Mental Health Exam 3

Name: Date: Mental Health Exam 3 (2) 1. Which statement describes the etiology of illness anxiety disorder from a psychodynamic theory perspective? A The client expresses physical complaints, which are less threatening than facing underlying feelings of poor self-esteem. B Emotions associated with traumatic events are viewed as morally or ethically unacceptable and are transferred into physical symptoms. C The client’s family has difficulty expressing emotions openly and resolving conflicts verbally; this is dealt with by focusing on the ill family member. D The deficiency of endorphins seems to correlate with an increase in incoming sensory stimuli. 2. Which statement describes the etiology of somatic symptom disorder from a biochemical theory perspective? A Unexpressed emotions are translated into symptoms of pain. B A deficiency of endorphins affects incoming sensory stimuli. C There is an increased incidence of this disorder in first-degree relatives. D Harmony around the illness replaces discord within the family. 3. Which statement describes the etiology of somatic symptom disorder from a learning theory perspective? A Studies have shown that there is an increase in the predisposition of somatic symptom disorder in first-degree relatives. B Positive reinforcement of somatic symptoms encourages behaviors to continue. C A client views self as “bad” and considers physical suffering as deserved and required for atonement. Mental Health Exam 3 (2) 4. A client, diagnosed with a specified somatic symptom disorder, is experiencing pain. The client has been assigned a nursing diagnosis of ineffective coping R/T repressed anxiety. Which is an appropriate correctly written outcome for this client? A The client will verbalize a pain rating of 0/10 by the end of the day. B The client will substitute one effective coping strategy for one physical complaint by discharge. C The client will express a realistic perception of his or her distorted self-image by discharge. D The client will rate anxiety as less than 3/10. 5. A client diagnosed with dissociative identity disorder (DID) has been hospitalized for 7 days. The client has a nursing diagnosis of ineffective coping R/T repressed severe anxiety. Which correctly written outcome would be appropriate? A The client will recover deficits in memory by day 14. B The client will be aware of alternate personalities by day 14. C The client will demonstrate the ability to perceive stimuli accurately. D The client will demonstrate one adaptive way to deal with stressful situations by day 14. 6. A client diagnosed with illness anxiety disorder complains to the nurse about others doubting the seriousness of the client’s disease. The client is angry, frustrated, and anxious. Which nursing intervention takes priority? A Remind the client that lab tests showed no evidence of physiological problems. B Document the client’s unwillingness to accept anxiety as the source of the illness. C Discuss with the client’s family ways to avoid secondary gains associated with physical complaints. D Acknowledge the client’s frustration without fostering continued focus on physical illness. Mental Health Exam 3 (2) 7. During group therapy, a client diagnosed with a specified somatic symptom disorder monopolizes the group by discussing back pain. Which nursing statement is an appropriate response in this situation? A “I can tell this is bothering you. Let’s briefly discuss this further after group.” B “Let’s see if anyone in the group has ideas on how to deal with pain.” C “We need to get back to the topic of dealing with anxiety.” D “Let’s check in and see how others in the group are feeling.” 8. A client who currently complains of vague weakness and multisystem symptoms has been diagnosed with a somatic symptom disorder. Which nursing intervention takes priority? A Discuss the client’s symptoms to provide secondary gains. B Discuss the stressor that the client is experiencing. C Evaluate signs and symptoms, vital signs, and lab tests. D Teach the client appropriate coping mechanisms to deal with stress. 9. After childhood sexual abuse, a client diagnosed with DID has an outcome that states, “The client will verbalize causative factors for the development of multiple personalities.” Which charting entry documents a successful outcome? A “Able to state the particular function of each of the different personalities.” B “Discussed history of childhood sexual abuse.” C “Was able to be redirected to topic at hand during group therapy.” D “Verbalizes understanding that treatment may be lengthy.” Mental Health Exam 3 (2) 10. In which situation is lorazepam (Ativan) used appropriately? A Long-term treatment of clients diagnosed with conversion disorder caused by anxiety. B Long-term treatment of clients diagnosed with illness anxiety disorder. C Short-term treatment of clients diagnosed with hypertension caused by atherosclerosis. D Short-term treatment of clients diagnosed with conversion disorder. 