162 Psych Final

Anna, who is 72 years old, is of an age when she may have experienced many losses coming close together. She is at risk for which of the following? a. Bereavement overload b. Normal mourning c. Isolation d. Cultural relativity

A

Anna's daughter notices that Anna appears to be listening to another voice when just the two of them are in a room together. When questioned, Anna admits that she hears someone telling her that she was a horrible caretaker for Lucky and did not deserve to ever have a pet. Which of the following best describes what Anna is experiencing? a. Neurosis b. Psychosis c. Depression d. Bereavement

B

The nurse is using nursing process to care for a patient who is suicidal. Which of the following nursing actions is a part of the evaluation step of the nursing process? a. Prioritizes the necessity for maintaining a safe environment for the patient b. Determines if nursing interventions have been appropriate to achieve desired results c. Obtains a commitment from the patient to collaboratively work to identify adaptive coping skills d. Identifies that the "Patient will not harm self during hospitalization"

B

Which of the following parts of the brain has control over the pituitary gland and autonomic nervous system as well as regulation of appetite and temperature? a. Temporal lobe b. Parietal lobe c. Cerebellum d. Hypothalamus

D

A battered woman presents to the emergency department with multiple cuts and abrasions. Her right eye is swollen shut. She says that her husband did this to her. Which of the following is the priority nursing intervention? a. Tending to the immediate care of her wounds b. Providing her with information about a safe place to stay c. Administering the prn tranquilizer ordered by the physician d. Explaining how she may go about bringing charges against her husband

a

A nurse who is helping a patient in the preparation stage of the Psychological Recovery Model might include which of the following interventions? a. Teach about effects of the illness and how to recognize, monitor, and manage symptoms. b. Help the patient identify "triggers" that cause distress or discomfort. c. Help the patient establish a daily maintenance list. d. Listen actively while the patient composes his or her personal story.

a

A patient with OCD spends many hours each day washing her hands. What is the most likely reason she washes her hands so much? a. To relieve her anxiety b. To reduce the probability of infection c. To gain a feeling of control over her life d. To increase her self-concept

a

A patient with depression asks the nurse, "Why would they be checking my thyroid function when I clearly have depression and I'm not overweight?" Which of these is an accurate response? a. An underactive thyroid gland can manifest as depression. b. Depression has been proven to be a hormonal illness. c. Thyroid hormone replacement is a first-line treatment for most people with depression. d. Abnormal thyroid function predicts positive response to antidepressant medication.

a

A polysubstance abuser makes the statement, "The green and whites do me good after speed." How might the nurse interpret the statement? a. The client abuses amphetamines and anxiolytics. b. The client abuses alcohol and cocaine. c. The client is psychotic. d. The client abuses narcotics and marijuana.

a

A school nurse notices bruises and scars on Jana's body. The nurse suspects that the child is being physically abused. How should the nurse proceed with this information? a. As a healthcare worker, report the suspicion to child protective services. b. Check Jana again in a week and see if there are any new bruises. c. Meet with Jana's parents and ask them how Jana got the bruises. d. Initiate paperwork to have Jana placed in foster care.

a

According to the literature, which of the following is most important for individuals to maintain a healthy, adaptive old age? a. To remain socially interactive b. To disengage slowly in preparation of the last stage of life c. To move in with family d. To maintain total independence and accept no help from anyone

a

Brandon, a patient on the psychiatric unit, has been diagnosed with schizophrenia. He begins to tell the nurse about how the CIA is looking for him and will kill him if they find him. Brandon's belief is an example of which of the following? a. Delusion of persecution b. Delusion of reference c. Delusion of control or influence d. Delusion of grandeur

a

Clara, an 80-year-old woman, says to the nurse, "I'm all alone now. My husband is gone. My best friend is gone. My daughter is busy with her work and family. I might as well just go, too." Which is the best response by the nurse? a. "Are you thinking that you want to die, Clara?" b. "You have lots to live for, Clara." c. "Cheer up, Clara. You have so much to be thankful for." d. "Tell me about your family, Clara."

a

Dan begins to attend AA meetings. Which of the statements by Dan reflects the purpose of this organization? a. "They claim they will help me stay sober." b. "I'll dry out in AA, then I can have a social drink now and then." c. "AA is only for people who have reached the bottom." d. "If I lose my job, AA will help me find another."

a

Dan, who has been admitted to the alcohol rehabilitation unit after being fired for drinking on the job, states to the nurse, "I don't have a problem with alcohol. I can handle my booze better than anyone I know. My boss is a jerk! I haven't missed any more days than my coworkers." What defense mechanism is Dan using? a. Denial b. Projection c. Displacement d. Rationalization

a

In group exercise, Mr. B, a 79-year-old man with major depression, reports feeling tired and states "Nothing is going to help." Which nursing action should take priority? a. Assess Mr. B. for suicide risk. b. Encourage Mr. B. to get more sleep. c. Give Mr. B. prn antianxiety medication. d. Instruct Mr. B. that if he doesn't participate in the activity he will have to leave the group.

a

Jack is a new patient on the psychiatric unit with a diagnosis of antisocial personality disorder. Which of the following characteristics would you expect to assess in Jack? a. Lack of guilt for wrongdoing b. Insight into his own behavior c. Ability to learn from past experiences d. Compliance with authority

a

John, a veteran of the war in Iraq, is diagnosed with PTSD. Which of the following therapy regimens would most appropriately be ordered for John? a. Paroxetine and group therapy b. Diazepam and implosion therapy c. Alprazolam and behavior therapy d. Carbamazepine and cognitive therapy

a

Kim, a patient diagnosed with BPD, manipulates the staff in an effort to fulfill her own desires. All of the following may be examples of manipulative behaviors in the borderline client except: a. Refusal to stay in room alone, stating, "It's so lonely." b. Asking the nurse for cigarettes after 30 minutes, knowing that the assigned nurse has explained she must wait 1 hour. c. Stating to the nurse, "I really like having you for my nurse. You're the best one around here." d. Cutting arms with razor blade after discussing discharge plans with physician.

a

Lorraine has been diagnosed with somatic symptom disorder. Which of the following symptom profiles would you expect when assessing Lorraine? a. Multiple somatic symptoms in several body systems b. Fear of having a serious disease c. Loss or alteration in sensorimotor functioning d. Belief that her body is deformed or defective in some way

a

Mr. B, age 79, is admitted to the psychiatric unit for depression. He has lost weight and has become socially isolated. His wife died 5 years ago, and his son tells the nurse, "He did very well when Mom died. He didn't even cry." Which would be the priority nursing diagnosis for Mr. B? a. Complicated grieving b. Imbalanced nutrition: Less than body requirements c. Social isolation d. Risk for injury

a

Mr. White is admitted to the hospital after an extended period of binge alcohol drinking. His wife reports that he has been a heavy drinker for a number of years. Laboratory reports reveal that he has a blood alcohol level of 250 mg/dL. He is placed on the chemical addiction unit for detoxification. When would the first signs of alcohol withdrawal symptoms be expected to occur? a. Several hours after the last drink b. 2 to 3 days after the last drink c. 4 to 5 days after the last drink d. 6 to 7 days after the last drink

a

Nancy's new in-laws came to dinner for the first time. When Nancy's mother-in-law left some food on her plate, Nancy thought, "I must be a lousy cook!" This is an example of which type of "automatic thought"? a. All or nothing b. Discounting positives c. Catastrophic thinking d. Personalizing

a

Shane, a patient diagnosed with PTSD tells the nurse that his social worker is recommending EMDR and asks the nurse to describe this treatment. Which of these is the most accurate response? a. EMDR is a therapy designed to help you process thoughts and emotions related to the trauma you've experienced. b. EMDR is a treatment to cure insomnia using hypnosis. c. EMDR is a treatment that uses electrical stimulation to induce a seizure and is beneficial in relieving depression associated with PTSD. d. EMDR is an acronym that stands for Emotional Motivation to Decrease Responsiveness and it will help you forget the trauma.

a

Shane, a veteran of the war in Iraq, has been diagnosed with post-traumatic stress disorder (PTSD). He is a client of a VA outpatient clinic. He tells the nurse that he experiences panic attacks. Which of the following medications may be prescribed for Shane to treat his panic attacks? a. Alprazolam b. Lithium c. Carbamazepine d. Haldol

a

Subluxation is a term used by chiropractic medicine to describe: a. Displacement of vertebrae in the spine. b. Adjustment of displaced vertebrae in the spine. c. Interference with the flow of energy from the brain. d. Pathways along which energy flows throughout the body

a

The Maudsley approach to treatment of adolescents with anorexia nervosa advances which of the following fundamental concepts? a. Family should be actively involved in each phase of treatment. b. Parents should be prohibited from involvement in helping their child eat more because there are often control issues. c. Adolescents need to work on developing healthy self-identities before they can begin to gain weight. d. Individual psychotherapy is the most effective treatment for adolescents with anorexia nervosa.

a

The goal of cognitive therapy with depressed clients is to: a. Identify and change dysfunctional patterns of thinking. b. Resolve the symptoms and initiate or restore adaptive family functioning. c. Alter the neurotransmitters that are creating the depressed mood. d. Provide feedback from peers who are having similar experiences.

a

The nurse identifies the primary nursing diagnosis for Theresa as "Risk for Suicide related to feelings of hopelessness from loss of relationship." Which is the outcome that would be most appropriate for this diagnosis? a. The patient has experienced no physical harm to herself. b. The patient sets realistic goals for herself. c. The patient expresses some optimism and hope for the future. d. The patient has reached a stage of acceptance in the loss of the relationship with her boyfriend.

a

The physician orders lithium carbonate 600 mg tid for a client newly diagnosed with Bipolar I Disorder. There is a narrow margin between the therapeutic and toxic levels of lithium. What is the therapeutic range for acute mania? a. 0.5 to 1.5 mEq/L b. 10 to 15 mEq/L c. 0.5 to 1 mEq/L d. 5 to 10 mEq/L

a

The physician orders sertraline (Zoloft) for a client who is hospitalized with adjustment disorder with depressed mood. What is this medication intended to do? a. Increase energy and elevate mood b. Stimulate the central nervous system c. Prevent psychotic symptoms d. Produce a calming effect

a

The physician orders trazadone (Desyrel) for Mrs. W, a 78-year-old widow with depression, 150 mg to take at bedtime. Which of the following statements about this medication would be appropriate for the home health nurse to make in teaching Mrs. W about trazadone? a. "You may feel dizzy when you stand up, so go slowly when you get up from sitting or lying down." b. "You must be sure and not eat any chocolate while you are taking this medicine." c. "We will need to draw a sample of blood to send to the lab every month while you are on this medication." d. "If you don't feel better right away with this medicine, the doctor can order a different kind for you."

a

Tina, who is experiencing a panic attack, has just arrived at the emergency department. Which is the priority nursing intervention for this patient? a. Stay with Tina and reassure her of her safety. b. Administer a dose of diazepam. c. Leave Tina alone in a quiet room so that she can calm down. d. Encourage Tina to talk about what triggered the attack.

a

What is the ultimate goal of therapy for a client with DID? a. Integration of the identities into one b. For the client to have the ability to switch from one identity to another voluntarily c. For the client to select which identity he or she wants to be the dominant self d. For the client to recognize that the various identities exist

a

When Frank's wife of 34 years dies, he is very stoic, handles all the funeral arrangements, doesn't cry or appear sad, and comforts all of the other family members in their grief. Two years later, when Frank's best friend dies, Frank has sleep disturbances, difficulty concentrating, loss of weight, and difficulty performing on his job. This is an example of which of the following maladaptive responses to loss? a. Delayed grieving b. Distorted grieving c. Prolonged grieving d. Exaggerated grieving

a

Which of the following behavioral patterns is characteristic of individuals with narcissistic personality disorder? a. Overly self-centered and exploitative of others b. Suspicious and mistrustful of others c. Rule conscious and disapproving of change d. Anxious and socially isolated

a

Which of the following factors is not associated with increased incidence of NCD due to Alzheimer's disease? a. Multiple small strokes b. Family history of Alzheimer's disease c. Head trauma d. Advanced age

a

Which of the following is a correct statement when attempting to distinguish normal grief from clinical depression? a. In clinical depression, anhedonia is prevalent. b. In normal grieving, the person has generalized feelings of guilt. c. The person who is clinically depressed relates feelings of depression to a specific loss. d. In normal grieving, there is a persistent state of dysphoria.

