Quiz #4 Practice Questions

Question 1

1. Which female patient should the nurse recognize as having
   the highest risk to have or develop bulimia nervosa? The one who:
   a. Grew up in an underserved area
   b. Lives in a society influenced by Eastern cultural beliefs
   c. Is 20 years old
   d. Is Asian Canadian

Answer 1

c. Is 20 years old

Question 2

2. The nurse is caring for a 16-year-old female patient with
   anorexia nervosa. What should the initial nursing intervention be upon the patient’s admission to the unit?
   a. Build a therapeutic relationship.
   b. Increase the patient’s caloric consumption.
   c. Involve the patient in group therapy to build a support
   group.
   d. Self-assess to decrease tendencies toward authoritarianism.

Answer 2

d. Self-assess to decrease tendencies toward authoritarianism.

Question 3

3. The nurse is caring for a patient with bulimia. Which nursing
   intervention is appropriate?
   a. Monitor patient on bathroom trips after eating.
   b. Allow patient extensive private time with family members.
   c. Provide meals whenever the patient requests them.
   d. Encourage patient to select foods that she or he likes.

Answer 3

a. Monitor patient on bathroom trips after eating.

Question 4

4. The nurse is admitting a patient who weighs 45 kilograms,
   is 167 centimetres tall, and is below ideal body weight. The
   patient’s blood pressure is 130/80 mm Hg, pulse is 72 beats
   per minute, potassium is 2.5 mmol/L, and ECG is abnormal.
   Her teeth enamel is eroded, her hands are visibly shaking,
   and her parotid gland is enlarged. The patient states, “I am
   really worked up about coming to this unit.” What is the
   priority nursing diagnosis?
   a. Powerlessness
   b. Risk for injury
   c. Imbalanced nutrition: Less than body requirements
   d. Anxiety

Answer 4

b. Risk for injury

Question 5

5. The nurse is planning care for a patient with an eating disorder.
   What outcomes are appropriate? Select all that apply.
   a. The patient will experience a decrease in depression.
   b. The patient will identify four methods to control anxiety.
   c. The patient will collect different kinds of cookbooks.
   d. The patient will identify two people to contact if suicidal
   thoughts occur.

Answer 5

a. The patient will experience a decrease in depression.
b. The patient will identify four methods to control anxiety.
d. The patient will identify two people to contact if suicidal
thoughts occur.

Question 6

6. What patient statement acknowledges the characteristic
   behaviour associated with a diagnosis of pica?
   a. “Nothing could make me drink milk.”
   b. “I’m ashamed of it, but I eat my hair.”
   c. “I haven’t eaten a green vegetable since I was 3 years old.”
   d. “I regurgitate and re-chew my food after almost every meal.”

Answer 6

b. “I’m ashamed of it, but I eat my hair.”

Question 7

A 73-year-old woman with pneumonia becomes agitated after
being admitted to the intensive care unit through the emergency department. She continually tries to leave her bed despite
being too weak to walk. Her vital signs are erratic, and her
thinking seems disorganized. During her first 24 hours in
ICU, the patient varies from somnolent to agitated, and from
laughing to angry. Her daughter reports that the patient “was
never like this at home.” What is the most likely explanation for the situation?
a. Pneumonia has worsened the patient’s early-stage dementia.
b. The patient is experiencing delirium secondary to the
pneumonia.
c. The patient is sundowning due to the decreased stimulation of the intensive care unit.
d. The patient does not want to be in the hospital and is angry that staff will not let her leave.

Answer 7

b. The patient is experiencing delirium secondary to the
pneumonia.

Question 8

2. Interventions appropriate for a hospitalized patient experiencing delirium include which of the following? Select all that apply.
   a. Immediately placing the patient in restraints if she begins to hallucinate or act in an irrational or unsafe manner
   b. Ensuring that a clock and a sign indicating the day and date is displayed where the patient can see it easily
   c. Being prepared for possible hostile responses to efforts to take vital signs or provide direct physical care
   d. Preventing sensory deprivation by placing the patient near
   the nurses’ station and leaving the television and multiple lights turned on 24 hours per day
   e. Speaking with the patient frequently for short periods for
   reassurance, assisting the patient in remaining oriented, and ensuring the patient’s safety
   f. Anticipating that the patient may try to leave if agitated, and providing a secure environment with direct observation to prevent wandering
   g. Promoting normalized sleep patterns by encouraging the patient to remain awake during the day and facilitating rest at night

