n320: hw #2 practice questions

A person has had difficulty keeping a job because of arguing with co-workers and accusing them of conspiracy. Today the person shouts, "They're all plotting to destroy me. Isn't that true?" The nurse's most therapeutic response is which one of the following? A. "Everyone here is trying to help you. No one wants to harm you." B. "All of the staff members are very qualified health care professionals who just want to help you. You should try to change your thinking and be open to our help." C. "Feeling that people want to destroy you must be very frightening." D. "That is not true. People here are trying to help you if you will let them."

"Feeling that people want to destroy you must be very frightening."

A client says, "I've done a lot of cheating and manipulating in my relationships." The nurse would like to apply therapeutic communication and respond appropriately. Which one of the following is the most appropriate and nonjudgmental response? A. "I am glad that you realize this." B. "Have you outgrown that type of behavior?" C. "That's not a good way to behave." D. "How do you feel about that?"

"How do you feel about that?"

A client says, "Please don't share information about me with the other people." Which one of the following is the nurse's best response? A. "It depends on what you choose to tell me. I will be glad to disclose at the end of each session what I will report to others." B. "I cannot tell anyone about you. It will be as though I am talking about my own problems, and we can help each other by keeping it between us." C. "A therapeutic relationship is just between the nurse and the client. It is up to you to tell others what you want them to know." D. "I will not share information with your family or friends without your permission, but I share information about you with other staff."

"I will not share information with your family or friends without your permission, but I share information about you with other staff."

A clinic treating a child for otitis media (ear infection) is an example of which type of care? A. Community-based care B. Community-oriented care C. Tertiary health care D. Public health care

Community-based care

A nurse planning a smoking cessation clinic for adolescents in the local middle schools and high schools is providing which one of the following types of care? A. Community-oriented care B. Community-based care C. Secondary care D. Tertiary care

Community-oriented care

A patient with a long history of hypertension and diabetes now develops confusion. The health care provider wants to make a differential diagnosis between Alzheimer's disease and multiple infarcts. Which diagnostic procedure should the nurse expect to prepare the patient for first? A. Single-photon emission computed tomography (SPECT) B. Positron-emission tomography (PET) C. Skull x-rays D. Computed tomography (CT) scan

Computed tomography (CT) scan

The public health nurse (PHN) deals with the examination of a community setting to determine the community's health status. Which of the following activities should be considered in the Community Assessment phase? Select all that apply: A. Assisting communities to implement and evaluate plans and project. B. Building constituencies to work with the community. C. Collecting, analyzing, and disseminating information. D.Reviewing the availability of health services to the community. E. Evaluating the social, economic, and environmental characteristics of the population.

D, E

Which one of the following terms most accurately completes this analogy. NANDA is to Clinical Judgment just as NIC is to_____ what? A. Nursing actions B. Diagnosis C. Patient outcomes D. Symptoms

Nursing actions

A nursing diagnosis for a client with a psychiatric disorder serves the purpose of which one of the following? A. Completing the medical diagnostic statement. B. Providing a framework for selecting appropriate interventions. C. Providing data essential for insurance reimbursement. D. Justifying the use of certain psychotropic medication.

Providing a framework for selecting appropriate interventions.

A poor, older Native Alaskan woman lives in a small, remote village near the Canadian border. She has been diagnosed with hypertension and diabetes but rarely makes it to the regional clinic in a distant town for checkups. This woman is most at risk for which one of the following problems? A. loss of independence B. disenfranchisement C. resilience D. health disparities

health disparities

The therapeutic action of inhibitors that block neurotransmitter (NT) reuptake cause which one of the following? A. increased concentration of the blocked neurotransmitter in the synaptic gap B. limbic system stimulation C. decreased concentration of the blocked neurotransmitter in the central nervous system D. destruction of receptor sites specific to the blocked neurotransmitter

increased concentration of the blocked neurotransmitter in the synaptic gap

The nurse administers a medication that potentiates the action of gamma-aminobutyric acid (GABA). Which effect would be expected? A. More organized thinking B. Improved memory C. Fewer sensory perceptual alterations D. Reduced anxiety

Reduced anxiety

A drug blocks the attachment of norepinephrine (NE) to α 1 receptors. The patient may experience which one of the following? A. orthostatic hypotension B. severe appetite disturbance C. an increase in psychotic symptoms D. hypertensive crisis

orthostatic hypotension

A nurse would anticipate that treatment for a patient with memory difficulties might include medications designed to do which one of the following? A. inhibit gamma-aminobutyric acid (GABA) B. prevent destruction of acetylcholine (ACh) C. increase dopamine (DA) activity D. reduce serotonin (5HT) metabolism

prevent destruction of acetylcholine (ACh)

