Mental Health Quizzes

Which of the following medications is from the classification of drugs that is given to inhibit the "Kindling Process"? Carbamazepine Haloperidol Sertraline Diphenhydramine

Carbamazepine

6. The client tells the nurse, "I'm frightened about my surgery tomorrow." What response by the nurse is best? A. "Can you tell me what frightens you?" - Therapeutic communication ("Encouraging expression") B. "Hundreds of people have this surgery daily." "Belittling feelings expressed" non-therapeutic. Telling/not asking) C. "Didn't the surgeon answer all your questions?" Yes-No question. Not addressing topic of "Client fears" D. "What's to be frightened about, the OR crew will take care of you." "Belittling feelings expressed" non-therapeutic. Telling/not asking)

"Can you tell me what frightens you?"

A student nurse is assigned to work with an experienced RN in the Neuropsychiatric Unit of the hospital. While talking with the student, the RN recognizes that the student does not understand an important legal concept when she says: "Mental health clients who are hospitalized voluntarily give up their right to leave the hospital. "A person can be detained in a psychiatric facility for 48 to 72 hours to determine if they should be committed." "A suicidal client may not be permitted to keep a belt." "Clients involuntarily committed to the psychiatric unit have the right to refuse treatment"

"Mental health clients who are hospitalized voluntarily give up their right to leave the hospital.

The provider prescribes an initial dose of alprazolam (Xanax) to treat situational anxiety in an adolescent weighing 132 pounds. The order reads: alprazolam 0.015 mg/kg/day PO divided TID. The first dose will be ____ mg.

0.3

The order for a patient with schizoaffective disorder reads: Haloperidol (Haldol) 2,500 mcg IM Stat. The nurse will prepare an injection with _________ mL from the multi-dose vial. Do Not type units in the answer blank or the question will be marked incorrect. Include the leading zero if the answer is less than 1.

0.5

Extra Credit: Fluoxetine (Prozac) is prescribed to treat depression and OCD for a child weighing 65 pounds. Prescribed is 4 mg PO. Based on the information on the medication label, the nurse will prepare how many mL: Do Not type units in the answer blank or the question will be marked incorrect. Include the leading zero if the answer is less than 1.

1

The belief that personal abilities and efforts affect the events in a person's life is the definition of this "Individual Factor" that influences a person's response to illness: A. Resilience B. Hardiness C. Spirituality D. Self-efficacy.

Self-efficacy

A mental health nurse has been invited as a guest lecturer to present information regarding schizophrenia to a Mental Health Nursing class at the community college. Which items of information will be included? (Select all that apply) 1. Schizophrenia can manifest with developmental and family stressors such as beginning college. 2. The symptoms of this disorder are observed in early childhood. 3. The intensity of psychosis increases with age and becomes more disruptive. 4. Schizophrenic hallucinations involve only hearing voices. 5. Psychotic symptoms later in life are usually associated with depression or dementia, not schizophrenia.

1&5 Correct Answers: #1 - pg. 1 of student outline, and #5, pg 279 2. Not dx'd until late adolescence or early adult age 3. Schizophrenia psychosis DECREASES with age and is LESS disruptive 4. Hallucinations can be visual, tactile, olfactory, gustatory, or auditory

Which of these statements is correct? (Select all that apply) 1. Associative Looseness is fragmented or poorly related thoughts and ideas. 2. Echopraxia is the ability to hold or maintain a body position for any period of time. 3. A person who shows little or a slow-to-respond facial expression has a flat affect. 4. The client who is exhausted with lack of energy has Avolition 5. Alogia describes the lack of any real meaning or substance in what the client says. 6. Thinking that is not bound to reality but reflects the private perceptual world of the individual describes autism.

1, 5, & 6 Correct Answers: #1, #5, #6 #2 is Waxy flexibility #3 is Blunted affect #4 is Anergia

The nurse receives calls on the crisis hotline. Which statement made by a caller to the nurse, causes the highest concern? 1. "I ran out of clozapine 2 days ago, and a voice is telling me that my baby is evil." 2. "My diazepam was not helping my nerves, so I drank 3 beers." 3. "My husband beats me if dinner is not ready by the time he gets home, and I just burned the spaghetti." 4. "I was committed to the psychiatric unit, but I sneaked out and I'm not going back."

1. "I ran out of clozapine 2 days ago, and a voice is telling me that my baby is evil." Correct Answer: #1: This is a Safety Issue involving an unprotected baby and is highest priority; Person has not taken antipsychotic medication, so baby is in danger because voices are saying the baby is evil. 2. Determine how much and when diazepam was consumed in relation to the beer. Not highest priority. 3. Not highest priority. Recommend that wife and children seek safe shelter; determine if client has a place to go and transportation 4. No indication that this patient is a safety issue. Further assessment is required. #1 is highest priority.

Matching Module 13

1. Loss of purposeful hand skills Rett's Syndrome 2. Not pointing to objects of interest by 14 months old Autism spectrum disorder ASD 3. Reduced sensitivity to reward/punishment (so do not learn from experience). Oppositional Defiance Disorder (ODD) 4. Fear of being alone Separation Anxiety Disorder 5. Anhedonia, social withdrawal, hyper or hyposomnia Mood disorders

MATCHING: Neurocognitive Disorders

1. Palilalia - Repeating one's own sounds or words over and over 2. Delirium - Transient cognitive impairment 3. Aphasia - Can be either "receptive" or "expressive" 4. Amnesia - Inability to recall information, facts, experiences 5. Echolalia - Repeating words/phrases said by others

Matching mod 10

1. Schizotypal Personality Disorder - Pervasive detachment from social and interpersonal relationships. 2. Paranoid Personality Disorder - Pervasive distrust and suspiciousness of others 3. Avoidant Personality Disorder - Strong desire for interpersonal relationships but evades them 4. Antisocial Personality - Consistent disregard for others through exploitation • Difficulty expressing emotions, but no perceptual distortions - Schizoid Personality Disorder • Need for admiration; Behavior can be arrogant/haughty - Narcissistic Personality Disorder • Excessive emotionality and attention seeking.- Histrionic PD • Needs advice and repeated reassurances for even minor decisions - Dependent PD

Extra Credit: A patient is to receive an IM injection of Lorazepam to treat a panic attack. The medical provider orders 3 mg IM now. Based on the information on the medication label, the nurse will give how many mL in the injection? Do Not type units in the answer blank or the question will be marked incorrect. Include the leading zero if the answer is less than 1.