Answer 8

b. Ensuring that a clock and a sign indicating the day and date is displayed where the patient can see it easily
c. Being prepared for possible hostile responses to efforts to take vital signs or provide direct physical care
e. Speaking with the patient frequently for short periods for
reassurance, assisting the patient in remaining oriented, and ensuring the patient’s safety
f. Anticipating that the patient may try to leave if agitated, and providing a secure environment with direct observation to prevent wandering
g. Promoting normalized sleep patterns by encouraging the patient to remain awake during the day and facilitating rest at night

Question 9

3. Which statement about dementia is accurate?
   a. The majority of people over age 85 are affected by dementia.
   b. Disorientation is the dominant and most disruptive
   symptom of dementia.
   c. People with dementia tend to be distressed by it and
   complain about its symptoms.
   d. Hypertension, diminished activity levels, and head injury
   increase the risk for dementia.

Answer 9

d. Hypertension, diminished activity levels, and head injury
increase the risk for dementia.

Question 10

4. Mrs. Smythe dies at the age of 82. In the 2 months following
   her death, her husband, age 84 and in good health, has begun
   to pay less attention to his hygiene and seems less aware of
   his surroundings. He complains of difficulty concentrating
   and sleeping and reports that he lacks energy. His family
   sometimes has to remind and encourage him to shower, take
   his medications, and eat, all of which he then does. Which response is most appropriate?
   a. Arrange for an appointment with a therapist for evaluation and treatment of suspected depression.
   b. Reorient Mr. Smythe by pointing out the day and date each time you interact with him.
   c. Meet with family and support persons to help them accept, anticipate, and prepare for the progression of his stage 2 dementia.
   d. Avoid touch and proximity, which are likely to be uncomfortable for Mr. Smythe and may provoke aggression when he is disoriented.

Answer 10

a. Arrange for an appointment with a therapist for evaluation and treatment of suspected depression.

Question 11

5. Which of the following interventions would be beneficial for
   those caring for a loved one with Alzheimer’s disease? Select
   all that apply.
   a. Guide the family to restrict the patient’s driving as soon
   as signs of forgetfulness are exhibited.
   b. Recommend switching to hospital-type gowns to facilitate bathing, dressing, and other physical care of the patient.
   c. Discourage wandering by installing complex locks or locks
   placed at the tops of doors, where the patient cannot readily reach them.
   d. For situations in which the patient becomes upset, teach loved ones to listen briefly, provide support, and then change the topic.
   e. Encourage caregivers to care for themselves, as well as the
   patient, via use of support resources such as adult day care or respite care.
   f. If the patient is prone to wander away, encourage family to notify police and neighbours of the patient’s condition, wandering behaviour, and description.

Answer 11

c. Discourage wandering by installing complex locks or locks
placed at the tops of doors, where the patient cannot readily reach them.
d. For situations in which the patient becomes upset, teach loved ones to listen briefly, provide support, and then change the topic.
e. Encourage caregivers to care for themselves, as well as the
patient, via use of support resources such as adult day care or respite care.
f. If the patient is prone to wander away, encourage family to notify police and neighbours of the patient’s condition, wandering behaviour, and description.

Question 12

1. Addiction is best explained as
   a. Occurring with games of chance such as roulette or poker
   b. A chronic brain disease
   c. A biopsychosocial phenomenon
   d. The domain of neurobiologists

Answer 12

c. A biopsychosocial phenomenon

Question 13

2. The nurse is caring for a patient with an addictive disorder
   who is currently drug-free. The patient is experiencing repeated
   occurrences of vivid, frightening images and thoughts. Which
   term would the nurse use to document this finding?
   a. Tolerance
   b. Flashbacks
   c. Withdrawal
   d. Physical dependency

Answer 13

b. Flashbacks

Question 14

3. The condition most concerning for the nurse who is caring
   for a patient who abuses alcohol would be
   a. Cirrhosis of the liver
   b. Suicidal potential
   c. Wernicke’s encephalopathy
   d. Korsakoff’s syndrome

Answer 14

b. Suicidal potential

Question 15

4. Which patient response to the question “Have you ever drunk
   more alcohol or used more drugs than you meant to?” should
   immediately cause the nurse to assess further?
   a. “No, I have never used drugs or alcohol.”
   b. “I have drunk alcohol before but have never let myself get
   drunk.”
   c. “I figured you’d ask me about that.”
   d. “Yes, I did that once and will never do it again.”

