Deck 2: Psychiatric-Mental Health Nursing Processes, and Clients With Mental Disorders

Question 1

Which of the following examinations will the nurse perform on a client who is not able to perform one or more of the activities of the Mini-Mental State Exam?

A) Minnesota Multiphasic Personality Inventory-2
B) Mental Status Examination
C) Millon Clinical Multiaxial Inventory-II
D) Thematic Apperception Test

Answer 1

B

Question 2

The nurse reviews the date family and friends provided in the comprehensive assessment of a client's situation. The nurse knows to treat the data as:

A) Invalid until confirmed with the client.
B) Subjective data.
C) Peripheral to the assessment.
D) Primary data.

Answer 2

B

Question 3

The intake nurse is screening clients for admission to the psychiatric-mental health inpatient unit. For which of the following individuals would the Mini-Mental State Exam be most appropriate?

A) The significant other accompanying a client seeking outpatient mental health resources
B) A client with a history of memory problems
C) A client seeking community resources
D) A client with disabilities affecting motor and sight, related to writing

Answer 3

B

Question 4

The information from a Mental State Examination indicates a client is depressed and has suicidal ideations. Based on this information, which of the following professionals should be included in the plan of care?
Select all that apply.

A) Social worker
B) Nursing assistant
C) Recreational therapist
D) Nurse therapist
E) Significant other

Question 5

A nursing student is working to develop assessment skills. The student knows that nurses utilize principles of assessment:

A) Prior to discharge.
B) At the point of entry to care.
C) Throughout hospitalization.
D) Upon admission.

Question 6

A depressed client asks why a physical exam is necessary before being admitted for outpatient treatment. The nurse explains to the client that a physical exam will:

A) Provide information about medications the client will need.
B) Complete the admission process.
C) Make sure the client gets all necessary treatment.
D) Ensure the client has not ingested any caustic material or inhaled noxious vapors.

Question 7

Select the priority nursing diagnosis for a client with a Global Assessment of Functioning (GAF) score of 10.

A) Risk for impaired social interaction
B) Risk for communication deficit
C) Risk for injury
D) Knowledge deficit

Question 8

After conducting a Mini-Mental State Assessment on a client, the nurse obtains a score of 30, which indicates a:

A) Perfect score; cognitive functioning has not declined.
B) Very low score; significant likelihood that cognitive functioning has declined.
C) Perfect score; the client demonstrates good insight.
D) Low score indicating the client lacks insight.

Question 9

A female client disclosed to the nurse that she is in an abusive situation. This information will be used to contribute to:

A) Axis I.
B) Axis IV.
C) Axis III.
D) Nothing since this is confidential information and should not be shared.

Question 10

How might the nurse make use of the information contained in a client's multiaxial diagnosis? Select all that apply.

A) To identify nursing diagnoses
B) To address physiological problems
C) To assess client strengths
D) To plan client centered interventions
E) To communicate client needs

Question 11

The psychiatric home health nurse is evaluating whether a client's level of functioning has improved since starting the prescribed psychotropic medication. What evidence does the nurse look for?

A) There is an increase in the client's GAF score.
B) There is no change in the GAF score.
C) The client no longer qualifies for a GAF score.
D) There is a significant decrease (by 10 or more points) in the client's GAF score.

Question 12

The nurse is assessing a client with a mood disorder. When analyzing the behaviors manifested by the client, the nurse considers which of the following?

A) Mental status
B) Life experience
C) Socioeconomic status
D) Cultural determination

Question 13

The school nurse, who must be familiar with mental health issues, will find child clinical disorders classified under:

A) Axis II.
B) Axis I.
C) Axis X.
D) Axis VII.

Question 14

During a mental status assessment, the examiner asks the client to repeat these words: motorcar, teacup, and lilies. Five minutes later the client is asked to repeat the words again. The purpose of this exercise is to test the client's:

A) Recall of recent past experiences.
B) Retention and recall.
C) Abstract thinking.
D) Insight.

Question 15

A client is admitted with the following diagnosis: Axis I: 300.01 Panic disorder without agoraphobia Axis II: 301.83 Borderline personality disorder Axis III: No diagnosis
Axis IV: Unemployment
What conclusions can the nurse make relative to the client's Axis III information?

