clinical supervision is needed? a. The nurse interacts with the patient in a protective fashion. b. The nurses comments to the patient are compassionate and nonjudgmental. c. The nurse teaches the patient to recognize signs of increasing anxiety and ways to intervene. d. The nurse refers the patient to a self-help group for individuals with eating disorders. a A nursing diagnosis for a patient diagnosed with bulimia nervosa is Ineffective coping related to feelings of loneliness as evidenced by overeating to comfort self, followed by self-induced vomiting. The best outcome related to this diagnosis is that within 2 weeks the patient will: a. appropriately express angry feelings. b. verbalize two positive things about self. c. verbalize the importance of eating a balanced diet. d. identify two alternative methods of coping with loneliness. d Which nursing intervention has the highest priority for a patient diagnosed with bulimia nervosa? a. Assist the patient to identify triggers to binge eating. b. Provide corrective consequences for weight loss. c. Assess for signs of impulsive eating. d. Explore needs for health teaching. a One bed is available on the inpatient eating disorders unit. Which patient should be admitted to this bed? The patient whose weight decreased from: a. 150 to 100 pounds over a 4-month period. Vital signs are temperature, 35.9 C; pulse, 38 beats/min; blood pressure 60/40 mm Hg b. 120 to 90 pounds over a 3-month period. Vital signs are temperature, 36 C; pulse, 50 beats/min; blood pressure 70/50 mm Hg c. 110 to 70 pounds over a 4-month period. Vital signs are temperature 36.5 C; pulse, 60 beats/min; blood pressure 80/66 mm Hg d. 90 to 78 pounds over a 5-month period. Vital signs are temperature, 36.7 C; pulse, 62 beats/min; blood pressure 74/48 mm Hg a A nurse provides health teaching for a patient diagnosed with binge-purge bulimia. Priority information the nurse should provide relates to: a. self-monitoring of daily food and fluid intake. b. establishing the desired daily weight gain. c. how to recognize hypokalemia. d. self-esteem maintenance. c As a patient admitted to the eating disorders unit undresses, a nurse observes that the patients body is covered by fine, downy hair. The patient weighs 70 pounds and is 5 feet 4 inches tall. Which term should be documented? a. Amenorrhea c. Lanugo b. Alopecia d. Stupor c A patient being admitted to the eating disorders unit has a yellow cast to the skin and fine, downy hair over the trunk. The patient weighs 70 pounds; height is 5 feet 4 inches. The patient says, I wont eat until I look thin. Select the priority initial nursing diagnosis. a. Anxiety related to fear of weight gain b. Disturbed body image related to weight loss c. Ineffective coping related to lack of conflict resolution skills d. Imbalanced nutrition: less than body requirements related to self-starvation d A nurse conducting group therapy on the eating disorders unit schedules the sessions immediately after meals for the primary purpose of: a. maintaining patients concentration and attention. b. shifting the patients focus from food to psychotherapy. c. promoting processing of anxiety associated with eating. d. focusing on weight control mechanisms and food preparation. c Physical assessment of a patient diagnosed with bulimia often reveals: a. prominent parotid glands. c. thin, brittle hair. b. peripheral edema. d. 25% underweight. a Which personality characteristic is a nurse most likely to assess in a patient diagnosed with anorexia nervosa? a. Carefree flexibility c. Open displays of emotion b. Rigidity, perfectionism d. High spirits and optimism b Which assessment finding for a patient diagnosed with an eating disorder meets criteria for hospitalization? a. Urine output 40 mL/hr c. Serum potassium 3.4 mEq/L b. Pulse rate 58 beats/min d. Systolic blood pressure 62 mm Hg d A nurse finds a patient diagnosed with anorexia nervosa vigorously exercising before gaining the agreed-upon weekly weight. Which response by the nurse is appropriate? a. You and I will have to sit down and discuss this problem. b. It bothers me to see you exercising. I am afraid you will lose more weight. c. Lets discuss the relationship between exercise, weight loss, and the effects on your body. d. According to our agreement, no exercising is permitted until you have gained a specific amount of weight. d Which nursing diagnosis is more appropriate for a patient diagnosed with anorexia nervosa who restricts intake and is 20% below normal weight than for a 130-pound patient diagnosed with bulimia nervosa who purges? a. Powerlessness b. Ineffective coping c. Disturbed body image d. Imbalanced nutrition: less than body requirements d An outpatient diagnosed with anorexia nervosa has begun refeeding. Between the first and second appointments, the patient gained 8 pounds. The nurse should: a. assess lung sounds and extremities. b. suggest use of an aerobic exercise program. c. positively reinforce the patient for the weight gain. d. establish a higher goal for weight gain the next week. a Three months ago a patient diagnosed with binge eating disorder weighed 198 pounds. Lorcaserin (Belviq) was prescribed. Which current assessment finding indicates the need for reevaluation of this treatment approach? The patient: a. now weighs 196 pounds. b. says, I am using contraceptives. c. says, I feel full after eating a small meal. d. reports problems with dry mouth and constipation. a A 5-year-old child was