Chapter 17 My Nursing Test Banks

 

Kneisl, Contemporary Psychiatric-Mental Health Nursing, 3/e Test Bank
Chapter 17

Question 1

Type: MCSA

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

1. Constipation and insomnia.

2. Helplessness.

3. Hopelessness.

4. Suicidal ideation and a plan.

Correct Answer: 1

Rationale 1: Constipation and insomnia is the only answer choice that is physiological. The vegetative signs of depression are physiological. Suicidal ideation and a plan, helplessness, and hopelessness are all psychological.

Rationale 2: Constipation and insomnia is the only answer choice that is physiological. The vegetative signs of depression are physiological. Suicidal ideation and a plan, helplessness, and hopelessness are all psychological.

Rationale 3: Constipation and insomnia is the only answer choice that is physiological. The vegetative signs of depression are physiological. Suicidal ideation and a plan, helplessness, and hopelessness are all psychological.

Rationale 4: Constipation and insomnia is the only answer choice that is physiological. The vegetative signs of depression are physiological. Suicidal ideation and a plan, helplessness, and hopelessness are all psychological.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Compare and contrast the similarities and differences between major depressive disorder and bipolar disorder and between bereavement and dysfunctional grieving.

Question 2

Type: MCSA

The major difference between bipolar disorder and major depressive disorder is that in bipolar disorder there is:

1. Suicidal ideation.

2. Only one week of symptoms.

3. A mania component.

4. No history of depressive feelings.

Correct Answer: 3

Rationale 1: A mania component is the defining feature of bipolar disorder. The client may or may not have suicidal ideation. Bipolar disorder has both mania and depressive components. Bipolar disorder is not diagnosed with only one week of symptoms.

Rationale 2: A mania component is the defining feature of bipolar disorder. The client may or may not have suicidal ideation. Bipolar disorder has both mania and depressive components. Bipolar disorder is not diagnosed with only one week of symptoms.

Rationale 3: A mania component is the defining feature of bipolar disorder. The client may or may not have suicidal ideation. Bipolar disorder has both mania and depressive components. Bipolar disorder is not diagnosed with only one week of symptoms.

Rationale 4: A mania component is the defining feature of bipolar disorder. The client may or may not have suicidal ideation. Bipolar disorder has both mania and depressive components. Bipolar disorder is not diagnosed with only one week of symptoms.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Diagnosis

Learning Outcome: Compare and contrast the similarities and differences between major depressive disorder and bipolar disorder and between bereavement and dysfunctional grieving.

Question 3

Type: MCSA

The treatment plan for a client with acute mania has been effective when the nurse charts that the client has:

1. Pressured speech and wears short shorts and a low-cut blouse.

2. An expansive mood and has organized a unit pool tournament.

3. An irritable mood and sat for one minute to eat lunch.

4. Been intrusive with peer conversations.

Correct Answer: 2

Rationale 1: An expansive mood and organizing a unit pool tournament is correct because though the client may have an expansive mood, the client was able to focus thinking and follow through with organizing an activity. Pressured speech is a symptom of mania. Seductive and inappropriate clothing is a symptom of mania. Irritability and hyperactivity are indicative of an ongoing acute manic phase. Being intrusive with peer conversations is indicative of lack of inhibition and poor personal boundaries in an ongoing acute manic phase.

Rationale 2: An expansive mood and organizing a unit pool tournament is correct because though the client may have an expansive mood, the client was able to focus thinking and follow through with organizing an activity. Pressured speech is a symptom of mania. Seductive and inappropriate clothing is a symptom of mania. Irritability and hyperactivity are indicative of an ongoing acute manic phase. Being intrusive with peer conversations is indicative of lack of inhibition and poor personal boundaries in an ongoing acute manic phase.

Rationale 3: An expansive mood and organizing a unit pool tournament is correct because though the client may have an expansive mood, the client was able to focus thinking and follow through with organizing an activity. Pressured speech is a symptom of mania. Seductive and inappropriate clothing is a symptom of mania. Irritability and hyperactivity are indicative of an ongoing acute manic phase. Being intrusive with peer conversations is indicative of lack of inhibition and poor personal boundaries in an ongoing acute manic phase.

Rationale 4: An expansive mood and organizing a unit pool tournament is correct because though the client may have an expansive mood, the client was able to focus thinking and follow through with organizing an activity. Pressured speech is a symptom of mania. Seductive and inappropriate clothing is a symptom of mania. Irritability and hyperactivity are indicative of an ongoing acute manic phase. Being intrusive with peer conversations is indicative of lack of inhibition and poor personal boundaries in an ongoing acute manic phase.

Global Rationale:

Cognitive Level: Creating

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: Compare and contrast the similarities and differences between major depressive disorder and bipolar disorder and between bereavement and dysfunctional grieving.

Question 4

Type: MCSA

During a nurseclient interaction, an adolescent client with a major depressive disorder stated, I was on the swim team at school, but I dont enjoy swimming anymore so I quit. The client is describing:

1. Anhedonia.

2. Aphasia.

3. Anergia.

4. Antagonism.

Correct Answer: 1

Rationale 1: Anhedonia describes the inability of the client to enjoy an activity that used to give pleasure and is a symptom of depression. Anergia is a lack of energy. Aphasia is a lack of language abilities. Antagonism is being oppositional.

Rationale 2: Anhedonia describes the inability of the client to enjoy an activity that used to give pleasure and is a symptom of depression. Anergia is a lack of energy. Aphasia is a lack of language abilities. Antagonism is being oppositional.

Rationale 3: Anhedonia describes the inability of the client to enjoy an activity that used to give pleasure and is a symptom of depression. Anergia is a lack of energy. Aphasia is a lack of language abilities. Antagonism is being oppositional.

Rationale 4: Anhedonia describes the inability of the client to enjoy an activity that used to give pleasure and is a symptom of depression. Anergia is a lack of energy. Aphasia is a lack of language abilities. Antagonism is being oppositional.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Compare and contrast the similarities and differences between major depressive disorder and bipolar disorder and between bereavement and dysfunctional grieving.

Question 5

Type: MCSA

A client told the nurse that even though his wife died three years ago, he continues to have dinner with his wife every Saturday night. He includes a table setting for her and he prepares their usual steak dinner. He also lights a candle for her each week marking the time of her death. This is evidence of:

1. Dysfunctional grieving.

2. Anticipatory grief.

3. Normal grief.

4. Bereavement.

Correct Answer: 1

Rationale 1: The client exhibits dysfunctional grieving through ritualistic behaviors and his grieving has not come to the point of resolution. Bereavement is a state of loss that is transient. Normal grief is a multidimensional response to loss; the client has not moved on in his life. The client is not anticipating the death of his wife; she died three years ago.

