1、美国护士资格认证(CGFNS)-17 及答案解析(总分：43.00，做题时间：90 分钟)一、Part One(总题数：43，分数：43.00)1.Which of the following BEST describes how the nurse should deal with manic patients?AEnthusiasm BEncouraging supportCA reassuring manner that reduces anxiety DQuiet calmness（分数：1.00）A.B.C.D.2.What should the nurses reaction be
2、 to a manic patients loud jokes and crude pranks? She shouldAReact with studied prudishness BChastise the patientCPut restraints on the patient DReact with silence, ignoring it（分数：1.00）A.B.C.D.3.How should the psychiatric nurse handle direct questions from the patient? The nurse should answerAAll qu
3、estions to substantiate her professional credentialsBQuestions about the patients illnessCQuestions about her behavior that the patient has observedDAll questions honestly（分数：1.00）A.B.C.D.4.A manic episode consists of a group of characteristic symptoms accompanying an abnormal mood that is predomina
4、ntly euphoric, expansive, or irritable. DSM-R diagnostic criteria for manic episodes include all of the following EXCEPTARapid shifts to anger or even short-lived spells of depressionBIncreased psychomotor activity and restlessness with flight of ideas and racing thoughtsCMost of the symptoms presen
5、t most of the time for at least six weeksDMood disturbances sufficiently severe to cause marked impairment in occupational functioning or in usual social activities（分数：1.00）A.B.C.D.5.While managing a manic episode, a nurse would NOTAProvide a quiet environment and decrease stimuliBArgue with patient
6、 about his disruptive behaviorCWhile administering medication as advised, observe for side effects, monitor lithium blood levels, and maintain fluid and salt intakeDAssist dressing and bathing（分数：1.00）A.B.C.D.6.When assessing a client with a diagnosis of mood disorder-manic episode, the nurse is awa
7、re that the manic episode is in reality anAExaggerated response to an elating situationBUncontrolled acting out of uncensored id drivesCIncorrect interpretation of environmental stimuliDAttempt to block unconscious feelings of depression（分数：1.00）A.B.C.D.7.When caring for clients demonstrating manic
8、behavior, the nurse must he aware of these clients physical needs. This is particularly important becauseALeft alone, these clients will withdraw to their roomsBThese clients have difficulty making their needs knownCThese clients may gain too much weight from overeatingDThe danger of exhaustion is a
9、lways present for these clients（分数：1.00）A.B.C.D.8.When selecting a room for a client with the diagnosis of bipolar disorder, manic phase, who is hyperactive and talking nonstop in a loud demanding voice, the nurse recognizes that a most important factor would be that theARoom have a pleasant view BA
10、tmosphere be quiet and restfulCLocation be close to the nursesstation DRoommates have similar behavioral responses（分数：1.00）A.B.C.D.9.When developing an initial nursing care plan for a female client with a bipolar disorder, manic phase, the nurse should plan toAIncrease her gym time BIsolate her from
11、 her peersCProvide food, fluids, and rest DEncourage her active participation in unit programs（分数：1.00）A.B.C.D.10.A nursing care plan for a client with a bipolar disorder should includeAProviding a structured environmentBTouching the client to provide reassuranceCEngaging the client in conversation
12、about current attainDDesigning activities that will require the client to maintain contact with reality.（分数：1.00）A.B.C.D.11.The nurse realizes that the environment is very important when caring for a client with a diagnosis of mood disorder manic episode. The nurse shouldAPut bright drapes in the cl
13、ients room to cheer up the clientBPlace the client in a private room to provide a quiet atmosphereCAssign the client to a room with other clients to provide companyDAssign the client to a room near the dayroom to be accessed to activities（分数：1.00）A.B.C.D.12.A client demonstrating manic behavior is e
14、lated and sarcastic. The client is constantly cursing and using foul language and has the other clients on the unit terrified. The nurse shouldAFirmly tell the client that the behavior is unacceptableBDemand that the client stop the behavior immediatelyCAsk the client to identify, what is precipitat
15、ing the behaviorDIncrease the clients medication or get additional medication ordered（分数：1.00）A.B.C.D.13.Encouragement and praise should be given to hyperactive clients to help them increase their feelings of self-esteem. When they have behaved welt, the best way to let them know the staffis aware o
16、f their improvement is for the nurse to sayA“You behaved well today. “B“We knew you could behave. “C“Everyone likes you better when you behave like this. “D“Your behavior today was much better than yesterday. /（分数：1.00）A.B.C.D.14.The major difference between bipolar and bipolar disorder is thatAClie
17、nts with bipolar have no symptoms of mania, but only depressionBThe prognosis for bipolar is much better than for bipolar CBoth disorders are the same, except that clients with bipolar disorders have a much higher incidence of suicideDClients with bipolar disorder do not have symptoms of mania that
18、interfere enough to cause marked functional disturbances（分数：1.00）A.B.C.D.15.James T. is admitted to the unit in an acute manic episode. He has had three major depressive episodes in the past 10 years and two other hospitalizations for mania. Which of the following disorders would reflect Jamessympto
19、m profile?ABipolar BBipolar CCyclothymic disorder DDysthymic disorder（分数：1.00）A.B.C.D.16.Ms. T. has been admitted to your unit for obsessive-compulsive personality disorder. He constantly washes his hands. In planning his nursing care which of the following is an important short-term goal. The clien
20、t willARefrain from washing his hands BDiscuss conflicts underlying his behaviorCBe protected from skin integrity breakdown DVerbalize understanding of his disorder（分数：1.00）A.B.C.D.17.Borderline personality disorder involves continuous dysfunctional behaviors in which patient may injury himself. Pre
21、disposing factors of this disorder include all of the following exceptADiagnosed with attention deficit hyperactivity disorder(ADHD) everBAbuse by his parents or others in childhoodCHis efforts to be autonomous were often punished by his grandmother who fosters himDNone of the above（分数：1.00）A.B.C.D.