diagnosed with encopresis. Which assessment finding would the nurse expect associated with this diagnosis? The child: a. frequently smears feces on clothing and toys. b. experiences frequent nocturnal episodes of bedwetting. c. has accidents of defecation at kindergarten three times a week. d. has occasional episodes of voiding accidents at the day care center. c A patient referred to the eating disorders clinic has lost 35 pounds in 3 months. For which physical manifestations of anorexia nervosa should a nurse assess? Select all that apply. a. Peripheral edema b. Parotid swelling c. Constipation d. Hypotension e. Dental caries f. Lanugo a,c,d,f A patient diagnosed with anorexia nervosa is hospitalized for treatment. What features should the milieu provide? Select all that apply. a. Flexible mealtimes b. Unscheduled weight checks c. Adherence to a selected menu d. Observation during and after meals e. Monitoring during bathroom trips f. Privileges correlated with emotional expression c,d,e A patient diagnosed with alcoholism asks, How will Alcoholics Anonymous (AA) help me? Select the nurses best response. a. The goal of AA is for members to learn controlled drinking with the support of a higher power. b. An individual is supported by peers while striving for abstinence one day at a time. c. You must make a commitment to permanently abstain from alcohol and other drugs. d. You will be assigned a sponsor who will plan your treatment program. b A nurse reviews vital signs for a patient admitted with an injury sustained while intoxicated. The medical record shows these blood pressure and pulse readings at the times listed: 0200: 118/78 mm Hg and 72 beats/min 0400: 126/80 mm Hg and 76 beats/min 0600: 128/82 mm Hg and 72 beats/min 0800: 132/88 mm Hg and 80 beats/min 1000: 148/94 mm Hg and 96 beats/min What is the nurses priority action? a. Force fluids. b. Consult the health care provider. c. Obtain a clean-catch urine sample. d. Place the patient in a vest-type restraint. b A nurse cares for a patient diagnosed with an opioid overdose. Which focused assessment has the highest priority? a. Cardiovascular c. Neurologic b. Respiratory d. Hepatic b A patient admitted for injuries sustained while intoxicated has been hospitalized for 48 hours. The patient is now shaky, irritable, anxious, diaphoretic, and reports nightmares. The pulse rate is 130 beats/min. The patient shouts, Bugs are crawling on my bed. Ive got to get out of here. Select the most accurate assessment of this situation. The patient: a. is attempting to obtain attention by manipulating staff. b. may have sustained a head injury before admission. c. has symptoms of alcohol-withdrawal delirium. d. is having an acute psychosis. c A patient admitted yesterday for injuries sustained while intoxicated believes bugs are crawling on the bed. The patient is anxious, agitated, and diaphoretic. What is the priority nursing diagnosis? a. Disturbed sensory perception c. Ineffective denial b. Ineffective coping d. Risk for injury d A hospitalized patient diagnosed with an alcohol abuse disorder believes the window blinds are snakes trying to get in the room. The patient is anxious, agitated, and diaphoretic. The nurse can anticipate the health care provider will prescribe a(n): a. narcotic analgesic, such as hydromorphone (Dilaudid). b. sedative, such as lorazepam (Ativan) or chlordiazepoxide (Librium). c. antipsychotic, such as olanzapine (Zyprexa) or thioridazine (Mellaril). d. monoamine oxidase inhibitor antidepressant, such as phenelzine (Nardil). b A hospitalized patient diagnosed with an alcohol abuse disorder believes spiders are spinning entrapping webs in the room. The patient is fearful, agitated, and diaphoretic. Which nursing intervention is indicated? a. Check the patient every 15 minutes c. Keep the room dimly lit b. One-on-one supervision d. Force fluids b A patient diagnosed with an alcohol abuse disorder says, Drinking helps me cope with being a single parent. Which therapeutic response by the nurse would help the patient conceptualize the drinking objectively? a. Sooner or later, alcohol will kill you. Then what will happen to your children? b. I hear a lot of defensiveness in your voice. Do you really believe this? c. If you were coping so well, why were you hospitalized again? d. Tell me what happened the last time you drank. d A patient asks for information about Alcoholics Anonymous. Select the nurses best response. Alcoholics Anonymous is a: a. form of group therapy led by a psychiatrist. b. self-help group for which the goal is sobriety. c. group that learns about drinking from a group leader. d. network that advocates strong punishment for drunk drivers. b Police bring a patient to the emergency department after an automobile accident. The patient demonstrates ataxia and slurred speech. The blood alcohol level is 500 mg%. Considering the relationship between the behavior and blood alcohol level, which conclusion is most probable? The patient: a. rarely drinks alcohol. b. has a high tolerance to alcohol. c. has been treated with disulfiram (Antabuse). d. has ingested both alcohol and sedative drugs recently. b A patient admitted to an alcoholism rehabilitation program tells the nurse, Im actually just a social drinker. I usually have a drink at lunch, two in the afternoon, wine with dinner, and a few drinks during the evening. The patient is using which defense mechanism? a. Denial c. Introjection b. Projection d. Rationalization a Which medication to maintain abstinence would most likely be prescribed for patients with an addiction to either alcohol or opioids? a. Bromocriptine (Parlodel) c. Disulfiram (Antabuse) b. Methadone (Dolophine) d. Naltrexone (ReVia) d