a

Which of the following is least likely to predispose a child to Tourette's disorder? a. Absence of parental bonding b. Family history of the disorder c. Abnormalities of brain neurotransmitters d. Structural abnormalities of the brain

a

Which of the following is thought to facilitate the grief process? a. The ability to grieve in anticipation of the loss b. The ability to grieve alone without interference from others c. Having recently grieved for another loss d. Taking personal responsibility for the loss

a

Which of the following nursing diagnoses would be considered the priority in planning care for the child with a severe ASD? a. Risk for self-mutilation evidenced by banging head against wall b. Impaired social interaction evidenced by unresponsiveness to people c. Impaired verbal communication evidenced by absence of verbal expression d. Disturbed personal identity evidenced by inability to differentiate self from others

a

Which of the following represents a nursing intervention at the primary level of prevention? a. Teaching a class in parental effectiveness training b. Leading a group of adolescents in drug rehabilitation c. Referring a married couple for sex therapy d. Leading a support group for battered women

a

Which of the following represents a nursing intervention at the tertiary level of prevention? a. Serving as case manager for a mentally ill homeless client b. Leading a support group for newly retired men c. Teaching prepared childbirth classes d. Caring for a depressed widow in the hospital

a

n reality therapy, a primary function of the therapist is: a. Assisting the client to deal with getting current needs fulfilled. b. Hypnotizing the client to delve into the unconscious. c. Analyzing the possible meanings behind the client's dreams. d. Taking a psychiatric history and establishing a diagnosis.

a

Annie has hair-pulling disorder. She is receiving treatment at the mental health clinic with HRT. Which of the following elements would be included in this therapy? (Select all that apply.) a. Awareness training b. Competing response training c. Social support d. Hypnotherapy e. Aversive therapy

a.b.c

Ellie presents in the emergency department loudly proclaiming with rapid speech, "If I don't get more pain medication right now, I'm going to call the attorney general and sue the entire health care network." Which of the following should be included in initial screening and assessment? (Select all that apply.) a. Substance use b. Pain c. Mental Illness d. Prior history of convictions e. Availability of an inpatient psychiatric bed

a.b.c

Which of the following interventions are appropriate for a patient on suicide precautions? (Select all that apply.) a. Remove all sharp objects, belts, and other potentially dangerous articles from the patient's environment. b. Accompany the patient to off-unit activities. c. Reassess intensity of suicidal thoughts and urges on a regular basis. d. Put all of the patient's possessions in storage and explain to her that she may have them back when she is off suicide precautions.

a.b.c

Amy's husband of 1 year left 2 weeks ago for a year-long deployment in Afghanistan. Amy makes an appointment with the psychiatric nurse practitioner at the community mental health clinic. She tells the nurse that she can't sleep, has no appetite, is chronically fatigued, thinks about her husband constantly, and fears for his life. Which of the following might the nurse suggest/prescribe for Amy? (Select all that apply.) a. A prescription for sertraline, 50 mg/day b. Participation in a support group c. Resume involvement in usual activities d. Perform regular relaxation exercises

a.b.c.d

Mandy presents in the emergency department with complaints of suicidal ideation. The following data is collected by the nurse. Which of these assessment findings suggests that bulimia nervosa might be a health problem? (Select all that apply.) a. Mandy's parotid glands appear enlarged. b. Mandy's teeth have a "moth eaten" pattern of tooth decay. c. Mandy reports that she takes laxatives daily. d. Mandy's weight is within the expected range.

a.b.c.d

Which of the following is most likely to initiate a grief response in an individual? (Select all that apply.) a. Death of a pet dog b. Being told by her doctor that she has begun menopause c. Failing an examination d. Losing a spouse through divorce

a.b.c.d

Which of the following issues have been identified as contributing to the rise in the population of those who are homeless? (Select all that apply.) a. Poverty b. Lack of affordable healthcare c. Substance abuse d. Severe and persistent mental illness e. Growth in the number of family members living together

a.b.c.d

A client admitted to the emergency department smells strongly of alcohol, and his wife reports that he has been a heavy drinker for the last 25 years. Which of the following assessment findings are consistent with long-term chronic alcohol abuse? (Select all that apply.) a. The client reports weak leg muscles, and his gait is unsteady. b. The client's abdomen is distended. c. The client reports that he was coughing up some blood. d. The client reports that he has double vision. e. Blood tests reveal a low white blood cell count.

a.b.c.d.e

A patient has just been admitted to the psychiatric unit with a diagnosis of Major Depressive Disorder. Which of the following manifestations may be apparent in a patient with this diagnosis? (Select all that apply.) a. Slumped posture b. Delusional thinking c. Feelings of despair d. Feels best early in the morning and worse as the day progresses e. Anorexia

a.b.c.e

A patient expresses interest in alternative treatments for depression with seasonal variations and asks the nurse about light therapy. Which of the following are evidence-based teaching points that the nurse may share with the patient? (Select all that apply.) a. Light therapy has demonstrated effectiveness that is comparable to antidepressants. b. Light therapy should be used regularly until the season changes. c. Light therapy should only be used when ECT has proven to be ineffective. d. Side effects such as headache, nausea, or agitation, when they occur, are usually mild and transient. e. Light therapy can cause sedation so the best time to use it is before bedtime.

a.b.d

Dana's husband, who was deployed to Afghanistan a year ago, is returning home this week. Which of the following postdeployment situations may be likely to occur during the first few months of his return? (Select all that apply.) a. A honeymoon period of physical reconnection b. Resistance from the spouse regarding possible loss of autonomy c. Rejection by the children for perceived abandonment d. A period of adjustment to reconnect emotionally

a.b.d

Shondra is admitted to the hospital with major depressive disorder and repeatedly makes negative statements about herself. Which of the following interventions is identified as an approach that promotes positive self-esteem in the patient? (Select all that apply.) a. Teach assertive communication skills. b. Make observations to Shondra when she completes a goal or task. c. Instruct Shondra that you will not talk with her unless she stops talking negatively about herself. d. Offer to spend time with Shondra using a nonjudgmental, accepting approach.

a.b.d

Which of the following food groups do the USDA/USDHHS food guidelines recommend using in moderation? (Select all that apply.) a. Refined carbohydrates b. Fats c. Milk and milk products d. Sodium chloride e. Whole grains

a.b.d

Recent research on the RAISE approach to treatment of schizophrenia incorporates which of the following elements as important to improving outcomes? (Select all that apply.) a. Early intervention at the first episode of psychosis b. Support for employment and/or educational pursuits c. Rapid, high-dose loading with antipsychotic medication d. Court-ordered sanctions for treatment e. Recovery-focused psychotherapy

a.b.e

Which of the following medications have been indicated for improvement in cognitive functioning in mild to moderate Alzheimer's disease? (Select all that apply.) a. Donepezil (Aricept) b. Rivastigmine (Exelon) c. Risperidone (Risperdal) d. Sertraline (Zoloft) e. Galantamine (Razadyne)

a.b.e

Trauma-informed care is a philosophical approach that includes which of the following principles? (Select all that apply.) a. Nurses need to be aware of the potential for trauma in any patient and provide care that minimizes the risk of revictimization or retraumatization. b. Medications need to be given before any other interventions are considered. c. Trauma-informed care highlights the importance of providing care that protects the physical, psychological, and emotional safety of the patient. d. Trauma-informed care is based on the principle that traumas are not correlated with depression or increased risk for suicide.

a.c

Although historically lithium has been the medication of choice for mania, several others have been used with good results. Which of the following are used in the treatment of bipolar disorder? (Select all that apply.) a. Olanzapine (Zyprexa) b. Oxycodone (Oxycontin) c. Carbamazepine (Tegretol) d. Gabapentin (Neurontin) e. Tranylcypromine (Parnate)

a.c.d

Mike, a veteran of combat in Afghanistan, has a diagnosis of mild traumatic brain injury (TBI). The psychiatric home health nurse from the VA medical center is assigned to make home visits to Mike and his wife, Marissa, who is his caregiver. Which of the following would be an appropriate nursing intervention by the home health nurse? (Select all that apply.) a. Assess for use of substances by Mike or Marissa. b. Encourage Marissa to do everything for Mike to prevent further deterioration in his condition. c. Assess Marissa's level of stress and potential for burnout. d. Encourage Marissa to allow Mike to be as independent as possible. e. Suggest that Marissa ask the physician for a nursing home placement for Mike.

a.c.d

The nurse in the emergency department encounters a patient, Niko, who is expressing suicide ideation. The nurse recognizes that which of the following considerations are important to good suicide risk assessment? (Select all that apply.) a. Collaborating with the patient b. Asking specific questions about leisure activities c. Establishing trust and open communication with the patient d. Asking the patient specific questions about the strength of his intention to die e. Identifying whether the patient has thought about a plan for trying to kill himself

a.c.d.e

In addition to disturbances in cognition and orientation, individuals with Alzheimer's disease may also show changes in which of the following? (Select all that apply.) a. Personality b. Vision c. Speech d. Hearing e. Mobility

a.c.e

Which of the following herbs is thought to be helpful in cases of nervousness, anxiety, and/or insomnia? (Select all that apply.) a. Chamomile b. Echinacea c. Kava-kava d. Ginseng e. Valerian f. Hops

a.c.e.f

Adam was admitted to the ICU after a single car accident in which he struck a cement wall. He is now responsive and wants to be discharged within the next couple of days. Which of the following are priorities for screening? (Select all that apply.) a. Traumatic brain injury b. Chronic pain c. Sexual dysfunction d. Depression and risk for suicide

a.d

Demitrius informs the nurse that his doctor is considering ECT and asks for some information about the procedure. Which of the following are accurate statements that the nurse can share with this patient? (Select all that apply.) a. ECT is typically used to treat patients who have not responded to antidepressant therapy. b. A long-acting anesthetic agent is given to the patient the morning of the treatment. c. One treatment is usually all that is needed to relieve depression. d. Side effects may include headache and some confusion or memory loss.

a.d

With which of the following conditions should massage not be performed? (Select all that apply.) a. High blood pressure b. Neck pain c. Arthritis d. Phlebitis e. Osteoporosis

a.d.e

Anna has been a widow for 20 years. Her maladaptive grief response to the loss of her dog may be attributed to which of the following? (Select all that apply.) a. Unresolved grief over loss of her husband b. Loss of several relatives and friends over the last few years c. Repressed feelings of guilt over the way in which Lucky died d. Inability to prepare in advance for the loss

a/b/c/d

A decrease in which of the following neurotransmitters has been implicated in depression? a. GABA, acetylcholine, and aspartate b. Norepinephrine, serotonin, and dopamine c. Somatostatin, substance P, and glycine d. Glutamate, histamine, and opioid peptides

b

A fellow worker often borrows small amounts of money from you with the promise that she will pay you back "tomorrow." She currently owes you $15 and has not yet paid back any money she has borrowed. She asks if she can borrow a couple of dollars for lunch. Which of the following is a nonassertive response? a. "I've decided not to loan you any more money until you pay me back what you already borrowed." b. "I'm so sorry. I only have enough to pay for my own lunch today." c. "Get a life, will you? I'm tired of you sponging off me all the time!" d. "Sure, here's two dollars." Then to the other workers in the office, "Be sure you never lend Cindy any money. She never pays her debts. I'd be sure never to go to lunch with her if I were you!"

b

A major difference between normal and maladaptive grieving has been identified by which of the following? a. There are no feelings of depression in normal grieving. b. There is no loss of self-esteem in normal grieving. c. Normal grieving lasts no longer than 1 year. d. In normal grief, the person does not show anger toward the loss.

b

A nurse is educating a patient about his lithium therapy. She is explaining signs and symptoms of lithium toxicity. Which of the following would she instruct the patient to be on the alert for? a. Fever, sore throat, malaise b. Tinnitus, severe diarrhea, ataxia c. Occipital headache, palpitations, chest pain d. Skin rash, marked rise in blood pressure, bradycardia

b

A patient states, "I refuse to shower in this room. I must be very cautious. The FBI has placed a camera in here to monitor my every move." Which of the following is the most therapeutic response? a. "That's not true." b. "I have a hard time believing that is true." c. "Surely you don't really believe that." d. "Let's search the room together to see if we can find a camera."

b

A young woman who was a recent victim of a sexual assault is brought into the emergency department by a friend. Which of the following is the priority nursing intervention? a. Help her to bathe and clean herself up. b. Provide physical and emotional support during evidence collection. c. Provide her with a written list of community resources for survivors of rape. d. Discuss the importance of a follow-up visit to evaluate for sexually transmitted diseases.

b

Abbey, an adolescent, just returned from group therapy and is crying. She says to the nurse, "All the other kids laughed at me! I try to fit in, but I always seem to say the wrong thing. I've never had a close friend. I guess I never will." Which is the most appropriate response by the nurse? a. "Why will you never have any friends?" b. "You're feeling pretty down on yourself right now." c. "I'm sure they didn't mean to hurt your feelings." d. "You don't need friends to be happy."

b

An acutely depressed patient isolates herself in her room and just sits and stares into space. Which of these is the best example of an active communication approach with this patient? a. "Do you like exercise?" b. "Come with me. I will go with you to group therapy." c. "Would you like to go to group therapy, stay in bed, or come out to the day lounge for some activities?" d. "Why do you stay in your room all the time?"

