NUR 220 PSYCHIA POST TEST #1

The family of a schizophrenic client asks the nurse if there is a genetic cause of this
disorder. To answer the family, which fact would the nurse cite? *
2/2

A. Conclusive evidence indicates a specific gene transmits the disorder.

B. Incidence of this disorder is variable in all families.
C. There is a little evidence that genes play a role in transmission.
D. Genetic factors can increase the vulnerability for this disorder.

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Rationale: Research shows that family history statistically increases the risk for development of
schizophrenia.

Which of the following characteristics is expected for a client with paranoid

personality disorder who receives bad news? *
2/2

A. The client is overly dramatic after hearing the facts

B. The client focuses on self to not become over-anxious
C. The client responds from a rational, objective point of view
D. The client doesn’t spend time thinking about the information.

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Rationale: Clients with paranoid personality disorder are affectively restricted, appear unemotional,
and appear rational
and objective.

A client is diagnosed with bipolar disorder and admitted to an inpatient psychiatric

unit. Which is the priority outcome for this client? *
2/2

A. The client will accomplish activities of daily living independently by discharge.

B. The client will verbalize feelings during group sessions by discharge.
C. The client will remain safe throughout hospitalization.
D. The client will use problem solving to cope adequately after discharge.

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Rationale: Bipolar clients are at high – risk for personal injury during the manic phase. Ensuring the
client’s safety is the
initial priority for these clients upon admission.
When planning the care of a client experiencing post – traumatic stress disorder, the
nurse identifies which of the following as an appropriate goal? The client will report:  *
2/2

A. A decrease in hearing voices

B. Spending less time on ritualistic behaviour
C. Having more energy
D. A decrease in flashbacks and nightmares

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Rationale: The target clinical manifestation for a client with PTSD is flashbacks and nightmares. These
are the most
common complaints that clients with PTSD report.

One important issue in therapy for specific phobias is to address: *

2/2

A. Ensure the individual never comes in contact with the phobic event or situation
B. The phobic beliefs that sufferers hold about their phobic event or situation
C. The individual has ample opportunity to talk about the phobic event
D. That any dreams about the phobic event or situation are analyzed

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Rationale: Phobias are intense, illogical beliefs that specific, objects, animals or situations cause fear
and anxiety.

Upon John’s admission for schizophrenia, Nurse Divine documents the following:
Client refuses to bathe or dress, remains in room most of the day, speaks infrequently
to peers or staff. Which nursing diagnosis would be the priority at this time? *
2/2

A. Anxiety
B. Decisional conflict
C. Self-care deficit
D. Social isolation

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Rationale: These behaviors indicate the client’s withdrawal from others and possible fear or mistrust
of relationships.

A client is diagnosed with bipolar disorder: manic phase. Which nursing intervention
would be implemented to achieve the outcome of "Client will gain 2lbs by the end of
the week?" *
2/2
A. Provide client with high-calorie finger foods throughout the day.
B. Accompany client to cafeteria to encourage adequate dietary consumption.
C. Initiate total parenteral nutrition to meet dietary needs.
D. Teach the importance of a varied diet to meet nutritional needs.

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Rationale: Providing high calorie finger foods ensures that a client in mania is able to obtain needed
nutrition. During
mania, individuals rarely have the focus to consume a full meal. Small, frequent feedings are therefore
the best option.

A newly admitted client is diagnosed with post – traumatic stress disorder. Which
behavioral symptom would the nurse expect to assess? *
2/2

A. Recurrent, distressing flashbacks

B. Intense fear, helplessness and horror
C. Diminished participation in significant activities
D. Detachment or estrangement from others

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Rationale: Diminished participation in significant activities is a behavioral symptom of PTSD.

Recurrent, distressing
flashbacks are emotional symptoms of PTSD. Intense fear, helplessness and horror are cognitive
symptoms while
detachment or estrangement from other is an interpersonal symptom.

All of the following are re-experiencing symptoms in PTSD EXCEPT:

2/2

A. Nightmares
B. Difficulty Sleeping
C. Frightening Thoughts
D. Flashbacks

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Rationale: Difficulty Sleeping is an arousal and reactivity symptom.

A group of community nurses sees and plans care for various clients with different
types of problems. Which of the following clients would they consider the most
vulnerable to post-traumatic stress disorder? *
2/2

A. An 8 year-old boy with asthma who has recently failed a grade in school
B. A 20 year-old college student with DM who experienced date rape
C. A 40 year-old widower who has recently lost his wife to cancer
D. A wife of an individual with a severe substance abuse problem

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Rationale: Post-traumatic stress disorder is caused by the the experience of severe, specific trauma.
Rape is a severely
traumatic event. Although the situations in options A, C, and D are certainly stressful, they are not at
the level of severe
trauma.

A patient diagnosed with bipolar disorder is dressed in a red leotard & brightly colored
scarves. The patient says, "I'll punch you, munch you, crunch you" while twirling &
shadowboxing. Then the patient says gaily, do you like my scarves? Here, they are my
gift to you. How should the nurse document the patient’s mood?
2/2

A. Labile and euphoric

B. Irritable and belligerent
C. Highly suspicious and arrogant
D. Excessively happy and confident

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Rationale: The patient has demonstrated angry behavior & pleasant, happy behavior within seconds of
each other.
Excessive happiness indicates euphoria. Mood swings are often rapid & seemingly without
understandable reason in
patients who are manic. These swings are documented as labile. Irritability, belligerence, excessive
happiness &
confidence are not entirely correct terms for the patient's mood. A high level of suspicion is not
evident.

A nurse notices other clients on the unit avoiding a client diagnosed with antisocial
personality disorder. When discussing appropriate behavior in group therapy, which of
the following comments is expected about this client by his peers? *
2/2

A. Lack of honesty
B. Belief in superstitions
C. Show of temper tantrums
D. Constant need for attention

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Rationale: Clients with antisocial personality disorder tend to engage in acts of dishonesty as shown
by lying.
The parents of Alexa, a child with attention deficit hyperactivity disorder, tell the nurse
they have tried everything to calm their child and nothing has worked. Which action by
the nurse is most appropriate initially? *
2/2

A. Actively listen to the parents’ concern before planning interventions.

B. Encourage the parents to discuss these issues with the mental health team.
C. Provide literature regarding the disorder and its management.
D. Tell the parents they are overacting to the problem.

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Rationale: The nurse would encourage parents to fully discuss and describe their perception of the
problem in order to
assess the family system before determining appropriate interventions.

Boy, a fruit vendor who lost his wife in a vehicular accident while they were on their
way home in a vehicular accident two weeks appears so fearful and severely anxious
is likely to be diagnosed with: *
2/2

A. Acute Stress Disorder

B. Post-Traumatic Stress Disorder
C. Adjustment disorder
D. None of the above

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Rationale: A client with ASD develops of severe anxiety, dissociative, and other symptoms that occurs
within one month
after exposure to an extreme traumatic stressor

A client experiencing a panic attack would display which physical symptom? *

2/2

A. Fear of dying
B. Depersonalization
C. Palpitations and abdominal distress
D. Restlessness and pacing

Feedback

Rationale: Palpitations and abdominal distress are physical symptoms of a panic attack. Fear of dying
is an affective not a
physical symptom. Depersonalization is an alteration in perception or experience so that one feels
temporarily lost.
Restlessness and pacing are behavioural symptoms.