Exam 1 Chapter questions

Question 1

The nurse is teaching a client taking an MAOI about foods with
tyramine that he or she should avoid. Which statement indicates that
the client needs further teaching?
a. “I’m so glad I can have pizza as long as I don’t order pepperoni.”
b. “I will be able to eat cottage cheese without worrying.”
c. “I will have to avoid drinking nonalcoholic beer.”
d. “I can eat green beans on this diet.”

Answer 1

a. “I’m so glad I can have pizza as long as I don’t order pepperoni.”

Question 2

A client who has been depressed and suicidal started taking a tricyclic
antidepressant 2 weeks ago and is now ready to leave the hospital to go
home. Which is a concern for the nurse as discharge plans are
finalized?
a. The client may need a prescription for diphenhydramine (Benadryl)
to use for side effects.
b. The nurse will evaluate the risk for suicide by overdose of the
tricyclic antidepressant.
c. The nurse will need to include teaching regarding the signs of
neuroleptic malignant syndrome.
d. The client will need regular laboratory work to monitor therapeutic
drug levels.

Answer 2

b. The nurse will evaluate the risk for suicide by overdose of the
tricyclic antidepressant.

Question 3

The signs of lithium toxicity include which?
a. Sedation, fever, and restlessness
b. Psychomotor agitation, insomnia, and increased thirst
c. Elevated WBC count, sweating, and confusion
109
d. Severe vomiting, diarrhea, and weakness

Answer 3

d. Severe vomiting, diarrhea, and weakness

Question 4

Which is a concern for children taking stimulants for ADHD for
several years?
a. Dependence on the drug
b. Insomnia
c. Growth suppression
d. Weight gain

Answer 4

c. Growth suppression

Question 5

The nurse is caring for a client with schizophrenia who is taking
haloperidol (Haldol). The client complains of restlessness, cannot sit
still, and has muscle stiffness. Of the following prn medications, which
would the nurse administer?
a. Haloperidol (Haldol), 5 mg PO
b. Benztropine (Cogentin), 2 mg PO
c. Propranolol (Inderal), 20 mg PO
d. Trazodone, 50 mg PO

Answer 5

b. Benztropine (Cogentin), 2 mg PO

Question 6

Client teaching for lamotrigine (Lamictal) should include which
instructions?
a. Eat a well-balanced diet to avoid weight gain.
b. Report any rashes to your doctor immediately.
c. Take each dose with food to avoid nausea.
d. This drug may cause psychological dependence.

Answer 6

b. Report any rashes to your doctor immediately.

Question 7

Which physician order would the nurse question for a client who has
stated, “I’m allergic to phenothiazines?”
a. Haldol, 5 mg PO bid
b. Navane, 10 mg PO bid
c. Prolixin, 5 mg PO tid
d. Risperdal, 2 mg bid

Answer 7

c. Prolixin, 5 mg PO tid

Question 8

Clients taking which type of psychotropic medications need close
monitoring of their cardiac status?
a. Antidepressants
b. Antipsychotics
c. Mood stabilizers
d. Stimulants

Answer 8

b. Antipsychotics

Question 9

Clozapine (Clozaril)

Answer 9

Atypical Antipsychotic

Question 10

Fluoxetine (Prozac)

Answer 10

Antidepressant; SSRI

Question 11

Amitriptyline (Elavil)

Answer 11

antidepressant; Tricyclic

Question 12

Benztropine (Cogentin)

Answer 12

Anticholinergic

Question 13

Methylphenidate (Ritalin)

Answer 13

stimulant; used for ADHD

Question 14

Carbamazepine (Tegretol)

Answer 14

Mood stabilizer; Anticonvulsant

Question 15

Clonazepam (Klonopin)

Answer 15

Benzodiazepine

Question 16

Quetiapine (Seroquel)

Answer 16

Atypical antipsychotic

Question 17

Building trust is important in
a. the orientation phase of the relationship.
b. the problem identification subphase of the relationship.
c. all phases of the relationship.
d. the exploitation subphase of the relationship.