b

Ann is a psychiatric home health nurse. She has just received an order to begin regular visits to Mrs. W, a 78-year-old widow who lives alone. Mrs. W's primary care physician has diagnosed her as depressed. Which of the following criteria would qualify Mrs. W for home health visits? a. Mrs. W never learned to drive and has to depend on others for her transportation. b. Mrs. W is physically too weak to travel without risk of injury. c. Mrs. W refuses to seek assistance as suggested by her physician because "I don't have a psychiatric problem." d. Mrs. W says she would prefer to have home visits than go to the physician's office.

b

Dan, who has been admitted to the alcohol rehabilitation unit after being fired for drinking on the job, states to the nurse, "I don't have a problem with alcohol. I can handle my booze better than anyone I know. My boss is a jerk! I haven't missed any more days than my coworkers." What is the nurse's best response? a. "Maybe your boss is mistaken, Dan." b. "You are here because your drinking was interfering with your work, Dan." c. "Get real, Dan! You're a boozer and you know it!" d. "Why do you think your boss is a jerk, Dan?"

b

Emma, age 14, has just been admitted to the psychiatric unit for anorexia nervosa. She is emaciated and refuses to eat. What is the primary nursing diagnosis for Emma? a. Complicated grieving b. Imbalanced nutrition: Less than body requirements c. Interrupted family processes d. Anxiety (severe)

b

From which of the following symptoms might the nurse identify a chronic cocaine user? a. Clear, constricted pupils b. Red, irritated nostrils c. Muscle aches d. Conjunctival redness

b

In an effort to help the child with mild to moderate intellectual developmental disorder develop satisfying relationships with others, which of the following nursing interventions is most appropriate? a. Interpret the child's behavior for others. b. Set limits on behavior that is socially inappropriate. c. Allow the child to behave spontaneously, for he or she has no concept of right or wrong. d. This child is not capable of forming social relationships.

b

In determining degree of suicide risk with a suicidal patient, the nurse assesses the following behavioral manifestations: severely depressed, withdrawn, statements of worthlessness, difficulty accomplishing activities of daily living, no close support systems. The nurse identifies the patient's risk for suicide as which of the following? a. Low risk b. High risk c. Imminent risk d. Unable to be determined

b

In establishing trust with Ellen, a client with the diagnosis of DID, the nurse must do which of the following? a. Try to relate to Ellen as though she did not have multiple identities. b. Listen nonjudgmentally and respond empathically when Ellen transitions to different identity states. c. Ignore behaviors that Ellen attributes to other subpersonalities. d. Explain to Ellen that he or she will work with her only if she maintains the status of the primary identity

b

Jareth has a diagnosis of generalized anxiety disorder. His physician has prescribed buspirone 15 mg daily. Jareth says to the nurse, "Why do I have to take this every day? My friend's doctor ordered Xanax for her, and she only takes it when she is feeling anxious." Which of the following would be an appropriate response by the nurse? a. "Xanax is not effective for generalized anxiety disorder." b. "Buspirone must be taken daily in order to be effective." c. "I will ask the doctor if he will change your dose of buspirone to prn so that you don't have to take it every day." d. "Your friend really should be taking the Xanax every day."

b

John has sought help for his concern that he is binge eating, and he feels it has "gotten out of control." He asks the nurse what can be done to help him. Which of the following is the most accurate response? a. "There is nothing that can be done." b. "There are some medications and psychological treatments that have demonstrated effectiveness in reducing binge eating behaviors." c. "The primary problem is obesity. I can help you set up a calorie-restricted diet." d. "There are medications that can help with weight loss, but there are no medications effective for reducing binge eating."

b

John, a veteran of the war in Iraq, is diagnosed with PTSD. He says to the nurse, "I can't figure out why God took my buddy instead of me." From this statement, the nurse assesses which of the following in John? a. Repressed anger b. Survivor's guilt c. Intrusive thoughts d. Spiritual distress

b

Josh, age 21, has been diagnosed with schizophrenia. He has been socially isolated and hearing voices telling him to kill his parents. He has been admitted to the psychiatric unit from the emergency department. The initial intervention for Josh is to: a. Give him an injection of haloperidol. b. Assess Josh to evaluate his safety toward himself and others. c. Place him in restraints. d. Order him a nutritious diet.

b

Kate is an 18-year-old freshman at the state university. She was extremely flattered when Don, a senior star football player, invited her to a party. On the way home, he parked the car in a secluded area by the lake. He became angry when she refused his sexual advances. He began to beat her and finally raped her. She tried to fight him, but his physical strength overpowered her. He dumped her in the dorm parking lot and left. The dorm supervisor rushed Kate to the emergency department. Kate says to the nurse, "It's all my fault. I shouldn't have allowed him to stop at the lake." Which of the following is the nurse's best response? a. "Yes, you're right. You put yourself in a very vulnerable position when you allowed him to stop at the lake." b. "You are not to blame for his behavior. You obviously made some right decisions, because you survived the attack." c. "There's no sense looking back now. Just look forward, and make sure you don't put yourself in the same situation again." d. "You'll just have to see that he is arrested so he won't do this to anyone else."

b

Lorraine, a client diagnosed with somatic symptom disorder, states, "My doctor thinks I should see a psychiatrist. I can't imagine why he would make such a suggestion." What is the most common basis for Lorraine's statement? a. She thinks her doctor wants to get rid of her as a client. b. She does not understand the correlation of symptoms and stress. c. She thinks psychiatrists are only for "crazy" people. d. She thinks her doctor has made an error in diagnosis.

b

Margaret, a 68-year-old widow experiencing a manic episode, is admitted to the psychiatric unit after being brought to the emergency department by her sister-in-law. Margaret yells, "My sister-in-law is just jealous of me! She's trying to make it look like I'm insane!" This behavior is an example of which of the following? a. A delusion of grandeur b. A delusion of persecution c. A delusion of reference d. A delusion of control or influence

b

Margaret, a 68-year-old widow, is brought to the emergency department by her sister-in-law. Margaret has a history of bipolar disorder and has been maintained on medication for many years. Her sister-in-law reports that Margaret quit taking her medication a few months ago, thinking she didn't need it anymore. Margaret is agitated, pacing, demanding, and speaking very loudly. Her sister-in-law reports that Margaret eats very little, is losing weight, and almost never sleeps. "I'm afraid she's going to just collapse!" Margaret is admitted to the psychiatric unit. What is the priority nursing diagnosis for Margaret? a. Imbalanced nutrition: Less than body requirements related to not eating b. Risk for injury related to hyperactivity c. Disturbed sleep pattern related to agitation d. Ineffective coping related to denial of depression

b

Marissa is hospitalized on the psychiatric unit. She has a history and current diagnosis of bulimia nervosa. Which of the following symptoms would be congruent with Marissa's diagnosis? a. Binging, purging, obesity, hyperkalemia b. Binging, purging, normal weight, hypokalemia c. Binging, laxative abuse, amenorrhea, severe weight loss d. Binging, purging, severe weight loss, hyperkalemia

b

Milieu therapy is a good choice for patients with antisocial personality disorder because it: a. Provides a system of punishment and rewards for behavior modification. b. Emulates a social community in which the patient may learn to live harmoniously with others. c. Provides mostly one-to-one interaction between the patient and therapist. d. Provides a structured setting in which the patients have very little input into the planning of their care.

b

Mr. Stone is a patient in the hospital with a diagnosis of vascular NCD. In explaining this disorder to Mr. Stone's family, which of the following statements by the nurse is correct? a. "He will probably live longer than if his disorder was of the Alzheimer's type." b. "Vascular NCD shows stepwise progression. This is why he sometimes seems okay." c. "Vascular NCD is caused by plaques and tangles that form in the brain." d. "The cause of vascular NCD is unknown."

b

Mrs. G has been diagnosed with NCD due to Alzheimer's disease. The primary nursing intervention in working with Mrs. G is which of the following? a. Ensuring that she receives food she likes to prevent hunger b. Ensuring that the environment is safe to prevent injury c. Ensuring that she meets the other patients to prevent social isolation d. Ensuring that she takes care of her own ADLs to prevent dependence

b

Mrs. G, who has NCD due to Alzheimer's disease, says to the nurse, "I have a date tonight. I always have a date on Christmas." Which of the following is the most appropriate response? a. "Don't be silly. It's not Christmas, Mrs. G." b. "Today is Tuesday, October 21, Mrs. G. We will have supper soon, and then your daughter will come to visit." c. "Who is your date with, Mrs. G?" d. "I think you need some more medication, Mrs. G. I'll bring it to you now."

b

Nancy has been diagnosed with dysthymic disorder. The physician has just prescribed 20 mg/day of fluoxetine. Nancy tells the nurse that she has been taking St. John's wort but still feels depressed. Which of the following is the appropriate response by the nurse? a. "St. John's wort is not effective for depression." b. "Do not take fluoxetine and St. John's wort together." c. "You probably just need to increase your dose of St. John's wort." d. "Go ahead and take the St. John's wort with the fluoxetine. Maybe both of them together will be more helpful."

b

Nina recently left her husband of 10 years. She was very dependent on her husband and is having difficulty adjusting to an independent lifestyle. She has been hospitalized with a diagnosis of adjustment disorder with depressed mood. Which of the following is the priority nursing diagnosis for Nina? a. Risk-prone health behavior related to loss of dependency b. Complicated grieving related to breakup of marriage c. Ineffective communication related to problems with dependency d. Social isolation related to depressed mood

b

Nina, who is depressed following the breakup of a very stormy marriage, says to the nurse, "I feel so bad. I thought I would feel better once I left, but I feel worse!" Which is the best response by the nurse? a. "Cheer up, Nina. You have a lot to be happy about." b. "You are grieving the loss of your marriage. It's natural for you to feel bad." c. "Try not to dwell on how you feel. If you don't think about it, you'll feel better." d. "You did the right thing, Nina. Knowing that should make you feel better."

b

Shane, a veteran of the war in Iraq, has been diagnosed with post-traumatic stress disorder (PTSD). He has been hospitalized after swallowing a handful of his antipanic medication. His physical condition has been stabilized in the emergency department, and he has been admitted to the psychiatric unit. In developing his initial plan of care, which is the priority nursing diagnosis for Shane? a. Post-trauma syndrome b. Risk for suicide c. Complicated grieving d. Disturbed thought processes

b

Sharon, a woman with multiple cuts and abrasions, arrives at the emergency department with her three small children. She tells the nurse that her husband inflicted these wounds on her. She says, "I didn't want to come. I'm really okay. He only does this when he has too much to drink. I just shouldn't have yelled at him." Which of the following is the best response by the nurse? a. "How often does he drink too much?" b. "It is not your fault. You did the right thing by coming here." c. "How many times has he done this to you?" d. "He is not a good husband. You have to leave him before he kills you."

b

Splitting" by the client with BPD denotes which of the following? a. Evidence of precocious development b. A primitive defense mechanism in which the client sees objects as all good or all bad c. A brief psychotic episode in which the client loses contact with reality d. Two distinct personalities within the borderline client

b

Success of long-term psychotherapy with Theresa (who attempted suicide following a break-up with her boyfriend) could be measured by which of the following behaviors? a. Theresa has a new boyfriend. b. Theresa has an increased sense of self-worth. c. Theresa does not take antidepressants anymore. d. Theresa told her old boyfriend how angry she was with him for breaking up with her.

b

The initial care plan for a patient with OCD who washes her hands obsessively would include which of the following nursing interventions? a. Keep the patient's bathroom locked so she cannot wash her hands all the time. b. Structure the patient's schedule so that she has plenty of time for washing her hands. c. Place the patient in isolation until she promises to stop washing her hands so much. d. Explain the patient's behavior to her because she is probably unaware that it is maladaptive.

b

The nurse is caring for a patient who has been hospitalized with anorexia nervosa and is severely malnourished. The patient continues to refuse to eat. What is the most appropriate response by the nurse? a. "You know that if you don't eat, you will die." b. "If you continue to refuse to take food orally, you will be fed through a nasogastric tube." c. "You might as well leave if you are not going to follow your therapy regimen." d. "You don't have to eat if you don't want to. It is your choice."

b

The nurse is interviewing a patient on the psychiatric unit. The patient tilts his head to the side, stops talking in midsentence, and listens intently. The nurse recognizes these behaviors as a symptom of the patient's illness. What is the most appropriate nursing intervention for this symptom? a. Ask the patient to describe his physical symptoms. b. Ask the patient to describe what he is hearing. c. Administer a dose of benztropine. d. Call the physician for additional orders.

b

The nurse manager recognizes a need to improve mental health and substance use screening and referral services for their clients in the public health clinic. Which of the following is a priority to begin an effective process for implementation? a. Provide a list of referral sources that is readily available to staff. b. Educate staff about the importance of prioritizing these public health concerns. c. Explore the literature for evidence-based screening tools. d. Inform the staff that they have been stigmatizing patients and this will not be tolerated.

