RN101 OIIQ et OIIAQ Examen des soins infirmiers
TROUBLES PSYCHIATRIQUES
QUESTIONS
1. A patient approached the nurse asking for advice on how to deal with his alcohol addiction.The nurse should tell the client that the only effective treatment for alcoholism is:
a. Psychotherapy
b. Alcoholics anonymous (A.A.)
c. Total abstinence
d. Aversion Therapy
2. A nurse is caring for a male client who experiences false sensory perceptions with no basis in reality. This perception is known as:
a. Hallucinations
b. Delusions
c. Loose associations
d. Neologisms
3. A nurse is caring for a female client who has a suicidal tendency. When accompanying the client to the restroom, the nurse should…
a. Give her privacy
b. Allow her to urinate
c. Open the window and allow her to get some fresh air
d. Observe her
4. You're developing a plan of care for a female client with anorexia nervosa. Which action should the nurse include in the plan?
a. Provide privacy during meals
b. Set-up a strict eating plan for the client
c. Encourage client to exercise to reduce anxiety
d. Restrict visits with the family
5. A client is experiencing with an anxiety attack. The most appropriate nursing intervention should include?
a. Turning on the television
b. Leaving the client alone
c. Staying with the client and speaking in short sentences
d. Ask the client to play with other clients
6. A female client is admitted with a diagnosis of delusions of GRANDEUR. This diagnosis reflects a belief that one is:
a. Being Killed
b. Highly famous and important
c. Responsible for evil world
d. Connected to client unrelated to oneself
7. A 20-year-old client was diagnosed with dependent personality disorder. Which behavior is not most likely to be evidence of ineffective individual coping?
a. Recurrent self-destructive behavior
b. Avoiding relationship
c. Showing interest in solitary activities
d. Inability to make choices and decision without advice
8. A male client is diagnosed with schizotypal personality disorder. Which signs would this client exhibit during social situation?
a. Paranoid thoughts
b. Emotional affect
c. Independence need
d. Aggressive behavior
9. A nurse is caring for a client diagnosed with bulimia. The most appropriate initial goal for a client diagnosed with bulimia is?
a. Encourage to avoid foods
b. Identify anxiety causing situations
c. Eat only three meals a day
d. Avoid shopping plenty of groceries
10. A nurse was caring for a 41-year-old female client. Which behavior by the client indicates adult cognitive development?
a. Generates new levels of awareness
b. Assumes responsibility for her actions
c. Has maximum ability to solve problems and learn new skills
d. Her perception is based on reality
11. A neuromuscular blocking agent is administered to a client before ECT therapy. The nurse should carefully observe the client for?
a. Respiratory difficulties
b. Nausea and vomiting
c. Dizziness
d. Seizures
12. 75-year-oldld client is admitted to the hospital with the diagnosis of dementia of the Alzheimer’s type and depression. The symptom that is unrelated to depression would be?
a. Apathetic response to the environment
b. “I don’t know” answer to questions
c. Shallow of labile effect
d. Neglect of personal hygiene
13. A nurse is working in a mental health facility; the nurse priority nursing intervention for a newly admitted client with bulimia nervosa would be to?
a. Teach client to measure I & O
b. Involve client in planning daily meal
c. Observe client during meals
d. Monitor client continuously
14. The nurse is aware that the major health complication associated with intractable anorexia nervosa would be?
a. Cardiac dysrhythmias resulting to cardiac arrest
b. Glucose intolerance resulting in protracted hypoglycemia
c. Endocrine imbalance causing cold amenorrhea
d. Decreased metabolism causing cold intolerance
15. The nurse can minimize agitation in a disturbed client by?
a. Increasing stimulation
b. limiting unnecessary interaction
c. increasing appropriate sensory perception
d. ensuring constant client and staff contact
16. A 39 year old mother with obsessive-compulsive disorder has become immobilized by her elaborate hand washing and walking rituals. The nurse recognizes that the basis of O.C. disorder is often:
a. Problems with being too conscientious
b. Problems with anger and remorse
c. Feelings of guilt and inadequacy
d. Feeling of unworthiness and hopelessness
17. A client is complaining to other clients about not being allowed by staff to keep food in his room. Which of the following interventions would be most appropriate?
