The nurse working with clients who have borderline personality disorder (BPD) understands that they need help to both recognize genuine respect from others as well as reciprocate that respect for others. How can the nurse model self-respect?
observe personal limits
be assertive
clearly communicate expectations
Disulfiram (Antabuse) has been prescribed for a client receiving treatment for alcoholism. Which of the following should be included in the client's plan of care?
avoid all products containing alcohol
You are working with a 50 year old woman admitted for major depressive episode. The client has remained isolated and withdrawn since her admission and is reluctant to speak. Which of the following therapeutic skills is most likely to encourage the client
silence and active listening
Which of the following is the most common defense mechanism used by a client diagnosed with a substance abuse problem?
denial
The psychiatric nurse documents that according to the cognitive development theory, a 20 year old client who refuses to compromise and consistently demands her own way is exhibiting...
egocentric behavior
Debbie is 5 feet 6 inches tall, weighs 105 lbs, exercises 4 hours per day, and does not engage in any binging or purging behaviors. She believes that she is becoming obese and states, "I'm shocked that you think I'm underweight. You don't understand me.
anorexia nervosa, restricting type
A client was brought into the ED because he was involved in an automobile accident. His BAL is 0.10 mg %. Based on this finding, the nurse would expect to assess which of the following?
difficulty with coordination
The major difference between bipolar I and II is that:
Clients with bipolar II disorder do not have symptoms of mania that interfere enough to cause marked functional disturbance
The nurse is providing care for a client who has been diagnoses with antisocial personality disorder. Which of the following outcomes should the nurse prioritize when planning this client's care?
the client will exhibit increased impulse control
Which of the following areas of the brain has been associated with the symptoms of eating disorders?
hypothalamus
When assessing a client who reports mild symptoms of depression, the nurse expects that the diagnostic tests ordered will include
TSH
The nurse in charge of an inpatient psychiatric unit finds herself frustrated and angry with a client who has borderline personality disorder. Which of the following steps should the nurse take?
examine her own feelings to discover the source of her anger
The monoamine hypothesis of depression...
holds that depression results from a deficiency in the concentrations or in metabolic dysregulation of the monoamines.
Which of the following terms describes a situation that occurs when very small amounts of alcohol intoxicates the person after continued heavy drinking?
tolerance break
Which of the following statements accurately reflects the prognosis for a client with personality disorder?
Prognosis varies based on the degree of functional impairment and the client's motivation to change
Dialectal behavior therapy (DBT) combines behavior therapy with which of the following types of therapy?
cognitive
For clients with bulimia, nursing interventions are often directed toward improving self-concept and regaining control. The primary interventions include
cognitive behavioral therapy (CBT) and guided self change (GSC)
When performing a social history on a client diagnosed with a borderline personality disorder, the most relevant question the psychiatric nurse asks is ...
Do you always practice safe sex?
The major difference between substance abuse and substance dependency is that
a person who is abusing does not have withdrawal symptoms, whereas the dependent person uses the substance despite significant functional difficulties and will have withdrawal
The nurse is told by a client that she is having suicidal thoughts. Which of the following interventions has the lowest priority?
administering a mental status exam to assess for psychosis
A client with a history of alcohol abuse is participating in a 12-step AA program. The nurse determines that the client is at step 2 when he states which of the following?
I realize that there is a higher power that can help me.
Which of the following is the most common disorder found in clients with bulimia nervosa?
depression
The nurse is caring for several hospitalized clients with anorexia nervosa. The nurse would be especially alert for which of the following if noted in the clients' histories?
depression
naltrexone (Trexan)
reduces the appeal of alcohol
One of the biosocial theories of the etiology of borderline personality disorder involves the role of an invalidating environment, a social situation that negates private emotional responses and communication. The most severe form of invalidation occurs i
child sexual abuse
PCP is classified as which type of substance?
hallucinogen
A client diagnosed with BPD tells the nurse that she "frequently spaces out." Which response by the nurse would be most appropriate?
What's happening around you when this occurs?
What constitutes a diagnosis for major depressive disorder?
one or more major depressive episodes for at least 2 weeks with other symptoms present
Which of the following statements most accurately describes the etiology of substance-related disorders?
substance-related disorders result from the interplay of biologic, genetic, and psychosocial factors
The nurse is performing a history and physical exam on a client with chronic alcoholism. The client has a history of gastritis, esophagitis, elevated liver enzymes, cardiomyopathy, and pancreatitis. Which of these conditions are attributable to his histor
all conditions listed
paroxetine (Paxil)
Selective serotonin reuptake inhibitors
A client who exhibits mild symptoms of a personality disorder will experience exacerbation of the symptomology when
losing the job he's had for 6 years
What is a dise effect of amitriptyline (Elavil)?
