Psych final exam

A nursing instructor is teaching about case management. What student statement indicates that learning has occurred?

"Case management provides coordination of services required to meet client needs."

An angry patient is in the community room. She picks up a chair and uses it to hit another patient on the head. When you come into the community room, what should your first response to the patient holding the chair be?

"Hitting others is unacceptable. Please put the chair completely down on the floor"

Which client statement indicates a knowledge deficit related to substance abuse?

"Marijuana is like smoking cigarettes. Everyone does it. It's essentially harmless."

The components of care in case management are:

-A comprehensive needs assessment -development plan of care -a method of ensuring the patient has access to care -a method of monitoring the care provided -ALL OF THE ABOVE

Necessary skills of a nurse case manager (select all that apply)

-Collaboration - Teaching -Leadership -Management

A mother of three comes into the office to discuss about her recent decision to divorce her husband of 20 years. The mother is very worried about how the divorce will affect her three children as they are all very young in age. What are some protective factors you can offer the mother to instill within her family unit? (Select all that apply)

-Create a very structured home and school life for the children -Starting family counseling

What should be expected in the stage of development of rapport in preschool children? Select all that apply.

-Difficulty putting feelings into words -Use of play and drawings -Thinking concretely

Which of the following are potential nursing diagnoses for a client with Bipolar Disorder? Select all that apply:

-Disturbed thought process -Interrupted family process -Impaired social interaction

Which support networks are considered formal? Select all that apply

-Hospital -Agency -Self Help groups

Some delirium risk factors include:

-Pre-existing cognitive impairment -Severe illness -Age -ALL OF THE ABOVE

Select all that apply: The biological domain for Alzheimer's disease focuses on the following interventions:

-Promotion of Self Care -Promotion of Sleep, activity and exercise -Pain management and comfort measures

A patient brings her 2 ½ year old child to the pediatricians office. The mother is concerned about her child because he is delayed in several developmental milestones a boy his age should be completed by now; the major one being his language development. After assessing the boy you notice that he displays several signs of autism disorder including: (select all that apply)

-Refusing to make eye contact -Flapping his hands -Constantly looking at the spinning ceiling fan -Rocking back and forth

Physical illness in children can affect both the child and their family members. Common childhood reactions are:

-Regression -Sleep and feeding difficulties -Behavior problems -Depression -ALL OF THE ABOVE

While there is no single cause to homelessness, what following factors may contribute to homelessness? Select all that apply.

-Substance Abuse -Mental Illness -Domestic Violence

What are some factors that can contribute to homelessness? Select all that apply

-Unemployment - Mental illness -Domestic violence -Substance abuse

A nurse in a mental health clinic is caring for a client who has bipolar disorder and reports they stopped taking lithium 2 weeks ago. The nurse should recognize which of the following as an expected adverse effect that might have caused the client to stop taking the medication? SELECT ALL THAT APPLY

-Weight gain -Sexual dysfunction

A mother of a school aged child brings her child into the office because she says that her child is not acting like himself. Upon further assessment, you discover that the child's father has recently died from huntington's disease. You explain to the child's mother that this type of behavior is expected from the child at his developmental age when he exhibits which signs: (Select all that apply)

-When the child constantly complains that his stomach hurts -When the child throws a temper tantrum when you tell him to go to bed -When the child refuses to play with his friends at the park

A home health nurse is assessing a client's home who has received a recent diagnosis of Alzheimer's disease. What should the nurse do to decrease the risk of potential injury? (Select all that apply)

-install childproof door locks -put the clients mattress on the floor -install light fixtures above stairways

What are the major risk factors for delirium? (Select all that apply)

-pre-existing cognitive impairment -severe illness -age

An intellectual disability is categorized by? Select all that apply

-significant limitations in both intellectual functions -Significantly below average intelligence accompanied by impaired adaptive functioning and developmental delays

When would early onset Alzheimer's typically be diagnosed

65 or younger

An alcoholic client tells the nurse, "I feel so depressed about what I've done to my family that I feel like giving up." It is most important for the nurse to assess the client for which of the following?

A plan for self-harm

A patient diagnosed with Alzheimer's will begin to exhibit which of the following symptoms: (Select all that apply):

A. Aphasia B. Apraxia C. Agnosia D.All of the Above D. All of the above

What are the nurse's role in Alternative Housing for mentally ill patients in the community?

A. determine appropriate outpatient setting B. evaluate Medication follow-up needs C. Make recommendations for necessary medical care D. ALL OF THE ABOVE

An elderly patient comes into the ED with a fluctuating level of consciousness, reduced awareness of the environment, restlessness, agitation, lethargy and is slow to respond. As the nurse, which nursing diagnosis would you give to this patient?

