2.

Malou is diagnosed with major depression spends majority of the day lying in bed with the sheet pulled over his head. Which of the following approaches by the nurse would be the most therapeutic? a. Question the client until he responds b. Initiate contact with the client frequently c. Sit outside the clients room d. Wait for the client to begin the conversation 4. When teaching Mario with a typical depression about foods to avoid while taking phenelzine(Nardil), which of the following would the nurse in charge include? a. Roasted chicken b. Fresh fish c. Salami d. Hamburger 5. When assessing a female client who is receiving tricyclic antidepressant therapy, which of the following would alert the nurse to the possibility that the client is experiencing anticholinergic effects? a. Urine retention and blurred vision b. Respiratory depression and convulsion c. Delirium and Sedation d. Tremors and cardiac arrhythmias 6. For a male client with dysthymic disorder, which of the following approaches would the nurse expect to implement? a. ECT b. Psychotherapeutic approach

c. Psychoanalysis d. Antidepressant therapy 7. Danny who is diagnosed with bipolar disorder and acute mania, states the nurse, Where is my daughter? I love Louis. Rain, rain go away. Dogs eat dirt. The nurse interprets these statements as indicating which of the following? a. Echolalia b. Neologism c. Clang associations d. Flight of ideas 10. Jun has been hospitalized for major depression and suicidal ideation. Which of the following statements indicates to the nurse that the client is improving? a. Im of no use to anyone anymore. b. I know my kids dont need me anymore since theyre grown. c. I couldnt kill myself because I dont want to go to hell. d. I dont think about killing myself as much as I used to. 12. When developing the plan of care for a client receiving haloperidol, which of the following medications would nurse Monet anticipate administering if the client developed extra pyramidal side effects? a. Olanzapine (Zyprexa) b. Paroxetine (Paxil) c. Benztropine mesylate (Cogentin) d. Lorazepam (Ativan)

14. A client is suffering from catatonic behaviors. Which of the following would the nurse use to determine that the medication administered PRN have been most effective? a. The client responds to verbal directions to eat b. The client initiates simple activities without direction c. The client walks with the nurse to her room d. The client is able to move all extremities occasionally 16. When planning care for Dory with schizotypal personality disorder, which of the following would help the client become involved with others? a. Attending an activity with the nurse b. Leading a sing a long in the afternoon c. Participating solely in group activities d. Being involved with primarily one to one activitie 17. Which statement about an individual with a personality disorder is true? a. Psychotic behavior is common during acute episodes b. Prognosis for recovery is good with therapeutic intervention c. The individual typically remains in the mainstream of society, although he has problems in social and occupational roles d. The individual usually seeks treatment willingly for symptoms that are personally distressful.

18. Nurse John is talking with a client who has been diagnosed with antisocial personality about how to socialize during activities without being seductive. Nurse John would focus the discussion on which of the following areas? a. Discussing his relationship with his mother b. Asking him to explain reasons for his seductive behavior c. Suggesting to apologize to others for his behavior d. Explaining the negative reactions of others toward his behavior 19. Tina with a histrionic personality disorder is melodramatic and responds to others and situations in an exaggerated manner. Nurse Trish would recommend which of the following activities for Tina? a. Baking class b. Role playing c. Scrap book making d. Music group 20. Joy has entered the chemical dependency unit for treatment of alcohol dependency. Which of the following clients possession will the nurse most likely place in a locked area? a. Toothpaste b. Shampoo c. Antiseptic wash d. Moisturizer 21. Which of the following assessment would provide the best information about

the clients physiologic response and the effectiveness of the medication prescribed specifically for alcohol withdrawal? a. Sleeping pattern b. Mental alertness c. Nutritional status d. Vital signs 22. After administering naloxone (Narcan), an opioid antagonist, Nurse Ronald should monitor the female client carefully for which of the following? a. Respiratory depression b. Epilepsy c. Kidney failure d. Cerebral edema 24. A female client is brought by ambulance to the hospital emergency room after taking an overdose of barbiturates is comatose. Nurse Trish would be especially alert for which of the following? a. Epilepsy b. Myocardial Infarction c. Renal failure d. Respiratory failure 26. Jose is diagnosed with amphetamine psychosis and was admitted in the emergency room. Nurse Ronald would most likely prepare to administer which of the following medication? a. Librium

b. Valium c. Ativan d. Haldol 35. The primary nursing diagnosis for a female client with a medical diagnosis of major depression would be: a. Situational low self-esteem related to altered role b. Powerlessness related to the loss of idealized self c. Spiritual distress related to depression d. Impaired verbal communication related to depression 36. When developing an initial nursing care plan for a male client with a Bipolar I disorder (manic episode) nurse Ron should plan to? a. Isolate his gym time b. Encourage his active participation in unit programs c. Provide foods, fluids and rest d. Encourage his participation in programs

