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\pard\sb0\sl-240{\bkmkstart Pg1}{\bkmkend Pg1}\par\pard\ql \li4641\sb0\sl-260\sl
mult0 \par\pard\ql\li4641\sb0\sl-260\slmult0 \par\pard\ql\li4641\sb0\sl-260\slmu
lt0 \par\pard\ql\li4641\ri4458\sb225\sl-260\slmult0\tx5064 \up0 \expndtw-3\chars
calex100 \ul0\nosupersub\cf1\f2\fs22 ARELLANO UNIVERSITY \line\tab \up0 \expndtw
-3\charscalex100 COURSE AUDIT 2 \par\pard\ql \li4634\ri4453\sb144\sl-280\slmult0
\tx5685 \up0 \expndtw-3\charscalex100 PSYCHIATRIC NURSING \line\tab \up0 \expndt
w-3\charscalex100 QUIZ 1 \par\pard\ql \li719\sb0\sl-253\slmult0 \par\pard\ql\li7
19\sb10\sl-253\slmult0 \up0 \expndtw-3\charscalex100 Set A/B \par\pard\qj \li720
\sb0\sl-220\slmult0 \par\pard\qj\li720\ri1055\sb15\sl-220\slmult0 \up0 \expndtw1\charscalex100 \ul0\nosupersub\cf3\f4\fs18 1/13. When planning the discharge of
a client with chronic anxiety, the nurse directs the goal at promoting a safe \
up0 \expndtw-1\charscalex100 environment at home. The appropriate maintenance go
al should focus on which of the following? \par\pard\li720\sb13\sl-207\slmult0\f
i0\tx7201 \up0 \expndtw-2\charscalex100 a. Ignoring feelings of anxiety\tab \up0
\expndtw-2\charscalex100 c. Continued contact with a crisis counselor\par\pard\
li720\sb14\sl-207\slmult0\fi0\tx7200 \up0 \expndtw-2\charscalex100 b. Identifyin
g anxiety-producing situations.\tab \up0 \expndtw-2\charscalex100 d. Eliminating
all anxiety from daily situations\par\pard\ql \li720\sb10\sl-207\slmult0 \up0 \
expndtw-2\charscalex100 \ul0\nosupersub\cf4\f5\fs18 ANSWER: B \par\pard\ql \li72
0\sb1\sl-198\slmult0 \up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf3\f4\fs18 R
ecognizing situations that produce anxiety allows the client to prepare to cope
with anxiety or avoid specific \par\pard\ql \li720\ri726\sb4\sl-220\slmult0 \up0
\expndtw-1\charscalex100 stimulus. Counselors will not be available for all anx
iety-producing situations, and this option does not encourage the \line \up0 \ex
pndtw-1\charscalex100 development of internal strengths. Ignoring feelings will
not resolve anxiety. Elimination of all anxiety from life is \line \up0 \expndt
w-2\charscalex100 impossible. \par\pard\qj \li720\ri1216\sb220\sl-220\slmult0 \u
p0 \expndtw-1\charscalex100 2/21. A woman comes into the emergency in a severe s
tate of anxiety following a car accident. The appropriate \up0 \expndtw-2\charsc
alex100 nursing intervention is to: \par\pard\li720\sb22\sl-207\slmult0\fi0\tx52
92 \up0 \expndtw-2\charscalex100 a. Remain with client.\tab \up0 \expndtw-2\char
scalex100 c. Teach the client deep breathing.\par\pard\li720\sb11\sl-207\slmult0
\fi0\tx5291 \up0 \expndtw-2\charscalex100 b. Put a client in a quiet room.\tab \
up0 \expndtw-2\charscalex100 d. Encourage the client to talk about their feeling
s and concerns.\par\pard\ql \li720\sb4\sl-207\slmult0 \up0 \expndtw-2\charscalex
100 \ul0\nosupersub\cf4\f5\fs18 ANSWER: A \par\pard\ql \li720\ri589\sb3\sl-220\s
lmult0\fi0 \up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf3\f4\fs18 If a client
with severe anxiety is left alone, the client may feel abandoned and become ove
rwhelmed. Placing the client \up0 \expndtw-1\charscalex100 in a quiet room is al
so important, but nurse must stay with the client. Teaching the client deep brea
thing or relaxation \up0 \expndtw-1\charscalex100 is not possible until the anxi
ety decreases. Encouraging the client to discuss concerns and feelings would not
take \line \up0 \expndtw-2\charscalex100 place until the anxiety has decrease.