1.5

The provider has ordered 75 mg of chlorpromazine to be given intramuscularly (IM) to a patient who is agitated. The medication label says "100 mg per 2 mL." How much medication should the nurse draw up in the syringe to administer? 0.75 mL 0.66 mL 1.5 mL 1.33 mL

1.5 mL

EXTRA CREDIT: Read the label to obtain the information you need for the "supply on hand." Order: azithromycin (Zithromax) oral susp 400 mg po every day × 4 days. How many mL of Zithromax syrup will you give each day? Type numbers only, not units.

10

A patient has been experiencing a psychotic break and has not eaten, slept, or had anything to drink for several days. The patient shows signs of severe dehydration and is lethargic. The physician orders an IV of 1000 mL of Lactated Ringers to infuse over ten hours. How many mL per hour should the nurse set the infusion pump?

100

The provider ordered 10mg of diazepam orally to treat anxiety. The pharmacist dispensed 5mg per tablet. How many tablets should the nurse administer? 0.5 tablets 1 tablet 2 tablets 2.5 tablets

2 tablets

A nurse is completing an admission assessment for a client who has schizophrenia. Which of the following findings should the nurse document as NEGATIVE symptoms? (Select all that apply) 1. Auditory hallucination 2. Lack of motivation 3. Use of clang associations 4. Delusion of persecution 5. Constantly waving arms 6. Flat affect

2&6 NEGATIVE symptoms described what "should be present in the person, but is missing, so #2 - lack of motivation (avolition) and #6 - flat affect (no facial expression) are "negative" s/s.

A client tells the nurse that he must leave the unit immediately due to the presence of dangerously high levels of radiation. Which of the following statements by the nurse would be MOST appropriate? 1. "Did you refuse to take your antipsychotic medication this morning?" 2. "It sounds like you feel frightened. You are safe here in the hospital." 3. "I will call the hospital administration immediately to take care of the radiation." 4. "What makes you think there is radiation in the building?"

2. "It sounds like you feel frightened. You are safe here in the hospital." Correct Answer #2: Validate patient's feelings and present reality without engaging in or fostering the delusion. #1 is confrontational, nontherapeutic. #3 and #4 engage in the patient's delusion.

Clozapine 450 mg qd in three divided doses for schizophrenia. On hand: Clozapine 50 mg/mL liquid. The patient will receive ____ mL per dose. (Type WHOLE number only. Do Not type units)

3

The physician prescribes diazepam for a 14-year-old patient with Anxiety. The patient is to receive 0.3 mg/kg of diazepam by IM injection. She weighs 110 pounds. The medication vial states the concentration is 5mg/mL You will give __________ mL:

3

The nurse notices that the client with schizophrenia has a protruding tongue and is "lip smacking." After conducting an AIMS test, the nurse notes that the client's score is higher than it was for the last AIMS test the client performed six months before. Based on this finding you know: 1. The client needs to immediately stop their antipsychotic medication to prevent serious complications. 2. The nurse should inform the physician that the client has improved significantly and no longer needs their medication. 3. The AIMS test was done because a protruding tongue and "lip smacking" are indicators of tardive dyskinesia that need to be assessed. 4. The AIMS test was performed by the nurse to measure the level of the client's perceptual impairment.

3. The AIMS test was done because a protruding tongue and "lip smacking" are indicators of tardive dyskinesia that need to be assessed. Correct Answer #3: AIMS test (Abnormal Involuntary Movement Scale) assesses movement associated with TD. #1. Antipsychotic drugs should never be stopped suddenly #2. A higher score indicates the client is getting worse, not better. #4. AIMS tests for involuntary movement, not perceptual impairment.

Prescribed is aminophylline to infuse IV at 30 mg/hr. The pharmacy sends aminophylline 250 mg in 500 mL of D5W. The IV infusion pump should be programmed to deliver how many milliliters per hour? (Type WHOLE number only. Do Not type units)

60

An example of transference as described by Freud would be: A parent displaces feelings related to their spouse onto one of their children. A physician displaces frustrated feelings onto the nurse. A patient displaces feelings related to people in his past onto the nurse. A nurse displaces feelings related to people in his/her past onto their patient.

A patient displaces feelings related to people in his past onto the nurse.

It is important for nursing staff to understand the importance and skill of setting limits for clients with disruptive disorders. Which steps are involved in limit-setting? Select all that apply. A. State the expected behavior. B. Inform clients of the rule or limit. C. Allow client to set the length and conditions for "time-out" periods. D. Explain the consequences if clients exceed the limit. E. Occasionally limit enforcement.

A, B, & D

Which factors increase the index of risk for self-harm for a patient experiencing the manic phase of bipolar I disorder? (Select three that apply.) A. Potential for delusional thinking B. Increased energy C. Lack of sleep D. Distractibility E. Distorted thinking

A, B, & E Rationale: A patient experiencing a manic episode is at high risk for suicide because of his or her increased energy, distorted thinking, and the potential for hallucinations and delusions. Distractibility and lack of sleep are risk factors for unintended injury. See Student outline.

13. When comparing the signs and symptoms of Major Depression vs. Mania / Hypomania, which of the following would be consistent with depressive episodes? (Select three that apply) A. Anhedonia B. Psychomotor agitation C. Irritable when having to follow rules D. Memory impairment E. Hypersomnia F. Grandiosity

A, D, & E Rationale: The topic of this question is knowing the difference between depression and mania (each at opposite ends of the continuum in bipolar disorder). Depressive episodes can include anhedonia (inability to feel pleasure), memory impairment and hypersomnia (excessive sleeping). Manic episodes would manifest as psychomotor agitation (hyperactivity/jittery), irritable when having to follow rules, and grandiosity. pg. 288

In your case study for this module you were asked to select nursing interventions from a list to describe and provide an example. From the case study exercise, you will be able to recognize which of the following statements is an example of "Seeking Clarification". A. "Did I get that right, you are hungry?" B. "You look worried. I don't know what's wrong, but let's go for a walk. C. "Can you come and help me find a good program on television?" D. "I can see that you are angry right now. I will come back in 5 or 10 minutes."

