Psych

The nurse reviews the components of Abraham Maslow's humanistic theory. Which component supports the outcome of a person-centered motivation to grow and develop in a healthy way? (Select all that apply.) a. Focus on health b. Needs and self-actualization c. Holistic, interactive approach d. Human potential for goodness e. Use of empathy and positive regard

a. Focus on health b. Needs and self-actualization c. Holistic, interactive approach

The nurse is reviewing the pharmacokinetic processes of a patient's prescribed medications. What factor should the nurse identify that influences the metabolic liver enzymes contained in the cytochrome P450 system? a. Genetics b. Excretion c. Drug half-life d. Acid-base balance in the body

a. Genetics

The nurse is caring for a family that demonstrates a high level of conflict. Which intervention would be most appropriate? a. Help them to learn more effective communication skills. b. Help them obtain medication to decrease their intensity levels. c. Help them to identify the family member who is causing the conflict. d. Help them decide which family member should have the most power in decision making.

a. Help them to learn more effective communication skills.

The nurse is preparing to assess a patient with a mental illness. Which model should the nurse use as a framework for the assessment? a. Holistic b. Spiritual c. Biological d. Psychosocial

a. Holistic

A patient reports having insomnia "for years." For which behaviors of chronic insomnia should the nurse assess the patient? (Select all that apply.) a. Spending more time in bed b. Watching television in bed c. Staying up as late as possible d. Taking hot showers at bedtime e. Spending more time with others

a. Spending more time in bed b. Watching television in bed d. Taking hot showers at bedtime

A patient with a history of schizophrenia has completed an advance directive agreeing to hospitalization should decompensation occur. How should the hospitalization be categorized if the patient is brought to the emergency department experiencing delusions, hallucinations, and unsafe behavior? a. Voluntary admission b. Involuntary admission c. Temporary involuntary admission d. Emergency involuntary admission

a. Voluntary admission

An older patient reports tremors, memory problems, and difficulty walking. Which disorder should the nurse suspect is occurring with this patient? a. Traumatic brain injury b. Parkinson disease c. Alzheimer disease d. Human Immunodeficiency Virus

b. Parkinson disease

The nurse is considering employment in a correctional facility. Which action should the nurse take before accepting the position? a. Ensure immunizations are current b. Reconcile personal moral objections c. Investigate other employment opportunities d. Complete continuing education courses about the facilities

b. Reconcile personal moral objections

The nurse is preparing a teaching tool on the treatment of mental health disorders. Which fundamental principle of mental health recovery should the nurse include? a. Recovery is culturally unrelated. b. Recovery is holistic. c. Recovery begins with despair. d. Recovery is solitary.

b. Recovery is holistic.

When reviewing the plan of care for a patient with mental illness, the nurse notes that the patient is not meeting one of the established goals. Which action should the nurse take? a. Collaborate with the patient to reassess the plan of care. b. Collaborate with the healthcare provider to reassess the plan of care. c. Change the plan of care according to the patient's most recent assessment. d. Change the plan of care according to the newly defined nursing diagnosis.

a. Collaborate with the patient to reassess the plan of care.

The nurse is caring for a patient with vascular dementia. Based on the neurobiology of this condition, what is the nurse's primary concern when caring for this patient? a. Pain b. Safety c. Communication d. Level of consciousness

b. Safety

A patient who has been prescribed sertraline (Zoloft) reports using St. John's wort. About which potential health problem should the nurse instruct this patient? a. Tardive dyskinesia b. Serotonin syndrome c. Stevens-Johnson rash d. Anaphylactic reaction

b. Serotonin syndrome

The nurse is engaged in a conversation with a patient. Which statement should the nurse avoid because it represents nontherapeutic communication? a. "Why do you think you will never get well?" b. "How do you feel about being discharged today?" c. "What are your concerns about your living situation?" d. "What happened when you quit taking your medications?"

a. "Why do you think you will never get well?"