A) This client has problems with environment, but they are not related to mental disorder.
B) The client has no diagnosed physiological health problems relevant to mental disorder at the time of admission.
C) The client's environment has not been evaluated.
D) The client's health status has not been evaluated.

Question 16

A client makes the following statement during a mental status assessment: "I can't use the phones; the CIA has bugged all the wires." Which of the following categories will the nurse use to document the client's response?

A) Orientation
B) Emotional state
C) General behavior
D) Content of thought

Question 17

Which of the following assessment tools is used to examine a client's mental status at the time of admission?

A) Mental State Assessment
B) Nurses Observation Scale for Inpatient Evaluations (NOSIE)
C) Personality inventory
D) Personal history

Question 18

As part of the comprehensive admission assessment, the nurse talks with family and friends who may contribute additional data to a client's psychiatric history. When reviewing the data obtained from these sources, the nurse keeps in mind which of the following perspectives of the data? The information provided:

A) Is considered false.
B) Will vary according to the source's relationship to the client.
C) Is considered accurate.
D) Comes from each individual's perspective.

Question 19

A nurse who is admitting a client to the inpatient unit conducts a comprehensive assessment. How does the nurse use the data gathered from the assessment?
Select all that apply.

A) To determine the length of stay
B) To make sound clinical judgments
C) To exclude data from secondary sources
D) To plan appropriate interventions
E) To support nursing diagnoses

Question 20

After interviewing a client for admission, the nurse gives the client a score of 50 on the Global Assessment of Functioning Scale (GAF). The nurse selected this score based on the client's level of functioning:

A) Within the past week.
B) Within the past year.
C) Since beginning the psychotropic medication.
D) Since being given a psychiatric diagnosis.

Question 21

The psychiatric examination includes a psychiatric history and a mental status assessment. When conducting the mental status assessment, the nurse:
Select all that apply.

A) Uses a group format.
B) Limits the assessment to verbal responses.
C) May or may not follow a strict sequence.
D) Provides the client with a form to complete.
E) Includes observations.

Question 22

Which of the following best describes the information the nurse will use to construct a nursing care plan?

A) A mental status examination
B) An intake assessment and reason for admission
C) A psychiatric history and mental status examination
D) A detailed psychiatric history

Question 23

The nurse is talking with the family of a mentally ill client who lives with them. The client is being admitted to the inpatient psychiatric unit. What is the priority information to gather from the family?

A) The number of medications prescribed for the client
B) How the client's symptoms are expressed at home
C) The type of soap the client prefers to use
D) Whether the client had a flu shot recently

Question 24

The intake nurse takes a psychiatric history of a client presenting for admission. In the mental status evaluation, the nurse observes circumstantiality. In which section of the MSE will the nurse document the finding?

A) Characteristics of speech
B) Abstract thinking
C) Emotional state
D) Attitude

Question 25

An anxious client is to complete the Minnesota Multiphasic Personality Inventory-2 as part of the psychological testing. The client is worried about not having enough time to prepare for the test. To decrease anxiety, the nurse reviews the purpose of the test and explains that the client will:

A) Just need to complete a series of sentences.
B) Interpret ink blots.
C) Only have to copy geometric designs.
D) Be answering true or false questions.

Question 26

The goal for the client's plan of care is for the client to list three positive characteristics of self. Select the statement that best describes evaluation of the goal.

A) "Client wrote out three positive characteristics. "
B) "Client listed 1) energetic, 2) trustworthy, and 3) faithful as positive characteristics of self."
C) "Nurse encouraged client to list three positive characteristics of self."
D) "Client listed three positive characteristics of self."

Question 27

The Mental Status Examination asks the question, "What would you do if you locked your keys in the car?" The nurse performing the assessment documents the response to the question under the category relating to:

A) Orientation.
B) Judgment.
C) Memory.
D) Insight.

Question 28

The nurse in the community mental health clinic assesses a client and determines the presence of an Axis II diagnosis. What conclusions can the nurse draw?

A) The client will need a special diet.
B) The client is in need of further evaluation.
C) The client is a candidate for the least restrictive environment.
D) The client has a personality disorder.

Question 29

A family member reports that his mother has started hiding valuables around the house, then can't remember where she put them. He asks the nurse to explain what is happening. Which of the following assessment tools might the nurse utilize to screen the mother for signs of cognitive
Dysfunction?

