Download NURS 302 Final Questions And Answers: A Comprehensive Guide to Psychiatric Nursing and more Exams Nursing in PDF only on Docsity!
NURS 302 Final Questions And Answers
With Complete Solutions
- A child has been diagnosed with autistic spectrum disorder. The distraught mother cries out, "I'm such a terrible mother. What did I do to cause this?" Which nursing response is most appropriate?
- "Researchers really don't know what causes autistic spectrum disorder, but the relationship between autistic disorder and fetal alcohol syndrome is being explored."
- "Poor parenting doesn't cause autistic spectrum disorder. Research has shown that abnormalities in brain structure or function are to blame. This is beyond your control."
- "Research has shown that the mother appears to play a greater role in the development of autistic spectrum disorder than the father."
- "Lack of early infant bonding with the mother has shown to be a cause of autistic spectrum disorder. Did you breastfeed or bottle-feed?" correct answer: 2
- In planning care for a child diagnosed with autistic spectrum disorder, which would be a realistic client outcome?
- The client will communicate all needs verbally by discharge.
- The client will participate with peers in a team sport by day four.
- The client will establish trust with at least one caregiver by day five.
- The client will perform most self-care tasks independently. correct answer: 3
- After an adolescent diagnosed with attention deficit- hyperactivity disorder (ADHD) begins methylphenidate (Ritalin) therapy, a nurse notes that the adolescent loses 10 pounds in a 2-month period. What is the best explanation for this weight loss?
- The pharmacological action of Ritalin causes a decrease in appetite.
- Hyperactivity seen in ADHD causes increased caloric expenditure.
- Side effects of Ritalin cause nausea, and, therefore, caloric intake is decreased.
- Increased ability to concentrate allows the client to focus on activities rather than food. correct answer: 1
- A nurse assesses an adolescent client diagnosed with conduct disorder who, at the age of 8, was sentenced to juvenile detention. How should the nurse interpret this assessment data?
- Childhood-onset conduct disorder is more severe than the adolescent-onset type, and these individuals likely develop antisocial personality disorder in adulthood.
- Childhood-onset conduct disorder is caused by a difficult temperament, and the child is likely to outgrow these behaviors by adulthood.
- Childhood-onset conduct disorder is diagnosed only when behaviors emerge before the age of 5, and, therefore, improvement is likely.
- Childhood-onset conduct disorder has no treatment or cure, and children diagnosed with this disorder are likely to develop progressive oppositional defiant disorder. correct answer: 1
- Reinforcing positive actions to encourage repetition of desirable behaviors
- Providing opportunities to learn appropriate peer interactions
- Administering psychotropic medications to improve quality of life correct answer: 2
- A child diagnosed with severe autistic spectrum disorder has the nursing diagnosis disturbed personal identity. Which outcome would best address this client diagnosis?
- The client will name own body parts as separate from others by day five.
- The client will establish a means of communicating personal needs by discharge.
- The client will initiate social interactions with caregivers by day four.
- The client will not harm self or others by discharge. correct answer: 1
- A nursing instructor presents a case study in which a three- year-old child is in constant motion and is unable to sit still during story time. She asks a student to evaluate this child's behavior. Which student response indicates an appropriate evaluation of the situation?
- "This child's behavior must be evaluated according to developmental norms."
- "This child has symptoms of attention deficit-hyperactivity disorder."
- "This child has symptoms of the early stages of autistic disorder."
- "This child's behavior indicates possible symptoms of oppositional defiant disorder." correct answer: 1
- A physician orders methylphenidate (Ritalin) for a child diagnosed with ADHD. Which information about this medication should the nurse provide to the parents?
- If one dose of Ritalin is missed, double the next dose.
- Administer Ritalin to the child after breakfast.
- Administer Ritalin to the child just prior to bedtime.
- A side effect of Ritalin is decreased ability to learn. correct answer: 2
- Which should be the priority nursing intervention when caring for a child diagnosed with conduct disorder?
- Modify environment to decrease stimulation and provide opportunities for quiet reflection.