A. "Did I get that right, you are hungry?" (seeking clarification) B. "You look worried. I don't know what's wrong, but let's go for a walk. (making an observation) C. "Can you come and help me find a good program on television?" (redirection/distraction) D. "I can see that you are angry right now. I will come back in 5 or 10 minutes." (time away)

Who is least likely to be a risk for suicide? A. A female client with obsessive-compulsive disorder who engages in onychophagia for self-soothing. B. 14-year-old girl who is a victim of cyberbullying on social media. C. Veteran of war who is having repeated flashbacks of violent episodes. D. A client with major depression who has been on antidepressant medications for a week.

A. A female client with obsessive-compulsive disorder who engages in onychophagia for self-soothing. Rationale: The patient who has OCD is anxious so is self-soothing by biting her names. This person is the LEAST likely to be at risk for self-harm. The teenage victim of cyberbullying, veteran with PTSD are at high risk of suicide due to the extreme nature of this type of anxiety. The client with depression who has been on medication for a week is at risk because they are not at therapeutic levels for 3 weeks but will initially develop enough energy from the medication to commit suicide.

13. After studying this module on all the various anxiety disorders listed in your student outline, you know that which of the following statements is correct: A. A nursing intervention for severe or panic-level anxiety is to teach coping skills. B. It is inappropriate to ask a person with a stress-related disorder if they are planning to kill themselves. C. Adolescents and children are more resistant to the effects of PTSD. D. Mild obsessions are normal and not an indicator of a mental health problem.

A. A nursing intervention for severe or panic-level anxiety is to teach coping skills. People with this level of anxiety cannot be taught new information (anxiety causes brain blood flow to redirect from the frontal lobe to the hind brain - "survival" functions - where new knowledge cannot be processed very well)

A client tells the nurse, "I am not going to take this new medication because nothing ever works for me." This is an example of what type of thinking: A. Catastrophizing B. Intrusions (intrusive thoughts) pg. 206 C. Avoidance D. Rumination

A. Catastrophizing irrationally assuming the "worst is going to happen"

8. Which pair correctly matches the personality disorder to its Personality Disorder Cluster? Pg. 328 A. Cluster A (Odd or Eccentric) - Paranoid personality disorder B. Cluster B (Dramatic Emotional or Erratic) - Schizotypal personality disorder C. Cluster C (Anxious or Fearful) - Narcissistic personality disorder D. Cluster A (Odd or Eccentric) - Obsessive/Compulsive personality disorder

A. Cluster A (Odd or Eccentric) - Paranoid personality disorder CORRECT ANSWER B. Cluster B (Dramatic Emotional or Erratic) - Schizotypal personality disorder Cluster A C. Cluster C (Anxious or Fearful) - Narcissistic personality disorder Cluster B D. Cluster A (Odd or Eccentric) - Obsessive/Compulsive personality disorder Cluster C

The most common type of prion disease in the United States, this condition affects adults aged 40 to 60 and dementia usually progresses rapidly within months. A. Creutzfeldt-Jacob disease B. Alzheimer disease C. Lewy body dementia D. Vascular dementia

A. Creutzfeldt-Jacob disease

Lloyd has been diagnosed with Obsessive-Compulsive Personality Disorder (OCPD). The new nurse in the psychiatric unit is confused between OCDP and OCD. Which finding would be characteristic of Lloyd's disorder? A. Having intrusive thoughts or obsessions that cause extreme anxiety in an individual B. Due to fixation with details and rules, people with this disorder cannot get their work done. C. People with obsessive-compulsive personality disorder will eventually develop Obsessive Compulsive Disorder D. Must perform repetitive behaviors such as counting steps to reduce anxiety

A. Having intrusive thoughts or obsessions that cause extreme anxiety in an individual (OCD) B. Due to fixation with details and rules, people with this disorder cannot get their work done. (TRUE) pg. 350 C. People with obsessive-compulsive personality disorder will eventually develop Obsessive Compulsive Disorder (OCPD and OCD are two different mental illnesses ) D. Must perform repetitive behaviors such as counting steps to reduce anxiety (OCD)

9. While discussing this module material with your study group, you determine that which of the following are correct: (Select all that apply) A. Nonverbal communication is often more accurate than verbal communication when the two are incongruent. B. Sympathy is perceiving the client's meanings and feelings and communicating that understanding. (Definition of empathy not sympathy) C. A distance of 2 feet between the nurse and patient is within the "Social Distance Zone" and is the appropriate distance for promoting comfortable therapeutic communication. (2 feet is within the "Personal Distance Zone"). D. A nurse displays empathy by showing feelings of concern and compassion. (Definition sympathy of not empathy) E. "Reassuring" is a nontherapeutic technique because it attempts to dismiss the patient's feelings.

A. Nonverbal communication is often more accurate than verbal communication when the two are incongruent. E. "Reassuring" is a nontherapeutic technique because it attempts to dismiss the patient's feelings.

The Freud defined three components in an individual's personality he called the id, ego, and superego. Which of the following is the domain of the "superego"? Select all that apply. A. Parental role B. Pleasure-seeking C. Moral and ethical values D. Mature adaptive behavior E. Aggression

A. Parental role C. Moral and ethical values

This inherited disease is characterized by constant "choreiform" (jerking or writhing) movements as well as dementia.

A. Parkinson Disease B. Huntington Disease C. Vascular dementia D. Prion disease

Which characteristic is linked to a person diagnosed with Avoidant Personality Disorder? A. Will not go out of doors or touch surfaces that feel may not be clean. B. Avoids responsibility for their own actions and misbehavior. C. Relies on others to make the decisions for them. D. Exhibits shyness, awkwardness, and fear of failure.

A. Will not go out of doors or touch surfaces that feel may not be clean. (phobia disorder) B. Avoids responsibility for their own actions and misbehavior. (Borderline PD) C. Relies on others to make the decisions for them. (Dependent PD) D. Exhibits shyness, awkwardness, and fear of failure. CORRECT ANSWER

Ruby was the victim of a sexual assault and beating. This is an example of which type of crisis. Adventitious Situational Maturational Developmental

Adventitious

Catastrophizing

An irrational negative thought - believing that something is far worse than it actually is

Metabolic Syndrome (obesity, hypertension, hyperglycemia and hypercholesterolemia) is associated with which class of drugs? Anticonvulsants Mood stabilizers Antidepressants Antipsychotics

Antipsychotics

The nurse should place the highest priority on which nursing activity when admitting a mentally ill patient who is experiencing crisis? Assess for self-harm potential and suicidal ideation Provide the patient with step by step discharge instructions Instruct the family to bring several clothing outfits because the patient will be hospitalized for six months. Reassure the patient that everything will be all right.