11. Which structure in the brain contains the appetite regulation center? A Thalamus B Amygdala C Hypothalamus D Medulla 12. Which anorexia nervosa etiology is from a neuroendocrine perspective? A Anorexia nervosa is more common among sisters and mothers of clients with the disorder than among the general population. B Altered structure and function of the thalamus is implicated in the diagnosis of anorexia nervosa. C There is a higher-than-expected frequency of mood disorders among first-degree relatives of clients diagnosed with anorexia nervosa. D Clients diagnosed with anorexia nervosa have elevated cerebrospinal fluid cortisol levels and possible alterations in the regulation of dopamine.  Mental Health Exam 3 (2) 13. A client is being admitted to the in-patient psychiatric unit with a diagnosis of bulimia nervosa. The nurse would expect this client to fall within which age range? A 5-10 years old B 10-14 years old C 18-22 years old D 40-45 years old 14. A client with a long history of bulimia nervosa is seen in the emergency department. The client is seeing things that others do not, is restless, and has dry mucous membranes. Which is most likely the cause of this client’s symptoms? A Mood disorders, which often accompany the diagnosis of bulimia nervosa. B Nutritional deficits, are characteristic of bulimia nervosa. C Vomiting, may lead to dehydration and electrolyte imbalance. D Binging, causes abdominal discomfort. 15. An 18 year-old female client weighs 95 pounds and is 70 inches tall. She has not had a period in 4 months and states, “I am so fat!” Which statement is reflective of this client’s symptoms? A The client meets the criteria for a diagnosis of bulimia nervosa. B The client meets the criteria for a diagnosis of anorexia nervosa. C The client needs further assessment to be diagnosed. D The client is exhibiting normal developmental tasks according to Erikson. Mental Health Exam 3 (2) 16. Which anorexia nervosa symptom is physical in nature? A Dry, yellow skin. B Perfectionism. C Frequent weighing. D Preoccupation with food 17. Which nursing intervention would directly assist a hospitalized client diagnosed with bulimia nervosa in avoiding the urge to purge after discharge? A Locking the door to the client’s bathroom. B Holding a mandatory group after mealtime to assist in the exploration of feelings. C Discussing preplanned meals to decrease anxiety around eating. D Educating the family to recognize purging side effects.  18. A client on an in-patient psychiatric unit has been diagnosed with bulimia nervosa. The client states, “I’m going to the bathroom and will be back in a few minutes.” Which nursing response is most appropriate? A “Thanks for checking in.” B “I will accompany you to the bathroom.” C “Let me know when you get back to the dayroom.” D “I’ll stand outside your door to give you privacy.” Mental Health Exam 3 (2) 19. A client diagnosed with bulimia nervosa has responded well to citalopram (Celexa). Which is the possible cause for this response? A There is an association between bulimia nervosa and dilated blood vessels and inactive alpha-adrenergic and serotoninergic receptors. B There is an association between bulimia nervosa and the neurotransmitter dopamine. C There is an association between bulimia nervosa and the neurotransmitters serotonin and norepinephrine. D There is an association between bulimia nervosa and a malfunction of the thalamus. 20. Which medication is used most often in the treatment of clients diagnosed with anorexia nervosa? A Fluphenazine (Prolixin). B Clozapine (Clozaril). C Fluoxetine (Prozac). D Methylphenidate (Ritalin). 21. A client is newly prescribed lithium carbonate (Lithium). Which teaching point by the nurse take priority? A “Make sure your salt intake is consistent.” B “Limit your fluid intake to 2000 mL/day.” C “Monitor your caloric intake because of potential weight gain.” D “Get yourself in a daily routine to assist in avoiding relapse.” Mental Health Exam 3 (2) 22. A client with cachexia states, “I don’t care what you say; I am horribly fat and will continue to diet.” The client is experiencing arrhythmias and bradycardia. Based on this client’s symptoms, which nursing diagnosis takes priority? A Ineffective denial. B Imbalanced nutrition: less than body requirements. C Disturbed body image. D Ineffective coping. 23. A client diagnosed with anorexia nervosa is newly admitted to an in-patient psychiatric unit. Which intervention takes priority? A Assessment of family issues and health concerns. B Assessment of early disturbances in mother-infant interactions. C Assessment of the client’s knowledge of selective serotonin reuptake inhibitors (SSRIs) used in treatment. D Assessment and monitoring of vital signs and lab values to recognize and anticipate medical problems. 24. Which is a dental complication associated with purging? A Seizures B Enlarged pancreas C Elevated blood urea nitrogen (BUN) D Erosion of dental enamel Mental Health Exam 3 (2) 25. A client diagnosed with bipolar affective disorder is prescribed carbamazepine (Tegretol). The client exhibits nausea, vomiting, and anorexia. Which is an appropriate nursing intervention at this time? A Stop the medication and notify the physician. B Hold the next dose until symptoms subside. C Administer the next dose with food. D Ask the physician for a stat carbamazepine level.