Psychiatric Nursing Practice Exam Questions with Answers and Essay Papers

May 30, | nursing, med, NURS, Paper

Psychiatric Nursing Practice Exam Questions with Answers and Essay Papers
Psychiatric Nursing Practice Exam Questions with Answers and Essay Papers
 

 
Question 1

Which nursing intervention is best for facilitating communication with a psychiatric client who speaks a foreign language?

A
Rely on nonverbal communication.

B
Select symbolic pictures as aids.

C
Speak in universal phrases.

D
Use the services of an interpreter.

 
Question 2

The nurse explains to a mental health care technician that a client’s obsessive-compulsive behaviors are related to unconscious conflict between id impulses and the superego (or conscience). On which of the following theories does the nurse base this statement?

A
Behavioral theory

B
Cognitive theory

C
Interpersonal theory

D
Psychoanalytic theory

 
Question 3

The nurse observes a client pacing in the hall. Which statement by the nurse may help the client recognize his anxiety?

A
“I guess you’re worried about something, aren’t you?

B
“Can I get you some medication to help calm you?”

C
“Have you been pacing for a long time?”

D
“I notice that you’re pacing. How are you feeling?”

 
Question 4

A client with obsessive-compulsive disorder is hospitalized on an inpatient unit. Which nursing response is most therapeutic?

A
Accepting the client’s obsessive-compulsive behaviors

B
Challenging the client’s obsessive-compulsive behaviors

C
Preventing the client’s obsessive-compulsive behaviors

D
Rejecting the client’s obsessive-compulsive behaviors

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Question 5

A 45-year-old woman with a history of depression tells a nurse in her doctor’s office that she has difficulty with sexual arousal and is fearful that her husband will have an affair. Which of the following factors would the nurse identify as least significant in contributing to the client’s sexual difficulty?

A
Education and work history

B
Medication used

C
Physical health status

D
Quality of spousal relationship

 
Question 6

Which nursing intervention is most appropriate for a client with anorexia nervosa during initial hospitalization on a behavioral therapy unit?

A
Emphasize the importance of good nutrition to establish normal weight.

B
Ignore the client’s mealtime behavior and focus instead on issues of dependence and independence.

C
Help establish a plan using privileges and restrictions based on compliance with refeeding.

D
Teach the client information about the long-term physical consequence of anorexia.

 
Question 7

A nurse is evaluating therapy with the family of a client with anorexia nervosa. Which of the following would indicate that the therapy was successful?

A
The parents reinforce increased decision making by the client.

B
The parents clearly verbalize their expectations for the client.

C
The client verbalizes that family meals are now enjoyable.

D
The client tells her parents about feelings of low-self-esteem.

 
Question 8

The nurse is working with a client with a somatoform disorder. Which client outcome goal would the nurse most likely establish in this situation?

A
The client will recognize signs and symptoms of physical illness.

B
The client will cope with physical illness.

C
The client will take prescribed medications.

D
The client will express anxiety verbally rather than through physical symptoms.

 
Question 9

Which method would a nurse use to determine a client’s potential risk for suicide?

A
Wait for the client to bring up the subject of suicide.

B
Observe the client’s behavior for cues of suicide ideation.

C
Question the client directly about suicidal thoughts.

D
Question the client about future plans.

 
Question 10

A client with a bipolar disorder exhibits manic behavior. The nursing diagnosis is Disturbed thought processes related to difficulty concentrating, secondary to flight of ideas. Which of the following outcome criteria would indicate improvement in the client?

A
The client verbalizes feelings directly during treatment.

B
The client verbalizes positive “self” statement.

C
The client speaks in coherent sentences.

D
The client reports feelings calmer.

 
Question 11

A client tells a nurse. “Everyone would be better off if I wasn’t alive.” Which nursing diagnosis would be made based on this statement?

A
Disturbed thought processes

B
Ineffective coping

C
Risk for self-directed violence

D
Impaired social interaction

 
Question 12

Which information is most essential in the initial teaching session for the family of a young adult recently diagnosed with schizophrenia?

A
Symptoms of this disease imbalance in the brain.

B
Genetic history is an important factor related to the development of schizophrenia.

C
Schizophrenia is a serious disease affecting every aspect of a person’s functioning.

D
The distressing symptoms of this disorder can respond to treatment with medications.

 
Question 13

A nurse is working with a client who has schizophrenia, paranoid type. Which of the following outcomes related to the client’s delusional perceptions would the nurse establish?

A
The client will demonstrate realistic interpretation of daily events in the unit.

B
The client will perform daily hygiene and grooming without assistance.

C
The client will take prescribed medications without difficulty.

D
The client will participate in unit activities.

 
Question 14

A client with bipolar disorder, manic type, exhibits extreme excitement, delusional thinking, and command hallucinations. Which of the following is the priority nursing diagnosis?

