Psychological Disorders and Treatments, Exams of Nursing

Download Psychological Disorders and Treatments and more Exams Nursing in PDF only on Docsity! Psych final exam- Townsend questions with verified answers graded A+ 1. Three years ago, Anna's dog Lucky, whom she had had for 16 years, was run over by a car and killed. Anna's daughter reports that since that time, Anna has lost weight, rarely leaves her home, and just sits and talks about Lucky. Anna's behavior would be considered maladaptive because a. it has been more than 3 years since Lucky died. b. her grief is too intense over just the loss of a dog. c. her grief is interfering with her functioning. d. people in this culture would not comprehend such behavior over the loss of a pet. - Correct Answer C 2. Based on the information in Question 1, Anna's grieving behavior would most likely be considered to be a. delayed. b. inhibited. c. prolonged. d. distorted. - Correct Answer D 3. Anna is diagnosed with Major Depressive Disorder. She is most likely fixed in which stage of the grief process? a. Denial b. Anger c. Depression d. Acceptance - Correct Answer B 4. Anna, who is 72 years old, is of the age when she may have experienced many losses coming close together. What is this called? a. Bereavement overload b. Normal mourning c. Isolation d. Cultural relativity - Correct Answer A 5. Anna, age 72, has been grieving the death of her dog, Lucky, for 3 years. She is not able to take care of her activities of daily living and wants only to make daily visits to Lucky's grave. Her daughter has likely put off seeking help for Anna because a. Women are less likely than men to seek help for emotional problems. b. Relatives often try to "normalize" the behavior rather than label it mental illness. c. She knows that all older people are expected to be a little depressed. d. She is afraid that the neighbors "will think her mother is crazy." - Correct Answer B 6. Anna's dog Lucky got away from her while they were taking a walk. He ran into the street and was hit by a car. Anna cannot remember any of these circumstances of his death. This is an example of what defense mechanism? a. Rationalization b. Suppression c. Denial d. Repression - Correct Answer D 7. Lucky sometimes refused to obey Anna and indeed did not come back to her when she called to him on the day he was killed. But Anna continues to insist, "He was the very best dog. He always minded me. He always did everything I told him to do." This represents the defense mechanism a. sublimation. b. compensation. c. reaction formation. d. undoing. - Correct Answer C 8. Anna has been a widow for 20 years. Her maladaptive grief response to the loss of her dog may be attributed to which of the following? Select all that apply. a. Unresolved grief over loss of her husband b. Loss of several relatives and friends over the last few years c. Repressed feelings of guilt over the way in which Lucky died d. Inability to prepare in advance for the loss - Correct Answer A, B, C, D 9. For what reason would Anna's illness be considered a neurosis rather than a psychosis? a. She is unaware that her behavior is maladaptive. b. She exhibits inappropriate affect (emotional tone). c. She experiences no loss of contact with reality. d. She tells the nurse, "There is nothing wrong with me!" - Correct Answer C 10.Which of the following statements by Anna might suggest that she is achieving resolution of her grief over Lucky's death? a. "I don't cry anymore when I think about Lucky." b. "It's true. Lucky didn't always mind me. Sometimes he ignored my commands." c. "I remember how it happened now. I should have held tighter to his leash!" d. "I won't ever have another dog. It's just too painful to lose them." - Correct Answer B 21.Which of the following parts of the brain is associated with multiple feelings and behaviors and is some- times referred to as the emotional brain? a. Frontal lobe b. Thalamus c. Hypothalamus d. Limbic system - Correct Answer D 22.Which of the following parts of the brain is concerned with visual reception and interpretation? a. Frontal lobe b. Parietal lobe c. Temporal lobe d. Occipital lobe - Correct Answer D 23.Which of the following parts of the brain is associated with voluntary body movement, thinking and judgment, and expression of feeling? a. Frontal lobe b. Parietal lobe c. Temporal lobe d. Occipital lobe - Correct Answer A 24.Which of the following parts of the brain integrates all sensory input (except smell) on the way to the cortex? a. Temporal lobe b. Thalamus c. Limbic system d. Hypothalamus - Correct Answer B 25.Which of the following parts of the brain deals with sensory perception and interpretation? a. Hypothalamus b. Cerebellum c. Parietal lobe d. Hippocampus - Correct Answer C 26.Which of the following parts of the brain is concerned with hearing, short-term memory, and sense