\par\pard\ql \li720\sb0\sl-210\slmult0 \par\pard\ql\li720\ri746\sb19\sl-210\slmu
lt0 \up0 \expndtw-1\charscalex100 3/16. The client is unwilling to go out of the

house for fear of \u8220?doing something crazy in public.\u8221? Because of thi

s fear, \up0 \expndtw-1\charscalex100 the client remains homebound, except when
accompanied outside by the spouse. Based on this data, the nurse \line \up0 \exp
ndtw-2\charscalex100 determines that the client is experiencing: \par\pard\li720
\sb31\sl-207\slmult0\fi0\tx3601\tx6480\tx9360 \up0 \expndtw-2\charscalex100 a. A
goraphobia\tab \up0 \expndtw-2\charscalex100 b. Social phobia\tab \up0 \expndtw2\charscalex100 c. Claustrophobia\tab \up0 \expndtw-2\charscalex100 d. Hypochond
riasis\par\pard\ql \li720\sb0\sl-202\slmult0 \up0 \expndtw-2\charscalex100 \ul0\
nosupersub\cf4\f5\fs18 ANSWER: A \par\pard\ql \li720\ri711\sb4\sl-220\slmult0 \u
p0 \expndtw-1\charscalex100 \ul0\nosupersub\cf3\f4\fs18 Agoraphobia is the fear
of open spaces and the fear of being trapped in a situation from which there may
not be an \line \up0 \expndtw-1\charscalex100 escape. Agoraphobia includes the
possibility of experiencing a sense of helplessness or embarrassment if an attac
k \line \up0 \expndtw-1\charscalex100 occurs. Avoidance of such situations usual
ly results in the reduction of social and professional interactions. Social \lin
e \up0 \expndtw-1\charscalex100 phobia focuses more on specific situations, such
as fear of speaking, performing or eating in public. Claustrophobia is \up0 \ex
pndtw-1\charscalex100 a fear of closed places. Clients who have hypochondriacal
symptoms focus their anxiety on physical complaints and \line \up0 \expndtw-2\ch
arscalex100 preoccupied with their health. \par\pard\ql \li720\ri598\sb220\sl-22
0\slmult0 \up0 \expndtw-1\charscalex100 4/14. A client is admitted to a medical
nursing unit with a diagnosis of acute blindness. Many tests are performed, and
\up0 \expndtw-1\charscalex100 there seems to be no organic reason why his client
cannot see. The nurse later learns that the client became blind \line \up0 \exp
ndtw-1\charscalex100 after witnessing a hit-and-run car accident, when a family
of three was killed. The nurse suspects that the client may \line \up0 \expndtw2\charscalex100 be experiencing a: \par\pard\li720\sb13\sl-207\slmult0\fi0\tx338
5\tx5943\tx9362 \up0 \expndtw-2\charscalex100 a. Psychosis\tab \up0 \expndtw-2\c
harscalex100 b. Repression\tab \up0 \expndtw-2\charscalex100 c. Conversion disor
der\tab \up0 \expndtw-2\charscalex100 d. Dissociative disorder\par\pard\ql \li72
0\sb11\sl-207\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf4\f5\fs18
ANSWER: C \par\pard\ql \li720\sb1\sl-198\slmult0 \up0 \expndtw-1\charscalex100 \
ul0\nosupersub\cf3\f4\fs18 A conversion disorder is the alteration or loss of a
physical function that cannot be explained by any known \par\pard\ql \li720\ri70
8\sb4\sl-220\slmult0 \up0 \expndtw-1\charscalex100 pathophysiological mechanism.
A conversion is thought to be an expression of a physiological need or conflict
. In this \up0 \expndtw-1\charscalex100 situation, the client witnessed an accid
ent that was so physiologically painful that the client became blind. A \line \u
p0 \expndtw-1\charscalex100 dissociative disorder is a disturbance or alteration
in the normally integrative functions of which identity, memory or \up0 \expndt
w-1\charscalex100 consciousness. Psychosis is a state of which a person\u8217?s
capacity to recognize reality, communicate, and relate to \line \up0 \expndtw-1\
charscalex100 others is impaired, thus, interfering with the person\u8217?s abil
ity to deal with life\u8217?s demands. Repression is coping \line \up0 \expndtw2\charscalex100 mechanism in which unacceptable feelings are kept out of awarene
ss. \par\pard\qj \li720\ri671\sb220\sl-220\slmult0 \up0 \expndtw-1\charscalex100
5/22. A client reports experiencing nightmares and constant worry about the wea
ther since typhoon Ondoy destroyed \up0 \expndtw-1\charscalex100 the client\u821
7?s house. The nurse assesses that this client is experiencing: \par\pard\li720\
sb16\sl-207\slmult0\fi0\tx3977\tx7201\tx10080 \up0 \expndtw-2\charscalex100 a. H
allucinations\tab \up0 \expndtw-2\charscalex100 b. Panic attacks\tab \up0 \expnd
