Review Ati nurs 4850 non comp exam (PEDS-mental)

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Ati nurs 4850 non comp exam (PEDS-mental)

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Total Questions : 75

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Question 1:

During a group therapy session, a nurse notes several clients using multiple defense mechanisms. Which of the following client statements demonstrates the maladaptive use of regression?

A. "I don't care about work anymore since I was not given a promotion" B. "I wrote a short story about a heroic woman when I was really mad at my boss." C. " I still cannot remember the scene of my husband's car accident" D. "I mentally separate myself from distractions around me when I paint on canvas. "

Answer and Explanation

Choice A:

"I don't care about work anymore since I was not given a promotion":This statement demonstrates the maladaptive use of regression. Regression involves reverting to an earlier stage of development in the face of unacceptable thoughts or impulses. In this case, the client's response to not receiving a promotion is to display a lack of interest in work, which can be seen as regressing to a less mature coping mechanism.

Choice B:

"I wrote a short story about a heroic woman when I was really mad at my boss."This statement describes the defense mechanism of sublimation rather than regression. Sublimation involves channeling unacceptable impulses or emotions into more socially acceptable activities or behaviors. In this case, the client channels their anger into writing a short story, which is a constructive and creative outlet.

Choice C:

"I still cannot remember the scene of my husband's car accident":This statement does not demonstrate regression. Instead, it suggests repression, which involves the unconscious blocking of unpleasant memories, thoughts, or feelings from conscious awareness. The client's inability to remember the scene of the accident may indicate repression as a defense mechanism.

Choice D:

"I mentally separate myself from distractions around me when I paint on canvas."This statement describes the defense mechanism of dissociation rather than regression. Dissociation involves a disconnection between a person's thoughts, identity, consciousness, or memory. In this case, the client mentally separates themselves from distractions while painting, which is a form of dissociative coping.

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Question 2:

A nurse on a long-term care unit is creating a plan of care for a client who has Alzheimer's disease. Which of the following interventions should the nurse include in the plan?

A. Limit time for the client to perform activities. B. Talk the client through tasks one step at a time C. Provide an activity schedule that changes from day to day D. Rotate assignment of daily caregivers

Answer and Explanation

Choice A:

Limit time for the client to perform activities. This intervention is not appropriate for a client with Alzheimer's disease. Limiting time for activities may increase agitation and frustration in individuals with cognitive impairments. Instead, it's important to allow adequate time for tasks and provide support as needed.

Choice B:

Talk the client through tasks one step at a time. This intervention is appropriate for a client with Alzheimer's disease. Breaking tasks into manageable steps and providing clear, simple instructions can help the client better understand and complete activities. This approach reduces confusion and frustration and promotes independence to the extent possible.

Choice C:

Provide an activity schedule that changes from day to day. Consistency is key in caring for individuals with Alzheimer's disease. A changing activity schedule may lead to increased confusion and disorientation. It's important to establish a routine and maintain consistency in daily activities and schedules to provide a sense of security and familiarity for the client.

Choice D:

Rotate assignment of daily caregivers. Consistency in caregiver assignments is essential for individuals with Alzheimer's disease. Changing caregivers frequently can disrupt the client's sense of security and increase confusion and anxiety. Continuity of care helps build trust and rapport between the client and caregivers, which is beneficial for the client's overall well-being.

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Question 3:

A nurse is caring for a client who has been diagnosed with obsessive compulsive disorder (OCD) and is constantly picking up after others in the day room. The nurse should recognize that the client uses this behavior to do which of the following?

A. Limit the amount of time available to interact with others. B. Manipulate and control others' behaviors. C. Decrease anxiety to a tolerable level D. Focus attention on meaningly tests

Answer and Explanation

Choice A:

Limit the amount of time available to interact with others. This statement does not align with the typical behavior of individuals with obsessive-compulsive disorder (OCD). While the client's behavior of constantly picking up after others may indirectly limit interaction time, the primary motivation behind this behavior is more likely related to managing anxiety rather than intentionally limiting social interaction.

