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Anxiety Disorder

1. Appropriate discharge criteria for a patient with chronic anxiety disorder are that the patient will: A. Experience no more anxiety. B. Suppress anxiety symptoms and focus on the future. C. Identify situations and events that trigger anxiety. D. Recognize the need to take medications for life to control anxiety. 2. The nurse must plan health teaching for a patient with generalized anxiety disorder who is taking lorazepam (Ativan). Which topic should be included? A. Tyramine-free diet. B. Caffeine restriction. C. Skin care to prevent breakdown. D. Dietary restriction of tryprophan. 3. Which statement made by a patient who washes his or her hands compulsively identifies the thinking typical of a patient with obsessive-compulsive disorder? A. "I know I'll get my hands clean eventually; it just takes time." B. "I need a milder soap that won't damage my hands so much." C. "I feel so much better when my hands are clean. I can get on to do other things." D. "I feel driven to wash my hands, although I don't like it." 4. A patient was admitted with a diagnosis of agoraphobia with panic attacks. Which of the following symptoms would the nurse expect the patient to experience during a panic attack? A. Paresthesias. B. Constipation. C. Feigned fears. D. Hypotension. 5. A patient has a history of pain related to at least four different sites that cannot be explained by a known general medical condition. The nurse analyzes this as most closely related to the medical diagnosis of: A. Somatoform disorder. B. Pain syndrome. C. Generalized anxiety disorder. D. Obsessive-compulsive disorder. 6. When the nurse has diagnosed a patient as experiencing panic-level anxiety, an intervention that should be implemented immediately is to: A. Teach relaxation techniques. B. Place the patient in four-point restraint. C. Reduce stimuli. D. Gather a show of force. 7. A patient was driving an auto along a deserted country road when a moderate earthquake caused the bridge she was passing over to collapse, which inadvertently caused her to be

trapped in her car for several hours. A year later she still has nightmares about the event, and reexperiences the feeling of fear feelings of fear and isolation associated with being trapped in the car in swirling water up to her neck, she avoids driving over bridges, she indicates that her relationships have not been "normal" since the event because she is so tense, the data collected are consistent with the symptoms of: A. Agoraphobia. B. Panic attacks. C. Generalized anxiety disorder. D. Posttraumatic stress disorder. 8. Which piece of subjective data obtained during the nurse's psychiatric assessment of a patient experiencing severe anxiety would indicate the possibility of posttraumatic stress disorder? A. "I keep washing my hands over and over." B. "My legs feel weak most of the time." C. "I'm afraid to go out in public." D. "I keep reliving the rape." 9. Which nursing diagnosis would be most useful for patients with anxiety disorders when the following defining characteristics have been identified: avoidance, poor concentration, nightmares, hypervigilance, exaggerated startle response, detachment, numbing, and flashbacks? A. Anxiety. B. Powerlessness. C. Disturbed sensory perception. D. Post-trauma syndrome. 10. Which of the following is a criterion for evaluation of the anxiety level in patients with an anxiety disorder? A. Ability to be assertive. B. Ability to determine appropriateness of own behavior. C. Attention span and concentration. D. Sleep pattern. 11. The patient tells the nurse feels as though something terrible is going to happen to him and displays symptoms of increased vital signs, dilated pupils, urinary frequency, rigid muscled, and decreased hearing. The nurse would assess these findings as being indicative of anxiety at the level of: A. Mild. B. Moderate. C. Severe. D. Panic. 12. For planning purposes, the nurse caring for a patient with obsessive-compulsive disorder should know that an effective treatment for obsessive-compulsive disorder is: A. Analysis. B. Group therapy.

