exam 1 practice questions Flashcards
The daily record of dysfunctional thoughts (DRDT) is used in cognitive therapy to help clients:
a. Identify automatic thoughts.
b. Modify automatic thoughts.
c. Identify rational alternatives.
d. All of the above.
d. All of the above.
Nancy says to the nurse, “I worked as a secretary to put my husband through college, and as soon as he graduated, he left me. I hate him! I hate all men!” Which of the following is an empathetic response by the nurse?
a. “You are very angry now. This is a normal response to your loss.”
b. “I know what you mean. Men can be very insensitive.”
c. “I understand completely. My husband divorced me, too.”
d. “You are depressed now, but you will feel better in time.”
a. “You are very angry now. This is a normal response to your loss.”
Which of the following statements is (are) correct regarding the use of restraints? (Select all that apply.)
a. Restraints may never be initiated without a physician’s order.
b. Orders for restraints must be reissued by a physician every 2 hours for children and adolescents.
c. Clients in restraints must be observed and assessed every hour for issues regarding circulation, nutrition, respiration, hydration, and elimination.
d. An in-person evaluation must be conducted within 1 hour of initiating restraints.
b. Orders for restraints must be reissued by a physician every 2 hours for children and adolescents.
d. An in-person evaluation must be conducted within 1 hour of initiating restraints.
Anna, age 72, has been grieving the death of her dog, Lucky, for 3 years. She is not able to take care of her activities of daily living, and wants only to make daily visits to Lucky’s grave. Her daughter has likely put off seeking help for Anna because:
a. Women are less likely to seek help for emotional problems than men.
b. Relatives often try to “normalize” the behavior, rather than label it mental illness.
c. She knows that all older people are expected to be a little depressed.
d. She is afraid that the neighbors “will think her mother is crazy.”
b. Relatives often try to “normalize” the behavior, rather than label it mental illness.
Client teaching is an important nursing function in milieu therapy. Which of the following statements by the client indicates the need for knowledge and a readiness to learn?
a. “Get away from me with that medicine! I’m not sick!”
b. “I don’t need psychiatric treatment. It’s my migraine headaches that I need help with.”
c. “I’ve taken Valium every day of my life for the last 20 years. I’ll stop when I’m good and ready!”
d. “The doctor says I have bipolar disorder. What does that really mean?”
d. “The doctor says I have bipolar disorder. What does that really mean?”
One of the goals of therapeutic community is for clients to become more independent and accept self-responsibility. Which of the following approaches by staff best encourages fulfillment of this goal?
a. Including client input and decisions into the treatment plan.
b. Insisting that each client take a turn as “president” of the community meeting.
c. Making decisions for the client regarding plans for treatment.
d. Requiring that the client be bathed, dressed and attend breakfast on time each morning.
a. Including client input and decisions into the treatment plan.
The most appropriate nursing intervention with Ginger (from question 7) would be to:
a. Suggest she move to a college closer to home.
b. Work with Ginger on unresolved dependency issues.
c. Help her find someone in the college town from whom she could seek assistance rather than calling her mother regularly.
d. Recommend that the college physician prescribe an antianxiety medication for Ginger.
b. Work with Ginger on unresolved dependency issues.
Joe is very restless and is pacing a lot. The nurse says to Joe, “If you don’t sit down in the chair and be still, I’m going to put you in restraints!” With which of the following legal actions might the nurse be charged because of this nursing action?
a. Defamation of character
b. Battery
c. Breach of confidentiality
d. Assault
d. Assault
Lucille has a diagnosis of somatic symptom disorder, predominantly pain. Which of the following medications would the psychiatric nurse practitioner most likely prescribe for Lucille?
a. Chlorpromazine (Thorazine)
b. Diazepam (Valium)
c. Carbamazepine (Tegretol)
d. Duloxetine (Cymbalta)
d. Duloxetine (Cymbalta)
The priority nursing intervention before starting ECT therapy is to:
a. Take vital signs and record.
b. Have the patient void.
c. Administer succinylcholine.
d. Ensure that the consent form has been signed.
d. Ensure that the consent form has been signed.
