moc final

The nurse is discussing the differences between a patient with a neurosis and one with a psychosis. What is true of the patient experiencing a neurosis?

The patient experiences a flight from reality.
The patient usually needs hospitalization.
The patient has insight that there is an emotional problem.
The patient has severe personality deterioration.
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Terms in this set (100)
The nurse is discussing the differences between a patient with a neurosis and one with a psychosis. What is true of the patient experiencing a neurosis?

The patient experiences a flight from reality.
The patient usually needs hospitalization.
The patient has insight that there is an emotional problem.
The patient has severe personality deterioration.
The patient has insight that there is an emotional problem.
When the patient with a psychosis is thought to be a danger to self or others, by what method should the patient be admitted to the hospital?

Probating
Family request
nurses request
health care providers order
family request
probating
What is the prognosis for a schizophrenic patient who is exhibiting positive behaviors?
a. Guarded
b. Poor
c. Good
d. Repeatable
good
The nurse asks a patient with schizophrenia if he had any visitors on Sunday. Which response indicates loose association?
"no"
"yes! I had 90 visitors who came from every state in the union!"
"sunday is the sabbath. Do we have visitors on the sabbath?"
"we visited yellowstone park last summer."
"we visited yellowstone park last summer:
The nurse is caring for a patient with a diagnosis of catatonic schizophrenia. What behavior is consistent with this diagnosis?
Talks excitedly about going home.
Suspiciously watches the staff.
Stands on one foot for 15 minutes.
States he has a cat under his bed that talks to him.
Stands on one foot for 15 minutes.
The home health nurse assesses a patient who creates elaborate excuses for not leaving home. Further questioning reveals the patient had not left home for 6 months. How should this be documented?
a. Mania
b. Depression
c. Agoraphobia
d. Anxiety
c. Agoraphobia
The patient complains of recurrent, multiple physical ailments for which there is no organic cause. How should the nurse assess this?
Obsessive-compulsive disorder
Phobia anxiety disorder
Somatic symptom disorder
Delusional disorder
Somatic symptom disorder
The nurse assesses an alcoholic patient carefully for signs of withdrawal. How soon after cessation of alcohol intake do withdrawal symptoms usually appear?
3 hours
4 hours
5 hours
6 hours
6 hours
What severe side effect will occur if an alcoholic patient consumes alcohol while taking disulfiram (Antabuse)?
a. Nausea
b. Blackouts
c. Headaches
d. Hypertension
nausea
What nursing intervention should be included in the plan of care for a baby born to a drug-addicted mother?
Swaddle the baby closely.
Place the baby in a brightly lit area.
Hold and rock the baby frequently.
Place the baby in a busy part of the nursery for stimulation.
Swaddle the baby closely.
Which question is likely to elicit the most valid response from the patient who is being interviewed about a neurologic problem? "Do you have any sensations of pins and needles in your feet?" "Does the pain radiate from your back into your legs?" "Can you describe the sensations you are having?" "Do you ever have any nausea or dizziness?""Can you describe the sensations you are having?"A frantic family member is distressed about the flaccid paralysis of her son following a spinal cord injury several hours ago. What does the nurse know about this condition? It is an ominous indicator of permanent paralysis. It is possibly a temporary condition and will clear. It degenerates into a spastic paralysis. It will progress up the cord to cause seizures.It is possibly a temporary condition and will clear.The nurse is aware that the characteristic gait of the person with Parkinson disease is a propulsive gait, which causes the patient to: stagger and need support of a walker. shuffle with arms flexed. fall over to one wide when walking. take small steps balanced on the toes.shuffle with arms flexed.A patient is in which stage of Alzheimer's disease when she demonstrates "sundowning"? Early stage Second stage Third stage Final stageSecond stageWhy is the patient with suspected Guillain-Barre Syndrome (GBS) hospitalized immediately? The infection needs to be treated with IV antibiotics to prevent paralysis. The brain may swell quickly causing seizures. The disease can rapidly progress into respiratory failure. IV hydration is needed to prevent possible fatal hypotension.The disease can rapidly progress into respiratory failure.The nurse explains that the two divisions of the autonomic nervous system work to maintain homeostasis. Which is the first autonomic event? Parasympathetic nervous system dominates Extremely stressful or frightening event Blood pressure, heart rate, and adrenaline output decrease