1. Which ego-defense mechanisms are most prominently used in obsessive-compulsive disorders?

A introjection is defined as a psychic representation of a loved or hated object taken into one's ego system; in projection, a person attributes to another ideas, thoughts, feelings, and impulses that are a part of his or her inner perception, but are unacceptable B compensation is a conscious or unconscious defense mechanism by which a person tries to make up for an imagined or real deficiency that is physical, psychologic, or both C displacement of the ego-dystonic idea into an unrelated and senseless activity temporarily lowers the anxiety of the individual. By carrying out the act, the client attempts to undo the uncontrollable impulse. Counting compulsions and rituals are examples of undoing (Correct Answer) D rationalization is unconscious defense mechanism in which an irrational behavior, motive, or feeling is made to appear reasonable; suppression is a conscious defense mechanism by which a person deliberately forgets those ideas, impulses, and affects that are unacceptable 2. Three of the following conditions are frequently characteristic of the client with anorexia nervosa. Which one is not? A hoarding food (Your Answer) B eating only low-calorie foods C napping frequently to conserve energy (Correct Answer) D abusing laxatives and diuretics 3. A B C Lorazepam (Ativan) is primarily effective in treating which of the following? hallucinations delusions anxiety (Correct Answer) D incoherent speech 4. In severe, major depression, which of the following defense mechanisms is most prominent? A introjection (Correct Answer) B projection C sublimation D rationalization 5. The ego-defense mechanism thought to be used by clients with phobic disorders is which of the following?

A sublimation (Your Answer) B displacement (Correct Answer) C substitution D suppression 6. Of the following side effects, which one is not expected with nortriptyline (Aventyl) 100 mg daily? A blurred vision B dry mouth C urinary retention (Your Answer) D restlessness (Correct Answer) 7. The most common side effects of ECT include which of the following? A aphasia and gait difficulties (Your Answer) B nausea and vomiting C confusion and memory loss (Correct Answer) D diarrhea and GI distress 8. A B C D Which of the following medications is used in conjunction with ECT? succinylcholine (Anectine) as a muscle relaxant methohexital (Brevital) as an anesthetic AtSO4 as an anticholinergic All of the above (Correct Answer) The most important advantage a depressed client gains from a group therapy is: improved social interactions and focus on other's problems improved reality orientation greater insights into problems through the concept of universality greater insight and knowledge of self through feedback provided by group members (Correct Answer)

9. A B C D

10. Dry mouth, constipation, and blurred vision are characteristic symptoms of the action of imipramine (Tofranil) on which of the following body systems? A cardiovascular system B endocrine system C autonomic nervous system (Correct Answer) D respiratory system 11. The therapeutic blood level for lithium therapy is maintained between which of the following? A 0.8 and 1.8 mEq/L (Correct Answer) B 2.5 and 3.5 mEq/L C 5.0 and 7.5 mg/ml D 0.3 and 0.75 mg/ml 12. As part of a teaching plan on lithium carbonate, clients are instructed to have lithium levels determined every 1 to 3 months when they are outpatients. Which statement best describes the reason for this? A lithium carbonate can produce potassium and magnesium depletion B triglyceride levels can increase as the lithium level increases C lithium carbonate in large quantities produces sedation resulting in safety risks D a narrow margin of safety exists between therapeutic and toxic levels of lithium carbonate (Correct Answer) 13. The initial treatment of a rape survivor can significantly affect the psychologic impact the assault will have on the survivor. The first information elicited from the client should be which of the following? A marital state of the survivor B survivor's perception of what occurred (Correct Answer) C whether the rapist was known to her D how she feels about having an abortion of she becomes pregnant 14. A B C The initial signs and symptoms of alcohol withdrawal are: hypotension, bradycardia, and decreased salivation fever, dehydration, and convulsions tremors, nervousness, and diaphroresis (Correct Answer)

D permanent cognitive impairment and ataxia 15. If a client experiences hallucinations during alcohol withdrawal, which would be the most appropriate nursing intervention? A a.a quiet room and PRN benzodiazepine medication (Correct Answer) B bed rest, soft music, and fluids C hot tea every 2 hours, blood pressure check every 30 minutes, and restraints (Your Answer) D ice cream every 2 hours, blood pressure check every 15 minutes, and restraints 16. Select the medication that best helps control hallucinations and delusions: A haloperidol (Haldol) (Correct Answer) B isocarboxazid (Marplan) C alprazolam (Xanax) D paroxetine (Paxil) 17. Which of the following activities attended by a client with agoraphobia indicates an improvement in the client's condition? A milieu group in the dayroom B occupational therapy in the adjunctive therapy room C recreational therapy on the outside volleyball court (Correct Answer) D Friday lunch in the hospital cafeteria 18. When planning the initial nursing care plan of a client with obsessive-compulsive handwashing behavior, which of the following should receive the highest priority? A client will maintain a role in the family B client will discontinue the handwashing behavior (Your Answer) C client will verbalize major causes of the handwashing behavior D client will reestablish skin integrity (Correct Answer) 19. A male lawyer has been committed to a psychiatric facility after being diagnosed with schizophrenia. One morning while walking outside with the nurse, the client runs away. The immediate responsibility of the nurse would be to notify the: A Client's psychiatrist of the elopement

(Your Answer) B Probate judge who committed the client C Client's family that the client has left the hospital D Local law enforcement officers of the client's escape (Correct Answer) 20. When planning care for a client with severe agoraphobia, the nurse should first: A Determine the client's degree of impairment (Correct Answer) B Support the client's self-esteem through verbal interactions (Your Answer) C Teach the client biofeedback techniques to reduce anxiety D Expose the client gradually to anxiety-provoking situations 21. Although upset by a young client's continuous complaints about all aspects of care, the nurse ignores them and attempts to divert the conversation. Immediately following this exchange, the nurse discusses with a friend the various stages of development of young adults. The defense mechanism the nurse is using is A Substitution (Your Answer) B Sublimation C Identification D Intellectualization (Correct Answer) 22. The best initial approach to take with a self-accusatory, guilt-ridden client would be to: A Contradict the client's persecutory delusions B Accept the client's statements as his beliefs (Correct Answer) C Medicate the client when these thoughts are expressed D Redirect the client whenever a negative topic is mentioned (Your Answer) 23. A client with a bipolar mood disorder, manic phase, had been hyperactive and sarcastic to the nurse and other clients. This behavior has been decreasing and the client tells the nurse, "My husband and I have problems getting along sometimes. We see things differently." The response by the nurse that would be the least therapeutic would be: A "Explain what you mean by seeing things differently." (Your Answer) B "Not getting along with one's spouse can be upsetting."

C "You are calmer today. What has made the difference?" (Correct Answer) D "Tell me about a specific time when you and your husband had problems." 24. Some clients repeatedly perform ritualistic behaviors throughout the day to limit anxious feelings. The nurse recognizes that these behaviors are: A Obsessions (Correct Answer) B Compulsions C Under personal control D Related to rebelliousness 25. The nurse plans to teach a client to use healthier coping behaviors that consciously can be used to reduce anxiety. These include: A Eating, dissociation, fantasy B Sublimation, fantasy, rationalization C Exercise, talking to friends, suppression (Correct Answer) D Repression, intellectualization, smoking