My psych questions

the nurse is unreasonably concerned, overly kind, or irrationally hostile. The most appropriate explanation is that the nurse is displaying: A) countertransference. B) empathic resonance. C) negative transference. D) splitting behavior.

A) countertransference.

2. A patient who was admitted yesterday with an adjustment disorder and depressed mood has not left his or her room. The psychiatric and mental health nurse's most appropriate approach at meal time today is to respond: A) "I will bring your tray to your room, if it will make you more comfortable." B) "I will walk with you to the dining room and sit with you while you eat." C) "Where would you like to eat your meal this noon?" D) "You will feel better if you go to the dining room and eat with the others."

B) "I will walk with you to the dining room and sit with you while you eat."

11) A patient with schizophrenia was changed to a new antipsychotic medication 3 weeks ago. The patient calls the clinic nurse complaining of sore throat, fever, and malaise. Which laboratory test would be most helpful in determining the cause of these findings? A) Serum lithium level B) Complete blood count C) Liver panel D) Urinalysis

B) Complete blood count

2) A woman gets a report of abnormal cells from a Pap smear. She calls her attorney to prepare a will and tells her family, "I won't be around much longer." Which nursing diagnosis and etiology best apply to this situation? A) Deficient knowledge related to reasons for pap smears B) Fear related to misinterpretation and misinformation about Pap tests C) Disturbed thought processes related to malignant cancer D) Risk-prone health behavior related to a negative vision for the future

B) Fear related to misinterpretation and misinformation about Pap tests

22. A patient is being discharged after spending six days in the hospital, due to depression with suicidal ideation. The psychiatric and mental health nurse knows that an important outcome has been met when the patient states: A) "I can't wait to get home and forget that this ever happened." B) "I feel so much better. If I continue to feel this way, I can probably stop taking my medications soon." C) "I have a list of support groups and a crisis line that I can call, if I feel suicidal." D) "I have to leave here soon, if I want to make it to the shelter before they run out of beds."

C) "I have a list of support groups and a crisis line that I can call, if I feel suicidal."

Question 1 1 pts 1) The nurse completes a thorough nursing assessment of a new client. What is the nurse's next action? A) Implement the plan of care B) Develop behavioral goals and outcomes C) Formulate the nursing diagnoses D) Construct interventions with rationale statements

C) Formulate the nursing diagnoses

8) A patient hospitalized for major depression has been taking sertraline (Zoloft. for the past week and has verbalized increased energy and improved sleep. What is the highest priority question the nurse should ask? A) "Have you experienced any side effects from this drug?" B) "How has your appetite changed since starting this drug?" C) "Do you think your depression is less severe?" D) "Are you having any thoughts of harming yourself?"

D) "Are you having any thoughts of harming yourself?"

9) Quetiapine (Seroquel., (an antipsychotic. is prescribed for a patient who smokes two packs of cigarettes per day. Which effect would be expected? A) Quetiapine will have a longer half-life for the patient, so fewer doses per day are needed. B) The doses of quetiapine will be lower than usual because of slowed metabolism. C) This patient has a higher risk of developing tardive dyskinesia. D) Higher doses of quetiapine will likely be needed to achieve therapeutic effects.

D) Higher doses of quetiapine will likely be needed to achieve therapeutic effects.

4) A client with bipolar disorder, who has been taking Lithium, is admitted to the mental health unit. In what part of the nursing care plan would the nurse record this item? "Monitor the client closely for nausea and vomiting, muscle weakness, lack of coordination, drowsiness, confusion, or seizures." A) Assessment B) Diagnosis C) Outcomes D) Planning E) Implementation F) Evaluation

D) Planning

16. Which factors are associated with the development of post-traumatic stress disorder? A) Anxiety and low self-esteem. B) Distorted and negative cognitive functioning. C) Excess serotonin and norepinephrine levels. D) Severity of the stressor and availability of support systems.

D) Severity of the stressor and availability of support systems.

1) A patient with generalized anxiety disorder receives a new prescription for Paroxetine (Paxil. 10 mg qHS (at hour of sleep.. The patient finds information on the Internet that states the drug is an antidepressant. The patient calls the nurse saying, "The doctor gave me the wrong drug. I have anxiety, not depression." Select the nurse's best response. A) "It's not a mistake. Some antidepressant medications also work well for managing anxiety." B) "Thank you for phoning about this error. I'll confer with the physician and call you back." C) "You misinterpreted the information. Paroxetine is a benzodiazepine, not an antidepressant." D) "The Internet is not always a reliable source for medication information."