A patient has fear as well as increased heart rate and blood pressure. The nurse suspects increased activity of which neurotransmitter? A. Acetylcholine (ACh) B. Gamma-aminobutyric acid (GABA) C. Histamine (H1) D. Norepinephrine (NE)

Norepinephrine (NE)

The parent of an adolescent diagnosed with schizophrenia asks the nurse, "My child's doctor ordered a PET. What kind of test is that?" Which one is the nurse's best reply? A. "It's a special x-ray that shows structures of the brain and whether there has ever been a brain injury." B. "A PET scan passes an electrical current through the brain and shows brain-wave activity. It can help diagnose seizures." C. "This test uses a magnetic field and gamma waves to identify problem areas in the brain. Does your teenager have any metal implants?" D. "PET means positron-emission tomography. It is a special type of scan that shows blood flow and activity in the brain."

"PET means positron-emission tomography. It is a special type of scan that shows blood flow and activity in the brain."

An aide in a psychiatric hospital says to the nurse, "We don't have time every day to help each client complete a menu selection. Let's tell dietary to prepare popular choices and send them to our unit." Which one of the following is the best nursing response? A. "Thanks for the suggestion, but that idea may not work because so many clients take dangerous medications that have food interactions, like the MAOI (monoamine oxidase inhibitor) antidepressants." B. "Thank you. That is a very good idea. It will make meal preparation easier for the dietary department." C. "Thank you for the suggestion, but the patients' bill of rights requires us to allow clients to select their own diet." D. "Thanks for the idea, but it's important to treat clients as individuals. Giving choices is one way we can respect clients' individuality."

"Thanks for the idea, but it's important to treat clients as individuals. Giving choices is one way we can respect clients' individuality."

The nurse prepares to assess a patient diagnosed with major depression for disturbances in circadian rhythms. Which question should the nurse ask this patient? A. "Do you think your memory is failing?" B. "How would you describe your thinking?" C. "Have you ever seen or heard things that others do not?" D. "What are your worst and best times of the day?"

"What are your worst and best times of the day?"

Which statement shows a nurse has empathy for a client who made a suicide attempt? A. "Suicide is a drastic solution to a problem that may not be such a serious matter." B. "It makes me sad to see you going through such a difficult experience." C. "You must have been very upset when you tried to hurt yourself." D. "If you tell me what is troubling you, I can help you solve your problems."

"You must have been very upset when you tried to hurt yourself."

A patient's sibling says, "My brother has a mental illness, but the doctor ordered a functional magnetic resonance image (fMRI) test. That test is too expensive and will just increase the hospital bill." Which are the nurse's best responses? Select all that apply: 1. "Sometimes there are physical causes for psychiatric symptoms. This test will help us understand whether that is the situation." 2. "Some mental illnesses are evident on fMRIs. This test will give information to help us plan the best care for your brother." 3. "Tell me more about what kinds of tests your brother's health insurance plan covers." 4. "It sounds like you do not truly believe your brother had a mental illness." 5. "It would be better for you to discuss your concerns with the doctor."

1, 2

A nurse caring for a patient taking a selective serotonin reuptake inhibitor (SSRI) has an expected outcome. Which of the following outcome criteria might be expected if the SSRI is effective? Select all that apply: 1. improved concentration and focus 2. improvement in depression 3. reduced levels of anxiety with more calmness 4. decreased extrapyramidal symptoms 5. decreased impulsivity

1, 2, 3

A patient takes a medication that causes anti-cholinergic side effects. What does the nurse expect to find in terms of subjective and objective assessment data in this patient? Select all that apply: 1. complaints of dry mouth 2. complaints of blurry vision 3. complaints of constipation 4. drowsy sedated appearance 5. excess saliva 6. urinary frequency r/t difficulty with urinary retention 7. delusions 8. hallucinations 9. memory impairment

1, 2, 3, 4, 6, 8, 9

Which of the following are factors that may contribute to health vulnerability, invisibility and marginalization of individuals in a community population? Select all that apply: 1. Exercise habits 2. Crime 3. Peeling lead paint 4. Social Support 5. Illiteracy Post-note: Please note that this is a poorly worded HESi-resourced question. The correct answer as it is currently worded is: 1, 2, 3 & 5. For studying purposes I wanted you to see this in its original form. So for the grading of this practice set, this is what you should answer. However, for clarity, I would rewrite the answer items and correct answer to state: Which factors contribute to health vulnerability, invisibility and marginalization of individuals in a community population? Select all that apply: 1. Poor Exercise habits Correct 2. Crime Correct 3. Peeling lead paint Correct 4. Lack of access to Social Support Correct 5. Illiteracy Correct A. 1, 2, 3, 4 B. 2, 3, 4, 5 C. 1, 2, 3, 5 D. 2, 3, 4 E. All of the above (correct)