a. Allowing a snack to be kept in his room
b. Reprimanding the client
c. Ignoring the client's behavior
d. Setting limits on the behavior
18. A patient with borderline personality disorder who is to be discharged soon threatens to “do something” to herself if discharged. Which of the following actions by the nurse would be most important?
a. Ask a family member to stay with the client at home temporarily
b. Discuss the meaning of the client’s statement with her
c. Request an immediate extension for the client
d. Ignore the client's statement because it’s a sign of manipulation
19. Joey a client with antisocial personality disorder belches loudly. A staff member asks Joey, “Do you know why people find you repulsive?” this statement most likely would elicit which of the following client reaction?
a. Depensiveness
b. Embarrassment
c. Shame
d. Remorsefulness
20. Which of the following approaches would be most appropriate to use with a client suffering from narcissistic personality disorder when discrepancies exist between what the client states and what actually exist?
a. Rationalization
b. Supportive confrontation
c. Limit setting
d. Consistency
21. A patient is experiencing alcohol withdrawal exhibits tremors, diaphoresis, and hyperactivity. Blood pressure is 190/87 mmHg and pulse is 92 bpm. Which of the medications would the nurse expect to administer?
a. Naloxone (Narcan)
b. Benztropine (Cogentin)
c. Lorazepam (Ativan)
d. Haloperidol (Haldol)
22. Which of the following foods would the nurse Trish eliminate from the diet of a client in alcohol withdrawal?
a. Milk
b. Orange Juice
c. Soda
d. Regular Coffee
23. Which of the following would Nurse Hazel expect to assess for a client who is exhibiting late signs of heroin withdrawal?
a. Yawning & diaphoresis
b. Restlessness & Irritability
c. Constipation & steatorrhea
d. Vomiting and Diarrhea
24. To establish open and trusting relationship with a female client who has been hospitalized with severe anxiety, the nurse in charge should?
a. Encourage the staff to have frequent interaction with the client
b. Share an activity with the client
c. Give client feedback about behavior
d. Respect client’s need for personal space
25. The nurse recognizes that the focus of environmental (MILIEU) therapy is to:
a. Manipulate the environment to bring about positive changes in behavior
b. Allow the client’s freedom to determine whether or not they will be involved in activities
c. Role play life events to meet individual needs
d. Use natural remedies rather than drugs to control behavior
26. The nurse would expect a child with a diagnosis of reactive attachment disorder to:
a. Have more positive relation with the father than the mother
b. Cling to mother & cry on separation
c. Be able to develop only superficial relation with the others
d. Have been physically abused
27. When teaching parents about childhood depression the nurse should say?
a. It may appear acting out behavior
b. Does not respond to conventional treatment
c. Is short in duration & resolves easily
d. Looks almost identical to adult depression
28. The nurse is aware that language development in autistic child resembles:
a. Scanning speech
b. Speech lag
c. Shuttering
d. Echolalia
29. A 60 year old female client who lives alone tells the nurse at the community health center “I really don’t need anyone to talk to”. The TV is my best friend. The nurse recognizes that the client is using the defense mechanism known as?
a. Displacement
b. Projection
c. Sublimation
d. Denial
30. When working with a male client suffering phobia about black cats, the nurse should anticipate that a problem for this client would be?
a. Anxiety when discussing phobia
b. Anger toward the feared object
c. Denying that the phobia exist
d. Distortion of reality when completing daily routines
31. A patient is pacing the floor and appears extremely anxious. The duty nurse approaches in an attempt to alleviate the patient’s anxiety. The most therapeutic question by the nurse would be?
a. Would you like to watch TV?
b. Would you like me to talk with you?
c. Are you feeling upset now?
d. Ignore the client
32. The nurse is aware that the symptoms that distinguish post-traumatic stress disorder from other anxiety disorder would be:
a. Avoidance of situation & certain activities that resemble the stress
b. Depression and a blunted affect when discussing the traumatic situation
c. Lack of interest in family & others
d. Re-experiencing the trauma in dreams or flashback
33. The nurse is communicating with a male client with substance-induced persisting dementia; the client cannot remember facts and fills in the gaps with imaginary information. The nurse is aware that this is typical of?