During the third week of treatment, the spouse of a patient in a rehabilitation program for substance abuse says, After this treatment program, I think everything will be all right. Which remark by the nurse will be most helpful to the spouse? a. While sobriety solves some problems, new ones may emerge as one adjusts to living without drugs and alcohol. b. It will be important for you to structure life to avoid as much stress as you can and provide social protection. c. Addiction is a lifelong disease of self-destruction. You will need to observe your spouses behavior carefully. d. It is good that you are supportive of your spouses sobriety and want to help maintain it. a The treatment team discusses the plan of care for a patient diagnosed with schizophrenia and daily cannabis abuse who is having increased hallucinations and delusions. To plan effective treatment, the team should: a. provide long-term care for the patient in a residential facility. b. withdraw the patient from cannabis, then treat the schizophrenia. c. consider each diagnosis primary and provide simultaneous treatment. d. first treat the schizophrenia, then establish goals for substance abuse treatment. c Select the most therapeutic manner for a nurse working with a patient beginning treatment for alcohol addiction. a. Empathetic, supportive c. Cool, distant b. Skeptical, guarded d. Confrontational a Which features should be present in a therapeutic milieu for a patient with a hallucinogen overdose? a. Simple and safe c. Stimulating and colorful b. Active and bright d. Confrontational and challenging a When a patient first began using alcohol, two drinks produced relaxation and drowsiness. After 1 year, four drinks are needed to achieve the same response. Why has this change occurred? a. Tolerance has developed. b. Antagonistic effects are evident. c. Metabolism of the alcohol is now delayed. d. Pharmacokinetics of the alcohol have changed. a At a meeting for family members of alcoholics, a spouse says, I did everything I could to help. I even requested sick leave when my partner was too drunk to go to work. The nurse assesses these comments as: a. codependence. c. role reversal. b. assertiveness. d. homeostasis. a In the emergency department, a patients vital signs are BP 66/40 mm Hg; pulse 140 beats/min; respirations 8 breaths/min and shallow. The nursing diagnosis is Ineffective breathing pattern related to depression of respiratory center secondary to narcotic intoxication. Select the priority outcome. a. The patient will demonstrate effective coping skills and identify community resources for treatment of substance abuse within 1 week of hospitalization. b. Within 4 hours, vital signs will stabilize, with BP above 90/60 mm Hg, pulse less than 100 beats/min, and respirations at or above 12 breaths/min. c. The patient will correctly describe a plan for home care and achieving a drug-free state before release from the emergency department. d. Within 6 hours, the patients breath sounds will be clear bilaterally and throughout lung fields. b
Family members of an individual undergoing a residential alcohol rehabilitation program ask, How can we help? Select the nurses best response. a. Alcoholism is a lifelong disease. Relapses are expected. b. Use search and destroy tactics to keep the home alcohol free. c. Its important that you visit your family member on a regular basis. d. Make your loved one responsible for the consequences of behavior. d Which goal for treatment of alcoholism should the nurse address first? a. Learn about addiction and recovery. c. Develop a peer support system. b. Develop alternate coping strategies. d. Achieve physiologic stability. d A patient with an antisocial personality disorder was treated several times for substance abuse, but each time the patient relapsed. Which treatment approach is most appropriate? a. 1-week detoxification program c. 12-step self-help program b. Long-term outpatient therapy d. Residential program d Select the priority nursing intervention when caring for a patient after an overdose of amphetamines. a. Monitor vital signs. b. Observe for depression. c. Awaken the patient every 15 minutes. d. Use warmers to maintain body temperature. a Symptoms of withdrawal from opioids for which the nurse should assess include: a. dilated pupils, tachycardia, elevated blood pressure, and elation. b. nausea, vomiting, diaphoresis, anxiety, and hyperreflexia. c. mood lability, incoordination, fever, and drowsiness. d. excessive eating, constipation, and headache. b A patient has smoked two packs of cigarettes daily for many years. When the patient tries to reduce smoking, anxiety, craving, poor concentration, and headache occur. This scenario describes: a. cross-tolerance. c. substance addiction. b. substance abuse. d. substance intoxication. c Which assessment findings are likely for an individual who recently injected heroin? a. Anxiety, restlessness, paranoid delusions b. Muscle aching, dilated pupils, tachycardia c. Heightened sexuality, insomnia, euphoria d. Drowsiness, constricted pupils, slurred speech d An adult in the emergency department states, Everything I see appears to be waving. I am outside my body looking at myself. I think Im losing my mind. Vital signs