Question 1
Wikes University NSG 520 Advanced Pathophysiology. The nurse is reviewing the medical record of a client who has anorexia nervosa and recently increased caloric intake. Which of the following findings indicate that the client’s condition is worsening?
- Shortness of breath
- Bilateral crackles
- 2+ bilateral lower-extremity pitting edema
- Potassium 3.0 mEq/L
- Phosphorus 2.3 mg/dL
- Magnesium 1.0 mg/dL
- Caloric intake has increased
Answer:
- Shortness of breath
- Bilateral crackles
- 2+ bilateral lower-extremity pitting edema
- Potassium 3.0 mEq/L
- Phosphorus 2.3 mg/dL
- Magnesium 1.0 mg/dL
Question 1
A nurse is discussing discipline techniques with the parent of a preschooler. Which of the following statements by the parent indicates an understanding of time-out as a form of discipline?
- “I place my child in time-out for 15 minutes when they misbehave.”
- “I send my child to their room for the time-out period.”
- “I make use of time-out after giving three warnings.”
- “I use a kitchen timer to mark the end of the time-out period.”
Question 2
A nurse is conducting an admission assessment for a client who is experiencing a manic episode of bipolar disorder. Which of the following behaviors should the nurse expect? (Select all that apply.)
- Grandiosity
- Flight of ideas
- Splitting
- Hyperactivity
- Withdrawal
Question 3
A nurse is reviewing the medical records of a group of clients. For which of the following clients should the nurse recommend a referral for assertive community treatment (ACT)? Wikes University NSG 520 Advanced Pathophysiology.
- A client who has a new diagnosis of major depressive disorder
- A client who has repeated acute care admissions due to schizophrenia
- A client who has requested family therapy following the death of a family member
- A client who has physical injuries following an incident of partner violence
Question 4
A nurse is caring for a client who has become violent and is threatening self-harm following a crisis. After ensuring enough staff are available, which of the following actions should the nurse take first?
- Administer a sedative medication.
- Perform a debriefing with the staff.
- Acknowledge the client’s emotions.
- Place the client in restraints.
Question 5
A nurse is caring for a client who has a history of suicide attempts. Which of the following findings places the client at risk for another suicide attempt? (Select all that apply.)
- Hallucinations
- Depression
- Delusions
- Catatonia
- Tinnitus
Question 6
A nurse is reviewing the medical record of a newly admitted client who has major depressive disorder. Which of the following findings should the nurse identify as a risk factor for this condition?
- The client has a serotonin deficiency.
- The client has acute bronchitis.
- The client has an elevated calcium level.
- The client is an only child.
Question 7
A nurse on a mental health unit is leading a group therapy session for a group of clients. Which of the following statements should the nurse expect from a client who has an anxiety disorder?
- “I check my breasts for lumps every day, but I’m still really scared about getting breast cancer.”
- “I have had several negative pregnancy tests, but I know they are all wrong.”
- “I double-check my pills because I think the pharmacist may be putting poison in them.”
- “I feel really nervous when my partner goes to work, and I am home alone during the day.”
Question 8
A nurse is caring for a client who exhibits excessive attention-seeking behaviors, including acting flirtatious and seductive. The nurse should identify these behaviors as manifestations of which of the following personality disorders?
- Paranoid
- Histrionic
- Narcissistic
- Antisocial
Question 9
A nurse is caring for a client who has a new diagnosis of major depressive disorder. Which of the following medications should the nurse expect the provider to prescribe to the client as a first-line treatment?
- Midazolam
- Fluoxetine
- Cyclobenzaprine
- Valproic acid
Question 10
A nurse is caring for a client who has bipolar disorder. The client says to the nurse, “Give me your pen to cut the pain out of my chest.” The nurse should identify that the client is at risk for which of the following?
- Illusion
- Hallucination
- Attention-seeking behavior
- Self-mutilation
Question 11
A nurse is caring for a client who has undergone electroconvulsive therapy (ECT). The nurse should monitor the client for which of the following adverse effects of ECT?
- Voice alteration
- Neck pain
- Memory deficit
- Headache
Question 12
A nurse is caring for a client who has dementia and insists that a doll is their infant child. Which of the following behavioral management techniques should the nurse use when interacting with the client?
- Cognitive reframing
- Thought stopping
- Validation therapy
- Operant conditioning
Question 13
A nurse is assessing a client who reports using cocaine 1 hr ago. Which of the following findings should the nurse expect? Wikes University NSG 520 Advanced Pathophysiology.
- Polyphagia
- Fever
- Bradycardia
- Oliguria
Question 14
A charge nurse is planning an in-service for newly licensed nurses on tort law in mental health care. Which of the following scenarios should the charge nurse provide as an example of an unintentional tort?
- A nurse did not clarify a client’s prescription that was difficult to read resulting in a medication error.
- A nurse posted private information on social media about a client who has substance use disorder.
- A nurse placed a client in mechanical restraints without obtaining a prescription, resulting in injury.
- A nurse threatened a client with physical harm after the client became verbally abusive to staff members.
Question 15
A nurse is preparing to administer ziprasidone 10 mg IM to a client who is experiencing acute agitation. Available is ziprasidone 20 mg/mL. How many mL should the nurse administer? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.) Wikes University NSG 520 Advanced Pathophysiology.