A) Benton Visual Retention Test
B) Raven's Progressive Matrices Test
C) Thematic Apperception Test
D) Sentence Completion Test

Question 30

The nurse on the inpatient unit is reviewing the record of a client admitted the previous day, and notes the client has an Axis I diagnosis. What inferences can the nurse make about the client?

A) The client has a clinical psychiatric disorder.
B) The client is in need of immediate medical attention.
C) The client has a chronic condition.
D) The client lacks a support system.

Question 31

Which of the following subgroups of the severely and persistently mentally ill are at particularly high risk for poor outcomes?

A) Clients who are homeless
B) Clients with chronic schizophrenia
C) Clients who are hospitalized in tertiary settings
D) Clients with bipolar disorder

Question 32

The psychiatric home health nurse has made repeated attempts to make a home visit to a homebound client, only to find that the client is not at home at the scheduled time. What is the best action by the nurse?

A) Wait outside in the car until the client returns home.
B) Call the client's landlord and ask to be let into the client's home.
C) Call the client the day before each scheduled visit as a reminder.
D) Reevaluate the client's homebound status.

Question 33

A client and his wife are visiting in the day room of an inpatient psychiatric unit when a client with acute psychosis experiencing auditory hallucinations sits down next to them and begins talking to the "voices." Which of the following nursing actions is most appropriate?

A) Observe the situation and intervene only if the client with psychosis becomes aggressive.
B) Take the client with psychosis by the hand and lead the client to another area in the day room.
C) Remind the client with psychosis to respect the privacy of the other client and his wife.
D) Announce over the intercom that visiting hours are over.

Question 34

Which of the following qualifications best explains why nurses are better suited for the role of case management than social workers?

A) Nurses have thorough training in psychobiology and pharmacology.
B) Nurses have superior therapeutic communication skills.
C) Nurses have better therapeutic relationships with their clients.
D) Nurses have broader clinical experiences with a variety of clients.

Question 35

Which of the following services are typically performed by psychiatric nurses employed in managed care organizations?
Select all that apply.

A) Scheduling appointments for therapy
B) Performing mental health assessments
C) Contacting medication prescribers to arrange for changes
D) Providing stress management classes
E) Triaging initial requests for services

Question 36

A psychiatric home health nurse makes home visits in a neighborhood that has a high incidence of reported crimes. What reasonable safety measures should the nurse implement during home visits?
Select all that apply.

A) Call the client before arrival at the home
B) Carry a cell phone at all times
C) Make all visits in the daytime
D) Ask to be accompanied on visits by a co-worker
E) Ask for a police escort during visits

Question 37

The nurse has completed a new client's orientation to the inpatient psychiatric unit and asks if the client has any questions. Which of the following questions indicates further teaching is needed regarding the client's rights in a therapeutic environment?

A) "What happens if I refuse to attend a group activity?"
B) "What time does morning group start?"
C) "Where do I go if I want to smoke?"
D) "What time are meals served on the unit?"

Question 38

Which of the following services are not typically offered by community mental health centers?

A) Legal assistance
B) Medication management clinics
C) Vocational rehabilitation
D) Psychoeducation groups

Question 39

Which of the following factors does not increase the risk for exacerbating psychiatric symptoms and leading to re-hospitalization of clients with severe and persistent mental illness?

A) Unstable living conditions
B) Substance abuse
C) Medication adherence
D) Criminal behavior

Question 40

Which of the following activities is the central element that differentiates case management from other types of care?

A) Preventing re-hospitalization
B) Advocating for clients requiring extensive services
C) Focusing treatment goals in the most restrictive setting
D) Coordinating one episode of care across multiple treatment settings

Question 41

A client with generalized anxiety disorder frequently skips weekly scheduled appointments with a primary nurse therapist in the managed care organization (MCO), showing up only when the client is feeling severely stressed. Which of the following statements best explains this behavior?

A) The client is aware that MCO's frequently "double-book" appointments to balance out the "no-shows."
B) MCO consumers find it easier than non-MCO consumers to not keep scheduled appointments, partly because services are prepaid.
C) MCO consumers do not have to make copayments for missed appointments.
D) The client does not have transportation for scheduled appointments with the therapist.

Question 42

A client admitted to the inpatient psychiatric unit after a recent suicide attempt tells the nurse, "Even though suicide is against my religion, I was in so much emotional distress that I didn't think I could keep on living. I'm really struggling with my spiritual conscience and don't know what I should do." Which of the following nurse responses is most appropriate?