Acute confusion related to delirium

What is the failure to recognize or identify objects often seen in patients with Alzheimers?

Agnosia

Which of the following neurocognitive disorders is thought to be caused by the buildup of amyloid plaques?

Alzheimers

Which law guarantees equal opportunity for individuals with disabilities in public accommodations, employment, transportation, state and local government services, and telecommunications?

Americans with Disabilities Act

Which definition best describes the term "aphasia"

An alteration in language

A 15-year-old boy was hospitalized in a psychiatric unit because he initiates frequent fights with peers. Which implementation is most appropriate?

Anticipate and neutralize potentially explosive situations

A nursing student would like to learn more about the continuum of mental health care. Which of the following is the first step?

Assessment

What is the most commonly diagnosed mental health disorder in children from 3-17, particularly in boys?

Attention Deficit Hyperactivity Disorder

The nurse is completing a physical assessment of a young adult who is being evaluated for anorexia. Which component should the nurse include in the nursing​ assessment? (Select all that​ apply.)

Attitude toward food -Condition of the teeth -Body mass index​ (BMI)

Which condition is not considered a psychiatric disorder, but a neurological disorder

Autism

What disorder includes repetitive patterns and actions, very specific interests, and impaired social skills?

Autism Spectrum Disorder

The nursing management of childhood schizophrenia is similar to:

Autism Spectrum Disorders

A 21-year-old patient has a diagnosis of schizophrenia and is stuporous, yet exhibits sudden, excessive motor activity with repetitive sit-ups. What is this behavior called?

Catatonic

What best describes somatic symptom disorder?

Changeable and complex

An example of a somatoform disorder is

Conversion disorder

A nurse is presenting a talk on homelessness and its effect on individuals. The nurse describes the resiliency of homeless individuals based on which of the following?

Coping with extreme stressors

What neurocognitive disorder can be described as imparied consciousness that develops over a short period of time?

Delirium

Which of the following statements are true?

Delirium can be caused due to hypoxia and psychological stress

True or False: Delirium is another term for Dementia.

False

True or False: The primary goal for a mental ill patient is the achievement of the highest level of functioning in the most restrictive environment, like an inpatient facility.

False

Group of people who are connected emotionally, by blood or in both ways that have developed a pattern of interactions and relationships.

Family

What does a genogram show?

Family's evolution

True or False: Autism and Asperger's Syndrome are different disorders.

Fasle

True or false: A patient with Obsessive Compulsive Disorder does not realize their actions and thoughts are excessive or unreasonable.

Flse

What is considered a stereotypical behavior for children diagnosed with Autism Spectrum disorder?

Hand flapping

The primary goal of the least restrictive environment is to achieve

Highest level of functioning

What is the main goal of a least restrictive environment

Highest level of functioning

Which is considered to be a formal support network relating to family social domain?

Hospital

Which nursing diagnosis would accurately describe a homeless person suffering from slurred speech, weak pulse, and lack of coordination?

Hypothermia

A nurse has formulated several nursing diagnoses for a homeless client after a thorough nursing assessment. Of these, which of the following would the nurse determine as the priority?

Imbalanced nutrition

For the homeless, health care is usually crisis oriented and sought in emergency departments. The most difficult challenge for nurses treating this vulnerable population is to recognize the client's:

Inability to follow prescribed treatment regimes

A nursing instructor is explaining the concept of the continuum of care to a group of students. Which of the following would the nurse include in this description?

Integrated system spanning illness to wellness states

Which neurotransmitter imbalance has been shown to have a relation to impulsive aggression?

Low levels of serotonin

An older adult client is brought to the ED after ingesting an unknown substance. The client, who appears to have dementia, tremors, ataxia of the upper and lower extremities, depression, and confusion. The nurse suspects ingestion of which of the following?

Mercury

What is the cause of homelessness?

No single cause

A client comes into the ED complaining about being followed and that aliens are trying to kill them. The nurse reviews the client's medications and notes the client is likely to have schizophrenia based on which medication?

Olanzapine (Zyprexa)

What activity is associated with boys and bullying?

Physical aggression

Which of the following would be a behavior of someone with a factitious disorder?

Pretending to be in severe pain in order to receive attention from health care providers

What is the priority nursing intervention to help orient a patient who has Alzheimer's disease?

Provide a daily routine and easy-to-read clocks.

A nurse is caring for a client with delirium. Which nursing intervention has the highest priority?

Providing a safe environment

The parents of a young adult diagnosed with schizophrenia are providing care for the patient in their home. During a home visit, the parents state, "It's been so difficult taking care of our son. We need a break. But he needs constant supervision." Which of the following would be appropriate for the nurse to suggest?

Respite residential care

What is the primary concern caring for a patient who has delirium?

