ISU Diagnostic.docx

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Care of Client with Psychiatric disorder

1. Francis who is addicted to cocaine withdraws from the drug. Nurse Ron should expect to observe:

a. Hyperactivity

b. Depression

c. uspicion

d. Delirium

! ". #ocaine is a chemical that when inhaled$ causes destruction of the mucous membranes of the nose.

%. Nurse &ohn is aware that a serious effect of inhaling cocaine is'

a. Deterioration of nasal septum

b. "cute fluid and electrolyte imbalances

c. (xtra pyramidal tract symptomsd. (sophageal varices

D. )hese adaptations are associated with opiate withdrawal which occurs after cessation or reduction of

prolonged moderate or heavy use of opiates.

*. " tentative diagnosis of opiate addiction$ Nurse #andy should assess a recently hospitali+ed client for

signs of opiate withdrawal. )hese signs would include:

a. Rhinorrhea$ convulsions$ subnormal temperature

b. Nausea$ dilated pupils$ constipation

c. ,acrimation$ vomiting$ drowsiness

d. -uscle aches$ papillary constriction$ yawning

. /hether there is a suicide plan is a criterion when assessing the client0s determination to mae another

attempt.

2. " 23 year old male client is brought to the psychiatric emergency room after attempting to 4ump off a

bridge. )he client0s wife states that he lost his 4ob several months ago and has been unable to find

another 4ob. )he primary nursing intervention at this time would be to assess for:

a. " past history of depression

b. #urrent plans to commit suicide

c. )he presence of marital difficulties

d. Feelings of excessive failure

". Rapists are believed to harbor and act out hostile feelings toward all women through the act of rape.

5. efore helping a male client who has been sexually assaulted$ nurse -aureen should recogni+e that the

rapist is motivated by feelings of:

a. Hostility

b. 6nade7uacy

c. 6ncompetence

d. 8assion

#. )hese children often have nonsexual needs met by individual and are powerless to refuse. "mbivalence

results in self9blame and also guilt.

. /hen woring with children who have been sexually abused by a family member it is important for the

nurse to understand that these victims usually are overwhelmed with feelings of:

a. Humiliation

b. #onfusion

c. elf blame

d. Hatred

Republic of the PhilippinesISABELA STATE UNIVERSITY

Ilagan, Isabela



. )he client0s anger over the abortion is shifted to the staff and the hospital because she is unable to deal

with the abortion at this time.

;. &oy who has 4ust experienced her second spontaneous abortion expresses anger towards her physician$ the

hospital and the <rotten nursing care=. /hen assessing the situation$ the nurse recogni+es that the client

may be using the coping mechanism of:

a. 8ro4ection

b. Displacement

c. Denial

d. Reaction formation

". 8ersonal internal strength and supportive individuals are critical factors that can be employed to assist the

individual to cope with a crisis.

3. )he most critical factor for nurse ,inda to determine during crisis intervention would be the client0s:

a. "vailable situational supports

b. /illingness to restructure the personality

c. Developmental theory

d.

>nderlying unconscious conflict

D. #risis intervention group helps client reestablish psychologic e7uilibrium by assisting them to explore

new alternatives for coping. 6t considers realistic situations using rational and flexible problem solving

methods.

?. Nurse )rish suggests a crisis intervention group to a client experiencing a developmental crisis. )hese

groups are successful because the:

a. #risis intervention worer is a psychologist and understands behavior patterns

b. #risis group supplies a worable solution to the client0s problem

c. #lient is encouraged to tal about personal problems

d. #lient is assisted to investigate alternative approaches to solving the identified problem

#. )his would document that the client feels comfortable enough to discuss the problems that have

motivated the behavior.

1@. Nurse Ronald could evaluate that the staff0s approach to setting limits for a demanding$ angry client was

effective if the client:

a. "pologi+es for disrupting the unit0s routine when something is needed

b. >nderstands the reason why fre7uent calls to the staff were made

c. Discuss concerns regarding the emotional condition that re7uired hospitali+ations

d. No longer calls the nursing staff for assistance

#. )he most successful therapy for people with phobias involves behavior modification techni7ues using

desensiti+ation.