of smell? a. Temporal lobe b. Parietal lobe c. Cerebellum d. Hypothalamus - Correct Answer A 27.Which of the following parts of the brain has control over the pituitary gland and autonomic nervous system? It also regulates appetite and temperature. a. Temporal lobe b. Parietal lobe c. Cerebellum d. Hypothalamus - Correct Answer D 28.At a synapse, the determination of further impulse transmission is accomplished by means of a. potassium ions. b. interneurons. c. neurotransmitters. d. the myelin sheath. - Correct Answer C 29.A decrease in which of the following neurotransmitters has been implicated in depression? a. GABA, acetylcholine, and aspartate b. Norepinephrine, serotonin, and dopamine c. Somatostatin, substance P, and glycine d. Glutamate, histamine, and opioid peptides - Correct Answer B 30.Which of the following hormones has been implicated in the etiology of mood disorder with seasonal pattern? a. Increased levels of melatonin b. Decreased levels of oxytocin c. Decreased levels of prolactin d. Increased levels of thyrotropin - Correct Answer A 31.Psychotropic medications that block the reuptake of serotonin may result in which of the following side effects? a. Dry mouth b. Constipation c. Blurred vision d. Sexual dysfunction - Correct Answer D 32.Psychotropic medications that block the acetylcholine receptor may result in which of the following side effects? a. Dry mouth b. Sexual dysfunction c. Nausea d. Priapism - Correct Answer A 33.Psychotropic medications that are strong blockers of the D2 receptor may result in which of the following side effects? a. Sedation b. Urinary retention c. Extrapyramidal symptoms d. Hypertensive crisis - Correct Answer C 34.Nurse Jones decides to go against family wishes and tell the client of his terminal status because that is what she would want if she were the client. Which of the following ethical theories is considered in this decision? a. Kantianism b. Christian ethics c. Natural law theories d. Ethical egoism - Correct Answer B 35.Nurse Jones decides to respect family wishes and not tell the client of his terminal status because that would bring the most happiness to the most people. Which of the following ethical theories is considered in this decision? a. Utilitarianism b. Kantianism c. Christian ethics d. Ethical egoism - Correct Answer A 36.Nurse Jones decides to tell the client of his terminal status because she believes it is her duty to do so. Which of the following ethical theories is considered in this decision? a. Natural law theories b. Ethical egoism c. Kantianism d. Utilitarianism - Correct Answer C 37.The nurse assists the physician with electroconvulsive therapy on his client who has refused to give consent. With which of the following legal actions might the nurse be charged because of this nursing action? a. Assault b. Battery c. False imprisonment d. Breach of confidentiality - Correct Answer B 38.A competent, voluntary client has stated he wants to leave the hospital. The nurse hides his clothes in an effort to keep him from leaving. With which of the following legal actions might the nurse be charged because of this nursing action? a. Assault b. Battery c. False imprisonment d. Breach of confidentiality - Correct Answer C 39.Joe is very restless and is pacing a lot. The nurse says to Joe, "If you don't sit down in the chair and be still, I'm going to put you in restraints!" With which of the following legal actions might the nurse be charged because of this nursing action? a. Defamation of character a. somatic delusions. b. catatonic stupor. c. auditory hallucinations. d. pseudoparkinsonism. - Correct Answer C 51.The nurse is interviewing a client on the psychiatric unit. The client tilts his head to the side, stops talking in midsentence, and listens intently. The nurse recognizes these behaviors as a symptom of the client's illness. The most appropriate nursing intervention for this symptom is to: a. ask the client to describe his physical symptoms. b. ask the client to describe what he is hearing. c. administer a dose of benztropine. d. call the physician for additional orders. - Correct Answer B 52.When a client suddenly becomes aggressive and violent on the unit, which of the following approaches would be best for the nurse to use first? a. Provide large motor activities to relieve the client's pent-up tension. b. Administer a dose of prn chlorpromazine to keep the client calm. c. Call for sufficient help to control the situation safely. d. Convey to the client that his behavior is unacceptable and will not be permitted. - Correct Answer C 53.The primary focus of family therapy for clients with schizophrenia and their families is a. to discuss concrete problem-solving and adaptive behaviors for coping with stress. b. to introduce the family to others with the same problem. c. to keep the client and family in touch with the