b

The physician orders sertraline (Zoloft) 50 mg PO bid for Margaret, a 68-year-old woman with major depressive disorder. After 3 days of taking the medication, Margaret says to the nurse, "I don't think this medicine is doing any good. I don't feel a bit better." What is the most appropriate response by the nurse? a. "Cheer up, Margaret. You have so much to be happy about." b. "Sometimes it takes a few weeks for the medicine to bring about an improvement in symptoms." c. "I'll report that to the physician, Margaret. Maybe he will order something different." d. "Try not to dwell on your symptoms, Margaret. Why don't you join the others down in the dayroom?"

b

The ultimate goal of therapy for a client with DID is most likely achieved through which of the following interventions? a. Crisis intervention and directed association b. Psychotherapy and hypnosis c. Psychoanalysis and free association d. Insight psychotherapy and dextroamphetamines

b

Which of the following activities would be most appropriate for the child with attention-deficit/hyperactivity disorder (ADHD)? a. Monopoly b. Volleyball c. Pool d. Checkers

b

Which of the following behavioral patterns is characteristic of individuals with schizotypal personality disorder? a. Belittling themselves and their abilities b. A lifelong pattern of social withdrawal c. Suspiciousness and mistrust of others d. Overreacting inappropriately to minor stimuli

b

Which of the following drug classes is most commonly used for management of the child with ADHD? a. CNS depressants (e.g., diazepam [Valium]) b. CNS stimulants (e.g., methylphenidate [Ritalin]) c. Anticonvulsants (e.g., phenytoin [Dilantin]) d. Major tranquilizers (e.g., haloperidol [Haldol])

b

Which of the following ego defense mechanisms describes the underlying psychodynamics of somatic symptom disorder? a. Denial of depression b. Repression of anxiety c. Suppression of grief d. Displacement of anger

b

Which of the following is the leading cause of traumatic brain injury (TBI) in active-duty military personnel in combat? a. Military vehicle accidents b. Blasts from explosive devices c. Falls d. Blows to the head from falling debris

b

Which of the following is the primary goal in working with an actively psychotic, suspicious patient? a. Promote interaction with others. b. Decrease his anxiety and increase trust. c. Improve his relationship with his parents. d. Encourage participation in therapy activities.

b

Which of the following medications is the physician most likely to order for a patient experiencing alcohol withdrawal syndrome? a. Haloperidol (Haldol) b. Chlordiazepoxide (Librium) c. Methadone (Dolophine) d. Cannabidiol (Epidiolex)

b

Which of the following medications is used to treat Tourette's disorder? a. Methylphenidate (Ritalin) b. Haloperidol (Haldol) c. Imipramine (Tofranil) d. Phenytoin (Dilantin)

b

Which of the following represents a nursing intervention at the secondary level of prevention? a. Teaching a class about menopause to middle-aged women b. Providing support in the emergency department to a rape victim c. Leading a support group for women in transition d. Making monthly visits to the home of a client with schizophrenia to ensure medication compliance

b

Why is it important for the nurse to check the temperature of the water before an elderly individual gets into the shower? a. The client may catch cold if the water temperature is too low. b. The client may burn himself because of a higher pain threshold. c. Elderly clients have difficulty discriminating between hot and cold. d. The water must be exactly 98.6°F.

b

ana, age 5, is sent to the school nurse's office with an upset stomach. She has vomited and soiled her blouse. When the nurse removes her blouse, she notices that Jana has numerous bruises on her arms and torso in various stages of healing. She also notices some small scars. Jana's abdomen protrudes on her small, thin frame. From the objective physical assessment, the nurse suspects that: a. Jana is experiencing physical and sexual abuse. b. Jana is experiencing physical abuse and neglect. c. Jana is experiencing emotional neglect. d. Jana is experiencing sexual and emotional abuse.

b

The child with ADHD has a nursing diagnosis of impaired social interaction. Which of the following nursing interventions are appropriate for this child? (Select all that apply.) a. Socially isolate the child when interactions with others are inappropriate. b. Set limits with consequences on inappropriate behaviors. c. Provide rewards for appropriate behaviors. d. Provide group situations for the child.

b.c.d

Sheila, a nurse, served as a captain in the military and returned from active duty 3 months ago. She reports experiencing nightmares and headaches since her return but denies being engaged in active combat during her tour of duty. Which of the following should the nurse include in the psychosocial assessment? (Select all that apply.) a. Folstein's mini-mental status exam b. History of sexual trauma c. History of military promotions d. Risks for substance use disorders

b.d

The nurse is prioritizing nursing diagnoses in the plan of care for a patient experiencing a manic episode. Number the diagnoses in order of the appropriate priority. a. Disturbed sleep pattern evidenced by sleeping only 4 to 5 hours per night b. Risk for injury related to manic hyperactivity c. Impaired social interaction evidenced by manipulation of others d. Imbalanced nutrition: Less than body requirements evidenced by loss of weight and poor skin turgor

b.d.a.c

Theresa, who has been hospitalized following a suicide attempt, is placed on suicide precautions on the psychiatric unit. She admits that she is still feeling suicidal. Which of the following interventions is most appropriate in this instance? (Select all that apply.) a. Restrict access to any item that might be harmful by placing the patient in a seclusion room. b. Check on Theresa every 15 minutes at irregular intervals or assign a staff person to stay with her on a one-to-one basis. c. Obtain an order from the physician to give Theresa a sedative to calm her and reduce suicide ideas. d. Do not allow Theresa to participate in any unit activities while she is on suicide precautions. e. Ask Theresa specific questions about her thoughts, plans, and intentions related to suicide.

b.e

A child with bipolar disorder also has attention deficit-hyperactivity disorder (ADHD). How would these comorbid conditions most likely be treated? a. No medication would be given for either condition. b. Medication would be given for both conditions simultaneously. c. The bipolar condition would be stabilized first before medication for the ADHD would be given. d. The ADHD would be treated before consideration of the bipolar disorder.

c

A competent, voluntary client has stated that he wants to leave the hospital. The nurse hides his clothes in an effort to keep him from leaving. With which of the following legal actions might the nurse be charged because of this nursing action? a. Assault b. Battery c. False imprisonment d. Breach of confidentiality

c

A hospitalized patient with bulimia nervosa has stopped vomiting in the hospital and tells the nurse she is afraid she is going to gain weight. Which is the most appropriate response by the nurse? a. "Don't worry. The dietitian will ensure you don't get too many calories in your diet." b. "Don't worry about your weight. We are going to work on other problems while you are in the hospital." c. "I understand that you are concerned about your weight, and we will talk about the importance of good nutrition; but for now, I want you to tell me about your recent invitation to join the National Honor Society. That's quite an accomplishment." d. "You are not fat, and the staff will ensure that you do not gain weight while you are in the hospital, because we know that is important to you."

c

A nurse is assisting an individual with mental illness recovery using the Tidal Model. Which of the following is a component of this model? a. The wellness toolbox b. The daily maintenance list c. The individual's personal story d. Triggers

c

A patient recently admitted to the hospital reports to the nurse, "I don't understand why I was brought here. I was simply hanging out in my apartment, and the police said I had to come with them." This is an example of what symptom of schizophrenia? a. Delusions of reference b. Loose association c. Anosognosia d. Auditory hallucinations

c

A patient whose husband died 6 months ago is diagnosed with major depressive disorder. She says to the nurse, "I start feeling angry that Harold died and left me all alone; he should have stopped smoking years ago! But then I start feeling guilty for feeling that way." What is an appropriate response by the nurse? a. "Yes, he should have stopped smoking. Then he probably wouldn't have gotten lung cancer." b. "I can understand how you must feel." c. "Those feelings are a normal part of the grief response." d. "Just think about the good times that you had while he was alive."

c

An elderly patient says to the nurse, "I don't want to go to that crafts class. I'm too old to learn anything." Based on knowledge of the aging process, which of the following is a true statement? a. Memory functioning in the elderly most likely reflects loss of long-term memories of remote events. b. Intellectual functioning declines with advancing age. c. Learning ability remains intact, but time required for learning increases with age. d. Cognitive functioning is rarely affected in aging individuals.

c

Ann is a psychiatric home health nurse. She has just received an order to begin regular visits to Mrs. W, a 78-year-old widow who lives alone. Mrs. W's primary care physician has diagnosed her as depressed. Which of these potential problems is a priority to evaluate during the first home visit? a. Complicated grieving b. Social isolation c. Risk for injury d. Sleep pattern disturbance

c

At a synapse, the determination of further impulse transmission is accomplished by means of which of the following? a. Potassium ions b. Interneurons c. Neurotransmitters d. The myelin sheath

c

Attempting to calm an angry client by using "talk therapy" is an example of which of the following clients' rights? a. The right to privacy b. The right to refuse medication c. The right to the least restrictive treatment alternative d. The right to confidentiality

c

Dan has been admitted to the alcohol rehabilitation unit after being fired for drinking on the job. Dan's drinking buddies come for a visit, and when they leave, the nurse smells alcohol on Dan's breath. Which of the following would be the best intervention with Dan at this time? a. Search his room for evidence. b. Ask, "Have you been drinking alcohol, Dan?" c. Send a urine specimen from Dan to the laboratory for drug screening. d. Tell Dan, "These guys cannot come to the unit to visit you again.

c

Gloria, a recent widow, states, "I'm going to have to learn to pay all the bills. Hank always did that. I don't know if I can handle all of that." This is an example of which of the tasks described by Worden? a. Task I. Accepting the reality of the loss b. Task II. Processing the pain of grief c. Task III. Adjusting to a world without the lost entity d. Task IV. Finding an enduring connection with the lost entity in the midst of embarking on a new life

c

In evaluating the progress of Jack, a patient diagnosed with antisocial personality disorder, which of the following behaviors would be considered the most significant indication of positive change? a. Jack got angry only once in group this week. b. Jack tells the nurse how much he respects her work and that she has helped him immensely. c. On his own initiative, Jack sent a note of apology to a man he had injured in a recent fight. d. Jack stated that he would not start any more fights.

c

John, a homeless person, has just come to live in the shelter. The shelter nurse is assigned to his care. Which of the following is a priority intervention on the part of the nurse? a. Referring John to a social worker b. Developing a plan of care for John c. Conducting a behavioral and needs assessment on John d. Helping John apply for Social Security benefits

c

John, a veteran of the war in Iraq, is diagnosed with PTSD. He experiences a nightmare during his first night in the hospital. He explains to the nurse that he was dreaming about gunfire all around and people being killed. Which of the following is the nurse's most appropriate initial intervention? a. Administer alprazolam as ordered prn for anxiety. b. Call the physician and report the incident. c. Stay with John and reassure him of his safety. d. Have John listen to a tape of relaxation exercises.

c

Joselyn is a new patient at the mental health clinic. She has been diagnosed with Body Dysmorphic Disorder. Which of the following medications is the psychiatric nurse practitioner most likely to prescribe for Joanie? a. Alprazolam (Xanax) b. Diazepam (Valium) c. Fluoxetine (Prozac) d. Olanzapine (Zyprexa)

c

Juan, a veteran of the war in Iraq, has been diagnosed with post-traumatic stress disorder (PTSD). He has been hospitalized on the psychiatric unit following an attempted suicide. In the middle of the night, he wakes up yelling and tells the nurse he was having a flashback to when his unit transport drove over an improvised explosive device (IED) and most of his fellow soldiers were killed. He is breathing heavily, perspiring, and his heart is pounding. The nurse's most appropriate initial intervention is which of the following? a. Contact the doctor on call to report the incident. b. Administer the prn order for chlorpromazine. c. Stay with Juan and reassure him of his safety. d. Have Juan sit outside the nurses' station until he is calm.

c

Katerina, who is experiencing a manic episode, enters the milieu area dressed in a provocative and physically revealing outfit. Which of the following is the most appropriate intervention by the nurse? a. Tell her, in front of the other patients, that she cannot dress like a ***** while she is in the hospital. b. Do nothing and allow her to learn from the responses of her peers. c. Quietly walk with her back to her room and help her change into something more appropriate. d. Explain to her that if she wears this outfit, she must remain in her room.

c

Lorraine, a client diagnosed with somatic symptom disorder, tells the nurse about a pain in her side. She says she has not experienced it before. Which is the most appropriate response by the nurse? a. "I don't want to hear about another physical complaint. You know they are all in your head. It's time for group therapy now." b. "Let's sit down here together, and you can tell me about this new pain you are experiencing. You'll just have to miss group therapy today." c. "I will report this pain to your physician. In the meantime, group therapy starts in 5 minutes." d. "I will call your physician and see if he will order a new pain medication for your side. The one you have now doesn't seem to provide relief. Why don't you get some rest for now?"