tw-2\charscalex100 c. flashbacks\tab \up0 \expndtw-2\charscalex100 d. delusions\
par\pard\ql \li720\sb8\sl-207\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosuper
sub\cf4\f5\fs18 ANSWER: C \par\pard\ql \li720\ri731\sb9\sl-213\slmult0 \up0 \exp
ndtw-1\charscalex100 \ul0\nosupersub\cf3\f4\fs18 A client who repeatedly experie
nces nightmares and constantly worries about the weather since a typhoon destroy
ed \up0 \expndtw-1\charscalex100 his house is experiencing flashbacks. Clients w
ho have flashbacks have recurrent intrusive recollections of the \line \up0 \exp
ndtw-1\charscalex100 traumatic event. Clients with delusions, hallucinations, an
d panic attacks would reexperience the traumatic event. \up0 \expndtw-1\charsca

lex100 \ul0\nosupersub\cf5\f6\fs18 Reference: Mary Ann Boyd. Psychiatric Nursing

. 4\ul0\super\cf6\f7\fs17 th\ul0\nosupersub\cf5\f6\fs18 edition. Page 428-429 \
par\pard\qj \li719\sb0\sl-220\slmult0 \par\pard\qj\li719\ri702\sb2\sl-220\slmult
0 \up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf3\f4\fs18 6/17. A 30 year old
male employee frequently complains of low back pain that leads to frequent absen
ces from work. \up0 \expndtw-1\charscalex100 Consultation and tests reveal negat
ive results. The client has which somatoform disorder? \par\pard\li719\sb26\sl-2
07\slmult0\fi0\tx3600\tx6136\tx8828 \up0 \expndtw-2\charscalex100 a. Somatizatio
n Disorder\tab \up0 \expndtw-2\charscalex100 b. Hypochondriaisis\tab \up0 \expnd
tw-2\charscalex100 c. Conversion Disorder\tab \up0 \expndtw-2\charscalex100 d. S
omatoform Pain Disorder\par\pard\ql \li720\sb0\sl-205\slmult0 \up0 \expndtw-2\ch
arscalex100 \ul0\nosupersub\cf4\f5\fs18 ANSWER: D \par\pard\ql \li720\sb14\sl-20
7\slmult0 \up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf3\f4\fs18 This is char
acterized by severe and prolonged pain that causes significant distress. Option
A: This is a chronic \par\pard\ql \li719\ri1173\sb3\sl-220\slmult0 \up0 \expndtw
-1\charscalex100 syndrome of somatic symptoms that cannot be explained medically
and is associated with psychosocial distress. \up0 \expndtw-1\charscalex100 Opt
ion B: This is an unrealistic preoccupation with a fear of having a serious illn
ess. Option C: Characterized by \up0 \expndtw-1\charscalex100 alteration or loss
in sensory or motor function resulting from a psychological conflict. \line \up
0 \expndtw-2\charscalex100 \ul0\nosupersub\cf5\f6\fs18 Reference: Mary Ann Boyd.
Psychiatric Nursing. 4\ul0\super\cf6\f7\fs17 th\ul0\nosupersub\cf5\f6\fs18 edi
tion. Page 497 \par\pard\qj \li719\ri1255\sb220\sl-220\slmult0 \up0 \expndtw-1\c
harscalex100 \ul0\nosupersub\cf3\f4\fs18 7/15. The nurse is assessing a parent w
ho abused her child. Which of the following risk factors would the nurse \up0 \e
xpndtw-2\charscalex100 suspect to find in this case? \par\pard\sect\sectd\fs24\p
aperw12240\paperh18720\pard\sb0\sl-240{\bkmkstart Pg2}{\bkmkend Pg2}\par\pard\li
720\sb0\sl-207\slmult0\par\pard\li720\sb0\sl-207\slmult0\par\pard\li720\sb76\sl207\slmult0\fi0\tx7201 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf3\f4\fs18
a. Flexible role functioning between parents\tab \up0 \expndtw-2\charscalex100
c. Single parent home situation\par\pard\li720\sb11\sl-207\slmult0\fi0\tx7200 \u
p0 \expndtw-2\charscalex100 b. History of parent having been abused as child\tab
\up0 \expndtw-2\charscalex100 d. Presence of parental mental illness\par\pard\q
l \li720\sb1\sl-198\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf4\f5
\fs18 ANSWER: B \par\pard\ql \li720\ri634\sb4\sl-220\slmult0 \up0 \expndtw-1\cha
rscalex100 \ul0\nosupersub\cf3\f4\fs18 One of the most important risk factors is
history of childhood abuse in the parent who abuses. Family violence follows \u
p0 \expndtw-1\charscalex100 a multigenerational pattern. Parents who are flexibl
e in their roles are characteristic of healthy functioning, not abuse. \up0 \exp
ndtw-1\charscalex100 Single parent households and a history of mental illness ar
e not established risk factors for child abuse by a parent. \up0 \expndtw-1\char
scalex100 \ul0\nosupersub\cf5\f6\fs18 Reference: Mary Ann Boyd. Psychiatric Nurs
ing. 4\ul0\super\cf6\f7\fs17 th\ul0\nosupersub\cf5\f6\fs18 edition. Page 865-86
6 \par\pard\qj \li719\ri916\sb220\sl-220\slmult0 \up0 \expndtw-1\charscalex100 \