Assess for self-harm potential and suicidal ideation

As a nurse in the psychiatric unit of the hospital, you know that which behaviors are most consistent with Borderline Personality Disorder? (Select All that apply) (pg. 340) A. Speech patterns may be distinctive and bizarre B. Telling one nurse that another nurse told the client he could have special privileges C. Impulsivity, volatile moods result in unstable relationships D. Excessive and chronic fears of abandonment even in normal situations E. High risk for self-harm and suicide. F. Dramatizes minor occurrences or has a crying outburst over perceived insults.

B. Telling one nurse that another nurse told the client he could have special privileges C. Impulsivity, volatile moods result in unstable relationships D. Excessive and chronic fears of abandonment even in normal situations E. High risk for self-harm and suicide.

Ted is a 9-month-old boy. According to Erikson's Theory of Psychosocial development, Individuals in this age group face which task of personality development? Trust vs. Mistrust Industry vs. Inferiority Identity vs. Role Confusion Autonomy vs. Shame

Trust vs. Mistrust

Nursing Interventions for Personality Disorders include which of the following: Select all that apply A. Allow for leniency in client's behavior while first establishing their trust. (False. Firm, consistent boundaries must be maintained from "day 1" with a client who has PD. B. Provide physical outlet for expression of anger. C. Encourage patient to self-reward for successful outcomes (patient using behavior modification techniques on themself. D. Provide frustration-triggering situations to allow the patient to work through them. E. Teach clients new skills such as thought-stopping, mindfulness and distress tolerance.

B, C, & E B. Provide physical outlet for expression of anger (this would be an "adaptive" Displacement intervention) D. Provide frustration-triggering situations to allow the patient to work through them. (Triggering or pushing a patient to the point of frustration would not be therapeutic.) E. Teach clients new skills such as thought-stopping, mindfulness and distress tolerance (These are CBT and DBT skills that are taught to individuals with Personality Disorders).

The patient with major depression tells the nurse, "Life is hard. I want to be done." Which response to the patient is MOST appropriate: A. "Tell me what led up to these thoughts you are having today." B. "Based on what you are saying, I wonder if you are planning to kill yourself?" C. "I sense you feel out of control." D. "You need to look on the bright side. Overall, you are doing much better." Rationale: The patient is giving the nurse a "covert cue" that they are planning self-harm. Most suicidal people are ambivalent about whether to live or die and often admit their plan when directly asked about it, i.e., "are you planning to kill yourself." If suicidal ideation is suspected, the nurse must be direct and ask the patient their intent, method, plan, etc.

B. "Based on what you are saying, I wonder if you are planning to kill yourself?" Rationale: The patient is giving the nurse a "covert cue" that they are planning self-harm. Most suicidal people are ambivalent about whether to live or die and often admit their plan when directly asked about it, i.e., "are you planning to kill yourself." If suicidal ideation is suspected, the nurse must be direct and ask the patient their intent, method, plan, etc.

What would the nurse most likely assess in a child with a conduct disorder? A. High self-esteem B. Aggression toward animals. C. Delusions and Hallucinations D. Lack of rational thinking

B. Aggression toward animals.

Gloria panics or becomes incapacitated around people, especially if she has to speak in front of a group. She says she cannot even go to work parties without having another person with her. She reports that she has been like this for six months. What can you conclude from her history? A. Gloria's symptoms are due to GAD (Generalized Anxiety Disorder) B. She suffers from Social Anxiety Disorder C. These are the hallmark signs of Agoraphobia D. This condition is called Xenophobia

B. She suffers from Social Anxiety Disorder

A nurse working with a client who is diagnosed with narcissistic personality disorder would expect the client to demonstrate all of the following characteristics EXCEPT: A. Underlying low self-esteem B. Shows false emotions of caring C. Exaggerated self-importance D. Hypersensitive to criticism

B. Shows false emotions of caring (Antisocial PD) Rationale: NOTE negative polarity question, "EXCEPT." A client with narcissistic personality disorder typically exhibits arrogance and self-importance behaviors, lack of empathy, and low self-esteem ("Underlying self-esteem is almost always fragile and vulnerable" Pg. 343). False display of emotions would be assessed in a client with antisocial personality disorder.

The psychiatrist treating a youth with Intermittent Explosive Disorder (IED) is prescribing medications from drug categories that have proven effective for this condition. Any of the following medications would be appropriate for this disorder, EXCEPT: A. phenytoin/Dilantin B. clonidine/Catapres. C. sertraline/Zoloft D. fluoxetine/Paxil

B. clonidine/Catapres.

Which of the following would the nurse include when assessing a client's self-concept? Roles Abstract thinking Support systems Body image

Body image

To best encourage medication adherence to her newly prescribed lithium therapy, which instructions should the nurse provide to a patient and her family? (Select three that apply.) A. Cease drinking any beverage containing caffeine B. It is common to have a fast heart rate until your body gets used to the lithium C. Drink plenty of water when taking the medication to minimize gastrointestinal upset D. Initially expect a sensation of thirst E. Expect intermittent bouts of nausea for several days after lithium therapy begins

C, D, & E Rationale: Lithium can produce side effects that discourage adherence to the prescribed therapy. Educating the patient that some effects are temporary, or can be managed fairly easily, will help the patient stay on the medication. Nausea and thirst are often experienced initially but generally subside in a few days. Taking the medication with a sufficient amount of water tends to help manage gastrointestinal upset. Major changes in salt and caffeine intake should be avoided without first consulting the healthcare provider.

Which assessment question should the nurse ask a patient to best help determine the cause of her manic behavior? A. "What were you doing when you fractured your ankle?" B. "When did you take your last dose of lithium?" C. "When were you diagnosed with bipolar disorder?" D. "What sort of stress have you been experiencing lately?"

C. "When were you diagnosed with bipolar disorder?" Rationale: Treatment for bipolar disorder involves a lifetime regimen of medications. Adherence to the prescribed medication therapy is critical to controlling the development of manic symptoms. Although the other options present appropriate assessment questions, none of them are as directly related to the development of manic behavior as medication compliance.

A nurse was unjustly yelled at by the charge nurse in front of other staff and patients, so the nurse went to a club after work and had several alcoholic drinks. This is an example of: A. An adaptive "Identification" defense mechanism B. An adaptive "Conversion" mechanism C. A maladaptive "Compensation" defensive mechanism D. A maladaptive "Reaction Formation" defense mechanism

C. A maladaptive "Compensation" defensive mechanism Unproductive "compensation" for low self-esteem.

Jeremy is a 13-year-old child who has poor school performance and disruptive behaviors related to attention deficit-hyperactivity disorder (ADHD). He has been given a psychostimulant medication to manage his symptoms. Which two medications are in this drug class? Select all that apply. A. Methylphenidate. Correct Answer B. Atomoxetine C. Adderall. D. Clonidine E. Lithium

C. Adderall.

A nurse is assisting with a court-ordered evaluation of a client who has antisocial personality disorder. Which of the following findings should the nurse expect? (Select all that apply) A. Demonstrates extreme anxiety when placed in a social situation. Avoidant Personality Disorder B. Exhibits perceptual distortions and an eccentric appearance. Schizotypal Personality Disorder C. Attempts to convince other clients to give him their belongings D. Becomes agitated if his personal area is not neat and orderly (OCPD) E. Blames others for personal past and current problems.

C. Attempts to convince other clients to give him their belongings E. Blames others for personal past and current problems.

The school-aged child will face which task of personality development according to Erickson's Theory of Psychosocial development? A. Trust vs. Mistrust Infant/first year of life B. Identity vs. Role Confusion Teenager C. Industry vs. Inferiority (School-aged child) D. Intimacy vs. isolation (Early Adult stage, 20 - 40)

C. Industry vs. Inferiority (School-aged child)

Which is considered a characteristic of intermittent explosive disorder (IED)? A. Episodes of anger lasting greater than 30 minutes B. No feeling of guilt or remorse after episode C. Injury to self, others, or property. D. Comorbidity of an autistic disorder

C. Injury to self, others, or property.

Personality Disorders are characterized as being "treatment resistant." Which statement correctly describes this term: A. Treatment resistance describes a lack of response to medications prescribed for the client. B. Individuals with personality disorders resist any form of treatment. C. This refers to the fact that it is difficult to change a person's personality D. Unlike other mental disorders, there is no effective psychotherapy for personality disorders.

C. This refers to the fact that it is difficult to change a person's personality Rationale: Treatment resistance = difficult to change a person's personality even if it is dysfunctional; PD cannot be changed with medication. Clients may lack insight into their PD but do not resist treatment necessarily. Therapies such as CBT and DBT are effective for PD.

12. The nurse should warn the patient taking lorazepam that this medication should not be stopped abruptly because doing so will likely result in which consequence? A. A manic episode B. A decrease in the effects of lithium C. Triggering of withdrawal symptoms D. A depressive episode

C. Triggering of withdrawal symptoms Rationale: Lorazepam is a benzodiazepine that can cause addiction when used long-term or when abused. Don't stop taking lorazepam abruptly after long-term use because withdrawal symptoms may occur.

-May cause potentially life-threatening agranulocytosis -High risk of suicide 2 weeks after starting -Do not stop suddenly, must taper off this medication -Treatment for EPS signs and symptoms -Stimulant drug for ADHD and narcolepsy

Clozapine Fluoxetine Diazepam Benztropine Methylphenidate

"Earlier today you said you were concerned that your son was still upset with you. When I stopped by your room about an hour ago, you and your son seemed relaxed and smiling as you spoke to each other. How did things go between the two of you?" This is an example of which therapeutic communication technique? A. Accepting "yes," "I follow what you said," nod B. General lead "Go on..." "and then..." C. Consensual validation "Tell me whether my understanding of it agrees with yours." D. Encouraging comparison "Have you had similar experiences before?"

Consensual validation

Which of the following are examples of disenfranchised grief? (Select all that apply) A. Lisa's house and all her belongings were destroyed in a house fire. She says she "feels nothing" and is void of all emotion after this incident. B. A woman's mother passed away suddenly, but the woman just can't believe her mother is gone. C. Betty's friends do not understand why she is sad about her pet dying, so she keeps her grief to herself. D. Earl's wife passed away and now he is having suicide ideation. E. A nurse does not feel he should show his grief over the death of a patient since that would be unprofessional.

Correct Answer is C, E: Disenfranchised grief is grief over loss that is not or cannot be openly acknowledged, mourned publicly, or supported socially A - Complicated Grief; B - "Denial" stage of normal grieving; D - Complicated Grief

June is the caregiver for her husband who has a neurocognitive disorder. All of the following will benefit June's ability to provide care, EXCEPT: A. Contacting local Aging Services to arrange for respite care B. Meeting with others in a caregiver support group C. Teaching June methods to distract her husband when he becomes restless or agitated. D. Reminding June that she should not leave her husband in the care of others to avoid upsetting his routine.

Correct Answer is D: Note negative polarity question (Except). Caregivers should arrange for others to assist in caring for the dementia patient to prevent "Caregiver Burnout."

A nurse in a long-term care facility is caring for a client who has major neurocognitive disorder and attempts to wander out of the building. The client states, "I have to get home." Which of the following statements should the nurse make? A. "You have forgotten that this is your home." B. "I am your nurse. Let's walk together to your room." C. "Why would you want to leave. Aren't you happy here?" D. "You cannot go outside without a staff member."

Correct answer is B: It is appropriate to introduce oneself with each new interaction and to promote reality in a calm, reassuring manner. Other answers can be interpreted as argumentative or demeaning. Also, do not ask "why" questions.

Which of the following statements is correct about mental illness treatment? Criminalization of mental illness is an effort to contain mentally ill individuals in some type of institution where they might receive needed treatment. Military veterans with mental illness receive a higher level of care for their condition than individuals in the general population. The purpose of an Evolving Consumer Household is a program is to provide temporary housing for the homeless population with mental illness. Partial hospitalization programs allow patients to come and go from the facility whenever they want.

Criminalization of mental illness is an effort to contain mentally ill individuals in some type of institution where they might receive needed treatment.

