1. What drug is frequently recommended as a first therapy for generalized anxiety disorder (GAD)?
Answer: B. Lorazepam
Explanation: Lorazepam, a benzodiazepine, is frequently recommended as a first-line therapy for generalized anxiety disorder (GAD) due to its fast onset of action and effectiveness in reducing anxiety symptoms. It works by enhancing the inhibitory effects of gamma-aminobutyric acid (GABA) in the brain, promoting relaxation and reducing anxiety. However, it should be used cautiously and for short-term periods due to the risk of tolerance, dependence, and potential for abuse.
2. The nurse is caring for a client with Alzheimer’s disease who is experiencing agitation and aggression. Which nonpharmacological intervention should the nurse prioritize?
Answer: B. Providing a structured and predictable environment
Explanation: In managing agitation and aggression in clients with Alzheimer’s disease, providing a structured and predictable environment is a priority. This involves maintaining a consistent daily routine, organizing familiar activities, and ensuring a calm and supportive atmosphere. Predictability and familiarity can help reduce anxiety and confusion, promoting a sense of security and well-being for individuals with Alzheimer’s disease.
3. A client diagnosed with schizophrenia is prescribed risperidone. The nurse should educate the client about which potential side effect?
Answer: A. Weight gain
Explanation: Risperidone, an atypical antipsychotic, is commonly prescribed for schizophrenia. One potential side effect of risperidone is weight gain. It can cause metabolic changes, including increased appetite and altered glucose and lipid metabolism, leading to weight gain in some individuals. It is important for the nurse to educate the client about this potential side effect and promote healthy lifestyle habits to minimize weight gain.
4. Which statement accurately describes major depressive disorder (MDD)?
Answer: C. It is a mental illness marked by persistent melancholy and interest loss.
Explanation: Major depressive disorder (MDD) is a mental illness characterized by persistent feelings of sadness, hopelessness, and a loss of interest or pleasure in activities. It is not characterized by manic episodes (as seen in bipolar disorder) or unstable relationships (as seen in borderline personality disorder). It is distinct from anxiety disorders, as it primarily involves a pervasive depressed mood rather than excessive worry or fear.
5. A client with borderline personality disorder is being evaluated by the nurse. Which behavior is commonly associated with this disorder?
Answer: C. Excessive need for reassurance
Explanation: Excessive need for reassurance is commonly associated with borderline personality disorder. Individuals with this disorder often have unstable self-esteem and experience intense fears of abandonment. They may seek constant reassurance from others to alleviate their anxiety and validate their self-worth. This behavior can strain relationships and contribute to emotional instability and impulsivity characteristic of borderline personality disorder.
6. A client with obsessive-compulsive disorder (OCD) engages in repetitive counting rituals to decrease anxiety. This behavior is an example of:
Answer: A. Compulsion
Explanation: Engaging in repetitive counting rituals to decrease anxiety is an example of a compulsion, which is a characteristic symptom of obsessive-compulsive disorder (OCD). Compulsions are repetitive behaviors or mental acts that individuals feel driven to perform in response to obsessive thoughts or according to specific rules. These behaviors are aimed at reducing distress or preventing a feared event, but they are excessive and not realistically connected to the situation.
7. Which defense mechanism involves attributing one’s own unacceptable thoughts or feelings to another person?
Answer: D. Projection
Explanation: Projection is a defense mechanism that involves attributing one’s own unacceptable thoughts, feelings, or impulses to another person. It allows individuals to avoid acknowledging their own undesirable qualities or emotions by projecting them onto someone else. By doing so, they can maintain a senseof self-worth and protect themselves from experiencing guilt or shame associated with these unacceptable thoughts or feelings.
8. The nurse is caring for a client with post-traumatic stress disorder (PTSD) who is experiencing nightmares. Which intervention is most appropriate?
Answer: C. Teach the client relaxation techniques to promote restful sleep.
Explanation: The most appropriate intervention for a client with PTSD experiencing nightmares is to teach relaxation techniques to promote restful sleep. Techniques such as deep breathing, progressive muscle relaxation, and guided imagery can help the client relax and decrease the frequency and intensity of nightmares. Encouraging the client to avoid sleep or administering sedatives may not address the underlying issue of PTSD and could potentially disrupt the client’s sleep patterns further.