Sympathetic nervous system dominates Heart rate and blood pressure rise, secretion of adrenalineExtremely stressful or frightening eventWhat are the three signs of Cushing response? (Select all that apply.) Increased pulse rate Increased blood pressure Widened pulse pressure Bradycardia Increased systolic blood pressure Uncontrolled thermoregulationWidened pulse pressure Bradycardia Increased systolic blood pressureWhen should family members of a stroke victim expect to see some of the neurologic involvement disappear? Within 2 to 3 weeks Within 1 to 2 months Within 3 to 6 months Within 6 to 9 monthsWithin 3 to 6 monthsWhat is the most common cause of dementia? Multi infarct Medications Alzheimer's disease Parkinson diseaseAlzheimer's diseaseWhich symptom of diabetes distorts tactile sensation? Proprioception Loss of visual acuity Progressive paresis Peripheral neuropathyPeripheral neuropathyWhat is one positive aspect of Parkinson disease? The disease does not alter ability to communicate. Anti-Parkinson drugs have few side effects. Intellectual function is not impaired. Involuntary movements can be controlled.Intellectual function is not impaired.What is the mental health nurse referring to when using the term behavior? An isolated incident The manner in which a person performs A product of a coping strategy Failure to adaptThe manner in which a person performsHow many people in the United States will develop a mental disorder during their lifetime? One in two One in five One in eight One in tenOne in twoDuring the 17th and 18th centuries, care of patients with mental illness often was cruel. What type of care was used by Dr. Philippe Pinel to bring about change? Personal care Individual care Behavior care Humane careHumane careWhich theorist believed that personality development was based on task mastery? Sigmund Freud Erik Erikson Jean Piaget Friedrich NietzscheErik EriksonWhat does any event that requires change stimulate? a. Anger b. Depression c. Stress d. AnxietystressWhat action by a student before taking a test should indicate to a nursing instructor that the student is demonstrating signs of moderate anxiety? Studies for 6 hours Sleeps 6 hours because of fatigue Vomits Argues about the scheduling of the testVomitsA 40-year-old patient cries and has a tantrum when the health care provider refuses to give her a prescription for diet pills. The nurse realizes that this is the use of which defense mechanism? a. Compensation b. Denial c. Regression d. Repressionc. RegressionWhen assisting the older adult who is despondent about the need to leave his home, what technique should the nurse use? Ask him if he has a drinking problem. Explore the option of his moving in with someone. Reminisce with the patient and review his life. Assess for hopelessness and helplessness.Reminisce with the patient and review his life.Why is it important for the nurse to be observant of patient behavior? Behavior is preformed. Behavior is important. Behavior is learned. Behavior is repeated.Behavior is learned.During the final weeks of pregnancy, urinary frequency may return due to the enlarged uterus, compressing the bladder against the pelvic bones. What does the nurse suggest to aid in relieving the urinary frequency? Decrease fluid intake. Use the knee-chest position. Sleep on her side. Avoid fluid intake in evening.Sleep on her side.When can the sex of the fetus be confirmed? Conception 2 weeks 6 weeks 9 weeks9 weeksWhat do the arteries in the umbilical cord carry? Nutrients to the fetus from the placenta Oxygenated blood to perfuse the placenta Antibodies from the fetus to the mother Deoxygenated blood back to the placentaDeoxygenated blood back to the placentaWhat does the increase in circulating blood volume during pregnancy cause in the mother? Shortness of breath Frontal headaches Decreased white blood cell count Decreased hemoglobinDecreased hemoglobinAt what week of fetal development can the nurse expect to first hear fetal heart tones with an amplified stethoscope? a. 10 b. 12 c. 14 d. 1616What area of the uterus provides the force during a contraction? a. Lower portion b. Middle portion c. Upper portion d. Cervical portionc. Upper portionWhat is the largest diameter of the fetal skull? a. Temporal b. Biparietal c. Lateral d. Frontal-occipitalb. BiparietalWhat is the ideal attitude for the fetal body during labor? a. Extension b. Lateral c. Flexion d. Transversec. FlexionDuring the second stage of labor, how often should the nurse should monitor the fetal heart rate? Every 5 minutes Every 15 minutes Every 30 minutes Every hourEvery 5 minutesWhen observing the fetal heart monitor, the nurse recognizes the fetal heart rate (FHR) decreases to 120 beats/min at the beginning of a contraction and returns to a baseline of 155 beats/min at the end of the contraction. What should this indicate to the nurse? Early deceleration due to head compression That the fetus is in acute distress Variable decelerations due