health-care system. d. to promote family interaction and increase understanding of the illness. - Correct Answer D 54.Margaret, age 68, is a widow of 6 months. Since her husband died, her sister reports that Margaret has become socially withdrawn, has lost weight, and does little more each day than visit the cemetery where her husband was buried. She told her sister today that she "didn't have anything more to live for." She has been hospitalized with Major Depressive Disorder. The priority nursing diagnosis for Margaret would be a. imbalanced nutrition: less than body requirements. b. complicated grieving. c. risk for suicide. d. social isolation. - Correct Answer C 55.The physician orders sertraline (Zoloft) 50 mg PO bid for Margaret, a 68-year-old woman with Major Depressive Disorder. After 3 days of taking the medication, Margaret says to the nurse, "I don't think this medicine is doing any good. I don't feel a bit better." What is the most appropriate response by the nurse? a. "Cheer up, Margaret. You have so much to be happy about." b. "Sometimes it takes a few weeks for the medicine to bring about an improvement in symptoms." c. "I'll report that to the physician, Margaret. Maybe he will order something different." d. "Try not to dwell on your symptoms, Margaret. Why don't you join the others down in the dayroom?" - Correct Answer B 56.The goal of cognitive therapy with depressed clients is to a. identify and change dysfunctional patterns of thinking. b. resolve the symptoms and initiate or restore adaptive family functioning. c. alter the neurotransmitters that are creating the depressed mood. c. provide feedback from peers who are having similar experiences. - Correct Answer A 57.Education for the client who is taking monoamine oxidase inhibitors (MAOIs) should include which of the following? a. Fluid and sodium replacement when appropriate, frequent blood drug levels, signs and symptoms of toxicity. b. Lifetime of continuous use, possible tardive dyskinesia, advantages of an injection every 2 to 4 weeks. c. Short-term use, possible tolerance to beneficial effects, careful tapering of the drug at end of treatment. d. Tyramine-restricted diet, prohibitive concurrent use of over-the-counter medications without physician notification. - Correct Answer D 58. In teaching a client about his antidepressant medication, fluoxetine, which of the following would the nurse include? Select all that apply. a. Don't eat chocolate while taking this medication. b. Keep taking this medication, even if you don't feel it is helping. It sometimes takes a while to take effect. c. Don't take this medication with the migraine drugs "triptans." d. Go to the lab each week to have your blood drawn for therapeutic level of this drug. e. This drug causes a high degree of sedation, so take it just before bedtime. - Correct Answer B, C 59.A client has just been admitted to the psychiatric unit with a diagnosis of Major Depressive Disorder. Which of the following behavioral manifestations might the nurse expect to assess? Select all that apply. a. Slumped posture b. Delusional thinking c. Feelings of despair d. Feels best early in the morning and worse as the day progresses e. Anorexia - Correct Answer A, B, C, E 60.A client with depression has just been prescribed the antidepressant phenelzine (Nardil). She says to the nurse, "The doctor says I will need to watch my diet while I'm on this medication. What foods should I avoid?" Which of the following is the correct response by the nurse? a. Blue cheese, red wine, raisins b. Black beans, garlic, pears c. Pork, shellfish, egg yolks d. Milk, peanuts, tomatoes - Correct Answer A 61.John is a client at the mental health clinic. He is depressed, has been expressing suicidal ideations, and has been seeing the psychiatric nurse every three days. He has been taking 100 mg of sertraline daily for about a month, receiving small amounts of the medication from his nurse at each visit. Today he comes to the clinic in a cheerful mood, much different than he seemed just 3 days ago. How might the nurse assess this behavioral change? a. The sertraline is finally taking effect. b. He is no longer in need of antidepressant medication. c. He has completed the grief response over loss of his wife. d. He may have decided to carry out his suicide plan. - Correct Answer D 62.The nurse is preparing a patient for an electroconvulsive therapy (ECT) treatment. About 30 minutes prior to the treatment the nurse administers atropine sulfate 0.4 mg IM. Rationale for this order is a. to decrease secretions and increase heart rate. b. to relax muscles. c. to produce a calming effect. d. to induce anesthesia. - Correct Answer A 63.A depressed client is receiving an ECT treatment. In the treatment room, the anesthesiologist administers methohexital sodium (Brevital) followed by IV succinylcholine (Anectine). The purposes of these medications are to a. decrease secretions and increase heart rate. b. prevent nausea and induce a calming effect. c. minimize memory loss and stabilize mood. d. induce anesthesia and relax muscles. - Correct Answer D 64.After receiving three ECT treatments, a client says to the nurse, "I feel so much better, but I'm having trouble remembering some things that happened this last week." The nurse's best response would be: a. "Don't worry about that. Nothing important happened." b. "Memory loss is just something you have to put up with in order to feel better." c. "Memory loss is a side effect of ECT, but it is only temporary. Your memory should return within a few weeks." d. "Forget about last week, Mr. C. You need to look forward from here." - Correct Answer C c. Quietly walk with her back to her room and help her change into something more appropriate. d. Explain to her that if she wears this outfit she must remain in her room. - Correct Answer C 75.The nurse is prioritizing nursing diagnoses in the plan of care for a client experiencing a manic episode. Number the diagnoses in order of the appropriate priority. a. Disturbed sleep pattern evidenced by sleeping only 4 to 5 hours per night b. Risk for injury related to manic hyperactivity c. Impaired social interaction evidenced by manipulation of others d. Imbalanced nutrition: Less than body requirements evidenced by loss of weight and poor skin turgor - Correct Answer 1. B 76.2. D 77.3. A 78.4. C 79.A child with bipolar disorder also has attention-deficit/hyperactivity disorder (ADHD). How would these comorbid conditions most likely be treated? a. No medication would be given for either condition. b. Medication would be given for both conditions simultaneously. c. The bipolar condition would be stabilized first before medication for the ADHD would be given. d. The ADHD would be treated before consideration of the bipolar disorder. - Correct Answer C 80.Ms. T. has been diagnosed with Agoraphobia. Which behavior would be most characteristic of this disorder? a. Ms. T. experiences panic anxiety when she encounters snakes. b. Ms. T. refuses to fly in an airplane. c. Ms. T. will not eat in a public place. d. Ms. T. stays in her home for fear of being in a place from which she cannot escape. - Correct Answer D 81.Which of the following is the most appropriate therapy for a client with agoraphobia? a. 10 mg Valium qid b. Group therapy with other agoraphobics c. Facing her fear in gradual step progression d. Hypnosis - Correct Answer C 82.With implosion therapy, a client with phobic anxiety would be a. taught relaxation exercises. b. subjected to graded intensities of the fear. c. instructed to stop the therapeutic session as soon as anxiety is experienced. d. presented with massive exposure to a variety of stimuli associated with the phobic object/situation. - Correct Answer D 83.A client with OCD spends many hours each day washing her hands. The most likely reason she washes her hands so much is that it a. relieves her anxiety. b. reduces the probability of infection. c. gives her a feeling of control over her life. d. increases her self-concept. - Correct Answer A 84.The initial care plan for a client with OCD who washes her hands obsessively would include which of the following nursing interventions? a. Keep the client's bathroom locked so she cannot wash her hands all the time. b. Structure the client's schedule so that she has plenty of time for washing her hands. c. Place the client in isolation until she promises to stop washing her hands so much. d. Explain the client's behavior to her, since she is probably unaware that it is maladaptive. - Correct Answer B 85.A client with OCD says to the nurse, "I've been here 4 days now, and I'm feeling better. I feel comfortable on this unit, and I'm not ill-at-ease with the staff or other patients anymore." In light of this change, which nursing intervention is most appropriate? a. Give attention to the ritualistic behaviors each time they occur and point out their inappropriateness. b. Ignore the ritualistic behaviors, and they will be eliminated for lack of reinforcement. c. Set limits on the amount of time Sandy may engage in the ritualistic behavior. d. Continue to allow Sandy all the time she wants to carry out the ritualistic behavior. - Correct Answer C 86.Annie has hair-pulling disorder. She is receiving treatment at the mental health clinic with habit-reversal therapy. Which of the following elements would be included in this therapy? Select all that apply. a. Awareness training b. Competing response training c. Social support d. Hypnotherapy e. Aversive therapy - Correct Answer A, B, C 87.Joanie is a new patient at the mental health clinic. She has been diagnosed with Body Dysmorphic Disorder. Which of the following medications is the psychiatric nurse practitioner most