22、18.John has been on the telephone for ten minutes. He has become increasingly loud and terminates the conversation by slamming the phone. He walks into the lounge and kicks a chair. The BEST nursing intervention for John would be toARespect John personal space and offer him one-to-one in a quiet are
23、aBLet J. know that continued agitation will result in restraintsCRemove other patients and let John “blow off steam“ in the lounge by himselfDImmediately gather several staff to physically take J. to seclusion（分数：1.00）A.B.C.D.19.The typical character of narcissistic personality disorder isAExtreme s
24、ocial anxiety BIntolerance of alonenessCApathy DLow self-esteem（分数：1.00）A.B.C.D.20.A nurse taking care of a patient with antisocial personality disorder shouldAHelp him to control impulsivityBPromote him taking responsibility for himself and othersCDiscern what and who will become his triggerDAll of
25、 the above（分数：1.00）A.B.C.D.21.When interviewing a patient with BPD, an attending nursing should assess whether the patient has a risk to suicide. The risk factors she should collect including the followings exceptAPhysiologic and self-care considerations BEmotional antecedentsCAbuse history DWorking
26、 performance（分数：1.00）A.B.C.D.22.The most important feeling for the nurse to convey to the client in order for the client with personality disorder to accept the nurse is one ofALet client feel warm and being care BWillingness to helpCRemorse for client DNo-nonsense demands with client（分数：1.00）A.B.C.
27、D.23.A patient being treated for an antisocial personality disorder insists that other nursing staff gave him lithium everyday in this time, which helped him, and he demands the current nurse get some immediately. The nurses BEST reply to this patent would beAI will go and get some for you if you ca
28、lm downBThere isnt any doctors advice for you about lithiumCI wont believe in what you saidDOk, be patient please, and Ill talk to your attending doctor about whether lithium would be appropriate for you（分数：1.00）A.B.C.D.24.Which one of the following is useful for treatment with BPD?ADBT BGestalt the
29、rapy CREBT DAll of the above（分数：1.00）A.B.C.D.25.Which one of the following type of PD has a high incidence of suicide?AAntisocial personality disorder BBordline personality disorderCParanoid personality disorder DSchizotypal personality disorder（分数：1.00）A.B.C.D.26.One morning the nurse overhears Elm
30、a, who is admitted with BPD, having an argument with her mother, When suppertime, Elma is very angry with the nurse and complains nurse must say something bad to her mother about her performance in ward. What the defense mechanism Elma is using?ADissociation BDenial CProjection DSplitting（分数：1.00）A.