1, 2, 3, 5 (for the poorly worded original question)

An individual is experiencing problems with memory. Which of these structures are most likely to be involved in this deficit? Select all that apply: 1. Amygdala 2. Hippocampus 3. Occipital lobe 4. Temporal lobe 5. Basal ganglia

1, 2, 4

Which are the best examples of 'internalized stigma' by a patient? Select all that apply: 1. A patient tells the nurse that he is embarrassed by his disability and is afraid to talk about his problems because he feels 'weak, like a failure'. 2. A patient refuses his routine psychiatric medications during a visit from his daughter, telling the nurse that there is a mistake and he does not take this medication. 3. A patient becomes angry and shuts down when the nurse is asking him about having 'depressed mood'. 4. A provider does not make a follow-up appointment for a homeless client to receive his anti-psychotic medication. 5. A patient appears ashamed of his inability to communicate clearly due to disorganized thinking and becomes frustrated, blaming the nurse who he calls 'incompetent'.

1, 2, 5

A nurse can anticipate anticholinergic side effects are likely when a patient takes which of the following medications? Select all that apply: 1. lithium (Lithobid) 2. buspirone (BuSpar) 3. imipramine (Tofranil) 4. clozapine (Clozaril) 5. diphenhydramine (Benadryl)

3, 4, 5

A citizen at a community health fair asks the nurse, "What is the most prevalent mental disorder in the United States?" The best nursing response is which one of the following? A. Alzheimer's disease (Dementia of Alzheimer's, DAT) B. Bipolar Disorder (Bipolar Affective Disorder, BAD) C. Schizophrenia, Chronic Paranoid Type (SCPT) D. Dissociative Identity Disorder (DID)

Alzheimer's disease (Dementia of Alzheimer's, DAT)

A new nurse is overwhelmed with the needs of the community. In deciding which problem should have first priority, the nurse should choose which one of the following? A. A problem that is very easy and inexpensive to address. B. A problem that affects the most disadvantaged residents in the community, since there is a moral obligation to do so. C. A particular problem that is of high concern to the community. D. A problem in an area in which the nurse is very comfortable and has a great deal of expertise.

A particular problem that is of high concern to the community.

Which attributes would be most helpful for a nurse working in a community mental health setting to have? Select all that apply: A. Flexibility and self-awareness. B. A reactive manner. C. A non-judgmental attitude D. An ability to cross service systems. E. Strong assessment, communication and advocacy skills.

A, C, D, E

A new nurse has a father with bipolar disorder. This nurse angrily recalls feelings of embarrassment about his father's behavior in the community. Which of the following are the best ways for this nurse to cope with these feelings? Select all that apply: A. Seek ways to use the understanding gained from the nurse's childhood experiences to help clients cope with their own illnesses. B. Recognize that these feelings are unhealthy. The nurse should try to suppress them when working with clients. C. Recognize that nursing is not an appropriate career choice. Explore other types of jobs. D. The nurse should begin new client relationships by saying, "My own parent had mental illness, so I understand your experiences and can accept it without stigma." E. Recognize that the feelings may add sensitivity to the nurse's practice, but supervision is important in order to ensure healthy boundaries and a client-centered focus.

A, E

Which need is the highest priority for a seriously and persistently ill client living in the community? A. Socialization and diversion. B. Access to medication. C. Engaging in meaningful work. D. Independent decision making.

Access to medication

A community mental health nurse is assigned to a mobile mental health care unit in a locale where the majority of the population are newly immigrated Vietnamese. The measure that will best help the nurse initially plan and implement culturally sensitive care for clients is which one of the following nursing actions? A. Taking a culture course and reading about the predominant health beliefs held by members of Asian cultures. B. Arranging for the services of an interpreter and cultural consultant and then asking the clients directly about their personal values, perceptions, health beliefs and practices. C. Treating clients in the same manner that clients of any culture would find satisfying. D. Doing self-reflection and then attempting to place yourself in the position of being an unassimilated member of a culture.

Arranging for the services of an interpreter and cultural consultant and then asking the clients directly about their personal values, perceptions, health beliefs and practices.

Which one of the following describes the purpose of surveillance systems today? Select all that apply: A. To obtain data used to fight for increased budgets from taxpayers. B. To evaluate the effectiveness of public health programs. C. Provides a means for nurses to reduce the incidence of chronic diseases, morbidity, and mortality rates and to improve health through disease trend monitoring. D. To Generate knowledge about disease or outbreak patterns and help prevent occupational exposure and diseases. E. Allows the nurse to advocate for policy changes.

B, C, D, E

A novice nurse tells a mentor, "I want to convey to my clients that I am interested in them and that I want to listen to what they have to say." Which behaviors will be helpful in meeting the nurse's goal? Select all that apply: A. Sitting behind a desk, facing the client. B. Introducing self to a client and identifying own role. C. Maintaining control of discussions by asking direct questions. D. Using facial expressions to convey interest and encouragement. E. Assuming an open body posture and sometimes mirror imaging.

B, D, E

A nurse attends a conference to learn more about public health surveillance. Which one of the following explains why it is it so important that the nurse is knowledgeable about this topic? A. Because nurses are typically the ones to interact with the public and the media. B. Because nurses are responsible for ensuring that action is taken when necessary. C. Because nurses are employed in public health agencies. D. Because nurses are often the first to recognize and respond to a problem.

Because nurses are often the first to recognize and respond to a problem.

Which one of the following direct care (interventions) is an experienced nurse working in an inpatient psychiatric mental health setting most likely to provide for a client? A. Building assertiveness skills. B. Diversional activities. C. Assistance with job hunting. D. Toileting assistance.

Building assertiveness skills.

According to the Minnesota Model of Public Health interventions, which one is the first step of surveillance for the public health nurse (PHN)? A. Interpret and disseminate the data. B. Organize the data. C. Analyze the data. D. Determine if surveillance is appropriate.

Determine if surveillance is appropriate.

A Department of Public Health (DPH) reports data from all local outpatient care organizations in a large community. The data shows a notable increase in the incidence of asthma cases treated this year over the numbers treated in the previous year. Which one of the following actions should the public health nurse (PHN) take first? A. Determine whether there are any other data sources that might confirm or dispute the apparent increase in asthma. B. Congratulate the public health staff on the success of their asthma awareness program. C. Review data with the inpatient and tertiary care staff to review and compare incidence rates for hospitalized patients. D. Analyze educational health programs offered to the public last year.

Determine whether there are any other data sources that might confirm or dispute the apparent increase in asthma.

A patient taking medication for mental illness develops restlessness and an uncontrollable need to be in motion. Which drug action causes these symptoms to develop? A. Endocrine-stimulating effects B. Anticholinergic effects C. Ability to stimulate spinal nerves D. Dopamine-blocking effects

Dopamine-blocking effects

A community health nurse (CHN) does a windshield survey of a community. She drives through her assigned community before visiting the community groups scheduled for the day. She then drives through the community again that evening before going home. From a community nursing perspective, which one might be the nurse's reason for driving through the community twice in the same day? A. On the second trip, the nurse can carefully confirm the results of the first assessment. B. When leaving in the evening, the nurse has more time to write down the results of the earlier assessment. C. Repeating the experience ensures that the nurse absorbed all the relevant details. D. Driving through twice allows the nurse to see the community when many residents are at work or at school and then again when most are at home.

Driving through twice allows the nurse to see the community when many residents are at work or at school and then again when most are at home.

A patient has disorganized thinking associated with schizophrenia. Neuroimaging would likely show dysfunction in which part of the brain? A. Cerebellum B. Frontal lobe C. Brainstem D. Hippocampus

Frontal lobe

Which one is the best example of tertiary prevention? A. Restraining an agitated patient who has become aggressive and assaultive. B. Helping a person diagnosed with a serious mental illness learn to manage money. C. Teaching school-age children about the dangers of drugs and alcohol. D. Genetic counseling with a young couple expecting their first child.

Helping a person diagnosed with a serious mental illness learn to manage money.

Which one is the best example of primary prevention? A. Helping school-age children identify and describe normal emotions. B. Leading a psycho-educational group in a community care home. C. Medicating an acutely ill patient who assaulted a staff person. D. Assisting a person diagnosed with a serious mental illness to fill a pill-minder.

Helping school-age children identify and describe normal emotions.

An obese patient has a diagnosis of schizophrenia. Medications that block which receptors would contribute to further weight gain? A. Acetylcholine (ACh) B. Histamine (H1) C. Serotonin (5 HT2) D. Gamma-aminobutyric acid (GABA)

Histamine (H1)

Which one of the following assessment information is uniquely important to the mental health client receiving outpatient care? A. The presenting problem and referring party. B. Mental status examination results. C. The client's strengths and deficits. D. Housing adequacy and stability.

Housing adequacy and stability.