A
Anxiety

B
Impaired social interaction

C
Disturbed sensory-perceptual alteration (auditory)

D
Risk for other-directed violence

 
Question 15

A client who abuses alcohol and cocaine tells a nurse that he only uses substances because of his stressful marriage and difficult job. Which defense mechanisms is this client using?

A
Displacement

B
Projection

C
Rationalization

D
Sublimation

 
Question 16

An 11-year-old child diagnosed with conduct disorder is admitted to the psychiatric unit for treatment. Which of the following behaviors would the nurse assess?

A
Restlessness, short attention span, hyperactivity

B
Physical aggressiveness, low stress tolerance disregard for the rights of others

C
Deterioration in social functioning, excessive anxiety and worry, bizarre behavior

D
Sadness, poor appetite and sleeplessness, loss of interest in activities

 
Question 17

The nurse understands that if a client continues to be dependent on heroin throughout her pregnancy, her baby will be at high risk for:

A
Mental retardation.

B
Heroin dependence.

C
Addiction in adulthood.

D
Psychological disturbances.

 
Question 18

The emergency department nurse is assigned to provide care for a victim of a sexual assault. When following legal and agency guidelines, which intervention is most important?

A
Determine the assailant’s identity.

B
Preserve the client’s privacy.

C
Identify the extent of injury.

D
Ensure an unbroken chain of evidence.

 
Question 19

Which factor is least important in the decision regarding whether a victim of family violence can safely remain in the home?

A
The availability of appropriate community shelters

B
The nonabusing caretaker’s ability to intervene on the client’s behalf

C
The client’s possible response to relocation

D
The family’s socioeconomic status

 
Question 20

The nurse would expect a client with early Alzheimer’s disease to have problems with:

A
Balancing a checkbook.

B
Self-care measures.

C
Relating to family members.

D
Remembering his own name.

 
Question 21

Which nursing intervention is most appropriate for a client with Alzheimer’s disease who has frequent episodes emotional lability?

A
Attempt humor to alter the client mood.

B
Explore reasons for the client’s altered mood.

C
Reduce environmental stimuli to redirect the client’s attention.

D
Use logic to point out reality aspects.

Question 22

Which neurotransmitter has been implicated in the development of Alzheimer’s disease?

A
Acetylcholine

B
Dopamine

C
Epinephrine

D
Serotonin

Question 23

Which factors are most essential for the nurse to assess when providing crisis intervention foe a client?

A
The client’s communication and coping skills

B
The client’s anxiety level and ability to express feelings

C
The client’s perception of the triggering event and availability of situational supports

D
The client’s use of reality testing and level of depression

Question 24

The nurse considers a client’s response to crisis intervention successful if the client:

A
Changes coping skills and behavioral patterns.

B
Develops insight into reasons why the crisis occurred.

C
Learns to relate better to others.

D
Returns to his previous level of functioning.

Question 25

Two nurses are co-leading group therapy for seven clients in the psychiatric unit. The leaders observe that the group members are anxious and look to the leaders for answers. Which phase of development is this group in?

A
Conflict resolution phase

B
Initiation phase

C
Working phase

D
Termination phase

Question 26

Group members have worked very hard, and the nurse reminds them that termination is approaching. Termination is considered successful if group members:

A
Decide to continue.

B
Elevate group progress

C
Focus on positive experience

D
Stop attending prior to termination.

Question 27

The nurse is teaching a group of clients about the mood-stabilizing medications lithium carbonate. Which medications should she instruct the clients to avoid because of the increased risk of lithium toxicity?

A
Antacids

B
Antibiotics

C
Diuretics

D
Hypoglycemic agents

Question 28

When providing family therapy, the nurse analyzes the functioning of healthy family systems. Which situations would not increase stress on a healthy family system?

A
An adolescent’s going away to college

B
The birth of a child

C
The death of a grandparent

D
Parental disagreement

Question 29

A client taking the monoamine oxidase inhibitor (MAOI) antidepressant isocarboxazid (Marplan) is instructed by the nurse to avoid which foods and beverages?

A
Aged cheese and red wine

B
Milk and green, leaf vegetables

C
Carbonated beverages and tomato products

D
Lean red meats and fruit juices

Question 30

Prior to administering chlorpromazine (Thorazine) to an agitated client, the nurse should:

A
Assess skin color and sclera

B
Assess the radial pulse

C
Take the client’s blood pressure

D
Ask the client to void

Question 31

The nurse understands that electroconvulsive therapy is primary used in psychiatric care for the treatment of:

A
Anxiety disorders.

B
Depression.

C
Mania.

D
Schizophrenia.

Question 32

A client taking the MAOI phenelzine (Nardil) tells the nurse that he routinely takes all of the medications listed below. Which medication would cause the nurse to express concern and therefore initiate further teaching?

A
Acetaminophen (Tylenol)

B
Diphenhydramine (Benadryl)

C
Furosemide (Lasix)

D
Isosorbide dinitrate (Isordil)

Question 33

The nurse is administering a psychotropic drug to an elderly client who has history of benign prostatic hypertrophy. It is most important for the nurse to teach this client to:

A
Add fiber to his diet.