ul0\nosupersub\cf3\f4\fs18 8/19. Incidents of a child molestation that come out
years later when the victims is an adult are best explained the \up0 \expndtw-2\
charscalex100 ego defense mechanism of: \par\pard\li719\sb19\sl-207\slmult0\fi0\
tx3447\tx6203\tx9272 \up0 \expndtw-2\charscalex100 a. Repression\tab \up0 \expnd
tw-2\charscalex100 b. Regression\tab \up0 \expndtw-2\charscalex100 c. Rationaliz
ation\tab \up0 \expndtw-2\charscalex100 d. Reaction formation\par\pard\ql \li719
\sb5\sl-207\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf4\f5\fs18 AN
SWER: A \par\pard\ql \li719\ri932\sb3\sl-220\slmult0 \up0 \expndtw-1\charscalex1
00 \ul0\nosupersub\cf3\f4\fs18 Repression is a coping mechanism in which unaccep
table feelings are kept out of conscious awareness; later under \up0 \expndtw-1\
charscalex100 stress or anxiety, thoughts or feelings surface and come into one\
u8217?s conscious awareness \line \up0 \expndtw-1\charscalex100 \ul0\nosupersub\
cf5\f6\fs18 Reference: Videbeck. Psychiatric Mental Health Nursing. 3\ul0\super\
cf6\f7\fs17 rd\ul0\nosupersub\cf5\f6\fs18 edition. Page 51-52 \par\pard\qj \li7
19\ri679\sb220\sl-220\slmult0 \up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf3\
f4\fs18 9/12. A nurse working in the emergency department is conducting an inter

view with a victim of spousal abuse. Which \up0 \expndtw-2\charscalex100 step sh

ould the nurse take first? \par\pard\ql \li719\sb11\sl-207\slmult0 \up0 \expndtw
-2\charscalex100 a. Contact appropriate legal service \par\pard\ql \li719\sb1\sl
-198\slmult0 \up0 \expndtw-2\charscalex100 b. Ensure privacy for interviewing th
e victim away from the abuser \par\pard\ql \li719\sb15\sl-207\slmult0 \up0 \expn
dtw-2\charscalex100 c. Establish rapport with the victim and abuser \par\pard\ql
\li719\sb13\sl-207\slmult0 \up0 \expndtw-2\charscalex100 d. Call security guard
\par\pard\ql \li719\sb13\sl-207\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosu
persub\cf4\f5\fs18 ANSWER: B \par\pard\ql \li719\ri927\sb3\sl-220\slmult0 \up0 \
expndtw-1\charscalex100 \ul0\nosupersub\cf3\f4\fs18 Privacy away from the abuser
is important. This allows the victim to discuss the problem freely, without fea
r of \line \up0 \expndtw-1\charscalex100 reprisal from the abuser. Option A: It
is not the responsibility of the nurse to call the legal service, it is up to th
e \line \up0 \expndtw-1\charscalex100 woman to make that decision. However if in
jury is inflicted the nurse is obligated to report the abuse. Option C: \line \u
p0 \expndtw-1\charscalex100 Although the nurse would want to establish rapport w
ith the victim, her initial concern would \ul0\nosupersub\cf7\f8\fs18 not be to
establish \line \up0 \expndtw-1\charscalex100 rapport with the abuser\ul0\nosupe
rsub\cf4\f5\fs18 . \ul0\nosupersub\cf3\f4\fs18 The situation does not describe t
he abuser as currently violent, requesting a security is \line \up0 \expndtw-2\c
harscalex100 inappropriate at this time. \par\pard\ql \li720\sb11\sl-207\slmult0
\up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf5\f6\fs18 Reference. Ann Isaacs
. Psychiatric Nursing. Page 175 \par\pard\qj \li720\sb0\sl-220\slmult0 \par\pard
\qj\li720\sb0\sl-220\slmult0 \par\pard\qj\li720\ri735\sb3\sl-220\slmult0 \up0 \e
xpndtw-1\charscalex100 \ul0\nosupersub\cf3\f4\fs18 10/23. The depressed client v
erbalizes feelings of low self-esteem and self-worth typified by statements such
as \u8220?I\u8217?m \up0 \expndtw-1\charscalex100 such a failure. I can\u8217?t
do anything right.\u8221? The best nursing response would be to: \par\pard\ql \
li720\sb1\sl-195\slmult0 \up0 \expndtw-1\charscalex100 a. Tell the client that t
his is not true, that we all have a purpose in life. \par\pard\ql \li720\sb16\s
l-207\slmult0 \up0 \expndtw-1\charscalex100 b. Identify recent behaviors or acco
mplishments that demonstrate the client\u8217?s skill. \par\pard\ql \li720\sb13\
sl-207\slmult0 \up0 \expndtw-1\charscalex100 c. Reassure the client that you kno
w how the client is feeling and that things will get better. \par\pard\ql \li720
\sb13\sl-207\slmult0 \up0 \expndtw-1\charscalex100 d. Remain with the client and
sit in silence; this will encourage the client to verbalize feelings. \par\pard