C. Flooding. D. Clomipramine.

Cognitive Disorders
1. Which of the following interventions should the nurse incorporate in the care plan of a patient with dementia to support short-term memory? A. Daily activity schedule B. Activities using large muscles C. Simple word games D. A discussion group 2. A 45-year-old male has been admitted with a diagnosis of delirium of unknown etiology. The nurse would expect to assess: A. fluctuating level of consciousness. B. gait abnormalities. C. apathetic affect. D. negative thought content. 3. A patient with dementia is unable to name ordinary objects. Instead, he describes the function, for example, "the thing you cut meat with." The nurse should assess this as: A. Apraxia B. Agnosia C. Aphasia D. Amnesia 4. Which of the following descriptions of patient experience and behavior can be assessed as an illusion? A patient A. states, "I keep hearing a man's voice telling me to run away." B. looks at the shadows on the wall and tells the nurse she sees frightening faces on the wall C. becomes anxiou whenever the nurse leaves her bedside D. tries to hit the nurse when vital signs are being taken 5. Which of the following would the nurse assess as an example of cognitive impairment? A. Crying when the occasion calls for laughter B. Inability to name a familiar object C. Incontinence D. Agitation 6. An action the nurse can advise a family to take in the home setting to enhance safety for the family member with Alzheimer's disease is A. placing throw rugs on tile or wooden floors. B. instructing patient on cooking safety. C. allowing patient to smoke unattended. D. having patient wear an identification bracelet with name, address, and telephone number

7. With respect to evaluation of outcomes and goals for the patient with Alzheimer's disease, the nurse should be aware of the need for A. changing expectations for the patient as patient abilities deteriorate. B. identifying stressors that impact negatively on the patient. C. simplifying the environment to reduce sensory perceptual alterations. D. changing interventions when goals are unmet. 8. Which of the following is an appropriate nursing intervention for a patient with dementia who develops a catastrophic reaction? A. Employ negative responses to the behavior. B. Use touch to communicate. C. Eliminate or reduce environmental stimulation. D. Maintain close personal boundaries. 9. The husband of a patient with moderately advanced Alzheimer's disease tells the nurse his wife becomes greatly distressed several times a week as she tells him she sees strangers walking around in the house. She thinks these strangers are taking her things. The nurse should advise the husband to: A. try to talk his wife out of these ideas by using logic. B. try diverting her by suggesting an activity. C. search the house with her and show her that no strangers are there. D. put locks on doors and windows to increase her sense of security. 10. An objective sign that frequently accompanies the subjective symptoms of delirium is: A. reduced awareness. B. disorganized thinking. C. psychomotor retardation. D. disturbed sleep-wake cycle 11. Which of the following nursing techniques are appropriate for successful interaction with a patient who has been diagnosed with Alzheimer's disease A. Giving all directions at one time to increase understanding B. Correcting errors made by the patient by speaking to him in a loud, clear voice C. Encouraging communication and maintaining a calm demeanor D. Setting strict time limits and repeatedly rephrasing misunderstood questions 12. The nurse notes that an elderly patient has fluctuating levels of awareness. She seems anxious. She tells the nurse she saw her granddaughter standing at the foot of the bed during the night. Later the nurse sees her moving her hands as though picking things out of the air. The nurse should suspect: A. delirium. B. dementia. C. bipolar disorder. D. Schizophrenia

13. When the nurse gives anticipatory guidance to the family of a patient with early Alzheimer's disease, which behavioral problem common to that stage of the disease should be mentioned? A. Violent outbursts B. Emotional disinhibition C. Inability to carry on an in-depth conversation D. Inability to eat and drink enough to meet body requirements