c

Lucky sometimes refused to obey Anna and indeed did not come back to her when she called to him on the day he was killed. But Anna continues to insist, "He was the very best dog. He always minded me. He always did everything I told him to do." Which of the following is the correct term for this defense mechanism? a. Sublimation b. Compensation c. Reaction formation d. Undoing

c

Margaret, age 68, is a widow of 6 months. Since her husband died, her sister reports that Margaret has become socially withdrawn, has lost weight, and does little more each day than visit the cemetery where her husband was buried. She told her sister today that "she doesn't have anything more to live for." She has been hospitalized with a diagnosis of Major Depressive Disorder. The priority nursing diagnosis for Margaret is: a. Imbalanced nutrition: Less than body requirements b. Complicated grieving c. Risk for suicide d. Social isolation

c

Margaret, age 68, is diagnosed with bipolar I disorder, current episode manic. She is extremely hyperactive and has lost weight. What is one way to promote adequate nutritional intake for Margaret? a. Sit with her during meals to ensure that she eats everything on her tray. b. Have her sister-in-law bring all her food from home because she knows Margaret's likes and dislikes. c. Provide high-calorie, nutritious finger foods and snacks that Margaret can eat "on the run." d. Tell Margaret that she will be on room restriction until she starts gaining weight.

c

Mike was injured during combat in Afghanistan. He has a diagnosis of traumatic brain injury (TBI). Which of the following medications might the physician prescribe to improve Mike's memory and thinking capability? a. Carbamazepine b. Duloxetine c. Donepezil d. Bupropion

c

Mr. B, age 79, is admitted to the psychiatric unit for depression. He has lost weight and has become socially isolated. His wife died 5 years ago, and he lives alone. A suicide assessment is conducted. Why is Mr. B at high risk for suicide? a. All depressed people are at high risk for suicide. b. Mr. B is in the age group in which the highest percentage of suicides occur. c. Mr. B is a white man, recently bereaved, living alone. d. His son reports that Mr. B owns a gun.

c

Nancy, who is dying of cancer, says to the nurse, "I just want to see my new grandbaby. If only God will let me live until she is born. Then I'll be ready to go." This is an example of which of Kübler-Ross's stages of grief? a. Denial b. Anger c. Bargaining d. Acceptance

c

Nina has been hospitalized with adjustment disorder with depressed mood following the breakup of her marriage. Which of the following is true regarding the diagnosis of adjustment disorder? a. Nina will require long-term psychotherapy to achieve relief. b. Nina likely inherited a genetic tendency for the disorder. c. Nina's symptoms will likely remit once she has accepted the change in her life. d. Nina probably would not have experienced adjustment disorder if she had a higher level of intelligence.

c

Sandy, a patient with OCD says to the nurse, "I've been here four days now, and I'm feeling better. I feel comfortable on this unit, and I'm not ill-at-ease with the staff or other patients anymore." In light of this change, which nursing intervention is most appropriate? a. Give attention to the ritualistic behaviors each time they occur and point out their inappropriateness. b. Ignore the ritualistic behaviors, and they will be eliminated for lack of reinforcement. c. Set limits on the amount of time Sandy may engage in the ritualistic behavior. d. Continue to allow Sandy all the time she wants to carry out the ritualistic behavior.

c

Sharon, a woman with multiple cuts and abrasions, arrives at the emergency department with her three small children. She tells the nurse that her husband inflicted these wounds on her. In the interview, Sharon tells the nurse, "He's been getting more and more violent lately. He's been under a lot of stress at work the last few weeks, so he drinks a lot when he gets home. He always gets mean when he drinks. I was getting scared. So I just finally told him I was going to take the kids and leave. He got furious when I said that and began beating me with his fists." With knowledge about the cycle of battering, what does this situation represent? a. Phase I. Sharon was desperately trying to stay out of his way and keep everything calm. b. Phase I. A minor battering incident for which Sharon assumes all the blame. c. Phase II. The acute battering incident that was provoked by her threat to leave. d. Phase III. The honeymoon phase when the husband believes that he has "taught her a lesson and she won't act up again."

c

Some obese individuals take amphetamines to suppress appetite and help them lose weight. Which of the following is an adverse effect associated with use of amphetamines that makes this practice undesirable? a. Bradycardia b. Amenorrhea c. Tolerance d. Convulsions

c

Stanley, age 72, is admitted to the hospital for depression. His son reports that he has periods of confusion and forgetfulness. In her admission assessment, the nurse notices an open sore on Stanley's arm. When she questions him about it he says, "I scraped it on the fence two weeks ago. It's smaller than it was." How might the nurse analyze these data? a. Consider that Stanley may have been attempting self-harm. b. The delay in healing may indicate that Stanley has developed skin cancer. c. A diminished inflammatory response in the elderly increases healing time. d. Age-related skin changes and distribution of adipose tissue delay healing in the elderly.

c

Symptoms of alcohol withdrawal include which of the following? a. Euphoria, hyperactivity, and insomnia b. Depression, suicidal ideation, and hypersomnia c. Diaphoresis, nausea and vomiting, and tremors d. Unsteady gait, nystagmus, and profound disorientation

c

The child with autism spectrum disorder (ASD) has difficulty with trust. With this in mind, which of the following nursing actions would be most appropriate? a. Encourage all staff to hold the child as often as possible, conveying trust through touch. b. Assign a different staff member each day so child will learn that everyone can be trusted. c. Assign same staff person as often as possible to promote feelings of security and trust. d. Avoid eye contact, because this is extremely uncomfortable for the child, and may even discourage trust.

c

The night nurse finds Mrs. G, a client with Alzheimer's disease, wandering the hallway at 4 a.m. and trying to open the door to the side yard. Which statement by the nurse reflects the most patient-centered approach to the situation? a. "That door leads out to the patio, Mrs. G. It's nighttime. You don't want to go outside now." b. 'You look confused, Mrs. G. What is bothering you?" c. "This is the patio door, Mrs. G. Are you looking for the bathroom?" d. "Are you lonely? Perhaps you'd like to go back to your room and talk for a while."

c

The nurse is caring for a patient with schizophrenia. Orders from the physician include haloperidol (Haldol) 5 mg. IM STAT and then 3 mg PO tid, 2 mg benztropine PO bid prn. Why is haloperidol ordered? a. To reduce extrapyramidal symptoms b. To prevent neuroleptic malignant syndrome c. To decrease psychotic symptoms d. To induce sleep

c

The nurse is interviewing a patient on the psychiatric unit. The patient tilts his head to the side, stops talking in midsentence, and listens intently. The nurse recognizes from these signs that the patient is likely experiencing which of the following? a. Somatic delusions b. Catatonic stupor c. Auditory hallucinations d. Pseudoparkinsonism

c

The nursing history and assessment of an adolescent with a conduct disorder might reveal all of the following behaviors except: a. Manipulation of others for fulfillment of own desires. b. Chronic violation of rules. c. Feelings of guilt associated with the exploitation of others. d. Inability to form close peer relationships.

c

Theresa is hospitalized following a suicide attempt after breaking up with her boyfriend. Theresa says to the nurse, "When I get out of here, I'm going to try this again, and next time I'll choose a no-fail method." Which is the best response by the nurse? a. "You are safe here. We will make sure nothing happens to you." b. "You're just lucky your roommate came home when she did." c. "What exactly do you plan to do?" d. "I don't understand. You have so much to live for."

c

Theresa, age 27, was admitted to the psychiatric unit from the medical intensive care unit where she was treated for taking a deliberate overdose of her antidepressant medication, trazodone (Desyrel). She says to the nurse, "My boyfriend broke up with me. We had been together for 6 years. I love him so much. I know I'll never get over him." Which is the best response by the nurse? a. "You'll get over him in time, Theresa." b. "Forget him. There are other fish in the sea." c. "You must be feeling very sad about your loss." d. "Why do you think he broke up with you, Theresa?"

c

When Shelly enters the emergency department she reports, "My bed is on fire, and my stomach, and we're all dead." The nurse's initial response is to call the psychiatric unit to secure an inpatient bed for this patient. This is an example of: a. Prompt, appropriate referral b. Patient-centered care c. Stigma d. Collaboration

c

When a patient suddenly becomes aggressive and violent on the unit, which of the following approaches would be best for the nurse to use first? a. Provide large motor activities to relieve the patient's pent-up tension. b. Administer a dose of prn olanzapine to keep the patient calm. c. Call for sufficient help to control the situation safely. d. Convey to the patient that his behavior is unacceptable and will not be permitted.

c

Which grief reaction can the nurse anticipate in a 10-year-old child? a. Statements that the deceased person will soon return b. Regressive behaviors, such as loss of bladder control c. A preoccupation with the loss d. Thinking that he or she may have done something to cause the death

c

Which medication has been used with some success in clients with anorexia nervosa? a. Lorcaserin (Belviq) b. Diazepam (Valium) c. Fluoxetine (Prozac) d. Carbamazepine (Tegretol)

c

Which of the following applies to vitamin C? a. Coenzyme in protein metabolism; found in meat and dairy products b. Necessary in formation of DNA; found in beans and other legumes c. A powerful antioxidant; found in tomatoes and strawberries d. Necessary for blood clotting; found in whole grains and bananas

c

Which of the following is not true regarding grieving by an adolescent? a. Adolescents may not show their true feelings about the death. b. Adolescents tend to have an immortal attitude. c. Adolescents do not perceive death as inevitable. d. Adolescents may exhibit acting-out behaviors as part of their grief.

c

Which of the following is the most appropriate therapy for a client with agoraphobia? a. 10 mg Valium qid b. Group therapy with other people with agoraphobia c. Facing her fear in gradual step progression d. Hypnosis

c

Which of the following physical manifestations would you expect to assess in a patient suffering from anorexia nervosa? a. Tachycardia, hypertension, hyperthermia b. Bradycardia, hypertension, hyperthermia c. Bradycardia, hypotension, hypothermia d. Tachycardia, hypotension, hypothermia

c

Which of the following herbs is thought to be helpful in relieving menstrual cramping? (Select all that apply.) a. Feverfew b. Ginger c. Chamomile d. Black cohosh

c.d

An example of a treatable (reversible) form of NCD is one that is caused by which of the following? (Select all that apply.) a. Multiple sclerosis b. Multiple small brain infarcts c. Electrolyte imbalances d. HIV disease e. Folate deficiency

c.e

Which of the following interventions is most appropriate in helping a patient with Alzheimer's disease with her ADLs? (Select all that apply.) a. Perform ADLs for her while she is in the hospital. b. Provide her with a written list of activities she is expected to perform. c. Assist her with step-by-step instructions. d. Tell her that if her morning care is not completed by 9:00 a.m., it will be performed for her by the nurse's aide so that she can attend group therapy. e. Encourage her and give her plenty of time to perform as many of her ADLs as possible independently.

c.e

A nurse is assisting an individual with mental illness recovery using the Psychological Recovery Model. The patient states to the nurse, "I have schizophrenia. Nothing can be done. I might as well die." In which stage of the Psychological Recovery Model would the nurse assess this individual to be? a. The awareness stage b. The preparation stage c. The rebuilding stage d. The moratorium stage

d

A school nurse notices bruises and scars on a child's body, but the child refuses to say how she received them. What is another way in which the nurse can get information from the child? a. Have her evaluated by the school psychologist. b. Tell her she may select a "treat" from the treat box (e.g., sucker, balloon, junk jewelry) if she answers the nurse's questions. c. Explain to her that if she answers the questions, she may stay in the nurse's office and not have to go back to class. d. Use a "family" of dolls to role-play the child's family with her.

d

A woman who has a long history of being battered by her husband is staying at the woman's shelter. She has received emotional support from staff and peers and has been made aware of the alternatives open to her. Nevertheless, she decides to return to her home and marriage. Which of the following is the best response by the nurse to the woman's decision? a. "I just can't believe you have decided to go back to that horrible man." b. "I'm just afraid he will kill you or the children when you go back." c. "What makes you think things have changed with him?" d. "I hope you have made the right decision. Call this number if you need help."

d

A woman who was sexually assaulted 6 months ago by a man with whom she was acquainted has since been attending a support group for survivors of rape. From this group, she has learned that the most likely reason the man raped her was: a. Because he had been drinking, he was not in control of his actions. b. He had not had sexual relations with a girl in many months. c. He was predisposed to become a rapist by virtue of the poverty conditions under which he was reared. d. He was expressing power and dominance by means of sexual aggression and violence.

d

According to Margaret Mahler, predisposition to BPD occurs when developmental tasks go unfulfilled in which of the following phases? a. Autistic phase, during which the child's needs for security and comfort go unfulfilled b. Symbiotic phase, during which the child fails to bond with the mother c. Differentiation phase, during which the child fails to recognize a separateness between self and mother d. Rapprochement phase, during which the mother withdraws emotional support in response to the child's increasing independence

d

An individual who is addicted to heroin is likely to experience which of the following symptoms of withdrawal? a. Increased heart rate and blood pressure b. Tremors, insomnia, and seizures c. Incoordination and unsteady gait d. Nausea and vomiting, diarrhea, and diaphoresis

d

Brandon, a patient on the psychiatric unit, has been diagnosed with schizophrenia. He begins to tell the nurse about how the CIA is looking for him and will kill him if they find him. Which of the following is the most appropriate response by the nurse? a. "That's ridiculous, Brandon. No one is going to hurt you." b. "The CIA isn't interested in people like you, Brandon." c. "Why do you think the CIA wants to kill you?" d. "I know you believe that, Brandon, but it's really hard for me to believe."