Answer 17

a. the orientation phase of the relationship.

Question 18

Abstract standards that provide a person with his or her code of
conduct are
a. values.
b. attitudes.
c. beliefs.
d. personal philosophy.

Answer 18

a. values.

Question 19

Ideas that one holds as true are
a. values.
b. attitudes.
c. beliefs.
d. personal philosophy.

Answer 19

c. beliefs.

Question 20

The emotional frame of reference by which one sees the world is
created by
a. values.
b. attitudes.
c. beliefs.
d. personal philosophy.

Answer 20

b. attitudes.

Question 21

The client tells the nurse, “My biggest problem right now is trying to
deal with a divorce. I didn’t want a divorce and I still don’t. But it is
happening anyway!” Which of the following responses by the nurse
will convey empathy?
a. “Can you tell me about it?”
b. “I’m so sorry. No wonder you’re upset.”
c. “Sounds like it has been a difficult time.”
d. “You must be devastated.”

Answer 21

c. “Sounds like it has been a difficult time.”

Question 22

1. Which are specific tasks of the working phase of a therapeutic
   relationship?
   SATA

a. Begin planning for termination.
b. Build trust.
c. Encourage expression of feelings.
d. Establish a nurse–client contract.
e. Facilitate behavior change.
f. Promote self-esteem.

Answer 22

c. Encourage expression of feelings.
e. Facilitate behavior change.
f. Promote self-esteem.

Question 23

2. Confidentiality means respecting the client’s right to keep his or her
   information private. When can the nurse share information about the
   client?
   SATA

a. The client threatens to harm a family member.
b. Sharing the information is in the client’s best interest.
c. The client gives written permission.
d. The client’s legal guardian asks for information.
e. The client is discharged to the parent’s care.
f. The client admits to domestic abuse.

Answer 23

a. The client threatens to harm a family member.
c. The client gives written permission.
d. The client’s legal guardian asks for information.

Question 24

1. Client: “I had an accident.”
   Nurse: “Tell me about your accident.”
   This is an example of which therapeutic communication technique?

a. Making observations
b. Offering self
c. General lead
d. Reflection

Answer 24

c. General lead

Question 25

2. “Earlier today you said you were concerned that your son was still
   upset with you. When I stopped by your room about an hour ago, you
   and your son seemed relaxed and smiling as you spoke to each other.
   How did things go between the two of you?”
   This is an example of which therapeutic communication technique?
   a. Consensual validation
   b. Encouraging comparison
   c. Accepting
   d. General lead

Answer 25

a. Consensual validation

Question 26

3. “Why do you always complain about the night nurse? She is a nice
   woman and a fine nurse and has five kids to support. You’re wrong
   when you say she is noisy and uncaring.”
   This example reflects which nontherapeutic technique?
   a. Requesting an explanation
   b. Defending
   c. Disagreeing
   d. Advising

Answer 26

b. Defending

Question 27

4. “How does Jerry make you upset?” is a nontherapeutic communication
   technique because it
   a. gives a literal response.
   b. indicates an external source of the emotion.
   c. interprets what the client is saying.
   d. is just another stereotyped comment.

Answer 27

b. indicates an external source of the emotion.

Question 28

5. Client: “I was so upset about my sister ignoring my pain when I broke
   my leg.”
   Nurse: “When are you going to your next diabetes education
   program?”
   This is a nontherapeutic response because the nurse has
   a. used testing to evaluate the client’s insight.
   b. changed the topic.
   c. exhibited an egocentric focus.
   d. advised the client what to do.

Answer 28

b. changed the topic.

Question 29

6. When the client says, “I met Joe at the dance last week,” what is the
   best way for the nurse to ask the client to describe her relationship with
   Joe?
   a. “Joe who?”
   b. “Tell me about Joe.”
   c. “Tell me about you and Joe.”
   d. “Joe, you mean that blond guy with the dark blue eyes?”