A) "It's not a mistake. Some antidepressant medications also work well for managing anxiety

19. The psychiatric and mental health nurse knows that the patient's spouse clearly understands the side effects of lithium carbonate (Eskalith), when he or she says: A) "I should call the doctor if my spouse shakes badly." B) "I should make sure my spouse drinks as much water as she or he can." C) "My spouse must remain on a salt-free diet." D) "When the lithium level is 1.6 mEq/L, my spouse can go back to work."

A) "I should call the doctor if my spouse shakes badly."

21. After taking an antidepressant for about a week, a patient reports constipation and blurred vision, with no improvement in mood. The psychiatric and mental health nurse informs the patient: A) "It takes approximately two to four weeks for depression to lessen, and side effects usually diminish over time." B) "Stop the medication immediately and contact your primary care physician." C) "You should contact your doctor. The doctor may need to change your medication." D) "You should schedule an appointment with your ophthalmologist."

A) "It takes approximately two to four weeks for depression to lessen, and side effects usually diminish over time."

7) A patient has been taking citalopram (Celexa. for 2 years for depression. The patient's outcomes have been achieved and the patient wants to discontinue the medication. Which information should the nurse provide? A) "It's important for you to gradually stop taking this drug over 2 to 4 weeks." B) "Citalopram is an antidepressant medication that is usually taken for life." C) "Because your depression is alleviated, you may discontinue the medication." D) "Stopping this medication all of a sudden can cause serotonin syndrome."

A) "It's important for you to gradually stop taking this drug over 2 to 4 weeks."

3) A young adult invites eight people to dinner. This person has never given a dinner party and wants to prepare every menu item. On the morning of the party, the young adult multitasks and makes progress preparing each food. As the time approaches for the guests to arrive, which change indicates an increased anxiety level? A) Blood pressure and pulse rates increase slightly. The person notices feelings of mild muscle tension. B) Muscles become tense. The person must stop cooking to use the bathroom every 10 to 15 minutes. C) Fond memories of family reunions and the good foods that were served drift in and out of the person's thoughts. D) The person notices there are cobwebs in the corner of the dining room and removes them before the guests arrive.

A) Blood pressure and pulse rates increase slightly. The person notices feelings of mild muscle tension.

2) Select the nursing diagnosis that best matches the following etiology and defining characteristics. _____________________________ related to lack of approval, and perceived lack of respect from others, as evidenced by, exaggerating or rejecting negative feedback about self. A) Chronic low self-esteem B) Social isolation C) Disturbed personal identity D) Powerlessness

A) Chronic low self-esteem

6) A nurse at a local mental health clinic prepares to give a client with schizophrenia a regularly scheduled monthly antipsychotic medication injection. Just before the nurse gives the injection, the client says, "Wait! I've changed my mind. I don't want to take that medicine anymore." Which initial action by the nurse would be legally and ethically appropriate? A) Say, "You have a right not to take it, but let's talk about how that could affect your illness." B) Remind the client that this medication has been used for months with no adverse effects. C) Assess the client for evidence of dangerousness to self or others. D) Call for assistance to restrain the client and proceed with the scheduled injection.

A) Say, "You have a right not to take it, but let's talk about how that could affect your illness."

4. A patient is admitted to the inpatient unit with a diagnosis of schizophrenia. The patient has had episodes of school absenteeism, withdrawal from friends, and bizarre behavior, including talking to his or her "keeper." The psychiatric and mental health nurse's most appropriate response is to: A) acknowledge that the patient's perceptions seem real to him or her, and refocus the patient's attention on a task or activity. B) encourage the patient to express his or her thoughts, to determine the meaning they have for the patient. C) ignore the patient's bizarre behavior, because it will diminish after he or she has been given the correct medication. D) inform the patient that his or her perceptions of reality have become distorted because of the illness.

A) acknowledge that the patient's perceptions seem real to him or her, and refocus the patient's attention on a task or activity.

18. To obtain an accurate medication list and assess a new patient's understanding of medications, the psychiatric and mental health nurse: A) asks about the patient's current medications, herbs, home remedies, and over-the-counter drugs. B) asks the patient to provide medical records of the medications taken in the past. C) instructs the patient to list medications and describe how the medications are taken. D) relies upon the medical record, rather than asking the patient.