In establishing trust with Ellen, a client with the diagnosis of DID, the nurse must:
a. Try to relate to Ellen as though she did not have multiple personalities.
b. Establish a relationship with each of the personalities separately.
c. Ignore behaviors that Ellen attributes to other subpersonalities.
d. Explain to Ellen that he or she will work with her only if she maintains the status of the primary personality.
b. Establish a relationship with each of the personalities separately.
Walter is angry with his psychiatrist and says to the nurse, “He doesn’t know what he is doing. That medication isn’t helping a thing!” The nurse responds, “He has been a doctor for many years and has helped many people.” This is an example of what nontherapeutic technique?
a. Rejecting
b. Disapproving
c. Probing
d. Defending
d. Defending
Nurse Jones decides to respect family wishes and not tell the client of his terminal status because that would bring the most happiness to the most people. Which of the following ethical theories is considered in this decision?
a. Utilitarianism
b. Kantianism
c. Christian ethics
d. Ethical egoism
a. Utilitarianism
Situation: B.J. has been out with his friends. He is late getting home. He knows his wife will be angry and will yell at him for being late. He stops at the florist’s and buys a dozen red roses for her. Questions 4, 5, and 6 are related to this situation.
Which of the following behaviors represents positive reinforcement on the part of the wife?
a. She meets him at the door, accepts the roses, and says nothing further about his being late.
b. She meets him at the door, yelling that he is late, and makes him spend the night on the couch.
c. She meets him at the door, expresses delight with the roses, and kisses him on the cheek.
d. She meets him at the door and says, “How could you? You know I’m allergic to roses!”
c. She meets him at the door, expresses delight with the roses, and kisses him on the cheek.
The nurse assists the physician with electroconvulsive therapy on his client who has refused to give consent. With which of the following legal actions might the nurse be charged because of this nursing action?
a. Assault
b. Battery
c. False imprisonment
d. Breach of confidentiality
b. Battery
Nurse Jones is the leader of a bereavement group for widows. Nancy is a new member. She listens to the group and sees that one member, Jane, has been a widow for 5 years now. Jane has adjusted well and Nancy thinks maybe she can too. This is an example of which curative factor?
a. Universality
b. Imitative behavior
c. Installation of hope
d. Imparting of information
c. Installation of hope
Which of the following is thought to facilitate the grief process?
a. The ability to grieve in anticipation of the loss
b. The ability to grieve alone without interference from others
c. Having recently grieved for another loss
d. Taking personal responsibility for the loss
a. The ability to grieve in anticipation of the loss
In prioritizing care within the therapeutic environment, which of the following nursing interventions would receive the highest priority?
a. Ensuring that the physical facilities are conducive to achievement of the goals of therapy.
b. Scheduling a community meeting for 8:30 each morning.
c. Attending to the nutritional and comfort needs of all clients.
d. Establishing contacts with community resources.
c. Attending to the nutritional and comfort needs of all clients.
A competent, voluntary client has stated he wants to leave the hospital. The nurse hides his clothes in an effort to keep him from leaving. With which of the following legal actions might the nurse be charged because of this nursing action?
a. Assault
b. Battery
c. False imprisonment
d. Breach of confidentiality
c. False imprisonment
Anna has been a widow for 20 years. Her maladaptive grief response to the loss of her dog may be attributed to which of the following? (Select all that apply.)
a. Unresolved grief over loss of her husband.
b. Loss of several relatives and friends over the last few years.
c. Repressed feelings of guilt over the way in which Lucky died.
d. Inability to prepare in advance for the loss.
a. Unresolved grief over loss of her husband.
b. Loss of several relatives and friends over the last few years.
c. Repressed feelings of guilt over the way in which Lucky died.
d. Inability to prepare in advance for the loss.
The ultimate goal of therapy for a client with DID is:
a. Integration of the personalities into one
b. For the client to have the ability to switch from one personality to another voluntarily
c. For the client to select which personality he or she wants to be the dominant self
d. For the client to recognize that the various personalities exist
a. Integration of the personalities into one
Situation: B.J. has been out with his friends. He is late getting home. He knows his wife will be angry and will yell at him for being late. He stops at the florist’s and buys a dozen red roses for her. Questions 4, 5, and 6 are related to this situation.