Choice B:

Manipulate and control others' behaviors. While individuals with OCD may engage in behaviors that affect others, such as seeking reassurance or involving others in their rituals, the behavior described in the scenario does not appear to be aimed at manipulating or controlling others. Instead, it seems driven by the client's internal need to alleviate anxiety through compulsive actions.

Choice C:

Decrease anxiety to a tolerable level. This is the correct choice. People with OCD often engage in compulsive behaviors as a way to reduce distressing feelings of anxiety or discomfort. By picking up after others compulsively, the client may experience temporary relief from obsessive thoughts and the associated anxiety. However, the relief is typically short-lived and can lead to a cycle of compulsive behaviors.

Choice D:

Focus attention on meaningless tasks. While the behavior of constantly picking up after others may seem repetitive or meaningless to an observer, individuals with OCD typically attribute great significance to their compulsive actions. These behaviors are driven by the need to reduce anxiety or prevent perceived harm rather than a deliberate focus on meaningless tasks.

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Question 4:

A nurse is assessing a client who has posttraumatic stress disorder (PTSD) following a sexual assault. Which of the following is an expected finding?

A. Constant need to talk about the event. B. Increasing feelings of anger. C. Sleeping 12 hr or more each day. D. Increasing sense of attachment to others.

Answer and Explanation

Choice A:

Constant need to talk about the event. While individuals with PTSD may experience intrusive thoughts or flashbacks related to the traumatic event, a constant need to talk about the event is not universally characteristic. Some individuals with PTSD may avoid discussing the traumatic event altogether due to the distress it causes them, while others may find it helpful to talk about it in therapy or support groups.

Choice B:

Increasing feelings of anger. This is the correct choice. Feelings of anger and irritability are common symptoms of PTSD. Individuals may experience heightened levels of anger as a result of feeling violated, powerless, or betrayed by the traumatic event. Anger may be directed toward the perpetrator, oneself, or others, and it can contribute to difficulties in interpersonal relationships and daily functioning.

Choice C:

Sleeping 12 hr or more each day. While sleep disturbances are common in PTSD, they typically manifest as insomnia, nightmares, or restless sleep rather than excessive sleep. Individuals with PTSD may struggle to fall asleep, experience frequent awakenings during the night, or have nightmares related to the traumatic event. Excessive sleeping is not typically associated with PTSD.

Choice D:

Increasing sense of attachment to others. Individuals with PTSD may experience difficulties in forming or maintaining relationships due to symptoms such as emotional numbing, avoidance of reminders of the trauma, and difficulties in trusting others. While some individuals may seek support from loved ones, an increasing sense of attachment to others is not typically an expected finding in PTSD.

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Question 5:

A nurse is performing an admission assessment for a client who has schizophrenia. Which of the following findings should the nurse identify as a negative symptom?

A. Bizarre behavior B. Somatic delusions C. Affective flattening D. Illogicality

Answer and Explanation

Choice A:

Bizarre behavior: Bizarre behavior is typically considered a positive symptom of schizophrenia rather than a negative symptom. Positive symptoms involve the presence of abnormal behaviors or experiences that are not typically seen in healthy individuals. Bizarre behavior can include hallucinations, delusions, disorganized thinking, and grossly disorganized or catatonic behavior.

Choice B:

Somatic delusions: Somatic delusions, where the individual believes they have a medical condition or physical defect that is not present, are also considered positive symptoms of schizophrenia. Positive symptoms involve distortions or exaggerations of normal functions.

Choice C:

Affective flattening: This is the correct choice. Affective flattening, also known as blunted affect, refers to a reduction in the intensity, range, and expression of emotional responses. Individuals with schizophrenia who exhibit affective flattening may have a limited range of facial expressions, reduced vocal inflections, and a diminished ability to express emotions appropriately. Affective flattening is considered a negative symptom because it reflects a decrease or absence of normal emotional functioning.