- Convey unconditional acceptance and positive regard.
- Recognize escalating aggressive behavior and intervene before violence occurs.
- Provide immediate positive feedback for appropriate behaviors correct answer: 3
- A mother questions the decreased effectiveness of methylphenidate (Ritalin), prescribed for her child's ADHD. Which nursing response best addresses the mother's concern?
- "The physician will probably switch from Ritalin to a central nervous system stimulant."
- "The physician may prescribe an antihistamine with the Ritalin to improve effectiveness."
- "Your child has probably developed a tolerance to Ritalin and may need a higher dosage."
- "Your child has developed sensitivity to Ritalin and may be exhibiting an allergy." correct answer: 3
An inpatient client is newly diagnosed with dissociative identity disorder (DID) stemming from severe childhood sexual abuse. Which nursing intervention takes priority? correct answer: Establish trust and rapport A client is diagnosed with illness anxiety disorder. Which of the following symptoms is the client most likely to exhibit? Select all that apply. correct answer: Disabling fear of having a serious illness Obsessive-compulsive traits Depression A client is diagnosed with dissociative identity disorder (DID). What is the primary goal of therapy for this client? correct answer: To collaborate among subpersonalities to improve functioning A nursing instructor is teaching students about clients diagnosed with histrionic personality disorder and the quality of their relationships. Which student statement indicates that learning has occurred? correct answer: "Their interpersonal relationships tend to be shallow and fleeting, serving their dependency needs." The family of a client diagnosed with conversion disorder asks the nurse, "Will his paralysis ever go away?" Which of these responses by the nurse is evidence-based? correct answer: "Most symptoms of conversion disorder resolve within a few weeks."
Which should the nurse recognize as an example of localized amnesia? correct answer: A client cannot remember events surrounding a fatal car accident. A nurse is working with a client diagnosed with somatic symptom disorder. What predominant symptoms should a nurse expect to assess? correct answer: Disproportionate and persistent thoughts about the seriousness of one's symptoms A nurse tells a client that the nursing staff will start alternating weekend shifts. Which response should a nurse identify as characteristic of clients diagnosed with obsessive-compulsive personality disorder? correct answer: "You can't make these kinds of changes! Isn't there a rule that governs this decision?" When a client on an acute care psychiatric unit demonstrates behaviors and verbalizations indicating a lack of guilt feelings, which nursing intervention would help the client to meet desired outcomes? correct answer: Provide external limits on client behavior. Which reaction to a compliment from another client should a nurse identify as a typical response from a client diagnosed with avoidant personality disorder? correct answer: Being grateful for the compliment but fearing later rejection and humiliation Looking at a slightly bleeding paper cut, the client screams, "Somebody help me, quick! I'm bleeding. Call 911!" A nurse should identify this behavior as characteristic of which personality disorder? correct answer: Histrionic personality disorder
asks, describe what you think about your present weight and how you look. Which response by the patient is most consistent with the diagnosis? correct answer: I am fat and ugly. Outpatient treatment is planned for a patient diagnosed with anorexia nervosa. Select the most important outcome related to the nursing diagnosis: Imbalanced nutrition: less than body requirements. Within 1 week, the patient will: correct answer: gain 1 to 2 pounds. Which nursing intervention has priority as a patient diagnosed with anorexia nervosa begins to gain weight? correct answer: Observe for adverse effects of re-feeding The nursing care plan for a patient diagnosed with anorexia nervosa includes the intervention Monitor for complications of re-feeding. Which body system should a nurse closely monitor for dysfunction? correct answer: Cardiovascular A nursing diagnosis for a patient diagnosed with bulimia nervosa is: Ineffective coping, related to feelings of loneliness as evidenced by overeating to comfort self, followed by self- induced vomiting. The best outcome related to this diagnosis is, within 2 weeks the patient will: correct answer: identify two alternative methods of coping with loneliness. While providing health teaching for a patient diagnosed with bulimia nervosa, a nurse should emphasize information about correct answer: recognizing symptoms of hypokalemia.