likely to prescribe for Joanie? a. Alprazolam (Xanax) b. Diazepam (Valium) c. Fluoxetine (Prozac) d. Olanzapine (Zyprexa) - Correct Answer C 88.A client who is experiencing a panic attack has just arrived at the emergency department. Which is the priority nursing intervention for this client? a. Stay with the client and reassure of safety. b. Administer a dose of diazepam. c. Leave the client alone in a quiet room so that she can calm down. d. Encourage the client to talk about what triggered the attack. - Correct Answer A 89.Janet has a diagnosis of Generalized Anxiety Disorder. Her physician has prescribed buspirone 15 mg daily. Janet says to the nurse, "Why do I have to take this every day? My friend's doctor ordered Xanax for her, and she only takes it when she is feeling anxious." Which of the following would be an appropriate response by the nurse? a. "Xanax is not effective for generalized anxiety disorder." b. "Buspirone must be taken daily in order to be effective." c. "I will ask the doctor if he will change your dose of buspirone to prn so that you don't have to take it every day." d. "Your friend really should be taking the Xanax every day." - Correct Answer B 90.John, a veteran of the war in Iraq, is diagnosed with PTSD. He says to the nurse, "I can't figure out why God took my buddy instead of me." From this statement, the nurse assesses which of the following in John? a. Repressed anger b. Survivor's guilt c. Intrusive thoughts d. Spiritual distress - Correct Answer B 91.John, a veteran of the war in Iraq, is diagnosed with PTSD. He experiences a nightmare during his first night in the hospital. He explains to the nurse that he was dreaming about gunfire all around and people being killed. The nurse's most appropriate initial intervention is to a. administer alprazolam as ordered prn for anxiety. b. call the physician and report the incident. c. stay with John and reassure him of his safety. d. have John listen to a tape of relaxation exercises. - Correct Answer C 92.John, a veteran of the war in Iraq, is diagnosed with PTSD. Which of the following therapy regimens would most appropriately be ordered for John? a. Paroxetine and group therapy b. Diazepam and implosion therapy 103. Dan, who has been admitted to the alcohol rehabilitation unit after being fired for drinking on the job, states to the nurse, "I don't have a problem with alcohol. I can handle my booze better than anyone I know. My boss is a jerk! I haven't missed any more days than my coworkers." The nurse's best response is: a. "Maybe your boss is mistaken, Dan." b. "You are here because your drinking was interfering with your work, Dan." c. "Get real, Dan! You're a boozer and you know it!" d. "Why do you think your boss sent you here, Dan?" - Correct Answer B 104. Dan, who has been admitted to the alcohol rehabilitation unit after being fired for drinking on the job, states to the nurse, "I don't have a problem with alcohol. I can handle my booze better than anyone I know. My boss is a jerk! I haven't missed any more days than my coworkers." The defense mechanism that Dan is using is: a. denial. b. projection. c. displacement. d. rationalization. - Correct Answer A 105. Dan has been admitted to the alcohol rehabilitation unit after being fired for drinking on the job. Dan's drinking buddies come for a visit, and when they leave, the nurse smells alcohol on Dan's breath. Which of the following would be the best intervention with Dan at this time? a. Search his room for evidence. b. Ask, "Have you been drinking alcohol, Dan?" c. Send a urine specimen from Dan to the lab for drug screening. d. Tell Dan, "These guys cannot come to the unit to visit you again." - Correct Answer C 106. Dan begins attendance at AA meetings. Which of the statements by Dan reflects the purpose of this organization? a. "They claim they will help me stay sober." b. "I'll dry out in AA, then I can have a social drink now and then." c. "AA is only for people who have reached the bottom." d. "If I lose my job, AA will help me find another." - Correct Answer A 107. From which of the following symptoms might the nurse identify a chronic cocaine user? a. Clear, constricted pupils b. Red, irritated nostrils c. Muscle aches d. Conjunctival redness - Correct Answer B 108. An individual who is addicted to heroin is likely to experience which of the following symptoms of withdrawal? a. Increased heart rate and blood pressure b. Tremors, insomnia, and seizures c. Incoordination and unsteady gait d. Nausea and vomiting, diarrhea, and diaphoresis - Correct Answer D 109. A polysubstance abuser makes the statement, "The green and whites do me good after speed." How might the nurse interpret the statement? a. The client abuses amphetamines and anxiolytics. b. The client abuses alcohol and cocaine. c. The client is psychotic. d. The client abuses narcotics and