Choice D:

Illogicality: Illogicality, or disorganized thinking, is another positive symptom of schizophrenia. It involves difficulties in organizing thoughts and expressing them coherently. Individuals with schizophrenia may exhibit illogical speech patterns, such as tangentiality (going off on tangents), loose associations (jumping from one unrelated topic to another), or thought blocking (sudden interruption of thoughts).

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Question 6:

A nurse is caring for a 4-year-old child who has a new diagnosis of diabetes mellitus and is distressed after an insulin injection. Which of the following play activities should the nurse recognize is therapeutic in helping the child deal with the injection?

A. A story book about a child who has diabetes B. A needleless syringe and a doll C. A period of play in the playroom D. A video game

Answer and Explanation

Choice A:

A story book about a child who has diabetes. While providing information about diabetes through a storybook may be beneficial for the child's understanding of the condition, it may not directly address the distress experienced after an insulin injection. This option focuses more on education rather than immediate coping with the injection-related distress.

Choice B:

A needleless syringe and a doll. This is the correct choice. Providing a needleless syringe and a doll allows the child to engage in pretend play and role-play scenarios related to the insulin injection experience. Through play, the child can express their feelings, fears, and experiences in a safe and non-threatening environment. This type of play activity can help the child gain a sense of control, familiarity, and mastery over the situation, thereby reducing distress and anxiety associated with future injections.

Choice C:

A period of play in the playroom. While engaging in play in the playroom may offer the child opportunities for distraction and enjoyment, it may not specifically address the distress experienced after an insulin injection. The effectiveness of this option in helping the child cope with the injection-related distress may depend on the specific activities available in the playroom and the child's preferences.

Choice D:

A video game. Playing a video game may provide the child with distraction and entertainment, but it may not directly address the distress experienced after an insulin injection. Additionally, screen time may not be suitable for every child, and the therapeutic benefits of video games in this context may vary.

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Question 7:

A nurse is caring for a client who has major depressive disorder and attempted suicide. The client tells the nurse, "I should have died because I am totally worthless." Which of the following responses should the nurse make?

A. "You have a great deal to live for." B. "It's not unusual for depressed people to feel that way." C. "You've been feeling that your life has no meaning." D. "Why do you feel you are worthless?"

Answer and Explanation

Choice A:

"You have a great deal to live for."While this response is supportive and positive, it may not effectively address the client's feelings of worthlessness. It may come across as dismissive or invalidating of the client's emotions.

Choice B:

"It's not unusual for depressed people to feel that way."This response acknowledges the commonality of feeling worthless among individuals with depression. While it normalizes the client's experience, it doesn't directly address the client's statement or offer support.

Choice C:

"You've been feeling that your life has no meaning."This response reflects active listening and demonstrates empathy by paraphrasing the client's statement to show understanding. It acknowledges the client's feelings and opens the door for further exploration of the underlying issues contributing to their sense of worthlessness.

Choice D:

"Why do you feel you are worthless?"While this response seeks to explore the underlying reasons for the client's feelings, it may come across as confrontational or judgmental. It puts the client on the spot to justify their emotions, which could make them feel defensive or invalidated.

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Question 8:

A nurse is caring for a client who has borderline personality disorder (BPD). As part of the client's plan of care, the nurse reviews the day's schedule with the client each morning. As the nurse begins to review the schedule with the client, the client says, "Why don't you shut up already? I can read it myself, you know!" Which of the following responses should the nurse give the client?

A. "I don't like it when you address me with that tone of voice." B. "I know you can, but are you going to read it or not?" C. "Fine. Here is the schedule, and I will expect you to be on time to your therapies." D. "We do this every day. Why are you so angry with me this morning?"