Which of the following behaviors represents negative reinforcement on the part of the wife?
a. She meets him at the door, accepts the roses, and says nothing further about his being late.
b. She meets him at the door, yelling that he is late, and makes him spend the night on the couch.
c. She meets him at the door, expresses delight with the roses, and kisses him on the cheek.
d. She meets him at the door and says, “How could you? You know I’m allergic to roses!”
a. She meets him at the door, accepts the roses, and says nothing further about his being late.
You’re on your way to the laundry room when you encounter a fellow dorm tenant who often asks you to “throw a few of my things in with yours.” You view this as an imposition. He asks you where you’re going. Which of the following is an example of a passive-aggressive response?
a. “I’m on my way to the Celtics game. Where do you think I’m going?”
b. “I’m on my way to do some laundry. Do you have anything you want me to wash with mine?”
c. “It’s none of your damn business!”
d. “I’m going to the laundry room. Please don’t ask me to do some of yours. I resent being taken advantage of in that way.”
a. “I’m on my way to the Celtics game. Where do you think I’m going?”
Succinylcholine is administered to a client receiving ECT for what purpose?
a. To alleviate anxiety
b. To decrease secretions
c. To relax muscles
d. As a short-acting anesthetic
c. To relax muscles
Paul is a member of an anger management group. He knew that people did not want to be his friend because of his violent temper. In the group, he has learned to control his temper and form satisfactory interpersonal relationships with others. This is an example of which curative factor?
a. Catharsis
b. Altruism
c. Imparting of information
d. Development of socializing techniques
d. Development of socializing techniques
The desired outcome of working with an individual who has witnessed a traumatic event and is now experiencing panic anxiety is:
a. The individual will experience no anxiety.
b. The individual will demonstrate hope for the future.
c. The individual will maintain anxiety at manageable level.
d. The individual will verbalize acceptance of self as worthy.
c. The individual will maintain anxiety at manageable level.
Lorraine, a client diagnosed with somatic symptom disorder, tells the nurse about a pain in her side. She says she has not experienced it before. Which is the most appropriate response by the nurse?
a. “I don’t want to hear about another physical complaint. You know they are all in your head. It’s time for group therapy now.”
b. “Let’s sit down here together and you can tell me about this new pain you are experiencing. You’ll just have to miss group therapy today.”
c. “I will report this pain to your physician. In the meantime, group therapy starts in 5 minutes. You must leave now to be on time.”
d. “I will call your physician and see if he will order a new pain medication for your side. The one you have now doesn’t seem to provide relief. Why don’t you get some rest for now?”
c. “I will report this pain to your physician. In the meantime, group therapy starts in 5 minutes. You must leave now to be on time.
A client who has been in restraints is now calm. He apologizes to the nurse and says, “I hope I didn’t hurt anyone.” The nurse’s best response is:
a. “This is our job. We know how to handle violent clients.”
b. “We understand you were out of control and didn’t really mean to hurt anyone.”
c. “It is fortunate that no one was hurt. You will not be placed in restraints as long as you can control your behavior.”
d. “It is an unpleasant situation to have to restrain someone, but we have to think of the other clients. We can’t have you causing injury to others. I just hope it won’t happen again.”
c. “It is fortunate that no one was hurt. You will not be placed in restraints as long as you can control your behavior.”
Which of the following is not true regarding grieving by an adolescent?
a. Adolescents may not show their true feelings about the death.
b. Adolescents tend to have an immortal attitude.
c. Adolescents do not perceive death as inevitable.
d. Adolescents may exhibit acting out behaviors as part of their grief.
c. Adolescents do not perceive death as inevitable.
Which of the following activities would be a responsibility of the clinical psychologist member of the IDT?
a. Locates halfway house and arranges living conditions for client being discharged from the hospital.
b. Manages the therapeutic milieu on a 24-hour basis.
c. Administers and evaluates psychological tests that assist in diagnosis.
d. Conducts psychotherapy and administers electroconvulsive therapy treatments.
c. Administers and evaluates psychological tests that assist in diagnosis.
