Question 1

When planning care for the client with a dissociative disorder, the nurse would include interventions addressing the issue that the client's use of defense mechanisms may be difficult to avoid because of:

Accepted Answer

Dissociative disorders often involve the use of defense mechanisms as a way to cope with past trauma or distressing memories. The client may have learned that using these defenses can result in secondary gain, such as avoidance of responsibilities or attention from others. Therefore, interventions should address this issue to help the client develop healthier coping mechanisms. Poor communication, predictable, or unpredictable behaviors may also be present in dissociative disorders, but they do not directly relate to the use of defense mechanisms.

Question 2

During assessment to determine whether a client has a "good sleep" pattern, the nurse should be aware of a behaviorally defined assessment that includes:

Accepted Answer

The answer of During assessment to determine whether a client...

Question 3

The nurse has instructed the client with a sleep disorder about sleep pattern variations. On reassessment, the nurse knows the teaching was effective when the client states that:

Accepted Answer

The statement “the average amount of sleep required to feel rested is unique to each person” demonstrates understanding of the concept that there is no one-size-fits-all approach to sleep requirements. It is important to recognize individual differences and adjust sleep patterns accordingly. Shortened sleep time may be habitual for some individuals, but is not a universal statement. The distinction between hours needed and obtained is important because it can help identify potential sleep deficits or disruptions. Chronic sleep deprivation is a recognized problem in the United States and globally.

Question 4

A client's depression is misdiagnosed as a primary sleep disorder of insomnia. The client is placed on hypnotic medication. What condition should the nurse anticipate as a potential safety problem?

Accepted Answer

Misdiagnosis of depression can lead to inadequate treatment and potentially increase the risk for suicide. Hypnotic medication can also increase the risk for suicidal ideation or behavior. Therefore, monitoring for suicide risk is important in this situation. Fatigue, hypersomnia, and sleep deprivation may be potential side effects of hypnotic medication, but they are not the most significant safety concern in this case.

Question 5

The nurse is conducting a class for clients on the basic anatomy of sleep. It would be most important for the nurse to explain which of the following concepts?
Select all that apply.

Accepted Answer

The sleep switch and circadian clock are essential concepts in understanding the basic anatomy of sleep, as they play a crucial role in regulating the sleep-wake cycle. Hormone serotonin, interventions for medical-surgical units, and diagnostic codes are not as relevant to a basic anatomy class on sleep.

Question 6

An 18-year-old client who joined the military shortly after graduating from high school is admitted to the mental health unit for depression and suicidal ideation. He tells the nurse the military is not what he expected and he wants to go home. The nurse observes a variance in affect between his interaction with peers and staff. The nurse suspects:

Accepted Answer

The client's variance in affect between peers and staff suggests that he may be malingering, or exaggerating his symptoms in order to obtain a discharge from the military. He may be feeling disillusioned with the military and seeking a way out. Body dysmorphic disorder involves excessive concern with perceived flaws in one's appearance, factitious disorder involves intentionally fabricating or inducing physical or psychological symptoms for attention or other personal gain, and conversion disorder involves experiencing physical symptoms that cannot be explained by a medical condition. None of these disorders seem to fit the client's particular symptoms and situation.

Question 7

The nurse finds that the client with a somatoform disorder has physical symptoms present, but there is no evidence of physiologic disease. The client may have decreased amounts of serotonin and endorphins, causing the client to experience an increased sensitivity to pain. This explanation of the client's symptoms is based in:

Accepted Answer

The explanation of the client's physical symptoms being caused by decreased amounts of serotonin and endorphins is based in biologic theory, which focuses on the relationship between biological factors and behavior.

Question 8

The nurse addressing gender identity issues instructs the client that there are gradations called transgender. The teaching would include information on transgender biologic gradations of which of the following?
Select all that apply.

Accepted Answer

The answer of The nurse addressing gender identity issues instructs...

Question 9

The nurse instructs the client that a person's sense of identity as a male or female develops from which of the following?
Select all that apply.

Accepted Answer

A person's sense of identity as male or female develops from self-identity, biological factors, and the identity imposed by others. Self-identity involves personal understanding and acceptance of one's gender, biology includes genetic and physiological aspects, and societal or external influences can shape one's gender identity.

Question 10

The client describes being uncomfortable as a male since kindergarten. "I liked playing with dolls and playing dress-up in my mom's prom dress and high heels." The client is relating an example of:

Accepted Answer

The client's discomfort with their assigned gender and preference for activities and clothing typically associated with the opposite gender suggests gender dysphoria, a condition in which a person experiences significant distress or discomfort due to a mismatch between their gender identity and their biological sex. Cross-dressing may be a behavior associated with gender dysphoria, but by itself does not necessarily indicate the condition. Androgyny refers to a blending of masculine and feminine characteristics, and fetishism involves deriving sexual pleasure from a specific object or body part, neither of which are described in the client's statement.