Answer 15

c. “I figured you’d ask me about that.”

Question 16

5. Which patient behaviours should the nurse suspect as being
   related to alcohol withdrawal?
   a. Hyperalert state, jerky movements, easily startled
   b. Tachycardia, diaphoresis, elevated blood pressure
   c. Peripheral vascular collapse, electrolyte imbalance
   d. Paranoid delusions, fever, fluctuating levels of consciousness

Answer 16

a. Hyperalert state, jerky movements, easily startled

Question 17

6. A patient at your community mental health centre smokes
   up to a half a pack of cigarettes daily but has tried, with
   limited success, to cut back over the past 2 weeks. Today he
   asked the pharmacist about the various products that could
   aid his attempts to quit smoking in time for him to manage
   a long overseas flight next month and travel with friends who
   are allergic to smoke. What phase of change is this patient
   demonstrating?
   a. Precontemplation
   b. Contemplation
   c. Preparation
   d. Action

Answer 17

c. Preparation

Question 18

1. The nurse is assessing a teenage patient for suicidal risk. Which
   patient response requires immediate further nursing
   assessment?
   a. “The idea of death really scares me.”
   b. “I smoked only one time in my life.”
   c. “My mom keeps a bunch of pills in her nightstand.”
   d. “I’ve never tried to kill myself before.”

Answer 18

c. “My mom keeps a bunch of pills in her nightstand.”

Question 19

2. The nurse meets with the parents of a child diagnosed with
   conduct disorder. What advice from the nurse is most
   appropriate?
   a. “Use time out as a way to control any unacceptable
   behaviour.”
   b. “Ignore his head banging. He is just trying to get
   attention.”
   c. “Allow the child to come up with a list of play
   activities.”
   d. “Encourage the child to talk when he is around others.”

Answer 19

a. “Use time out as a way to control any unacceptable
behaviour.”

Question 20

3. The nurse is caring for a 9-year-old patient who will be entering
   a freedom room. Which activity should the nurse anticipate
   the child would engage in?
   a. Listening to a CD
   b. Throwing pillows
   c. Sitting in the periphery of the room
   d. Punching soft objects

Answer 20

a. Listening to a CD

Question 21

4. A 7-year-old male who has not met earlier normal expectations
   in cognitive and language development and who has difficulty
   establishing friendships with other schoolchildren develops
   a fascination with the water fountain in his neighbourhood.
   Which condition should the nurse anticipate?
   a. Intellectual developmental disorder
   b. Major depressive disorder
   c. Tourette’s disorder
   d. Autism spectrum disorder

Answer 21

d. Autism spectrum disorder

Question 22

5. The school nurse is assessing Than, who has been coming to
   the office over the past week with cuts and bruises for treatment. What must the nurse include in his assessment?
   a. Assess for suicidal ideation
   b. Offer professional advice about his reasons for the visits
   c. Question Than directly about bullying
   d. Anticipate the need for an anti-anxiety agent

Answer 22

d. Autism spectrum disorder

Question 23

1. The nurse is caring for an older adult patient. Which symptom
   should the nurse recognize as a normal part of aging?
   a. Depression
   b. Memory loss
   c. Situational grieving
   d. Dementia

Answer 23

c. Situational grieving

Question 24

The nurse is caring for an older adult patient with depression.
Which nursing response is appropriate when the patient’s
daughter asks, “Will he ever stop acting like this?”
a. “I’m sorry, your father will likely be in this state from now
on.”
b. “Although older adults have a high incidence of depression,
it is treatable and your father will improve on the
antidepressants.”
c. “Depression is caused by infections or electrolyte imbalances, and the damage is permanent.”
d. “A benzodiazepine will help alleviate the depression.”

Answer 24

b. “Although older adults have a high incidence of depression,
it is treatable and your father will improve on the
antidepressants.”

Question 25

The nurse is caring for an older adult patient with pain. What
is one myth about pain held by health care providers?
a. Pain is an inevitable part of aging.
b. Older adults may understate their pain using words such
as discomfort, hurting, or aching.
c. Dementia and depression can add to the difficulty of
obtaining an accurate pain assessment.
d. An interview with family members, caregivers, or friends
is vital.

