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NUR220 - Mental Health 300+ Questions and all correct answers

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NUR220

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NUR220 - Mental Health 300+ Questions and all correct answers/NUR220 - Mental Health 300+ Questions and all correct answers/NUR220 - Mental Health 300+ Questions and all correct answers

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nur220 mental health 300 questions and all corr

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NUR220 - Mental Health Questions
A charge nurse overhears another nurse talking with a client who has schizophrenia. Suddenly
the client yells, "I am the devil. I am God. Open the gate for me!" Which of the following replies
by the nurse requires intervention by the charge nurse?

A. Tell me who you are
B. I don't understand. Can you tell me what that means?
C. Are you saying that you are both good and bad?
D. There is no gate - correct answer D. There is no gate
A nurse in a psychiatric unit is caring for a client who is being admitted involuntarily after
attacking a neighbor. The nurse knows that the client can be kept in the hospital after the 72-
hour hold is over if the client:

A. is a danger to herself or others
B. is unwilling to accept that treatment is needed
C. does not have anyone that she could stay with
D. is financially incapable of paying for prescription medications - correct answer A. is a danger
to herself or others
A nurse in the ED is caring for a client taking haldol for the past 3 months. The client's
temperature is 102F, BP 150/110 and has tachycardia. The nurse should know that these
indicate a diagnosis of:

A. agranulocytosis
B. neuroleptic malignant syndrome (NMS)
C. hypertensive crisis
D. tardive dyskinesia - correct answer B. neuroleptic malignant syndrome (NMS)
A nurse is admitting a client who has multiple trauma after a motor vehicle accident. Shortly
after admission her husband arrives. He is distraught and blames himself for the accident.
Which of the following is an appropriate nursing response?

A. Don't worry about that. Your wife will be fine.

,NUR220 - Mental Health Questions
B. I think you should calm down a little before you see your wife
C. Why do you think the accident was your fault?
D. Tell me more about your feelings about what happened to your wife - correct answer D. Tell
me more about your feelings about what happened to your wife

"tell me more" encourages him to express feelings and uses the technique of exploring
A nurse is assessing a client receiving treatment for schizophrenia with the typical antipsychotic
fluphenazine (Prolixin) for 12 months. The nurse observes fine, fasciculating tongue movements
and associates this finding with which of the following?

A. A drug-food reaction to grapefruit juice
B. The client has missed several doses of medication
C. Early symptoms of neuroleptic malignant syndrome (NMS)
D. Early symptoms of tardive dyskinesis (TD) - correct answer D. Early symptoms of tardive
dyskinesis (TD)
The nurse is assessing an adolescent client with anorexia. Which of the following client
statements is a sign of cognitive distortion?

A. I like to cut my food into small portions
B. I really need to get in shape
C. If I eat one piece of candy, I may as well eat ten
D. I can't afford to gain weight - correct answer C. If I eat one piece of candy, I may as well eat
ten

"If I eat one piece" displays all or nothing thinking, a form of cognitive distortion
A nurse is assessing for the presence of extrapyramidal side effects (EPSs) in a client taking
chlorpromazine (Thorazine). Which of the following findings should the nurse recognize as
EPSs? Select all that apply.

A. Muscle contractions of the neck

,NUR220 - Mental Health Questions
B. Fidgeting behavior
C. Fluctuating vital signs
D. Impaired gait
E. Sexual dysfunction - correct answer A, B and D
A nurse is caring for a client admitted with acute psychosis, being treated with haloperidol
(Haldol). The nurse should suspect tardive dyskinesis as an adverse reaction when the client
exhibits which of the following? Select all that apply.

A. Urinary retention and constipation
B. Tongue twisting and lip smacking
C. Fine hand tremors and pill rolling
D. Facial grimacing and eye blinking
E. Extreme sedation and lethargy
F. Repetitive involuntary movements - correct answer B, D and F
A nurse is caring for a client in an urgent care center with traumatic injuries following an
assault. She sits quietly and calmly in the exam room. The nurse should recognize this behavior
as which of the following?

A. Denial
B. Deplacement
C. Introjection
D. Undoing - correct answer A. Denial
A nurse is caring for a client who has anorexia nervosa and over-exercises to avoid gaining
weight. Which of the following nursing interventions is appropriate?

A. Praise the client for looking at herself in the mirror
B. Establish a contract with the client requiring her to talk to the nurse when she feels the urge
to exercise
C. Confront the client about damage over-exercising can do to her body

, NUR220 - Mental Health Questions
D. Restrict the client from being weighed - correct answer B. Establish a contract with the
client requiring her to talk to the nurse when she feels the urge to exercise
A nurse is caring for a client who is cognitively impaired. Which of the following is a therapeutic
environment for this client?

A. A bright colorful room close to the nursing station
B. A room with little furniture and many safety devices
C. A clean room with monitors and a TV
D. A quiet room with personal belongings - correct answer D. A quiet room with personal
belongings
A nurse is caring for a client who receiving chlorpromazine (Thorazine) and is given a pass to
attend a family outing on a sunny day. Which of the following is most important for the nurse
to include in the client's teaching about the side effects of chlorpromazine?

A. Wear a hat and a long-sleeved shirt
B. Suck on hard candies
C. Drink plenty of fluids
D. Limit alcoholic beverages to one beer only - correct answer A. Wear a hat and a long-
sleeved shirt
A nurse is caring for an adolescent client with an eating disorder. The client is 64 inches tall and
weighs 85lb. Upon assessment, which of the following manifestations should the nurse
recognize are consistent with the admitting diagnosis? Select all that apply.

A. Amenorrhea
B. Verbalized desire to gain weight
C. Altered body image
D. Over-exercizing
E. Bradycardia - correct answer A, C, D and E
A nurse is counseling a client for management of anxiety. The client is consistently late for
appointments and ignores household chores. The client states, "I'm just too stressed. I need to

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