Answer 29

c. “Tell me about you and Joe.”

Question 30

7. Which of the following is a concrete message?
   a. “Help me put this pile of books on Marsha’s desk.”
   b. “Get this out of here.”
   c. “When is she coming home?”
   d. “They said it is too early to get in.”

Answer 30

a. “Help me put this pile of books on Marsha’s desk.”

Question 31

1. The advantages of assertive communication are
   SATA
   a. all persons’ rights are respected.
   b. it gains approval from others.
   c. it protects the speaker from being exploited.
   d. the speaker can say no to another person’s request.
   e. the speaker can safely express thoughts and feelings.
   f. the speaker will get his or her needs met.

Answer 31

a. all persons’ rights are respected.
c. it protects the speaker from being exploited.
d. the speaker can say no to another person’s request.
e. the speaker can safely express thoughts and feelings.

Question 32

2. Which of the following are examples of a therapeutic communication
   response?
   SATA
   a. “Don’t worry; everybody has a bad day occasionally.”
   b. “I don’t think your mother will appreciate that behavior.”
   c. “Let’s talk about something else.”
   d. “Tell me more about your discharge plans.”
   e. “That sounds like a great idea.”
   f. “What might you do the next time you’re feeling angry?”

Answer 32

d. “Tell me more about your discharge plans.”
f. “What might you do the next time you’re feeling angry?”

Question 33

1. Which is an example of an open-ended question?
   a. Who is the current president of the United States?
   b. What concerns you most about your health?
   c. What is your address?
   d. Have you lost any weight recently?

Answer 33

b. What concerns you most about your health?

Question 34

2. Which is an example of a closed-ended question?
   a. How have you been feeling lately?
   b. How is your relationship with your wife?
   c. Have you had any health problems recently?
   d. Where are you employed?

Answer 34

d. Where are you employed?

Question 35

3. Assessment data about the client’s speech patterns are categorized in
   which of the following areas?
   a. History
   b. General appearance and motor behavior
   c. Sensorium and intellectual processes
   d. Self-concept

Answer 35

b. General appearance and motor behavior

Question 36

4. When the nurse is assessing whether the client’s ideas are logical and
   make sense, the nurse is examining which of the following areas?
   a. Thought content
   b. Thought process
   c. Memory
   d. Sensorium

Answer 36

b. Thought process

Question 37

5. The client’s belief that a news broadcast has special meaning for him
   or her is an example of
   a. abstract thinking.
   b. flight of ideas.
   c. ideas of reference.
   d. thought broadcasting.

Answer 37

c. ideas of reference.

Question 38

6. The client who believes everyone is out to get him or her is
   experiencing a(n)
   a. delusion.
   b. hallucination.
   c. idea of reference.
   d. loose association.

Answer 38

a. delusion.

Question 39

7. To assess the client’s ability to concentrate, the nurse would instruct
   the client to do which?
   a. Explain what “a rolling stone gathers no moss” means.
   b. Name the last three presidents.
   c. Repeat the days of the week backward.
   d. Talk about what a typical day is like.

Answer 39

c. Repeat the days of the week backward.

Question 40

8. The client tells the nurse “I never do anything right. I make a mess of
   everything. Ask anyone; they’ll tell you the same thing.” The nurse
   recognizes these statements as examples of
   a. emotional issues.
   b. negative thinking.
   c. poor problem-solving.
   d. relationship difficulties.

Answer 40

b. negative thinking.