to cord compression That these are late decelerationsEarly deceleration due to head compressionA woman is admitted in active labor, and the nurse assesses the fetal heart rate (FHR) at 124 beats/min. What action should the nurse take based on the assessment? Position patient on her left side. Start oxygen per nasal cannula. Reassure the mother the rate is normal. Notify the health care provider at once.Reassure the mother the rate is normal.A patient arrives at the hospital having contractions. How should the nurse determine that the patient is in true labor? There is no dilation. The contractions are in the fundus. The cervix has softened and effaced. The contractions are irregular.The cervix has softened and effaced.The nurse is alarmed as she assesses a protruding umbilical cord from the vagina. What immediate action should the nurse take? Monitor intensity of contractions. Place the patient in the knee-chest position. Notify the charge nurse. Ask the patient to perform a Valsalva's maneuver.Place the patient in the knee-chest position.A mother is in early labor and asks the nurse how long the labor will last. The nurse explains that the first stage of labor lasts from the beginning of regular contractions until when? The cervix is completely effaced. The baby is in position. The cervix is fully dilated. The woman begins pushing.The cervix is fully dilated.A primigravida patient is admitted to the labor and delivery unit. During initial assessment, the baby is found to be engaged. Which statement is true? The narrowest diameter of the presenting part has reached the pelvic outlet. The descending part is being initiated through the midpelvis. The widest diameter of the presenting part crosses the pelvic inlet. The narrowest diameter of the presenting part is at the ischial spines.The widest diameter of the presenting part crosses the pelvic inlet.Why is oxytocin administered in the third stage of labor? To stimulate lactation To relieve postpartum pain To stimulate uterine contractions To sedate the mother so she can restTo stimulate uterine contractionsAn infant presents 5 minutes after delivery with a heart rate of 105, is crying, has some flexion in the arms, sneezes, and has a pink body and blue limbs. What Apgar score should be assigned to this infant? a. 5 b. 7 c. 8 d. 108When the nurse performs the Nitrazine test on vaginal secretions of a patient who thinks her membranes have ruptured, the paper turns yellow. What does this finding indicate? Acidic discharge, membranes intact Acidic discharge, membranes have ruptured Neutral, not enough discharge to measure Alkaline, membranes have rupturedAcidic discharge, membranes intactThe postpartum mother with a third degree laceration tells the nurse she is afraid to have a bowel movement because of her painful episiotomy. What should the nurse do? Offer a suppository or enema. Encourage ambulation. Offer stool softeners as prescribed. Offer pain medication before defecating.Offer stool softeners as prescribed.The nurse identifies that the newborn is jaundiced within the first 24 hours of birth, with jaundice occurring over bony prominences of the face and the mucous membrane. What type of jaundice does this represent? a. Physiologic b. Normal c. Pathologic d. Transitoryc. PathologicWhich tests are performed to detect inborn errors of metabolism in the newborn? Blood glucose Phenylketonuria (PKU) Blood urea nitrogen (BUN) Prothrombin time (PT)Phenylketonuria (PKU)What should be included when discussing the care of a circumcised infant after discharge from the hospital? Gently remove the yellow exudate from the foreskin. Apply sterile petroleum gauze after each diaper change. Wipe the circumcision with alcohol each day. Avoid the use of cloth diapers until the foreskin has healed.Apply sterile petroleum gauze after each diaper change.Which finding should the nurse suspect as abnormal in the newborn during the initial assessment? Eyes crossed at times Persistent high-pitched cry Arms and legs flexed Slight bluish tinge of the extremitiesPersistent high-pitched cryA patient is admitted to the hospital with hyperemesis gravidarum. The patient is malnourished and severely dehydrated. The care plan should be altered to include which interventions? Hyperalimentation IV fluids and electrolyte replacement Hormone replacement therapy Vitamin supplementsIV fluids and electrolyte replacementWhat complication of delivery should the nurse expect with the birth of multiple fetuses? An ectopic tendency Difficulty with breast-feeding A vaginal delivery Loss of uterine toneLoss of uterine toneWhat percent of first-trimester pregnancies spontaneously abort? 