Answer 25

a. Pain is an inevitable part of aging.

Question 26

An older adult patient experiencing pain states that she is
going to use kava kava, which she has heard provides pain
relief. Which nursing response is appropriate?
a. “Kava kava is an appropriate herb to use for pain relief.”
b. “Older adults should not use herbal preparations.”
c. “Willow bark would be a better herbal supplement to use.”
d. “Are you using any other treatments for pain relief?”

Answer 26

d. “Are you using any other treatments for pain relief?”

Question 27

Which statement demonstrates that a parent understands the diagnosis of attention deficit-hyperactivity disorder?
A. “My child will never be able to graduate or go to college but may be able to learn a vocational skill.”
B. “My child’s performance will improve in a structured setting that provides rewards for appropriate behaviour.”
C. “Nothing is wrong with my child. The school hasn’t provided qualified teachers and classroom settings.”
D. “My child is just going through a stage. This problem will go away with time.”

Question 28

The mother of a 6-year-old child
expresses concern over the
child’s frequent temper outbursts.
The child deals with any
frustration by bullying and hitting,
and seldom shows any remorse.
The nurse who gathers these
data will note that the child’s
behaviours are most consistent
with which DSM-5 diagnosis?
a) Social phobia
b) Conduct disorder
c) Oppositional defiant disorder
d) ADHD

Question 29

A nursing diagnosis that
should be considered for
a child diagnosed with
conduct disorder who
shows no capacity for
empathy would be which
of the following?
a) Fear
b) Anxiety
c) Impaired social
interaction
d) Risk for self-mutilation

Question 30

Which statement is true
about the characteristics of a
child with oppositional
defiant disorder?
a) The defiance is
generally directed
towards parents and
siblings
b) These behaviours are a
predicter of future
mental health disorders
c) Arguing tends to be
more prevalent in boys
d) Girls display more
blaming than boys do

Question 31

The mother of a 3-year-old boy recently
diagnosed with autism spectrum
disorder is tearful and states, “Dr.
Cohen said we need to start therapy
right away. I just don’t understand how
helpful it will be—he’s only 3 years old!”
Which is the most therapeutic statement
made by the nurse?
a) “You are right, 3 years old is very young
to start therapy, but it will make you feel
better to be doing something.”
b) ”Starting him on treatment now gives
Taylor a much greater chance for a
productive life.” Correct
c) “If Taylor starts therapy now, he will be
able to stop therapy sooner.”
d) “If you have questions, it’s best to ask
Dr. Cohen.”

Question 32

The nurse has made the following
diagnosis for a newly admitted
patient, Impaired social
relationships due to attention
deficit-hyperactivity disorder
(ADHD).” What has the nurse
determined about the signs and
symptoms related to this
disorder?
a) Inattention occurs in times of
severe stress.
b) Hyperactivity occurs in
supervised clinical
observations.
c) The patient has symptoms
both at home and at
school. Correct
d) Impulsivity has resulted in
repeated injuries.

Question 33

A 7-year-old who is
described as impulsive and
hyperactive tells the nurse, “I
am a dummy because I don’t
pay attention, and I can’t
read like the other kids.” The
nurse notes that these
behaviours are most
consistent with which DSM-
5 diagnosis?
a) Attention deficit disorder
b) Attention deficit-
hyperactivity disorder
c) Autism
d) Conduct disorder

Question 34

An adolescent female is brought to the school
nurse after fainting during gym class. She is
grossly underweight, wears baggy clothes, and
has dry skin. She complains of feeling cold
despite wearing two sweaters. To further assess
for an eating disorder, the nurse should ask
which of the following questions?
A. “Do you ever experience lost time?”
B. “When was your last menstrual period?”
C. “Do you often wear heavy clothing in warm weather?”
D. “How long does it take you to fall asleep at night?”