Question 41

1. Assessment of sensorium and intellectual processes includes which?
   SATA
   a. Concentration
   b. Emotional feelings
   c. Memory
   d. Judgment
   e. Orientation
   f. Thought process

Answer 41

a. Concentration
c. Memory
e. Orientation

Question 42

2. Assessment of suicidal risk includes which?
   SATA
   a. Intent to die
   b. Judgment
   c. Insight
   d. Method
   e. Plan
   f. Reason

Answer 42

a. Intent to die
d. Method
e. Plan
f. Reason

Question 43

1. Which is an example of assertive communication?
   a. “I wish you would stop making me angry.”
   b. “I feel angry when you walk away when I’m talking.”
   c. “You never listen to me when I’m talking.”
   d. “You make me angry when you interrupt me.”

Answer 43

b. “I feel angry when you walk away when I’m talking.”

Question 44

2. Which statement about anger is true?
   a. Expressing anger openly and directly usually leads to arguments.
   b. Anger results from being frustrated, hurt, or afraid.
   c. Suppressing anger is a sign of maturity.
   d. Angry feelings are a negative response to a situation.

Answer 44

b. Anger results from being frustrated, hurt, or afraid.

Question 45

3. Which type of drugs requires cautious use with potentially aggressive
   clients?
   a. Antipsychotic medications
   b. Benzodiazepines
   c. Mood stabilizers
   d. Lithium

Answer 45

b. Benzodiazepines

Question 46

4. A client is pacing in the hallway with clenched fists and a flushed face.
   She is yelling and swearing. In which phase of the aggression cycle is
   she?
   a. Anger
   b. Triggering
   c. Escalation
   d. Crisis

Answer 46

c. Escalation

Question 47

5. The nurse observes a client muttering to himself and pounding his fist
   in his other hand while pacing in the hallway. Which principle should
   guide the nurse’s action?
   a. Only one nurse should approach an upset client to avoid threatening
   the client.
   b. Clients who can verbalize angry feelings are less likely to become
   physically aggressive.
   c. Talking to a client with delusions is not helpful, because the client
   has no ability to reason.
   d. Verbally aggressive clients often calm down on their own if staff
   members don’t bother them.

Answer 47

b. Clients who can verbalize angry feelings are less likely to become
physically aggressive.

Question 48

1. Behaviors observed during the recovery phase of the aggression cycle
   include
   a. angry feelings.
   b. anxiety.
   c. apologizing to staff.
   d. decreased muscle tension.
   e. lowered voice volume.
   f. rational communication.

Answer 48

d. decreased muscle tension.
e. lowered voice volume.
f. rational communication.

Question 49

2. Which statements are examples of unacceptable behaviors under the
   JCAHO standards for a culture of safety?
   SATA
   a. “According to your performance evaluation, you must decrease
   your absenteeism.”
   b. “Don’t page me again, I’m very busy.”
   c. “If you tell my supervisor, you’ll never hear the end of it.”
   d. “I don’t deserve to be yelled at.”
   e. “I haven’t seen such stupid behavior since grade school.”
   f. “I request a different assignment today.”

Answer 49

b. “Don’t page me again, I’m very busy.”
c. “If you tell my supervisor, you’ll never hear the end of it.”
e. “I haven’t seen such stupid behavior since grade school.”

Question 50

1. The client who is involuntarily committed to an inpatient psychiatric
   unit loses which right?
   a. Right to freedom
   b. Right to refuse treatment
   c. Right to sign legal documents
   d. The client loses no rights

Answer 50

a. Right to freedom

Question 51

2. A client has a prescription for haloperidol, 5 mg orally two times a
   day, as ordered by the physician. The client is suspicious and refuses to
   take the medication. The nurse says, “If you don’t take this pill, I’ll get
   an order to give you an injection.” The nurse’s statement is an example
   of
   a. assault.
   b. battery.
   c. malpractice.
   d. unintentional tort.

Answer 51

a. assault.

Question 52

3. A hospitalized client is delusional, yelling, “The world is coming to an
   end. We must all run to safety!” When other clients complain that this
   client is loud and annoying, the nurse decides to put the client in
   seclusion. The client has made no threatening gestures or statements to
   anyone. The nurse’s action is an example of
   a. assault.
   b. false imprisonment.
   c. malpractice
   d. negligence.

