PROC per Marc

Question 1

A nurse is obtaining a medical history from a client who is requesting a prescription for bupropion for smoking cessation. Which of the following assessment findings in the client’s history should the nurse report to the provider?

a. Knee arthroplasty 1 month ago
b. Hepatitis B infection
c. Recent head injury
d. Hypothyroidism

Answer 1

c. Recent head injury

Question 2

A nurse is assessing a client who has histrionic personality disorder. Which of the following findings should the nurse expect?

a. Lack of remorse - conduct
b. Splitting of staff
c. Attention-seeking - have to be the center of attention
d. Identity disturbance

Answer 2

c. Attention-seeking

Question 3

A nurse is providing teaching to the daughter of an older adult who has obsessive compulsive disorder. Which of the following statements indicates an understanding of the teaching?

a. “ I will provide my mother with detailed instructions about how to perform self care.”
b. “ I will limit my mother’s clothes choices when she is getting dressed.”
c. “ I will wake my mother up a couple of times in the night to check on her.”
d. “ I will discourage my mother from talking about her physical complaints.”

Answer 3

b. “ I will limit my mother’s clothes choices when she is getting dressed.”

Question 4

A nurse is caring for a client who has depression following a recent job loss. Which of the following questions should the nurse ask to assess the client’s personal coping skills?

a. “ Can you describe how you are feeling currently?”
b. “ How does this situation affect your life?”
c. “ Do you see your current situation affecting your future?”
d. “ How have you dealt with similar situations in the past?”

Answer 4

d. “ How have you dealt with similar situations in the past?”

Question 5

A nurse is performing a Mental Status Examination for a client who has schizophrenia. The nurse should recognize that which of the following actions requires the client to think abstractly?

a. Determine the meaning of a proverb
b. Count by adding sevens consecutively
c. Explain what to do if he misses the bus
d. Name the last three presidents of the United States of America

Answer 5

a. Determine the meaning of a proverb

Question 6

A nurse in a Center Rehab unit is caring for a client who has a traumatic brain injury. To which of the following members of the clients interprofessional team to the nurse prefer the client in order to help him learn how to use eating utensils?

a. Physical therapist
b. Neuro psychiatrist
c. Social worker
d. Occupational therapist

Answer 6

d. Occupational therapist

Question 7

A nurse is leading a grief support group for bereaved clients, which of the following statements should the nurse report to the provider as an indication of clinical depression?

a. “ It’s been a long time before I’m happy again.”
b. “ I don’t feel anything but numbness anymore.”
c. “ I feel like I’m angry at the whole world right now.”
d. “ I don’t know how I could cope if I didn’t have my family’s support.”

Answer 7

b. “ I don’t feel anything but numbness anymore.”

Question 8

A nurse is planning care for a client who has bipolar disorder. The client reports not sleeping for 3 days and is exhibiting a euphoric mood. The nurse should identify which of the following as a priority intervention?

a. Secure a client’s valuable possessions
b. Limit loud noises in a client’s environment
c. Provide high calorie snacks to the client
d. Encourage the client to participate in structured solitary activities

Answer 8

b. Limit loud noises in a client’s environment

Question 9

A nurse is providing teaching for the family of a client who has dementia. Which of the following should the nurse include in the teaching as a contributing factor for the disorder?
a. Alcohol use disorder
b. Dehydration
c. Change in environment-
d. Hypotension

Answer 9

a. Alcohol use disorder

Question 10

A nurse is caring for a client in the emergency department who states that she was beaten and sexually assaulted by her partner. After a rapid assessment, which of the following actions should the nurse take first?

a. Conduct a pregnancy test
b. Offer prophylactic medication to prevent STIs
c. Request a mental health consultation for the client
d. Provide a trained advocate to stay with the client

Answer 10

d. Provide a trained advocate to stay with the client

Question 11

A nurse is caring for a client who has bipolar disorder and is experiencing a manic episode. Which of the following actions should the nurse take?

a. Place a client in a group therapy session
b. Rotate staff members who work with the client
c. Distract the client w increased environmental stimuli
d. Encourage the client to participate in physical activities