a. Flight of ideas
b. Associative looseness
c. Confabulation
d. Concretism
34. The nurse is aware that the signs & symptoms that would be most specific for diagnosis anorexia are?
a. Excessive weight loss, amenorrhea & abdominal distension
b. Slow pulse, 10% weight loss & alopecia
c. Compulsive behavior, excessive fears & nausea
d. Excessive activity, memory lapses & an increased pulse
35. A characteristic that would suggest to the nurse that an adolescent may have bulimia would be:
a. Frequent regurgitation & re-swallowing of food
b. Previous history of gastritis
c. Badly stained teeth
d. Positive body image
36. The nurse is aware that extremely depressed clients seem to do best in settings where they have:
a. Multiple stimuli
b. Routine Activities
c. Minimal decision making
d. Varied Activities
37. To further assess a client’s suicidal potential. The nurse should be especially alert to the client expression of:
a. Frustration & fear of death
b. Anger & resentment
c. Anxiety & loneliness
d. Helplessness & hopelessness
38. A nursing care plan for a male client with bipolar I disorder should include:
a. Providing a structured environment
b. Designing activities that will require the client to maintain contact with reality
c. Engaging the client in conversing about current affairs
d. Touching the client provide assurance
39. When planning care for a female client using ritualistic behavior, the nurse must recognize that the ritual:
a. Helps the client focus on the inability to deal with reality
b. Helps the client control the anxiety
c. Is under the client’s conscious control
d. Is used by the client primarily for secondary gains
40. A 32 year old male graduate student, who has become increasingly withdrawn and neglectful of his work and personal hygiene, is brought to the psychiatric hospital by his parents. After detailed assessment, a diagnosis of schizophrenia is made. It is unlikely that the client will demonstrate:
a. Low self esteem
b. Concrete thinking
c. Effective self boundaries
d. Weak ego
41. A 23 year old client has been admitted with a diagnosis of schizophrenia says to the nurse “Yes, its march, March is little woman”. That’s literal you know”. These statement illustrate:
a. Neologisms
b. Echolalia
c. Flight of ideas
d. Loosening of association
42. A long term goal for a paranoid male client who has unjustifiably accused his wife of having many extramarital affairs would be to help the client develop:
a. Insight into his behavior
b. Better self control
c. Feeling of self worth
d. Faith in his wife
43. A male client who is experiencing disordered thinking about food being poisoned is admitted to the mental health unit. The nurse uses which communication technique to encourage the client to eat dinner?
a. Focusing on self-disclosure of own food preference
b. Using open-ended question and silence
c. Offering opinion about the need to eat
d. Verbalizing reasons that the client may not choose to eat
44. A nurse is assigned to care for a client diagnosed with Catatonic Stupor. When the nurse enters the client’s room, the client is found lying on the bed with a body pulled into a fetal position, the nurse should?
a. Ask the client direct questions to encourage talking
b. Rake the client into the dayroom to be with other clients
c. Sit beside the client in silence and occasionally ask open-ended question
d. Leave the client alone and continue with providing care to the other clients
45. A nurse is caring for a client with delirium and states that “look at the spiders on the wall”. What should the nurse respond to the client?
a. “You’re having hallucination, there are no spiders in this room at all”
b. “I can see the spiders on the wall, but they are not going to hurt you”
c. “Would you like me to kill the spiders”
d. “I know you are frightened, but I do not see spiders on the wall”
46. A nurse is providing information to a community group about violence in the family. Which statement by a group member would indicate a need to provide additional information?
a. “Abuse occurs more in low-income families”
b. “Abuser Are often jealous or self-centered”
c. “Abuser use fear and intimidation”
d. “Abuser usually have poor self-esteem”
47. During electroconvulsive therapy (ECT) the client receives oxygen by mask via positive pressure ventilation. The nurse assisting with this procedure knows that positive pressure ventilation is necessary because?
a. Anesthesia is administered during the procedure
b. Decrease oxygen to the brain increases confusion and disorientation
c. Grand mal seizure activity depresses respirations
d. Muscle relaxations given to prevent injury during seizure activity depress respirations.
48. When planning the discharge of a client with chronic anxiety, the nurse evaluates achievement of the discharge maintenance goals. Which goal would be most appropriately having been included in the plan of care requiring evaluation?
a. The client eliminates all anxiety from daily situations
b. The client ignores feelings of anxiety
c. The client identifies anxiety producing situations
d. The client maintains contact with a crisis counselor
49. The nurse is caring for a client with depression who has not responded to antidepressant medication. The nurse anticipates that what treatment procedure may be prescribed?
a. Neuroleptic medication
b. Short term seclusion
c. Psychosurgery
d. Electroconvulsive therapy
50. The patient is admitted to the emergency room with drug-included anxiety related to over ingestion of prescribed antipsychotic medication. The most important piece of information the nurse in charge should obtain initially is the:
a. Length of time on the med.
b. Name of the ingested medication & the amount ingested
c. Reason for the suicide attempt
d. Name of the nearest relative & their phone number
RÉPONSE ET JUSTIFICATION
1. C.
L'abstinence totale est le seul traitement efficace de l'alcoolisme.
