The nurse is caring for a client with a history of admissions to several hospitals over the
last several years. Each hospitalization was for a different disorder in which there was
no physical evidence. The medical record indicates the client is a pathological liar.
Which of the following disorders does the client suffer from?
1. A somatoform disorder
2. Factitious disorder by proxy
3. Adult factitious disorder
4. Dissociative identity disorder
Answer:
In assessing a client who has suffered domestic violence, the nurse observes that the
client is regressing back to childhood, is having difficulty trusting the nurse, is
expressing rage and grief, and is talking about how unfair God has been and wondering
why God has been “so insensitive.” Based on these observations, what would be the
most appropriate plan of action for the nurse?
1. Suggest that the client join a survivor support group.
2. Encourage the client to attend religious activities at the local church.
3. Refer the client to a religious counselor.
4. Explain to the client that God has his own reasons that most of us do not understand.
Answer:
During the assessment of a client with an anxiety disorder, the client becomes very
anxious. The nurse should:
1. Suspend data gathering and wait until the next day to resume the assessment.
2. Suspend data gathering and take action to reduce anxiety.
3. Continue data gathering and ask what the precipitating factor for the anxiety is.
4. Continue data gathering and ask clarifying questions.
Answer:
The nurse is teaching the client regarding the concept of mental disorders. In instructing
the client, what areas should be covered in the explanation of what impacts the
determination of a mental disorder?
Standard Text: Select all that apply.
1. Social conditions
2. Biochemistry
3. Mother”child interactions
4. Brain structure
5. Culture
Answer:
Meditation, with or without cognitive behavioral therapy (CBT):
Standard Text: Select all that apply.
1. Increases levels of dopamine.
2. Increases mood disturbance.
3. May reduce cognitive decline associated with aging.
4. Is equivalent to a state of rest.
5. Is a difficult technique to master.
Answer:
The psychiatric home health nurse is evaluating whether a client’s level of functioning
has improved since starting the prescribed psychotropic medication. What evidence
does the nurse look for?
1. There is no change in the GAF score.
2. There is a significant decrease (by 10 or more points) in the client’s GAF score.
3. The client no longer qualifies for a GAF score.
4. There is an increase in the client’s GAF score.
Answer:
The nurse is planning care for the client who presents with frequent reports of multiple
physical complaints. Given knowledge of the leading causes of mental disability, the
nurse should plan to include further data collection in which of the following priority
areas?
1. Relationships with others
2. History of family violence
3. Alcohol usage
4. Clarity of thought processes
Answer:
The school nurse is observing a young child who has episodes of rage toward peers
during recess and at lunchtime. The advantage of conducting an assessment in this
environment is:
1. This will assist in identifying the bullies who trigger the explosive episodes.
2. This provides an opportunity to collect data in the event that other children are
injured and legal documentation is needed.
3. To provide data for the parents who are in denial about the problem.
4. This provides a picture of problems and strengths in a realistic context.
Answer:
The nurse is working with a client who has just stated that she beats her toddler with a
wooden paddle. The nurse determines that the client’s verbal admission warrants:
1. A report to appropriate government authorities.
2. A report to the nursing supervisor.
3. A report to the physician.
4. A report to the chief of staff.
Answer:
A client familiar to the nurse is grief-stricken and in tears after learning that his wife has
decided to file for divorce and sue for full custody of their children. Which of the
following actions by the nurse are appropriate?
Standard Text: Select all that apply.
1. Wiping away the client’s tears without permission
2. Asking the client if it is okay to give him a hug
3. Holding the client’s hand with his permission
4. Patting the client on the shoulder and offering reassurance
Answer:
A client in an alcohol rehabilitation program tells the nurse, “I”ve been such a loser all
my life! I feel so ashamed for what I have put my family through! Now I am in rehab
and I am not sure I can stay sober.” What nursing diagnosis would be most appropriate?
1. Self-Esteem Disturbance
2. High Risk for Violence
3. Powerlessness
4. Alteration in Health Maintenance
Answer:
A client has compulsive cleaning behaviors, scrubbing areas throughout the house over
and over, especially areas where the family gathers. It is most important for the nurse to
assess:
1. For vomiting during cleaning.
2. The impact of symptoms on the family system.
3. How frequently the client cleans the house.
4. For forgetfulness.
Answer:
Which questions would assist the nurse in developing self-awareness when working
with clients who have cognitive disorders?
Standard Text: Select all that apply.
1. How do the clients with cognitive disorders feel about working with me?
2. How do I feel about working with clients with cognitive disorders?
3. What do the clients like about working with me?
4. How can I help the client who is confused?
5. What frustrates me about working with them?
Answer:
The nurse is developing a plan of care for a client. Which of the following interventions
must the nurse be careful to avoid?
1. Discussing expectations with the client
2. Selecting interventions that conflict with the client’s value system
3. Identifying the client’s perception of the problem
4. Addressing issues related to the client’s past experiences
Answer:
A client who abuses alcohol states that the client drinks because the client’s job is so
stressful. Recognizing this as rationalization, the nurse makes a response to the client.
The nurse would know treatment was effective when the client says which of the
following?
1. “Maybe my “just needing a little drink to do my job” has gotten way out of hand.”
2. “If I took a less stressful job, I wouldn”t have to drink.”
3. “I can quit drinking whenever I want.”
4. “Listen, I”m not a drunk, and I don”t have a problem with alcohol.”
Answer:
Which of the following information should be included in psychoeducation with a
family of a client recently diagnosed with a mental illness?
1. “Most mental illnesses are inherited so the entire family should be tested for the same
disorder.”
2. “Mental illness is extremely complex and it may take several years for the right
treatment to be effective.”
3. “Most mental illnesses are caused by an imbalance of chemicals in the brain and can
be treated with medications and therapy.”
4. “Earlier screening and diagnosis could have prevented the severity of symptoms and
behavior problems.”
Answer:
A client diagnosed with bipolar disorder is starting the first family therapy session. The
nurse knows the client’s children, aged 2 and 4, will:
1. Not be included in the therapy session.
2. Help the client acclimate to the mental health clinic.
3. Benefit from the therapy session.
4. Help the client understand the importance of getting well.
Answer:
Which of the following professionals would be most helpful in providing
interdisciplinary supervision regarding specific culture-bound syndromes that interfere
with the therapeutic nurse”client relationship?
1. Religious consultant
2. Ethnic consultant
3. Psychologist
4. Psychiatrist
Answer:
The psychiatric home health nurse has made repeated attempts to make a home visit to
a homebound client, only to find that the client is not at home at the scheduled time.
What is the best action by the nurse?
1. Wait outside in the car until the client returns home.
2. Reevaluate the client’s homebound status.
3. Call the client the day before each scheduled visit as a reminder.
4. Call the client’s landlord and ask to be let into the client’s home.
Answer: