Mental Health Exam 3

Chapter 19 Evolve Which statement by a patient who was educated about the importance of acquiring adequate sleep indicates a need for further teaching? 1. "I will be sure to try to get 8 hours of sleep every night, and 9 or 10 hours of sleep if I can." 2. "Getting less than 6 hours of sleep at night may increase my risk for medical problems." 3. "Getting enough sleep will increase my productivity at work." 4. "Since I have to drive for my job, getting enough sleep will help me avoid accidents."

1. "I will be sure to try to get 8 hours of sleep every night, and 9 or 10 hours of sleep if I can."

Which statement is true of pharmacological therapies associated with the treatment of personality disorders? 1. Although there are no FDA-approved drugs specific to the treatment of personality disorders, patients benefit from specific off-label uses of antipsychotics, mood stabilizers, and antidepressants, depending on which personality disorder is evident. 2. Research has shown that currently available psychotropic drugs have not been shown to be effective in treating personality disorders. 3. Patients with narcissistic personality disorder and obsessive-compulsive personality disorder have shown the most benefit from the use of antianxiety medications along with use of selective serotonin reuptake inhibitors. 4. Patients with personality disorders have been shown to be resistant to accepting medication, and as a result most providers do not prescribe psychotropic drugs to these patients.

1. Although there are no FDA-approved drugs specific to the treatment of personality disorders, patients benefit from specific off-label uses of antipsychotics, mood stabilizers, and antidepressants, depending on which personality disorder is evident.

A client recently diagnosed with schizophrenia is hospitalized. The client appears distraught and says to the nurse, "The voices are bad today...they are so angry with me." Which of the following is the best response by the nurse? 1. Do you need something to help you calm down? 2. Don't pay any attention to the voices. Let's go into the dayroom. 3. The voices are not real. Tell them to go away. 4. What are the voices saying to you?

1. Do you need something to help you calm down?

The nurse is caring for a client with bulimia nervosa. Which is the most important time for the nurse to monitor the client's behavior? 1. During 1-2 hours after each meal 2. During every meal 3. During the evening meal 4. During the overnight hours

1. During 1-2 hours after each meal

A man who frequently experiences premature ejaculation tells the nurse, "I feel like such a failure. It's so awful for both me and my partner." Which of the following would be the most appropriate therapeutic response by the nurse? 1. I sense you are feeling frustrated and upset 2. Tell me more about feeling like a failure 3. You are too hard on yourself 4. What do you mean by awful?

1. I sense you are feeling frustrated and upset

Patients diagnosed with BPD exhibit negative effect, which includes rapidly moving from one emotional extreme to another. What term is used to describe this characteristic? 1. Lability 2. Impulsivity 3. Splitting 4. Denial

1. Lability

Chapter 18 Evolve Which statement is true of the eating disorder referred to as bulimia? 1. Patients with bulimia often appear at a normal weight. 2. Patients with bulimia binge eat but do not engage in compensatory measures. 3. Patients with bulimia severely restrict their food intake. 4. One sign of bulimia is lanugo.

1. Patients with bulimia often appear at a normal weight.

A nurse appropriately set limits while interacting with a client diagnosed with a borderline personality disorder. The client tells the nurse, "You used to care about me. I thought you were wonderful. Now I can see I was wrong. You're the worst nurse ever." Which defense mechanism is being used by this client? 1. Splitting 2. Projection 3. Displacement 4. Reaction formation

1. Splitting

A 24-year-old patient diagnosed with borderline personality disorder (BPD) is admitted to the inpatient psychiatric unit following a suicide attempt. Which client statements illustrate a primary coping style of persons with BPD? 1. "My provider says I might get out of here tomorrow. Do you think I'm ready to go?" 2. "Last night the nurse let me go outside and smoke. I can't believe you aren't letting me. I used to think you were the best nurse here." 3. "I will never again speak to any of my messed up family members. I know that this will help me to be more functional." 4. "I promise I am not feeling suicidal. I won't hurt myself."

2. "Last night the nurse let me go outside and smoke. I can't believe you aren't letting me. I used to think you were the best nurse here."

A 16-year-old patient being treated for anorexia, has been prescribed medication to reduce compulsive behaviors regarding food now that ideal weight has been reached. Which class of medication is prescribed for this specific issue associated with eating disorders? 1. Mood stabilizers 2. Antidepressants 3. Anxiolytics 4. Atypical antipsychotics

2. Antidepressants

Quiz The nurse is developing a plan of care for a 16-year-old client with bulimia nervosa. Which intervention would be included in the plan of care? Select all that apply. 1. Allow client to remain on current laxatives 2. Assess the client for electrolyte imbalances 3. Be alert to hidden or discarded food wrapper 4. Do not allow client to keep a food diary during hospitalization 5. Monitor the client for 1-2 hours after each meal in a central area

2. Assess the client for electrolyte imbalances 3. Be alert to hidden or discarded food wrapper 5. Monitor the client for 1-2 hours after each meal in a central area

Chapter 12 Evolve Nico, a 22-year-old patient, is diagnosed with schizophrenia. Which of the following symptoms would alert a provider to a possible diagnosis of schizophrenia in a 22-year-old male client? 1. Excessive sleeping with disturbing dreams 2. Hearing voices telling him to hurt his roommate 3. Withdrawal from college because of failing grades 4. Chaotic and dysfunctional relationships with his family and peers

2. Hearing voices telling him to hurt his roommate

A 38-year-old patient referred for sleep studies reports frequent daytime lethargy, unintended lapses into sleep, and never feeling rested on awakening in the morning. These symptoms support which sleep-related diagnosis? 1. Circadian rhythm disorder 2. Hypersomnolence 3. REM sleep behavior disorder 4 Breathing-related sleep disorder

2. Hypersomnolence

When educating a client diagnosed with bulimia nervosa about the medication fluoxetine, the nurse should include what information about this medication? 1. It will reduce the need for cognitive therapy. 2. It will be prescribed at a higher than typical dose. 3. There are a variety of medications to prescribe if fluoxetine proves to be ineffective. 4. Long-term management of symptoms is best achieved with tricyclic antidepressants.

2. It will be prescribed at a higher than typical dose.

A new client at the sleep disorders clinical tells the nurse, "I have not slept well in a year, so I never feel good. I do not expect things will ever improve or be any different." Which of the following interventions should the nurse consider for this client? 1. Suggest the use of alcohol as a sedative to promote sleep 2. Provide instruction on relaxation techniques 3. Teach fatigue producing exercises for the client to become overtired 4. Encourage long daytime naps to compensate for the sleep deprivation

2. Provide instruction on relaxation techniques

A client diagnosed with schizophrenia has been taking chlorpromazine daily for several weeks. The nurse observes that the client's head and neck are contracted and the client's eyes are locked in an upward position. Which of the following is the nurse's best analysis and action? 1. The client has tardive dyskinesia. The nurse should teach the client relaxation exercises. 2. The client is having an acute dystonic reaction. The nurse should administer benztropine IM per PRN order. 3. The client has akathisia. The nurse should notify the psychiatrist to discuss a possible change in medication. 4. The client is experiencing auditory hallucinations. The nurse should administer haloperidol PO per PRN order.

2. The client is having an acute dystonic reaction. The nurse should administer benztropine IM per PRN order.

Ali is a 17-year-old patient with bulimia coming to the outpatient mental health clinic for counseling. Which of the following statements by Ali indicates that an appropriate outcome for treatment has been met? 1. "I purge only once a day now instead of twice." 2. "I feel a lot calmer lately, just like when I used to eat four or five cheeseburgers." 3. "I am a hard worker and I am very compassionate toward others." 4. "I always purge when I'm alone so that I'm not a bad role model for my younger sister."

3. "I am a hard worker and I am very compassionate toward others."

A client newly diagnosed with hypersomnolence asks about what medication will be prescribed to manage this disorder. The nurse will base his/her response based on what knowledge? 1. There is no effective medication treatment for hypersomnolence disorder. 2. Medication therapy with benzodiazepines may be initiated. 3. A stimulant will most likely be prescribed. 4. The client will be started on an anticholinesterase inhibitor.

3. A stimulant will most likely be prescribed.

According to current theory, which statement regarding eating disorders is accurate? 1. Eating disorders are psychotic disorders in which patients experience body dysmorphic disorder. 2. Eating disorders are frequently misdiagnosed. 3. Eating disorders are possibly influenced by sociocultural factors. 4. Eating disorders are rarely comorbid with other mental health disorders.

3. Eating disorders are possibly influenced by sociocultural factors.

The nurse is planning long-term goals for a 17-year-old male client recently diagnosed with schizophrenia. Which statement should serve as the basis for the goal-setting process? 1. If treated quickly following diagnosis, schizophrenia can be cured. 2. Schizophrenia can be managed by receiving treatment only at the time of acute exacerbations. 3. Patients with schizophrenia often do not fully respond to treatment and have residual symptoms and varying degrees of disability. 4. If patients with schizophrenia stay on their drug regimen, they usually lead fully productive lives with no further symptoms.

3. Patients with schizophrenia often do not fully respond to treatment and have residual symptoms and varying degrees of disability.

A teenaged client is being discharged from the psychiatric unit with a prescription for risperidone. The nurse providing medication teaching to the client's mother should provide which response when asked about the risk her son faces for extrapyramidal side effects (EPSs)? 1. All antipsychotic medications have an equal chance of producing EPSs. 2. Newer antipsychotic medications have a higher risk for EPSs. 3. Risperidone is a newer antipsychotic medication and has a lower risk of EPSs than older antipsychotics. 4. Advise the mother to ask the provider to change the medication to clozapine instead of risperidone.

3. Risperidone is a newer antipsychotic medication and has a lower risk of EPSs than older antipsychotics.

A client asks the nurse to explain what basal sleep requirement is. What is the nurse's best response? 1. The basal temperature of your body needed to induce the best sleep. 2. The sleep time by your body needed to repair cellular damage. 3. The amount of sleep needed to be fully awake and perform well in the daytime. 4. The amount of sleep needed to transition to rapid eye movement (REM) sleep.

3. The amount of sleep needed to be fully awake and perform well in the daytime.

4. Which treatment is typically prescribed for primary insomnia? Select all that apply. A. Cognitive-behavioral therapy-insomnia (CBT-I) B. Intravenous medication for sedation C. Stimulus control D. Sleep restriction E. Sleep hygiene measures

A. Cognitive-behavioral therapy-insomnia (CBT-I) C. Stimulus control D. Sleep restriction E. Sleep hygiene measures

8. Safety measures are of concern in eating disorder treatments. Patients with anorexia nervosa are supervised closely to monitor: Select all that apply. A. Foods that are eaten B. Attempts at self induced vomiting C. Relationships with other patients D. Weight

A. Foods that are eaten B. Attempts at self induced vomiting D. Weight

8. Larry is a 50 year old man who works about 60 hours per week. He arrives at the clinic seeking assistance with a weight gain of 50 pounds over the past year. Larry admits to sleeping 4 to 5 hours a night. The nurse recognizes that the weight gain may be related to: A. A new onset of diabetes B. Suspected cardiovascular disease C. Dysregulation of hormones that influence appetite D. Comorbidity of depression with obesity

C. Dysregulation of hormones that influence appetite

9. Garret's wife of 8 years is divorcing him because the marriage never developed a warm or loving atmosphere. Garrett states in therapy, "I have always been a loner," and was never concerned about what others think. The nurse practitioner suggests that Garrett try a trial of bupropion (Well-butrin) to: A. Improve his flat emotions B. Assist in getting a good night's sleep C. Increase the pleasure of living D. Prepare Garrett for group therapy

C. Increase the pleasure of living

5. Light projected into the retina is believed to trigger changes in sleep patterns and quality of sleep. Therefore the nurse should suggest: A. Not reading within an hour of bedtime B. Exercising before bedtime in a darkened environment C. Limiting use of electronic devices in the hour before bedtime D. Dimming the screen on cellphones and computers in the evening

C. Limiting use of electronic devices in the hour before bedtime

7. When Melissa was a small child, she insisted that she was a boy, refused to wear dresses, and wanted to be called Mitch. As Melissa reached puberty, she no longer displayed a desire to be male. This change in identity is considered: A. Gender dysphoria B. Reaction formation C. Normal D. Early transgender syndrome

C. Normal

7. Larry is from a small town and began displaying aggressive and manipulative traits while still a teenager. Now at 40 years old, Larry is serving a life sentence for the murders of his wife and her brother. John, the prison psychiatric nurse practitioner, recognizes that Larry's treatment will most likely: A. Transform Larry to a model prisoner B. Not improve Larry's coping skills C. Reaffirm Larry's high-risk behaviors D. Manifest as small incremental changes

D. Manifest as small incremental changes

5. Which characteristic presents the greatest risk for injury to others by the patient diagnosed with schizophrenia? A. Depersonalization B. Pressured speech C. Negative symptoms D. Paranoia

D. Paranoia

4. A female patient diagnosed with schizophrenia has been prescribed a first-generation antipsychotic medication. What information should the nurse provide to the patient regarding her signs and symptoms? A. Her memory problems will likely decrease. B. Depressive episodes should be less severe. C. She will probably enjoy social interactions more. D. She should experience a reduction in hallucinations.

D. She should experience a reduction in hallucinations.

8. When patients diagnosed with schizophrenia suffer from anosognosia (an inability to realize they are ill caused by the illness itself), they often refuse medication, believing that: A. Medications provided are ineffective. B. Nurses are trying to control their minds. C. The medications will make them sick. D. They are not actually ill.

D. They are not actually ill.

6. Gilbert, age 19, is described by his parents as a "moody child" with an onset of odd behavior about at age 13, which caused Gilbert to suffer academically and socially. Gilbert has lost the ability to complete household chores, is reluctant to leave the house, and is obsessed with the locks on the windows and doors. Due to Gilbert's early and slow onset of what is now recognized as schizophrenia, his prognosis is considered: A. Favorable with medication B. In the relapse stage C. Improvable with psychosocial interventions D. To have a less positive outcome.

D. To have a less positive outcome.

5. Obtaining a sexual history can be embarrassing for the patient and practitioner. Experience with addressing the topic can help, as well as: A. Using informal language familiar to the patient's age B. Avoiding specifics and keeping the interview on general topics C. Avoiding eye contact D. Using professional tone of voice and a relaxed posture

D. Using professional tone of voice and a relaxed posture

Benztropine, Diphenhydramine, Propranolol, Lorazepam, Diazepam treat which types of adverse reactions?

EPS

Assuming unusual and illogical expressions (often grimaces) or positions.

Gesturing or posturing

Excited behavior such as running or pacing rapidly, often in response to internal or external stimuli. The agitation can put the patient at risk (exhaustion, running into traffic) or others at risk (being knocked down).

Motor agitation

Lithium, Carbamazepine, Valproate, Olanzepine, Risperidone, Beta-blockers are used for what treatment?

Personality Disorders

Repetitive behaviors that do not serve a logical purpose.

Stereotyped behaviors

Maintaining a given posture inappropriately, usually seen in catatonia. When the nurse raises the arm, the patient continues to hold this position in a statue-like manner.

Waxy flexibility

2. The nurse should plan to educate the male patients prescribed a statin medication on the possible development of which commonly observed side effect? A. Impotence B. Gynecomastia C. Decreased libido D. Delayed ejaculation

C. Decreased libido

A client diagnosed with borderline personality disorder and chronic back pain takes the maximum safe dose of opioid analgesic medication. The client tells the nurse, "The other nurses don't care about my pain, but you've always been so good to me. Could you give me a little extra medication? I won't tell anyone." Which of the following is the nurse's best response? 1. "I'll check with your doctor and get back to you." 2. "I'm sorry. I wish there was something more we could do to help you." 3. "No. I think you're trying to manipulate me into giving you more medication." 4. "I understand that you are in pain, but giving you more medication would not be safe."

4. "I understand that you are in pain, but giving you more medication would not be safe."

A client diagnosed with schizophrenia states to the nurse, "My, oh my. My mother is brother. Anytime now it can happen to my mother." Your best response would be: 1. "You are having problems with your speech. You need to try harder to be clear." 2. "You are confused. I will take you to your room to rest a while." 3. "I will get you a prn medication for agitation." 4. "I'm sorry, I didn't understand that. Do you want to talk more about your mother as we did yesterday?"

4. "I'm sorry, I didn't understand that. Do you want to talk more about your mother as we did yesterday?"

A client diagnosed with a chronic sleep disorders begins to cry and states, "I can't keep going like this! I work in a bank and if I can't function correctly I'll lose my job. I just don't think I'll get better." Which statement provides a therapeutic response to the client's concerns? 1. "Don't worry! I'm sure with treatment everything will get better." 2. "You are not alone. Many people who come for sleep studies are going through the same thing." 3. "You seem so sad. May I ask if something else is troubling you?" 4. "There is much hope for improvement through treatment. Let's talk about some strategies for your problems at work."

4. "There is much hope for improvement through treatment. Let's talk about some strategies for your problems at work."

A client tells the nurse, "Everyone says we should sleep 8 hours a night. I can only sleep 6 hours no matter how hard I try. Am I doing harm to my body?" Which of the following would be the most appropriate response by the nurse? 1. Tell me about strategies you have tried to increase your total sleep hours 2. Lack of sleep acts as a stressor on the body and can cause physical changes 3. If you have really tried to sleep more, maybe you should consult your healthcare provider 4. If you function well with 6 hours of sleep, you are a short sleeper. That's normal for some people

4. If you function well with 6 hours of sleep, you are a short sleeper. That's normal for some people

Chapter 24 Evolve Which statement is true regarding antisocial personality disorder (APD)? Select all that apply. 1. It is the least studied of the personality disorders. 2. It is characterized by rigidity and inflexible standards of self and others. 3. Persons with APD display magical thinking. 4. Persons with APD are concerned with personal pleasure and power. 5. It is characterized by deceitfulness, disregard for others, and manipulation. 6. Persons with APD usually present for treatment because of awareness of how their behavior is affecting others. 7. Frontal lobe dysfunction is a brain change identified in APD.

4. Persons with APD are concerned with personal pleasure and power. 5. It is characterized by deceitfulness, disregard for others, and manipulation. 7. Frontal lobe dysfunction is a brain change identified in APD.

A 37-year-old patient, referred to the mental health clinic with a suspected personality disorder, is withdrawn and suspicious and states, "I've always preferred to be alone" and then adds, "I can read your thoughts whenever I want to." This presentation supports which psychiatric diagnosis? 1. Obsessive-compulsive personality disorder 2. Narcissistic personality disorder 3. Avoidant personality disorder 4. Schizotypal personality disorder (STPD)

4. Schizotypal personality disorder (STPD)

Tara and Aaron are twins who are both diagnosed with schizophrenia. Aaron was diagnosed at 23 years old and Tara at 31 years old. Based on your knowledge of early and late onset of schizophrenia, which of the following is true? 1. Tara and Aaron have the same expectation of a poor long-term prognosis. 2. Tara will experience more positive signs of schizophrenia such as hallucinations. 3. Aaron will be more likely to hold a job and live a productive life. 4. Tara has a better chance for positive outcomes because of later onset.

4. Tara has a better chance for positive outcomes because of later onset.

Which nursing action should occur first regarding a client who has a problem of sexual dysfunction or sexual disorder? 1. The nurse should develop an understanding of human sexual response 2. The nurse should assess the client's sexual functioning and needs 3. The nurse should acquire knowledge of the client's sexual roles 4. The nurse should clarify own personal values about sexuality

4. The nurse should clarify own personal values about sexuality

7. Taylor, a psychiatric registered nurse, orients Regina, a patient with anorexia nervosa, to the room where she will be assigned during her stay. After getting Regina settled, the nurse informs Regina: A. "I need to go through the belongings you have brought with you." B. "You can use the scale in the back room when you need to." C. "You will be eating five times a day here." D. "The daily structure is based around your desire to eat."

A. "I need to go through the belongings you have brought with you."

4. Which statement describes a common sexual side effect of diazepam (Valium)? A. "I'm just not interested in sex as much." B. "I'm experiencing vaginal dryness." C. "I don't have orgasms anymore." D. "My breasts have gotten larger."

A. "I'm just not interested in sex as much."

5. Which patient statement supports the diagnosis of anorexia nervosa? A. "I'm terrified of gaining weight." B. "I wish I had a good friend to talk to." C. "I've been told I drink way too much alcohol." D. "I don't get much pleasure out of life anymore."

A. "I'm terrified of gaining weight."

2. When considering an eating disorder, what is a physical criterion for hospital admission? A. A daytime heart rate of less than 50 beats per minute B. An oral temperature of 100F or more C. 90% of ideal body weight D. Systolic blood pressure greater than 130 mm Hg

A. A daytime heart rate of less than 50 beats per minute

6. Sleep disturbances are often overlooked or undiagnosed due to: A. A lack of formal nurse and physician training in sleep disturbances B. Patients not often accurately describing sleep disturbance patterns C. The belief that sleep disturbance is a necessary part of hospitalization D. Patients hiding the fact that they have issues with sleep

A. A lack of formal nurse and physician training in sleep disturbances

6. Which patient has the greatest risk for suicide? A. A patient who expresses the inability to stop searching the internet for child pornography. B. A patient who reports having lost interest in having a sexual relationship with his wife. C. A patient with a history of exposing himself to female strangers on the bus. D. A patient whose attraction to prepubescent girls has increased.

A. A patient who expresses the inability to stop searching the internet for child pornography.

9. Malika has been overweight all of her life. Now an adult, she has health problems related to her excessive weight. Seeking weight loss assistance at a primary care facility Malika is surprised when the nurse practitioner suggests: A. A trial of SSRI antidepressant therapy B. Mild exercise to start, increasing in intensity over time C. Removing snack foods from the home D. Medication treatment for hypertension

A. A trial of SSRI antidepressant therapy

3. To provide effective care for the patient diagnosed with schizophrenia, the nurse should frequently assess for which associated condition? Select all that apply. A. Alcohol use disorder B. Major depressive disorder C. Stomach Cancer D. Polydipsia E. Metabolic Syndrome

A. Alcohol use disorder B. Major depressive disorder D. Polydipsia E. Metabolic Syndrome

Chapter 12 Review Questions 1. Which characteristics in an adolescent female is sometimes associated with the prodromal phase of schizophrenia? A. Always afraid another student will steal her belongings. B. An unusual interest in numbers and specific topics. C. Demonstrates no interest in athletics or organized sports. D. Appears more comfortable among males.

A. Always afraid another student will steal her belongings.

3. Which behaviors will the nurse encourage a patient diagnosed with insomnia disorder to adopt? Select all that apply. A. Avoiding exercising at bedtime B. Avoiding napping during the day C. Eating a hearty snack at bedtime D. Getting up at the same time each day E. Moving the clock so it is not visible from the bed

A. Avoiding exercising at bedtime B. Avoiding napping during the day D. Getting up at the same time each day E. Moving the clock so it is not visible from the bed

8. Connor is a 28 year old student, referred by his university for a psychiatric evaluation. He reports that he has no friends at the university and people call him a loner. Recently, Connor has been giving lectures to pigeons at the university fountains. Connor is diagnosed as schizotypal, which differs from schizophrenia in that persons diagnosed as schizotypal: A. Can be made aware of their delusions B. Are far more delusional than schizophrenics C. Have a greater need for socialization D. Do not usually respond to antipsychotic medications

A. Can be made aware of their delusions

9. Kyle, a patient with schizophrenia, began to take the first generation antipsychotic haloperidol (Haldol) last week. One day you find him sitting very stiff and not moving. He is diaphoretic, and when you ask if he is okay he seems unable to respond verbally. His vitals are: BP 170/100, P 110, T 104.2F. What is the priority nursing intervention? Select all that apply. A. Hold his medication and contact his prescriber. B. Wipe him with a washcloth wet with cold water or alcohol. C. Administer a medication such as benztropine IM to correct this dystonic reaction. D. Reassure him that although there is no treatment for his tardive dyskinesia, it will pass. E. Hold his medication for now and consult his prescriber when he comes to the unit later today.

A. Hold his medication and contact his prescriber. B. Wipe him with a washcloth wet with cold water or alcohol.

9. A male arrested for inappropriate sexual contact in a subway car denies the allegation. Upon interviewing the man, the nurse suspects frotteuristic disorder due to his: A. Lack of relationships B. Overall aggressive nature C. Criminal history including robbery D. Intense hatred of women

A. Lack of relationships

10. The stage of sleep known as rapid eye movement or REM sleep is characterized by atonia and myoclonic twitches in addition to the actual rapid movement of the eyes. Atonia is thought to be a protective mechanism as it: A. Limits physical movements B. Prevents nightmares C. Enhances the dream state D. Regulates the autonomic nervous system

A. Limits physical movements

4. Which personality disorders are generally associated with behaviors described as "odd or eccentric"? Select all that apply. A. Paranoid B. Schizoid C. Histrionic D. Obsessive-compulsive E. Avoidant

A. Paranoid B. Schizoid

3. When considering the need for monitoring, which intervention should the nurse implement for a patient with anorexia nervosa? Select all that apply. A. Provide scheduled portion controlled meals and snacks. B. Congratulate patients for weight gain and behaviors that promote weight gain. C. Limit time spent in the bathroom during periods when not under direct supervision. D. Promote exercise as a method to increase appetite. E. Observe patient during and after meals/snacks to ensure that adequate intake is achieved and maintained.

A. Provide scheduled portion controlled meals and snacks. C. Limit time spent in the bathroom during periods when not under direct supervision. E. Observe patient during and after meals/snacks to ensure that adequate intake is achieved and maintained.

5. Which behaviors are examples of a primitive defense mechanism often relied upon by those diagnosed with a personality disorder? Select all that apply. A. Regularly attempts to split the staff B. Attempts to undo feelings of anger by offering to do favors C. Regresses to rocking and humming to sooth themselves when fearful D. Lashes out verbally when confronted with criticism E. Destroys another person's belongings when angry

A. Regularly attempts to split the staff B. Attempts to undo feelings of anger by offering to do favors C. Regresses to rocking and humming to sooth themselves when fearful

2. Which nursing intervention is particularly well chosen for addressing a population at high risk for developing schizophrenia? A. Screening a group of males between the ages of 15 and 25 for early symptoms. B. Forming a support group for females aged 25 to 35 who are diagnosed with substance abuse. C. Providing a group for patients between the ages of 45 and 55 with information on coping skills that have proven to be effective. D. Educating the parents of a group of developmentally delayed 5 to 6 year olds on the importance of early intervention.

A. Screening a group of males between the ages of 15 and 25 for early symptoms.

3. Which medications are currently approved for the treatment of male erectile disorder? Select all that apply. A. Sildenafil (Viagra) B. Flibanserin (Addyi) C. Tadalafil (Cialis) D. Vardenafil (Levitra) E. Avanafil (Stendra)

A. Sildenafil (Viagra) C. Tadalafil (Cialis) D. Vardenafil (Levitra) E. Avanafil (Stendra)

3. What is the current accepted professional view of the effect of culture on the development of a personality disorder? A. There aren't sufficient studies to confirm the role that ethnicity and race have on the prevalence of personality disorders B. The North American and Australian cultures produce higher incidences of personality disorders among their populations C. Neither culture nor ethnic background is generally considered in the development of personality disorders D. Personality disorders have been found to be primarily the products of genetic factors, not cultural factors

A. There aren't sufficient studies to confirm the role that ethnicity and race have on the prevalence of personality disorders

Carbamazepine, Divalproex are which types of medications?

Anticonvulsants

Citalopram, Escitalopram, Fluoxetine, Paroxetine, Sertraline, Trazodone are which types of medications?

Antidepressants

Diphenydramine is what drug classification?

Antihistamine

Chlorpromazine, Haloperidol, Clozapine, Olanzapine, Paliperidone, Quetiapine, Risperidone, Ziprasidone, Aripiprazole are which types of medications?

Antipsychotics

Chapter 24 Review Questions 1. Which statement made by the psychiatric nurse demonstrates an accurate understanding of the factors that affect an individual's personality? A. "Therapy will help her identify that her problems are personality related." B. "I'll need to learn more about this patient's cultural beliefs." C. "It's encouraging to know that personality disorders respond well to treatment." D. "A person's personality is fluid and adjusts to current social situations."

B. "I'll need to learn more about this patient's cultural beliefs."

Chapter 18 Review Questions 1. Which patient statement acknowledges the characteristic behavior associated with a diagnosis of pica? A. "Nothing could make me drink mild." B. "I'm ashamed of it, but I eat my hair." C. "I haven't eaten a green vegetable since I was 3 years old." D. "I regurgitate and re-chew my food after almost every meal."

B. "I'm ashamed of it, but I eat my hair."

10. Josie, a 27 year old patient, complains that most of the staff do not like her. She says she can tell that you are a caring person. Josie is unsure of what she wants to do with her life and her "mixed-up feelings" about relationships. When you tell her that you will be on vacation next week, she becomes very angry. Two hours later, she is found using a curling iron to burn her underarms and explains that it "makes the numbness stop." Given this presentation, which personality disorder would you suspect? A. Obsessive-compulsive B. Borderline C. Antisocial D. Schizotypal

B. Borderline

6. Obesity can be the end result of a binge eating disorder. The nurse understands that the best treatment option in persons with a binge eating disorder promotes: A. Bariatric surgery B. Coping strategies C. Avoidance of public eating D. Appetite suppression medications

B. Coping strategies

6. Personality disorders often co-occur with mood and eating disorders. A young woman is undergoing treatment at an eating disorders clinic and her nurse suspects the patient may also have a Cluster B personality disorder due to the young woman's: A. Desire to avoid eating B. Dramatic response to frustration C. Excessive exercise routine D. Morose personality traits

B. Dramatic response to frustration

8. Phillip, a 63 year old male, has exposed his genitals in public for all of his adult life, but the act has lost some of the former thrill. A rationale for this change in his experience may be: A. An increasing sense of shame B. Disgust over his lack of control C. Desire waning with age D. Progression into actual assault

C. Desire waning with age

10. Pedophilic disorder is the most common paraphilic disorder where adults who have a primary or exclusive sexual preference for prepubescent children. A subset of this disorder is termed hebephilia and is defined as attraction to: A. Infants B. Pubescent individuals C. Teens between the ages of 15 and 19 D. Males only

B. Pubescent individuals

Temazepam, Zolpidem are which class of medications?

Benzodiazepines or similar

Chapter 19 Review Questions 1. Which patient statement supports a diagnosis of narcolepsy? A. "My wife tells me I snore at night." B. "I sleepwalk several nights a week." C. " I have no control over when I fall asleep." D. "My legs feel funny, and that keeps me awake."

C. " I have no control over when I fall asleep."

10. Malika agrees to try losing weight according to the nurse practitioner's outlined plan. Additional teaching is warranted when Malika states: A. "I am willing to admit I am depressed." B. "Psychotherapy will be a part of my treatment." C. "I prefer to have a gastric bypass rather than use this plan." D. "My comorbid conditions may improve with weight loss."

C. "I prefer to have a gastric bypass rather than use this plan."

7. Which therapeutic communication statement might a psychiatric mental health registered nurse use when a patient's nursing diagnosis is altered thought processes? A. "I know you say you hear voices, but I cannot hear them." B. "Stop listening to the voices, they are NOT real." C. "You say you hear voices, what are they telling you?" D. "Please tell the voices to leave you alone for now."

C. "You say you hear voices, what are they telling you?"

9. Sleep deprivation is considered a safety issue that results in loss of life and property. Psychomotor impairments of sleep deprivation are similar to symptoms caused by: A. Sleeping in excess of 10 hours B. Misuse of caffeine products C. Alcohol consumption D. Working more than 40 hours per week

C. Alcohol consumption

10. Tomas is a 21 year old male with a recent diagnosis of schizophrenia. Tomas's nurse recognizes that self medicating with excessive alcohol is common in this disease and can co-occur along with: A. Generally good health despite the mental illness. B. An aversion to drinking fluids. C. Anxiety and depression. D. The ability to express his needs.

C. Anxiety and depression.

2. Madelyn, a 29 year old patient recently diagnosed with depression, comes to the mental health clinic complaining of continued difficulty sleeping. One week ago she was started on a selective serotonin reuptake inhibitor (SSRI), fluoxetine (Prozac), for her depressive symptoms. When educating Madelyn your response is guided by the knowledge that: A. SSRIs such as fluoxetine more commonly cause hypersomnolence as opposed to difficulty sleeping. B. The sleep problem is caused by the depression and is unrelated to the medication. C. The neurotransmitters involved in sleep and wakefulness are the same neurotransmitters targeted by many psychiatric medications and the problem may be temporary. D. The medication should be discontinued since sleep is the most important element to her recovery.

C. The neurotransmitters involved in sleep and wakefulness are the same neurotransmitters targeted by many psychiatric medications and the problem may be temporary.

A pronounced increase or decrease in the rate and amount of movement. Excessive motor activity is purposeless and accompanied by echolalia ( repeating others' words) and echopraxia ( mimicking others' movements). The most common form is when the person moves little or not at all. Muscular rigidity may be so severe that the limbs remain in whatever position they are placed.

Catatonia

7. Many people allow life circumstances to dictate their amount of sleep instead of recognizing sleep as a priority. Which statement will the nurse recognize as progress in the patient's sleep hygiene program? A. "I go to bed even if I am not sleepy, hoping I will fall asleep." B. "I have one glass of red wine at bedtime each night." C. "I take a nap each day to 'catch up' on my sleep deficit." D. "I have removed the television from my bedroom."

D. "I have removed the television from my bedroom."

2. When assessing a patient diagnosed with a borderline personality disorder, which statement by the patient warrants immediate attention? A. "My mother died ten years ago." B. "I haven't needed medication in weeks." C. "My dad never loved me." D. "I'd really like to hurt her for hurting me."

D. "I'd really like to hurt her for hurting me."

Chapter 20 Review Questions 1. Which patient statement suggests a concern over one's ability to perform sexually? A. "My partner and I aren't as close as we once were." B. "I'm not as desirable as I once was." C. "My personal life has changed a lot." D. "I'm not the partner I used to be."

D. "I'm not the partner I used to be."

4. Which intervention will promote independence in a patient being treated for bulimia nervosa? A. Have the patient monitor daily caloric intake and intake and output of fluids. B. Encourage the patient to use behavior modification techniques to promote weight gain behaviors. C. Ask the patient to use a daily log to record feelings and circumstances related to urges to purge. D. Allow the patient to make limited choices about eating and exercise as weight gain progresses.

D. Allow the patient to make limited choices about eating and exercise as weight gain progresses.