A) asks about the patient's current medications, herbs, home remedies, and over-the-counter drugs.

25. When a research study is based on a small sample size, the findings may: A) be statistically significant, but will be less generalizable than if the sample size had been larger. B) be statistically significant, but will not be clinically significant. C) not be statistically significant, because the research design was quasi-experimental, instead of experimental. D) not be statistically significant, because the research was poorly conducted.

A) be statistically significant, but will be less generalizable than if the sample size had been larger.

7. During an initial patient interview, the psychiatric and mental health nurse begins by asking the patient to describe his or her: A) current situation. B) feelings about the current situation. C) personal history. D) thoughts about the current situation.

A) current situation.

17. A selective serotonin reuptake inhibitor targets which part of the brain? A) Basal ganglia. B) Frontal cortex. C) Hippocampus. D) Putamen.

B) Frontal cortex.

23. When developing a lecture series for nursing home residents, the psychiatric and mental health nurse considers which factor to be the primary barrier to learning? A) Decreased bodily functions. B) Information processing impairments. C) Lack of interest. D) Lack of patience.

B) Information processing impairments.

4) After 3 weeks of hemoptysis (coughing blood., a person finally seeks treatment. A chest x-ray film is taken and the person waits for the results. When the physician explains the report, the person complains, "I can't understand what you're saying. You're talking so fast. All I hear is a loud clicking on my watch." The client is wet with perspiration. Which level of anxiety is evident? A) Mild B) Moderate C) Severe D) Panic

C) Severe

8. In which circumstance is a breach of patient confidentiality appropriate? A) A supervisor inquires about the patient. B) The family inquires about the patient without his or her knowledge. C) The patient appears sincere in threatening to harm another person. D) The patient has participated in illegal activity.

C) The patient appears sincere in threatening to harm another person.

10) A patient with bipolar disorder takes lithium. After playing soccer on a hot summer day, the patient complains of nausea, vomiting, diarrhea, and thirst. The patient's hands begin to tremble and the gait becomes unsteady. Select the priority nursing interventions. You may select more than one answer. A) Complete an AIMS evaluation on this patient immediately. B) Instruct the patient not to take any more lithium until directed the physician. C) Collaborate with the physician about drawing a serum lithium level immediately. D) Administer an antiemetic medication to the patient. Collaborate with the physician regarding increasing the daily lithium dose.

B) Instruct the patient not to take any more lithium until directed the physician. C) Collaborate with the physician about drawing a serum lithium level immediately.

24. When screening families for post-traumatic stress disorder following a major natural disaster, psychiatric and mental health nurses are practicing which type of disease prevention? A) Primary. B) Secondary. C) Tertiary. D) Universal.

B) Secondary.

5) Which individual with a mental illness may need emergency or involuntary hospitalization for mental illness? A) The individual who sees visions of angels dancing on the television screen. B) The individual who throws a lamp at the owner of a local department store. C) The individual who resumes using cocaine after 1 year of being clean. D) The individual who stops taking prescribed antipsychotic medications.

B) The individual who throws a lamp at the owner of a local department store.

11. Older adults have reached Erikson's developmental stage of ego integrity, when they: A) acknowledge that one cannot get everything one wants in life. B) assess their lives and identify actions that had value and purpose. C) express a wish that life could be relived differently. D) feel that they are being punished for things they did not do.

B) assess their lives and identify actions that had value and purpose.

20. A school-aged patient with attention-deficit hyperactivity disorder is displaying disruptive behaviors at home. The psychiatric and mental health nurse modifies the treatment plan for the social domain, by advising the patient's parents to: A) establish eye contact before giving directions. B) initiate a point system, to reward the patient for appropriate behavior. C) instruct the patient to work on one homework assignment at a time. D) maintain a predictable environment in the home.

B) initiate a point system, to reward the patient for appropriate behavior.

15. A patient who is admitted to the psychiatric unit with a diagnosis of obsessive-compulsive disorder spends a significant amount of time during the day and night washing his or her hands. On the third hospital day, the patient reports feeling better and more comfortable with the staff and other patients. The psychiatric and mental health nurse knows that the most appropriate nursing intervention is to: A) acknowledge the ritualistic behavior each time and point out that it is inappropriate. B) allow the patient to carry out the ritualistic behavior, since it is helping him or her. C) collaborate with the patient to reduce the amount of time he or she engages in ritualistic behavior. D) ignore the ritualistic behaviors, and the behaviors will be eliminated due to lack of reinforcement.