5% to 10% 10% to15% 20% to 25% 40% to 50%10% to15%A patient in her second trimester of pregnancy arrives at the hospital complaining of bright red, painless vaginal bleeding. What condition should the nurse immediately suspect? Abruptio placentae Hemorrhage Placenta previa PlacentitisPlacenta previaA pregnant woman visits a clinic visit during her 21st week of pregnancy. The nurse identifies edema, hypertension, and proteinuria. What condition does the nurse suspect? Allergy Protein deficiency Circulatory problem Gestational hypertensionGestational hypertensionA pregnant patient who has type 2 diabetes (NIDDM) may require insulin. Why is the insulin necessary? The growing baby will require more glucose. Oral hypoglycemic agents may be teratogenic. Increased hormone levels raise blood glucose. Oral hypoglycemics do not reach the fetus.Oral hypoglycemic agents may be teratogenic.A 14-year-old pregnant adolescent arrives at the hospital in early labor. The nurse should recognize that the adolescent is at a greater risk for which problem? Calcium deficit Cephalopelvic disproportion Bleeding tendency Low hemoglobin levelsCephalopelvic disproportionWhat is the single most preventable cause of death and disease in the United States today? Drug use Alcohol addiction Cigarette smoking MalnutritionCigarette smokingApproximately half of all new HIV cases are among people under what age? 50 years 40 years 30 years 25 years25 yearsA major dental problem among very young children is bottle mouth caries. What is a preventive measure the nurse should suggest? Juice at bedtime Milk at bedtime A sugar-coated pacifier Water at bedtimeWater at bedtimeWhat is the third leading cause of accidental death in children 1 to 4 years of age? a. Falls b. Asphyxiation c. Poisonsd. d. Burnsd. burnsThe nurse sets up a sample physical activities schedule to fit the FDA's Dietary Guidelines for Americans that recommends that children get at least how many minutes of physical activity per day? a. 15 b. 30 c. 45 d. 60d. 60The nurse explains to the parents of a child with developmental hip dysplasia that the application of a Pavlik harness is necessary. In what position will the harness hold the child's femur? A. Adduction B. Flexion C. Abduction D. ExtensionC. AbductionWhen selecting patient problems for the 4-year-old child with nephrosis, what should be a priority for the nurse? A. Nutritional deficit B. Skin impairment C. Injury D. Impaired body imageB. Skin impairmentThe parents of a child who has been diagnosed with sickle cell anemia ask why their child experiences pain. What is the most likely cause of the pain? A. Overhydration B. Obstructed blood flow C. Inflammation of the vessels D. Stress-related headachesB. Obstructed blood flowWhat is the most common clinical manifestation of coarctation of the aorta? A. Loud systolic ejection murmur B. Pedal edema and portal congestion C. Upper extremity hypertension D. Clubbing of the digitsC. Upper extremity hypertensionWhat is the best time to administer pancreatic enzyme replacement? Before meals and snacks Before bedtime Early in the morning After meals and snacksBefore meals and snacksWhich is a causative factor of Hirschsprung disease? Frequent evacuation of solids, liquid, and gases Excessive peristaltic movement The absence of parasympathetic ganglion cells in a portion of the colon One portion of the bowel telescoping into anotherThe absence of parasympathetic ganglion cells in a portion of the colonWhen caring for a 7-week-old infant with hypothyroidism, the nurse explains that the prevention of what complication is dependent on the administration of oral thyroid replacement therapy and is critical for the child? Excessive growth Cognitive impairment Damage to the nervous system Damage to the urinary systemCognitive impairmentA child with Duchenne muscular dystrophy rises from the floor by walking up the thighs with the hands. How should the nurse record this observation? Hand assistance Leg crawling Gowers sign Bright signGowers signWhich signs/symptoms would be considered classical signs of meningeal irritation? Positive Kernig sign, diarrhea, and headache Negative Brudzinski sign, positive Kernig sign, and irritability Positive Brudzinski sign, positive Kernig sign, and photophobia Negative Kernig sign, vomiting, and feverPositive Brudzinski sign, positive Kernig sign, and photophobiaWhat are priority nursing interventions designed to do for a 4-year-old child with cerebral palsy? Assist with referral to specialized education. Support the child with independent toileting. Assist the child to develop effective communication. Encourage the child to ambulate independently.Encourage the child to ambulate independently.When speaking to young parents, the nurse states that lead poisoning is one of the most common preventable health problems affecting children. What condition occurs when the level of lead ingested exceeds the amount that can be absorbed by the bone? Malnutrition Anemia Bone pain DiarrheaAnemiaWhat are early signs of varicella disease? High fever over 101°F (38.3°C) General malaise Increased appetite Crusty soresGeneral malaiseThe nurse explains that cognitive impairment is categorized by four levels that depend on the intelligence quotient (IQ). How is a child with