\ql \li720\sb13\sl-207\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf4
\f5\fs18 ANSWER: B \par\pard\ql \li720\ri630\sb3\sl-220\slmult0 \up0 \expndtw-1\
charscalex100 \ul0\nosupersub\cf3\f4\fs18 Feeling of low self-esteem and worthle
ssness are common symptoms of the depressed client. An effective plan of care \u
p0 \expndtw-1\charscalex100 to enhance the client\u8217?s personal self-esteem i
s to provide experiences for the client that are challenging but that will \up0
\expndtw-1\charscalex100 not be met with failure. Reminders of client\u8217?s pa
st accomplishments or personal successes are ways to interrupt the \up0 \expndtw
-1\charscalex100 client\u8217?s negative self-talk, and distorted cognitive view
of self. Silence may be interpreted as agreement. Options A \up0 \expndtw-2\cha
rscalex100 and C give advice and devalue the client\u8217?s feelings. \par\pard\
ql \li720\sb0\sl-207\slmult0 \par\pard\ql\li720\sb24\sl-207\slmult0 \up0 \expndt
w-1\charscalex100 11/18. A client with a diagnosis of major depression, recurren
t, with psychotic features is admitted to the mental \par\pard\qj \li720\ri787\s
b3\sl-220\slmult0 \up0 \expndtw-1\charscalex100 health unit. To create a safe en
vironment for the client, the nurse most importantly devises a plan of care that
deals \up0 \expndtw-2\charscalex100 specifically with the client\u8217?s: \par\
pard\li720\sb13\sl-207\slmult0\fi0\tx3130\tx5895\tx8577 \up0 \expndtw-2\charscal
ex100 a. Self-care deficit.\tab \up0 \expndtw-2\charscalex100 b. Imbalanced nutr
ition.\tab \up0 \expndtw-2\charscalex100 c. Deficient knowledge.\tab \up0 \expnd
tw-2\charscalex100 d. Disturbed thought processes.\par\pard\ql \li720\sb11\sl-20
7\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf4\f5\fs18 ANSWER: D \p
ar\pard\ql \li720\ri622\sb0\sl-220\slmult0 \up0 \expndtw-1\charscalex100 \ul0\no
supersub\cf3\f4\fs18 Major depressions, recurrent, with psychotic features, aler

t the nurse that in addition to the criteria that designate the \up0 \expndtw-1\
charscalex100 diagnosis of major depression, one also must deal with client\u821
7?s psychosis. Psychosis is defined as a state in which a \up0 \expndtw-1\charsc
alex100 person\u8217?s mental capacity to recognize reality and communicate and
relate to others is impaired, thus, referring with \up0 \expndtw-1\charscalex100
the person\u8217?s ability to deal with the demands of life. Disturbed thought
processes generally indicate a state of \line \up0 \expndtw-1\charscalex100 incr
eased anxiety in which hallucinations and delusions prevail. Although all the nu
rsing diagnosis may be appropriate \up0 \expndtw-1\charscalex100 because the cli
ent is experiencing psychosis, option D is the correct option. \par\pard\qj \li7
20\ri999\sb203\sl-220\slmult0 \up0 \expndtw-1\charscalex100 12/24. The nurse ass
esses a client with the admitting diagnosis of bipolar affective disorder, mania
. The symptom \up0 \expndtw-1\charscalex100 presented by the client that require
s the nurse\u8217?s immediate intervention is the client\u8217?s: \par\pard\ql \
li720\sb11\sl-207\slmult0 \up0 \expndtw-2\charscalex100 a. Outlandish behaviors
and inappropriate dress \par\pard\ql \li720\sb13\sl-207\slmult0 \up0 \expndtw-2\
charscalex100 b. Nonstop physical therapy and nutritional intake \par\pard\ql \l
i720\sb13\sl-207\slmult0 \up0 \expndtw-2\charscalex100 c. Grandiose delusions of
being a royal descendent of King Arthur \par\pard\ql \li720\sb13\sl-207\slmult0
\up0 \expndtw-1\charscalex100 d. Constant, incessant talking that includes sexu
al innuendos and teasing the staff \par\pard\ql \li720\sb13\sl-207\slmult0 \up
0 \expndtw-2\charscalex100 \ul0\nosupersub\cf4\f5\fs18 ANSWER: B \par\pard\ql \l
i720\ri907\sb9\sl-213\slmult0 \up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf3\
f4\fs18 Mania is a mood characterized by excitement, euphoria, hyperactivity, ex
cessive energy, decreased need for sleep, \line \up0 \expndtw-1\charscalex100 an
d impaired ability to concentrate or complete a single trend of thought. Mania i
s a period when the mood is \line \up0 \expndtw-1\charscalex100 predominantly el
evated, expansive, or irritable. All options reflect a client\u8217?s symptomato
logy. Option 2, however, \line \up0 \expndtw-1\charscalex100 clearly presents a