B
Exercise on a regular basis.

C
Report incomplete bladder emptying.

D
Take the prescribed dose at bedtime.

Question 34

The nurse correctly teaches a client taking the benzodiazepine oxazepam (Serax) to avoid excessive intake of:

A
Cheese

B
Coffee

C
Sugar

D
Shellfish

Question 35

The nurse provides a referral to Alcoholics Anonymous to a client who describes a 20-year history of alcohol abuse. The primary function of this group is to:

A
Encourage the use of a 12-step program.

B
Help members maintain sobriety.

C
Provide fellowship among members.

D
Teach positive coping mechanisms.

Question 36

Which client outcome is most appropriately achieved in a community approach setting in psychiatric nursing?

A
The client performs activities of daily living and learns about crafts.

B
The client’s is able to prevent aggressive behavior and monitors his use of medications.

C
The client demonstrates self-reliance and social adaptation.

D
The client experience experiences anxiety relief and learns about his symptoms.

Question 37

A client with panic disorder experiences an acute attack while the nurse is completing an admission assessment. List the following interventions according to their level of priority. a. Remain with the client. b. Encourage physical activity. c. Encourage low, deep breathing. d. Reduce external stimuli. e. Teach coping measures.

A
ABCDE

B
ADBCE

C
ACDBE

D
ADCBE

Question 38

The doctor has prescribed haloperidol (Haldol) 2.5 mg. I.M. for an agitated client. The medication is labeled haloperidol 10 mg/2 ml. The nurse prepares the correct dose by drawing up how many milliliters in the syringe?

A
0.3

B
0.4

C
0.5

D
0.6

Question 39

The nurse enters the room of a client with a cognitive impairment disorder and asks what day of the week it is: what the date, month, and year are; and where the client is. The nurse is attempting to assess:

A
Confabulation

B
Delirium

C
Orientation

D
Perseveration

Question 40

Which of the following will the nurse use when communicating with a client who has a cognitive impairment?

A
Complete explanations with multiple details

B
Picture or gestures instead of words

C
Stimulating words and phrases to capture the client’s attention

D
Short words and simple sentences

Question 41

A 75-year-old client has dementia of the Alzheimer’s type and confabulates. The nurse understands that this client:

A
Denies confusion by being jovial.

B
Pretends to be someone else.

C
Rationalizes various behaviors.

D
Fills in memory gaps with fantasy.

Question 42

An elderly client with Alzheimer’s disease becomes agitated and combative when a nurse approaches to help with morning care. The most appropriate nursing intervention in this situation would be to:

A
Tell the client family that it is time to get dressed.

B
Obtain assistance to restrain the client for safety.

C
Remain calm and talk quietly to the client.

D
Call the doctor and request an order for sedation.

Question 43

In clients with a cognitive impairment disorder, the phenomenon of increased confusion in the early evening hours is called:

A
Aphasia

B
Agnosia

C
Sundowning

D
Confabulation

Question 44

Which of the following outcome criteria is appropriate for the client with dementia?

A
The client will return to an adequate level of self-functioning.

B
The client will learn new coping mechanisms to handle anxiety.

C
The client will seek out resources in the community for support.

D
The client will follow an establishing schedule for activities of daily living.

Question 45

The school guidance counselor refers a family with an 8-year-old child to the mental health clinic because of the child’s frequent fighting in school and truancy. Which of the following data would be a priority to the nurse doing the initial family assessment?

A
The child’s performance in school

B
Family education and work history

C
The family’s perception of the current problem

D
The teacher’s attempts to solve the problem

Question 46

The parents of a young man with schizophrenia express feelings of responsibility and guilt for their son’s problems. How can the nurse best educate the family?

A
Acknowledge the parent’s responsibility.

B
Explain the biological nature of schizophrenia.

C
Refer the family to a support group.

D
Teach the parents various ways they must change.

Question 47

The nurse collecting family assessment data asks. “Who is in your family and where do they live?” which of the following is the nurse attempting o identify?

A
Boundaries

B
Ethnicity

C
Relationships

D
Triangles

Question 48

According to the family systems theory, which of the following best describes the process of differentiation?

A
Cooperative action among members of the family

B
Development of autonomy within the family

C
Incongruent messages wherein the recipient is a victim

D
Maintenance of system continuity or equilibrium

Question 49

The nurse is interacting with a family consisting of a mother, a father, and a hospitalized adolescent who has a diagnosis of alcohol abuse. The nurse analyzes the situation and agrees with the adolescent’s view about family rules. Which intervention is most appropriate?

A
The nurse should align with the adolescent, who is the family scapegoat.

B
The nurse should encourage the parents to adopt more realistic rules.

C
The nurse should encourage the adolescent to comply with parental rules.

D
The nurse should remain objective and encourage mutual negotiation of issues.