Rationale 2: The client exhibits dysfunctional grieving through ritualistic behaviors and his grieving has not come to the point of resolution. Bereavement is a state of loss that is transient. Normal grief is a multidimensional response to loss; the client has not moved on in his life. The client is not anticipating the death of his wife; she died three years ago.

Rationale 3: The client exhibits dysfunctional grieving through ritualistic behaviors and his grieving has not come to the point of resolution. Bereavement is a state of loss that is transient. Normal grief is a multidimensional response to loss; the client has not moved on in his life. The client is not anticipating the death of his wife; she died three years ago.

Rationale 4: The client exhibits dysfunctional grieving through ritualistic behaviors and his grieving has not come to the point of resolution. Bereavement is a state of loss that is transient. Normal grief is a multidimensional response to loss; the client has not moved on in his life. The client is not anticipating the death of his wife; she died three years ago.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Compare and contrast the similarities and differences between major depressive disorder and bipolar disorder and between bereavement and dysfunctional grieving.

Question 6

Type: MCMA

What treatment approach(es) would the nurse use for a client with dysfunctional grieving?

Standard Text: Select all that apply.

1. Teach about maladaptive dependence on the nurse

2. Talk therapies

3. Antidepressants

4. Cognitive therapy

5. Teach anger management

Correct Answer: 2,3,4

Rationale 1: The treatment for dysfunctional grieving is similar to the treatment for depression. Cognitive therapy, talk therapies, and antidepressants are all treatment options. The question does not indicate the client has a problem with anger management or maladaptive dependence.

Rationale 2: The treatment for dysfunctional grieving is similar to the treatment for depression. Cognitive therapy, talk therapies, and antidepressants are all treatment options. The question does not indicate the client has a problem with anger management or maladaptive dependence.

Rationale 3: The treatment for dysfunctional grieving is similar to the treatment for depression. Cognitive therapy, talk therapies, and antidepressants are all treatment options. The question does not indicate the client has a problem with anger management or maladaptive dependence.

Rationale 4: The treatment for dysfunctional grieving is similar to the treatment for depression. Cognitive therapy, talk therapies, and antidepressants are all treatment options. The question does not indicate the client has a problem with anger management or maladaptive dependence.

Rationale 5: The treatment for dysfunctional grieving is similar to the treatment for depression. Cognitive therapy, talk therapies, and antidepressants are all treatment options. The question does not indicate the client has a problem with anger management or maladaptive dependence.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Compare and contrast the similarities and differences between major depressive disorder and bipolar disorder and between bereavement and dysfunctional grieving.

Question 7

Type: MCMA

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

Standard Text: Select all that apply.

1. A crisis.

2. Bereavement.

3. Delayed grief.

4. Normal grief.

5. Dysfunctional grieving.

Correct Answer: 2,4,5

Rationale 1: Normal grief is a multidimensional response to loss. Although he is sad, the client has started to move on in his life by making plans for the future. In bereavement, this client is sad in response to the death of his wife. He is not mentally ill. When a client has resolved his grieving to the point of making plans for the future, it is not dysfunctional grieving. In delayed grief, the client would avoid his feelings. The clients response is not one of crisis. The client is able to plan and move his life forward.

Rationale 2: Normal grief is a multidimensional response to loss. Although he is sad, the client has started to move on in his life by making plans for the future. In bereavement, this client is sad in response to the death of his wife. He is not mentally ill. When a client has resolved his grieving to the point of making plans for the future, it is not dysfunctional grieving. In delayed grief, the client would avoid his feelings. The clients response is not one of crisis. The client is able to plan and move his life forward.

Rationale 3: Normal grief is a multidimensional response to loss. Although he is sad, the client has started to move on in his life by making plans for the future. In bereavement, this client is sad in response to the death of his wife. He is not mentally ill. When a client has resolved his grieving to the point of making plans for the future, it is not dysfunctional grieving. In delayed grief, the client would avoid his feelings. The clients response is not one of crisis. The client is able to plan and move his life forward.

Rationale 4: Normal grief is a multidimensional response to loss. Although he is sad, the client has started to move on in his life by making plans for the future. In bereavement, this client is sad in response to the death of his wife. He is not mentally ill. When a client has resolved his grieving to the point of making plans for the future, it is not dysfunctional grieving. In delayed grief, the client would avoid his feelings. The clients response is not one of crisis. The client is able to plan and move his life forward.

Rationale 5: Normal grief is a multidimensional response to loss. Although he is sad, the client has started to move on in his life by making plans for the future. In bereavement, this client is sad in response to the death of his wife. He is not mentally ill. When a client has resolved his grieving to the point of making plans for the future, it is not dysfunctional grieving. In delayed grief, the client would avoid his feelings. The clients response is not one of crisis. The client is able to plan and move his life forward.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Compare and contrast the similarities and differences between major depressive disorder and bipolar disorder and between bereavement and dysfunctional grieving.

Question 8

Type: MCSA

Which biopsychosocial theory would most support the development of depression in a client who went to live with his father at 3 months of age when his mother was sentenced to jail for 15 years?

1. Object loss theory

2. Gender theory

3. Genetic theory

4. Cognitive theory

Correct Answer: 1

Rationale 1: Object loss theory is correct because it addresses the separation of an infant from the primary caregiver during the first six months of life. Genetic theory deals with heredity; there is no information to indicate that the depression was inherited. Cognitive theory believes depression is based on distorted cognition. There is no information given to support this theory. Gender theory states that men are not as prone to depression as womenthe client is male.

Rationale 2: Object loss theory is correct because it addresses the separation of an infant from the primary caregiver during the first six months of life. Genetic theory deals with heredity; there is no information to indicate that the depression was inherited. Cognitive theory believes depression is based on distorted cognition. There is no information given to support this theory. Gender theory states that men are not as prone to depression as womenthe client is male.

Rationale 3: Object loss theory is correct because it addresses the separation of an infant from the primary caregiver during the first six months of life. Genetic theory deals with heredity; there is no information to indicate that the depression was inherited. Cognitive theory believes depression is based on distorted cognition. There is no information given to support this theory. Gender theory states that men are not as prone to depression as womenthe client is male.