Eating Disorders
1. An early step for the nurse to take in developing the nurse-patient relationship with a patient with anorexia nervosa is: A. Recommending a therapeutic group. B. Formulating a nurse-patient contract. C. Intense confrontation to attack denial. D. Excluding the family from treatment. 2. The priority nursing diagnosis that should be completed for a patient who restrict food and is 15% underweight is: A. Risk for injury. B. Disturbed though processes. C. Ineffective coping. D. Imbalanced nutrition: less than body requirements. 3. Which of these finding would the nurse attribute to purging? A. Excessive facial hair. B. Elevated blood pressure. C. Polyuria. D. Dental enamel erosion. 4. Which of theses measures should be initiated first for a new patient with anorexia nervosa who displays malnutrition, extreme weight loss, weakness, and fatigue? A. Determining electrolyte levels. B. Placing on suicide precautions. C. Providing a nutrition meal. D. Placing on bed rest with bathroom privileges. 5. A patient with anorexia nervosa engages in manipulative behavior. She tell the nurse, "I can't get weighed this morning because I drank a glass of juice a few minutes before breakfast." The best approach by the nurse would be: A. "I'm pleased that you took in some calories." B. "We can get around this, if you'll eat a doughnut, too." C. "The rule is 'weight before eating;' now we have to put it off until tomorrow." D. "This is record weight day. Please step on the scale."

6. The nurse, who works with patients who have eating disorders, is involved in teaching patients and family members about the disorder, including its symptoms and management. What is the rationale for including family in this teaching? A. Eating disorders are usually caused by dysfunctional family interaction. B. Knowledge promoted power and reduces fear and anxiety. C. Family members need to learn to monitor the eating pattern of the identified patient. D. Having an understanding of the disorder will prevent other family members from developing a similar problem. 7. An early step for the nurse to take in developing the nurse-patient relationship with a patient with anorexia nervosa is: A. Recommending a therapeutic group. B. Formulating a nurse-patient contract. C. Intense confrontation to attack denial. D. Excluding the family from treatment. 8. Which of these personality traits would the nurse evaluate as being common among individuals with eating disorders? A. Excellent coping skills. B. Security in social relationships. C. Noncompliance. D. Interoceptive deficits. 9. When a patient with an eating disorder asks to be excused from the meal to use the restroom, the best response by the nurse would be: A. "Only if you eat your pork chop first." B. "Yes, we can go to the bathroom together." C. "No one leaves the table during meals." D. "No, I know you want to vomit and that's not permitted." 10. Nursing assessment of bulimic patient often reveals A. Clubbing of the fingers. B. Hoarseness. C. Amenorrhea. D. Thin, brittle hair. 11. The nurse is performing a physical assessment of a patient with bulimia nervosa. What assessment findings would confirm patient use of purging behaviors? A. Sore tongue and buccal lesions. B. Enlarged parotid glands and dental erosions. C. Runny nose and reddened conjunctiva. D. Circumoral pallor and crusted nares.

12. Which performing the assessment of a patient with the binge-purge type of bulimia, the nurse should be particularly alert for signs and symptoms of: A. Hypernatremia. B. Hypokalemia. C. Hypercalcemia. D. Fluid volume excess. 13. When a patient with anorexia nervosa is admitted for treatment, the nurse's priority interventions will be directed toward: A. Teaching assertiveness. B. Sharing information on self-help group. C. Supervision of patient activities. D. Developing a friendship with the patient. 14. During the nurse assessment of a patient that was newly admitted to the eating disorders unit, the nurse asks the patient, "How do you feel about being here today?" The purpose of this question is to: A. Reduce the patient's anxiety level from moderate to mild. B. Encourage the patient to communicate openly with the nurse. C. Determine the patient's willingness to engage in treatment. D. Assess the patient's level of feeling of guilt and shame. 15. What behavior on the part of the nurse caring for a patient with anorexia nervosa would indicate a need for supervision? A. Being consistent and reliable. B. Using an acceptant, nonjudgmental manner. C. Being matter-of-fact and neutral. D. Being flexible about limits for the patient.

Mood Disorder
1. Nursing care of the depressed and the manic patient are similar in that both call for: A. Providing challenging group interactions. B. Limiting stimulation. C. Observation of intake and sleep pattern. D. Suicide and escape precautions. 2. Which of the following is a priority assessment for the patient with major depression? A. Nutritional status. B. Fluid and electrolyte balance. C. Suicidal ideation. D. Mood and affect. 3. A patient who has been diagnosed with seasonal affective disorder asks the nurse, "Will I ever feel better?" The best response, based on understanding of this psychopathology, is: A. "Your low mood will probably spontaneously improve in 6 months to a year."