Question 50

A 16-year-old girl has returned home following hospitalization for treatment of anorexia nervosa. The parents tell the family nurse performing a home visit that their child has always done everything to please them and they cannot understand her current stubbornness about eating. The nurse analyzes the family situation and determines it is characteristic of which relationship style?

A
Differentiation

B
Disengagement

C
Enmeshment

D
Scapegoating

 
Psychiatric Nursing Practice Exam Questions with Answers and Essay Papers
Answers with explanations

 
Question 1

Correct answer is D
Which nursing intervention is best for facilitating communication with a psychiatric client who speaks a foreign language?

Rely on nonverbal communication.

Select symbolic pictures as aids.

Speak in universal phrases.

Use the services of an interpreter.

Question 1 Explanation:
An interpreter will enable the nurse to better assess the client’s problems and concerns. Nonverbal communication is important; however for the nurse to fully determine the client’s problems and concerns, the assistance of an interpreter is essential. The use of symbolic pictures and universal phrases may assist the nurse in understanding the basic needs of the client; however these are insufficient to assess the client with a psychiatric problem.

 
Question 2
Correct answer is D

The nurse explains to a mental health care technician that a client’s obsessive-compulsive behaviors are related to unconscious conflict between id impulses and the superego (or conscience). On which of the following theories does the nurse base this statement?

Behavioral theory

Cognitive theory

Interpersonal theory

Psychoanalytic theory

Question 2 Explanation:
Psychoanalytic is based on Freud’s beliefs regarding the importance of unconscious motivation for behavior and the role of the id and superego in opposition to each other. Behavioral cognitive and interpersonal theories do not emphasize unconscious conflicts as the basis for symptomatic behavior.

 
Question 3
Correct answer is D

The nurse observes a client pacing in the hall. Which statement by the nurse may help the client recognize his anxiety?

“I guess you’re worried about something, aren’t you?

“Can I get you some medication to help calm you?”

“Have you been pacing for a long time?”

“I notice that you’re pacing. How are you feeling?”

 
Question 3 Explanation:
By acknowledging the observed behavior and asking the client to express his feelings the nurse can best assist the client to become aware of his anxiety. In option A, the nurse is offering an interpretation that may or may not be accurate; the nurse is also asking a question that may be answered by a “yes” or “no” response, which is not therapeutic. In option B, the nurse is intervening before accurately assessing the problem. Option C, which also encourages a “yes” or “no” response, avoids focusing on the client’s anxiety, which is the reason for his pacing.

 
Question 4
Correct answer is A

A client with obsessive-compulsive disorder is hospitalized on an inpatient unit. Which nursing response is most therapeutic?

Accepting the client’s obsessive-compulsive behaviors

Challenging the client’s obsessive-compulsive behaviors

Preventing the client’s obsessive-compulsive behaviors

Rejecting the client’s obsessive-compulsive behaviors

Question 4 Explanation:
A client with obsessive-compulsive behavior uses this behavior to decrease anxiety. Accepting this behavior as the client’s attempt to feel secure is therapeutic. When a specific treatment plan is developed, other nursing responses may also be acceptable. The remaining answer choices will increase the client’s anxiety and therefore are inappropriate.

 
Question 5
Correct answer is A

A 45-year-old woman with a history of depression tells a nurse in her doctor’s office that she has difficulty with sexual arousal and is fearful that her husband will have an affair. Which of the following factors would the nurse identify as least significant in contributing to the client’s sexual difficulty?

Education and work history

Medication used

Physical health status

Quality of spousal relationship

Question 5 Explanation:
Education and work history would have the least significance in relation to the client’s sexual problem. Age, health status, physical attributes and relationship issues have great influence on sexual expression.

 
Question 6
Correct answer is C

Which nursing intervention is most appropriate for a client with anorexia nervosa during initial hospitalization on a behavioral therapy unit?

Emphasize the importance of good nutrition to establish normal weight.

Ignore the client’s mealtime behavior and focus instead on issues of dependence and independence.

Help establish a plan using privileges and restrictions based on compliance with refeeding.

Teach the client information about the long-term physical consequence of anorexia.

Question 6 Explanation:
Inpatient treatment of a client with anorexia usually focuses initially on establishing a plan for refeeding to combat the effects of self-induced starvation. Refeeding is accomplished through behavioral therapy, which uses a system of rewards and reinforcements to assist in establishing weight restoration. Emphasizing nutrition and teaching the client about the long-term physical consequences of anorexia maybe appropriate at a later time in the treatment program. The nurse needs to assess the client’s mealtime behavior continually to evaluate treatment effectiveness.

 
Question 7
Correct answer is A

A nurse is evaluating therapy with the family of a client with anorexia nervosa. Which of the following would indicate that the therapy was successful?

The parents reinforce increased decision making by the client.

The parents clearly verbalize their expectations for the client.

The client verbalizes that family meals are now enjoyable.

The client tells her parents about feelings of low-self-esteem.