are slightly elevated. The nurse should suspect: a. a schizophrenic episode. c. opium intoxication. b. hallucinogen ingestion. d. cocaine overdose. b A nurse wants to research epidemiology, assessment techniques, and best practices regarding persons with addictions. Which resource will provide the most comprehensive information? a. Substance Abuse and Mental Health Services Administration (SAMHSA) b. Institute of Medicine National Research Council (IOM) c. National Council of State Boards of Nursing (NCSBN) d. American Society of Addictions Medicine a A patient is thin, tense, jittery, and has dilated pupils. The patient says, My heart is pounding in my chest. I need help. The patient allows vital signs to be taken but then becomes suspicious and says, You could be trying to kill me. The patient refuses further examination. Abuse of which substance is most likely? a. PCP c. Barbiturates b. Heroin d. Amphetamines d Select the priority outcome for a patient completing the fourth alcohol-detoxification program in the past year. Prior to discharge, the patient will: a. state, I know I need long-term treatment. b. use denial and rationalization in healthy ways. c. identify constructive outlets for expression of anger. d. develop a trusting relationship with one staff member. a A nurse prepares for an initial interaction with a patient with a long history of methamphetamine abuse. Which is the nurses best first action? a. Perform a thorough assessment of the patient. b. Verify that security services are immediately available. c. Self-assess personal attitude, values, and beliefs about this health problem. d. Obtain a face shield because oral hygiene is poor in methamphetamine abusers. c A patient undergoing alcohol rehabilitation decides to begin disulfiram (Antabuse) therapy. Patient teaching should include the need to: (select all that apply) a. avoid aged cheeses. b. avoid alcohol-based skin products. c. read labels of all liquid medications. d. wear sunscreen and avoid bright sunlight. e. maintain an adequate dietary intake of sodium. f. avoid breathing fumes of paints, stains, and stripping compounds. b,c,f The nurse can assist a patient to prevent substance abuse relapse by: (select all that apply) a. rehearsing techniques to handle anticipated stressful situations. b. advising the patient to accept residential treatment if relapse occurs. c. assisting the patient to identify life skills needed for effective coping. d. advising isolating self from significant others until sobriety is established. e. informing the patient of physical changes to expect as the body adapts to functioning without substances. a,c,e A patient took a large quantity of bath salts. Priority nursing and medical measures include: (select all that apply) a. administration of naloxone (Narcan). b. vitamin B12 and folate supplements. c. restoring nutritional integrity. d. management of heart rate. e. environmental safety. d,e A new patient beginning an alcoholism rehabilitation program says, Im just a social drinker. I usually have one drink at lunch, two in the afternoon, wine at dinner, and a few drinks during the evening. Select the nurses most therapeutic responses. Select all that apply. a. I see, and use interested silence. b. I think you are drinking more than you report. c. Social drinkers have one or two drinks, once or twice a week. d. You describe drinking steadily throughout the day and evening. e. Your comments show denial of the seriousness of your problem. c,d A student nurse visiting a senior center says, Its depressing to see these old people. They are weak and frail. I doubt any of them can engage in a discussion. The student is expressing: a. reality. c. empathy. b. ageism. d. vulnerability. b A nurse plans an educational program for staff of a home health agency specializing in care of the elderly. Which topic is the highest priority to include? a. Pain assessment techniques for older adults b. Psychosocial stimulation for those who live alone c. Preparation of psychiatric advance directives in the elderly d. Ways to manage disinhibition in elderly persons with dementia a elect the best comment for a nurse to begin an interview with an elderly patient. a. I am a nurse. Are you familiar with what nurses do? b. Hello. I am going to ask you some questions to get to know you better. c. You look comfortable and ready to participate in an admission interview. Shall we get started? d. Hello. My name is _______ and I am a nurse. How you would like to be addressed by staff? d Which information is most important to obtain during assessment of an older adult diagnosed with a mental disorder? a. Functional ability and emotional status b. Chronological age and sexual function c. Economic status and sources of income d. Developmental history, interests, and activities a A 75-year-old patient comes to the clinic reporting frequent headaches. As the nurse begins the interaction, which action is most important? a. Complete a neurological assessment. b. Determine whether the patient can hear as the nurse speaks. c. Suggest that the patient lie down in a darkened room for a few minutes. d. Administer medication to relieve the patients pain before continuing the assessment. b Which statement about aging provides the best rationale for focused assessment of elderly patients? a. The elderly are usually socially isolated and lonely. b. Vision, hearing, touch, taste, and smell decline with age. c. The majority of elderly patients have