B. "Usually people who have seasonal mood swings feel better in the spring and summer when there is more light." C. "Unfortunately, the antidepressant medications are not particularly effective in treating this disorder." D. "Most people with this disorder feel better during the fall and winter as the experience the pleasure of the holiday season." 4. To plan effective care for a depressed patient, the nurse must be aware of what relationship between emotional pain and apathy? A. There is no relationship. B. Apathy produces emotional pain. C. Extreme emotional pain causes "shut down," resulting in apathy. D. Emotional pain produces anxiety, which, in turn, produces apathy. 5. To plan care for a patient with severe major depressive disorder, the nurse will make it a priority to: A. Avoid creating a stressful situation by asking for patient participation. B. Assess patient cognition and ability to participate in planning. C. Include teaching about the possibility of developing mania. D. Advise the patient the electroconvulsive therapy (ECT) may be indicated. 6. A patient with bipolar disorder is to be discharged on a maintenance dose of lithium. The nurse plans teaching to foster compliance. Which factor will be of least consequence in developing the teaching plan? A. Lithium side effects are unpleasant. B. The patient enjoys feeling energetic. C. The patient feels well and denies the possibility of relapse. D. Auditory hallucinations tell the patient he/she is being poisoned. 7. What can a nurse do to avoid feelings of frustration when establishing a relationship and working with a severely depressed patient? Expect the patient to: A. Be receptive to the plans for nursing care. B. Be withdrawn and disinterested in a relationship. C. Show signs of improvement after several scheduled dessions. D. Show gratitude for attention. 8. In planning care for a newly admitted patient with depression, the highest priority for the nurse is: A. Orienting the patient to the unit. B. Encouraging expression of feelings. C. Providing a safe environment. D. Meeting the patient at an appropriate affective level. 9. During the interview with a depressed person, it is important for the nurse to assess for impaired social interactions to determine: A. Disruptions in relationships with others.

B. Need for diversional activities therapy. C. Patient ability to make decisions about care. D. Need for patient to participate in a "no-haem" contract with staff. 10. A principle of value when interacting with a patent who is experiencing a manic episode is: A. Use a calm, matter-of-fact approach. B. Avoid mentioning limits. C. Do not interrupt patient. D. Encourage joking. 11. A depressed patient who is receiving a tricyclic antidepressant tells the nurse, "My mood is a little better, but I'm so sleepy all the time that I can't do much of anything." The nurse should: A. Tell the patient that the sleepiness will probably wear off in about 6 weeks. B. Suggest to the physician that the medication be administered in one bedtime dose. C. Withhold the drug until the physician examines the patient. D. Perform a mental status examination on the patient. 12. A patient who lives at home and is on maintenance doses of lithium should be advised to maintain an adequate dietary intake of: A. Protein. B. Calcium. C. Glucose. D. Sodium. 13. A priority nursing intervention for a patient who underwent his first electroconvulsive therapy (ECT) treatment a half hour ago would be: A. Monitoring vital signs. B. Offering oral fluids. C. Encouraging group interaction. D. Evaluating ECT effectiveness. 14. What characteristic usually manifested by an individual during a manic episode can be used positively as a part of nursing intervention? A. Distractibility B. Clang association C. Flight of ideas D. Poor concentration 15. Based on the patient's behavior and ideation, which of the following personality types would the nurse interviewing a patient with major depression be most likely to identify? A. Egocentric B. Eccentric C. Narcissistic D. Dependent