d

Certain family dynamics often predispose adolescents to the development of conduct disorder. Which of the following patterns is thought to be a contributing factor? a. Parents who are overprotective b. Parents who have high expectations for their children c. Parents who consistently set limits on their children's behavior d. Parents who are alcohol dependent

d

Education for the patient who is taking MAOIs should include which of the following? a. Fluid and sodium replacement when appropriate, frequent drug blood levels, signs and symptoms of toxicity b. Lifetime of continuous use, possible tardive dyskinesia, advantages of an injection every 2 to 4 weeks c. Short-term use, possible tolerance to beneficial effects, careful tapering of the drug at end of treatment d. Tyramine-restricted diet, prohibitive concurrent use of over-the-counter medications without physician notification

d

Ellen has a history of childhood physical and sexual abuse. She was diagnosed with dissociative identity disorder (DID) 6 years ago. She has been admitted to the psychiatric unit following a suicide attempt. What is the primary nursing diagnosis for Ellen? a. Disturbed personal identity related to childhood abuse b. Disturbed sensory perception related to repressed anxiety c. Impaired memory related to disturbed thought processes d. Risk for suicide related to unresolved grief

d

Emma, age 16, has recently been diagnosed with diabetes mellitus. She must watch her diet and take an oral hypoglycemic medication daily. She has become very depressed, and her mother reports that Emma refuses to change her diet and often skips her medication. Emma has been hospitalized for stabilization of her blood sugar. The psychiatric nurse practitioner has been called in as a consultant. Which of the following nursing diagnoses by the psychiatric nurse would be a priority for Emma at this time? a. Anxiety related to hospitalization evidenced by noncompliance b. Low self-esteem related to feeling different from her peers evidenced by social isolation c. Risk for suicide related to new diagnosis of diabetes mellitus d. Risk-prone health behavior related to denial of seriousness of her illness evidenced by refusal to follow diet and take medication

d

Engel identifies which of the following as successful resolution of the grief process? a. When the bereaved person can talk about the loss without crying b. When the bereaved person no longer talks about the lost entity c. When the bereaved person puts all remembrances of the loss out of sight d. When the bereaved person can discuss both positive and negative aspects about the lost entity

d

Jessica is a nurse who was floated to the psychiatric unit to cover for a staff nurse who called out sick. She encounters a patient who is diagnosed with BPD, and the patient states, "Thank goodness they sent you to the unit. No one else here has taken the time to listen to my concerns." This may be an example of which symptom common in BPD? a. Impulsivity b. Self-harming behaviors c. Dissociation d. Splitting

d

John, a homeless person, has a history of schizophrenia and nonadherence to his medication regimen. Which of the following medications might be the best choice for John? a. Haldol b. Navane c. Lithium carbonate d. Prolixin decanoate

d

Kim has a diagnosis of BPD. She often exhibits alternating clinging and distancing behaviors. Which of the following is the most appropriate nursing intervention with this type of behavior? a. Encourage Kim to establish trust in one staff person with whom all therapeutic interaction should take place. b. Secure a verbal contract from Kim that she will discontinue these behaviors. c. Withdraw attention if these behaviors continue. d. Rotate staff members who work with Kim so that she will learn to relate to more than one person.

d

Lucille has a diagnosis of Illness Anxiety Disorder. Which of the following symptoms would be consistent with this diagnosis? a. Complains of a multitude of incapacitating physical symptoms b. Manifests with pseudoseizures or pseudocyesis c. Takes substances to induce vomiting in order to convince the nurse that she needs treatment d. Expresses persistent fears of having life-threatening disease e. All of the above

d

Mr. B, age 79, is admitted to the psychiatric unit for depression. He has lost weight and has become socially isolated. His wife died 5 years ago, and his son tells the nurse, "He did very well when Mom died. He didn't even cry." Which would be the priority nursing intervention for Mr. B? a. Take blood pressure once each shift. b. Ensure that Mr. B attends group activities. c. Encourage Mr. B to eat all of the food on his food tray. d. Encourage Mr. B to talk about his wife's death

d

Mr. Li is a patient on a medical unit and is identified as having suicidal ideation. Which of the following is a priority in managing his immediate care? a. Screen for depression b. Provide sedative medication c. Refer him to another setting d. Continuous monitoring and observation

d

Mrs. G has been diagnosed with NCD due to Alzheimer's disease. This disorder is associated with the presence of which of the following? a. Multiple small brain infarcts b. Lewy bodies c. Cerebral abscess d. Amyloid beta plaques and neurofibrillary tangles

d

Mrs. G, who has NCD due to Alzheimer's disease, has trouble sleeping and wanders around at night. Which of the following nursing actions would be best to promote sleep in Mrs. G? a. Ask the doctor to prescribe flurazepam (Dalmane). b. Ensure that Mrs. G gets an afternoon nap so she will not be overtired at bedtime. c. Make Mrs. G a cup of tea with honey before bedtime. d. Ensure that Mrs. G gets regular physical exercise during the day.

d

Mrs. W, a 78-year-old depressed widow, says to her home health nurse, "What's the use? I don't have anything to live for anymore." Which is the best response on the part of the nurse? a. "Of course you do, Mrs. W. Why would you say such a thing?" b. "You seem so sad. I'm going to do my best to cheer you up." c. "Let's talk about why you are feeling this way." d. "Have you been thinking about harming yourself in any way?"

d

Ms. T has been diagnosed with agoraphobia. Which behavior would be most characteristic of this disorder? a. Ms. T experiences panic anxiety when she encounters snakes. b. Ms. T refuses to fly in an airplane. c. Ms. T will not eat in a public place. d. Ms. T stays in her home for fear of being in a place from which she cannot escape.

d

Nursing care for Jenna, a patient with somatic symptom disorder, would focus on helping her to do which of the following? a. Eliminate the stress in her life. b. Discontinue her numerous physical complaints. c. Take her medication only as prescribed. d. Learn more adaptive coping strategies.

d

The nurse is caring for a patient with schizophrenia. Orders from the physician include 5 mg haloperidol IM STAT and then 3 mg PO tid, 2 mg benztropine PO bid prn. Because benztropine was ordered on a prn basis, which of the following assessments by the nurse would convey a need for this medication? a. The patient's level of agitation increases. b. The patient complains of a sore throat. c. The patient's skin has a yellowish cast. d. The patient develops muscle spasms.

d

Theresa is hospitalized following a suicide attempt after breaking up with her boyfriend. Klonsky and May's "Three-Step Theory" suggests that the nurse should assess which three issues to evaluate Theresa's active risk for a suicide attempt? a. Level of education, ethnic background, and current employment b. Relationships with previous boyfriends, coping mechanisms, and intent to have future boyfriends c. Self-esteem, grade point average, and physical attractiveness d. Degree of psychological pain, connectedness with others, and suicide ideation in combination with capacity to make an attempt

d

What is the most appropriate way to communicate with an elderly person who is deaf in his right ear? a. Speak loudly into his left ear. b. Speak to him from a position on his left side. c. Speak face-to-face in a high-pitched voice. d. Speak face-to-face in a low-pitched voice.

d

Which of the following applies to calcium? a. Coenzyme in carbohydrate metabolism; found in whole grains and citrus fruits b. Facilitates iron absorption; found in vegetable oils and liver c. Prevents night blindness; found in egg yolk and cantaloupe d. Important for nerve and muscle functioning; found in dairy products and oysters

d

Which of the following is the most common comorbid condition in children with bipolar disorder? a. Schizophrenia b. Substance disorders c. Oppositional defiant disorder d. Attention deficit-hyperactivity disorder

d

Which of the following is the primary focus of family therapy for patients with schizophrenia and their families? a. To discuss concrete problem-solving and adaptive behaviors for coping with stress b. To introduce the family to others with the same problem c. To keep the patient and family in touch with the healthcare system d. To promote family interaction and increase understanding of the illness

d

Which of the following may be influential in the predisposition to PTSD? a. Unsatisfactory parent-child relationship b. Excess of the neurotransmitter serotonin c. Distorted, negative cognitions d. Severity of the stressor and availability of support systems

d

Which of the following psychosocial therapies has been shown to be helpful for clients with traumatic brain injury (TBI)? a. Eye movement desensitization b. Psychoanalysis c. Reality therapy d. Cognitive behavioral therapy

d

With implosion therapy, a client with phobic anxiety would be: a. Taught relaxation exercises. b. Subjected to graded intensities of the fear. c. Instructed to stop the therapeutic session as soon as anxiety is experienced. d. Presented with massive exposure to a variety of stimuli associated with the phobic object or situation.

d

Anna states that Lucky was her closest friend, and since his death, there is no one who could ever replace the relationship they had. According to Maslow's hierarchy of needs, which level of need is not being met? a. Physiological needs b. Self-esteem needs c. Safety and security needs d. Love and belonging needs

D

Three years ago, Anna's dog Lucky, whom she had had for 16 years, was run over by a car and killed. Anna's daughter reports that since that time, Anna has lost weight, rarely leaves her home, and just sits and talks about Lucky. Anna's behavior would be considered maladaptive for which of the following reasons? a. It has been more than 3 years since Lucky died. b. Her grief is too intense over just the loss of a dog. c. Her grief is interfering with her functioning. d. Cultural norms typically don't comprehend grief over the loss of a pet.

C

Which of the following parts of the brain deals with sensory perception and interpretation? a. Hypothalamus b. Cerebellum c. Parietal lobe d. Hippocampus

C

Mrs. S. asks the nurse, "Do you think I should tell my husband about my affair with my boss?" Which is the most appropriate response by the nurse? a. "What do you think would be best for you to do?" b. "Of course you should. Marriage has to be based on truth." c. "Of course not. That would only make things worse." d. "I can't tell you what to do. You have to decide for yourself."

a

Amanda's mobile home was destroyed by a tornado. Amanda received only minor injuries but is experiencing disabling anxiety in the aftermath of the event. What is this type of crisis called? a. Crisis resulting from traumatic stress b. Maturational or developmental crisis c. Dispositional crisis d. Crisis of anticipated life transitions

a

Chelsea says to the nurse, "I worked as a secretary to put my husband through college, and as soon as he graduated, he left me. I hate him! I hate all men!" Which is an empathetic response by the nurse? a. "You are very angry now. This is a normal response to your loss." b. "I know what you mean. Men can be very insensitive." c. "I understand completely. My husband is a jerk, too." d. "You are depressed now, but you will feel better in time."

a

Eric is a staff nurse on a surgical unit. He has been selected as leader of a newly established group of staff nurses organized to determine ways to decrease the number of medication errors occurring on the unit. Eric has definite ideas about how to bring this about. He has also applied for the position of Head Nurse on the unit and believes that if he is successful in leading the group toward achievement of its goals, he can also facilitate his chances for promotion. At each meeting, he addresses the group in an effort to convince the members to adopt his ideas. Which type of group and style of leadership is described in this situation? a. Task; autocratic b. Teaching; autocratic c. Self-help; democratic d. Supportive-therapeutic; laissez-faire

a

How do antianxiety medications, such as benzodiazepines, produce a calming effect by which of the following actions? a. Depressing the CNS b. Decreasing levels of norepinephrine and serotonin in the brain c. Decreasing levels of dopamine in the brain d. Inhibiting production of the enzyme MAO

a

Nancy, a depressed patient who has been unkempt and untidy for weeks, today comes to group therapy wearing makeup and a clean dress and having washed and combed her hair. Which of the following responses by the nurse is most therapeutic? a. "Nancy, I see you have put on a clean dress and combed your hair." b. "Nancy, you look wonderful today!" c. "Nancy, I'm sure everyone will appreciate that you have cleaned up for the group today." d. "Now that you see how important it is, I hope you will do this every day."

