Nclex-Rn Practice Questions-Care Of The Psychiatric Client - Dissociative Disorders Part 2
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Question 1 |
A client with depersonalization disorder tells the nurse, “I feel like such a freak when I have an out-of-body experience.” What is the most appropriate response by the nurse?
A | “How often do you have these feelings?” |
B | “I don’t understand what you mean by a freak.” |
C | “Tell me more about these out-of-body experiences.” |
D | “How does your husband feel about you having these experiences?” |
Question 2 |
A client with dissociative identity disorder experiences frequent periods of memory loss. What is the most appropriate nursing intervention for this client?
A | Orienting the client to time, place, person, and situation |
B | Explaining to the client the circumstances surrounding the memory loss |
C | Assessing for cues that the client is ready to discuss the memory loss |
D | Telling the client not to worry because the memory loss has no physiological base |
Question 3 |
After taking a potentially lethal drug overdose, a client tells the nurse that his alter “did it.” Which nursing diagnosis takes highest priority?
A | Posttrauma syndrome |
B | Anxiety |
C | Risk for self-directed violence |
D | Disturbed personal identity |
Question 4 |
A client with a dissociative identity disorder experiences amnesia. Which nursing diagnosis is most appropriate?
A | Powerlessness |
B | Ineffective coping |
C | Disturbed sensory perception, visual |
D | Risk for self-directed violence |
Question 5 |
The nurse has just completed an assessment of a client. Which assessment findings place the client at the highest risk of suicide?
A | Suicide plan, handy means of carrying out plan, and history of previous attempt |
B | Preoccupation with morbid thoughts and limited support system |
C | Suicidal ideation, active suicide planning, and family history of suicide |
D | Threats of suicide, recent job loss, and intact support system |
Question 6 |
A nurse conducts an admission assessment on a client diagnosed with dissociative identity disorder. Which sign or symptom supports this diagnosis?
A | A sense of being in a dream |
B | Inability to remember a particular event |
C | Having two or more personalities |
D | Ritualistic behavior |
Question 7 |
A client experiencing a dissociative disorder suddenly wanders away from the facility. When the nurse finds him, he can’t recall what happened. The nurse interprets this behavior as which of the following?
A | Repression |
B | Depersonalization |
C | Derealization |
D | Dissociative fugue |
Question 8 |
A client diagnosed with depersonalization disorder tells the nurse, “I feel like my arm isn’t attached to my body.” What is the most appropriate response by the nurse?
A | “Do you know where you are?” |
B | “What makes you feel that way?” |
C | “Don’t worry because I can see your arm is attached to your body.” |
D | “This disorder causes people to feel that body parts may be unattached to the rest of the body.” |
Question 9 |
The nurse is assessing a client diagnosed with dissociative disorder. Which of the following characteristics would the nurse most likely observe?
A | A group of disorders with the common symptom of hallucinations |
B | A group of disorders with a rapid disruption of the client’s memory |
C | A group of disorders with impairment of memory or identity due to the development of organic changes in the brain |
D | A group of disorders with impairment of memory or identity due to an unconscious attempt to protect the person from emotional pain or traumatic experiences |
Question 10 |
A client tells the nurse that he frequently feels that he’s floating above his body. During these times, he says he’s aware of who he is and where he’s located. The nurse determines that this client is experiencing:
A | depersonalization disorder. |
B | dissociative amnesia. |
C | dissociative identity disorder. |
D | dissociative fugue. |
Question 11 |
A client with depersonalization disorder spends much of his day in a dreamlike state during which he ignores personal care needs. Which nursing diagnosis is most appropriate for this client?
A | Disturbed personal identity related to organic brain damage |
B | Impaired memory related to frequently being in a dreamlike state |
C | Dressing self-care deficit related to perceptual impairment |
D | Deficient knowledge related to performance or personal care needs due to lack of information |
Question 12 |
A client with depersonalization disorder verbalizes understanding of the ways to decrease his symptoms when he makes which statement?