31、B.C.D.27.A nurse in a psychiatric setting has promoted a therapeutic relationship with an APD patient. One day the nurse is off duty and is prepare for leaving, the clients says in a pity tone, “Dont let me alone, please, other staff dont like me and often punish me. “ What the nurse say is suitable
32、 and can assist the patient?A“Dont worry, I will be back soon. “B“I will ask the staff not to punish you. “C“You are lying, none of staff will punish you. “D“You know I leave at this time everyday. Well talk about this in my next duty time. /（分数：1.00）A.B.C.D.28.A patient with BPD cries bitterly, pou
33、nds the bed in frustration, and said: “this therapist also dislike me, I am going to die rather than stay here. “ If you were his attending nurse, what would be the most helpful for you to assist the patient?ALeave him alone until he calm downBTell him that the therapist is very kind and experienced
34、CSit down and listen attentively if he wishes to talk about somethingDPat the patient reassuringly on the back and say, “I can understand its difficult to bear. /（分数：1.00）A.B.C.D.29.Which one is not right about personality disorder?AMultiple personality disorder is distinct and separate personalitie
35、s within the same personBPeople with personality disorder often experience child abuse or traumaticCOnly the symptoms of personality disorder represent the persons stable characteristics and social functioning, he can be diagnosed personality disorderDParanoid and antisocial personality disorders ar
36、e more commonly diagnosed in women than men（分数：1.00）A.B.C.D.30.One afternoon, many patients are discussing a topic about substance abuse in an activity room of psychiatric unit. A patient with APD wont join them and he turn on the TV in same activity roorm. The most appropriate response by nurse wou
37、ld beATurn down the TV and say, “now is the decided discussing time for all patients, this topic is also helpful for you. If you really arent interested in it, you can keep silence, but you cant interfere other patients. “BTurn up volume of TV and say, “if you think the discussing isnt helpful for y
38、ou, you can watch TV, but the volume need be turn down little. “CArrange other patients changing to another room for discussing and leave him alone.DTurn down the TV and say, “this isnt your home, its public activity room, you need apply public norm./（分数：1.00）A.B.C.D.31.An adolesent who is extremely
39、 underweight talks constantly about being fat, refuse to eat hardly any food, and disppears into the bathroom after meals, angrily says to the nurse, “I dont need to be here. I dont have any problems. Stop watching me. “ To reduce the clients feeling of being threatened, the nurse would be most ther
40、apeutic by respondingA“I hear how frustrated you are to be here. “B“If you do not follow the rules you will lose your privileges. “C“Your feeling are part of your illness. You will feel different. “D“111 get you the medication your physician ordered for anxiety. /（分数：1.00）A.B.C.D.32.Many clients on
41、the eating disorders unit have been admitted for anorexia nervosa. The signs and symptoms that would be most specific for this diagnosis areASlow pulse, 10% weight loss, and alopeciaBCompulsive behaviors, excessive fears, and nauseaCExcessive activity, memory lapses, and an increased pulseDExcessive
42、 weight loss, amenorrhea, and abdominal distention（分数：1.00）A.B.C.D.33.A major recognizable difference between clients with anorexia nervosa and clients with bulimia nervosa is that clients with anorexia usuallyATend to be more extroverted than clients with bulimia nervosaBSeek intimate relationships
43、 whie clients with bulimia avoid themCDeny the problem while clients with bulimia generally recognize that their eating pattern is abnormalDAct at greater risk for physical problems such as fluid and electro（分数：1.00）A.B.C.D.34.The nurse interviews a young female client with anorexia nervosa to obtai
44、n information for the nursing history. The clients history is likely to revealAA strong desire to improve her self-imageBA close, supportive mother-daughter relationshipCLow achievement in school, with little concern for gradesDsatisfaction with and a desire to maintain her present weight（分数：1.00）A.
45、B.C.D.35.The nursing intervention that should receive the highest priority in the period immediately following an emaciated 13-year-olds admission to the hospital for starvation secondary to anorexia nervosa would beAProviding adequate rest and nutritionBMonitoring clients fluid and electrolyte bala
46、nceCCompleting an assessment of the clients mental statusDObtaining more data about the clients diet and exercise program（分数：1.00）A.B.C.D.36.The nurse is aware that the major health complication associated with severe anorexia nervosa isAProtein depletion resulting in muscle wastingBEndocrine imbala
47、nce resulting in amenorrheaCGlucose intolerance resulting in hypoglycemiaDCardiac dysrhythmias resulting in cardiac arrest（分数：1.00）A.B.C.D.37.While admitting a young client with severe anorexia nervosa to the unit, the nurse finds a bottle of assorted pills in the clients luggage. The client tells t
48、he nurse they are antacids for stomach pains. The best initial response by the nurse would beA“Lets talk about your drug use. “B“These pills dont look like antacids. “C“Tell me more about these stomach pains. “D“Some adolescents take pills to lose weight. /（分数：1.00）A.B.C.D.38.The parents of an adole
49、scent female are very upset about their daughters diagnosis of anorexia nervosa and the treatment plan proposed. The best intervention by the nurse when the clients parents ask to bring food in for the client is to stateA“Your concern about food contribute to her problem. “B“While in the hospital, she should eat the hospital food. “C“For now, allow the hospital staff to handle her food ne