a

One of the goals of therapeutic community is for patients to become more independent and accept self-responsibility. Which of the following approaches by staff best encourages fulfillment of this goal? a. Including patient input and decisions into the treatment plan b. Insisting that each patient take a turn as "president" of the community meeting c. Making decisions for the patient regarding plans for treatment d. Requiring that the patient be bathed and dressed and attend breakfast on time each morning

a

Part of the nurse's continual assessment of the patient taking antipsychotic medications is to observe for extrapyramidal symptoms. Examples include which of the following? a. Muscular weakness, rigidity, tremors, facial spasms b. Dry mouth, blurred vision, urinary retention, orthostatic hypotension c. Amenorrhea, gynecomastia, retrograde ejaculation d. Elevated blood pressure, severe occipital headache, stiff neck

a

Sandra is the nurse leader of a supportive-therapeutic group for individuals with anxiety disorders. Violet, who lacks self-confidence, states to the group, "Maybe if I became a blond, my boyfriend would love me more." Larry responds, "Listen, dummy, you need more than blond hair to keep the guy around. A bit more in the brains department would help!" What type of member role is Larry assuming in this group? a. Aggressor b. Monopolizer c. Blocker d. Seducer

a

The most appropriate nursing intervention with Jenny (from question 5) would be to: a. Make arrangements for her to start attending Alateen meetings. b. Help her identify the positive things in her life and recognize that her situation could be a lot worse than it is. c. Teach her about the effects of alcohol on the body and that it can be hereditary. d. Refer her to a psychiatrist for private therapy to learn to deal with her home situation.

a

The nurse decides to respect family wishes and not tell the patient of his terminal status because that would bring the most happiness to the most people. Which of the following ethical theories is considered in this decision? a. Utilitarianism b. Kantianism c. Christian ethics d. Ethical egoism

a

The nurse is using nursing process to care for a patient who is suicidal. Which of the following nursing actions is a part of the diagnosis step of the nursing process? a. Identifies patient as "At risk for suicide" b. Notes that patient's family reports recent suicide attempt c. Prioritizes the necessity for maintaining a safe environment for the patient d. Obtains a commitment from the patient to work collaboratively to identify adaptive coping skills

a

The nurse is using nursing process to care for a patient who is suicidal. Which of the following nursing actions is a part of the implementation step of the nursing process? a. Prioritizes the necessity for maintaining a safe environment for the patient b. Determines if nursing interventions have been appropriate to achieve desired results c. Collaborates with the patient to develop a plan for ongoing safety and suicide prevention d. Identifies that "Patient will not harm self during hospitalization"

a

Which of the following hormones has been implicated in the etiology of mood disorder with seasonal pattern? a. Increased levels of melatonin b. Decreased levels of oxytocin c. Decreased levels of prolactin d. Increased levels of thyrotropin

a

Which of the following individuals demonstrates the highest number of risk factors for suicide? a. John, who reports that he is in deep emotional pain, feels hopeless, and says "No one is there for me." b. Kelly, who has been seeing a doctor for chronic, intractable pain, verbalizes a deep commitment to her religious faith and is taking pain medication. c. Jim, an American Indian, who graduated from high school with honors but does not yet have a job. d. Mike, a physician, who reports feeling "burnt out" and is considering retirement.

a

Which of the following is a concern with children on long-term therapy with CNS stimulants for ADHD? a. Addiction b. Weight gain c. Substance abuse d. Growth suppression

a

Which of the following parts of the brain is associated with voluntary body movement, thinking and judgment, and expression of feeling? a. Frontal lobe b. Parietal lobe c. Temporal lobe d. Occipital lobe

a

Which of the following parts of the brain is concerned with hearing, short-term memory, and sense of smell? a. Temporal lobe b. Parietal lobe c. Cerebellum d. Hypothalamus

a

Guidelines relating to "duty to warn" state that a therapist should consider taking action to warn a third party when his or her client does which of the following? (Select all that apply.) a. Threatens violence toward another individual b. Identifies a specific intended victim c. Is having command hallucinations d. Reveals paranoid delusions about another individual

a.b

Sally was sexually abused as a child. She is a client on the milieu unit with a diagnosis of borderline personality disorder. She has refused to talk to anyone. Which of the following therapies might the IDT team recommend for Sally? (Select all that apply.) a. Music therapy b. Art therapy c. Seclusion d. Electroconvulsive therapy

a.b

Clozapine (Clozaril) is an antipsychotic required to have an approved risk evaluation and mitigation strategy (REMS) program. Which of the following actions are included in that program? (Select all that apply.) a. Absolute neutrophil counts are assessed before initiation of treatment. b. Initially only 1-week supply of clozapine is dispensed at a time. c. Acceptable ANC levels for continuation of treatment are identified as 1,500 µL. d. Patients are not permitted to smoke cigarettes while on clozapine.

a.b.c

Psychotropic medications may act at the neural synapse to accomplish which of the following? (Select all that apply.) a. Inhibit the reuptake of certain neurotransmitters, creating more availability. b. Inhibit catabolic enzymes, promoting more availability of a neurotransmitter. c. Block receptors, resulting in less neurotransmitter activity. d. Add synthetic neurotransmitters found in the drug.

a.b.c

Which of the following are basic assumptions of milieu therapy? (Select all that apply.) a. Each individual owns his or her own environment. b. Each individual owns his or her behavior. c. Peer pressure is a useful and powerful tool. d. Inappropriate behaviors are punished immediately.

a.b.c

Which of the following behaviors suggests a possible breach of professional boundaries? (Select all that apply.) a. The nurse repeatedly requests to be assigned to a specific patient. b. The nurse shares the details of her divorce with the patient. c. The nurse makes arrangements to meet the patient outside of the therapeutic environment. d. The nurse shares how she dealt with a similar difficult situation.

a.b.c

S.T. is a 15-year-old girl who has just been admitted to the adolescent psychiatric unit with a diagnosis of anorexia nervosa. She is 5 ft 5 in. tall and weighs 82 lb. She was elected to the cheerleading squad for the fall but states that she is not as good as the others on the squad. The treatment team has identified the following problems: refusal to eat, occasional purging, refusing to interact with staff and peers, and fear of failure. Which of the following nursing diagnoses would be appropriate for S.T.? (Select all that apply.) a. Social isolation b. Disturbed body image c. Low self-esteem d. Imbalanced nutrition: Less than body requirements

a.b.c.d

An individual may be considered gravely disabled for which of the following reasons? (Select all that apply.) a. A person, because of mental illness, cannot fulfill basic needs. b. A mentally ill person is in danger of physical harm based on inability to care for self. c. A mentally ill person lacks the resources to provide the necessities of life. d. A mentally ill person is unable to make use of available resources to meet daily living requirements.

a.b.d

On the milieu unit, duties of the staff psychiatric nurse include which of the following? (Select all that apply.) a. Medication administration b. Patient teaching c. Medical diagnosis d. Reality orientation e. Relationship development f. Group therapy

a.b.d.e

Which of the following describe advantages of electronic health records (EHRs)? (Select all that apply.) a. They reduce redundancy of information. b. They reduce issues regarding privacy. c. They decrease charting time. d. They facilitate communication between disciplines.

a.c.d

Anna, age 72, has been grieving the death of her dog, Lucky, for 3 years. She is not able to take care of her activities of daily living and wants only to make daily visits to Lucky's grave. What is the most likely reason her daughter has put off seeking help for Anna? a. Women are less likely than men to seek help for emotional problems. b. Relatives often try to "normalize" the behavior rather than label it mental illness. c. She knows that all older people are expected to be a little depressed. d. She is afraid that the neighbors "will think her mother is crazy."

b

Antipsychotic medications are thought to decrease psychotic symptoms by which of the following actions? a. Blocking reuptake of norepinephrine and serotonin b. Blocking the action of dopamine in the brain c. Inhibiting production of the enzyme MAO d. Depressing the CNS

b

If extrapyramidal symptoms should occur, which of the following would be a priority nursing intervention? a. Notify the physician immediately. b. Administer prn trihexyphenidyl (Artane) as ordered. c. Withhold the next dose of antipsychotic medication. d. Explain to the patient that these symptoms are only temporary and will disappear shortly.

b

In the community meeting, which of the following actions is most important for reinforcing the democratic posture of the therapy setting? a. Allowing each person a specific and equal amount of time to talk b. Reviewing group rules and behavioral limits that apply to all patients c. Reading the minutes from yesterday's meeting d. Waiting until all patients are present before initiating the meeting

b

John tells the nurse, "I think lights out at ten o'clock on a weekend is stupid. We should be able to watch TV until midnight!" Which of the following is the most appropriate response from the nurse on the milieu unit? a. "John, you were told the rules when you were admitted." b. "You may bring it up before the others at the community meeting, John." c. "Some people want to go to bed early, John." d. "You are not the only person on this unit, John. You must think of others besides yourself."

b

Marie, age 56, is the mother of five children. Her youngest child, who had been living at home and attending the local college, recently graduated and accepted a job in another state. Marie has never worked outside the home and has devoted her life to satisfying the needs of her husband and children. Since the departure of her last child from home, Marie has become increasingly despondent. Her husband is very concerned and takes her to the local mental health center. What is this type of crisis called? a. Dispositional crisis b. Crisis of anticipated life transitions c. Psychiatric emergency d. Crisis resulting from traumatic stress

b

Nicole is the nurse leader of a childbirth preparation group. Each week, she shows various films and sets out various reading materials. She expects the participants to utilize their time on a topic of their choice or practice skills they have observed on the films. Two couples have dropped out of the group, stating, "This is a big waste of time." Which type of group and style of leadership is described in this situation? a. Task; democratic b. Teaching; laissez-faire c. Self-help; democratic d. Supportive-therapeutic; autocratic

b

Sandra is the nurse leader of a supportive-therapeutic group for individuals with anxiety disorders. In this group, Helen talks incessantly. When someone else tries to make a comment, Helen refuses to allow him or her to speak. What type of member role is Helen assuming in this group? a. Aggressor b. Monopolizer c. Blocker d. Seducer

b

The most appropriate crisis intervention with Amanda (from question 3) would be to: a. Encourage her to recognize how lucky she is to be alive. b. Discuss stages of grief and feelings associated with each. c. Identify community resources that can help Amanda. d. Suggest that she find a place to live that provides a storm shelter.

b

The most appropriate nursing intervention with Ginger (from question 7) would be to: a. Suggest she move to a college closer to home. b. Work with Ginger on unresolved dependency issues. c. Help her find someone in the college town from whom she could seek assistance rather than calling her mother regularly. d. Recommend that the college physician prescribe an antianxiety medication for Ginger.

b

The nurse assists the physician with electroconvulsive therapy on his patient who has refused to give consent. With which of the following legal actions might the nurse be charged because of this nursing action? a. Assault b. Battery c. False imprisonment d. Breach of confidentiality

b

The nurse decides to go against family wishes and tell the patient of his terminal status because that is what she would want if she were the patient. Which of the following ethical theories is considered in this decision? a. Kantianism b. Christian ethics c. Natural law theories d. Ethical egoism

b

The nurse is using nursing process to care for a patient who is suicidal. Which of the following nursing actions is a part of the assessment step of the nursing process? a. Identifies the nursing diagnosis: Risk for suicide b. Notes that patient's family reports recent suicide attempt c. Prioritizes the necessity for maintaining a safe environment for the patient d. Obtains a commitment from the patient to work collaboratively to identify adaptive coping

b

There is a very narrow margin between the therapeutic and toxic levels of lithium carbonate. Symptoms of toxicity are most likely to appear if the serum levels exceed which of the following levels? a. 0.15 mEq/L b. 1.5 mEq/L c. 15 mEq/L d. 150 mEq/L

b

What is the reason that doses of bupropion should be administered at least 4 to 6 hours apart and never doubled when a dose is missed? a. To prevent orthostatic hypotension b. To prevent seizures c. To prevent hypertensive crisis d. To prevent extrapyramidal symptoms

b

Which of the following activities would be a responsibility of the psychiatric clinical nurse specialist on the IDT team? a. Manages the therapeutic milieu on a 24-hour basis b. Conducts group therapies and provides consultation and education to staff nurses c. Directs a group of patients in acting out a situation that is otherwise too painful for a patient to discuss openly d. Locates halfway house and arranges living conditions for patient being discharged from the hospital

b

Which of the following statements by Anna might suggest that she is achieving resolution of her grief over Lucky's death? a. "I never cry when I think about Lucky." b. "It's true. Lucky didn't always mind me. Sometimes he ignored my commands, but he was also a good companion." c. "I remember how it happened now. I should have held tighter to his leash! I didn't deserve to have a dog." d. "I won't ever have another dog. It's just too painful to lose them."

b

Psychoneuroimmunology is a branch of science that involves which of the following? (Select all that apply.) a. The impact of psychoactive medications at the neural synapse. b. The relationship among the immune system, the nervous system, and psychological processes, including mental illness. c. The correlation between psychosocial stress and the onset of illness. d. The potential role of viruses in the onset of schizophrenia. e. The genetic factors that influence prevention of mental illness.

b.c.d

Which of the following is a true statement about mental health recovery? (Select all that apply.) a. Mental health recovery applies only to severe and persistent mental illnesses. b. Mental health recovery serves to provide empowerment to the consumer. c. Mental health recovery is based on the medical model. d. Mental health recovery is a collaborative process.