Answer 11

d. Encourage the client to participate in physical activities

Question 12

A nurse in a mental health facility is caring for a client. Which of the following actions should the nurse take during the working phase of the nurse client relationship?

a. Summarize his goals and objectives
b. Address confidentiality
c. Promote problem solving skills
d. Establish a participation contract

Answer 12

c. Promote problem solving skills

Question 13

A nurse is reviewing the lab results of an adolescent who has anorexia nervosa. which of the following findings should the nurse expect?

a. Hgb 10 g/dL (anemia)
b. Potassium 3.7 mEq/L
c. Blood glucose 100 mg/dL
d. T4 11 mcg/dL [ 4-12 ]

Answer 13

a. Hgb 10 g/dL (anemia)

Question 14

A nurse in a mental health facility is assessing a client for suicide risk factors using the SAD PERSONS scale. Which of the following findings should indicate a risk for suicide?
a. The client is married
b. The client is female
c. The client is 50 years old
d. The client has diabetes mellitus

Answer 14

d. The client has diabetes mellitus

Question 15

A nurse is counseling an adult client whose parent just died. The client states, “My son is four, and I don’t know how he’ll react when he finds out that his Grandpa died.” The nurse should inform the client that the preschool age child, commonly has which of the following concepts of death?

a. Death is contagious and can cause other people he loves to die
b. Death create an interest in the physical aspects of dying
c. Death is a part of life that eventually happens to everyone
d. Death is not permanent and the loved one may come back to life

Answer 15

d. Death is not permanent and the loved one may come back to life

Question 16

A nurse in a mental health facility is making plans for a client’s discharge. Which of the following interdisciplinary team members should the nurse contact to assist a client with housing placement?

a. Social worker
b. Clinical nurse specialists
c. Occupational therapist
d. Recreational therapist

Answer 16

a. Social worker

Question 17

A nurse is caring for a client who reports that he’s angry with his partner because she thinks he’s just trying to gain attention. When the nurse attempts to talk to the client he becomes angry and tells the nurse to leave. Which of the following defense mechanisms is a client demonstrating?

a. Rationalization
b. Compensation
c. Denial
d. Displacement

Answer 17

d. Displacement

Question 18

A nurse is assessing a client who recently started antidepressant therapy for the treatment of major depressive disorder. Which of the following findings indicates the client is in an increased risk for suicide?

a. Increased energy
b. Unkempt appearance
c. Hypersomnia
d. Psychomotor retardation

Answer 18

a. Increased energy

Question 19

A nurse and a mental health facility is caring for a client who has borderline personality disorder. Which of the following findings should the nurse expect?

a. Self-mutilation
b. Pacing back and forth
c. Disorganized speech
d. Preoccupation with details

Answer 19

a. Self-mutilation

Question 20

A nurse is caring for a client who exhibits excessive compliance passivity and self-denial. The nurse should recognize that these findings are associated with which of the following personality disorders?

a. Dependent
b. Histrionic
c. Paranoid
d. Borderline

Answer 20

a. Dependent

Question 21

A nurse is caring for a group of clients on a mental health unit. For which of the following clients is a nurse considered a mandated reporter to the appropriate agency?

a. A client reports that he enjoy smoking marijuana on weekends
b. A client reports that she took $20 from the cash register and where she works
c. A client who reports lying to his provider about having suicidal ideation
d. A client reports that her partner tied their children to a bed as punishment

Answer 21

d. A client reports that her partner tied their children to a bed as punishment

Question 22

A nurse is creating a plan of care for a client who has major depressive disorder. Which of the following interventions should the nurse include in the plan?

a. Encourage physical activity for the client during the day
b. Keep a bright light on in the client room at night
c. Identify and schedule alternative group activities for the client
d. Discourage the client from expressing feelings of anger

Answer 22

a. Encourage physical activity for the client during the day

Question 23

A nurse is caring for a client who has been taking valproic acid. Which of the following is
an expected outcome of the med?
a. The client has decreased anxiety
b. The client reports improved short-term memory
c. The client reports absence of auditory hallucination
d. The client has decreased euphoric mood

