1. Situation: Knowledge and skills in the care of violent clients is vital in the psychiatric unit. A nurse observes that a client with a potential for violence is agitated, pacing up and down the hallway and making aggressive remarks. Which of the following statements is most appropriate to make to this patient?
a. What is causing you to become agitated?
b. You need to stop that behavior now.
c. You will need to be restrained if you do not change your behavior.
d. You will need to be placed in seclusion.
2. The nurse closely observes the client who has been displaying aggressive behavior. The nurse observes that the client’s anger is escalating. Which approach is least helpful for the client at this time?
a. Acknowledge the client’s behavior
b. Maintain a safe distance from the client
c. Assist the client to an area that is quiet
d. Initiate confinement measures
3. The charge nurse of a psychiatric unit is planning the client assignment for the day. The most appropriate staff to be assigned to a client with a potential for violence is which of the following:
a. A timid nurse
b. A mature experienced nurse
c. an inexperienced nurse
d. a soft spoken nurse
4. The nurse exemplifies awareness of the rights of a client whose anger is escalating by:
a. Taking a directive role in verbalizing feelings
b. Using an authoritarian, confrontational approach
c. Putting the client in a seclusion room
d. Applying mechanical restraints
5. The client jumps up and throws a chair out of the window. He was restrained after his behavior can no longer be controlled by the staff. Which of these documentations indicates the safeguarding of the patient’s rights?
a. There was a doctor’s order for restraints/seclusion
b. The patient’s rights were explained to him.
c. The staff observed confidentiality
d. The staff carried out less restrictive measures but were unsuccessful.
6. Situation: Clients with personality disorders have difficulties in their social and occupational functions.
Clients with personality disorder will most likely:
a. recover with therapeutic intervention
b. respond to antianxiety medication
c. manifest enduring patterns of inflexible behaviors
d. Seek treatment willingly from some personally distressing symptoms
7. A client tends to be insensitive to others, engages in abusive behaviors and does not have a sense of remorse. Which personality disorder is he likely to have?
8. The client joins a support group and frequently preaches against abuse, is demonstrating the use of:
b. reaction formation
9. A teenage girl is diagnosed to have borderline personality disorder. Which manifestations support the diagnosis?
a. Lack of self esteem, strong dependency needs and impulsive behavior
b. social withdrawal, inadequacy, sensitivity to rejection and criticism
c. Suspicious, hypervigilance and coldness
d. Preoccupation with perfectionism, orderliness and need for control
10. The plan of care for clients with borderline personality should include:
a. Limit setting and flexibility in schedule
b. Giving medications to prevent acting out
c. Restricting her from other clients
d. Ensuring she adheres to certain restrictions
11. Situation: A 42 year old male client, is admitted in the ward because of bizarre behaviors. He is given a diagnosis of schizophrenia paranoid type. The client should have achieved the developmental task of:
a. Trust vs. mistrust
b. Industry vs. inferiority
c. Generativity vs. stagnation
d. Ego integrity vs. despair
12. Clients who are suspicious primarily use projection for which purpose:
a. deny reality
b. to deal with feelings and thoughts that are not acceptable
c. to show resentment towards others
d. manipulate others
13. The client says “ the NBI is out to get me.” The nurse’s best response is:
a. “The NBI is not out to catch you.”
b. “I don’t believe that.”
c. “I don’t know anything about that. You are afraid of being harmed.”
d. “ What made you think of that.”
14. The client on Haldol has pill rolling tremors and muscle rigidity. He is likely manifesting:
a. tardive dyskinesia
15. The client is very hostile toward one of the staff for no apparent reason. The client is manifesting:
16. Situation: An 18 year old female was sexually attacked while on her way home from work. She is brought to the hospital by her mother. Rape is an example of which type of crisis:
17. During the initial care of rape victims the following are to be considered EXCEPT:
a. Assure privacy.
b. Touch the client to show acceptance and empathy
c. Accompany the client in the examination room.
d. Maintain a non-judgmental approach.
18. The nurse acts as a patient advocate when she does one of the following:
a. She encourages the client to express her feeling regarding her experience.
b. She assesses the client for injuries.
c. She postpones the physical assessment until the client is calm
d. Explains to the client that her reactions are normal
19. Crisis intervention carried out to the client has this primary goal:
a. Assist the client to express her feelings
b. Help her identify her resources
c. Support her adaptive coping skills
d. Help her return to her pre-rape level of function
20. Five months after the incident the client complains of difficulty to concentrate, poor appetite, inability to sleep and guilt. She is likely suffering from:
a. Adjustment disorder
b. Somatoform Disorder
c. Generalized Anxiety Disorder
d. Post traumatic disorder
21. Situation: A 29 year old client newly diagnosed with breast cancer is pacing, with rapid speech headache and inability to focus with what the doctor was saying. The nurse assesses the level of anxiety as:
22. Anxiety is caused by:
a. an objective threat
b. a subjectively perceived threat
c. hostility turned to the self
d. masked depression
23. It would be most helpful for the nurse to deal with a client with severe anxiety by:
a. Give specific instructions using speak in concise statements.
b. Ask the client to identify the cause of her anxiety.
c. Explain in detail the plan of care developed
d. Urge the client to focus on what the nurse is saying
24. Which of the following medications will likely be ordered for the client?”
25. Which of the following is included in the health teachings among clients receiving Valium?:
a. Avoid foods rich in tyramine.
b. Take the medication after meals.
c. It is safe to stop it anytime after long term use.
d. Double up the dose if the client forgets her medication.
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