9. A client diagnosed with bipolar disorder is experiencing a manic episode. Which intervention is most appropriate?
Answer: A. Provide a calm and structured environment.
Explanation: Providing a calm and structured environment is the most appropriate intervention for a client experiencing a manic episode in bipolar disorder. Manic episodes are characterized by elevated mood, increased energy, and impulsivity. A calm and structured environment can help reduce stimulation, promote stability, and minimize the risk of impulsive behaviors or harm to self or others.
10. Electroconvulsive therapy (ECT) is commonly used in the treatment of:
Answer: C. Major depressive disorder (MDD)
Explanation: Electroconvulsive therapy (ECT) is commonly used in the treatment of major depressive disorder (MDD) when other treatments have been ineffective or when rapid response is necessary. It involves delivering electrical currents to the brain to induce controlled seizures, which can lead to improvements in depressive symptoms. ECT is not typically used as a first-line treatment and is reserved for severe cases of MDD or when other treatments have failed.
11. The nurse is caring for a client with delirium. Which intervention is most appropriate to promote orientation and prevent confusion?
Answer: D. Use clocks, calendars, and personal items to establish a sense of time and place.
Explanation: Using clocks, calendars, and personal items to establish a sense of time and place is the most appropriate intervention to promote orientation and prevent confusion in a client with delirium. Delirium is characterized by acute changes in cognition, attention, and awareness. Providing environmental cues, such as familiar objects and reminders of time, can help the client maintain a connection to reality and reduce disorientation.
12. Which therapeutic communication technique involves summarizing the main points of a conversation to ensure understanding?
Answer: A. Restating
Explanation: Restating is a therapeutic communication technique that involves summarizing the main points of a conversation to ensure understanding. By restating what the client has said, the nurse confirms their comprehension and allows the client to clarify any misunderstandings. It demonstrates active listening and helps build rapport and therapeutic trust between the nurse and client. Restating can also validate the client’s feelings and provide an opportunity for further exploration of their concerns.
13. A client diagnosed with schizophrenia is experiencing negative symptoms such as social withdrawal and anhedonia. Which medication may be prescribed to alleviate these symptoms?
Answer: C. Olanzapine
Explanation: Olanzapine, an atypical antipsychotic, may be prescribed to alleviate negative symptoms such as social withdrawal and anhedonia in clients with schizophrenia. Olanzapine has shown efficacy in targeting both positive and negative symptoms of schizophrenia. Negative symptoms refer to the absence or reduction of normal functions, including social withdrawal, reduced emotional expression, and lack of motivation. Olanzapine helps improve these symptoms by modulating dopamine and serotonin receptor activity in the brain.
14. The nurse is caring for a client diagnosed with anorexia nervosa. Which laboratory finding would be expected in this client?
Answer: C. Hypokalemia
Explanation: In a client diagnosed with anorexia nervosa, hypokalemia (low potassium levels) is a commonly observed laboratory finding. Anorexia nervosa is an eating disorder characterized by severe restriction of food intake and an intense fear of gaining weight. The inadequate intake of essential nutrients, including potassium, can lead to imbalances in electrolytes, such as hypokalemia. This can have significant effects on various body systems, including cardiac function and muscle weakness.
15. A client diagnosed with antisocial personality disorder consistently violates the rights of others without remorse. This behavior is primarily associated with:
Answer: D. Lack of empathy
Explanation: Consistently violating the rights of others without remorse is primarily associated with a lack of empathy, which is a characteristic feature of antisocial personality disorder. Individuals with antisocial personality disorder often display a disregard for the feelings, rights, and boundaries of others. They may exploit or manipulate others for personal gain without feeling remorse or guilt. This lack of empathy and disregard for others’ rights contributes to the pattern of antisocial behaviors seen in this disorder.
16. A client with a history of alcohol use disorder is prescribed disulfiram. The nurse should educate the client about the potential adverse reaction when consuming alcohol, which is:
Answer: D. Flushing and palpitations
Explanation: Disulfiram is a medication used in the treatment of alcohol use disorder. It works by inhibiting the enzyme aldehyde dehydrogenase, leading to the accumulation of acetaldehyde when alcohol is consumed. When alcohol is ingested while taking disulfiram, it can cause a severe adverse reaction characterized by flushing, palpitations, nausea, and other unpleasant symptoms. This aversive reaction is intended to deter individuals from consuming alcohol by associating it with unpleasant physical effects.