marijuana. - Correct Answer A 110. Anne, age 24, and her husband are seeking treatment at the sex therapy clinic. They have been married for 3 weeks and have never had sexual intercourse together. Pain and vaginal tightness prevent penile entry. Sexual history reveals Anne was raped when she was 15 years old. The physician would most likely assign which of the following diagnoses to Anne? a. Female orgasmic disorder b. Genito-pelvic pain/penetration disorder c. Female sexual interest/arousal disorder d. Sexual aversion disorder - Correct Answer B 111. Anne, age 24, and her husband are seeking treatment at the sex therapy clinic. They have been married for 3 weeks and have never had sexual intercourse together. Pain and vaginal tightness prevent penile entry. Sexual history reveals Anne was raped when she was 15 years old. The most appropriate nursing diagnosis for Anne would be a. pain related to vaginal constriction. b. ineffective sexuality patterns related to inability to have vaginal intercourse. c. sexual dysfunction related to history of sexual trauma. d. complicated grieving related to loss of self-esteem because of rape. - Correct Answer C 112. A client comes to the mental health clinic with a complaint of lack of sexual desire. In the initial interview, what assessments would the nurse make? Select all that apply. a. Mood b. Level of energy c. Medications being taken d. Previous level of sexual activity - Correct Answer A, B, C, D 113. Which of the following medications may be prescribed for early ejaculation? a. Paroxetine b. Tadalafil c. Diazepam d. Imipramine - Correct Answer A 114. Tom watches his neighbor through her window each night as she undresses for bed. Later he fantasizes about having sex with her. This is an example of which paraphilic disorder? a. Exhibitionistic disorder b. Voyeuristic disorder c. Frotteuristic disorder d. Pedophilic disorder - Correct Answer B 115. Frank drives his car up to a strange woman, stops, and asks her for directions. As she is explaining, he reveals his erect penis to her. This is an example of which paraphilic disorder? a. Sexual sadism disorder b. Sexual masochism disorder c. Frotteuristic disorder d. Exhibitionistic disorder - Correct Answer D 116. Tim, age 18, babysits for his 11-year-old neighbor, Jeff. Six months ago, Tim began fondling Jeff's genitals. They now engage in mutual masturbation each time they are together. This is an example of which pedophilic disorder? a. Fetishistic disorder b. Pedophilic disorder c. Exhibitionistic disorder d. Voyeuristic disorder - Correct Answer B 117. John is 32 years old. He buys women's clothing at the thrift shop. Sometimes he dresses as a woman and goes to a singles' bar. He becomes sexually excited as he fantasizes about men being attracted to him as a woman. This is an example of which paraphilic disorder? a. Sexual masochism disorder b. Voyeuristic disorder c. Exhibitionistic disorder d. Transvestic disorder - Correct Answer D 118. Fred rides a crowded subway every day. He stands beside a woman he views as very attractive. Just as the subway is about to stop, he places his hand on her breast and rubs his genitals against her buttock. As the door opens, he dashes out and away. Later he fantasizes she is in love with him. This is an example of which paraphilia? a. Voyeuristic disorder b. Sexual sadism disorder c. Frotteuristic disorder 130. Kim has a diagnosis of Borderline Personality Disorder. She often exhibits alternating clinging and dis tancing behaviors. The most appropriate nursing intervention with this type of behavior would be to a. encourage Kim to establish trust in one staff person, with whom all therapeutic interaction should take place. b. secure a verbal contract from Kim that she will discontinue these behaviors. c. withdraw attention if these behaviors continue. d. rotate staff members who work with Kim so that she will learn to relate to more than one person. - Correct Answer D 131. Kim, a client diagnosed with Borderline Personality Disorder, manipulates the staff in an effort to fulfill her own desires. All of the following may be examples of manipulative behaviors in the borderline client except a. refusal to stay in room alone, stating, "It's so lonely." b. asking Nurse Jones for cigarettes after 30 minutes, knowing the assigned nurse has explained she must wait 1 hour. c. stating to Nurse Jones, "I really like having you for my nurse. You're the best one around here." d. cutting arms with razor blade after discussing dismissal plans with physician. - Correct Answer A 132. Splitting by the client with borderline personality disorder denotes a. evidence of precocious development. b. a primitive defense mechanism in which the client sees objects as all good or all bad. c. a brief psychotic episode in which the client loses contact with reality. d. two distinct personalities