When there is congruence between what is felt and what is being expressed, the nurse is exhibiting which of the following characteristics?
a. Trust
b. Respect
c. Genuineness
d. Empathy
c. Genuineness
J.J. is a staff nurse on a surgical unit. He has been selected as leader of a newly established group of staff nurses organized to determine ways to decrease the number of medication errors occurring on the unit. J.J. has definite ideas about how to bring this about. He has also applied for the position of Head Nurse on the unit and believes that if he is successful in leading the group toward achievement of its goals, he can also facilitate his chances for promotion. At each meeting he addresses the group in an effort to convince the members to adopt his ideas. Which type of group and style of leadership is described in this situation?
a. Task/autocratic
b. Teaching/autocratic
c. Self-help/democratic
d. Supportive-therapeutic/laissez-faire
a. Task/autocratic
Sandra is the nurse leader of a supportive-therapeutic group for individuals with anxiety disorders. In this group, Helen talks incessantly. When someone else tries to make a comment, she refuses to allow him or her to speak. What type of member role is Helen assuming in this group?
a. Aggressor
b. Monopolizer
c. Blocker
d. Seducer
b. Monopolizer
Marie, age 56, is the mother of five children. Her youngest child, who had been living at home and attending the local college, recently graduated and accepted a job in another state. Marie has never worked outside the home and has devoted her life to satisfying the needs of her husband and children. Since the departure of her last child from home, Marie has become more and more despondent. Her husband has become very concerned, and takes her to the local mental health center. This type of crisis is called:
a. Dispositional crisis
b. Crisis of anticipated life transitions
c. Psychiatric emergency
d. Crisis resulting from traumatic stress
b. Crisis of anticipated life transitions
Nurse Mary has been providing care for Tom during his hospital stay. On Tom’s day of discharge, his wife brings a bouquet of flowers and box of chocolates to his room. He presents these gifts to Nurse Mary saying, “Thank you for taking care of me.” What is a correct response by the nurse?
a. “I don’t accept gifts from patients.”
b. “Thank you so much! It is so nice to be appreciated.”
c. “Thank you. I will share these with the rest of the staff.”
d. “Hospital policy forbids me to accept gifts from patients.”
c. “Thank you. I will share these with the rest of the staff.”
Barbara burned the toast. She thinks, “I’m a totally incompetent person.” What automatic thought does this statement represent?
a. Selective abstraction
b. Magnification
c. Minimization
d. Personalization
b. Magnification
A client tells the therapist, “I thought I would just die when my husband told me he was leaving me. If I had been a better wife, he wouldn’t have fallen in love with another woman. It’s all my fault.” The therapist wants to use the technique of “examining the evidence.” Which of the following statements reflects this technique?
a. “How do you think you could have been a better wife?”
b. “Okay, you say it’s all your fault. Let’s discuss why it might be your fault and then we will look at why it may not be.”
c. “Let’s talk about what would make you a happier person.”
d. “Would you have wanted him to stay if he didn’t really want to?”
b. “Okay, you say it’s all your fault. Let’s discuss why it might be your fault and then we will look at why it may not be.”
Nancy, a depressed client who has been unkept and untidy for weeks, today comes to group therapy wearing makeup and a clean dress and having washed and combed her hair. Which of the following responses by the nurse is most appropriate?
a. “Nancy, I see you have put on a clean dress and combed your hair.”
b. “Nancy, you look wonderful today!”
c. “Nancy, I’m sure everyone will appreciate that you have cleaned up for the group today.”
d. “Now that you see how important it is, I hope you will do this every day.”
a. “Nancy, I see you have put on a clean dress and combed your hair.”
Which of the following ego defense mechanisms describes the underlying psychodynamics of somatic symptom disorder?
a. Denial of depression
b. Repression of anxiety
c. Suppression of grief
d. Displacement of anger
b. Repression of anxiety
On the milieu unit, duties of the staff psychiatric nurse include which of the following? (Select all that apply.)
a. Medication administration
b. Client teaching
c. Medical diagnosis
d. Reality orientation
e. Relationship development
f. Group therapy
a. Medication administration
b. Client teaching
d. Reality orientation
e. Relationship development
Guidelines relating to “duty to warn” state that a therapist should consider taking action to warn a third party when his or her client: (Select all that apply.)
a. Threatens violence toward another individual
b. Identifies a specific intended victim
c. Is having command hallucinations
d. Reveals paranoid delusions about another individual
a. Threatens violence toward another individual
b. Identifies a specific intended victim
Anna, who is 72 years old, is of the age when she may have experienced many losses coming close together. What is this called?
