NURS 222 Schizophrenia, Major Depressive Disorder,
Narcissistic Personality Disorder, Proctor Practice,
(Updated 2020)
1. . A nurse in an alcohol treatment facility is caring for a client who states, “My job is so
stressful that the only way I can cope is to drink.” The nurse should recognize that the client is
displaying which of the following defense mechanisms?
A. Introjection (Unconscious adoption of the ideas or attitudes of others)
B. Repression
C. . Rationalization
D. Intellectualization
Repression
● U nconsciously putting unacceptable ideas, thoughts, and emotions o ut of awareness
● ADAPTIVE USE: A person preparing to give a speech unconsciously forgets about the
time when he was young and kids laughed at him while on stage.
● MALADAPTIVE USE: A person who has a fear of the dentist
Rationalization
● Creating reasonable and acceptable explanations for u nacceptable behavior
● ADAPTIVE USE: An adolescent boy says, “she must already have a boyfriend” when rejected
by a girl
● MALADAPTIVE USE: A young adult explains he had to drive home from a party after
drinking alcohol because he had to feed his dog
Intellectualization
● S eparation of e motions and logical facts when analyzing or coping with a situation or
event
● ADAPTIVE USE: A law enforcement officer blocks out the emotional aspect of a crime
so he can objectively focus on the investigation.
● MALADAPTIVE USE: A person who learns he has a terminal illness focuses on creating a
will and financial matters rather than acknowledging his grief.
2. . A nurse is obtaining a medical history from a client who is requesting a prescription for
bupropion for
s moking 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 (Avoid administering to clients at risk for seizures, such as a client who has a
head injury)
D. Hypothyroidism
Bupropion = ATYPICAL ANTIDEPRESSANT, inhibits Dopamine uptake
○ Alternative to SSRIs for clients unable to tolerate sexual dysfunction side
effects
○ C omplications: Headache, dry mouth, GI distress, constipation, increased heart
rate, nausea, restlessness, insomnia
■ Suppression of appetite = weight loss, contraindicated for those who
have anorexia or bulimia
3. . A nurse is assessing a client who has histrionic personality disorder. Which of the
following findings should the nurse expect?
A. Lack of remorse
, B. Splitting of staff
C. . Attention-seeking
D. Identity disturbance
Histrionic
● “POK POK” - Characterized by e motional attention-seeking behavior, in which the person
needs to be the center of attention; often seductive and flirtatious.
, 4. . A nurse is providing teaching to the daughter of an older client who has obsessive-compulsive
disorder.
Which of the following statements by the daughter indicates an understanding of the
teaching?
A. “I will provide my mother with detailed instructions about how to perform self-care.”
(Give simple directions)
B. . “I will limit my mother’s clothing choices when she is getting dressed.” (If client is
indecisive, limit the client's choices; if client still unable to make a decision, give client one outfit to
wear)
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.”
OCD
● The client a ttempts to suppress persistent thoughts or urges that cause a nxiety
through compulsive or obsessive behaviors, such as repetitive hand washing.
● Obsessions or compulsions are time-consuming and result in impaired social and
occupational functioning.
6. . A nurse is providing c risis intervention for a client who was involved in a violent mass
casualty situation in the community. Which of the following actions should the nurse take during
the i nitial session with the client?
A. . Identify the client’s usual coping style.
B. Encourage the client to display anger toward the cause of the crisis. (Reduce
stress-related manifestations, such as using techniques to alleviate a panic attack)
C. Tell the client that this life will soon return to normal (False assurance)
D. Help the client focus on a w ide variety of topics regarding the crisis. (Reduce stress)
18. 8. A charge nurse is orienting a newly licensed nurse and observes the newly licensed nurse
imitating her behaviors. The nurse should recognize this behavior as which of the following
defense mechanisms?
A. Suppression (Voluntarily denying unpleasant thoughts and feelings)
B. . Identification (Conscious or unconscious assumption of the characteristics of another
individual or group)
C. Compensation (Emphasizing strengths to make up for weaknesses)
D. Reaction formation (Overcompensating or demonstrating the opposite behavior of what is felt)
21. 1. A nurse in an inpatient mental health facility is assessing a client who has schizophrenia and
is taking
haloperidol. Which of the following clinical findings is the nurse’s priority?
A. Insomnia (Sedation)
B. Urinary frequency (Complication → ANTIcholinergic
effects) C . High fever (Complication →
agranulocytosis)
D. Headache
Other complications: Acute dystonia, Pseudoparkinsonism, Akathisia, Tardive dyskinesia,
Neuroendocrine effects (Gynecomastia, Weight gain, Menstrual irregularities), NMS, Orthostatic
Hypotension, Sedation, Sexual dysfunction, Skin effects, Liver impairment
27. 7. 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 goals and objectives.
B. Address confidentiality.
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