Question 35

In contrast to the patient
diagnosed with anorexia
nervosa, which of the
following is usually true for
the patient diagnosed with
bulimia?
a) Increased levels of anxiety
b) Deceased awareness of
eating disorder
c) Higher risk for electrolyte
imbalances
d) Decreased risk of
substance dependency

Question 36

When can the nurse determine
that inpatient treatment for a
patient diagnosed with an
eating disorder would be
warranted?
a) When the patient weighs
10% below ideal body
weight
b) When the patient has a
serum potassium level of 3
mEq/Lor greater
c) When the patient has a
heart rate less than 60
beats/min
d) When the patient has
systolic pressure less than
70 mmHg

Question 37

Which of the following
would be a focus for the
acute phase of treatment
for anorexia nervosa?
a) Weight restoration
b) Improving interpersonal
skills
c) Learning effective
coping methods
d) Changing family
interaction patterns

Question 38

Which assessment question
should be asked of a patient
suspected of demonstrating
characteristics of anorexia ?
a) Did you find yourself
feeling hungry?
b) How would you describe
your body?
c) How often do you force
yourself to vomit?
d) Why do you choose to
take laxatives?

Question 39

Assessment of a patient
suspected of experiencing
bulimia nervosa requires
the nurse to perform which
of the following?
a) A range of motion
assessment
b) Inspection of body
cavities
c) Inspection of the oral
cavity
d) Body fat analysis

Question 40

The nurse is caring for a patient
with bulimia nervosa. Which
statement indicates that the
patient continues to use denial
during the assessment
interview?
a) I eat three meals each day
and purge every evening.
b) I am concerned about what
others think about me
binging and purging
c) I feel as though my earing
and purging are out of
control
d) When I eat, I feel calm, but
then I realize I have to make
myself vomit or gain weight

Question 41

An 80-year-old who has difficulty walking because
of shortness of breath secondary to COPD says,
“everyday is a struggle when you get old. No one
cares about old people.” Select the nurse’s best
response.
A. “Rest periods are important. Don’t try to overexert yourself.”
B. “It sounds like you’re having a difficult time. Tell me about
it.”
C. “Let’s not focus on the negative. Tell me something good.”
D. “You are still able to get around, and your mind is alert.”

Question 42

An older adult patient tells the
nurse that ‘I prefer not to
attend senior citizens meeting
because they are all old
people who talk and talk and
talk but never take action.’
What can the nurse conclude
from this assessment finding?
a) He may be exhibiting
ageism
b) He may be somewhat
paranoid in his thinking
c) He may be projecting his
own weaknesses onto
others
d) He may be hypercritical of
his peers’ age-appropriate
behaviours

Question 43

In performing quality assurance
surveys of health education
received by older adult patients, the
nurse is most likely to find which of
the following about older adults?
a) They received considerably less
information about older adults?
b) They received maximal
evaluation and treatment for
acute illness
c) They waste resources that are
available for the population at
large
d) They are too pessimistic to seek
out and use community
resources

Question 44

When considering suitable patients
for inclusion in a day treatment
program, which is the most
appropriate patient?
a) One who is forgetful and
withdrawn and sits starting out
the window most of the day
b) One who is confused and
cognitively impaired, but
interest in activities
c) One who is angry and hostile
toward other patients and
stays by himself to watch TV
d) One who is alert and oriented ,
interest in others, and slowly
rehabilitating a right-sided
paralysis

Question 45

A patient has been a resident of the
long-term care centre for 6 weeks,
has been able to bathe with minimal
assistance, feed herself, and
ambulate short distances. Today,
she tells the nurse “you bathe me.”
When the nurse asks why the
resident is making this request, she
states, “I don’t do that anymore. The
nursing assistant say it is faster to
take care of me.” The nurse can
assess this as which of the
following?
a) Learned helplessness
b) Lack of cooperation
c) Continuing independence
d) Striving for autonomy

Question 46

When visited by the community health
nurse, a patient who recently lost his
wife is found disheveled and wearing
dirty clothing. An empty vodka bottle is
among the trash littering the home. The
patient tells the nurse he has nothing to
do with his time now that he is alone so
he has ‘several’ cocktails daily, Which
intervention would be most helpful?
a) Arrange for a mental health
consultation to screen for alcoholism
b) Remind the patient to limit his
drinking because alcoholism can
develop insidiously
c) Suggest that the patient is unwise to
drink alone, which will make him
more depressed
d) Accompany the patient to a meeting
for residents with drinking problems
held at the community centre

Question 47

What is the most therapeutic
way the nurse can ask an
older adult about suicidal
ideation?
a) You have lost a lot of your
friends, do you think about
joining them?
b) It must be very lonely after
your wife died, do you think
about escaping the
loneliness?
c) Have you ever thought
about killing yourself?
d) Have you imagined what it
would be like if you were
not here?