11. Nurse &ohn is aware that the therapy that has the highest success rate for people with phobias would be:

a. 8sychotherapy aimed at rearranging maladaptive thought process

b. 8sychoanalytical exploration of repressed conflicts of an earlier development phase

c. ystematic desensiti+ation using relaxation techni7ue

d. 6nsight therapy to determine the origin of the anxiety and fear

". 8erceptual field is a ey indicator of anxiety level because the perceptual fields narrow as anxiety

increases.

1%. /hen nurse Ha+el considers a client0s placement on the continuum of anxiety$ a ey in determining the

degree of anxiety being experienced is the client0s:

a. 8erceptual field

b. Delusional system

c. -emory state

d. #reativity level

D. Ane of the symptoms of autistic child displays a lac of responsiveness to others. )here is little or no

extension to the external environment.



1*. 6n the diagnosis of a possible pervasive developmental autistic disorder. )he nurse would find it most

unusual for a * year old child to demonstrate:

a. "n interest in music

b. "n attachment to odd ob4ects

c. Ritualistic behavior

d. Responsiveness to the parents

. omatic delusions focus on bodily functions or systems and commonly include delusion about foul odor

emissions$ insect manifestations$ internal parasites and misshapen parts.

12. -alou with schi+ophrenia tells Nurse -elinda$ <-y intestines are rotted from worms chewing on them.=

)his statement indicates a:

a. &ealous delusion

b. omatic delusion

c. Delusion of grandeur

d. Delusion of persecution

D. " client with borderline personality displays a pervasive pattern of unpredictable behavior$ mood and self

image. 6nterpersonal relationships may be intense and unstable and behavior may be inappropriate andimpulsive.

15. "ndy is admitted to the psychiatric unit with a diagnosis of borderline personality disorder. Nurse Hilary

should expects the assessment to reveal:

a. #oldness$ detachment and lac of tender feelings

b. omatic symptoms

c. 6nability to function as responsible parent

d. >npredictable behavior and intense interpersonal relationships

". 8ropranolol is a potent beta adrenergic blocer and producing a sedating effect$ therefore it is used to

treat antipsychotic induced aathisia and anxiety.

1. 8RA8R"NA,A, B6nderalC is used in the mental health setting to manage which of the following

conditions'

a. "ntipsychotic induced aathisia and anxiety

b. Absessive compulsive disorder BA#DC to reduce ritualistic behavior

c. Delusions for clients suffering from schi+ophrenia

d. )he manic phase of bipolar illness as a mood stabili+er

. "mantadine is an anticholinergic drug used to relive drug9induced extra pyramidal adverse effects such as

muscle weaness$ involuntary muscle movements$ pseudoparinsonism and tar dive dysinesia.

1;. /hich medication can control the extra pyramidal effects associated with antipsychotic agents'

a. #lora+epate B)ranxeneC

b. "mantadine BymmetrelC

c. Doxepin Bine7uanC

d. 8erphena+ine B)rilafonC

#. -"A6 antidepressants when combined with a number of drugs can cause life9threatening hypertensive

crisis. 6t0s imperative that a client checs with his physician and pharmacist before taing any other

medications

13. /hich of the following statements should be included when teaching clients about monoamine oxidaseinhibitor B-"A6C antidepressants'

a. Don0t tae aspirin or nonsteroidal anti9inflammatory drugs BN"6DsC

b. Have blood levels screened weekly for leucopenia

c. "void strenuous activity because of the cardiac effects of the drug

d. Don0t tae prescribed or over the counter medications without consulting the physician

.

1?. Eris periodically has acute panic attacs. )hese attacs are unpredictable and have no apparent

association with a specific ob4ect or situation. During an acute panic attac$ Eris may experience:



a. Heightened concentration

b. Decreased perceptual field

c. Decreased cardiac rate

d. Decreased respiratory rate

. 8anic is the most severe level of anxiety. During panic attac$ the client experiences a decrease in the

perceptual field$ becoming more focused on self$ less aware of surroundings and unable to process

information from the environment. )he decreased perceptual field contributes to impaired attention and

inability to concentrate

%@. 6nitial interventions for -arco with acute anxiety include all except which of the following'

a. )ouching the client in an attempt to comfort him

b. "pproaching the client in calm$ confident manner

c. (ncouraging the client to verbali+e feelings and concerns

d. 8roviding the client with a safe$ 7uiet and private place

". )he emergency nurse must establish rapport and trust with the anxious client before using therapeutic

touch. )ouching an anxious client may actually increase anxiety.

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ISU Diagnostic.docx