Answer 52

b. false imprisonment.

Question 53

4. Which would indicate a duty to warn a third party?
   a. A client with delusions states, “I’m going to get them before they
   get me.”
   b. A hostile client says, “I hate all police.”
   c. A client says he plans to blow up the federal government.
   d. A client states, “If I can’t have my girlfriend back, then no one can
   have her.”

Answer 53

d. A client states, “If I can’t have my girlfriend back, then no one can
have her.”

Question 54

5. The nurse gives the client quetiapine (Seroquel) in error when
   olanzapine (Zyprexa) was ordered. The client has no ill effects from
   the quetiapine. In addition to making a medication error, the nurse has
   committed which?
   a. Malpractice
   b. Negligence
   c. Unintentional tort
   d. None of the above

Answer 54

d. None of the above

Question 55

1. Which elements are essential in a clinician’s duty to warn?
   a. Client makes threatening statements
   b. History of violence
   c. Potential victim(s) are identifiable
   d. Potential victim is easy to locate
   e. Threat is not a delusion
   f. Threat of harm is serious

Answer 55

a. Client makes threatening statements
c. Potential victim(s) are identifiable
f. Threat of harm is serious

Question 56

2. Which elements are necessary to prove liability in a malpractice
   lawsuit?
   SATA

a. Client is injured
b. Failure to conform to standards of care
c. Injury caused by breach of duty
d. Injuries must be visible and verified
e. Nurse intended to cause harm
f. Recognized relationship between client and nurse

Answer 56

a. Client is injured
b. Failure to conform to standards of care
c. Injury caused by breach of duty
f. Recognized relationship between client and nurse

Question 57

1. Which of the following give cues to the nurse that a client may be
   grieving for a loss?
   a. Sad affect, anger, anxiety, and sudden changes in mood
   b. Thoughts, feelings, behavior, and physiologic complaints
   c. Hallucinations, panic level of anxiety, and sense of impending
   doom
   d. Complaints of abdominal pain, diarrhea, and loss of appetite

Answer 57

b. Thoughts, feelings, behavior, and physiologic complaints

Question 58

2. Situations that are considered risk factors for complicated grief are
   a. inadequate support and old age.
   b. childbirth, marriage, and divorce.
   c. death of a spouse or child, death by suicide, and sudden and
   unexpected death.
   d. inadequate perception of the grieving crisis.

Answer 58

c. death of a spouse or child, death by suicide, and sudden and
unexpected death.

Question 59

3. Physiologic responses of complicated grieving include
   a. tearfulness when recalling significant memories of the lost one.
   b. impaired appetite, weight loss, lack of energy, and palpitations.
   c. depression, panic disorders, and chronic grief.
   d. impaired immune system, increased serum prolactin level, and
   increased mortality rate from heart disease.

Answer 59

d. impaired immune system, increased serum prolactin level, and
increased mortality rate from heart disease.

Question 60

4. Critical factors for successful integration of loss during the grieving
   process are
   a. the client’s adequate perception, adequate support, and adequate
   coping.
   b. the nurse’s trustworthiness and healthy attitudes about grief.
   c. accurate assessment and intervention by the nurse or helping
   person.
   d. the client’s predictable and steady movement from one stage of the
   process to the next.

Answer 60

a. the client’s adequate perception, adequate support, and adequate
coping.

Question 61

1. Rando’s six Rs of grieving tasks include
   a. react.
   b. read.
   c. readjust.
   d. recover.
   e. reinvest.
   f. restitution.

Answer 61

a. react.
c. readjust.
e. reinvest.

Question 62

2. Nursing interventions that are helpful for the grieving client include
   SATA
   a. allowing denial when it is useful.
   b. assuring the client that it will get better.
   c. correcting faulty assumptions.
   d. discouraging negative, pessimistic conversation.
   e. providing attentive presence.
   f. reviewing past coping behaviors.

