Examen

NR 326 Exam #2

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NR 326

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NR 326 Exam #2
Which of the following actions should the nurse take prior to the scheduled ECT?
a. Witness the informed consent
b. Request an ECG
c. Obtain a serum parathyroid hormone level
d. Check the client's blood pressure
a. Witness the informed consent
b. Request and ECG
d. Check the client's BP
Client w/bipolar disorder shows the nurse fresh self-inflicted cuts along her right
arm. Nursing priority:
a. Inspect the cuts for debris
b. Document the size and location of the cuts
c. Implement the client’s behavioral modification plan.
d. Administer a tetanus antitoxin
a. Inspect the cuts for debris
Nurse uses cognitive reframing techniques for a patient w/anxiety disorder.
Which will the nurse choose?
a. Yoga and diaphragmatic breathing
b. Pet therapy and music therapy
c. Gym activities and power walking
d. Priority restructuring and journaling
d. Priority restructuring and journaling
During an admission, an assessment of the client's protective factors includes:
a. Client's plans for self-harm and ability to carry it out
b. Client's support from family, spiritual beliefs, problem-solving skills
c. Client's thoughts for harm to others and means to carry it out
d. Client's amount of desired medications and therapeutic benefits
b. Client's support from family, spiritual beliefs, problem-solving skills
Which of the following is true about suicide risk?
a. Using the term suicide increases the client's risk for a suicide attempt.
b. A no-suicide contract with the client may reduce risk.
c. A client's verbal threat of suicide is attention-seeking behavior.
d. Interventions are ineffective for clients really wanting to commit suicide.
b. A no-suicide contract with the client may reduce risk.
The nurse is including which of the following as suicide risk factors?
a. Client's recent residential move, support, lack of access to medications
b. Clients w/ recent unemployment, new relationship, loss of transportation
c. Client is impulsive, has hallucinations, w/past history of suicide attempts
d. Client is homeless, seeks employment, decides to stop using street drugs
c. Client is impulsive, has hallucinations, w/past history of suicide attempts
Which of the following findings should the nurse identify as an indication of
Derealization?
a. Client describes a feeling of floating above the ground
b. Client has suspicions of being targeted in order to be killed and robbed
c. Client cannot recall anything that happened during the past 2 weeks

,d. Client states the furniture in the room seems small and far away.
d. Client states the furniture in the room seems small and far away.
Which of the following findings should the nurse expect w/PTSD?
a. Client avoids talking about the traumatic event has diminished reflexes
b. Client has recurring nightmares and negative self-image.
c. Client presents with obsessive compulsive disorders and diminished reflexes
d. Client presents with a positive self-image and has recurring nightmares
b. Client has recurring nightmares and negative self-image.
Nursing interventions for Dissociative Identify Disorder (DID) include which of the
following?
a. The goal is to get alters to continue to talk to each other
b. Use grounding techniques like clapping hands, touching an object
c. Use antipsychotics and antidepressants
d. The goal is to integrate alters
b. Use grounding techniques like clapping hands, touching an object
d. The goal is to integrate alters
The nurse conducts a family therapy group and identifies attributes of healthy
families as having the following:
a. Placating boundaries
b. Enmeshed boundaries
c. Distinguishable boundaries
d. Rigid boundaries
c. Distinguishable boundaries
Which statement indicates understanding by the nurse about Transcranial
magnetic stimulation (TMS)?
a. “TMS treatments usually last 5-10 min.”
b. “I will provide post-anesthesia care following TMS.”
c. “TMS is indicated for clients who have schizophrenia spectrum disorders.”
d. “I will schedule the client for daily TMS treatments for 4- 6 weeks."
d. "I will schedule the client for daily TMS treatments for 4- 6 weeks."
Which of the following is thought to facilitate the grief process?
a. The ability to grieve alone without interference from others
b. Having recently grieved for another loss
c. Taking personal responsibility for the loss
d. The ability to grieve in anticipation of the loss
d. The ability to grieve in anticipation of the loss
The major difference between normal and maladaptive grieving has been
identified as which of the following?
a. There is no loss of self-esteem in normal grieving.
b. There are no feelings of depression in normal grieving.
c. In normal grief the person does not show anger toward the loss.
d. Normal grieving lasts no longer than 1 year.
a. There is no loss of self-esteem in normal grieving.
Which client statement should the nurse expect about a client who has factitious
disorder imposed on another
a. “I became deaf when I heard my daughter's husband abandoned her.”