b.d

Which of the following statements is correct regarding the use of restraints? (Select all that apply.) a. Restraints may never be initiated without a physician's order. b. Orders for restraints must be reissued by a physician every 2 hours for children and adolescents. c. Clients in restraints must be observed and assessed every hour for issues regarding circulation, nutrition, respiration, hydration, and elimination. d. An in-person evaluation must be conducted within 1 hour of initiating restraints.

b.d

Which of the following tasks are associated with the orientation phase of relationship development? (Select all that apply.) a. Promoting the patient's insight and perception of reality. b. Creating an environment for the establishment of trust and rapport. c. Using the problem-solving model toward goal fulfillment. d. Obtaining available information about the patient from various sources. e. Formulating nursing diagnoses and setting goals.

b.e

. Nursing diagnoses are prioritized according to which of the following? a. Degree of potential for resolution b. Legal implications associated with nursing intervention c. Life-threatening potential d. Client and family requests

c

A nurse who is helping a patient with mental illness recovery using the WRAP Model says, "First you must create a wellness toolbox." She explains to the patient that a wellness toolbox is which of the following? a. A list of words that describe how the individual feels when he or she is feeling well b. A list of things the individual needs to do every day to maintain wellness c. A list of strategies the individual has used in the past that help relieve disturbing symptoms d. A list of the patient's favorite healthcare providers and phone numbers.

c

Andrew, a firefighter, and his entire unit responded to the aftermath of an earthquake. Working as a team, he and his best friend, Carlo, entered a building together to search for survivors. Carlo was killed when the building collapsed. Andrew was injured but survived. Since that time, Andrew has had frequent nightmares and anxiety attacks. He says to the mental health worker, "I don't know why Carlo had to die and I didn't!" This statement by Andrew suggests that he is experiencing: a. Spiritual distress. b. Night terrors. c. Survivor's guilt. d. Suicidal ideation.

c

Benjamin is a member of an Alcoholics Anonymous group. He learned about the effects of alcohol on the body when a nurse from the chemical dependency unit spoke to the group. This is an example of which therapeutic factor? a. Catharsis b. Altruism c. Imparting of information d. Universality

c

Carol is the nurse leader of a bereavement group for widows. Nancy is a new member. She listens to the group and learns that Jane has been a widow for 5 years. Jane has adjusted well, and Nancy thinks maybe she can too. This is an example of which therapeutic factor? a. Universality b. Imitative behavior c. Installation of hope d. Imparting of information

c

In prioritizing care within the therapeutic environment, which of the following nursing interventions would receive the highest priority? a. Ensuring that the physical facilities are conducive to achievement of the goals of therapy b. Scheduling a community meeting for 8:30 each morning c. Attending to patients' physiological and safety needs d. Establishing contacts with community resources

c

Initial symptoms of lithium toxicity include which of the following? a. Constipation, dry mouth b. Dizziness, thirst c. Vomiting, diarrhea d. Anuria, arrhythmias

c

Jenny reported to the high school nurse that her mother drinks too much. She is drunk every afternoon when Jenny gets home from school. Jenny is afraid to invite friends over because of her mother's behavior. What is this type of crisis called? a. Crisis resulting from traumatic stress b. Maturational or developmental crisis c. Dispositional crisis d. Crisis reflecting psychopathology

c

Judy has been in the hospital for 3 weeks. She has used Valium "to settle her nerves" for the past 15 years. She was admitted by her psychiatrist for safe withdrawal from the drug. She has passed the physical symptoms of withdrawal at this time but states to the nurse, "I don't know if I will make it without Valium after I go home. I'm already starting to feel nervous. I have so many personal problems." Which is the most appropriate response by the nurse? a. "Why do you think you have to have drugs to deal with your problems?" b. "Everybody has problems, but not everybody uses drugs to deal with them. You'll just have to do the best that you can." c. "Let's explore some things you can do to decrease your anxiety without resorting to drugs." d. "Just hang in there. I'm sure everything is going to be okay."

c

On Tom's day of discharge from the hospital, his wife brings a bouquet of flowers and box of chocolates to give to his primary care nurse. Tom presents these gifts to the nurse saying, "Thank you for taking care of me." What is a correct response by the nurse? a. "I don't want a gift from you!" b. "Thank you so much! I think you're really extra special, too!" c. "Thank you. I will share these with the rest of the staff." d. "I love chocolate but let me pay you for them!"

c

Tam has a new diagnosis of panic disorder. Dr. S has written a prn order for alprazolam (Xanax) for when Tam is feeling anxious. She says to the nurse, "Dr. S prescribed buspirone for my friend's anxiety. Why did he order something different for me?" The nurse's answer is based on which of the following? a. Buspirone is not an antianxiety medication. b. Alprazolam and buspirone are essentially the same medication, so either one is appropriate. c. Buspirone has delayed onset of action and cannot be used on a prn basis. d. Alprazolam is the only medication that really works for panic disorder.

c

The nurse decides to tell the patient of his terminal status because she believes it is her duty to do so. Which of the following ethical theories is considered in this decision? a. Natural law theories b. Ethical egoism c. Kantianism d. Utilitarianism

c

The nurse leader is explaining about group "therapeutic factors" to members of the group. She tells the members that group situations are beneficial because members can see that they are not alone in their experiences. This is an example of which therapeutic factor? a. Altruism b. Imitative behavior c. Universality d. Imparting of information

c

When Anna's daughter expresses concern about her mother's reports of hearing troubling voices and recommends she see a counselor, Anna declares, "I'm fine. There is nothing wrong with me!" Which of the following best describes Anna's response? a. Grief resolution b. Somatic disorder c. Anosognosia d. Intellectualization

c

Which of the following activities would be a responsibility of the clinical psychologist member of the IDT team? a. Locates halfway house and arranges living conditions for patient being discharged from the hospital b. Manages the therapeutic milieu on a 24-hour basis c. Administers and evaluates psychological tests that assist in diagnosis d. Conducts psychotherapy and administers electroconvulsive therapy treatments

c

Which of the following is a correct assumption regarding the concept of crisis? a. Crises occur only in individuals with psychopathology. b. The stressful event that precipitates crisis is seldom identifiable. c. A crisis situation contains the potential for psychological growth or deterioration. d. Crises are chronic situations that recur many times during an individual's life.

c

Which of the following is the desired outcome of working with an individual who has witnessed a traumatic event and is now experiencing panic anxiety? a. The individual will experience no anxiety. b. The individual will demonstrate hope for the future. c. The individual will identify that anxiety is at a manageable level. d. The individual will verbalize acceptance of self as worthy.

c

Aisha is a psychiatric nurse who has been selected to lead a group for women who desire to lose weight. The criterion for membership is that they must be at least 20 pounds overweight. All have tried to lose weight on their own many times in the past without success. At their first meeting, Aisha provides suggestions as the members determine what their goals will be and how they plan to achieve those goals. They decide how often they want to meet and what they plan to do at each meeting. Which type of group and style of leadership is described in this situation? a. Task; autocratic b. Teaching; democratic c. Self-help; laissez-faire d. Supportive-therapeutic; democratic

d

Anna's dog Lucky got away from her while they were taking a walk. He ran into the street and was hit by a car. Anna cannot remember any of these circumstances of his death. This is an example of what defense mechanism? a. Rationalization b. Suppression c. Denial d. Repression

d

Bill, who has been diagnosed with schizophrenia and has been on medication for several months, states, "I'm not taking that stupid medication anymore!" Which of the following responses demonstrates a motivational interviewing style of communication? a. "Don't you know that if you don't take your medication you will never recover?" b. "Why won't you cooperate with the treatment your doctor prescribed?" c. "Bill, the medication is not stupid." d. "Tell me more about why you don't want to take the medication."

d

Crises occur when an individual: a. Is exposed to a precipitating stressor. b. Perceives a stressor to be threatening. c. Has no support systems. d. Experiences a stressor and perceives coping strategies to be ineffective.

d

Dorothy was involved in an automobile accident while under the influence of alcohol. She swerved her car into a tree and narrowly missed hitting a child on a bicycle. She is in the hospital with multiple abrasions and contusions. She is talking about the accident with the nurse. Which of the following statements by the nurse is most appropriate? a. "Now that you know what can happen when you drink and drive, I'm sure you won't let it happen again." b. "You know that was a terrible thing you did. That child could have been killed." c. "I'm sure everything is going to be okay now that you understand the possible consequences of such behavior." d. "How are you feeling about what happened?"

d

Education for the patient who is taking an MAOI should include which of the following? a. Fluid and sodium replacement when appropriate, frequent drug blood levels, signs and symptoms of toxicity b. Lifetime of continuous use, possible tardive dyskinesia, advantages of an injection every 2 to 4 weeks c. Short-term use, possible tolerance to beneficial effects, careful tapering of the drug at end of treatment d. Tyramine-restricted diet, prohibitive concurrent use of over-the-counter medications without physician notification

d

Ginger, age 19 and an only child, left 3 months ago to attend a college of her choice 500 miles away from her parents. It is Ginger's first time away from home. She has difficulty making decisions and will not undertake anything new without first consulting her mother. They talk on the phone almost every day. Ginger has recently started having anxiety attacks. She consults the nurse practitioner in the student health center. What is this type of crisis called? a. Crisis resulting from traumatic stress b. Dispositional crisis c. Psychiatric emergency d. Maturational or developmental crisis

d

Joe has been in rehabilitation for alcohol dependence. When he returns from a visit to his home, he tells the nurse, "We were having a celebration and I did have one drink, but it really wasn't a problem." The nurse notices that his breath smells of alcohol. Which of the following responses by the nurse demonstrates a motivational interviewing style of communication? a. "You are obviously not motivated to change so perhaps we should discuss your discharge from the treatment program." b. "You need to abstain from alcohol in order to recover, so let me talk to your doctor about the consequences for your behavior." c. "Why would you destroy everything you've worked so hard to achieve?" d. "What do you mean when you say, 'it really wasn't a problem'?"

d

Joe is very restless and is pacing a lot. The nurse says to Joe, "If you don't sit down in the chair and be still, I'm going to put you in restraints!" With which of the following legal actions might the nurse be charged because of this nursing action? a. Defamation of character b. Battery c. Breach of confidentiality d. Assault

d

Patient teaching is an important nursing function in milieu therapy. Which of the following statements by the patient indicates the need for knowledge and a readiness to learn? a. "Get away from me with that medicine! I'm not sick!" b. "I don't need psychiatric treatment. It's my migraine headaches that I need help with." c. "I've taken Valium every day of my life for the last 20 years. I'll stop when I'm good and ready!" d. "The doctor says I have bipolar disorder. What does that really mean?"

d

Paul is a member of an anger management group. He knew that people did not want to be his friend because of his violent temper. In the group, he has learned to control his temper and form satisfactory interpersonal relationships with others. This is an example of which therapeutic factor? a. Catharsis b. Altruism c. Imparting of information d. Development of socializing techniques

d

S.T. is a 15-year-old girl who has just been admitted to the adolescent psychiatric unit with a diagnosis of anorexia nervosa. She is 5 ft 5in. tall and weighs 82 lb. She was elected to the cheerleading squad for the fall but states that she is not as good as the others on the squad. The treatment team has identified the following problems: refusal to eat, occasional purging, refusing to interact with staff and peers, and fear of failure. Which of the following nursing diagnoses would be the highest priority diagnosis for S.T.? a. Social isolation b. Disturbed body image c. Low self-esteem d. Imbalanced nutrition: Less than body requirements

d

Sandra is the nurse leader of a supportive-therapeutic group for individuals with anxiety disorders. On the first day the group meets, Valerie speaks first and begins by sharing the intimate details of her incestuous relationship with her father. What type of member role is Valerie assuming in this group? a. Aggressor b. Monopolizer c. Blocker d. Seducer

d

The most appropriate nursing intervention with Marie (from question 9) would be to: a. Refer her to her family physician for a complete physical examination. b. Suggest she seek outside employment now that her children have left home. c. Identify convenient support systems for times when she is feeling particularly despondent. d. Begin grief work and assist her to recognize areas of self-worth separate and apart from her children.

d

The nurse is using nursing process to care for a patient who is suicidal. Which of the following nursing actions is a part of the planning step of the nursing process? a. Prioritizes the necessity for maintaining a safe environment for the patient b. Determines if nursing interventions have been appropriate to achieve desired results c. Obtains a commitment from the patient to work collaboratively to identify adaptive coping skills d. Identifies that the "Patient will not harm self during hospitalization"

d

Which of the following parts of the brain is associated with multiple feelings and behaviors and is sometimes referred to as the "emotional brain"? a. Frontal lobe b. Thalamus c. Hypothalamus d. Limbic system

d

Which of the following parts of the brain is concerned with visual reception and interpretation? a. Frontal lobe b. Parietal lobe c. Temporal lobe d. Occipital lobe

d

Intervention with Andrew (from question 12) would include: a. Encouraging expression of feelings. b. Antianxiety medications. c. Participation in a support group. d. a and c. e. All of the above.

e