41. When asking the parents about the onset of problems in young client with the diagnosis of schizophrenia, Nurse Linda would expect that they would relate the clients difficulties began in:

a. Early childhood

b. Late childhood

c. Adolescence

d. Puberty 47. Nurse John recognizes that paranoid delusions usually are related to the defense mechanism of: a. Projection b. Identification c. Repression d. Regression 49. Nurse Gerry is aware that the defense mechanism commonly used by clients who are alcoholics is: a. Displacement b. Denial c. Projection d. Compensation Answers: 2. B. The nurse should initiate brief, frequent contacts throughout the day to let the client know that he is important to the nurse. This will positively affect the clients self-esteem.
4. C. Foods high in tyramine, those that are fermented, pickled, aged, or smoked must be avoided because when they are ingested in combination with MAOIs a hypertensive crisis will occur. 5. A. Anticholinergic effects, which result from blockage of the parasympathetic (craniosacral) nervous system including urine

retention, blurred vision, dry mouth & constipation. 6. B. Dysthymia is a less severe, chronic depression diagnosed when a client has had a depressed mood for more days than not over a period of at least 2 years. Client with dysthymic disorder benefit from psychotherapeutic approaches that assist the client in reversing the negative self image, negative feelings about the future. 7. D. Flight of ideas is speech pattern of rapid transition from topic to topic, often without finishing one idea. It is common in mania.

10. D. The statement I dont think about killing myself as much as I used to. Indicates a lessening of suicidal ideation and improvement in the clients condition. 12. C. The drug of choice for a client
experiencing extra pyramidal side effects from haloperidol (Haldol) is benztropine mesylate (cogentin) because of its anti cholinergic properties.

14. B. Although all the actions indicate improvement, the ability to initiate simple activities without directions indicates the most improvement in the catatonic behaviors.
16.C. Attending activity with the nurse assists the client to become involved with others slowly. The client with schizotypal personality disorder needs support, kindness & gentle suggestion to improve social skills & interpersonal relationship. 17.C. An individual with personality disorder usually is not hospitalized unless a coexisting Axis I psychiatric disorder is present. 18.D. The nurse would explain the negative reactions of others towards the clients behaviors to make the clients aware of the

impact of his seductive behaviors on others. 19. B. The nurse would use roleplaying to teach the client appropriate responses to others and in various situations. This client dramatizes events, drawn attention to self, and is unaware of and does not deal with feelings. The nurse works to help the client clarify true feelings & learn to express them appropriately. 20.C. Antiseptic mouthwash often contains alcohol & should be kept in locked area, unless labeling clearly indicates that the product does not contain alcohol. 21.D. Monitoring of vital signs provides the best information about the clients overall physiologic status during alcoholwithdrawal & the physiologic response to the medication used. 22.A. After administering naloxone (Narcan) the nurse should monitor the clients respiratory status carefully, because the drug is short acting & respiratory depression may recur after its effects wear off. 24.D. Barbiturates are CNS depressants; the nurse would be especially alert for the possibility of respiratory failure. Respiratory failure is the most likely cause of death from barbiturate over dose. 26.D. The nurse would prepare to administer an antipsychotic medication such as Haldol to a client experiencingamphetamine psychosi s to decrease agitation & psychotic symptoms, including delusions, hallucinations & cognitive impairment. 35.D. Depressed clients demonstrate decreased communication because of lack of psychic or physical energy. 36.C. The client in a manic episode of the illness often neglects basic needs, these needs are a priority to

ensure adequate nutrition, fluid, and rest. 41.C. The usual age of onset of schizophrenia is adolescence orearly childhood. 47.A. Projection is a mechanism in which inner thoughts and feelings are projected onto the environment, seeming to come from outside the self rather than from within. 49.B. Denial is a method of resolving conflict or escaping unpleasant realities by ignoring their existence.