16. Which symptom related to disordered communication is the nurse most likely to assess in a patient who is having a manic episode? A. Mutism B. Flight of ideas C. Loose associations D. Echolalia 17. The side effect of lithium the nurse can expect the patient to demonstrate when the serum lithium level is within the therapeutic range include: A. Extreme thirst and vomiting. B. Polyuria and fine hand tremor. C. Ataxia and orthostatic hypotension. D. Confusion, restlessness, and sleeplessness. 18. A parameter that should be observed when planning activities for a manic patient is: A. Promote group activities. B. Avoid competitive activities. C. Discourage solitary activities. D. Require attendance at the community meetings. 19. a 60-year-old man who cones to the health clinic for his annual flu shot tells the nurse he feels tired all the time, finds little pleasure in things anymore, and has difficulty sleeping. The best nursing intervention would be to: A. Have him remain in the clinic until evaluated by a mental health professional. B. Instruct him in how to manage these typical complaints associated with aging. C. Explore his psychiatric history and futher assess his current mental status. D. Explain that this is not a psychiatric clinic and provide a follow-up referral. 20. Information given to a depressed patient and his or her family when the patient id begun on tricyclic antidepressant therapy should include A. The need to avoid exposure to bright sunlight. B. The fact that mood improvement may take 7 to 28 days. C. Instructions to restrict sodium intake to 1 g daily. D. The need to maintain a tyramine-free diet. 21. The nurse who presents a psycho-education program to patients with bipolar disorder and their families mentions that the sighs of impending relapse include: A. Sleep disturbance and racing thoughts. B. Diarrhea, thirst, and gross tremor. C. Complacency with the status quo and agreeability. D. Sense of pleasure in feeling well, optimistic outlook. 22. What initial nursing intervention is appropriate to take in the immediate postelectroconvulsive therapy (ECT) treatment period? A. Place the patient in the lateral position. B. Repeatedly stimulate the patient to respond.

C. Assist the patient to sit up, then ambulate. D. Begin forcing fluids. 23. A patient with depression is pacing and pulling at her clothing constantly. She wrings her hands and cannot sit for longer than 5 minutes, even at meals. The nurse would document this behavior as: A. Senility. B. Hypomanic activity. C. Psychomotor agitation. D. Catatonic excitement. 24. A depressed patient is admitted following a suicide attempt. She had taken an overdose of sedatives and was found by her husband. Presently she states that she is too tired to consider signing a no-harm contract and that she is angry that her spouse thwarted her attempt. What, if any, level of suicide precautions should the nurse recommend? A. No precautions. B. Routine observation appropriate for all patients. C. Every-15-minute observation by staff. D. One-to-one continuous supervision by staff. 25. A student nurse caring for a depressed patient reads the following in the patient's medical record: "This patient clearly shows the vegetative signs of depression." What can the student expect to observe? A. Suicidal ideation. B. Feelings of hopelessness, helplessness, and worthlessness. C. Constipation, anorexia, and sleep disturbance. D. Anxiety and psychomotor agitation. 26. Seclusion is being considered for a severely hyperactive, aggressive manic patient. Which rational explains the usefulness of this intervention? A. It permits uninterrupted nursing intervention time with other patients. B. It assists in limit setting, enabling the patient to learn to follow unit rules. C. It is an effective way of protecting the patient until medication can take effect. D. It provides reduction of environmental stimuli that impact negatively on the patient.

Personality Disorders
1. Which of the following behaviors would the nurse expect to observe while interacting with a 43-year-old woman diagnosed with narcissistic personality disorder? a. Attention seeking. b. Empathy towards others. c. Lack of trust in others. d. Labile affect.