problem that compromises physiological integrity and needs to be addressed immed
iately. \par\pard\qj \li720\sb0\sl-220\slmult0 \par\pard\qj\li720\ri816\sb2\sl-2
20\slmult0 \up0 \expndtw-1\charscalex100 13/20. A client who has been raped tell
s the nurse that the rape was her fault because she walked down an alley on \up0
\expndtw-1\charscalex100 her way to school. Which response by the nurse would b
e best in this situation? \par\pard\ql \li720\sb11\sl-207\slmult0 \up0 \expndtw2\charscalex100 a. Accept the client\u8217?s statement that this was risk-taking
behavior \par\pard\ql \li720\sb13\sl-207\slmult0 \up0 \expndtw-2\charscalex100
b. Ask the client what other behaviors may have been risky \par\pard\ql \li720\s
b13\sl-207\slmult0 \up0 \expndtw-2\charscalex100 c. Emphasize that the rapist, n
ot the client is responsible \par\pard\ql \li720\sb13\sl-207\slmult0 \up0 \expnd
tw-2\charscalex100 d. Suggest that the client discuss this issue later \par\pard
\ql \li720\sb13\sl-207\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf4
\f5\fs18 ANSWER: C \par\pard\qj \li720\ri660\sb3\sl-220\slmult0\fi0 \up0 \expndt
w-1\charscalex100 \ul0\nosupersub\cf3\f4\fs18 The client\u8217?s feeling of self
-blame is a common response to rape-trauma crisis. However, this is not realisti
c perception \line \up0 \expndtw-1\charscalex100 of the event, and the nurse sho
uld point out reality (telling the victim that the rapist is responsible). The r
esponses in \par\pard\sect\sectd\fs24\paperw12240\paperh18720\pard\sb0\sl-240{\b
kmkstart Pg3}{\bkmkend Pg3}\par\pard\qj \li720\sb0\sl-210\slmult0 \par\pard\qj\l
i720\sb0\sl-210\slmult0 \par\pard\qj\li720\ri732\sb66\sl-210\slmult0 \up0 \expnd
tw-1\charscalex100 \ul0\nosupersub\cf3\f4\fs18 options A and B would only serve
to reinforce the client\u8217?s misperception that her own behavior caused the r
ape and, \up0 \expndtw-1\charscalex100 therefore, are incorrect. The response in
option D is incorrect because it avoids addressing the client\u8217?s distress
and is \up0 \expndtw-2\charscalex100 unsupportive to the situation. \par\pard\ql
\li720\sb13\sl-207\slmult0 \up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf5\f6
\fs18 Reference: Norman Keltner. Psychiatric Nursing. 5\ul0\super\cf6\f7\fs17 th
\ul0\nosupersub\cf5\f6\fs18 edition. Page 612-613 \par\pard\ql \li719\sb0\sl-20
7\slmult0 \par\pard\ql\li719\sb26\sl-207\slmult0 \up0 \expndtw-1\charscalex100 \
ul0\nosupersub\cf3\f4\fs18 14/25. The client is admitted to the mental health un

it with a diagnosis of schizophrenia. A nursing diagnosis \par\pard\qj \li719\ri

628\sb3\sl-220\slmult0 \up0 \expndtw-1\charscalex100 formulated for the client i
s thought processes, disturbed related to paranoia. In formulating nursing inter
ventions with \up0 \expndtw-1\charscalex100 the members of the health care team,
the nurse provides instructions to: \par\pard\ql \li720\sb11\sl-207\slmult0 \up
0 \expndtw-2\charscalex100 a. Increase socialization of the client with peers. \
par\pard\ql \li720\sb13\sl-207\slmult0 \up0 \expndtw-2\charscalex100 b. Avoid la
ughing or whispering in front of the client. \par\pard\ql \li720\sb13\sl-207\slm
ult0 \up0 \expndtw-2\charscalex100 c. Begin to educate the client about social s
upports in the community. \par\pard\qj \li720\ri1083\sb3\sl-220\slmult0\tx1440 \
up0 \expndtw-1\charscalex100 d. Have the client sign a release of information to
appropriate parties so that adequate date can be obtained for \line\tab \up0
\expndtw-2\charscalex100 assessment purposes. \par\pard\ql \li719\sb11\sl-207\sl
mult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf4\f5\fs18 ANSWE: B \par\pa
rd\qj \li719\ri640\sb3\sl-220\slmult0\fi0 \up0 \expndtw-1\charscalex100 \ul0\nos
upersub\cf3\f4\fs18 Disturbed thought process related to paranoia is the client\
u8217?s problem, and the plan of care must address this problem. \up0 \expndtw-1
\charscalex100 The client is experiencing paranoia and is distrustful and suspic
ious of others. The members of the health care team \up0 \expndtw-1\charscalex10
0 need to establish a rapport and trust with the client. therefore, laughing or
whispering in front of the client would be \up0 \expndtw-1\charscalex100 counter
productive. Options A, C and D ask the client to trust on a multitude of levels.