,b. “I know that my abdominal pain is caused by a malignant tumor.”
c. “I needed to make my son sick so someone else would take care of him.”
d. “I had to pretend I was injured in order to get disability benefits”
c. "I needed to make my son sick so someone else would take care of him."
A client in mania says he is superman and has not taken prescribed medications
for one month. Nursing care includes:
a. Provide activities to avoid social isolation, assess for suicidal thoughts
b. Provide frequent rest periods while assessing for suicidal thoughts.
c. Provide the client with more activities, prn medications
d. Provide 1:1 monitoring, seclusion, and medications.
b. Provide frequent rest periods while assessing for suicidal thoughts.
A client demonstrates speech w/a circuitous route before reaching its goal; often
needs redirection. Nursing action:
a. Speech is circumstantial, the nurse will redirect client responses.
b. Speech has loose associations, the nurse will give scheduled medications.
c. Speech is pressured, the nurse will offer the client a prn med.
d. Speech is tangential, the nurse will speak slower
a. Speech is circumstantial, the nurse will redirect client responses.
The nurse reviews the following during an assessment for suicide risk (SATA):
a. Assess the patient’s thoughts
b. Assess the patient’s ability
c. Assess the patient’s plan
d. Assess the patient’s patterns of speech
a. Assess the patient's thoughts
b. Assess the patient's ability
c. Assess the patient's plan
Which question is most important for the nurse to assess suicide risk in a client?
a. "Has anyone in your family committed suicide?"
b. "Why do you want to hurt yourself?"
c. "Do you have a plan to hurt yourself?"
d. "Can you describe how you are feeling right now?"
c. "Do you have a plan to hurt yourself?"
A charge nurse reviews one of the 5 stages of grief according to Kubler-Ross:
a. Disequilibrium
b. Developing awareness
c. Restitution
d. Anger
d. Anger
Which of the following statements by a client dx w/Bipolar Disorder indicate
adaptive coping?(SATA)
a. “I think about being on my favorite beach vacation when I get anxious.”
b. “I tense and release my muscles, starting with my feet.”
c. “I exercise aerobically three times a day for 30 minutes at a time.”
d. "I get about 2-3 hours of sleep because I don't need sleep."
a. "I think about being on my favorite beach vacation when I get anxious."
b. "I tense and release my muscles, starting with my feet."

, Which of the following medications should the nurse anticipate administering
prior to ECT procedure?
a. Diphenhydramine
b. Epinephrine
c. Fluoxetine
d. Atropine
d. Atropine
Preoccupation > 6 months w/excessive anxiety thinking a serious illness is
present or will be acquired.
a. Illness anxiety disorder
b. Somatic symptom disorder
c. Conversion disorder
d. Factitious disorder
a. Illness anxiety disorder
A nurse is going to implement cognitive reframing techniques for a client who
has an anxiety disorder. Which of the following techniques should the nurse
prepare to include in the plan of care? (Mark all that apply):
a. Priority restructuring
b. Monitoring thoughts
c. Diaphragmatic breathing
d. Journal keeping
e. Meditation
a. Priority Restructuring
b. Monitoring thoughts
d. Journal keeping
A nurse is caring for a client who is prescribed disulfiram (Antabuse) for the
treatment of alcohol use disorder. The nurse informs the client that this
medication can cause nausea and vomiting if he drinks alcohol. Which of the
following types of treatment is this method an example?
a. Aversion therapy
b. Flooding
c. Biofeedback
d. Dialectical behavior therapy
a. Aversion therapy
A nurse is assisting with systematic desensitization for a client who has an
extreme fear of elevators. Which of the following actions should the nurse
implement with this form of therapy?
a. Demonstrate riding in an elevator, then ask the client to imitate the behavior
b. Advise the client to say, “stop,” out loud every time he begins to feel an
anxiety response related to an elevator
c. Gradually expose the client to an elevator while practicing relaxation
techniques
d. Stay with the client in an elevator until his anxiety response diminishes
c. Gradually expose the client to an elevator while practicing relaxation techniques

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NR 326 Exam #2

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