Which one is the typical choice of intervention when the nurse chooses to focus on the process dimension (or Intervention level) of community health? A. Assessment of the health care services available in a community. B. Implementation of health promotion activities such as education programs. C. Planning for new programs to be developed based on identified needs. D. Establishing screening programs to diagnosis diseases as early as possible so treatment can begin.

Implementation of health promotion activities such as education programs.

A category 5 tornado occurred in a community of 400 people resulting in destruction of many homes and businesses. In the 2 years after this disaster, 140 individuals were diagnosed with post traumatic stress disorder (PTSD). Which one of the following terms best applies to these newly diagnosed cases? A. Co-morbidity B. Incidence C. Prevalence D. Parity

Incidence

Where would a nurse best access important community health information specific to a very small rural community (where there is no DPH) where she is about to start working? A. Census Bureau B. State Department of Public Health C. Local Sheriff's Department D. Center for Disease Control E. World Health Organization F. Department of Vital Statistics

Local Sheriff's Department

By which mechanism do selective serotonin reuptake inhibitors (SSRI) improve depression? A. Making more serotonin (5HT) available at the synaptic gap. B. Destroying increased amounts of serotonin (5HT). C. Increasing production of acetylcholine (ACH) and dopamine (DA). D. Blocking muscarinic and α1norepinephrine (NE) receptors.

Making more serotonin (5HT) available at the synaptic gap.

A client's priority nursing diagnosis has been established as: "Risk for self-directed violence: suicide related to multiple losses as evidenced by suicidal ideation and reports of "I want to die". The priority outcome would be that the client will do which one of the following? A. Attend self-help group daily. B. State absence of feelings of powerlessness. C. Refrain from attempting suicide. D. Be placed on suicide precautions and monitored 1:1 as needed.

Refrain from attempting suicide.

A patient begins therapy with a phenothiazine (anti-psychotic) medication. What teaching should the nurse provide related to the drug's strong dopaminergic (DA) effect? A. Increase dietary fiber. B. Report changes in muscle movement. C. Arise slowly from bed. D. Chew sugarless gum.

Report changes in muscle movement.

Which level of prevention activities would a nurse working in an emergency department (ED) employ most often? A. Secondary B. Tertiary C. Primary D. Quaternary

Secondary

Jonah is a 43-year-old client being seen in the mental health clinic with depression. Jonah states, "I have always been a practicing Jew, but in the past few months I am questioning everything. I just don't know if I believe in it anymore." Which one of the following nursing diagnoses best describes Jonah's comment? A. Hopelessness B. Risk for self-harm C. Spiritual distress D. Ineffective coping

Spiritual distress

One of the basic concepts in epidemiology is the concept of risk (ie. risk factors or risk indicators). Risk, in this sense, refers to which one of the following definitions? A. The probability that an event will occur within a specified time period. B. The rate of development of new cases. C. The population most likely to develop a disease. D. The prevalence of an event occurring.

The probability that an event will occur within a specified time period.

During the assessment phase, the nurse compiles and interprets available data and draws conclusions as to the community's strengths and concerns. Why might the nurse go on to continue to observe and interview key informants? (choose one) A. To generate non-statistical (descriptive) data such as values, beliefs, and perceived needs. B. To confirm the nurse's initial findings and conclusions. C. To ensure that others agree with the nurse's plans for interventions. D. To encourage community partners to feel they "own" the data.

To generate non-statistical (descriptive) data such as values, beliefs, and perceived needs.

A rural public health nurse is spending time reviewing death certificates. Which one of the following best explains the purpose of this activity? A. To obtain mortality data for the local area. B. To evaluate effectiveness of health promotion programs. C. To confirm that no local health problems are beginning. D. To ensure that local causes of death are consistent with national causes of death.

To obtain mortality data for the local area.

A nurse wishes to assess the status of a community's health. Which one of the following would the nurse examine? A. Health care person power B. Vital statistics C. Health facilities D. Community awareness

Vital statistics

Two nurses in community health schedule a day to ride through a low-income community to better understand the community and its boundaries, trends, rhythm, stability, and changes that can affect the health of that community. This direct data collection method is often referred to as which one of the following? A. Composite database B. Participant observation C. Secondary analysis D. Windshield survey

Windshield survey

According to the DSM-5, there is evidence that symptoms and causes of mental illness are influenced by which one of the following?: A. Immunizations. B. cultural and ethnic factors. C. food allergies. D. sexual preference. E. occupation and status.

cultural and ethnic factors.

A drug causes muscarinic receptor blockade. The nurse will assess the patient for which one of the following effects? A. pseudoparkinsonism B. gynecomastia C. orthostatic hypotension D. dry mouth

dry mouth