A group member argues against most of the ideas and proposals discussed in the group. This growth-inhibiting behavior is assuming the role of? Aggressor Monopolizer Recognition seeker Critic

Critic

A 72-year-old client is scheduled for an initial treatment of electroconvulsive therapy (ECT). Which information should a nurse include when teaching about the potential side effects of this procedure? A. "Because you are older, this treatment may not be as effective." B. "Unfortunately, you will be at a higher risk for subsequent seizures. C. "You can expect dysthymia to develop during the week if the treatment is effective." D. "A common side effect is to experience some memory deficit after the ECT."

D. "A common side effect is to experience some memory deficit after the ECT." Rationale: Temporary or permanent memory loss is a side effect of EDT. In older patients ECT more commonly used for treatment with more rapid response. ECT is a tx for dysthymia, so it should decrease if tx is effective. ECT does not induce seizures after the procedure, only during the tx.

When considering the differences between delirium and dementia, select the following that are associated with Dementia: (Select all that apply) A. Transient change in cognition B. Could be due to drug intoxication or medication side effects. C. Disturbance of consciousness and changes in cognition. D. Anomia E. Progressively worsening cognitive impairment F. Develops over a short period of time

D. Anomia E. Progressively worsening cognitive impairment

A 13-year-old child is constantly involved in breaking tables and chairs at school. On further assessment, the nurse finds that the child has conduct disorder. Which condition is the child most likely to develop in the future if not treated effectively for this condition? A. Depression B. Schizophrenia C. Anxiety disorder D. Antisocial personality disorder.

D. Antisocial personality disorder.

While discussing Autism Spectrum Disorders (ASD) in your mental health study group, all of the following are identified as being part of the "Spectrum," EXCEPT: (NOTE - this is a negative polarity question) A. ASDs are characterized by stereotyped motor behaviors. B. Autism is a life-long neurodevelopmental disability which has no cure. C. This condition affects social interaction and communication skills. D. Individuals with autism always have an intellectual disability and low IQ.

D. Individuals with autism always have an intellectual disability and low IQ.

The General Adaptation Syndrome (GAS) is a theory developed by Hans Selye's which describes a human's reaction to stress. Which statement is correct? A. GAS describes the mental stages of anxiety from mild to severe B. All humans respond the same psychologically to a given stimuli C. During stress events, the digestive system increases activity. D. This theory describes the physiological aspects of stress

D. This theory describes the physiological aspects of stress

"Why do you always complain about the night nurse? She is a nice woman and a fine nurse and has five kids to support. You're wrong when you say she is noisy and uncaring." This example reflects which nontherapeutic technique? A. Defending B. Advising C. Disagreeing D. Requesting an explanation

Defending

Matching

Depersonalization - Sensation of being detached from body or mind. Dissociative disorders - disruption in usually integrated functions of consciousness Generalized Anxiety Disorder - worries excessively and feels highly anxious at least 50% of the time for 6 months Derealization - Sensation of being detached from surroundings Oniomania - Compulsive buying even though the person does not have money Body Dysmorphic Disorder (BDD) - preoccupation with an imagined or slight defect in physical appearance that causes significant distress

Extra Credit The medication fluphenazine (Prolixin) is available as a depot injection. Select the correct statements: (Select all that apply) Depot injections are more likely to result in better patient compliance. The patient must be monitored for postinjection delirium/sedation syndrome Prolixin is in the "Typical" antipsychotic drug class Because this is a neuroleptic medication, EPS could develop This medication must be given daily to be effective

Depot injections are more likely to result in better patient compliance. Prolixin is in the "Typical" antipsychotic drug class Because this is a neuroleptic medication, EPS could develop

Obsessions

Disturbing thoughts, impulses, or images that recur, causing anxiety.

While assessing a 17-year-old male patient for potential suicidal risk, the emergency room nurse will evaluate all the following as part of the Suicide Assessment EXCEPT: Does he intent to die Does he have a method Does he have a plan Does he have insight into his feelings

Does he have insight into his feelings

Sylvia is attending group therapy dealing for victims of abuse. She says, "My husband is much older than me and does not believe women should have access to a bank account. He says I am not very smart and I would spend the money foolishly. I have to ask him for money to buy groceries and gas. I am just glad he doesn't hit me." What types of abuse is Sylvia describing? (Select all that apply). Neglect Elder Economic Sexual Emotional Physical

Economic Emotional

Flooding

Exposes the patient to a large amount of undesirable stimulus

Which of the following types of therapy is helpful for patients with schizophrenia? 1. Electroconvulsive treatments (ECT) 2. Family Therapy 3. Anticonvulsant medication therapy 4. Occupational therapy

Family Therapy

Anhedonia - loss of interest in activities

Flight of ideas - Racing, often unconnected thoughts Pressured speech - Unrelenting, rapid, loud talking. Hypomania - Abnormally elevated mood that does not impair the person's ability to function Mania - Abnormally elevated mood that impairs the person's ability to function Seasonal Affective Disorder (SAD) - Treated with Light Therapy Nonsuicidal Self-injury disorder - Self-mutilating behaviors Dysthymic disorder - also known as persistent depressive disorder

Which of the following Group Roles are matched to their correct definition? (Select all that apply) Gatekeeper - Manages flow of conversation so that all group members can participate. Initiator - Clarifies and coordinates ideas, suggestions, and activities of the group. Energizer - Stimulates and prods the group to act and raises the level of its actions. Elaborator - Takes over communication by doing all the talking Information giver - Seeks opinions that clarify or reflect the value of other members' suggestions.

Gatekeeper - Manages flow of conversation so that all group members can participate. Energizer - Stimulates and prods the group to act and raises the level of its actions.

This nursing theorist described the importance of the Nurse-Client relationship which forms the foundation of nursing practice today. This theorist is: Dorothea Dix June Mellow Linda Richards Hildegard Peplau

Hildegard Peplau

Which of the following are stages of crisis? Select all that apply. Increased efforts to deal with stressor Steadily decreasing anxiety Successful resolution of conflict Disequilibrium, significant distress Exposure to stressor

Increased efforts to deal with stressor Disequilibrium, significant distress Exposure to stressor

The nurse is attending a training conference about appropriate treatment of sexual assault victims and patients with Rape Trauma Syndrome (RTS). During this conference she learns that which of the following are considered best practices: Advise the patient that since this is a criminal investigation, she is required to have a physical exam to collect evidence for court purposes. Inform the victim that during the acute phase, symptoms of RTS can begin immediately and last for 2 - 3 weeks. Before beginning a physical exam, the nurse should establish rapport by offering the victim a beverage of her choice and a snack. Patient teaching should include that victims of RTS are expected to reach a full recovery by 4 weeks after the assault.