17. A client with schizophrenia being treated by the nurse is having extrapyramidal adverse effects after taking antipsychotic medication. Which drug would be most suited to treat these symptoms?
Answer: D. Benztropine
Explanation: Benztropine, an anticholinergic medication, is commonly used to treat extrapyramidal adverse effects caused by antipsychotic medications. Extrapyramidal symptoms (EPS) are movement disorders that can occur as side effects of antipsychotics, particularly first-generation or typical antipsychotics. Benztropine helps reduce EPS by blocking the action of acetylcholine, a neurotransmitter involved in motor control. It can alleviate symptoms such as muscle stiffness, tremors, and dystonia.
18. When assessing a client with depression, the nurse notes feelings of worthlessness, guilt, and thoughts of suicide. These symptoms are most indicative of:
Answer: C. Major depressive disorder (MDD)
Explanation: Feelings of worthlessness, guilt, and thoughts of suicide are most indicative of major depressive disorder (MDD). These symptoms are commonly seen in individuals experiencing a depressive episode. MDD is a mood disorder characterized by a persistent depressed mood, loss of interest or pleasure in activities, and a range of cognitive, emotional, and physical symptoms. Thoughts of suicide indicate the severity of the depressive symptoms and the need for immediate attention and intervention.
19. A client with attention deficit hyperactivity disorder (ADHD) is being cared for by the nurse. Which medicine is widely used to treat ADHD symptoms?
Answer: B. Methylphenidate
Explanation: Methylphenidate is widely used to treat symptoms of attention deficit hyperactivity disorder (ADHD). It is a central nervous system stimulant that helps increase attention span and reduce impulsivity and hyperactivity in individuals with ADHD. Methylphenidate affects the levels of certain neurotransmitters, such as dopamine and norepinephrine, in the brain, helping to improvefocus, concentration, and impulse control in individuals with ADHD.
20. A client with a history of self-harm is admitted to the psychiatric unit. Which intervention should the nurse prioritize?
Answer: A. Monitoring the client’s suicide risk
Explanation: When caring for a client with a history of self-harm, the nurse should prioritize monitoring the client’s suicide risk. Self-harm behaviors can be indicative of underlying emotional distress and an increased risk of suicide. Close observation and assessment of the client’s emotional state, ideation, and behaviors are essential to ensure their safety. This includes maintaining a safe environment, implementing suicide precautions if necessary, and involving the appropriate multidisciplinary team members in the client’s care.
21. Which neurotransmitter is primarily associated with anxiety disorders?
Answer: B. Serotonin
Explanation: Serotonin is primarily associated with anxiety disorders. It is a neurotransmitter that plays a key role in regulating mood, emotions, and anxiety. Low levels of serotonin have been implicated in the development and exacerbation of anxiety disorders. Medications that target serotonin, such as selective serotonin reuptake inhibitors (SSRIs), are commonly used in the treatment of anxiety disorders to increase serotonin availability and alleviate symptoms of anxiety.
22. The nurse is caring for a client diagnosed with borderline personality disorder who is engaging in manipulative behaviors. Which response by the nurse is most appropriate?
Answer: A. Setting firm limits and boundaries
Explanation: When caring for a client diagnosed with borderline personality disorder who is engaging in manipulative behaviors, the most appropriate response by the nurse is to set firm limits and boundaries. Individuals with borderline personality disorder may display manipulative behaviors as a way to test boundaries, seek attention, or gain control. Establishing clear and consistent boundaries helps maintain a therapeutic and safe environment, promotes accountability, and reduces the potential for exploitation or harm.
23. A client with major depressive disorder is prescribed tricyclic antidepressants (TCAs). The nurse should monitor the client for the development of:
Answer: D. Cardiac dysrhythmias
Explanation: When a client with major depressive disorder is prescribed tricyclic antidepressants (TCAs), the nurse should monitor the client for the development of cardiac dysrhythmias. TCAs can prolong the QT interval, potentially leading to life-threatening arrhythmias such as ventricular tachycardia or torsades de pointes. Regular monitoring of the client’s electrocardiogram (ECG) and periodic assessment of cardiac function are essential to detect any abnormalities and ensure the client’s safety.