some form of early dementia. d. As people age, thinking becomes more rigid and learning is impaired. b A nurse assesses an elderly patient. The nurse should complete the Geriatric Depression Scale if the patient answers which question affirmatively. a. Would you say your mood is often sad? b. Are you having any trouble with your memory? c. Have you noticed an increase in your alcohol use? d. Do you often experience moderate to severe pain? a A health care provider writes these new prescriptions for a resident in a skilled nursing facility: 2 G sodium diet, Restraint as needed, Limit fluids to 1800 mL daily, Continue antihypertensive medication, Milk of magnesia 30 mL PO once if no bowel movement for 3 days. The nurse should: a. question the fluid restriction. b. question the order for restraint. c. transcribe the prescriptions as written. d. assess the residents bowel elimination. b An elderly patient must be physically restrained. Who is responsible for the patients safety? a. The nurse assigned to care for the patient b. Unlicensed assistive personnel who apply the restraint c. Family member who agrees to application of the restraint d. Health care provider who prescribed application of restraint a A new nurse asks, My elderly patient has Lewy body disease. What should I do about assessing for pain? Select the best response from the nurse manager. a. Ask the patients family if they think the patient is experiencing pain. b. Use a visual analog scale to help the patient determine the presence and severity of pain. c. There are special scales for assessing patients with dementia. Lets review how to use them. d. The perception of pain is diminished by this type of dementia. Focus your assessment on the patients mental status. c An advance directive gives legally binding direction for health care interventions when a patient: a. has a new diagnosis of cancer. b. is diagnosed with Parkinsons disease. c. is unable to make decisions for self because of illness. d. diagnosed with amyotrophic lateral sclerosis is unable to speak. c A patient asks, What advantage does a durable power of attorney for health care have over a living will? The nurse should reply, A durable power of attorney for health care: a. gives your agent authority to make decisions during any illness if you are incapacitated. b. can be given only to a relative, usually the next of kin, who has your best interests at heart. c. can be used only if you have a terminal illness and become incapacitated. d. cannot be implemented until 30 days after the documents are signed. a A physically frail elderly patient with mild cognitive impairments needs services of a facility that can provide supervision and safety as well as recreation and social interaction. The family cares for this patient during the evening and night. Which type of facility should the nurse suggest to meet this patients needs? a. Adult day care program c. Partial hospitalization b. Skilled nursing facility d. Group home a A 79-year-old white male tells a nurse, I have felt very sad lately. I do not have much to live for. My family and friends are all dead, and my own health is failing. The nurse should analyze this comment as: a. normal pessimism of the elderly. c. a call for sympathy. b. evidence of risks for suicide. d. normal grieving. b In a sad voice, an elderly patient tells the nurse of the recent deaths of a spouse and close friend. The patient has no other family and only a few acquaintances in the community. The nurses priority is to determine whether which nursing diagnosis applies to this patient? a. Risk for suicide related to recent deaths of significant others b. Anxiety related to sudden and abrupt lifestyle changes c. Social isolation related to loss of existing family d. Spiritual distress related to anger with God a When making a distinction as to whether an elderly patient has confusion related to delirium or another problem, what information would be of particular value? a. Evidence of spasticity or flaccidity b. The patients level of motor activity c. Medications the patient has recently taken d. Level of preoccupation with somatic symptoms c An 85-year-old has difficulty walking after a knee replacement. The patient tells the nurse, Its awful to be old. Every day is a struggle. No one cares about old people. Select the nurses best response. a. Everyone here cares about old people. Thats why we work here. b. It sounds like youre having a difficult time. Tell me about it. c. Lets not focus on the negative. Tell me something good. d. You are still able to get around, and your mind is alert. b A 76-year-old is regressed, indifferent, and responds to others only when they initiate an interaction. What form of group therapy would be most useful to promote resocialization? a. Remotivation c. Psychotherapy b. Activity group d. Reminiscence (life review) a A nurse assesses four patients between the ages of 70 and 80. Which patient has the highest risk for alcohol abuse? The patient who: a. consumes 1 glass of wine nightly with dinner. b. began drinking alcohol daily after retirement and says, A few drinks keep my mind off my arthritis. c. drank socially throughout adult life and continues this pattern, saying Ive earned the right to do as I please. d. abused alcohol between the ages of 25 and 40 but now abstains and occasionally attends Alcoholics Anonymous (AA). b A nurse wants to assess for suicidal ideation in an elderly patient. Select the best question to begin