A) "It sounds like spirituality plays a significant role in your life. Tell me what beliefs are most important to you."
B) "I think you should pray for forgiveness and turn all your problems over to God."
C) "I hear that you are having a real struggle with your spiritual beliefs. Tell me what I can do to help."
D) "I'm not very comfortable discussing religious matters. This is something you should talk to your priest or pastor about."

Question 43

A psychiatric home care nurse knocks on the client's door for the first time and is told by the client, "Go away and leave me alone. I don't want to buy any Girl Scout cookies." What should the nurse do in this instance?

A) Offer to give the client money to buy Girl Scout cookies.
B) Show the client identification and explain the purpose of the visit.
C) Leave, and try to gain admittance to the client's home tomorrow.
D) Call the home health agency and request a new assignment.

Question 44

Which of the following nursing interventions is not consistent with the philosophy of psychiatric rehabilitation?

A) Identifying highly individualized goals with the client
B) Discharging a client from services when treatment goals are reached
C) Planning behavioral interventions that target specific functional deficits
D) Performing a functional assessment of the client

Question 45

Which of the following statements regarding the impact of managed health care on the delivery of psychiatric services is true?

A) Cost containment has created an entire range of ambulatory care services that are considered ineffective.
B) Managed mental health care has resulted in shorter, more intense psychiatric hospital stays to keep costs down.
C) Shorter models for psychiatric services and outpatient treatment do not meet the lifestyle needs of clients and their employers.
D) Clients are admitted to hospitals in earlier stages of psychiatric illnesses.

Question 46

A client with chronic paranoid schizophrenia is scheduled to be discharged from the inpatient psychiatric unit in two days. The nurse is working with the client's family to develop a plan for managing psychotic symptoms and emergency behaviors after discharge. Which of the following nursing diagnoses is most appropriate?

A) Risk for violence directed toward others related to delusional and persecutory thought process
B) Noncompliance: medication regimen related to paranoid ideation
C) Knowledge deficit: symptom management related to inadequate understanding of disease processes
D) Self-care deficit: bathing/hygiene related to irrational thought processes

Question 47

A client on the inpatient psychiatric unit asks the nurse, "Why is the daily schedule so full of activities and why do we have so many rules to follow?" Which of the following is the best response by the nurse?

A) "The real world is full of rules and activities for everyone to follow."
B) "Clients with mental illness get too chaotic and unpredictable when they don't have a structured routine to follow."
C) "Idle hands and minds are the devil's playground."
D) "A daily routine helps you keep on track and organize your thoughts. The rules help people live together respectfully."

Question 48

Which of the following case management activities differentiates case management from medical care management?

A) Assessing for mental and physical health problems
B) Negotiating complex health care systems
C) Advocating for mentally ill clients
D) Detecting mental and physical illness

Question 49

Which of the following programs are often available to mentally ill clients in community treatment settings?
Select all that apply.

A) Adult day care centers
B) Group homes
C) Sheltered workshops
D) Halfway houses
E) Day treatment centers

Question 50

Which of the following aspects of the structural environment pose the greatest risk to client safety in the hospital setting?

A) Potted plants in plastic containers in the day room
B) Plastic clothes hangers in clients' closets
C) Program schedules posted on bulletin boards behind glass doors
D) Breakaway shower rods in the clients' bathrooms

Question 51

A nurse case manager is assigned to a client with recurring substance abuse issues. Which of the following strategies would be most important in providing care to this client?

A) Ordering psychological testing
B) Arranging for inpatient hospital care
C) Administering medications
D) Assessment and problem identification

Question 52

Which of the following treatment programs would be most appropriate for homeless clients whose judgment is severely impaired by paranoid delusions and command hallucinations due to medication and treatment nonadherence?

A) Partial hospitalization programs
B) Assertive community treatment
C) Mobile outreach units
D) Inpatient hospital-based care

Question 53

The interdisciplinary treatment team is discussing appropriate strategies for a homebound client who has a history of medication nonadherence. Which of the following .XAs should the nurse case manager use when a treatment team member suggests that the nurse case manager make daily home visits to administer medications?