A | “I’ll avoid any stressful situation.” |
B | “Meditation will help control my symptoms.” |
C | “I’ll need to practice relaxation exercises regularly.” |
D | “I may need to remain on antipsychotic medication for the rest of my life.” |
Question 13 |
The nurse is performing an assessment on a client diagnosed with depersonalization disorder. The nurse anticipates the client will display which of the following?
A | Disorientation to time, place, and person |
B | Sensation of detachment from body or mind |
C | Unexpected and sudden travel to another location |
D | A feeling that one’s environment will never change |
Question 14 |
What is the most important intervention to implement when caring for a client with a dissociative disorder?
A | Encourage the client to participate in unit activities and meetings. |
B | Question the client about the events triggering the dissociative disorder. |
C | Allow the client to remain in his room anytime he’s experiencing feelings of dissociation. |
D | Encourage the client to form friendships with other clients in his therapy groups to decrease his feelings of isolation. |
Question 15 |
A client experiencing dissociative amnesia says, “You must think I’m really stupid because I have no recollection of the accident.” What is the best response by the nurse?
A | “Why would I think you’re stupid?” |
B | “Have I acted like I think you’re stupid?” |
C | “What kind of grades did you get in school?” |
D | “As a protective measure, the brain sometimes doesn’t let us remember traumatic events.” |
Question 16 |
Amobarbital (Amytal) has been prescribed for a client with dissociative amnesia. The nurse determines that teaching about the medication has been successful when the client makes which statement?
A | “This medication helps me sleep.” |
B | “This medication helps me control my anxiety.” |
C | “I must take this drug once a day after discharge if the drug is to be therapeutically beneficial.” |
D | “I’m given this medication during therapy sessions to increase my ability to remember forgotten events.” |
Question 17 |
A client is admitted for a diagnostic workup for possible dissociative amnesia. What is the most appropriate nursing intervention for this client?
A | Restrain the client if he attempts to wander off the unit. |
B | Question the client every hour about orientation to time, place, and person. |
C | Provide teaching on computed tomography scans and other imaging tests. |
D | Encourage the client not to dwell on the traumatic event that lead to his memory loss. |
Question 18 |
A client with dissociative amnesia shows understanding of the condition when which statement is made?
A | “I’ll probably never be able to regain my memories of the fire.” |
B | “I have problems with my memory due to my abuse of tranquilizers.” |
C | “If I concentrate hard enough, I’ll be able to bring up memories of the car accident.” |
D | “To protect my mental well-being, my brain has temporarily hidden my memories of the rape from me.” |
Question 19 |
The nurse is assessing a client with dissociative amnesia. Which circumstance would most likely contribute to this condition?
A | Binge drinking |
B | A hostage situation |
C | A closed-head injury |
D | A fight with a family member |
Question 20 |
The nurse is teaching the family of a client with depersonalization disorder. The family wants to know which setting has the most success in treating this disorder. What is the best response by the nurse?
A | Inpatient psychiatric hospital |
B | Community mental health clinic |
C | Family practice physician’s office |
D | Support group for clients with depersonalization disorder |
Question 21 |
A client was the driver in an automobile accident in which a 3-year-old boy was killed. The client is diagnosed with dissociative amnesia. He verbalizes understanding of his treatment plan when he makes which statement?
A | “I won’t drive a car again for at least a year.” |
B | “I’ll take my Ativan (lorazepam) anytime I feel upset about this situation.” |
C | “I’ll visit the child’s grave as soon as I’m released from the hospital.” |
D | “I’ll attend my hypnotic therapy sessions prescribed by my psychiatrist.” |
Question 22 |
A nurse finds a client experiencing suicidal ideation. The client attempted to hang themselves. What is the most important intervention for the nurse to implement?
A | Place the client in seclusion with checks every 15 minutes. |
B | Assign a nursing staff member to remain with the client at all times. |
C | Make the client stay with the group at all times. |
D | Refuse to let the client in his room. |
Question 23 |
A 32-year-old client tells the nurse his home was lost in a flood last month. When questioned about his feelings about the loss, he doesn’t remember being in a flood or owning a home. What is the client most likely exhibiting?
A | Depersonalization disorder |
B | Dissociative amnesia |
C | Dissociative fugue |
D | Dissociative identity disorder |
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