this assessment. a. Are there any things going on in your life that would cause you to consider suicide? b. What are your beliefs about a persons right to take his or her own life? c. Do you think you are vulnerable to developing a depressed mood? d. If you felt suicidal, would you tell someone about your feelings? b A community health nurse visits an elderly person whose spouse died 6 months ago. Two vodka bottles are in the trash. When the nurse asks about alcohol use, this person says, I get lonely and drink a little to help me forget. Select the nurses most therapeutic intervention. a. Assess whether this patient is drinking and driving. b. Advise the person not to drink alone because the risks for injury increase. c. Teach the person about risks for alcoholism and suggest other coping strategies. d. Arrange for the person to attend an Alcoholics Anonymous meeting for older adults. d Discharge planning begins for an elderly patient hospitalized for 2 weeks diagnosed with major depression. The patient needs ongoing assessment and socialization opportunities as well as education about medication and relapse prevention. The patient lives with a daughter, who works during the week. Select the best referral for this patient. a. Behavioral health home care c. Partial hospitalization b. A skilled nursing facility d. A halfway house c A patient living in community housing for the elderly says, I dont go to the senior citizens club. They play cards and talk about the past because thats all they can do. The nurse analyzes these remarks to represent: a. failure to achieve developmental tasks. b. thinking associated with ageism. c. hypercritical behavior. d. paranoid thinking. b A nurse plans a staff education program for employees of a senior living community. Which topic has priority? a. Late-onset schizophrenia c. Dementia b. Depression and suicide d. Delirium b An older adult patient was diagnosed with schizophrenia at age 18. A nurse at the outpatient medication clinic interviews this patient. Which communication strategy will be most helpful? a. Ask questions that can be answered with yes or no. b. Ask clear, simple questions using concrete language. c. Use silence often and let the patient take the lead. d. Use open-ended, indirect questions. b An elderly patient brings a bag of medications to the clinic. The nurse finds a bottle labeled Ativan and one labeled lorazepam, both of which are to be taken BID. There are also bottles labeled hydrochlorothiazide, Inderal, and rofecoxib, each to be taken once daily. Which conclusion is accurate? a. Rofecoxib should not be taken with Ativan. b. Lorazepam interferes with the action of Inderal. c. The patient should not self-administer medication. d. Lorazepam and Ativan are the same drug, so the dose is excessive. d The highest priority for assessment by nurses caring for older adults who self-administer medications is: a. use of multiple drugs with anticholinergic effects. b. overuse of medications for erectile dysfunction. c. missed doses of medications for arthritis. d. trading medications with acquaintances. a A nurse and social worker co-lead a reminiscence group for eight elite-old adults. Which activity is appropriate to include in the group? a. Mild aerobic exercise b. Singing a song from World War II c. Discussing national leadership during the Vietnam War d. Identifying the most troubling story in todays newspaper b A nurse and social worker co-lead a reminiscence group for eight young-old adults. Which activity is most appropriate to include in the group? a. Mild aerobic exercise b. Singing a song from World War II c. Discussing national leadership during the Vietnam War d. Identifying the most troubling story in todays newspaper c A nurse leads a staff development session about ageism among health care workers. What information should the nurse include about the consequences of ageism? Select all that apply. a. Failure of the elderly to receive necessary medical information b. Development of public policy that discriminates against the elderly c. Staff shortages because caregivers prefer working with younger adults d. The perception that elderly consume a smaller share of medical resources e. More ancillary than professional personnel discriminate with regard to age a,b,c A nurse assessing an elderly patient for depression and suicide potential should include questions about mood as well as: (select all that apply) a. anhedonia. b. increased appetite. c. sleep pattern changes. d. evidence of grandiosity. e. increased concerns with bodily functions. a,c,e Which assessment findings would alert the nurse that an older patient may have an increased risk for development of geriatric alcohol abuse? Select all that apply. a. Mild recent memory impairment b. Eighth grade education c. Death of spouse d. Retirement e. Loneliness b,c,d,e Which remarks by a 72-year-old patient should prompt the nurse to assess for depression? Select all that apply. a. Lately I have had a lot of aches and pains and just havent felt very well. b. People are in and out of my room all day and all night taking my things. c. Dont ask me to eat. I cant because my stomach is upset all the time. d. Im eating more than usual, and I am sleeping about 6 hours a night. e. Life seems more organized now that I dont live in my own home. a,b,c Which beliefs by a nurse facilitate provision of safe, effective care for older adult patients? Select all that apply. a. Sexual interest declines with