Inform the victim that during the acute phase, symptoms of RTS can begin immediately and last for 2 - 3 weeks.

When performing an intake assessment, the client's family tells the psychiatric nurse that the client spends a lot of money on electronic devices and video games even though he does not have enough money to buy food. The nurse documents that the client has impaired Judgment and insight Sensorium and intellectual processes Thought process and content Mood and Affect

Judgment and insight

You learned from watching the assigned videos about the obstacles to obtaining mental illness treatment. Four specific barriers for individuals needing mental health services were identified which are: (Select all that apply) Prevalence of agoraphobia causing them to fear leaving their house. Low education level of most people seeking help Lack of understanding of mental health problems The stigma attached to seeking help for mental illness Fear of disclosing mental health problems. Uncertainty of how to obtain help

Lack of understanding of mental health problems The stigma attached to seeking help for mental illness Fear of disclosing mental health problems. Uncertainty of how to obtain help

Severe vomiting, diarrhea, lack of coordination, anorexia, fine hand tremor are indicators of which adverse condition: Lithium Toxicity Benzodiazepine withdrawal Agranulocytosis Ritalin overdose

Lithium Toxicity

-Involves therapy as a search for life with meaning. -Client's learn how to recognize how their behavior blocks them from achieving life's goals. -Focuses on 11 irrational beliefs and automatic thoughts. -Helping client to identify their thoughts and feelings in the here and now.

Logotherapy Reality therapy Rational emotive therapy Gestalt therapy

Lithium is prescribed to treat a patient with bipolar disorder. Prescribed is 1,350 mg qd (each day) divided q 8hr PO. The medication is supplied in several strengths. Which is best for the prescribed one-time dose? One 300 mg tablet and one 150 mg tablet 600 mg tablet 450 mg tab x 3 600 mg tab x 2 and 150 mg tablet

One 300 mg tablet and one 150 mg tablet

Which of the following would be considered an unintentional tort? Battery Assault False imprisonment Malpractice

Malpractice

When evaluating a patient for mental illness indicators, assessment of sensorium and intellectual processes includes which? Select three that apply. Orientation Judgement Memory Concentration Emotional feelings Thought process

Memory Concentration Orientation

The guest speaker from a community mental health organization is lecturing to your nursing class. Which statement by the speaker is NOT CORRECT? Deinstitutionalization is a deliberate shift from institutional care to community facilities. Mental illness includes disorders that affect mood, behavior and/or thinking. Mental illness is primarily a genetic condition A function of the mental health nurse is to assess their patients for comorbid medical conditions.

Mental illness is primarily a genetic condition

A mental health nurse is leading a peer group discussion about the dynamics of abuse and violence. Which of the following statements by a member of the group indicates they do not understand this concept? People who abuse elders almost always are in a caretaker role One risk factor for victims of violence is pregnancy Most rapes are impulsive acts involving a person the victim does not know. A history of violent or aggressive behavior is one of the best predictors of future aggression.

Most rapes are impulsive acts involving a person the victim does not know.

Several children a day are seen in the emergency department for treatment of illnesses and injuries. Any of these indicators would create a high suspicion of child abuse Except: Nausea and lower right quadrant pain. Circumferential bruise marks around both upper arms. Spiral fracture of left humerus Perineal bruises and urinary tract infections.

Nausea and lower right quadrant pain.

Which of these findings would be classified as a General Appearance and Motor Behavior assessment: Neologisms Flat affect Loose associations Delusion

Neologisms

A nurse in the ER is prioritizing patient care for the following psychiatric patients who are experiencing side effects of their psychotropic medication. The highest priority is the patient who is experiencing - Neuroleptic Malignant Syndrome Opisthotonus Prolonged akathisia Oculogyric crisis

Neuroleptic Malignant Syndrome

Matching (11)

Nihilistic-Belief that some body part is horribly disfigured Referential-Belief that the celebrity on television is talking to you personally Guilt or unworthiness-This belief is a common false, fixed idea for individuals with depression Religious-Believes that God communicates directly to him

One ethical concept is defined as not doing harm to others, either intentionally or unintentionally. This ethical concept is: Utilitarianism Nonmaleficence Beneficence Fidelity

Nonmaleficence

After spending 15 minutes talking with a client, the client leaves the interaction feeling defensive. This is evidence that the communication can be described as what? A. Therapeutic B. Nontherapeutic C. Blocked by external noise D. In an improper environment

Nontherapeutic

Which of the following statements by the nurse to the client's family is true of treatment of people with mental illness in the United States today? Substance abuse is effectively treated with brief hospitalization. Only one in four people needing mental health services are receiving those services. Financial resources are reallocated from state hospitals to community programs and support. Emergency department visits by persons who are acutely disturbed are declining.

Only one in four people needing mental health services are receiving those services.

Calmly discuss behavior (no lecturing or chastising) A period of contrition or remorse before tension builds again Debriefing occurs in this stage to allow for discussion of the event

Postcrisis phase Honeymoon phase Recovery phase

-Involves providing services to people with severe mental illness, i.e., help with activities of daily living. -Includes interventions such as meditation, herbal supplements, or biofield therapies. -Focuses on schizophrenia, bipolar disorder, clinical depression, panic disorder and OCD. Organized to help members who share a common problem cope with it.

Psychiatric Rehabilitation Complimentary Medicine Family-to-Family Education Course Support Groups

According to Sigmund Freud, we all employ ego defense mechanisms to help ourselves cope with stress in our life. The ego defense behavior of acting the opposite of what one thinks or feels is called: Projection Reaction formation Conversion Displacement

Reaction formation

Flashbacks

Reliving a traumatic experience

Rumination

Repetitively thinking about the same thing, recycling same thought

Client teaching for lamotrigine (Lamictal) should include which instructions? This drug may cause psychological dependence. Eat a well-balanced diet to avoid weight gain. Take each dose with food to avoid nausea. Report any rashes to your doctor immediately.

Report any rashes to your doctor immediately.