a. Bereavement overload
b. Normal mourning
c. Isolation
d. Cultural relativity
a. Bereavement overload
M.K. is a psychiatric nurse who has been selected to lead a group for women who desire to lose weight. The criterion for membership is that they must be at least 20 lb. overweight. All have tried to lose weight on their own many times in the past without success. At their first meeting, M.K. provides suggestions as the members determine what their goals will be and how they plan to go about achieving those goals. They decided how often they wanted to meet, and what they planned to do at each meeting. Which type of group and style of leadership is described in this situation?
a. Task/autocratic
b. Teaching/democratic
c. Self-help/laissez-faire
d. Supportive-therapeutic/democratic
d. Supportive-therapeutic/democratic
You have been studying for a nursing exam all afternoon and lost track of time. Your husband expects dinner on the table when he gets home from work. You have not started cooking yet when he walks in the door and shouts, “Why the heck isn’t dinner ready?” Which of the following is an example of a passive-aggressive response?
a. “I’m sorry. I’ll have it done in no time, honey.” But then you move very slowly and take a long time to cook the meal.
b. “I’m tired from studying all afternoon. Make your own dinner, you bum! I’m tired of being your slave!”
c. “I haven’t started dinner yet. I’d like some help from you.”
d. “I’m so sorry. I know you’re tired and hungry. It’s all my fault. I’m such a terrible wife!”
a. “I’m sorry. I’ll have it done in no time, honey.” But then you move very slowly and take a long time to cook the meal.
Which of the following behaviors suggest a possible breach of professional boundaries? (Select all that apply.)
a. The nurse repeatedly requests to be assigned to a specific client.
b. The nurse shares the details of her divorce with the client.
c. The nurse makes arrangements to meet the client outside of the therapeutic environment.
d. The nurse shares how she dealt with a similar difficult situation.
a. The nurse repeatedly requests to be assigned to a specific client.
b. The nurse shares the details of her divorce with the client.
c. The nurse makes arrangements to meet the client outside of the therapeutic environment.
The environment in which the communication takes place influences the outcome of the interaction. Which of the following are aspects of the environment that influence communication? (Select all that apply.)
a. Territoriality
b. Density
c. Dimension
d. Distance
e. Intensity
a. Territoriality
b. Density
d. Distance
Judy has been in the hospital for 3 weeks. She has used Valium “to settle my nerves” for the past 15 years. She was admitted by her psychiatrist for safe withdrawal from the drug. She has passed the physical symptoms of withdrawal at this time, but states to the nurse, “I don’t know if I will be able to make it without Valium after I go home. I’m already starting to feel nervous. I have so many personal problems.” Which is the most appropriate response by the nurse?
a. “Why do you think you have to have drugs to deal with your problems?”
b. “Everybody has problems, but not everybody uses drugs to deal with them. You’ll just have to do the best that you can.”
c. “We will just have to think about some things that you can do to decrease your anxiety without resorting to drugs.”
d. “Just hang in there. I’m sure everything is going to be okay.”
c. “We will just have to think about some things that you can do to decrease your anxiety without resorting to drugs.”
A decrease in which of the following neurotransmitters has been implicated in depression?
a. GABA, acetylcholine, and aspartate
b. Norepinephrine, serotonin, and dopamine
c. Somatostatin, substance P, and glycine
d. Glutamate, histamine, and opioid peptides
b. Norepinephrine, serotonin, and dopamine
The nurse leader is explaining about group “curative factors” to members of the group. She tells the group that group situations are beneficial because members can see that they are not alone in their experiences. This is an example of which curative factor?
a. Altruism
b. Imitative behavior
c. Universality
d. Imparting of information
c. Universality
Jenny reported to the high school nurse that her mother drinks too much. She is drunk every afternoon when Jenny gets home from school. Jenny is afraid to invite friends over because of her mother’s behavior. This type of crisis is called:
a. Crisis resulting from traumatic stress
b. Maturational/developmental crisis
c. Dispositional crisis
d. Crisis reflecting psychopathology
c. Dispositional crisis
Dorothy was involved in an automobile accident while under the influence of alcohol. She swerved her car into a tree and narrowly missed hitting a child on a bicycle. She is in the hospital with multiple abrasions and contusions. She is talking about the accident with the nurse. Which of the following statements by the nurse is most appropriate?
a. “Now that you know what can happen when you drink and drive, I’m sure you won’t let it happen again.”
b. “You know that was a terrible thing you did. That child could have been killed.”
c. “I’m sure everything is going to be okay now that you understand the possible consequences of such behavior.”
d. “How are you feeling about what happened?”
d. “How are you feeling about what happened?”