aging. b. Older adults are able to learn new tasks. c. Aging results in a decline in restorative sleep. d. Older adults are prone to become crime victims. e. Older adults are usually lonely and socially isolated. b,c,d Which factor presents the highest risk for a child to develop a psychiatric disorder? a. Having an uncle with schizophrenia c. Living with an alcoholic parent b. Being the oldest child in a family d. Being an only child c Which nursing diagnosis is universally applicable for children diagnosed with autism spectrum disorders? a. Impaired social interaction related to difficulty relating to others b. Chronic low self-esteem related to excessive negative feedback c. Deficient fluid volume related to abnormal eating habits d. Anxiety related to nightmares and repetitive activities a Which behavior indicates that the treatment plan for a child diagnosed with an autism spectrum disorder was effective? The child: a. plays with one toy for 30 minutes. b. repeats words spoken by a parent. c. holds the parents hand while walking. d. spins around and claps hands while walking. c A kindergartener is disruptive in class. This child is unable to sit for expected lengths of time, inattentive to the teacher, screams while the teacher is talking, and is aggressive toward other children. The nurse plans interventions designed to: a. promote integration of self-concept. b. provide inpatient treatment for the child. c. reduce loneliness and increase self-esteem. d. improve language and communication skills. c A nurse will prepare teaching materials for the parents of a child newly diagnosed with attention deficit hyperactivity disorder (ADHD). Which medication will the information focus on? a. Paroxetine (Paxil) c. Methyphenidate (Ritalin) b. Imipramine (Tofranil) d. Carbamazepine (Tegretol) c What is the nurses priority focused assessment for side effects in a child taking methylphenidate (Ritalin) for attention deficit hyperactivity disorder (ADHD)? a. Dystonia, akinesia, and extrapyramidal symptoms b. Bradycardia and hypotensive episodes c. Sleep disturbances and weight loss d. Neuroleptic malignant syndrome c A desired outcome for a 12-year-old diagnosed with attention deficit hyperactivity disorder (ADHD) is to improve relationships with other children. Which treatment modality should the nurse suggest for the plan of care? a. Reality therapy c. Social skills group b. Simple restitution d. Insight-oriented group therapy c The parent of a 6-year-old says, My child is in constant motion and talks all the time. My child isnt interested in toys but is out of bed every morning before me. The childs behavior is most consistent with diagnostic criteria for: a. communication disorder. b. stereotypic movement disorder. c. intellectual development disorder. d. attention deficit hyperactivity disorder. d A child diagnosed with attention deficit hyperactivity disorder had this nursing diagnosis: impaired social interaction related to excessive neuronal activity as evidenced by aggression and demanding behavior with others. Which finding indicates the plan of care was effective? The child: a. has an improved ability to identify anxiety and use self-control strategies. b. has increased expressiveness in communication with others. c. shows increased responsiveness to authority figures. d. engages in cooperative play with other children. d When a 5-year-old diagnosed with attention deficit hyperactivity disorder (ADHD) bounces out of a chair and runs over and slaps another child, what is the nurses best action? a. Instruct the parents to take the aggressive child home. b. Direct the aggressive child to stop immediately. c. Call for emergency assistance from other staff. d. Take the aggressive child to another room. d A child diagnosed with attention deficit hyperactivity disorder will begin medication therapy. The nurse should prepare a plan to teach the family about which classification of medications? a. Central nervous system stimulants c. Antipsychotics b. Tricyclic antidepressants d. Anxiolytics a Soon after parents announced they were divorcing, a child stopped participating in sports, sat alone at lunch, and avoided former friends. The child told the school nurse, If my parents loved me, they would work out their problems. Which nursing diagnosis has the highest priority? a. Social isolation c. Chronic low self-esteem b. Decisional conflict d. Disturbed personal identity a A nurse works with a child who is sad and irritable because the childs parents are divorcing. Why is establishing a therapeutic alliance with this child a priority? a. Therapeutic relationships provide an outlet for tension. b. Focusing on the strengths increases a persons self-esteem. c. Acceptance and trust convey feelings of security to the child. d. The child should express feelings rather than internalize them. c A nurse assesses a 3-year-old diagnosed with an autism spectrum disorder. Which finding is most associated with the childs disorder? The child: a. has occasional toileting accidents. b. is unable to read childrens books. c. cries when separated from a parent. d. continuously rocks in place for 30 minutes. d A 4-year-old cries for 5 minutes when the parents leave the child at preschool. The parents ask the nurse, What should we do? Select the nurses best response. a. Ask the teacher to let the child call you at play time. b. Withdraw the child from preschool until maturity increases. c. Remain with your child for the first hour of