2. Which of the following would the nurse analyze as indicating improvement in a patient with a diagnosis of high risk for self-mutilation related to feelings of abandonment and impulsivity? a. Patient controls self-destructive impulses when feeling empty or upset. b. Patient vows never to get involved in a close relationship again. c. Patient expresses deep rage at the ending of a relationship. d. Patient suppresses feelings of abandonment. 3. The problem that is most likely to occur when a nurse sets unrealistically high goals for an antisocial patient is: a. The nurse becomes frustrated and angry with the patient when goals are not met. b. The nurse adopts various acting out behaviors used by the patient. c. The patient's acting out behaviors intensify in response to frustration over inability to meet the expectations of others. d. The patient experiences anger and directs inward. 4. When caring for a patient with dependent personality disorder, the behavior the nurse would positively reinforce would be: a. Choosing which outfit to wear. b. Asking another patient for advice. c. Sitting next to the nurse at community meeting. d. Concealing anger with a member of the family. 5. When a patient demonstrates behaviors and verbalizations indicating a lack of guilt feelings, desired outcomes will be facilitated by interventions that: a. Provide external limits on patient behavior. b. Foster discussion of rationales for behavior. c. Encourage interactions with vulnerable patients. d. Require participation in activities therapies. 6. A patient with a personality disorder told the nurse during the interview that he believes that people in general do not like him, and may even wish to harm him. This thinking can be assessed as showing evidence of the use of: a. Projection. b. Conversion. c. Intellectualization. d. Introjection. 7. Which of the following would the nurse expect to observe in a patient diagnosed with schizotypal personality disorder? a. Brief psychotic episodes in response to stress. b. Intense, stormy relationships. c. Incorrect interpretation of external events. d. Lack of tender feelings toward others. The nurse caring for an individual with schizoid personality disorder would expect to assess:

8.

a. b. c. d.

Impulsive, restless, aggressive behavior. Magical thinking and suspicious, odd behavior. Distrustful, cold, often angry behaviors. Few interactions with others and little verbalization.

9. A nursing diagnosis appropriate to consider for a patient with any of the personality disorders is: a. Noncompliance. b. Impaired social interaction. c. Disturbed personal identity. d. Disturbed sensory perception. 10. The nurse working with a patient who has borderline personality disorder must consider in advance strategies for intervening in: a. Grief and social isolation. b. Withdrawal and social avoidance. c. Mood shifts, impulsivity, and manipulation. d. Though disorder, grandiosity, and overreaction. 11. A nurse wishing to assess a patient's interpersonal relationships would obtain most data by asking: a. "How would you describe yourself?" b. "Describe your relationship with friends." c. "Do you have any persistent worries?" d. "Tell me about strange or unusual things that have ever happened to you." 12. The distinguishing characteristic the nurse is likely to assess in a patient with antisocial personality disorder that is absent in most other personality disorders is: a. Exhibiting guilt and remorse. b. Responding well to neuroleptics. c. Disregarding the rights of others. d. Responding to kindly, gentle suggestions. 13. For which of the following behaviors would it be most essential for the nurse to use limit setting? a. Dependence. b. Avoidance. c. Suspicion. d. Manipulation. 14. A patient admitted for psychiatric examination ordered by the court following arrest for embezzlement from his workplace has a history of blaming others for his problems and becoming defensive and angry when criticized. He expresses no remorse for his actions, bur claims his actions were justified because his company did not pay him what he is worth. The nurse would correctly determine that this patient displays symptoms most closely associated with:

a. b. c. d.

Avoidant personality disorder. Schizotypal personality disorder. Antisocial personality disorder. Borderline personality disorder.

15. Which assessment would a nurse be most likely to make when working with a patient with a personality disorder? a. Patient behavior demonstrates similarity to cultural norms for behavior. b. Patient behavior causes little distress to self or others. c. Patient behavior is inflexibly dysfunctional. d. Patient seeks an intense relationship with nurse. 16. When planning limit setting for a manipulative patient, which of the following steps would be omitted? a. Establishing realistic limits. b. Making sure limits are enforceable. c. Making patient aware of limits and consequences of violating limits. d. Allowing staff to use own judgment in event the patient exceeds limits.