Rationale 4: Object loss theory is correct because it addresses the separation of an infant from the primary caregiver during the first six months of life. Genetic theory deals with heredity; there is no information to indicate that the depression was inherited. Cognitive theory believes depression is based on distorted cognition. There is no information given to support this theory. Gender theory states that men are not as prone to depression as womenthe client is male.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Describe the elements of the biopsychosocial theories discussed here that contribute most to the current understanding of mood disorders.

Question 9

Type: MCSA

When taking the admission history of a client with bipolar disorder, which information would be most significant to determine circadian rhythm dysfunction?

1. Negative thought patterns

2. Sleep and appetite patterns

3. Psychiatric diagnosis

4. Personality patterns

Correct Answer: 2

Rationale 1: Sleep and appetite patterns are part of the physiologic circadian rhythms and a pattern disruption may explain many mood disorder symptoms. A psychiatric diagnosis, personality patterns, and negative thought patterns are incorrect because they are not physiologic.

Rationale 2: Sleep and appetite patterns are part of the physiologic circadian rhythms and a pattern disruption may explain many mood disorder symptoms. A psychiatric diagnosis, personality patterns, and negative thought patterns are incorrect because they are not physiologic.

Rationale 3: Sleep and appetite patterns are part of the physiologic circadian rhythms and a pattern disruption may explain many mood disorder symptoms. A psychiatric diagnosis, personality patterns, and negative thought patterns are incorrect because they are not physiologic.

Rationale 4: Sleep and appetite patterns are part of the physiologic circadian rhythms and a pattern disruption may explain many mood disorder symptoms. A psychiatric diagnosis, personality patterns, and negative thought patterns are incorrect because they are not physiologic.

Global Rationale:

Cognitive Level: Evaluating

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Describe the elements of the biopsychosocial theories discussed here that contribute most to the current understanding of mood disorders.

Question 10

Type: MCSA

Your client with a mood disorder states, My husband never calls to tell me he will be late for dinner, and then dinner is always ruined. The nurse knows that a priority teaching for this client would be:

1. Cognitive theory

2. Psychoanalytic Theory

3. Object loss theory

4. Genetic theory

Correct Answer: 1

Rationale 1: Cognitive theory is a biopsychosocial theory that addresses distorted thinking processes. The key words are never and always. The nurse needs to teach ways to change the thinking on this clients stressor. Object loss theory addresses the separation of an infant from the primary caregiver during the first six months of life and does not address the clients thought pattern. Psychoanalytic theory focuses on the unsatisfactory relationship of the mother and infant and does not address the client thought pattern. Genetic theory deals with heredity and does not address the clients thought pattern.

Rationale 2: Cognitive theory is a biopsychosocial theory that addresses distorted thinking processes. The key words are never and always. The nurse needs to teach ways to change the thinking on this clients stressor. Object loss theory addresses the separation of an infant from the primary caregiver during the first six months of life and does not address the clients thought pattern. Psychoanalytic theory focuses on the unsatisfactory relationship of the mother and infant and does not address the client thought pattern. Genetic theory deals with heredity and does not address the clients thought pattern.

Rationale 3: Cognitive theory is a biopsychosocial theory that addresses distorted thinking processes. The key words are never and always. The nurse needs to teach ways to change the thinking on this clients stressor. Object loss theory addresses the separation of an infant from the primary caregiver during the first six months of life and does not address the clients thought pattern. Psychoanalytic theory focuses on the unsatisfactory relationship of the mother and infant and does not address the client thought pattern. Genetic theory deals with heredity and does not address the clients thought pattern.

Rationale 4: Cognitive theory is a biopsychosocial theory that addresses distorted thinking processes. The key words are never and always. The nurse needs to teach ways to change the thinking on this clients stressor. Object loss theory addresses the separation of an infant from the primary caregiver during the first six months of life and does not address the clients thought pattern. Psychoanalytic theory focuses on the unsatisfactory relationship of the mother and infant and does not address the client thought pattern. Genetic theory deals with heredity and does not address the clients thought pattern.

Global Rationale:

Cognitive Level: Evaluating

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Describe the elements of the biopsychosocial theories discussed here that contribute most to the current understanding of mood disorders.

Question 11

Type: MCSA

A priority nursing intervention for a client with bipolar mania who has difficulty sleeping is to:

1. Have the night nurse talk with the client.

2. Encourage long naps during the day.

3. Administer PRN zolpidem tartrate (Ambien).

4. Provide strenuous exercise prior to bedtime.

Correct Answer: 3

Rationale 1: Administering PRN zolpidem tartrate (Ambien) does not suppress REM sleep and is effective for sleep. Sleep should be encouraged because sleep deprivation may enhance mood disorder symptoms. Having the night nurse talk with the client does not encourage the client to rest. Sleeping during the day interferes with establishing a regular sleep pattern at night. Providing strenuous exercise prior to bedtime promotes stimulation rather than relaxation.

Rationale 2: Administering PRN zolpidem tartrate (Ambien) does not suppress REM sleep and is effective for sleep. Sleep should be encouraged because sleep deprivation may enhance mood disorder symptoms. Having the night nurse talk with the client does not encourage the client to rest. Sleeping during the day interferes with establishing a regular sleep pattern at night. Providing strenuous exercise prior to bedtime promotes stimulation rather than relaxation.

Rationale 3: Administering PRN zolpidem tartrate (Ambien) does not suppress REM sleep and is effective for sleep. Sleep should be encouraged because sleep deprivation may enhance mood disorder symptoms. Having the night nurse talk with the client does not encourage the client to rest. Sleeping during the day interferes with establishing a regular sleep pattern at night. Providing strenuous exercise prior to bedtime promotes stimulation rather than relaxation.

Rationale 4: Administering PRN zolpidem tartrate (Ambien) does not suppress REM sleep and is effective for sleep. Sleep should be encouraged because sleep deprivation may enhance mood disorder symptoms. Having the night nurse talk with the client does not encourage the client to rest. Sleeping during the day interferes with establishing a regular sleep pattern at night. Providing strenuous exercise prior to bedtime promotes stimulation rather than relaxation.

Global Rationale:

Cognitive Level: Creating

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Explain the principles upon which the various biologic therapies for clients with mood disorders are based.

Question 12

Type: MCSA

A client with bipolar disorder, mania, states, I had a test to look at my ventricles before I came in. The nurse thinks it most likely was a/an:

1. Electroencephalography (EEG).

2. Magnetic Resonance Imaging (MRI).

3. Polysomnography.

4. Single photon-emission computed tomography.

Correct Answer: 2

Rationale 1: Magnetic Resonance Imaging (MRI) is correct because it will image the ventricles. Electroencephalography (EEG) measures the electrical activity of the brain. Single photon-emission computed tomography images the neuroreceptors. Polysomnography measures the electrical activity of the brain while sleeping throughout the night.