The nurse assesses a 4-year-old child. The nurse observes multiple bruises on the child's back and buttocks. The parents state they don't know how the child sustained the bruises. Which action by the nurse is BEST? Report the suspected child abuse to the nursing supervisor. Ask the parents about the suspected abuse. Suggest to the family that they contact social services for counseling. Thoroughly document the suspicions about the child abuse in the child's medical records.

Report the suspected child abuse to the nursing supervisor.

Which of the following is the highest priority for admission to inpatient care? Withdrawal from alcohol or other drugs Safety of self or others Confusion or disorientation Need for medication changes

Safety of self or others

An example of an opened ended question is: Tell me what has been happening to you. How many meals do you eat a day. How well do you sleep? How old are you?

Tell me what has been happening to you.

The nurse leader of a therapy group asks the group members to think about the growth they have experienced while attending group meetings. The group is in which stage of group development? Pregroup Termination Beginning Working

Termination

Based on JCAHO standards regarding workplace hostility, which of the following are behaviors that undermine a culture of safety in the workplace: (Select all that Apply) PG. 182 A. The clinic nurse is refusing to perform tasks assigned by the charge nurse. B. A staff nurse requests a change in patient assignments. C. One nurse telling another nurse, "I feel upset when you yell at me like that." D. A nurse received notification from a supervisor that they are on probation for being late to work. E. An experienced RN is not answering questions asked by a newly hired nurse.

The clinic nurse is refusing to perform tasks assigned by the charge nurse. An experienced RN is not answering questions asked by a newly hired nurse.

The nurse is reading a patient's chart note written by another nurse that states, "patient has been hostile and aggressive during the day shift." These terms are interchangeable so the nurse should chart either "hostile" or "aggressive" but not both. Aggression refers to being verbally abusive to another person. Hostility involves injury to a person or destruction of property. The nurse's chart note is correct if the patient had yelled at a staff member and bit them on the arm.

The nurse's chart note is correct if the patient had yelled at a staff member and bit them on the arm.

In the acute battering phase of the Cycle of Abuse and Violence you would expect to note that: The abuser makes promises to change The victim feels helpless, becomes compliant, and accepts blame The victim may provoke the incident to get it over with. The abuser yells at and demeans the victim

The victim may provoke the incident to get it over with.

The client's belief that other people can hear what he is thinking is called: 1. Word salad 2. Flight of ideas 3. Ideas of reference 4. Thought Broadcasting

Thought Broadcasting

Which of the following would be a reason for a student nurse to use the DSM-5? Choose clients' treatment Evaluate treatments Understand the reason for the admission and the nature of psychiatric illnesses. To identify a medical diagnosis

Understand the reason for the admission and the nature of psychiatric illnesses.

According to Maslow's Hierarchy of Human Needs theory, what statement best describes motivation? All needs have equal power in motivation. Unsatisfied needs trigger behavior. Physiologic needs are the least valued Some individuals have hereditary needs.

Unsatisfied needs trigger behavior.

Phobia

an irrational fear of a specific object, activity, or situation

According to Peplau's theory of Therapeutic Nurse-Patient Relationships, which nursing role involves promotes experiences leading to health for the client, such as expression of feelings? counselor resource person teacher surrogate

counselor

A client is being interviewed by a nurse in an out-patient psychiatric clinic. She states that her boyfriend just broke up with her and tells the nurse, "If I can't have my boyfriend back, then no one can have him." In this situation, the nurse: should offer to give the client medication to calm her nerves. has a duty to warn the boyfriend of the potential threat. should tell the client that the situation is not as bad as it seems. is required by HIPPA to maintain client confidentiality

has a duty to warn the boyfriend of the potential threat.

The appropriate action for a student nurse who says the wrong thing is to... state that it was a joke. ignore the error, since no one is perfect. restate it by saying, "That didn't come out right. What I meant was..." pretend that the student nurse did not say it.

restate it by saying, "That didn't come out right. What I meant was..."

A client with schizophrenia has been non-compliant with medications. The client requires frequent admissions to the psychiatric unit for acute psychotic episodes. What is this process called? boarding deinstitutionalization revolving door Assertive community treatment (ACT)

revolving door

Secondary gain

the attention a person receives from others because they are ill

Intrusions

occurrence of flashbacks in which the traumatic experience is relived.

Compulsions

repetitive behaviors that are intended to reduce anxiety

Primary gain

the direct internal benefits that being sick provides, such as relief of anxiety, conflict, or distress.

"Building trust" is the main goal in which phase of the therapeutic relationship as identified in Peplau's model? A. in the termination phase as the patient prepares for discharge from care. B. the orientation phase of the relationship. C. the exploitation subphase of the relationship. D. the problem identification subphase of the relationship.

the orientation phase of the relationship.

More Matching

• Chronic repetitive hair-pulling - (Trichotillomania) • Excessive acquisition of animals or apparently useless things - (Hoarding Disorder) • Feels "overcomplete," or alienated from a part of their body leading to a desire for amputation. (B I I D ) • An irrational negative thought - believing that something is far worse than it actually is - (Catastrophizing) • Formerly called multiple personality disorder (Dissociative Identity Disorder) • Suddenly moves to a new geographic location with no memory of past events - (Dissociative Amnesia)

A student appears very nervous on the first day of clinical in a psychiatric setting. The student reviews the instructor's guidelines and appropriately takes which of the following actions? Select All that apply. • Tells the client about the student's personal events and interests • Discusses the anxious feelings with the instructor • Assumes that the client's unwillingness to talk to a student nurse is a personal insult or failure • Builds rapport with the patient before asking personal questions • Consults the instructor if a shocking situation arises

• Discusses the anxious feelings with the instructor • Builds rapport with the patient before asking personal questions • Consults the instructor if a shocking situation arises

▪ The study of distance zones between people during communication. ▪ The unconditional nonjudgmental attitude demonstrated by the nurse to the client ▪ Persistent questioning of the client. ▪ Telling a client the meaning of his or her experience.

▪ The study of distance zones between people during communication. - Proxemics ▪ The unconditional nonjudgmental attitude demonstrated by the nurse to the client. - Positive regard ▪ Persistent questioning of the client. - Probing ▪ Telling a client the meaning of his or her experience. - Interpreting Incorrect Match Options: • Verbalizing the implied • Restating • Incongruence • Preconceptions • Empathy