These options are actions that \up0 \expndtw-1\charscalex100 are too intrusive
of levels. These options are actions that are too intrusive for a client who is
paranoid. \par\pard\qj \li719\ri1276\sb200\sl-220\slmult0 \up0 \expndtw-1\charsc
alex100 15/11. A client is admitted to a psychiatric unit with a diagnosis of un
differentiated schizophrenia. Which of the \up0 \expndtw-2\charscalex100 followi
ng defense mechanism is probably used? \par\pard\li719\sb25\sl-207\slmult0\fi0\t
x3600\tx6480\tx9360 \up0 \expndtw-2\charscalex100 a. Projection\tab \up0 \expndt
w-2\charscalex100 b. Rationalization\tab \up0 \expndtw-2\charscalex100 c. Regres
sion\tab \up0 \expndtw-2\charscalex100 d. Repression\par\pard\ql \li719\sb0\sl-2
06\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf4\f5\fs18 Answer: C \
par\pard\ql \li719\sb14\sl-207\slmult0 \up0 \expndtw-1\charscalex100 \ul0\nosupe
rsub\cf3\f4\fs18 Regression, a return to earlier behavior to reduce anxiety, is
the basic defense mechanism in schizophrenia. \par\pard\ql \li719\sb13\sl-207\sl
mult0 \up0 \expndtw-1\charscalex100 Repression is the basic defense mechanism in
the neuroses. Rationalization is a defense mechanism used to justify \par\pard\
qj \li719\ri746\sb3\sl-220\slmult0 \up0 \expndtw-1\charscalex100 one\u8217?s act
ion. Projection is a defense mechanism in which one blames others and attempts t
o justify actions; it\u8217?s used \up0 \expndtw-1\charscalex100 primarily by pe
ople with paranoid schizophrenia and delusional disorder. \par\pard\qj \li719\ri
745\sb220\sl-220\slmult0\fi0 \up0 \expndtw-1\charscalex100 16/6. A client with a
diagnosis of schizophrenia, paranoid type, is admitted to an acute-care psychia
tric hospital unit. \up0 \expndtw-1\charscalex100 In anticipation of the client\
u8217?s needs, what nursing diagnosis would be given the highest priority? \par\
pard\li719\sb15\sl-207\slmult0\fi0\tx6481 \up0 \expndtw-2\charscalex100 a. Alter
ed thought processes\tab \up0 \expndtw-2\charscalex100 c. Social isolation\par\p
ard\li719\sb12\sl-207\slmult0\fi0\tx6481 \up0 \expndtw-2\charscalex100 b. Impair
ed verbal communication\tab \up0 \expndtw-2\charscalex100 d. Risk for violence d
irected at self or at others\par\pard\ql \li719\sb10\sl-207\slmult0 \up0 \expndt
w-2\charscalex100 \ul0\nosupersub\cf4\f5\fs18 Answer: D \par\pard\ql \li719\ri7
48\sb0\sl-220\slmult0 \up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf3\f4\fs18
Safety is always the highest priority when caring for a client with a diagnosis
of schizophrenia, paranoid type. Clients \line \up0 \expndtw-1\charscalex100 wit
h diagnosis are potentially violent and can quickly become aggressive as a resul
t of their psychosis. The other \line \up0 \expndtw-1\charscalex100 options (A,B
and C) of diagnoses are appropriate for the client\u8217?s care plan but are no
t given the highest priority. \par\pard\qj \li719\ri764\sb203\sl-220\slmult0 \up
0 \expndtw-1\charscalex100 17/1. A client\u8217?s disruptive behavior on the war
d has been increasingly annoying to the other patients. One approach \up0 \expn

dtw-2\charscalex100 by the nurse might be to \par\pard\ql \li719\sb11\sl-207\slm

ult0 \up0 \expndtw-2\charscalex100 a. Tell her she is annoying others and confin
e her to her room \par\pard\ql \li719\sb13\sl-207\slmult0 \up0 \expndtw-2\charsc
alex100 b. Ignore her behavior, realizing it is consistent with her illness \par
\pard\ql \li719\sb13\sl-207\slmult0 \up0 \expndtw-2\charscalex100 c. Set limits
on her behavior and be consistent in approach \par\pard\ql \li719\sb13\sl-207\sl
mult0 \up0 \expndtw-2\charscalex100 d. Make a rigid structured plan that she wil
l have to follow \par\pard\ql \li719\sb13\sl-207\slmult0 \up0 \expndtw-2\charsca
lex100 \ul0\nosupersub\cf4\f5\fs18 Answer: C \par\pard\qj \li719\ri952\sb3\sl-2
20\slmult0\fi0 \up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf3\f4\fs18 Set lim
its on her behavior and be consistent in approach - this is important to avoid r
ejection of the other patients \up0 \expndtw-2\charscalex100 with subsequent low
ering of self - esteem. \par\pard\qj \li719\ri615\sb220\sl-220\slmult0 \up0 \exp
ndtw-1\charscalex100 18/5. A client\u8217?s illness can best be understood as th
e ego\u8217?s attempt to compensate for an assault against it and fear of \up0 \
expndtw-1\charscalex100 the punitive superego. What underlying condition would
be the source of the mania? \par\pard\li719\sb10\sl-207\slmult0\fi0\tx4320\tx685
8\tx9360 \up0 \expndtw-2\charscalex100 a. Delusions of grandeur\tab \up0 \expndt
w-2\charscalex100 b. Depression\tab \up0 \expndtw-2\charscalex100 c. Fear of los
s\tab \up0 \expndtw-2\charscalex100 d. Malformed superego\par\pard\ql \li719\sb1
\sl-199\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf4\f5\fs18 Answer
: B \par\pard\ql \li719\sb15\sl-207\slmult0 \up0 \expndtw-1\charscalex100 \ul0\
nosupersub\cf3\f4\fs18 Depression - is a result of the assault on the ego and th
e mania covers the depression. \par\pard\qj \li719\sb0\sl-220\slmult0 \par\pard\
qj\li719\ri818\sb3\sl-220\slmult0 \up0 \expndtw-1\charscalex100 19/9. During a m
anic state, a client paced around the dayroom for 3 days. He talked to the furni
ture, proclaimed he \up0 \expndtw-1\charscalex100 was a king, and refused to par
take in unit activities. Which of the following nursing diagnoses has priority?