Rationale 2: Magnetic Resonance Imaging (MRI) is correct because it will image the ventricles. Electroencephalography (EEG) measures the electrical activity of the brain. Single photon-emission computed tomography images the neuroreceptors. Polysomnography measures the electrical activity of the brain while sleeping throughout the night.

Rationale 3: Magnetic Resonance Imaging (MRI) is correct because it will image the ventricles. Electroencephalography (EEG) measures the electrical activity of the brain. Single photon-emission computed tomography images the neuroreceptors. Polysomnography measures the electrical activity of the brain while sleeping throughout the night.

Rationale 4: Magnetic Resonance Imaging (MRI) is correct because it will image the ventricles. Electroencephalography (EEG) measures the electrical activity of the brain. Single photon-emission computed tomography images the neuroreceptors. Polysomnography measures the electrical activity of the brain while sleeping throughout the night.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Explain the principles upon which the various biologic therapies for clients with mood disorders are based.

Question 13

Type: MCMA

A client describes being very sad during dreary winter seasons. The nurse knows that this disorder may be treated with:

Standard Text: Select all that apply.

1. Light therapy.

2. Haloperidol (Haldol).

3. Group therapy.

4. Assertiveness training.

5. Bupropion ER (Wellbutrin ER).

Correct Answer: 1,3,5

Rationale 1: Light therapy has been effective with Seasonal Affective Disorder. Bupropion ER (Wellbutrin ER) is the only antidepressant approved for treatment of Seasonal Affective Disorder.

Rationale 2: Light therapy has been effective with Seasonal Affective Disorder. Bupropion ER (Wellbutrin ER) is the only antidepressant approved for treatment of Seasonal Affective Disorder.

Rationale 3: Light therapy has been effective with Seasonal Affective Disorder. Bupropion ER (Wellbutrin ER) is the only antidepressant approved for treatment of Seasonal Affective Disorder.

Rationale 4: Light therapy has been effective with Seasonal Affective Disorder. Bupropion ER (Wellbutrin ER) is the only antidepressant approved for treatment of Seasonal Affective Disorder.

Rationale 5: Light therapy has been effective with Seasonal Affective Disorder. Bupropion ER (Wellbutrin ER) is the only antidepressant approved for treatment of Seasonal Affective Disorder.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: Explain the principles upon which the various biologic therapies for clients with mood disorders are based.

Question 14

Type: MCSA

A client with a mood disorder is admitted to the mental health unit. The priority nursing activity should be to:

1. Orient the client to group therapy.

2. Complete the mental and physical assessment.

3. Work on clients current stressors.

4. Teach social skills.

Correct Answer: 2

Rationale 1: The nurse needs the information from a complete mental and physical assessment to plan appropriate care with the new client, especially for safety related issues, so assessment is the priority. The client may not have group therapy ordered until assessments are completed. Working on the clients current stressors and teaching social skills are parts of the implementation of the nursing process.

Rationale 2: The nurse needs the information from a complete mental and physical assessment to plan appropriate care with the new client, especially for safety related issues, so assessment is the priority. The client may not have group therapy ordered until assessments are completed. Working on the clients current stressors and teaching social skills are parts of the implementation of the nursing process.

Rationale 3: The nurse needs the information from a complete mental and physical assessment to plan appropriate care with the new client, especially for safety related issues, so assessment is the priority. The client may not have group therapy ordered until assessments are completed. Working on the clients current stressors and teaching social skills are parts of the implementation of the nursing process.

Rationale 4: The nurse needs the information from a complete mental and physical assessment to plan appropriate care with the new client, especially for safety related issues, so assessment is the priority. The client may not have group therapy ordered until assessments are completed. Working on the clients current stressors and teaching social skills are parts of the implementation of the nursing process.

Global Rationale:

Cognitive Level: Creating

Client Need: Safe Effective Care Environment

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Systematically conduct a nursing assessment of a client with a mood disorder.

Question 15

Type: MCMA

What items should be included in the admission nursing assessment for a new client?

Standard Text: Select all that apply.

1. Genetic counseling

2. Health history

3. Support systems

4. Current stressors

5. Genetic testing

Correct Answer: 2,3,4,5

Rationale 1: The health history may help rule out a physiologic disorder and gives baseline information for the physical assessment. It will be important to know what support systems are available to assist the client in the recovery process. It is important to know what types of immediate interventions may be necessary to address current stressors as they may contribute to being helpless and hopeless. Neither genetic testing nor genetic counseling is necessary for the immediate care of the client.

Rationale 2: The health history may help rule out a physiologic disorder and gives baseline information for the physical assessment. It will be important to know what support systems are available to assist the client in the recovery process. It is important to know what types of immediate interventions may be necessary to address current stressors as they may contribute to being helpless and hopeless. Neither genetic testing nor genetic counseling is necessary for the immediate care of the client.

Rationale 3: The health history may help rule out a physiologic disorder and gives baseline information for the physical assessment. It will be important to know what support systems are available to assist the client in the recovery process. It is important to know what types of immediate interventions may be necessary to address current stressors as they may contribute to being helpless and hopeless. Neither genetic testing nor genetic counseling is necessary for the immediate care of the client.

Rationale 4: The health history may help rule out a physiologic disorder and gives baseline information for the physical assessment. It will be important to know what support systems are available to assist the client in the recovery process. It is important to know what types of immediate interventions may be necessary to address current stressors as they may contribute to being helpless and hopeless. Neither genetic testing nor genetic counseling is necessary for the immediate care of the client.

Rationale 5: The health history may help rule out a physiologic disorder and gives baseline information for the physical assessment. It will be important to know what support systems are available to assist the client in the recovery process. It is important to know what types of immediate interventions may be necessary to address current stressors As they may contribute to being helpless and hopeless. Neither genetic testing nor genetic counseling is necessary for the immediate care of the client.

Global Rationale:

Cognitive Level: Creating

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Systematically conduct a nursing assessment of a client with a mood disorder.

Question 16

Type: MCSA

During the admission nursing assessment for a new client, the nurse recognizes which objective assessment data consistent with a diagnosis of major depression?

1. Fatigue

2. Feeling sad

3. Psychomotor retardation

4. Impaired concentration

Correct Answer: 3

Rationale 1: The nurse observes psychomotor retardation, which is objective data. Fatigue, feeling sad, and impaired concentration are subjective data reported by the client.