Answer 62

a. allowing denial when it is useful.
c. correcting faulty assumptions.
e. providing attentive presence.
f. reviewing past coping behaviors.

Question 63

1. The family of a client with schizophrenia asks the nurse about the
   difference between conventional and atypical antipsychotic
   medications. The nurse’s best answer may include which information?
   a. Atypical antipsychotics are newer medications but act in the same
   ways as conventional antipsychotics.
   b. Conventional antipsychotics are dopamine antagonists; atypical
   antipsychotics inhibit the reuptake of serotonin.
   c. Conventional antipsychotics have serious side effects; atypical
   antipsychotics have virtually no side effects.
   d. Atypical antipsychotics are dopamine and serotonin antagonists;
   conventional antipsychotics are only dopamine antagonists.

Answer 63

d. Atypical antipsychotics are dopamine and serotonin antagonists;
conventional antipsychotics are only dopamine antagonists.

Question 64

2. The nurse is planning discharge teaching for a client taking clozapine(Clozaril). Which teaching is essential to include?

a. Caution the client not to be outdoors in the sunshine without
protective clothing.
b. Remind the client to go to the lab to have blood drawn for a white
blood cell count.
c. Instruct the client about dietary restrictions.
d. Give the client a chart to record the daily pulse rate.

Answer 64

b. Remind the client to go to the lab to have blood drawn for a white
blood cell count.

Question 65

.
3. The nurse is caring for a client who has been taking fluphenazine
(Prolixin) for 2 days. The client suddenly cries out, his neck twists to
one side, and his eyes appear to roll back in the sockets. The nurse
finds the following PRN medications ordered for the client. Which one should the nurse administer?
a. Benztropine (Cogentin), 2 mg PO, bid, PRN
b. Fluphenazine (Prolixin), 2 mg PO, tid, PRN
c. Haloperidol (Haldol), 5 mg IM, PRN extreme agitation
d. Diphenhydramine (Benadryl), 25 mg IM, PRN

Answer 65

d. Diphenhydramine (Benadryl), 25 mg IM, PRN

Question 66

4. Which of the following statements would indicate family teaching
   about schizophrenia had been effective?
   a. “If our son takes his medication properly, he won’t have another
   psychotic episode.”
   b. “I guess we’ll have to face the fact that our daughter will eventually
   be institutionalized.”
   c. “It’s a relief to find out that we did not cause our son’s
   schizophrenia.”
   d. “It is a shame our daughter will never be able to have children.”

Answer 66

c. “It’s a relief to find out that we did not cause our son’s
schizophrenia.”

Question 67

5. When the client describes fear of leaving his apartment as well as the desire to get out and meet others, it is called

a. ambivalence.
b. anhedonia.
c. alogia.
d. avoidance.

Answer 67

a. ambivalence.

Question 68

6. The client who hesitates 30 seconds before responding to any question is described as having

a. blunted affect.
b. latency of response.
c. paranoid delusions.
d. poverty of speech.

Answer 68

b. latency of response.

Question 69

7. The overall goal of psychiatric rehabilitation is for the client to gain

a. control of symptoms.
b. freedom from hospitalization.
c. management of anxiety.
d. recovery from the illness.

Answer 69

d. recovery from the illness.

Question 70

1. A teaching plan for the client taking an antipsychotic medication will
   include which instructions?

a. Apply sunscreen before going outdoors.
b. Drink sugar-free beverages for dry mouth.
c. Have serum blood levels drawn once a month.
d. Rise slowly from a sitting position.
e. Skip any dose that is not taken on time.
f. Take medication with food to avoid nausea.

Answer 70

a. Apply sunscreen before going outdoors.
b. Drink sugar-free beverages for dry mouth.
d. Rise slowly from a sitting position.