\par\pard\li719\sb22\sl-207\slmult0\fi0\tx6480 \up0 \expndtw-2\charscalex100 a.
Hypertension related to hyperactivity\tab \up0 \expndtw-2\charscalex100 c. Alter
ed nutrition related to hyperactivity\par\pard\li719\sb14\sl-207\slmult0\fi0\tx6
481 \up0 \expndtw-2\charscalex100 b. Risk for violence related to manic state\ta
b \up0 \expndtw-2\charscalex100 d. Ineffective individual coping related to mani
c state\par\pard\ql \li719\sb1\sl-207\slmult0 \up0 \expndtw-2\charscalex100 \ul0
\nosupersub\cf4\f5\fs18 Answer: C \par\pard\ql \li719\sb13\sl-207\slmult0 \up0 \
expndtw-1\charscalex100 \ul0\nosupersub\cf3\f4\fs18 During a manic state, client
s are at risk for malnutrition due to not taking in enough calories for the ener
gy they\u8217?re \par\pard\qj \li719\ri699\sb3\sl-220\slmult0 \up0 \expndtw-1\ch
arscalex100 expending. This client isn\u8217?t showing violent behavior. Individ
ual coping issues aren\u8217?t the primary concern at this time. \up0 \expndtw-2
\charscalex100 Hypertension isn\u8217?t an approved nursing diagnosis. \par\pard
\qj \li719\ri1125\sb220\sl-220\slmult0 \up0 \expndtw-1\charscalex100 20/2. Which
word best describes the type of schizophrenia identified by marked negativism,
rigidity, excitement, \up0 \expndtw-2\charscalex100 stupor or posturing? \par\pa
rd\li719\sb13\sl-207\slmult0\fi0\tx3600\tx6733\tx10080 \up0 \expndtw-2\charscale
x100 a. Catatonic\tab \up0 \expndtw-2\charscalex100 b. Disorganized\tab \up0 \ex
pndtw-2\charscalex100 c. Undifferentiated\tab \up0 \expndtw-2\charscalex100 d. P
aranoid\par\pard\ql \li719\sb11\sl-207\slmult0 \up0 \expndtw-2\charscalex100 \ul
0\nosupersub\cf4\f5\fs18 Answer: A \par\pard\ql \li719\sb1\sl-198\slmult0 \up0
\expndtw-1\charscalex100 \ul0\nosupersub\cf3\f4\fs18 Catatonic schizophrenia is
a state of psychologically induced immobilization, which is, at times, interrupt
ed by \par\pard\ql \li719\sb15\sl-207\slmult0 \up0 \expndtw-1\charscalex100 epis
odes of extreme agitation, such as negativism, rigidity, excitement, stupor, or
posturing. Undifferentiated \par\pard\ql \li719\sb13\sl-207\slmult0 \up0 \expndt
w-1\charscalex100 schizophrenia occurs when no single clinical presentation domi
nates (paranoid, disorganized, or catatonic). \par\pard\qj \li719\ri769\sb3\sl-2
20\slmult0 \up0 \expndtw-1\charscalex100 Disorganized schizophrenia is character
ized by disorganized speech, disorganized behavior, and inappropriate affect. \u
p0 \expndtw-1\charscalex100 The dominant theme in paranoid schizophrenia is one
of delusions and hallucinations. \par\pard\qj \li719\ri802\sb220\sl-220\slmult0\

fi0 \up0 \expndtw-1\charscalex100 21/7. The neuroleptic malignant syndrome was u

nder control, which of the following statement if made by the client \up0 \expnd
tw-1\charscalex100 would indicate an understanding of the resumption of antipsyc
hotic medications? \par\pard\li719\sb19\sl-207\slmult0\fi0\tx6012 \up0 \expndtw2\charscalex100 a. \u8220?After three days I will resume my medication\u8221?\ta
b \up0 \expndtw-2\charscalex100 c. \u8220?I can restart my medication after 2 to
3 weeks\u8221?\par\pard\li719\sb12\sl-207\slmult0\fi0\tx6011 \up0 \expndtw-2\ch
arscalex100 b. \u8220?Immediately after the resolution of NMS\u8217?\tab \up0 \e
xpndtw-2\charscalex100 d. \u8220?I can resume anytime I feel like taking the med
ications\u8221?\par\pard\ql \li719\sb6\sl-207\slmult0 \up0 \expndtw-2\charscalex
100 \ul0\nosupersub\cf4\f5\fs18 ANSWER: \par\pard\sect\sectd\fs24\ul0\nosupersub
\cf999999\f1000000
\pard\fs32 ATTENTION!\fs24\par
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