Rationale 2: The nurse observes psychomotor retardation, which is objective data. Fatigue, feeling sad, and impaired concentration are subjective data reported by the client.

Rationale 3: The nurse observes psychomotor retardation, which is objective data. Fatigue, feeling sad, and impaired concentration are subjective data reported by the client.

Rationale 4: The nurse observes psychomotor retardation, which is objective data. Fatigue, feeling sad, and impaired concentration are subjective data reported by the client.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Systematically conduct a nursing assessment of a client with a mood disorder.

Question 17

Type: MCMA

In assessing a client, which of the following would indicate that the client is experiencing mania?

Standard Text: Select all that apply.

1. Pressured speech

2. Feeling worthless

3. Isolating

4. Flight of ideas

5. Constant motor activity

Correct Answer: 1,4,5

Rationale 1: Constant motor activity and movement are mania symptoms. Pressured speech is talking continuously which is a mania symptom. Flight of ideas is moving from one topic to another and is also a mania symptom. Feeling worthless and isolating are depressive symptoms.

Rationale 2: Constant motor activity and movement are mania symptoms. Pressured speech is talking continuously which is a mania symptom. Flight of ideas is moving from one topic to another and is also a mania symptom. Feeling worthless and isolating are depressive symptoms.

Rationale 3: Constant motor activity and movement are mania symptoms. Pressured speech is talking continuously which is a mania symptom. Flight of ideas is moving from one topic to another and is also a mania symptom. Feeling worthless and isolating are depressive symptoms.

Rationale 4: Constant motor activity and movement are mania symptoms. Pressured speech is talking continuously which is a mania symptom. Flight of ideas is moving from one topic to another and is also a mania symptom. Feeling worthless and isolating are depressive symptoms.

Rationale 5: Constant motor activity and movement are mania symptoms. Pressured speech is talking continuously which is a mania symptom. Flight of ideas is moving from one topic to another and is also a mania symptom. Feeling worthless and isolating are depressive symptoms.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Systematically conduct a nursing assessment of a client with a mood disorder.

Question 18

Type: MCSA

When a client with a major depressive disorder states, I dont care about anything anymore, the nurse would respond:

1. You have such a good life!

2. Are you feeling suicidal?

3. What about your children? They are so cute and wonderful!

4. Dont worry. Youll feel better tomorrow.

Correct Answer: 2

Rationale 1: Are you feeling suicidal? asks the client directly about suicide. It assesses for initial suicidal risk and the need for increased safety precautions. What about your children? They are so cute and wonderful! changes the topic and a cheerful attitude about the children does not make a depressed person feel better or assess for safety needs. You have such a good life! does not encourage expression of thoughts and feelings. Dont worry. Youll feel better tomorrow. offers false reassurance. The client may remain depressed and may not feel better tomorrow.

Rationale 2: Are you feeling suicidal? asks the client directly about suicide. It assesses for initial suicidal risk and the need for increased safety precautions. What about your children? They are so cute and wonderful! changes the topic and a cheerful attitude about the children does not make a depressed person feel better or assess for safety needs. You have such a good life! does not encourage expression of thoughts and feelings. Dont worry. Youll feel better tomorrow. offers false reassurance. The client may remain depressed and may not feel better tomorrow.

Rationale 3: Are you feeling suicidal? asks the client directly about suicide. It assesses for initial suicidal risk and the need for increased safety precautions. What about your children? They are so cute and wonderful! changes the topic and a cheerful attitude about the children does not make a depressed person feel better or assess for safety needs. You have such a good life! does not encourage expression of thoughts and feelings. Dont worry. Youll feel better tomorrow. offers false reassurance. The client may remain depressed and may not feel better tomorrow.

Rationale 4: Are you feeling suicidal? asks the client directly about suicide. It assesses for initial suicidal risk and the need for increased safety precautions. What about your children? They are so cute and wonderful! changes the topic and a cheerful attitude about the children does not make a depressed person feel better or assess for safety needs. You have such a good life! does not encourage expression of thoughts and feelings. Dont worry. Youll feel better tomorrow. offers false reassurance. The client may remain depressed and may not feel better tomorrow.

Global Rationale:

Cognitive Level: Creating

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Implement an understanding of suicide prevention and safety promotion in the plan of care for clients with mood disorders.

Question 19

Type: MCSA

The nurses priority intervention for a newly hospitalized suicidal client is to:

1. Obtain a no-suicide contract for the day.

2. Have the client write a list of the clients weaknesses.

3. Require the client to participate in the goals group.

4. Request the client to describe previous stressors.

Correct Answer: 1

Rationale 1: Obtaining a no-suicide contract for the day conveys to the client that the staff members want to maintain client safety. Requiring the client to participate in the goals group may be overwhelming for a newly admitted client. Writing a list of weaknesses may reinforce the clients suicidality. The focus should be on the here and now; current stressors are more important than previous stressors.

Rationale 2: Obtaining a no-suicide contract for the day conveys to the client that the staff members want to maintain client safety. Requiring the client to participate in the goals group may be overwhelming for a newly admitted client. Writing a list of weaknesses may reinforce the clients suicidality. The focus should be on the here and now; current stressors are more important than previous stressors.

Rationale 3: Obtaining a no-suicide contract for the day conveys to the client that the staff members want to maintain client safety. Requiring the client to participate in the goals group may be overwhelming for a newly admitted client. Writing a list of weaknesses may reinforce the clients suicidality. The focus should be on the here and now; current stressors are more important than previous stressors.

Rationale 4: Obtaining a no-suicide contract for the day conveys to the client that the staff members want to maintain client safety. Requiring the client to participate in the goals group may be overwhelming for a newly admitted client. Writing a list of weaknesses may reinforce the clients suicidality. The focus should be on the here and now; current stressors are more important than previous stressors.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: Implement an understanding of suicide prevention and safety promotion in the plan of care for clients with mood disorders.

Question 20

Type: MCSA

A severely depressed clients risk for self-directed violence increases when:

1. A no-suicide contract is made with the client.

2. The client is encouraged to discuss feelings.

3. The client is asked to discuss the suicide plan.

4. The antidepressant medication begins to work.

Correct Answer: 4

Rationale 1: When the antidepressant medication begins to work, the depression begins to lift and the client may have the energy to follow through with self-directed violence. Asking to discuss the suicide plan and encouraging the client to discuss feelings convey care and concern and do not increase the risk of self-directed violence. A no-suicide contract conveys to the client that the staff members want to maintain client safety.