Answer 23

d. The client has decreased euphoric mood

Question 24

An older adult client is brought to the mental health clinic by her daughter. The daughter reports that her mother is not eating and seems uninterested in routine activities. The daughter states, “I am so worried that my mother is depressed.” Which of the following responses should the nurse make?

a. Tell me the reasons you think your mother is depressed
b. You shouldn’t worry about this, because depressive disorder is easily treated c. Everyone gets depressed from time to time
d. Older adults are usually diagnosed with depressive disorder as they age

Answer 24

a. Tell me the reasons you think your mother is depressed

Question 25

A nurse is assessing a client who is experiencing alcohol withdrawal period for which of the following findings should the nurse anticipate administration of lorazepam?

a. Afebrile
b. Bradycardia

c. Hypertension (+ lightheadedness, delirium, seizures, muscle twitching)
i. Tremors, diaphoresis, anxiety, insomnia

d. Stupor
i. Benzodiazepine: prevention and tx of acute withdrawal sx

Answer 25

c. Hypertension

Question 26

A school nurse is caring for an adolescent client whose teacher reports changes in school performance and withdrawal from interaction with classmates. Which of the following interventions is the nurse’s priority at this time?

a. Suggest the client joins a support group
b. Contact the adolescents parents
c. Ask the adolescent if he is considering hurting himself
d. Determine when the adolescents change in behavior began

Answer 26

c. Ask the adolescent if he is considering hurting himself

Question 27

A nurse in a provider’s office is assessing a school-age child who has a spiral fracture. The parent of the child provides different accounts of the cause of the injury. Which of the following actions should the nurse take first?
a. Ask the child how the injury occurred
b. Request that the parent leave the room while interviewing the child
c. Report suspected abuse to Child Protective Services
d. Determine immediate safety needs of the child

Answer 27

b. Request that the parent leave the room while interviewing the child

Question 28

A nurse is obtaining a medical history from a client who is requesting a prescription for bupropion for smoking cessation. Which of the following assessment findings in a client’s history should the nurse report to provider?

a. Recent head injury - risk for seizures
b. Hypothyroidism
c. Hippie infection
d. Knee arthroplasty 1 month ago

Answer 28

a. Recent head injury

Question 29

A nurse is preparing for an interprofessional team meeting regarding client who has major depressive disorder. Which of the following findings obtained during the initial assessment is a priority to report to other disciplines?

a. Significant weight loss
b. Neglected hygiene
c. Psychomotor retardation
d. Problem solving skills

Answer 29

b. Neglected hygiene

Question 29

A nurse is assessing a client who has delirium. Which of the following findings requires immediate intervention by the nurse?
a. Rapid mood swings
b. Inappropriate speech patterns
c. Command hallucinations
d. Impaired memory

Answer 29

c. Command hallucinations

Question 30

A nurse in an outpatient clinic is assessing a client who has anorexia nervosa. Which of the following findings indicates a need for hospitalization?
a. Potassium 3.8
b. HR 56/min
c. Temperature 96.1 F
d. Weight 10% below ideal weight

Answer 30

c. Temperature 96.1 F

Question 31

A nurse is developing a plan of care for a client who has paranoid personality disorder. Which of the following actions should the nurse include in the plan?

a. Provide written information about the client’s treatment plan
b. Monitor the client for splitting behaviors
c. Encourage countertransference when developing the nurse client relationship
d. Isolate the client from social or group interactions

Answer 31

d. Isolate the client from social or group interactions

Question 32

A nurse is caring for a client who has schizophrenia. The client’s employer calls to discuss the client’s condition. Which of the following is appropriate nursing action?

a. Consult the client’s family
b. Contact the facility legal department
c. Contact the provider
d. Consult the client

Answer 32

d. Consult the client

Question 33

A nurse in the emergency department is caring for a client who has serotonin syndrome. The nurse should assess the client for which of the following manifestations?
a. Bradycardia - tachycardia
b. Priapism
c. Paresthesia
d. Hyperpyrexia

Answer 33

d. Hyperpyrexia

Question 34

A nurse in a mental health facility is caring for a client who is being aggressive toward other clients. Which of the following actions is a priority for the nurse to take?