2. UNE.
Les hallucinations sont des perceptions visuelles, auditives, gustatives, tactiles ou olfactives qui n'ont aucun fondement dans la réalité.
3. RÉ.
L'infirmière a la responsabilité d'observer en permanence le client fortement suicidaire. L'infirmière doit surveiller les indices, tels que la communication de pensées suicidaires et de messages ; accumuler des médicaments et parler de la mort.
4. B.
L'établissement d'un régime alimentaire cohérent et la surveillance du poids du client sont importants pour ce trouble.
5. C.
Les interventions infirmières appropriées pour une crise d'anxiété comprennent l'utilisation de phrases courtes, rester avec le client, diminuer les stimuli, rester calme et prendre des médicaments au besoin.
6. B.
L'illusion de grandeur est une fausse croyance que l'on est très célèbre et important.
sept. RÉ.
Une personne atteinte d'un trouble de la personnalité dépendante montre généralement une indécision, une soumission et un comportement d'attachement afin que les autres prennent des décisions avec elle.
8. UNE.
Les clients atteints d'un trouble de la personnalité schizotypique éprouvent une anxiété sociale excessive qui peut conduire à des pensées paranoïaques.
9. B.
Le trouble boulimique est généralement une réponse inadaptée au stress et aux problèmes sous-jacents. Le client doit identifier les situations causant de l'anxiété qui stimulent le comportement boulimique, puis apprendre de nouvelles façons de faire face à l'anxiété.
dix. UNE.
Un adulte de 31 à 45 ans génère un nouveau niveau de conscience.
11. UNE.
Le bloqueur neuromusculaire, tel que la SUCCINYLCHOLINE (Anectine) produit une dépression respiratoire car il inhibe les contractions des muscles respiratoires.
12. C.
Avec la dépression, il y a peu ou pas d'implication émotionnelle donc peu d'altération de l' affect .
13. RÉ.
Ces clients cachent souvent de la nourriture ou forcent à vomir; par conséquent, ils doivent être soigneusement surveillés.
14. UNE.
Ces clients ont des niveaux sévèrement épuisés de sodium et de potassium en raison de leur régime de famine et de leur dépense énergétique, ces électrolytes sont nécessaires au fonctionnement cardiaque.
15. B.
Limiter les interactions inutiles réduira la stimulation et l'agitation.
16. C.
Le comportement rituel observé dans ce trouble vise à contrôler la culpabilité et l'insuffisance en maintenant un modèle de comportement absolu.
17. RÉ.
L'infirmière doit fixer des limites au comportement manipulateur du client pour aider le client à contrôler son comportement dysfonctionnel. Une approche cohérente par le personnel est nécessaire pour diminuer la manipulation
.
18. B.
Toute déclaration suicidaire doit être évaluée par l'infirmière. L'infirmière doit discuter avec elle de la déclaration de la cliente pour déterminer sa signification en termes de suicide.
19. UNE.
Lorsque le membre du personnel demande au client s'il se demande pourquoi les autres le trouvent répugnant, le client est susceptible de se sentir sur la défensive parce que la question le rabaisse. La tendance naturelle est de contre-attaquer la menace à l'image de soi.
20. B.
L'infirmière utiliserait spécifiquement la confrontation positive avec le client pour souligner les divergences entre ce que le client déclare et ce qui existe réellement pour accroître la responsabilité de soi.
21. C.
L'infirmière administrerait très probablement des benzodiazépines, comme le lorazépam ( Ativan ) au client qui éprouve des symptômes : Le client éprouve des symptômes de sevrage en raison du phénomène de rebond lorsque la sédation du SNC due à l'alcool commence à diminuer.
22. RÉ.
Le café ordinaire contient de la caféine qui agit comme stimulant psychomoteur et provoque des sentiments d'anxiété et d'agitation. Servir le café en haut du client peut ajouter aux tremblements ou à l'éveil.