orthostatic hypotension
A client who has been hospitalized for anorexia is now being discharges. Which of the following would the nurse identify as a criteria for discharge?
client has reached 85% of ideal weight
The nurse is in the process of planning the care of a psychiatric-mental health client and has specified the following outcome: The client will be free from self-inflicted harm. What is this client;s most likely diagnosis?
borderline personality disorder
A nursing instructor is preparing an education plan for a class of nursing students about antisocial personality disorder. Which of the following would the nurse include as a term often used to describe the behaviors associated with this condition?
psychopath, sociopath
Shaundra was admitted to the ED for intoxication with alcohol. She has an unsteady gait, myopathy, and neuropathy, and cannot remember past or recent events. When treated with thiamine, her symptoms greatly improve. Shaundra is most likely suffering from.
Wernicke-Korsakoff syndrome
Susan was abandoned by her parents at age 3, resulting in her perception of the world as a hostile place and the subsequent development of rage against men. This statement is an example of..
a psychodynamic interpretation of Susan's major depressive disorder
Which medication classification has been effective in stabilizing moods in people with bipolar disorder?
anticonvulsants
Safe alcohol withdrawal usually is accomplished with administration of which medication class?
benzo's
Which mental health disorder is most commonly seen in a shoplifter?
depression
Which personality disorder is most commonly found in clinical settings?
BPD
A client on an inpatient psychiatric unit has features of BPD. She is frequently angry, has an unstable sense of herself, and is highly impulsive. She can be verbally abusive to staff, who feel manipulated by her behaviors. Which of the following interven
setting limits
A 51 y/o male has been admitted to the detox unit with acute symptoms of alcohol withdrawal. Nursing assessment is likely to reveal what?
tremors, headache, flushed face, and hallucinations
Which of the following is likely the etiologic basis of the compulsive patterns seen in people with OCPD>
parental overcontrol
The sum of each person's unique biopsychosocial characteristics is known as which of the following?
personality
After educating a group of students about caffeine, the instructor determines that the education was successful when the group identifies which of the following as indicating intoxication?
restlessness, nervousness, excitement, insomnia, urinary retention
When clients diagnosed with BPD see nurses as either all good or all bad, the client us using which primitive defense?
splitting
The ingestion of mood-altering substances stimulates which neurotransmitter pathway in the limbic system to produce a "high" that is a pleasant experience?
dopamine
After teaching a group of nursing students about different personality disorders, the instructor determines that the education was successful when the students identify which of the following as characteristic of schizotypal personality disorder?
increased eccentricity
A group of nursing students is reviewing information about schizoid personality trait. The students demonstrate understanding of the information when they identify which disorder as the most common comorbid disorder?
avoidant personality disorder
Which of the following occurs when a client tends to adore and idealize other people even after a brief acquaintance but then quickly leaves them if these others do not meet the client's expectations in some way?
splitting
Violence and insensitivity are associated with which personality disorder?
antisocial personality disorder
A client who is abusing drugs is to undergo brief intervention. The nurse understands that this technique is most effective for a client who exhibits which of the following?
short history of drug use
What would the nurse expect to find in a client with OCPD?
need for perfection, adherence to a highly structured life, overly moralistic
When a client is working toward the prevention of an alcohol abuse relapse, the nurse is most therapeutic when...
helping the client identify positive coping mechanisms
People who are impulse driven and have difficulty delaying gratification frequently participate in what behaviors?
gambling, shopping beyond their means, binge eating, abusing alcohol
When discussing methadone treatment with a client, the nurse teaches what?
it decreases the severity of heroin withdrawal symptoms
Which of the following statements about clients with a dual diagnosis is accurate?
traditional methods of treatment have not been very successful for these clients
Wernicke's encephalopathy is a degenerative brain disorder characterized by which type of deficiency?
vitamin B1
Signs of alcohol withdrawal usually begin how many hours after the last drink?
12
A client with a history of opioid abuse is exhibiting manifestations of moderate withdrawal. Which of the following would the nurse expect to assess?
dilated pupils
A nurse is implementing a brief intervention with a client who is abusing alcohol. The nurse most likely would be involved with which of the following?
negotiating a conversation with the client to reduce use
The nurse is conducting a health promotion class on drug awareness with a group of junior high school students. Which of the following teaching points should the nurse include in this session?
marijuana use can result in psychological dependence, which can have a very negative effect on your life
A nurse suspects that a client is experiencing alcohol withdrawal based on assessment of which of the following?
elevated temp
Which of the following clients is exhibiting the effects of an alcohol use disorder?
a 22 y/o male student who now drinks nine or ten drinks to get the same effect that he used to get from drinking a 6 pack