Question 7 Explanation:
One of the core issues concerning the family of a client with anorexia is control. The family’s acceptance of the client’s ability to make independent decisions is key to successful family intervention. Although the remaining options may occur during the process of therapy they would not necessarily indicate a successful outcome; the central family issues of dependence and independence are not addressed in these responses.

 
Question 8
Correct answer is D

The nurse is working with a client with a somatoform disorder. Which client outcome goal would the nurse most likely establish in this situation?

The client will recognize signs and symptoms of physical illness.

The client will cope with physical illness.

The client will take prescribed medications.

The client will express anxiety verbally rather than through physical symptoms.

Question 8 Explanation:
The client with a somatoform disorder displaces anxiety onto physical symptoms. The ability to express anxiety verbally indicates a positive change toward improved health. The remaining responses do not indicate any positive change toward increased coping with anxiety.

 
Question 9
Correct answer is C

Which method would a nurse use to determine a client’s potential risk for suicide?

Wait for the client to bring up the subject of suicide.

Observe the client’s behavior for cues of suicide ideation.

Question the client directly about suicidal thoughts.

Question the client about future plans.

Question 9 Explanation:
Directly questioning a client about suicide is important to determine suicide risk. The client may not bring up this subject for several reasons, including guilt regarding suicide, wishing not to be discovered, and his lack of trust in staff. Behavioral cues are important, but direct questioning is essential to determine suicide risk. Indirect questions convey to the client that the nurse is not comfortable with the subject of suicide and, therefore, the client may be reluctant to discuss the topic.

 
Question 10
Correct answer is C

A client with a bipolar disorder exhibits manic behavior. The nursing diagnosis is Disturbed thought processes related to difficulty concentrating, secondary to flight of ideas. Which of the following outcome criteria would indicate improvement in the client?

The client verbalizes feelings directly during treatment.

The client verbalizes positive “self” statement.

The client speaks in coherent sentences.

The client reports feelings calmer.

Question 10 Explanation:
A client exhibiting flight of ideas typically has a continuous speech flow and jumps from one topic to another. Speaking in coherent sentences is an indicator that the client’s concentration has improved and his thoughts are no longer racing. The remaining options do not relate directly to the stated nursing diagnosis.

 
Question 11
Correct answer is C

A client tells a nurse. “Everyone would be better off if I wasn’t alive.” Which nursing diagnosis would be made based on this statement?

Disturbed thought processes

Ineffective coping

Risk for self-directed violence

Impaired social interaction

Question 11 Explanation:
The nurse should take any nurse statements indicating suicidal thoughts seriously and further assess for other risk factors. The remaining diagnoses fail to address the seriousness of the client’s statement.

Question 12
Correct answer is D

Which information is most essential in the initial teaching session for the family of a young adult recently diagnosed with schizophrenia?

Symptoms of this disease imbalance in the brain.

Genetic history is an important factor related to the development of schizophrenia.

Schizophrenia is a serious disease affecting every aspect of a person’s functioning.

The distressing symptoms of this disorder can respond to treatment with medications.

Question 12 Explanation:
This statement provides accurate information and an element of hope for the family of a schizophrenic client. Although the remaining statements are true, they do not provide the empathic response the family needs after just learning about the diagnosis. These facts can become part of the ongoing teaching.

Question 13
Correct answer is A

A nurse is working with a client who has schizophrenia, paranoid type. Which of the following outcomes related to the client’s delusional perceptions would the nurse establish?

The client will demonstrate realistic interpretation of daily events in the unit.

The client will perform daily hygiene and grooming without assistance.

The client will take prescribed medications without difficulty.

The client will participate in unit activities.

Question 13 Explanation:
A client with schizophrenia, paranoid type, has distorted perceptions and views people, institutions, and aspects of the environment as plotting against him. The desired outcome for someone with delusional perceptions would be to have a realistic interpretation of daily events. The client with a distorted perception of the environment would not necessarily have impairments affecting hygiene and grooming skills. Although taking medications and participating in unit activities may be appropriate outcomes for nursing intervention, these responses are not related to client perceptions.

Question 14
Correct answer is D

A client with bipolar disorder, manic type, exhibits extreme excitement, delusional thinking, and command hallucinations. Which of the following is the priority nursing diagnosis?

Anxiety

Impaired social interaction

Disturbed sensory-perceptual alteration (auditory)

Risk for other-directed violence

Question 14 Explanation:
A client with these symptoms would have poor impulse control and would therefore be prone to acting-out behavior that may be harmful to either himself or others. All of the remaining nursing diagnoses may apply to the client with mania; however, the priority diagnosis would be risk for violence.

Question 15
Correct answer is C

A client who abuses alcohol and cocaine tells a nurse that he only uses substances because of his stressful marriage and difficult job. Which defense mechanisms is this client using?