a. Ask the client if he intends to harm others
b. Role model healthy ways to express anger
c. Assist the client to explore techniques to reduce stress
d. Suggest that the client make a list of things that make him angry

Answer 34

a. Ask the client if he intends to harm others

Question 35

A nurse is assisting with obtaining informed consent for a client who has been declared legally incompetent. Which of the following actions should the nurse take?
a. Request of the client’s guardian sign the consent
b. Ask the charge nurse to obtain informed consent
c. Contact the social worker to obtain the consent
d. Explain implied consent to the client’s family

Answer 35

a. Request of the client’s guardian sign the consent

Question 36

A nurse is admitting a client who has a new dx of schizophrenia and history of aggression. Which of the following actions should the nurse include in the client’s initial plan of care?

a. Ignore the clients hallucinations - should assess
b. Agree with the client when he’s upset until he can calm down - never agree
c. Avoid eye contact with the client for the first few days - therapeutic comm
d. Provide a physical exercise activity for the client - distracts the client

Answer 36

d. Provide a physical exercise activity for the client

Question 37

A nurse is observing a newly licensed nurse administer an IM medication to a client who is manic and refuses the medication. Which of the following actions should the nurse take first?
a. Talk to the newly licensed nurse about the incident
b. Call the provider for an alternate medication route
c. Stop the newly licensed nurse from administering the medication
d. Report the occurrence to the nurse manager

Answer 37

c. Stop the newly licensed nurse from administering the medication

Question 38

A nurse is creating a plan of care for a client who has major depressive disorder. Which of the following interventions should the nurse include in the plan?
a. Encourage physical activity for the client during the day - yay endorphins
b. Discourage the client from expressing feelings of anger
c. Keep a bright light on in the client’s room at night
d. Identify and schedule alternate group activities for the client

Answer 38

a. Encourage physical activity for the client during the day

Question 39

A nurse is reviewing the medication administration record of a client who has major depressive disorder and a new prescription for selegiline. The nurse should recognize that which of the following client medications is contraindicated when taking with selegiline?
a. Warfarin
b. Calcium carbonate
c. Acetaminophen
d. Fluoxetine

Answer 39

d. Fluoxetine

Question 40

A nurse is providing teaching to a client who is prescribed methylphenidate for ADHD. Which of the following statements by the client indicates an accurate understanding of this medication’s effects?

a. I know that I will be able to think more clearly now - stimulates CNS
b. I need to tell my doctor if I start gaining weight - weight loss
c. I’ll take my medicine at bedtime because it will make me drowsy
i. Take last dose before 4pm
d. This medicine will help me relax and feel less anxious
i. Used to increase ability to focus, complete tasks, interact w peers and manage impulsivity

Answer 40

a. I know that I will be able to think more clearly now

Question 41

A nurse in a long-term care facility is assessing an older client for depression. Which of the following findings should the nurse expect?
a. Rambling speech
b. Sundowning
c. Rapid mood swings
d. Insomnia

Answer 41

d. Insomnia

Question 42

A nurse is caring for a client who receives Lamotrigine daily for bipolar disorder and reports a rash on his arm. Which of the following actions should the nurse take?
a. Explain that the medication causes of temporary rash
b. Apply hydrocortisone cream on the clients rash
c. Withhold the next dose of the medication
d. Ask the client about a recent change in laundry detergent

Answer 42

c. Withhold the next dose of the medication

Question 43

A nurse is reviewing the lab report of a client who is taking carbamazepine for bipolar disorder. Which of the following lab results should the nurse report to the provider?
a. Urine specific gravity 1.029
b. Platelets 90,000/mm3
c. Urine pH 5.6
d. RBC 4.7/mm3

Answer 43

b. Platelets 90,000/mm3

Question 44

A nurse is providing crisis intervention for a client who was involved in a violent mass casualty situation in the community. Which of the following should the nurse take during the initial session with the client?

a. Identify the client’s usual coping style
b. Tell the client that his life will soon return to normal
c. Encourage the client to display anger toward the cause of the crisis d. Help the client focus on a wide variety of topics regarding the crisis

Answer 44

a. Identify the client’s usual coping style