Safety

Which nursing diagnosis should be investigated for clients with somatoform disorders?

Self-care deficit

What is the expected behavior of a school-aged child (6-12) after a family loss?

Showing behavioral changes of withdrawal, or hostility

A patient expresses to the nurse many physical complaints for 6 months. The patient has a history of pain, GI symptoms, sexual reproductive symptom, and pseudoneurologic syndrome. These are all diagnostic criteria for what disorder?

Somatic Symptom Disorder

A nurse is developing a plan of care for a male client who is homeless. Which of the following would the nurse do first?

Stabilize the client's physical health status

A parent brings a preschooler to the ED for treatment of a dislocated shoulder, which the parent states happened when the child tripped down the stairs. Which action should the nurse suspect that the child was abused?

The child does not cry at all when the shoulder is examined

In planning care for a suicidal client, which correctly written outcome should be a nurse's first priority?

The client will remain safe during the hospital stay.

A 25-year old client experiencing alcohol withdrawal is upset about going through detoxification. Which of the following goals in a priority?

The client will work with the nurse to remain safe

What is not an example of a dysfunctional family dynamic?

The family has one member going to law school and they are worried it will be hard

A 68-year-old patient who is hospitalized with pneumonia is disoriented and confused 3 days after admission. Which information indicates that the patient is experiencing delirium rather than dementia?

The patient was oriented and alert when admitted.

A parent brings her 15-year-old son into the emergency room. She states that he has missed school multiple times throughout the year due to feeling sick and leaves school often because he hurts/injures himself. A nurse assesses the patient and sees that the vital signs are all normal for the patient. What is the best answer for why the patient is acting this way?

The son is suffering from a factitious disorder

A client taking lithium carbonate started complaining of nausea, vomiting, diarrhea, drowsiness, muscle weakness, tremor, blurred vision and ringing in the ears. The lithium level is 1.5 mEq/L. The nurse interprets this value as:

Toxic

Occurrence of Autism Spectrum Disorder, Attention-Deficit Hyperactivity Disorder, and Tourette's Disorder is more likely to affect boys than girls.

True

True or False: Delirium is usually reversible if the underlying cause is identified

True

True or False: More than half of children have a comorbid disorder (tics, mood, or anxiety disorder)

True

True or false: A case manager's goal is to help the patient gain access to high-quality and cost-effective mental health services.

True

True or false: Aphasia, Apraxia, and Agnosia are three multiple cognitive disorders involved in patients with Alzheimer's Disease.

True

True or false: Children are more likely to be mentally healthy if they have good physical and positive social development

True

True or false: Children with somatic symptoms but disorders are usually not diagnosed until adolescence

True

True or false: Emotional detachment is a negative dissociation symptom.

True

True or false: Lack of a fixed permanent nighttime residence or living in nighttime residences that are temporary shelters, welfare hotels, transitional housing for mentally ill persons , or any public, private place not designated a sleeping accommodation for human beings is the definition of homelessness

True

True or false: Psychosomatic is used to describe, explain, and predict the psychological origins of illness and disease

True

True or false? The primary goal for mental health care in the community is an achievement of the highest level of functioning in the least restrictive environment.

True

true or false: Somatization is a manifestation of psychological distress as physical symptoms

True

What type of Homelessness is shown when a homeless individual lives in places that are not used for housing such as cars, parks, abandoned buildings, tents, bus/train stations.

Unsheltered

A nurse is teaching a client who has a depressive disorder about fluoxetine. Which of the following information should the nurse include in the teaching?

You might experience sexual dysfunction

The psychiatric-mental health nurse practitioner and a team of local mental health professionals are asked to provide crisis counseling service, after a gunman recently took a class hostage at a local elementary school, wounded several students, and then shot himself. In preparing for this assignment, the nurse practitioner recognizes that:

a child's developmental stage will influence his or her response to catastrophic stress.

What are the risk factors associated with being homeless?

a. Lack of skills b. Mental illness c. Substance abuse d. Unemployment e. ALL OF THE ABOVE

When administering a mental status examination to a patient with delirium, the nurse should:

choose a place without distracting stimuli.

What is agnosia?

failure to recognize or identify objects

A short-term goal for a patient with Alzheimer's disease is:

improved functioning in the least restrictive environment.

An adolescent male is swearing and shouting at his physician, who refused to give him a pass to leave the unit. This behavior

is a major indicator that the client may become physically aggressive

Which of the following would be considered the least restrictive environments?

outpatient care

The psychiatric-mental health nurse practitioner uses a cognitive-behavioral approach to help a patient address self-defeating behavior. After identifying the stressor that causes the inappropriate behavior, the initial strategy is to explore:

rational and irrational beliefs about the stressor.

What is the major cause of homelessness?

there is no single cause