Question 71

2. Which of the following are considered to be positive signs of
   schizophrenia?

a. Anhedonia
b. Delusions
c. Hallucinations
d. Disorganized thinking
e. Illusions
f. Social withdrawal

Answer 71

b. Delusions
c. Hallucinations
d. Disorganized thinking

Question 72

1. The nurse observes that a client with bipolar disorder is pacing in the
   hall, talking loudly and rapidly, and using elaborate hand gestures. The
   nurse concludes that the client is demonstrating which?

a. Aggression
b. Anger
c. Anxiety
d. Psychomotor agitation

Answer 72

d. Psychomotor agitation

Question 73

2. A client with bipolar disorder begins taking lithium carbonate (lithium) 300 mg four times a day. After 3 days of therapy, the client says, “My hands are shaking.” Which is the best response by the nurse?

a. “Fine motor tremors are an early effect of lithium therapy that
usually subsides in a few weeks.”
b. “It is nothing to worry about unless it continues for the next
month.”
c. “Tremors can be an early sign of toxicity, but we’ll keep
monitoring your lithium level to make sure you’re OK.”
d. “You can expect tremors with lithium. You seem very concerned
about such a small tremor.”

Answer 73

a. “Fine motor tremors are an early effect of lithium therapy that
usually subsides in a few weeks.”

Question 74

3. What are the most common types of side effects from SSRIs?

a. Dizziness, drowsiness, and dry mouth
b. Convulsions and respiratory difficulties
c. Diarrhea and weight gain
d. Jaundice and agranulocytosis

Answer 74

a. Dizziness, drowsiness, and dry mouth

Question 75

4. The nurse observes that a client with depression sat at a table with two other clients during lunch. Which is the best feedback the nurse could give the client?

a. “Do you feel better after talking with others during lunch?”
b. “I’m so happy to see you interacting with other clients.”
c. “I see you were sitting with others at lunch today.”
d. “You must feel much better than you were a few days ago.”

Answer 75

c. “I see you were sitting with others at lunch today.”

Question 76

5. Which term typifies the speech of a person in the acute phase of
   mania?

a. Flight of ideas
b. Psychomotor retardation
c. Hesitant
d. Mutism

Answer 76

a. Flight of ideas

Question 77

6. What is the rationale for a person taking lithium to have enough water
   and salt in his or her diet?

a. Salt and water are necessary to dilute lithium to avoid toxicity.
b. Water and salt convert lithium into a usable solute.
c. Lithium is metabolized in the liver, necessitating increased water
and salt.
d. Lithium is a salt that has greater affinity for receptor sites than
sodium chloride.

Answer 77

d. Lithium is a salt that has greater affinity for receptor sites than
sodium chloride.

Question 78

7. Identify the serum lithium level for maintenance and safety.

a. 0.1 to 1 mEq/L
b. 0.5 to 1.5 mEq/L
c. 10 to 50 mEq/L
d. 50 to 100 mEq/L

Answer 78

b. 0.5 to 1.5 mEq/L

Question 79

8. A client says to the nurse, “You are the best nurse I’ve ever met. I want you to remember me.” What is an appropriate response by the nurse?

a. “Thank you. I think you are special too.”
b. “I suspect you want something from me. What is it?”
c. “You probably say that to all your nurses.”
d. “Are you thinking of suicide?”

Answer 79

d. “Are you thinking of suicide?”

Question 80

9. A client with mania begins dancing around the day room. When she
   twirled her skirt in front of the male clients, it was obvious she had no
   underwear on. The nurse distracts her and takes her to her room to put on underwear. The nurse acted as she did to

a. minimize the client’s embarrassment about her present behavior.
b. keep her from dancing with other clients.
c. avoid embarrassing the male clients who are watching.
d. teach her about proper attire and hygiene.

Answer 80

a. minimize the client’s embarrassment about her present behavior.