A major difference between normal and maladaptive grieving has been identified by which of the following?
a. There are no feelings of depression in normal grieving.
b. There is no loss of self-esteem in normal grieving.
c. Normal grieving lasts no longer than 1 year.
d. In normal grief the person does not show anger toward the loss.
b. There is no loss of self-esteem in normal grieving.
Henry is a member of an Alcoholics Anonymous group. He learned about the effects of alcohol on the body when a nurse from the chemical dependency unit spoke to the group. This is an example of which curative factor?
a. Catharsis
b. Altruism
c. Imparting of information
d. Universality
c. Imparting of information
John and his girlfriend had an argument during her visit. Which behavior by John would indicate he is learning to adaptively problem-solve his frustrations?
a. John says to the nurse, “Give me some of that medication before I end up in restraints!”
b. When his girlfriend leaves, John goes to the exercise room and punches on the punching bag.
c. John says to the nurse, “I guess I’m going to have to dump that broad!”
d. John says to his girlfriend, “You’d better leave before I do something I’m sorry for.”
b. When his girlfriend leaves, John goes to the exercise room and punches on the punching bag.
- The most appropriate crisis intervention with Amanda (from question 3) would be to:
a. Encourage her to recognize how lucky she is to be alive.
b. Discuss stages of grief and feelings associated with each.
c. Identify community resources that can help Amanda.
d. Suggest that she find a place to live that provides a storm shelter.
( Amanda’s mobile home was destroyed by a tornado. Amanda received only minor injuries, but is experiencing disabling anxiety in the aftermath of the event. This type of crisis is called:)
b. Discuss stages of grief and feelings associated with each.
Crises occur when an individual:
a. Is exposed to a precipitating stressor
b. Perceives a stressor to be threatening
c. Has no support systems
d. Experiences a stressor and perceives coping strategies to be ineffective
d. Experiences a stressor and perceives coping
Situation: B.J. has been out with his friends. He is late getting home. He knows his wife will be angry and will yell at him for being late. He stops at the florist’s and buys a dozen red roses for her. Questions 4, 5, and 6 are related to this situation.
Which of the following behaviors represents an aversive stimulus on the part of the wife?
a. She meets him at the door, accepts the roses, and says nothing further about his being late.
b. She meets him at the door, yelling that he is late, and makes him spend the night on the couch.
c. She meets him at the door, expresses delight with the roses, and kisses him on the cheek.
d. She meets him at the door and says, “How could you? You know I’m allergic to roses!”
b. She meets him at the door, yelling that he is late, and makes him spend the night on the couch.
The ultimate goal of therapy for a client with DID is most likely achieved through:
a. Crisis intervention and directed association
b. Psychotherapy and hypnosis
c. Psychoanalysis and free association
d. Insight psychotherapy and dextroamphetamines
b. Psychotherapy and hypnosis
Carol, an adolescent, just returned from group therapy and is crying. She says to the nurse, “All the other kids laughed at me! I try to fit in, but I always seem to say the wrong thing. I’ve never had a close friend. I guess I never will.” Which is the most appropriate response by the nurse?
a. “What makes you think you will never have any friends?”
b. “You’re feeling pretty down on yourself right now.”
c. “I’m sure they didn’t mean to hurt your feelings.”
d. “Why do you feel this way about yourself?”
b. “You’re feeling pretty down on yourself right now.”
A negative reinforcer:
a. Increases the probability that a behavior will recur
b. Decreases the probability that a behavior will recur
c. Has nothing to do with modifying behavior
d. Always results in unacceptable behavior
a. Increases the probability that a behavior will recur
Which of the following is a correct statement when attempting to distinguish normal grief from clinical depression?
a. In clinical depression, anhedonia is prevalent.
b. In normal grieving, the person has generalized feelings of guilt.
c. The person who is clinically depressed relates feelings of depression to a specific loss.
d. In normal grieving, there is a persistent state of dysphoria.
a. In clinical depression, anhedonia is prevalent.