A) "My job description does not include medication administration to clients in the home."
B) "My role as case manager is to remain objective and look at the whole picture. If I deliver direct care, I may lose this perspective."
C) "My time is more importantly spent supervising others to provide this type of direct care."
D) "My daily schedule is too full to commit this amount of time to administering medications."

Question 54

Which of the following community support programs should the nurse recommend to family members of a client with severe and persistent mental illness (SPMI) who is living independently in the community?
Select all that apply.

A) Case management
B) Residential special care units
C) Hospices
D) Day treatment
E) Medication management

Question 55

A client with chronic paranoid schizophrenia was recently referred to a Sheltered Workshop and has been participating in a supported employment program for three weeks. Which of the following client outcomes would indicate that the client is demonstrating successful behaviors in this program?

A) The client applied for and obtained subsidized housing from the local housing authority.
B) The client applied for and was approved by the Medicaid program for supplemental income.
C) The client attended 85% of recreational and educational group activities.
D) The client worked four hours per day making protective facemasks for a local company.

Question 56

Which of the following community support programs are uniquely suited to meet the needs of clients with severe and persistent mental illness (SPMI)?
Select all that apply.

A) Nursing homes
B) Depot medication therapy
C) Residential group homes
D) Partial hospitalization programs
E) Vocational training programs

Question 57

A client with chronic paranoid schizophrenia was recently referred to a psychosocial rehabilitation "clubhouse" program following discharge from the inpatient psychiatric unit. Which of the following client goals is most appropriate for this situation?

A) The client will identify career goals and develop a resume of job experiences.
B) The client will obtain a sponsor and attend weekly AA meetings.
C) The client will obtain food, clothing, and transportation services.
D) The client will attend recreational and educational group activities on a daily basis.

Question 58

For a nurse studying bioethics, which of the following statements would indicate that learning has occurred regarding autonomy?

A) "Part of our profession is doing good things for others."
B) "We must always be honest with clients."
C) "After I provide information, I will respect my client's right to make a decision."
D) "All clients should be given their due."

Question 59

A nurse is planning a presentation for psychiatric clients and their families on client rights. This would be an example of:

A) Duty to warn.
B) Competency.
C) Advocacy.
D) Maleficence.

Question 60

The relative of a chronically mentally ill woman requests that the mentally ill woman be committed because of her history of 12 previous hospitalizations and because she sits around the house all day refusing to get dressed. The nurse tells the relative that the woman cannot be committed because:

A) It is less than two weeks since her most recent hospital discharge.
B) She has used up her hospital coverage.
C) There is no evidence that she is a danger to self or others.
D) She has not voluntarily requested hospitalization.

Question 61

The nurse is working with a client who has just stated that she beats her toddler with a wooden paddle. The nurse determines that the client's verbal admission warrants:

A) A report to the physician.
B) A report to the chief of staff.
C) A report to appropriate government authorities.
D) A report to the nursing supervisor.

Question 62

When a client gives written notice of intention to leave the hospital after a voluntary admission, what determines the number of hours or days between the notice and the discharge?

A) Hospital policy
B) State law
C) Insurer
D) Federal law

Question 63

When comparing forensic nursing practice with correctional mental health nursing practice, the nurse correctly identifies that correctional mental health nurses focus on:

A) Criminal investigative analysis.
B) The client's past state of mind.
C) The client's present needs.
D) Offering consulting services.

Question 64

The nurse acts on the client's behalf as an advocate for the client's needs and best interests. What principle of bioethics is being demonstrated by the nurse?

A) Beneficence
B) Fidelity
C) Justice
D) Veracity

Question 65

A 15-year-old female is brought by her mother to see a psychiatric nurse practitioner. The client's mother demands that her daughter be admitted for treatment of "behavioral problems." Her mother states that the daughter stays out until 4 a.m. and is hanging out with "bad" kids. The nurse will recommend which of the following?

A) Outpatient therapy for the mother and daughter
B) Therapy for the daughter
C) Therapy for the mother
D) Involuntary admission for the daughter

Question 66

The staff are discussing competency. Which of the following statements about competency is inaccurate?

A) A competent client means the client can make reasonable judgments and decisions.
B) Competency is a medical determination made by the client's physician.
C) Competency is affected by client compliance with treatment.
D) A guardian is appointed to make decisions on the person's behalf when the client is determined to be incompetent.

Question 67

Which situation would support the use of involuntary commitment?