23. RÉ.
Les vomissements et la diarrhée sont généralement les signes tardifs du sevrage de l'héroïne, accompagnés de spasmes musculaires, de fièvre, de nausées, de crampes abdominales répétitives et de maux de dos.
24. RÉ.
Se déplacer dans l'espace personnel d'un client augmente le sentiment de menace, ce qui augmente l'anxiété.
25. UNE.
La thérapie environnementale (MILIEU) vise à avoir tout dans l'environnement du client pour aider le client.
26. C.
Les enfants qui ont éprouvé des difficultés d'attachement avec le principal fournisseur de soins ne sont pas capables de faire confiance aux autres et ont donc des relations superficielles
27. UNE.
Les enfants ont de la difficulté à exprimer verbalement leurs sentiments, des comportements passés à l'acte, tels que des crises de colère, peuvent indiquer une dépression sous-jacente.
28. RÉ.
L'enfant autiste répète des sons ou des mots prononcés par d'autres.
29. RÉ.
La déclaration du client est un exemple d'utilisation du déni, une défense qui bloque le problème en refusant inconscient d'admettre qu'il existe.
30. UNE.
La discussion sur l'objet redouté déclenche une réponse émotionnelle à l'objet.
31. B.
La présence de l'infirmière peut fournir au client un soutien et un sentiment de contrôle.
32. RÉ.
L'expérience du traumatisme réel dans les rêves ou le flash-back est le symptôme majeur qui distingue le trouble de stress post-traumatique des autres troubles anxieux.
33. C.
La confabulation ou le remplissage des trous de mémoire avec des faits imaginaires est un mécanisme de défense utilisé par les personnes souffrant de déficits de mémoire.
34. UNE.
Ce sont les principaux signes de l'anorexie mentale. La perte de poids est excessive (15 % du poids attendu).
35. C.
L'érosion de l'émail dentaire se produit à la suite de vomissements auto-induits répétés.
36. B.
La dépression est généralement à la fois émotionnelle et physique. Une routine quotidienne simple est la meilleure, la moins stressante et la moins anxiogène.
37. RÉ.
L'expression de ces sentiments peut indiquer que ce client est incapable de continuer le combat de la vie.
38. UNE.
La structure tend à diminuer l'agitation et l'anxiété et à augmenter le sentiment de sécurité du client.
39. B.
Les rituels utilisés par un client atteint de trouble obsessionnel-compulsif aident à contrôler le niveau d'anxiété en maintenant un modèle d'action défini.
40. C.
Une personne atteinte de ce trouble n'aurait pas de limites de soi adéquates.
41. RÉ.
Les associations lâches sont des pensées qui sont présentées sans les connexions logiques habituellement nécessaires à l'écoute pour interpréter le message.
42. C.
Aider le client à développer un le sentiment d' estime de soi réduirait le besoin du client d'utiliser des défenses pathologiques.
43. B.
Les questions ouvertes et le silence sont des stratégies utilisées pour encourager les clients à discuter de leur problème dans un manière descriptive .
44. C.
Les clients en retrait peuvent être immobiles et muets et nécessiter des interventions cohérentes et répétées. La communication avec les clients retirés exige beaucoup de patience de la part de l'infirmière. L'infirmière facilite la communication avec le client en restant assise en silence, en demandant à un question ouverte et faire une pause pour donner au client la possibilité de répondre.
45. RÉ.
Lorsque l'hallucination est présente, l'infirmière doit renforcer la réalité avec le client.
46. UNE.
Caractéristiques personnelles du l'agresseur comprend une faible estime de soi, l'immaturité, la dépendance , l' insécurité et la jalousie.
47. RÉ.
Un relaxant des muscles squelettiques à courte durée d'action tel que la succinylcholine (Anectine) est administré au cours de cette procédure pour prévenir les blessures au cours d'une saisie .
48. C.
Reconnaître les situations qui produisent de l'anxiété permet au client de se préparer à faire face à l'anxiété ou d'éviter un stimulation spécifique.
49. RÉ.
La thérapie par électrochocs est un traitement efficace pour la dépression qui n'a pas répondu aux médicaments.
50. B.
En cas d'urgence, les faits qui sauvent des vies sont obtenus en premier. Le nom et la quantité de médicament ingéré sont de la plus haute importance dans le traitement de cette situation potentiellement mortelle .
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