Rationale 2: When the antidepressant medication begins to work, the depression begins to lift and the client may have the energy to follow through with self-directed violence. Asking to discuss the suicide plan and encouraging the client to discuss feelings convey care and concern and do not increase the risk of self-directed violence. A no-suicide contract conveys to the client that the staff members want to maintain client safety.

Rationale 3: When the antidepressant medication begins to work, the depression begins to lift and the client may have the energy to follow through with self-directed violence. Asking to discuss the suicide plan and encouraging the client to discuss feelings convey care and concern and do not increase the risk of self-directed violence. A no-suicide contract conveys to the client that the staff members want to maintain client safety.

Rationale 4: When the antidepressant medication begins to work, the depression begins to lift and the client may have the energy to follow through with self-directed violence. Asking to discuss the suicide plan and encouraging the client to discuss feelings convey care and concern and do not increase the risk of self-directed violence. A no-suicide contract conveys to the client that the staff members want to maintain client safety.

Global Rationale:

Cognitive Level: Creating

Client Need: Safe Effective Care Environment

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Implement an understanding of suicide prevention and safety promotion in the plan of care for clients with mood disorders.

Question 21

Type: MCSA

A hospitalized client with a mood disorder is assessed to be high risk for suicide. The nurse should intervene by:

1. Encouraging repetitive discussions of suicidal ruminations.

2. Removing dangerous objects from the clients room.

3. Evaluating suicide intention every three days.

4. Using a strict regular schedule for client observation.

Correct Answer: 2

Rationale 1: The nurse is ensuring safety by removing dangerous objects from the clients room. Using a strict regular schedule for client observation allows the client to predict when staff will not be present. Evaluating suicide intention every three days does not capture the impulsivity of self-directed violence. It should be evaluated every shift. Encouraging repetitive discussions of suicidal ruminations reinforces the preoccupation with suicidal ideation.

Rationale 2: The nurse is ensuring safety by removing dangerous objects from the clients room. Using a strict regular schedule for client observation allows the client to predict when staff will not be present. Evaluating suicide intention every three days does not capture the impulsivity of self-directed violence. It should be evaluated every shift. Encouraging repetitive discussions of suicidal ruminations reinforces the preoccupation with suicidal ideation.

Rationale 3: The nurse is ensuring safety by removing dangerous objects from the clients room. Using a strict regular schedule for client observation allows the client to predict when staff will not be present. Evaluating suicide intention every three days does not capture the impulsivity of self-directed violence. It should be evaluated every shift. Encouraging repetitive discussions of suicidal ruminations reinforces the preoccupation with suicidal ideation.

Rationale 4: The nurse is ensuring safety by removing dangerous objects from the clients room. Using a strict regular schedule for client observation allows the client to predict when staff will not be present. Evaluating suicide intention every three days does not capture the impulsivity of self-directed violence. It should be evaluated every shift. Encouraging repetitive discussions of suicidal ruminations reinforces the preoccupation with suicidal ideation.

Global Rationale:

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Implement an understanding of suicide prevention and safety promotion in the plan of care for clients with mood disorders.

Question 22

Type: MCSA

In planning care for a client with negative thinking, the nurse would intervene by teaching the client to:

1. Identify and reframe negative thoughts.

2. Discuss personal worthlessness with all unit peers.

3. Make a list of things the client does poorly.

4. Avoid unit activities until the client desires to participate.

Correct Answer: 1

Rationale 1: Research shows that the cognitive behavioral therapy techniques of identifying and reframing negative thoughts are effective. Avoiding participation in unit activities until the client desires to participate allows the client to isolate and become more self-absorbed. Discussing personal worthlessness with all unit peers may reinforce the negative thought patterns.

Rationale 2: Research shows that the cognitive behavioral therapy techniques of identifying and reframing negative thoughts are effective. Avoiding participation in unit activities until the client desires to participate allows the client to isolate and become more self-absorbed. Discussing personal worthlessness with all unit peers may reinforce the negative thought patterns.

Rationale 3: Research shows that the cognitive behavioral therapy techniques of identifying and reframing negative thoughts are effective. Avoiding participation in unit activities until the client desires to participate allows the client to isolate and become more self-absorbed. Discussing personal worthlessness with all unit peers may reinforce the negative thought patterns.

Rationale 4: Research shows that the cognitive behavioral therapy techniques of identifying and reframing negative thoughts are effective. Avoiding participation in unit activities until the client desires to participate allows the client to isolate and become more self-absorbed. Discussing personal worthlessness with all unit peers may reinforce the negative thought patterns.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: Design a plan of care to reduce negative thinking and promote improved self-esteem.

Question 23

Type: MCMA

In preparing the care plan for a client to reduce negative thinking and promote improved self-esteem, identify all of the appropriate short-term goals. Client will:

Standard Text: Select all that apply.

1. Wash and comb hair.

2. Eat meals and snacks to meet daily calorie requirements.

3. Sit and walk erectly.

4. Participate in activities that can be completed successfully.

5. Verbalize positive aspects of self.

Correct Answer: 1,3,4,5

Rationale 1: Sitting and walking erectly, washing and combing hair, and participating in activities that can be completed successfully increase feelings of self-worth. Verbalizing positive aspects of self minimizes a negative self-view. Eating enough meals and snacks to meet daily calorie requirements deals with inadequate nutrition, not negative thinking and self-esteem.

Rationale 2: Sitting and walking erectly, washing and combing hair, and participating in activities that can be completed successfully increase feelings of self-worth. Verbalizing positive aspects of self minimizes a negative self-view. Eating enough meals and snacks to meet daily calorie requirements deals with inadequate nutrition, not negative thinking and self-esteem.

Rationale 3: Sitting and walking erectly, washing and combing hair, and participating in activities that can be completed successfully increase feelings of self-worth. Verbalizing positive aspects of self minimizes a negative self-view. Eating enough meals and snacks to meet daily calorie requirements deals with inadequate nutrition, not negative thinking and self-esteem.

Rationale 4: Sitting and walking erectly, washing and combing hair, and participating in activities that can be completed successfully increase feelings of self-worth. Verbalizing positive aspects of self minimizes a negative self-view. Eating enough meals and snacks to meet daily calorie requirements deals with inadequate nutrition, not negative thinking and self-esteem.