Question 81

1. Which actions would indicate an increased suicidal risk?
   SATA

a. An abrupt improvement in mood
b. Calling family members to make amends
c. Crying when discussing sadness
d. Feeling overwhelmed by simple daily tasks
e. Statements such as “I’m such a burden for everyone”
f. Statements such as “Everything will be better soon”

Answer 81

a. An abrupt improvement in mood
b. Calling family members to make amends
f. Statements such as “Everything will be better soon”

Question 82

2. Which activities would be appropriate for a client with mania?
   SATA

a. Drawing a picture
b. Modeling clay
c. Playing bingo
d. Playing table tennis
e. Stretching exercises
f. Stringing beads

Answer 82

a. Drawing a picture
b. Modeling clay
e. Stretching exercises

Question 83

1. Which statement would indicate that teaching about naltrexone
   (ReVia) has been effective?

a. “I’ll get sick if I use heroin while taking this medication.”
b. “This medication will block the effects of any opioid substance I
take.”
c. “If I use opioids while taking naltrexone, I’ll become extremely
ill.”
d. “Using naltrexone may make me dizzy.”

Answer 83

b. “This medication will block the effects of any opioid substance I
take.”

Question 84

2. Clonidine (Catapres) is prescribed for symptoms of opioid withdrawal.
   Which nursing assessment is essential before giving a dose of this
   medication?

a. Assessing the client’s blood pressure
b. Determining when the client last used an opiate
c. Monitoring the client for tremors
d. Completing a thorough physical assessment

Answer 84

a. Assessing the client’s blood pressure

Question 85

3. Which behaviors would indicate stimulant intoxication?

a. Slurred speech, unsteady gait, impaired concentration
b. Hyperactivity, talkativeness, euphoria
c. Relaxed inhibitions, increased appetite, distorted perceptions
d. Depersonalization, dilated pupils, visual hallucinations

Answer 85

b. Hyperactivity, talkativeness, euphoria

Question 86

4. The 12 steps of AA teach that

a. acceptance of being an alcoholic will prevent urges to drink.
b. a higher power will protect individuals if they feel like drinking.
c. once a person has learned to be sober, he or she can graduate and
leave AA.
d. once a person is sober, he or she remains at risk for drinking.

Answer 86

d. once a person is sober, he or she remains at risk for drinking.

Question 87

5. The nurse has provided an in-service program on impaired
   professionals. She knows that teaching has been effective when staff identify which as the highest risk for substance abuse among
   professionals?

a. Most nurses are codependent in their personal and professional
relationships.
b. Most nurses come from dysfunctional families and are at risk for
developing addiction.
c. Most nurses are exposed to various substances and believe they are not at risk of developing the disease.
d. Most nurses have preconceived ideas about what kind of people
become addicted.

Answer 87

c. Most nurses are exposed to various substances and believe they are not at risk of developing the disease.

Question 88

6. A client comes to day treatment intoxicated but says he is not. The
   nurse identifies that the client is exhibiting symptoms of

a. denial.
b. reaction formation.
c. projection.
d. transference.

Answer 88

a. denial.

Question 89

7. The client tells the nurse that she has a drink every morning to calm
   her nerves and stop her tremors. The nurse realizes the client is at risk
   for
   a. an anxiety disorder.
   b. a neurologic disorder.
   c. physical dependence.
   d. psychological addiction.

Answer 89

c. physical dependence

Question 90

1. Which conditions would the nurse recognize as signs of alcohol
   withdrawal?
   SATA

a. Blackouts
b. Diaphoresis
c. Elevated blood pressure
d. Lethargy
e. Nausea
f. Tremulousness

Answer 90

b. Diaphoresis
c. Elevated blood pressure
e. Nausea
f. Tremulousness

Question 91

1. The nurse would recognize which drugs as central nervous system
   depressants?
   SATA

a. Cannabis
b. Diazepam (Valium)
c. Heroin
d. Meperidine (Demerol)
e. Phenobarbital
f. Whiskey

Answer 91

b. Diazepam (Valium)
e. Phenobarbital
f. Whiskey