24. Which statement accurately describes bipolar disorder?
Answer: C. It is a mood illness characterized by manic and depressive periods.
Explanation: Bipolar disorder is a mood illness characterized by alternating periods of manic and depressive episodes. Manic episodes are marked by elevated mood, increased energy, impulsivity, and potentially psychotic symptoms, while depressive episodes involve persistent feelings of sadness, hopelessness, and a loss of interest or pleasure in activities. Bipolar disorder is distinct from other mental health conditions such as generalized anxiety disorder or personality disorders, as it specifically involves the cycling between manic and depressive states.
25. The nurse takes care of a client who has a history of alcoholism and has been prescribed naltrexone. This medication’s objective is to:
Answer: A. Reduce alcohol cravings
Explanation: Naltrexone is a medication commonly prescribed to individuals with a history of alcoholism. Its objective is to reduce alcohol cravings by blocking the effects of opioids in the brain. Naltrexone helps reduce the reinforcing effects of alcohol, making it less pleasurable and reducing the desire to drink. By reducing cravings, naltrexone can support individuals in maintaining abstinence or moderate their alcohol consumption.
26. A client diagnosed with bulimia nervosa isat risk for which electrolyte imbalance?
Answer: A. Hypokalemia
Explanation: A client diagnosed with bulimia nervosa is at risk for hypokalemia (low potassium levels). Bulimia nervosa is an eating disorder characterized by recurrent episodes of binge eating followed by compensatory behaviors such as self-induced vomiting, laxative use, or excessive exercise. These behaviors can lead to electrolyte imbalances, including hypokalemia. Potassium plays a vital role in muscle and nerve function, and a deficiency can lead to cardiac arrhythmias, muscle weakness, and other complications.
27. The nurse is caring for a client with dissociative identity disorder (DID). Which intervention is most appropriate for this client?
Answer: A. Promoting integration and communication among alter personalities
Explanation: When caring for a client with dissociative identity disorder (DID), the most appropriate intervention is promoting integration and communication among alter personalities. DID is characterized by the presence of two or more distinct identities or personality states. Integration aims to facilitate communication, cooperation, and cohesion among these identities to promote a sense of wholeness and reduce dissociative symptoms. This may involve therapy techniques such as integration therapy or facilitating internal communication between alter personalities.
28. Which statement accurately describes schizophrenia?
Answer: D. It is a psychotic disease marked by hallucinations and delusions.
Explanation: Schizophrenia is a psychotic disorder characterized by a combination of positive symptoms (such as hallucinations, delusions, and disorganized thinking) and negative symptoms (such as social withdrawal, anhedonia, and reduced emotional expression). It is distinct from mood disorders or personality disorders. Hallucinations and delusions are prominent symptoms of schizophrenia, involving perceptual disturbances and false beliefs that are not based on reality.
29. The nurse is evaluating a client who has been diagnosed with post-traumatic stress disorder (PTSD). Which of the following symptoms is frequently linked with this disorder?
Answer: C. Intrusive memories and flashbacks
Explanation: Intrusive memories and flashbacks are frequently linked symptoms in post-traumatic stress disorder (PTSD). PTSD can develop following exposure to a traumatic event, and individuals may experience intrusive, distressing memories or flashbacks of the event. These memories can be triggered by various reminders or cues associated with the traumatic experience, leading to intense emotional and physiological distress. Other common symptoms of PTSD include avoidance of triggers, hyperarousal, and negative changes in mood and cognition.
30. The nurse is caring for a client diagnosed with schizophrenia who is experiencing auditory hallucinations. Which intervention is most appropriate?
Answer: C. Distraction techniques to redirect the client’s attention
Explanation: When caring for a client with schizophrenia experiencing auditory hallucinations, the most appropriate intervention is to use distraction techniques to redirect the client’s attention. Distraction techniques can help shift the client’s focus away from the hallucinations and onto other stimuli or activities. This can provide temporary relief from the distress caused by the hallucinations and help the client regain a sense of control. Distraction techniques may include engaging in conversation, listening to music, engaging in a pleasant activity, or focusing on the present moment.