- 0.5 mL
Question 16
A nurse is planning care for a client who has obsessive-compulsive disorder (OCD) and continually washes their hands. Which of the following actions should the nurse take?
- Give the client a schedule with plenty of free time.
- Set a time limit for the client’s ritualistic behaviors.
- Discourage the client from discussing their handwashing.
- Explain the irrationality of the handwashing to the client.
Question 17
A nurse is caring for a client who has bipolar disorder and is experiencing a manic episode. Which of the following actions should the nurse take?
- Provide high-calorie finger foods for the client.
- Encourage the client to participate in group therapy.
- Place the client in a room with a roommate who has depression.
- Allow the client to lead a community meeting.
Question 18
A nurse is providing teaching for a client who has a new prescription for lithium. Which of the following instructions should the nurse include?
- “Maintain a consistent intake of sodium.”
- “Limit fluid intake to 1,000 milliliters per day.”
- “Expect to have a dry cough while taking this medication.”
- “Take the medication on an empty stomach.”
Question 19
A nurse is assessing a client who is taking chlorpromazine. Which of the following findings should the nurse identify as an extrapyramidal symptom (EPS)?
- Shuffling gait
- Fever
- Polyuria
- Dry mouth
Question 20
A nurse is conducting a counseling session for a client who has a substance use disorder. Which of the following statements by the client indicates they are in the contemplation stage of change?
- “I don’t think I have a problem with my drinking.”
- “I know I need to stop drinking, but I’m not sure if I can.”
- “I haven’t had a drink in two weeks.”
- “I am looking for a treatment center in my area.”
Question 21
A nurse is planning care for a client who has anorexia nervosa. Which of the following interventions should the nurse include in the plan?
- Weigh the client once per week.
- Observe the client for 60 minutes after meals.
- Allow the client to choose their own meal times.
- Encourage the client to engage in vigorous exercise.
Question 22
A nurse is caring for a client who is experiencing a panic attack. Which of the following actions should the nurse take?
- Stay with the client and remain calm.
- Ask the client to explain why they are feeling anxious.
- Encourage the client to attend a group therapy session.
- Provide a detailed explanation of the causes of panic attacks.
Question 23
A nurse is assessing a client who has bulimia nervosa. Which of the following findings should the nurse expect?
- Lanugo
- Amenorrhea
- Tooth erosion
- Bradycardia
Question 24
A nurse is caring for a client who has schizophrenia and is experiencing auditory hallucinations. Which of the following actions should the nurse take?
- Ask the client directly what the voices are saying.
- Tell the client that the voices are not real.
- Whisper to another staff member in the client’s presence.
- Agree with the client’s perception of the hallucinations.
Question 25
A nurse is caring for a client who has posttraumatic stress disorder (PTSD) after being physically assaulted. The client is unable to recall any details of the event. Which of the following defense mechanisms should the nurse recognize that the client is displaying?
- Dissociation
- Rationalization
- Undoing
- Reaction formation
Question 26
A nurse is teaching the guardian of a school-age child who has autism spectrum disorder about a new prescription for risperidone. Which of the following statements by the guardian demonstrates an understanding of the teaching?
- “This medication will help control my child’s aggressive behavior.”
- “This medication can cause my child to have low blood sugar.”
- “This medication won’t require my child to have routine lab tests.”
- “This medication might need to be increased if my child has muscle spasms.”
Question 27
A nurse on a medical-surgical unit is caring for a client who tells the nurse about their intentions to harm an ex-partner. Which of the following actions is a legal duty of the nurse?
- Keep the client hospitalized until there is no longer a threat.
- Ensure the client’s ex-partner is notified of the threat.
- Ask a friend or family member to monitor the client.
- Transfer the client to a mental health facility.
Question 28
A home health nurse is caring for a client who reports feeling tired and being unable to grocery shop. Which of the following responses by the nurse is an example of therapeutic communication?
- “Have you thought about taking a sleeping pill?”
- “Your fatigue will pass, and everything will be just fine.”
- “Do you have a family member who can assist you?”
- “Let’s discuss how to get you the help you need.”
Question 29
A charge nurse is providing education to a group of newly licensed nurses about the rights of clients who are involuntarily admitted. Which of the following responses indicates understanding of the teaching?
- “These clients can receive packages after they are privately inspected by security.”
- “These clients cannot be considered for a research study.”
- “These clients can vote in local and federal elections.”
- “These clients cannot refuse their prescribed antipsychotic medications.”
Question 30
A nurse is preparing to teach a client who has major depressive disorder and is scheduled to undergo electroconvulsive therapy (ECT). Which of the following statements should the nurse include in the teaching?
- “ECT is contraindicated in clients who have psychotic symptoms.”
- “ECT is delivered through electrodes attached to the head.”
- “ECT cannot be administered to clients who have suicidal ideation.”
- “ECT is conducted under regional anesthesia.”
Question 31
A nurse is caring for a 4-year-old child who has autism spectrum disorder. Which of the following behaviors should the nurse expect? (Select all that apply.) Wikes University NSG 520 Advanced Pathophysiology.
- Lack of eye contact
- Inability to play quietly
- Constant spinning of a toy
- Withdrawal from physical contact
- Repeated voiding in clothes
