Psych quiz Name: Score:

1. Situation: Knowledge and skills in the care of violent clients is vital in the psychiatric unit. A nurse observes that a client with a potential for violence is agitated, pacing up and down the hallway and making aggressive remarks. Which of the following statements is most appropriate to make to this patient? a. What is causing you to become agitated? b. You need to stop that behavior now. c. You will need to be restrained if you do not change your behavior. d. You will need to be placed in seclusion. 2. The nurse closely observes the client who has been displaying aggressive behavior. The nurse observes that the clients anger is escalating. Which approach is least helpful for the client at this time? a. Acknowledge the clients behavior b. Maintain a safe distance from the client c. Assist the client to an area that is quiet d. Initiate confinement measures 3. The charge nurse of a psychiatric unit is planning the client assignment for the day. The most appropriate staff to be assigned to a client with a potential for violence is which of the following: a. A timid nurse b. A mature experienced nurse c. an inexperienced nurse d. a soft spoken nurse 4. The nurse exemplifies awareness of the rights of a client whose anger is escalating by: a. Taking a directive role in verbalizing feelings b. Using an authoritarian, confrontational approach c. Putting the client in a seclusion room d. Applying mechanical restraints 5. The client jumps up and throws a chair out of the window. He was restrained after his behavior can no longer be controlled by the staff. Which of these

documentations indicates the safeguarding of the patients rights? a. There was a doctors order for restraints/seclusion b. The patients rights were explained to him. c. The staff observed confidentiality d. The staff carried out less restrictive measures but were unsuccessful. 6. Situation: Clients with personality disorders have difficulties in their social and occupational functions. Clients with personality disorder will most likely: a. recover with therapeutic intervention b. respond to antianxiety medication c. manifest enduring patterns of inflexible behaviors d. Seek treatment willingly from some personally distressing symptoms 7. A client tends to be insensitive to others, engages in abusive behaviors and does not have a sense of remorse. Which personality disorder is he likely to have? a. Narcissistic b. Paranoid c. Histrionic d. Antisocial 8. The client joins a support group and frequently preaches against abuse, is demonstrating the use of: a. denial b. reaction formation c. rationalization d. projection 9. A teenage girl is diagnosed to have borderline personality disorder. Which manifestations support the diagnosis? a. Lack of self esteem, strong dependency needs and impulsive behavior b. social withdrawal, inadequacy, sensitivity to rejection and criticism c. Suspicious, hypervigilance and coldness d. Preoccupation with perfectionism, orderliness and need for control

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Answer: (A) What is causing you to become agitated? In a non-violent aggressive behavior, help the client identify the stressor or the true object of hostility. This helps reveal unresolved issues so that they may be confronted. B. Pacing is a tension relieving measure for an agitated client. C. This is a threatening statement that can heighten the clients tension. D. Seclusion is used when less restrictive measures have failed. Answer: (D) Initiate confinement measures The proper procedure for dealing with harmful behavior is to first try to calm patient verbally. . When verbal and psychopharmacologic interventions are not adequate to handle the aggressiveness, seclusion or restraints may be applicable. A, B and C are appropriate approaches during the escalation phase of aggression.

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3.

Answer: (B) A mature experienced nurse The unstable, aggressive client should be assigned to the most experienced nurse. A, C and D. A shy, inexperienced, soft spoken nurse may feel intimidated by the angry patient.

4.

Answer: (A) Taking a directive role in verbalizing feelings Taking a directive role in the clients verbalization of feelings can deescalate the clients anger. B. A confrontational approach can be threatening and adds to the clients tension. C and D. Use of restraints and isolation may be required if less restrictive interventions are unsuccessful.

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Answer: (D) The staff carried out less restrictive measures but were unsuccessful. This documentation indicates that the client has been placed on restraints after the least restrictive measures failed in containing the clients violent behavior.

6.

Answer: (C) manifest enduring patterns of inflexible behaviors Personality disorders are characterized by inflexible traits and characteristics that are lifelong. A and D. This disorder is manifested by life-long patterns of behavior. The client with this disorder will not likely present himself for treatment unless something has gone wrong in his life so he may not recover from therapeutic intervention. B. Medications are generally not recommended for personality disorders.

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Answer: (D) Antisocial These are the characteristics of an individual with antisocial personality. A. Narcissistic personality disorder is characterized by grandiosity and a need for constant admiration from others. B. Individuals with paranoid personality demonstrate a pattern of distrust and suspiciousness and interprets others motives as threatening. C. Individuals with histrionic have excessive emotionality, and attention-seeking behaviors.

8.

Answer: (B) reaction formation Reaction formation is the adoption of behavior or feelings that are exactly opposite of ones true emotions. A. Denial is refusal to accept a painful reality. C. Rationalization is attempting to justify ones behavior by presenting reasons that sounds logical. D. Projection is attributing of ones behaviors and feelings to another person.

9.

Answer: (A) Lack of self esteem, strong dependency needs and impulsive behavior These are the characteristics of client with borderline personality. B. This describes the avoidant personality. C. These are the characteristics of a client with paranoid personality D. This describes the obsessive compulsive personality