Answer and Explanation

Choice A:

"I don't like it when you address me with that tone of voice.": This is the most therapeutic response. It addresses the inappropriate behavior (the rude tone) in a calm and direct manner, setting a clear boundary while remaining respectful. By focusing on the behavior, the nurse can maintain professionalism and avoid escalating the situation. This response also encourages the client to recognize the impact of their behavior without feeling attacked.

Choice B:

"I know you can, but are you going to read it or not?"This response confronts the client's behavior and directs them back to the task at hand. However, it could be seen as somewhat dismissive and may not effectively address the client's underlying emotions or needs.

Choice C:

Fine. Here is the schedule, and I will expect you to be on time to your therapies.": While this response gives the schedule, it is dismissive of the client's feelings and does not address the inappropriate tone or set a boundary for future behavior. It also might contribute to a power struggle, which is not helpful in managing a client with borderline personality disorder.

Choice D:

"We do this every day. Why are you so angry with me this morning?"This response seeks to explore the client's feelings but may come across as confrontational or accusatory. It does not effectively address the client's behavior or provide clear direction.

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Question 9:

A nurse is caring for a client who has been hospitalized for treatment of bipolar disorder and will be discharged with a prescription for lithium.
The nurse's discharge teaching should include information cautioning against which of the following factors that may cause lithium toxicity?

A. Experiencing diarrhea B. Drinking green tea C. Exercising moderately D. Increasing sodium intake

Answer and Explanation

Choice A:

Lithium toxicity is a significant concern for clients taking lithium, a mood stabilizer commonly prescribed for bipolar disorder. Diarrhea can lead to dehydration and electrolyte imbalances, which can increase lithium levels in the blood, potentially leading to toxicity. Therefore, cautioning against experiencing diarrhea is essential in discharge teaching for clients prescribed lithium.

Option A is correct because it identifies a factor that can contribute to lithium toxicity. Diarrhea can lead to fluid and electrolyte imbalances, affecting lithium levels in the blood.

Choice B:

Option B, drinking green tea, is not typically associated with lithium toxicity. Green tea contains caffeine, but its consumption is not a significant risk factor for lithium toxicity.

Choice C:

Option C, exercising moderately, is generally encouraged for overall health and well-being. However, it does not directly relate to lithium toxicity unless excessive sweating leads to dehydration and electrolyte imbalances.

Choice D:

Option D, increasing sodium intake, is typically discouraged for clients taking lithium because high sodium levels can affect lithium reabsorption in the kidneys, potentially leading to increased lithium levels and toxicity. However, this option is not directly related to the question about factors causing lithium toxicity.

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Question 10:

A nurse who works in a psychiatric unit is caring for a client who has bipolar disorder. The client comes to the nurse's station at 0300 demanding that the nurse call the provider immediately. Which of the following responses by the nurse is appropriate?

A. "You are being unreasonable, and I will not call your doctor at this hour." B. "I can't call a doctor in the middle of the night unless it's an emergency C. "You must be very upset about something." D. "Go back to your room, and I'll try to get in touch with your doctor"

Answer and Explanation

Choice A:

"You are being unreasonable, and I will not call your doctor at this hour."This response may escalate the situation by invalidating the client's feelings and refusing to address their request. It fails to recognize the client's distress and could lead to increased agitation or frustration.

Choice B:

"I can't call a doctor in the middle of the night unless it's an emergency."While it's true that non-urgent matters may be deferred until regular hours, this response comes across as dismissive and may exacerbate the client's distress. It does not validate the client's feelings or offer support.

Choice C:

"You must be very upset about something."This response acknowledges the client's emotions and shows empathy. It opens the door for the client to express their concerns, allowing the nurse to assess the situation further and address any immediate needs. It also avoids dismissing the client's request outright and maintains a therapeutic relationship.

Choice D:

"Go back to your room, and I'll try to get in touch with your doctor."This response instructs the client to return to their room without addressing their emotional state or concerns. It lacks empathy and fails to engage with the client's needs effectively.

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Ati nurs 4850 non comp exam (PEDS-mental)

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