Rationale 5: Sitting and walking erectly, washing and combing hair, and participating in activities that can be completed successfully increase feelings of self-worth. Verbalizing positive aspects of self minimizes a negative self-view. Eating enough meals and snacks to meet daily calorie requirements deals with inadequate nutrition, not negative thinking and self-esteem.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: Design a plan of care to reduce negative thinking and promote improved self-esteem.

Question 24

Type: MCSA

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

1. Electroconvulsive therapy.

2. Fluoxetine (Prozac).

3. Seclusion and restraint.

4. Group therapy.

Correct Answer: 1

Rationale 1: Electroconvulsive therapy has been proven useful to clients with acute mania. A client with acute mania has difficulty sitting through a group therapy session due to hyperactivity. Fluoxetine (Prozac) is an antidepressant medication, not an antimanic drug. Seclusion and restraint are used only as an emergency measure.

Rationale 2: Electroconvulsive therapy has been proven useful to clients with acute mania. A client with acute mania has difficulty sitting through a group therapy session due to hyperactivity. Fluoxetine (Prozac) is an antidepressant medication, not an antimanic drug. Seclusion and restraint are used only as an emergency measure.

Rationale 3: Electroconvulsive therapy has been proven useful to clients with acute mania. A client with acute mania has difficulty sitting through a group therapy session due to hyperactivity. Fluoxetine (Prozac) is an antidepressant medication, not an antimanic drug. Seclusion and restraint are used only as an emergency measure.

Rationale 4: Electroconvulsive therapy has been proven useful to clients with acute mania. A client with acute mania has difficulty sitting through a group therapy session due to hyperactivity. Fluoxetine (Prozac) is an antidepressant medication, not an antimanic drug. Seclusion and restraint are used only as an emergency measure.

Global Rationale:

Cognitive Level: Creating

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: Educate clients and their families about biologic treatments for mood disorders such as antidepressant medications and electroconvulsive therapy.

Question 25

Type: MCSA

The nurse knows that teaching has been effective when the clients state that upon awakening following electroconvulsive therapy they:

1. Should be assisted to ambulate.

2. May have water immediately.

3. May be confused and disoriented.

4. Should eat breakfast.

Correct Answer: 3

Rationale 1: Clients may be confused and disoriented because electroconvulsive therapy may cause short-term memory loss. Fluids are not given until the client is fully recovered from anesthesia and demonstrates a gag reflex. Clients should be placed in the lateral recumbent position and should not be assisted to ambulate. Food is not given until the client is fully recovered from anesthesia. The client must have a gag reflex.

Rationale 2: Clients may be confused and disoriented because electroconvulsive therapy may cause short-term memory loss. Fluids are not given until the client is fully recovered from anesthesia and demonstrates a gag reflex. Clients should be placed in the lateral recumbent position and should not be assisted to ambulate. Food is not given until the client is fully recovered from anesthesia. The client must have a gag reflex.

Rationale 3: Clients may be confused and disoriented because electroconvulsive therapy may cause short-term memory loss. Fluids are not given until the client is fully recovered from anesthesia and demonstrates a gag reflex. Clients should be placed in the lateral recumbent position and should not be assisted to ambulate. Food is not given until the client is fully recovered from anesthesia. The client must have a gag reflex.

Rationale 4: Clients may be confused and disoriented because electroconvulsive therapy may cause short-term memory loss. Fluids are not given until the client is fully recovered from anesthesia and demonstrates a gag reflex. Clients should be placed in the lateral recumbent position and should not be assisted to ambulate. Food is not given until the client is fully recovered from anesthesia. The client must have a gag reflex.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: Educate clients and their families about biologic treatments for mood disorders such as antidepressant medications and electroconvulsive therapy.

Question 26

Type: MCSA

The nurse instructs the family and client on phenelzine (Nardil) about:

1. No risk for concomitant use with a Selective Serotonin Reuptake Inhibitor (SSRI).

2. No risk for concomitant use with opioids.

3. Use of a low glycemic diet.

4. Use of a low-tyramine diet.

Correct Answer: 4

Rationale 1: Nardil is a monoamine oxidase inhibitor (MAOI) and requires the use of a low-tyramine diet, not a low glycemic diet. These diets are not the same. There is a death risk for concomitant use of a MAOI with a SSRI and/or opioid.

Rationale 2: Nardil is a monoamine oxidase inhibitor (MAOI) and requires the use of a low-tyramine diet, not a low glycemic diet. These diets are not the same. There is a death risk for concomitant use of a MAOI with a SSRI and/or opioid.

Rationale 3: Nardil is a monoamine oxidase inhibitor (MAOI) and requires the use of a low-tyramine diet, not a low glycemic diet. These diets are not the same. There is a death risk for concomitant use of a MAOI with a SSRI and/or opioid.

Rationale 4: Nardil is a monoamine oxidase inhibitor (MAOI) and requires the use of a low-tyramine diet, not a low glycemic diet. These diets are not the same. There is a death risk for concomitant use of a MAOI with a SSRI and/or opioid.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Teaching and Learning

Learning Outcome: Educate clients and their families about biologic treatments for mood disorders such as antidepressant medications and electroconvulsive therapy.

Question 27

Type: MCSA

The nurse is teaching a client with bipolar disorder about their newly prescribed lithium carbonate (Lithobid). Which is the correct instructional information?

1. Serum levels must be tested regularly

2. For fine hand tremors, take a double dose of the medication.

3. Decrease salt and fluid intake

4. Discontinue the medication when feeling better

Correct Answer: 1

Rationale 1: Serum levels must be tested regularly to prevent drug toxicity. The client must have adequate salt and fluid intake. The medication must be continued when the client is feeling better because discontinuance may precipitate mania. Since fine hand tremors may indicate lithium toxicity, a double dose of the medication may increase symptoms of toxicity.

Rationale 2: Serum levels must be tested regularly to prevent drug toxicity. The client must have adequate salt and fluid intake. The medication must be continued when the client is feeling better because discontinuance may precipitate mania. Since fine hand tremors may indicate lithium toxicity, a double dose of the medication may increase symptoms of toxicity.

Rationale 3: Serum levels must be tested regularly to prevent drug toxicity. The client must have adequate salt and fluid intake. The medication must be continued when the client is feeling better because discontinuance may precipitate mania. Since fine hand tremors may indicate lithium toxicity, a double dose of the medication may increase symptoms of toxicity.

Rationale 4: Serum levels must be tested regularly to prevent drug toxicity. The client must have adequate salt and fluid intake. The medication must be continued when the client is feeling better because discontinuance may precipitate mania. Since fine hand tremors may indicate lithium toxicity, a double dose of the medication may increase symptoms of toxicity.