an IQ of 45 classified? Within the normal low range Educable Trainable SevereTrainableWhat is the most common method of attempted suicide? Hanging Drug overdose Gunshot Slashing the wristsDrug overdoseA woman who is 38 weeks' pregnant tells the nurse that the baby has dropped and she is having urinary frequency again. What do these symptoms describe? Lightening Braxton-Hicks contractions Initiation of labor EngagementLighteningWhat method is used to visualize soft tissue and to determine adequacy of the pelvis with no detrimental effects to the fetus? a. Pelvimetry b. Palpation c. Ultrasonography d. X-rayc. UltrasonographyThe first-time mother has been told by the nurse that the first stage of labor is the longest. What would be an appropriate nursing intervention for comfort during this time? Cool fluids to drink A backrub in the sacral area Assisting to lie in a supine position Decreasing illumination in the roomA backrub in the sacral areaThe health care provider has decided to induce labor with prostaglandin gel and an amniotomy. When should the nurse expect that labor will start? 1 hour 4 hours 8 hours 12 hours1 hourA mother has entered the second stage of labor. When does the second stage of labor end? a. When the mother begins to push b. When the baby's head crowns c. With delivery of the baby d. With delivery of the placentac. With delivery of the babyWhich assessment findings suggest probable fetal distress? (Select all that apply.) Fetal heart rate (FHR) of 120 Meconium-stained amniotic fluid Decreased FHR during contractions Strong contractions 10 seconds apart Slow return of FHR to baselineMeconium-stained amniotic fluid Slow return of FHR to baselineThe new mother calls the nurse to her room to show how her baby is jerking around when she changes his position. The nurse understands that the baby is exhibiting which normal reflex? Traction reflex Babinski reflex Tonic neck reflex Moro reflexMoro reflexFollowing delivery of the newborn, which nursing intervention should be carried out immediately? Weigh the infant. Warm the infant. Bathe the infant. Inoculate the infant.Warm the infant.What is the term for the cream cheese like substance that protects the infants skin from amniotic fluid? a. Lanugo b. Meconium c. Desquamation d. Vernix caseosad. Vernix caseosaWhich newborn assessment finding can suggest a chromosomal disorder? Epstein pearls Gynecomastia Babinski reflex Simian creaseSimian creaseWhy is vitamin K given by injection to the newborn? Most mothers have a vitamin K deficiency that develops during pregnancy. Bacteria that synthesize vitamin K are not present in newborns. Vitamin K prevents the synthesis of prothrombin. The newborn does not store vitamin K.Bacteria that synthesize vitamin K are not present in newborns.What is a characteristic of a normal breast-fed infants stool? Green and loose Dark green and sticky Pale yellow and frequent Light brown and pastyPale yellow and frequentThe nurse is giving a bath demonstration for a group of new mothers. What should be included in the demonstration? Apply baby powder generously to keep baby dry. Cleanse perineum from front to back. Use scented soap to make baby smell good. Partially submerge head in water when shampooing.Cleanse perineum from front to back.The newborn infant has oxygenation problems and a lack of subcutaneous fat. What should the nurse determine as the gestational age of this infant? 20 to 37 completed weeks of pregnancy 38 to 41 completed weeks of pregnancy 14 to 36 completed weeks of pregnancy 42 or more completed weeks of pregnancy20 to 37 completed weeks of pregnancyA neonate is born with weak muscle tone, froglike extremities, and ears that fold easily. From these observations, what gestational age should the nurse give this infant? Full term Small for gestational age Preterm PosttermPretermThe nurse is assessing the newborn and discovers a yellowing of the skin. What is true for jaundice that appears at birth? Within normal limits Pathologic A result of iron deficiency Indicating possible hepatitisPathologicCognitive impairment, facial abnormalities, and growth retardation are characteristics of which abnormality in a fetus? Fetal dependency Fetal immaturity Malnutrition dependency Fetal alcohol syndromeFetal alcohol syndromeWhat should be specifically monitored in a patient who is hospitalized with gestational hypertension? Blood sugar Temperature Level of consciousness Deep tendon reflexesDeep tendon reflexesWhat is the usual treatment for severe postpartum depression? Improved nutrition Vitamin therapy Pharmacologic interventions Support group therapyPharmacologic interventionsWhen should the gestational age of the infant be determined? Within 5 to 10 minutes of delivery Within 1 to 2 hours of delivery Within 2 to 8 hours of delivery Within 12 to 24 hours of deliveryWithin 2 to 8 hours of deliveryWhat condition is a possible cause of gestational hypertension? Too much salt A toxin Renal disease Diabetes