preschool time. d. Give your child a kiss before you leave the preschool program. d Which assessment finding would cause the nurse to consider a child to be most at risk for the development of mental illness? a. The child has been raised by a parent with chronic major depression. b. The childs best friend was absent from the childs birthday party. c. The child was not promoted to the next grade one year. d. The child moved to three new homes over a 2-year period. a The child prescribed an antipsychotic medication to manage violent behavior is one most likely diagnosed with: a. attention deficit hyperactivity disorder. b. posttraumatic stress disorder. c. communication disorder. d. an anxiety disorder. a A child reports to the school nurse of being verbally bullied by an aggressive classmate. What is the nurses best first action? a. Give notice to the chief administrator at the school regarding the events. b. Encourage the victimized child to share feelings about the experience. c. Encourage the victimized child to ignore the bullying behavior. d. Discuss the events with the aggressive classmate. b Assessment data for a 7-year-old reveals an inability to take turns, blurting out answers to questions before a question is complete, and frequently interrupting others conversations. How should the nurse document these behaviors? a. Disobedience c. Impulsivity b. Hyperactivity d. Anxiety c A child diagnosed with attention deficit hyperactivity disorder (ADHD) shows hyperactivity, aggression, and impaired play. The health care provider prescribed amphetamine salts (Adderall). The nurse should monitor for which desired behavior? a. Increased expressiveness in communication with others b. Abilities to identify anxiety and implement self-control strategies c. Improved abilities to participate in cooperative play with other children d. Tolerates social interactions for short periods without disruption or frustration c When group therapy is prescribed as a treatment modality, the nurse would suggest placement of a 9-year-old in a group that uses: a. guided imagery. b. talk focused on a specific issue. c. play and talk about a play activity. d. group discussion about selected topics. c Which child demonstrates behaviors indicative of a neurodevelopmental disorder? a. A 4-year-old who stuttered for 3 weeks after the birth of a sibling b. A 9-month-old who does not eat vegetables and likes to be rocked c. A 3-month-old who cries after feeding until burped and sucks a thumb d. A 3-year-old who is mute, passive toward adults, and twirls while walking d The parent of a child diagnosed with Tourettes disorder says to the nurse, I think my child is faking the tics because they come and go. Which response by the nurse is accurate? a. Perhaps your child was misdiagnosed. b. Your observation indicates the medication is effective. c. Tics often change frequency or severity. That doesnt mean they arent real. d. This finding is unexpected. How have you been administering your childs medication? c When a 5-year-old is disruptive, the nurse says, You must take a time-out. The expectation is that the child will: a. go to a quiet room until called for the next activity. b. slowly count to 20 before returning to the group activity. c. sit on the edge of the activity until able to regain self-control. d. sit quietly on the lap of a staff member until able to apologize for the behavior.
c A parent diagnosed with schizophrenia and 13-year-old child live in a homeless shelter. The child formed a trusting relationship with a shelter volunteer. The child says, My three friends and I got an A on our school science project. The nurse can assess that the child: a. displays resiliency. b. has a passive temperament. c. is at risk for posttraumatic stress disorder. d. uses intellectualization to deal with problems. a A nurse prepares to lead a discussion at a community health center regarding childrens health problems. The nurse wants to use current terminology when discussing these issues. Which terms are appropriate for the nurse to use? Select all that apply. a. Autism b. Bullying c. Mental retardation d. Autism spectrum disorder e. Intellectual development disorder b,d,e A nurse prepares the plan of care for a 15-year-old diagnosed with moderate intellectual developmental disorder. What are the highest outcomes that are realistic for this patient? Within 5 years, the patient will: (select all that apply) a. graduate from high school. b. live independently in an apartment. c. independently perform own personal hygiene. d. obtain employment in a local sheltered workshop. e. correctly use public buses to travel in the community. c,d,e At the time of a home visit, the nurse notices that each parent and child in a family has his or her own personal online communication device. Each member of the family is in a different area of the home. Which nursing actions are appropriate? Select all that apply. a. Report the finding to the official child protection social services agency. b. Educate all members of the family about risks associated with cyberbullying. c. Talk with the parents about parental controls on the childrens communication devices. d. Encourage the family to schedule daily time together without communication devices. e. Obtain the familys network password and examine online sites family members have visited. b,c,d |
Essentials of psychiatric mental health nursing test bank quizlet
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