Global Rationale:

Cognitive Level: Creating

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Educate clients and their families about biologic treatments for mood disorders such as anti depressant medications and electroconvulsive therapy.

Question 28

Type: MCSA

When communicating with a client who has major depressive disorder, the nurse should avoid being:

1. Warm and patient.

2. Gently encouraging.

3. Cheerful and outgoing.

4. Slow and empathic.

Correct Answer: 3

Rationale 1: A cheerful and outgoing attitude does not make the client feel better. It may be more comfortable for the nurse to avoid dealing with the clients feelings, but it may lead the client to feel worse, because their feelings seem less important. Warmth and patience are beneficial. Clients with depression may have trouble when others talk too quickly or do not seem to understand, so communication that is slow and empathic would be beneficial. Clients with depression do not want to do things like get out of bed, shower, and put on clothes. They must be encouraged to do so.

Rationale 2: A cheerful and outgoing attitude does not make the client feel better. It may be more comfortable for the nurse to avoid dealing with the clients feelings, but it may lead the client to feel worse, because their feelings seem less important. Warmth and patience are beneficial. Clients with depression may have trouble when others talk too quickly or do not seem to understand, so communication that is slow and empathic would be beneficial. Clients with depression do not want to do things like get out of bed, shower, and put on clothes. They must be encouraged to do so.

Rationale 3: A cheerful and outgoing attitude does not make the client feel better. It may be more comfortable for the nurse to avoid dealing with the clients feelings, but it may lead the client to feel worse, because their feelings seem less important. Warmth and patience are beneficial. Clients with depression may have trouble when others talk too quickly or do not seem to understand, so communication that is slow and empathic would be beneficial. Clients with depression do not want to do things like get out of bed, shower, and put on clothes. They must be encouraged to do so.

Rationale 4: A cheerful and outgoing attitude does not make the client feel better. It may be more comfortable for the nurse to avoid dealing with the clients feelings, but it may lead the client to feel worse, because their feelings seem less important. Warmth and patience are beneficial. Clients with depression may have trouble when others talk too quickly or do not seem to understand, so communication that is slow and empathic would be beneficial. Clients with depression do not want to do things like get out of bed, shower, and put on clothes. They must be encouraged to do so.

Global Rationale:

Cognitive Level: Evaluating

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Assess personal feelings, values, and attitudes toward clients with mood disorders that may provide challenges to professional practice.

Question 29

Type: MCSA

To work effectively with mood-disordered clients, it is most important that the nurse have:

1. Self-awareness.

2. The ability to sympathize.

3. An extroverted personality.

4. Good recall.

Correct Answer: 1

Rationale 1: Self-awareness is most important because knowledge of self is the first step toward an effective nurseclient relationship. An extroverted personality is not needed to work effectively with mood-disordered clients. Many personality types are able to work with clients. The ability to sympathize is a barrier to an effective therapeutic relationship. Good recall does not ensure effective work with mood-disordered clients. If necessary, a nurse may take notes to assist with recall.

Rationale 2: Self-awareness is most important because knowledge of self is the first step toward an effective nurseclient relationship. An extroverted personality is not needed to work effectively with mood-disordered clients. Many personality types are able to work with clients. The ability to sympathize is a barrier to an effective therapeutic relationship. Good recall does not ensure effective work with mood-disordered clients. If necessary, a nurse may take notes to assist with recall.

Rationale 3: Self-awareness is most important because knowledge of self is the first step toward an effective nurseclient relationship. An extroverted personality is not needed to work effectively with mood-disordered clients. Many personality types are able to work with clients. The ability to sympathize is a barrier to an effective therapeutic relationship. Good recall does not ensure effective work with mood-disordered clients. If necessary, a nurse may take notes to assist with recall.

Rationale 4: Self-awareness is most important because knowledge of self is the first step toward an effective nurseclient relationship. An extroverted personality is not needed to work effectively with mood-disordered clients. Many personality types are able to work with clients. The ability to sympathize is a barrier to an effective therapeutic relationship. Good recall does not ensure effective work with mood-disordered clients. If necessary, a nurse may take notes to assist with recall.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Assess personal feelings, values, and attitudes toward clients with mood disorders that may provide challenges to professional practice.

Question 30

Type: MCSA

Which action should the nurse take to prevent emotional contagion when working with hospitalized depressed clients? Expect the clients to:

1. Be appreciative of a daily one-to-one session.

2. Be open to working on their problems.

3. Show improvement within 24 hours after admission.

4. Be disinterested in a nurseclient relationship.

Correct Answer: 4

Rationale 1: Clients who are hospitalized for depression will be disinterested in a nurseclient relationship. It is easy for the nurse to internalize the clients mood if the nurse is not self-aware. Depressed clients are usually not open to working on their problems. They may feel hopeless and helpless. Depressed clients may not show improvement within 24 hours of hospitalization. Most hospitalized clients with depression are not appreciative of a daily one-to-one session because they desire to isolate and to be left alone.

Rationale 2: Clients who are hospitalized for depression will be disinterested in a nurseclient relationship. It is easy for the nurse to internalize the clients mood if the nurse is not self-aware. Depressed clients are usually not open to working on their problems. They may feel hopeless and helpless. Depressed clients may not show improvement within 24 hours of hospitalization. Most hospitalized clients with depression are not appreciative of a daily one-to-one session because they desire to isolate and to be left alone.

Rationale 3: Clients who are hospitalized for depression will be disinterested in a nurseclient relationship. It is easy for the nurse to internalize the clients mood if the nurse is not self-aware. Depressed clients are usually not open to working on their problems. They may feel hopeless and helpless. Depressed clients may not show improvement within 24 hours of hospitalization. Most hospitalized clients with depression are not appreciative of a daily one-to-one session because they desire to isolate and to be left alone.

Rationale 4: Clients who are hospitalized for depression will be disinterested in a nurseclient relationship. It is easy for the nurse to internalize the clients mood if the nurse is not self-aware. Depressed clients are usually not open to working on their problems. They may feel hopeless and helpless. Depressed clients may not show improvement within 24 hours of hospitalization. Most hospitalized clients with depression are not appreciative of a daily one-to-one session because they desire to isolate and to be left alone.

Global Rationale:

Cognitive Level: Evaluating

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Assess personal feelings, values, and attitudes toward clients with mood disorders that may provide challenges to professional practice.

Kneisl, Contemporary Psychiatric-Mental Health Nursing, 3/e Test Bank

Copyright 2012 by Pearson Education, Inc.

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