The nurse prepares to assess the spiritual needs of a patient with depression. On which areas should the nurse focus during this assessment? (Select all that apply.) a. Beliefs b. Triggers c. Traditions d. Affiliation e. Symptoms

a. Beliefs b. Triggers e. Symptoms

The nurse is preparing a teaching tool about the sexual response cycle. In which way should the nurse describe this cycle when using the Masters and Johnson model? a. Linear b. Nonlinear c. Cluster d. Gap

a. Linear

The nurse cares for a patient taking clozapine (Clozaril). Which laboratory data should the nurse monitor in this patient? a. WBC b. RBC count c. Fasting blood sugar d. Pro-times and creatine kinase

a. WBC

The nurse is reviewing the mechanism of action of medications. What drug should the nurse identify that acts as an inhibitor to activity by the protein receptor? a. Agonist b. Antagonist c. Therapeutic d. Partial agonist

b. Antagonist

The nurse facilitating a group session has chosen not to emphasize group rules or interpersonal orientation. What factor will be most impaired if these elements of group dynamics are missing? a. Trust b. Cohesion c. Uniqueness d. Universality

b. Cohesion

The nurse is performing a family assessment. Which factor will the nurse include in the social functioning portion of the assessment? a. Legal problems b. Marital patterns c. Family strengths d. Educational history

b. Marital patterns

The nurse is asked to identify the term describing a drug's ability to bind to a particular receptor site. Which term should the nurse identify? a. Affinity b. Selectivity c. Intrinsic activity d. Hyperosmolarity

b. Selectivity

The nurse sees patients in the outpatient clinic. Which should the nurse recognize as an indicator that a patient has schizotypal personality disorder? a. The patient is awkward and has a flat affect. b. That patient has odd mannerisms and eccentric dress. c. The patient is suspicious and distrustful. d. The patient shows a lack of remorse for others.

b. That patient has odd mannerisms and eccentric dress.

A patient with a major depressive disorder has recently been terminated from a job and has no idea what to do since the patient's identification of self was through work. Which psychological theorist best describes the patient's current identification of self? a. Erik Erikson b. William James c. Abraham Maslow d. Harry Stack Sullivan

b. William James

A patient diagnosed with restless leg syndrome (RLS) asks for an explanation for the disorder. In which way should the nurse respond? a. "It is an anxiety disorder." b. "It is a physical disorder." c. "It is a neurological disorder." d. "It is an obsessive-compulsive disorder."

c. "It is a neurological disorder."

A patient prescribed ramelteon (Rozerem) asks how the medication will improve sleep. Which response should the nurse make? a. "By inhibiting the work of melatonin in the body." b. "It acts as an off switch to deactivate melatonin that your body produces." c. "It produces the same response in the body as melatonin." d. "It will prevent you from building up a tolerance to melatonin."

c. "It produces the same response in the body as melatonin."

The nurse is evaluating the most effective interventions for a patient with selective mutism. What option should the nurse consider? (Select all that apply.) a. Hypnotherapy b. Parenting education classes c. Antidepressant medications d. Brief-solution focused therapy e. Cognitive-behavioral therapy (CBT)

c. Antidepressant medications e. Cognitive-behavioral therapy (CBT)

The nurse notes that a patient with a history of addiction is not receiving pain medication when requested. Which ethical principle should the nurse use when advocating for appropriate pain relief? a. Justice b. Autonomy c. Beneficence d. Nonmaleficence

c. Beneficence

A school nurse is preparing a presentation for school faculty and staff on substance use disorders (SUDs) and addiction. How will the nurse explain behavior observed in the addictive process? a. History of a neurodevelopmental disorder b. History of a cognitive disorder c. Changes in neurochemistry d. Changes in emotional state

c. Changes in neurochemistry

The nurse is preparing teaching on elder abuse. Which should the nurse include as risk factors? (Select all that apply.) a. Cancer b. Diabetes c. Dementia d. Paraplegia e. Mental illness

c. Dementia e. Mental illness

Parents of a school-age child seek medical attention for the child because of uncontrollable behavior changes. For which diagnostic feature should the child be assessed to validate the diagnosis of pediatric bipolar disorder (PBD)? a. Loss of appetite and extreme energy b. Getting up early in the morning to play with toys c. Episodic irritability lasting 4 to 7 days with elation d. Inability to pay attention in school and picking fights with others