Question 11

A client who cross-dresses is intent on keeping it a secret and not disclosing it to his partner. The nurse should:

Accepted Answer

The nurse should offer education and support to the client in a non-judgmental and empathetic manner. Confidentiality should be maintained unless there is a serious safety concern or legal requirement to disclose the information. It is not the nurse's place to reveal the client's personal information to others without their consent. Determining when or where the cross-dressing occurs is also not relevant to the client's health or well-being.

Question 12

When doing the morning medication count for the past two weeks, the nurse noticed several drugs that had been "wasted" or "re-ordered." Which of the following is the most appropriate intervention when suspecting drug diversion?

Accepted Answer

It is important to document any suspicions of drug diversion and report them to appropriate authorities. This should be done while following facility policies and procedures. It is not appropriate for the nurse to try to obtain definitive evidence or set up a "sting" operation on their own. Staying out of the situation is also not appropriate, as drug diversion can potentially harm patients and the nurse has an obligation to report any concerns.

Question 13

Select the responses which are true regarding the interactional model for schizophrenia. Select all that apply.

Accepted Answer

The interactional model for schizophrenia suggests that vulnerability, stressors, and risk factors interact with each other to increase the risk of experiencing symptoms and relapse. People with schizophrenia have a greater potential for vulnerability to stress, and stressors and risk factors can enhance and potentiate each other in people with schizophrenia. Additionally, research has shown that people with schizophrenia are more likely to relapse if they are from families demonstrating high expressed emotion (EE). Option D and E are incorrect as they suggest that people with schizophrenia are less sensitive to interpersonal and environmental stressors, respectively, which is not supported by the interactional model.

Question 14

Which of the following aspects of family communication patterns may be problematic? Select all that apply.

Accepted Answer

Unusual language patterns may indicate a culture within the family that is exclusive and difficult to penetrate for outsiders, while enmeshed or over-involved family members may indicate a lack of healthy boundaries and individual autonomy. The other options (A, B, and E) demonstrate positive aspects of family communication patterns.

Question 15

A client tells the nurse, "I refuse to take quetiapine (Seroquel) because it is manufactured by Al Qaeda. If I take it, I'll die." This is an example of:

Accepted Answer

The statement made by the client is a clear indication of a delusion, which is a type of positive symptom of schizophrenia. The client is making a statement that is clearly not based in reality and is unlikely to be true. The delusional belief that the medication is manufactured by a terrorist group is causing the client to refuse taking the medication.

Question 16

The nurse is interacting with a client. The client states, "I am from the planet Shoz, so I am a Shozoid." The client is manifesting which type of communication?

Accepted Answer

The client's statement of being from the planet Shoz and being a Shozoid is an example of a neologism, which is a made-up word or phrase that has special meaning to the individual.

Question 17

A client describes being sad since his wife died three weeks ago. When he describes the memorial service, funeral, and his plans for the future, the nurse assesses this as:
Select all that apply.

Accepted Answer

The client's description aligns with normal grief and bereavement, as it is expected that he would feel sad after the loss of his wife. There are no indications that the grieving process is dysfunctional or delayed, and it does not appear to be a crisis at this time.

Question 18

The nurse would expect a client who is exhibiting the vegetative signs of depression to have:

Accepted Answer

Vegetative signs of depression refer to the physical or bodily symptoms associated with depression, such as changes in sleep patterns (like insomnia) and gastrointestinal issues (like constipation). Suicidal ideation, hopelessness, and helplessness are more related to the emotional or cognitive symptoms of depression rather than the vegetative or physical signs.

Question 19

The nurse tells the client with acute mania that an effective treatment may be:

Accepted Answer

Electroconvulsive therapy (ECT) is a safe and effective treatment for acute mania. It is often used when medications are not effective or in cases where rapid stabilization is needed. Fluoxetine (Prozac) is an antidepressant and may not be effective in treating acute mania. Seclusion and restraint are only used as a last resort for safety reasons. Group therapy may be beneficial for long-term management but not as an effective treatment for acute mania.

Question 20

The nurse's priority intervention for a newly hospitalized suicidal client is to:

Accepted Answer

Obtaining a no-suicide contract is the priority intervention for a newly hospitalized suicidal client as it helps establish a commitment to safety and can serve as a starting point for ongoing evaluation of the client's risk for suicide. Requesting the client to describe previous stressors or requiring participation in a group may be helpful interventions but are not the priority at this time. Asking the client to write a list of their weaknesses may worsen their already fragile emotional state and is not an appropriate intervention.

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