As a patient admitted to the eating disorders unit undresses, a nurse observes that the patient's body is covered by fine, downy hair. The patient weighs 70 pounds and is 5 feet, 4 inches tall. Which condition should be documented? correct answer: Lanugo Physical assessment of a patient diagnosed with bulimia nervosa often reveals correct answer: prominent parotid glands. Which personality characteristic is a nurse most likely to assess in a patient diagnosed with anorexia nervosa? correct answer: Rigidity, perfectionism Which statement is a nurse most likely to hear from a patient diagnosed with anorexia nervosa? correct answer: I would be happy if I could lose 20 more pounds. A patient diagnosed with anorexia nervosa has a body mass index (BMI) of 14.8 kg/m2. Which assessment finding is most likely to accompany this value? correct answer: Cachexia A nurse is assessing a client diagnosed with schizophrenia. The nurse asks the client, "Do you receive special messages from certain sources, such as the television or radio?" Which potential symptom of this disorder is the nurse assessing? correct answer: Delusions of reference A client diagnosed with bipolar disorder: depressive episode intentionally overdoses on sertraline (Zoloft). Family reports that the client has experienced anorexia, insomnia, and recent
Increased temperature Pulmonary crackle When assessing a patient diagnosed with schizophrenia, which of the following will the healthcare provider identify as a negative symptom? correct answer: Anhedonia The client hears the word "match." The client replies, "A match. I like matches. They are the light of the world. God will light the world. Let your light so shine." Which communication pattern does the nurse identify? correct answer: Loose association A nurse begins the intake assessment of a client diagnosed with bipolar I disorder. The client shouts, "You can't do this to me. Do you know who I am?" Which is the priority nursing action in this situation? correct answer: To provide self and client with a safe environment The healthcare provider is teaching a group of students about the biological basis of schizophrenia. Which of the following will be included in the teaching? Select all that apply. correct answer: Increased dopamine levels Decreased norepinephrine levels Family history of schizophrenia Prenatal exposure to influenza GABAergic interneuron dysregulation A client diagnosed with schizophrenia tells a nurse, "The 'Shopatouliens' took my shoes out of my room last night." Which is an appropriate charting entry to describe this client's
statement? correct answer: The client is expressing a neologism." A nursing instructor is teaching about the prevalence of bipolar disorder. Which student statement indicates that learning has occurred? correct answer: This disorder is more prevalent in the higher socioeconomic groups." Parents ask a nurse how they should reply when their child, diagnosed with schizophrenia, tells them that voices command him to harm others. Which is the appropriate nursing reply? correct answer: "Focus on the feelings generated by the hallucinations and present reality." What is the main difference between an individual diagnosed with bipolar I and bipolar II? correct answer: An individual diagnosed with bipolar II has never had a manic episode. An individual diagnosed with bipolar I disorder has had at least one manic episode. What tool should a nurse use to differentiate occasional spontaneous behaviors of children from behaviors associated with bipolar disorder? correct answer: FIND" tool An elderly client diagnosed with schizophrenia takes an antipsychotic and a beta-adrenergic blocking agent (propranolol) for hypertension. Understanding the combined side effects of these drugs, the nurse would most appropriately make which statement? correct answer: "Rise slowly when you change position from lying to sitting or sitting to standing."
with this diagnosis? Select all that apply. correct answer: Insomnia Anorexia Hypersomnia Emergency medical personnel bring a patient to the emergency department. The patient reports overdosing on sertraline (Paxil) in a suicide attempt. Which of these would the healthcare provider identify as consistent with serotonin syndrome? Select all that apply. correct answer: Diaphoresis Gastrointestinal distress Muscle rigidity Tachycardia A nurse is planning care for a child who is experiencing depression. Which medication is approved by the U.S. Food and Drug Administration (FDA) for the treatment of depression in children and adolescents? correct answer: Fluoxetine (Prozac) An isolative client was admitted 4 days ago with a diagnosis of major depressive disorder. Which nursing statement would best motivate this client to attend a therapeutic group being held in the milieu? correct answer: "I'll walk with you to the day room. Group is about to start." A client who is diagnosed with major depressive disorder asks the nurse what causes depression. Which of these is the most accurate response? correct answer: The exact cause of depressive disorders is unknown. A number of things, including genetic, biochemical, and environmental influences, likely play a role.