Displacement

Projection

Rationalization

Sublimation

Question 15 Explanation:
Rationalization is the defense mechanism that involves offering excuses for maladaptive behavior. The client is defending his substance abuse by providing reasons related to life stressors. This is a common defense mechanism used by clients with substance abuse problems. None of the remaining defense mechanisms involves making excuses for behaviors.

Question 16
Correct answer is B

An 11-year-old child diagnosed with conduct disorder is admitted to the psychiatric unit for treatment. Which of the following behaviors would the nurse assess?

Restlessness, short attention span, hyperactivity

Physical aggressiveness, low stress tolerance disregard for the rights of others

Deterioration in social functioning, excessive anxiety and worry, bizarre behavior

Sadness, poor appetite and sleeplessness, loss of interest in activities

Question 16 Explanation:
Physical aggressiveness, low stress tolerance, and a disregard for the rights of others are common behaviors in clients with conduct disorders. Restlessness, short attention span, and hyperactivity are typical behaviors in a client with attention deficit hyperactivity disorder. Deterioration in social functioning, excessive anxiety and worry and bizarre behaviors are typical in schizophrenic disorders. Sadness, poor appetite, sleeplessness, and loss of interest in activities are behaviors commonly seen in depressive disorders.

Question 17
Correct answer is B

The nurse understands that if a client continues to be dependent on heroin throughout her pregnancy, her baby will be at high risk for:

Mental retardation.

Heroin dependence.

Addiction in adulthood.

Psychological disturbances.

Question 17 Explanation:
Babies born to heroin-dependent women are also heroin-dependent and need to go through withdrawal. There is no evidence to support any of the remaining answer choices.

Question 18
Correct answer is D

The emergency department nurse is assigned to provide care for a victim of a sexual assault. When following legal and agency guidelines, which intervention is most important?

Determine the assailant’s identity.

Preserve the client’s privacy.

Identify the extent of injury.

Ensure an unbroken chain of evidence.

Question 18 Explanation:
Establishing an unbroken chain of evidence is essential in order to ensure that the prosecution of the perpetrator can occur. The nurse will also need to preserve the client’s privacy and identify the extent of injury. However, it is essential that the nurse follow legal and agency guidelines for preserving evidence. Identifying the assailant is the job of law enforcement, not the nurse.

Question 19
Correct answer is D

Which factor is least important in the decision regarding whether a victim of family violence can safely remain in the home?

The availability of appropriate community shelters

The no

Antisocial Personality Disorder essay research case study example

May 30, | nursing, med, NURS, Paper

Antisocial Personality Disorder essay research case study example
Antisocial Personality Disorder essay research case study example
Assignment : Antisocial Personality Disorder
For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat adult and older adult clients presenting symptoms of a mental health disorder.

Learning Objectives

Students will:

Evaluate clients for treatment of mental health disorders

Analyze decisions made throughout diagnosis and treatment of clients with mental health disorders
Antisocial Personality Disorder essay research case study example
THE CASE STUDY

Antisocial Personality Disorder
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BACKGROUND
SUBJECTIVE

Rhonda is a 32-year-old Hispanic female who presents to your office for her initial appointment. When you ask what brought her to your office, she states: “I’m at the end of my rope, I don’t know what else to do.” She then bursts into tears. Rhonda explains that she has very few friends left, and everyone seems to have “abandoned” her. Rhonda explains that she goes out of her way to help other people, and to be nice to them, but this does not seem to help.

Rhonda then stands up and begins to pace around your office at times using wild hand gestures to explain the circumstances that led up to her making the appointment with you. She describes the recent breakup with her boyfriend as traumatic and explains “when we first met, he was the best guy in the world. He treated me really well. But he just became a complete monster! Even though he broke off the relationship with me, I was glad to see it end. I hate his guts!” Antisocial Personality Disorder essay research case study example.

Rhonda explains that her current financial situation is also precarious. She states that she recently purchased an automobile, and is not certain how she is going to pay for it. She states that she had a car that was repossessed last year at that time, and that she borrowed some money from a friend to help pay for the car; the friend later turned around and accused her of theft. “It was my friend’s fault. She told me she would loan me the money and then backed out. I only took the money because she said she would loan it to me … people just can’t go back on their word like that when other people are counting on them.”

Rhonda reports that she was “always in trouble” as a kid. She states that people were always picking on her, to which she adds: “the other kids my age were just stupid. Antisocial Personality Disorder essay research case study example. They didn’t know how to have fun.” She says “I have always been impulsive, but it’s fun. Sometimes people can be such prudes … you only go around life once, so you have to make the best of it.”
OBJECTIVE

Rhonda is currently single. She has no children. Educationally, she had completed two semesters toward her bachelor of arts degree in fine arts. Rhonda currently works as a waitress at a local restaurant. She has held this job for about 2 weeks. Prior to this, Rhonda worked as a housekeeper for a local hotel chain. She states that she was fired from this job because her coworkers were jealous of her and “planted” evidence of her stealing from hotel patrons. She was also arrested for cashing checks under an alias, for which she spent 120 days in jail. Antisocial Personality Disorder essay research case study example.

