Summary NURS 222 Schizophrenia, Major Depressive Disorder, Narcissistic Personality Disorder, Proctor Practice, (2021/2022) West Coast University, Orange County
1 view 0 purchase
Course
Nursing course
Institution
Nursing Course
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 i...
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
● Unconsciously putting unacceptable ideas, thoughts, and emotions out 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 unacceptable 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
● Separation of emotions 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
smoking 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
○ Complications: 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 emotional 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 attempts to suppress persistent thoughts or urges that cause anxiety 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 crisis 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 initial 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 wide variety of topics regarding the crisis. (Reduce stress)
18. 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. 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. 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.
C. Promote problem-solving skills.
D. Establish a participation contract
, 30. A nurse is providing behavioral therapy for a client who has OCD. The client repeatedly checks that the
doors are locked at night. Which of the following instructions should the nurse give the client when using
thought stopping technique?
A. “Keep a journal of how often you check the locks each night.”
B. “Ask a family member to check the locks for you at night.”
C. “Focus on abdominal breathing whenever you go to check the locks.”
D. “Snap a rubber band on your wrist when you think about checking the locks.”
Thought stopping: teach pt to say “stop” when negative thoughts/compulsive behaviors arise & substitute
positive thought - goal for pt use command silently over time
33. A nurse is assisting with obtaining informed consent for a client who has been legally incompetent.
Which of the following actions should the nurse take?
A. Explain implied consent to the client’s family.
B. Contact the facility social work to obtain the consent.
C. Request that the client’s guardian sign the consent
D. Ask the charge nurse to obtain informed consent.
Client who has been judged incompetent has a temporary or permanent guardian appointed by the court. The
guardian can sign the informed consent for the client.
46. A nurse is reviewing the laboratory report of a client who is taking carbamazepine for bipolar disorder.
Which of the following laboratory results should the nurse report to the provider?
A. Urine specific gravity 1.029
B. Platelets 90,000/mm
C. Urine pH 5.6
D. RBC 4.7/mm
Complications: CNS effects, Blood Dyscrasias, Teratogenesis, Hyperosmolality (ANTI-diuretic), Skin
Disorders
49. A nurse in a mental health facility is making plans for client’s discharge. Which of the following
interdisciplinary team members should the nurse contact to assist the client with housing placement?
A. Social worker
B. Occupational therapist
C. Clinical nurse specialist
D. Recreational therapist
50. A nurse is caring for a client who reports that he is angry with his partner because she thinks he is trying
to gain attention. When the nurse attempts to talk to the client, he becomes angry and tells her to leave.
Which of the following defense mechanisms is the client demonstrating? (ATI p.21)
A. Rationalization
B. Compensation
C. Denial
D. Displacement
Displacement - shifting feelings r/t to an object, person or situation to another less threatening object,
person, or situation
59. A nurse is creating a plan of care for a client who has major depressive disorder. Which of the
following interventions should the nurse include in the plan?
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller BrilliantScores. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $14.49. You're not tied to anything after your purchase.