A client diagnosed with major depressive disorder states, "I've been feeling 'down' for 3 months. Will I ever feel like myself again?" Which reply by the nurse will best assess this client's affective symptoms? correct answer: Help me understand what you mean when you say, 'feeling down'?" A client is admitted for alcohol detoxification. During detoxification, which symptoms should the nurse expect to assess? correct answer: Gross tremors, delirium, hyperactivity, and hypertension A parent has consulted the school nurse because she is concerned about her 16-year-old son and the possibility of drug abuse. What indication of substance abuse in adolescents should the nurse plan to teach the mother? correct answer: Unexplained moodiness A client who has been on the unit for 2 weeks relates a 15-year history of polysubstance abuse with several detoxifications followed by relapses. The client mentions that when he is released from the hospital, he tries to "get on with my life and put this other stuff in the past." The nurse identifies an appropriate outcome as being that client will: correct answer: View recovery is a lifelong process occurring a day at a time A priority nursing diagnosis for a 25-year-old client admitted to a drug rehabilitation program 4 days ago for chronic cocaine abuse would be: correct answer: Risk for self-directed violence related to suicidal depression
Upon admission for symptoms of alcohol withdrawal, a client states, "I haven't eaten in 3 days." Assessment reveals BP 170/100 mm Hg, P 110, R 28, and T 97∘∘F (36∘∘C) with dry skin, dry mucous membranes, and poor skin turgor. What should be the priority nursing diagnosis? correct answer: Imbalanced nutrition: less than body requirements A patient presents to the clinic with a report of fatigue and difficulty concentrating. Which additional statement made by the patient would alert the healthcare provider to possible marijuana use? correct answer: "I've noticed that my eyes are red lately." A patient is admitted to the medical unit after experiencing chest pain. Which of these additional findings would support a diagnosis of cocaine abuse? correct answer: Perforated nasal septum A client is admitted for alcohol detoxification. During detoxification, which symptoms should the nurse expect to assess? correct answer: Gross tremors, delirium, hyperactivity, and hypertension Rationale: Withdrawal is defined as the physiological and mental readjustment that accompanies the discontinuation of an addictive substance. Symptoms can include gross tremors, delirium, hyperactivity, hypertension, nausea, vomiting, tachycardia, hallucinations, and seizures. A parent has consulted the school nurse because she is concerned about her 16-year-old son and the possibility of drug
abuse. What indication of substance abuse in adolescents should the nurse plan to teach the mother? correct answer: Unexplained moodiness Rationale: New friends (option 1) do not indicate a problem. With substance abuse, impaired academic performance may occur, not improved (option 2). Option 4 is incorrect as headaches do not necessarily indicate substance abuse. Moodiness (option 3) can be indicative of substance abuse. A client who has been on the unit for 2 weeks relates a 15-year history of polysubstance abuse with several detoxifications followed by relapses. The client mentions that when he is released from the hospital, he tries to "get on with my life and put this other stuff in the past." The nurse identifies an appropriate outcome as being that client will: correct answer: View recovery is a lifelong process occurring a day at a time Rationale: Options 2 and 3 are past issues and not as helpful as a future focus. Methadone maintenance is not appropriate for polysubstance abuse, so option 4 is incorrect. A helpful view of recovery is described in option 1. A priority nursing diagnosis for a 25-year-old client admitted to a drug rehabilitation program 4 days ago for chronic cocaine abuse would be: correct answer: Risk for self-directed violence related to suicidal depression Rationale: One of the main symptoms of cocaine withdrawal is intense depression; therefore option 1 is a priority. Risk for noncompliance in option 2 is not the priority, and disturbed