A) The client uses profanity when angry.
B) The client has threatened family members.
C) The client reports auditory hallucinations.
D) The client self-medicates with marijuana.

Question 68

A client is voluntarily admitted to the mental health unit. The nurse knows that this means:

A) The client has signed away all civil rights.
B) The client will need a court hearing within seven days.
C) The client has to remain hospitalized for three days.
D) The client gave informed consent for hospitalization.

Question 69

The nurse is attempting to obtain informed consent for the administration of electroconvulsive treatment for a depressed client. The client expresses some fears and concerns regarding the treatment. The nurse should:

A) Recognize that the client does not want ECT and document a refusal to sign the informed consent.
B) Reassure the client and then have the client sign the informed consent.
C) Notify the physician.
D) Provide the client with additional information and cancel any scheduled ECT treatments until the client is able to give informed consent.

Question 70

A client with schizophrenia has decided to develop a psychiatric advance directive. What would be included in this document?

A) List of persons who can make decisions on the client's behalf
B) A legal representative for power of attorney
C) Do not resuscitate (DNR) requests
D) Conditions under which life support will be discontinued

Question 71

A client tells the nurse, "My therapist stroked my face and asked me to come to his house for a romantic evening." What action should the nurse take?

A) Do nothing, as psychiatric clients often are unreliable.
B) Call the police.
C) Discuss the statements with the medical director.
D) Immediately report the client's claims to the appropriate authority.

Question 72

A client tells the nurse, "I considered it my goal to burn down my neighbor's house with him in it to pay him back for what he has done to me." The nurse is confronted with:

A) Involuntary commitment.
B) Accuracy in reporting.
C) Confidentiality.
D) Duty to warn.

Question 73

The nurse at the unit desk answers the telephone. The caller asks for permission to speak to a specific client. The nurse responds, "The client is busy in a meeting, and I don't see your name on the client's telephone list." The nurse can best be described as:

A) Following orders.
B) Showing disrespect to the caller.
C) Pursuing informed consent.
D) Breaking the client's right to confidentiality.

Question 74

The nurse is having lunch with colleagues from a medical-surgical unit. One of the medical-surgical nurses states, "I don't know how you can work with psych patients! They scare the heck out of me." How should the nurse respond?

A) "I don't know; sometimes I wonder what I am doing."
B) "The clients I work with have physical disorders just like the clients you work with."
C) "I must have better nursing skills than you do."
D) "It's not that bad, and most of the clients are not that scary."

Question 75

When comparing forensic nursing practice with correctional mental health nursing practice, the student nurse identifies that correctional mental health nurses:

A) Apply psychiatric nursing skills.
B) Work only in prisons.
C) Apply forensic nursing skills.
D) Apply both psychiatric and forensic nursing skills.

Question 76

The nurse and a client talk about the signs and symptoms of acute mania. The client states, "When I am feeling really good and don't need to sleep, I am manic, but the last thing I want is treatment." The nurse recognizes that this experience is indicative of the need for:

A) Psychiatric advance directive (PAD).
B) Competency.
C) Right to treatment.
D) Informed consent.

Question 77

The student nurse is learning how to reduce the stigma associated with mental illness. Which of the following statements by the student nurse reflects that learning has taken place?

A) "They've added another paranoid to the unit."
B) "A 19-year-old who reports hearing voices is being admitted with a diagnosis of psychosis not otherwise specified."
C) "We're admitting another crazy client."
D) "We're admitting another schizophrenic who hears God talking."

Question 78

A unit has a protocol for research on medications. The protocol identifies essential items that must be shared with clients to ensure ethical nursing practice. Which of the following factors should be shared with clients?

A) All aspects of the research study
B) Cost of the research
C) Problems that all other clients have had in the study
D) Risks that can be encountered

Question 79

Which change in mental status is consistently seen in delirious individuals that differentiates it from dementia?

A) Clouding of consciousness
B) Disorientation to self
C) Impaired short-term memory
D) Apraxia

Question 80

A client is 72 years old and has Alzheimer's dementia. Her husband of 50 years is no longer able to safely care for her at home and has her placed in a long-term care facility. When her husband visits her, she smiles and talks about their many travels around the world. Intrigued, the nurse asks the husband to describe his travels. The husband laughs and says, "We've never been out of the states." The client's tales are an example of:

A) Delirium.
B) Apraxia.
C) Confabulation.
D) Aphasia.