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NR 326 Exam 3
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NR 326 Exam 3 NR 326 Exam 3 NR 326 Exam 3
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NR 326 Exam 3A nurse in an acute mental health facility is creating a plan of care for a new client who has a co-
occurring histrionic personality disorder. Which of the following is the priority intervention for the
nurse to make?
A. Promote appropriate behavior during group therapy sessions.
B. Encourage client input in the treatment plan.
C. Communicate with the client using concrete language.
D. Demonstrate assertive behavior. - ANS A. Promote appropriate behavior during group therapy
sessions.
Rationale: Managing the client's behavior within the group is the priority intervention for the client
who has histrionic personality disorder because these clients display extreme attention-seeking
behaviors and are often impulsive, which can be extremely disruptive in a group setting with other
members.
A nurse is reviewing the history and physical of an adolescent client who has conduct disorder.
Which of the following is an expected finding?
A. Death of client's father two months ago
B. Experiences frequent facial tics
C. Suspended from school several times in the past year
D. Adheres strictly to routines - ANS C. Suspended from school several times in the past year
Rationale: Conduct disorder is an impulse-control disorder which includes a long-term pattern of
violating the rights of others and performing violent or hostile acts.
A nurse is planning discharge for a client who has a co-occurring borderline personality disorder.
Which of the following interventions should be included for this client?
A. Dialectical behavior therapy
B. Behavioral contract
C. Bibliotherapy
D. Safety plan - ANS A. Dialectical behavior therapy
Rationale: Dialectical behavior therapy is appropriate for the treatment of clients with borderline
personality disorder and is often a part of the discharge plan.
A nurse is planning care for a client who has dependent personality disorder. Which of the following
actions should the nurse plan to take?
,A. Monitor the client closely to prevent self-mutilation.
B. Set limits to prevent exploitation of other clients.
C. Discourage flamboyant or seductive behaviors.
D. Give positive feedback when client is assertive with staff or clients. - ANS D. Give positive
feedback when client is assertive with staff or clients.
Rationale: The client who has dependent personality disorder has great difficulty demonstrating
assertive behavior and commonly relies on others to make decisions. The nurse should encourage
the client to be more assertive and independent.
A nurse is reviewing the medical record of a client who performs self-injury. Which of the following
information should the nurse identify as placing the client at risk for self-harm behaviors?
A. The client has a co-occurring borderline personality disorder.
B. The client has a parent who has dependent personality disorder.
C. The client has a history of bulimia nervosa.
D. The client has a diagnosis of anti-social personality disorder. - ANS A. The client has a co-occurring
borderline personality disorder.
Rationale: A diagnosis of borderline personality disorder is associated with an increased risk for self-
harm.
A nurse is caring for a client who has schizophrenia and tells the nurse, "They lie about me all the
time and they are trying to poison my food." Which of the following statements should the nurse
make?
A. "You are mistaken. Nobody is lying about you or trying to poison you."
B. "You seem to be having very frightening thoughts."
C. "Why do you think you are being lied about and poisoned?"
D. "Who is lying about you and trying to poison you?" - ANS B. "You seem to be having very
frightening thoughts."
Rationale: When responding to a client who is delusional, the nurse should avoid making statements
that directly confront or affirm the client's delusional beliefs. Instead of responding literally to the
client's words, the nurse should respond to the feelings that the client is attempting to
communicate. By doing this, the nurse is shifting the focus from the delusional beliefs, which are not
real, to the client's fear, which is real.
A nurse is conducting a group therapy session for several clients. The group is laughing at a joke one
of the clients told, when a client who is schizophrenic jumps up and runs out of the room yelling,
"You are all making fun of me!" The nurse should identify this behavior as which of the following
characteristics of schizophrenia?
,A. Magical thinking
B. Delusions of grandeur
C. Ideas of reference
D. Looseness of association - ANS C. Ideas of reference
Rationale: When ideas of reference are present, the client believes all events, situations, or
interactions are directly related to him.
A nurse is providing teaching for a client who has schizophrenia and a new prescription for
fluphenazine. Which of the following information should the nurse provide?
A. "This medication might turn urine your orange."
B. "Sleepiness should subside within a week."
C. "Stop the medication if hypotension occurs."
D. "A low-grade fever is expected with first doses." - ANS B. "Sleepiness should subside within a
week."
Rationale: The nurse should inform the client that fluphenazine, like other first-generation
antipsychotics, may cause sedation with early treatment, but should subside within a week or so.
A nurse in a mental health clinic is conducting a staff education session on schizophrenia. Which of
the following manifestations should the nurse include in the teaching plan as negative symptoms?
(Select all that apply.)
A. Delusions
B. Hallucinations
C. Anhedonia
D. Poor judgment
E. Blunt affect - ANS C. Anhedonia
E. Blunt affect
Rationale: Delusions is incorrect. Delusions are an example of a positive symptom of schizophrenia.
Hallucinations is incorrect. Hallucinations are an example of a positive symptom of schizophrenia.
Anhedonia is correct. Anhedonia is an example of a negative symptom of schizophrenia. Poor
judgment is incorrect. Poor judgment is an example of a cognitive symptom of schizophrenia. Blunt
affect is correct. Blunt affect is an example of a negative symptom of schizophrenia.
A nurse is caring for an adolescent client who has a new diagnosis of schizophrenia. The client's
parents are tearful and express feelings of guilt. Which of the following statements should the nurse
make?
, A. "You said that you feel guilty about your daughter's diagnosis. Let's talk about what is causing you
to feel this way."
B. "You should not feel guilty about your daughter's diagnosis. Schizophrenia is unpreventable."
C. "I'm sure your daughter's diagnosis is very difficult to deal with, but everything will be all right
once she receives the proper treatment."
D. "Your provider has explained the causes of schizophrenia. Why do you feel guilty about your
daughter's diagnosis?" - ANS A. "You said that you feel guilty about your daughter's diagnosis. Let's
talk about what is causing you to feel this way."
Rationale: This statement is an example of clarification and promotes further discussion, which is a
therapeutic communication technique.
A nurse is assisting a client who has schizophrenia prepare a relapse plan. Which of the following
statements should the nurse verbalize during the session?
A. "You should be aware that excessive sleeping is an early sign of relapse."
B. "Relapse is an indication that you are not taking your medications properly."
C. "You should keep your provider's and therapist's number with you."
D. "Taking an additional dose of medication is appropriate as soon as signs of relapse appear." - ANS
C. "You should keep your provider's and therapist's number with you."
Rationale: The client should have a written plan, including important numbers, available at all times
in case relapse occurs.
A nurse in an acute care mental health facility is sitting with a client who has schizophrenia. The
client whispers to the nurse, "I'm being kept in this prison against my will. Please try to get me out."
Which of the following responses should the nurse make?
A. "Why do feel that you need to leave?"
B. "You feel that you don't belong here."
C. "We are here to help you and give you the care that you need right now."
D. "Try to take some deep breaths and I'm sure you'll feel better." - ANS B. "You feel that you don't
belong here."
Rationale: Restating is a therapeutic communication technique and encourages further dialogue.
A nurse is caring for a client who has schizophrenia and is having difficulty with performing ADLs. The
nurse should consult with which of the following members of the interdisciplinary team to assist the
client?
A. Occupational therapist
B. Psychiatric social worker
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