within the borderline client. - Correct Answer B 133. According to Margaret Mahler, predisposition to borderline personality disorder occurs when develop- mental tasks go unfulfilled in which of the following phases? a. Autistic phase, during which the child's needs for security and comfort go unfulfilled b. Symbiotic phase, during which the child fails to bond with the mother c. Differentiation phase, during which the child fails to recognize a separateness between self and mother d. Rapprochement phase, during which the mother withdraws emotional support in response to the child's increasing independence - Correct Answer D 134. Jack is a new client on the psychiatric unit with a diagnosis of Antisocial Personality Disorder. Which of the following characteristics would you expect to assess in Jack? a. Lack of guilt for wrongdoing b. Insight into his own behavior c. Ability to learn from past experiences d. Compliance with authority - Correct Answer A 135. Milieu therapy is a good choice for clients with antisocial personality disorder because it a. provides a system of punishment and reward for behavior modification. b. emulates a social community in which the client may learn to live harmoniously with others. c. provides mostly one-to-one interaction between the client and therapist. d. provides a very structured setting in which the clients have very little input into the planning of their care. - Correct Answer B 136. In evaluating the progress of Jack, a client diagnosed with Antisocial Personality Disorder, which of the following behaviors would be considered the most significant indication of positive change? a. Jack got angry only once in group this week. b. Jack was able to wait a whole hour for a cigarette without verbally abusing the staff. c. On his own initiative, Jack sent a note of apology to a man he had injured in a recent fight. d. Jack stated that he would no longer start any more fights. - Correct Answer C 137. Which of the following behavioral patterns is characteristic of individuals with narcissistic personality disorder? a. Overly self-centered and exploitative of others b. Suspicious and mistrustful of others c. Rule conscious and disapproving of change d. Anxious and socially isolated - Correct Answer A 138. 96. Carol is a new nursing graduate being oriented on a medical/surgical unit by the head nurse, Mrs. Carey. When Carol describes a new technique she has learned for positioning immobile clients, Mrs. Carey states, "What are you trying to do . . . tell me how to do my job? We have always done it this way on this unit, and we will continue to do it this way until I say differently!" This is an example of which type of personality characteristic? a. Antisocial b. Paranoid c. Passive-aggressive d. Obsessive-compulsive - Correct Answer D 139. Which of the following behavioral patterns is characteristic of individuals with schizotypal personality disorder? a. Belittling themselves and their abilities b. A lifelong pattern of social withdrawal c. Suspicious and mistrustful of others d. Overreacting inappropriately to minor stimuli - Correct Answer B 140. Some obese individuals take amphetamines to suppress appetite and help them lose weight. Which of the following is an adverse effect associated with use of amphetamines that makes this practice undesirable? a. Bradycardia b. Amenorrhea c. Tolerance d. Convulsions - Correct Answer C 141. Psychoanalytically, the theory of obesity relates to the individual's unconscious equation of food with a. nurturance and caring. b. power and control. c. autonomy and emotional growth. d. strength and endurance. - Correct Answer A 142. From a physiological point of view, the most common cause of obesity is probably a. lack of nutritional education. b. more calories consumed than expended. c. impaired endocrine functioning. d. low basal metabolic rate. - Correct Answer B 143. Nancy, age 14, has just been admitted to the psychiatric unit for anorexia nervosa. She is emaciated and refusing to eat. What is the primary nursing diagnosis for Nancy? a. Complicated grieving b. Imbalanced nutrition: Less than body requirements c. Interrupted family processes d. Anxiety (severe) - Correct Answer B 144. Which of the following physical manifestations would you expect to assess in a client suffering from anorexia nervosa? a. Tachycardia, hypertension, hyperthermia b. Bradycardia, hypertension, hyperthermia c. Bradycardia, hypotension, hypothermia d. Tachycardia, hypotension, hypothermia - Correct Answer C 145. Nurse Jones is caring for a client who has been hospitalized with anorexia nervosa and is severely malnourished. The client continues to refuse to eat. What is the most appropriate response by the nurse? a. "You know that if you don't eat, you will die." b. "If you continue to refuse to take food orally, you will be fed through a nasogastric tube."