Rhonda has a history of multiple incarcerations for offences ranging from larceny to possession of controlled substances to possession of an illegal firearm. She was also arrested several times for fighting and on at least one occasion, used a baseball bat to beat up a girl who she thought was trying to “set her up” with the police.
MENTAL STATUS EXAM

Rhonda is alert and oriented × 4 spheres. Her speech is clear, coherent, goal directed, and spontaneous. She reports her mood as “terrible!” Affect is labile and seems to change rapidly with the subject being discussed. Her eye contact is normal, but at times, she appears to stare at you. Rhonda is oriented to person, place, and time. She denies visual/auditory hallucinations, no overt paranoia or delusional thought processes noted. Rhonda denies any suicidal or homicidal ideation. Antisocial Personality Disorder essay research case study example.

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Decision Point One
1. Diagnosis: Antisocial Personality Disorder
Decision Point Two
2.Refer to psychologist for psychological testing

RESULTS OF DECISION POINT TWO

– Client returns to clinic in four weeks

– The psychologist’s report indicates that a comprehensive psychological battery was performed for the purposes of diagnostic clarification. The end result suggested that Rhonda has traits of multiple personality disorders, but scores highest in antisocial personality traits, suggesting antisocial personality disorder. Antisocial Personality Disorder essay research case study example.

-When Rhonda returns to the office, you review the psychologist’s report with her. Rhonda seems upset, but also states “well, that’s why I am here, to get better … what do I need to do?”
Decision Point Three

3. Refer to group-based cognitive behavior therapy

Guidance to Student
Referral to a psychologist was appropriate for the purposes of diagnostic clarification. Psychological tests can help tease out the actual personality disorder that Rhonda has. In this case, Rhonda’s symptoms are most consistent with antisocial personality disorder, but as you can see, she has signs/symptoms of other personality disorders.

Of the available choices, group-based cognitive behavior therapy may be useful in treating individuals with this personality disorder, but all “improvement” in signs/symptoms should be met with great skepticism. Antisocial Personality Disorder essay research case study example.

Dialectical behavior therapy is ineffective in people with APD.

Beginning Latuda is not appropriate, as there are currently no FDA-approved medications to treat APD. Also, prescribing medications to someone with antisocial personality disorder could lead to misuse or diversion. Antisocial Personality Disorder essay research case study example.
The Assignment:

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At each Decision Point, stop to complete the following:
Decision #1: Antisocial Personality Disorder

Which Decision did you select?

o Why did you select this Decision? Support your response with evidence and references to the Learning Resources.

o What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources. Antisocial Personality Disorder essay research case study example.

o Explain any difference between what you expected to achieve with Decision #1 and the results of the Decision. Why were they different?
Decision #2: Treatment Plan for Psychotherapy

o Why did you select this Decision? Support your response with evidence and references to the Learning Resources.

o What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources.

o Explain any difference between what you expected to achieve with Decision #2 and the results of the Decision. Why were they different?
Decision #3: Treatment Plan for Psychopharmacology
o Why did you select this Decision? Support your response with evidence and references to the Learning Resources.

o What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources. Antisocial Personality Disorder essay research case study example.

o Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
Also include how ethical considerations might impact your treatment plan and communication with clients and their families. Antisocial Personality Disorder essay research case study example.
Antisocial Personality Disorder essay
Antisocial personality disorder (ASPD) is a powerlessness to fit in with the social standards that customarily govern numerous parts of a person’s behavior (Sadock, Sadock & Ruiz, 2014). A person with ASPD are often called sociopathy, is a psychological condition in which a person reliably demonstrates no respect for good and bad and disregards the rights and feelings of others. Individuals with the above disorder tend to estrange, unstable, aggressive, control or treat others cruelly or with hard aloofness. They demonstrate no blame or regret for their conduct. Ms. Rhonda is a 32year old Hispanic with no children. In the scenario She presently works at local restaurant as a waitress and in college with two semesters left from graduation. She is alert and oriented × 4. She is well spoken, speech is clear, normal eye contact, goal directed, and spontaneous. She verbalized having a terrible mood. She appears to change discussed subject quickly with a labile affect. She denies any auditory or visual hallucinations, homicidal or suicidal ideation (Laureate Education, 2017a). Antisocial Personality Disorder essay research case study example.
She is manipulating, exploiting impulsive, others and violated the right of others. She is also irresponsible with her work and finances. According to the American Psychiatric Association (2013), there are four diagnostic criteria for ASPD: Individual with ASPD violate others rights deceitful, impulsive, irritability, aggressiveness, irresponsible, and lack remorse with an onset before 15 years. They must be 18 years old to be diagnoses with ASPD.
                                                     Differential Diagnosis
It is important to determine which started first, if the patient started abusing drugs before their antisocial behavior began may have behavior caused from the impacts of their drug addiction. Antisocial Personality Disorder essay research case study example.
                                                        Expected Result
Ms. Rhonda showed behavior indicative of ASPD. She is deceitful with friends. She stated that she has “always been impulsive” which she finds funny (Laureate Education, 2017a). She is consistently irresponsible (her current financial situation risky/ awful). She does not know her car note will be paid for. She stated that her last car was repossessed last year because of her friends, who promised to loan her money but later backed out. Antisocial Personality Disorder essay research case study example. She expresses that she was terminated from a job because her colleagues were envious of her and “planted” proof of her stealing from hotel patrons. She was arrested for cashing checks using fake name, for which she was imprison for 120 days (lack remorse).
Rhonda has a background of various detainments for offenses running from possession of an unlawful gun to stealing to possession of controlled substances. Antisocial Personality Disorder essay research case study example. She was arrested a few times for combating and on somewhere around one event, utilized a baseball bat to thrash a young lady who she thought was attempting to “set her up” with the police (lack remorse) (Laureate Education, 2017a).
              Difference Between Expected Result and the Achieved Result
There is no difference between the expected result and achieved result since Ms. Rhonda exhibited signs and symptoms indicative of ASPD.
                                                      Decision Point Two
                                      Refer to psychologist for psychological testing
The explanation behind this choice is because diagnosing ASPD is based on psychological evaluation. Patient will be referred to psychologist for psychological testing this will enable the psychologist to even more likely comprehend the patient and her behavior. psychological testing is a procedure of critical thinking in which the psychologist attempts and decide the main components of a patient’s mental or mental health problems, Intellectual Functioning IQ, personality, behavioral or some other component. It is additionally a procedure that aides distinguish a person strength and weakness (Laureate Education, 2017a). Antisocial Personality Disorder essay research case study example.
Expected Result with this Decision
There is no different between expected result and the actual result because the psychologist report shows that a thorough psychological battery was performed for the motivations behind diagnostic elucidation. The psychological report stated that although Rhonda had other qualities of multiple personality disorder. She scored highest in antisocial personality disorder test indicating that she has ASPD.
                     Difference between what you expected to achieve with Decision #2
Rhonda was referred to psychologist so that she can get the best treatment need for her symptoms.  Rhonda has a lots of other personality disorder symptoms. The psychological tests will enable persuade to out the actual personality disorder that Rhonda possess. Rhonda’s indications are most predictable with reserved ASPD, however as should be obvious, she has signs/side effects of other identity issue (Laureate Education, 2017a).
                                                        Decision Point Three
                                Refer to group-based cognitive behavior therapy
Reason for Decision
There is at present no FDA-approve medication for the treatment of ASPD so prescribing medication to the patient may result to diversion or abuse. Antisocial Personality Disorder essay research case study example. Psychotherapy is effective in the treatment of ASPD. Group-based cognitive behavior has proven to be effective with ASPD.CBT uses cognitive restructuring, exposure, behavior modification, psychoeducation, and skills education.
                                            Expected Result with this Decision.
Group-based cognitive behavior has proven to be effective with ASPD. Cognitive behavioral relapse prevention theory is linked with successful correctional treatment programs (Davidson, 2008). It focuses on challenging dysfunctional beliefs and teaches the patient tactics, exercises and behavioral experiments to acquire more socially acceptable behavior. It deals with the premise that antisocial behavior is learned, motivated and strengthened within the person and within the environment factors. Antisocial Personality Disorder essay research case study example. There a few cognitive behavioral strategies can be used to acknowledge new cognitive and behavioral techniques to break the sequences of antisocial behavior (Davidson, 2008).
      Difference between Expected Result and the Achieved Result with Decision
The expected result and achieved result are the same. Ms. Rhonda returned to the clinic showing empathy, compassion, remorseful for her action and demonstrating acceptable social behavior.
                                                      Ethical Considerations
People with ASPD are responsible for an extreme amount of social discomfort, crime, and violence and pose a critical burden to society causing distress to others, to a great extent because of the violations they commit and their antisocial behavior.  Working with ASPD patients can be challenging. ASPD is a mental disorder and requires clinicians to give proper consideration and treatment nonjudgmental (De Brito & Hodgins, 2009). Antisocial Personality Disorder essay research case study example.
 
                                                        References
Davidson K.M. (2008). Cognitive therapy for personality disorders: a guide for clinicians. Second Edition.  Routledge: Hove
De Brito S, Hodgins S (2009) Antisocial personality disorder. In: McMurran M, Howard R, editors. Personality, Personality Disorder and Risk of Violence: An Evidence-Based Approach. West Sussex, UK: John Wiley and Sons. Antisocial Personality Disorder essay research case study example.
Framingham, J. (2016). Types of Psychological Testing. Psych Central. Retrieved on September 23, 2018, from https://psychcentral.com/lib/types-of-psychological-testing/
Laureate Education. (2017a). A woman with personality disorder [Interactive media file] Baltimore, MD: Author.
Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer. Antisocial Personality Disorder essay research case study example.