Sexual Disorders
1. A patient who is a pedophile tells the nurse that he is feeling a huge amount of guilt and shame over molesting a child. He is concerned about the impact on his family and states that the family would be better off without him. The nurse should: a. Explore feelings in greater depth b. Set limits on patient disclosure c. Consider instituting suicide precautions d. Provide PRN anxiolytic medication 2. Which question would be preferable to ask at or near the beginning of the interview with a patient diagnosed as having sexual dysfunction? a. Is there a family history of sexual dysfunction? b. Were you sexually abused as a child or adolescent? c. What makes you think you have a sexual dysfunction? d. Why did you come for treatment at this time? 3. While a nurse is volunteering at a soup kitchen, she observes a known pedophile leaving the bathroom with a small child while the others are eating. The nurse's responsibility in this situation is: a. As a mandated reporter, the nurse must report the incident to the authorities b. To protect the child without involving self with the perpetrator c. To let the staff of the soup kitchen handle the situation d. To avoid jumping to conclusions by watching and waiting 4. A patient has been diagnosed with gender identity disorder. The characteristic assessment find the nurse would expect is: a. discomfort with biological sex

b. an intense sexual urge focused on an object c. compromised sexual response cycle d. need to humiliate partner during sex 5. A 56-year-old man has been feeling great tension since losing his job. He leaves home one morning, and while sitting in the park feeding birds, impulsively publicly exposes himself to a group of mothers and children. This behavior should be assessed as a. Voyeurism b. Dyspareunia c. Exhibitionism d. Sexual masochism 6. The nurse manager is interviewing nurses to staff a unit that will admit and treat patients experiencing sexual dysfunction. Which qualification would be most important for a nurse working with this specific group to have? a. Previous experience working with individuals with sexual dysfunction b. A keen awareness of personal feelings about sexuality c. The belief that all types of sexual dysfunction can be corrected d. Understanding that the prognosis for most sexual dysfunction disorders is guarded 7. The physician mentions to the nurse that a patient is "an ego-syntonic pedophile." The nurse understands that the statement that best expresses the feelings of an ego-syntonic pedophile is: a. "I know what I do is wrong, but I am comfortable the way I am. b. "Being this way makes me so miserable that I want to get help." c. "If parents supervised their children more closely, molestation would stop." d. "I decided on my own that I needed help. No one sent me here." 8. A patient seen in outpatient therapy described symptoms indicative of scatologia. He acknowledges that he has a problem and asks for help in avoiding a repeat of these behaviors. Which information should be included in the patient's teaching plan? a. Triggers must be identified that provoke the inappropriate behavior b. Making obscene phone calls relates to his hatred of women c. The obscene message is generally not a problem to the receiver of the call d. The etiology of this disorder is usually related to dysfunctional parenting 9. A couple is in marriage counseling for the initial visit because of the husband's decreased interest in an intimate relationship with his wife. He admitted that his job is a constant source of worry and that he feels "tied in knots all the time." They admit that any mention of sex results in a verbal battle. Which of these patient outcomes is realistic for this initial session? a. The husband will be able to focus on body feelings during intimacy rather than anxiety b. Both partners will express their perception of the problem in the presence of the therapist c. Both partners will discuss job concerns creating stress in their lives and strategies for change d. The wife will talk openly about her feelings of inadequacy

10. A new staff nurse tells the clinical nurse specialist, "I'm unsure about my role when patients bring up sexual problems." The clinical nurse specialist should give clarification by saying, "All nurses a. qualify as sexual counselors. Each has knowledge about the biopsychosocial aspects of sexuality throughout the life cycle b. should be able to screen for sexual dysfunction and give basic information about sexual feelings, behaviors, and myths." c. should defer questions about sex to other health care professionals because of their limited knowledge of sexuality." d. who are interested in sexual dysfunction can provide sex therapy for individuals and couples." 11. The patient's medical record documents the diagnosis of sexual masochism. The nurse understands this to mean the patient derives sexual pleasure: a. From inanimate objects b. When sexually humiliated by a partner c. From inflicting pain on a partner d. From touching a nonconsenting person 12. As nurses perform screening assessments of sexual function or dysfunction, which problem will be seen as the most frequently occurring? a. Dyspareunia b. Vaginismus c. Sexual aversion disorder d. Hypoactive sexual desire disorder