C) collaborate with the patient to reduce the amount of time he or she engages in ritualistic behavior.

10. A 23-year-old patient with borderline personality disorder reports a frequent desire to cut him- or herself and insists that only a specific psychiatric and mental health nurse can help the patient. The nursing care plan for the patient includes: A) allowing the patient to choose the nurse assigned to him or her. B) decreasing the patient's stimuli. C) holding frequent, interdisciplinary staff meetings to provide consistent care. D) providing one-to-one suicide precautions.

C) holding frequent, interdisciplinary staff meetings to provide consistent care.

3. A 17-year-old, female patient with anorexia nervosa has just been released from the hospital. To facilitate recovery at home, the psychiatric and mental health nurse instructs the family to: A) discourage the patient from sneaking food between meals, by unobtrusively reducing her access to the kitchen. B) encourage the patient's interest in menu planning, food magazines, and cooking lessons, by leaving information and materials around the house. C) inform the patient that she is expected to join in routine family meals and clear the dishes after dinner, even if she does not eat. D) permit the patient to eat her meals privately in her bedroom to discourage family preoccupation with meals.

C) inform the patient that she is expected to join in routine family meals and clear the dishes after dinner, even if she does not eat.

12. A patient states that unit staff members have been avoiding him or her since an attempt to self-mutilate. The psychiatric and mental health nurse's most appropriate response is to: A) apologize for the staff's behavior. B) explain that feelings of rejection are typical after self-mutilation. C) listen, redirect the patient to his or her feelings, and explore the issue with the staff. D) report the matter to the nurse manager.

C) listen, redirect the patient to his or her feelings, and explore the issue with the staff.

9. A short-term goal for a patient with Alzheimer's disease is: A) improved problem solving in activities of daily living. B) increased self-esteem and improved self-concept. C) optimum functioning in the least restrictive environment. D) regained sensory perception and cognitive function.

C) optimum functioning in the least restrictive environment.

1. To evaluate whether patient teaching for coping skills has been effective, the psychiatric and mental health nurse asks an adolescent patient to: A) consider the outcomes objectively. B) keep a written journal. C) perform a return demonstration. D) set measurable goals.

C) perform a return demonstration.

13. When planning inpatient psychotherapeutic activities for a patient who has antisocial personality disorder, the psychiatric and mental health nurse: A) focuses on group, rather than individual, therapy. B) provides a permissive atmosphere, so the patient feels a sense of control. C) provides an organized, structured environment. D) recognizes that the disorder is characterized by social withdrawal.

C) provides an organized, structured environment

14. According to family systems theory, removing the "identified patient" from the environment most likely causes the: A) patient to decompensate, due to the loss of his or her support system. B) patient to significantly improve, often with minimal or no additional therapy. C) remaining family members to decompensate, as evidenced by new, dysfunctional behavior. D) remaining family members to lose motivation and withdraw from therapy.

C) remaining family members to decompensate, as evidenced by new, dysfunctional behavior.

5. Nursing staff members at a community mental health center are formulating an outpatient treatment plan with a 30-year-old patient with schizophrenia. A major consideration is that: A) the patient will likely need weekly supportive treatment for life. B) the patient will require a referral for vocational rehabilitation services. C) the patient's contact with the center will diminish as he or she becomes stable, but the patient will continue to need support. D) the patient's contact with the center will gradually decrease until his or her therapy can be terminated.

C) the patient's contact with the center will diminish as he or she becomes stable, but the patient will continue to need support.

3) Which of the following diagnostic documentation formats would the nurse expect to see in a psychiatric acute care setting? A) I Congestive heart failure. II 30/60. III Schizophrenia, undifferentiated type. IV Ran away from Board and Care Home 3 days ago. V Paranoid personality disorder B) I Substance abuse, alcohol. II Antisocial personality disorder. III 65/85. IV Chronic renal failure. V Arrested for domestic violence 5 days ago C) I Generalized anxiety disorder. II Hypertension. III 65/75. IV No personality disorder. V Loss of employment 1 month ago D) I Major depression. II Dependent personality disorder. III Diabetes type II. IV Home foreclosed 2 weeks ago. V 60/80

D) I Major depression. II Dependent personality disorder. III Diabetes type II. IV Home foreclosed 2 weeks ago. V 60/80