c. Episodic irritability lasting 4 to 7 days with elation

A patient says, "My therapist touched my face and asked me out for a romantic evening." The nurse recognizes the therapist engaged in which unethical behavior? a. Invasion of privacy b. Inappropriate self-disclosure c. Failure to maintain boundaries d. False imprisonment

c. Failure to maintain boundaries

The psychiatric nurse is discussing indicators of conduct disorders in children. Which behavior should the nurse include that children with conduct disorders find challenging? a. Seeking out peers b. Eating a balanced diet c. Following rules and norms of behavior d. Interpreting internal stimuli or external cues

c. Following rules and norms of behavior

A patient is taking sertraline (Zoloft). Because of the danger of toxicity, the nurse should advise the patient to avoid which food? a. Milk b. Peanuts c. Grapefruit d. Orange juice

c. Grapefruit

The nurse notes that one of the members in a group therapy session is asking the other members for help with problems, but then appears to reject all the solutions that the members suggest. What is the best way the nurse will describe this patient? a. Help-seeking protestor b. Help-rejecting protestor c. Help-rejecting complainer d. Help-seeking manipulator

c. Help-rejecting complainer

A dying patient states a belief in karma. Which religion does the nurse suspect the patient follows? (Select all that apply.) a. Islam b. Judaism c. Hinduism d. Buddhism e. Christianity

c. Hinduism d. Buddhism

After asking a patient to explain current symptoms, the nurse yawns, looks at the clock, and folds the arms over the chest. In which way should the nurse's behavior be interpreted? a. Disinterest in the patient's answers b. Boredom with the therapy session c. Incongruence of verbal and nonverbal communication d. Incongruence of nonverbal communication and meta-communication

c. Incongruence of verbal and nonverbal communication

The nurse attends a community event where the different cultures of area residents are represented. In which way will this enhance the nurse's cultural competence? a. Reduce stereotyping b. Eliminate microaggression c. Increase understanding of other cultures d. Improve acceptance by patients of different cultures

c. Increase understanding of other cultures

The nurse is caring for a patient with a dissociative disorder. Which treatment should the nurse anticipate for this patient? a. Group therapy b. Support groups c. Individual psychotherapy d. Dialectical behavior therapy

c. Individual psychotherapy

The nurse is reviewing information about drug and food interactions. What drug interactions in the liver are of primary importance? (Select all that apply.) a. Excretion b. Dependence c. Induction d. Inhibition e. Tolerance

c. Induction d. Inhibition

Parents are concerned that their adolescent male child has not yet started puberty. For which health condition should the nurse prepare teaching for this family? a. Gender dysphoria b. Priapism c. Intersex d. Erectile dysfunction

c. Intersex

A mental health facility is adopting the SBIRT approach to substance abuse intervention and treatment. Which should the nurse identify as the core concept behind SBIRT? a. It employs a cognitive approach utilizing rational emotive behavior therapy. b. It helps clinicians recognize when individuals are able to acknowledge the impact of drug use on their lives and their willingness to change behaviors that support drug use. c. It may be used to help individuals identify and address problems in life that arise from substance use/misuse or abuse. d. It asks individuals to examine their own actions and accept responsibility.

c. It may be used to help individuals identify and address problems in life that arise from substance use/misuse or abuse.

The nurse is caring for flood victims who are staying in a shelter. According to Maslow's hierarchy of needs, on what category should the nurse focus in order to provide effective assistance? a. Physiological b. Self-actualization c. Safety and security d. Love and belonging

c. Safety and security

The nurse is describing the biological impact on the development of mental health and illness to the parents of a child recently diagnosed with autism spectrum disorder. Which statement should the nurse include? a. Exposure to drugs and alcohol has been associated with psychiatric disorders. b. Early psychological trauma may create deficits or abnormalities in brain structure. c. The child's genetically determined attributes and life experiences interact to influence mental health outcomes. d. The feedback mechanism appears dysfunctional, creating neurotoxic effects on brain development and function.

c. The child's genetically determined attributes and life experiences interact to influence mental health outcomes.

The nurse notes that a patient with Alzheimer disease has neurocognitive disorder instead of dementia listed as the medical diagnosis. Why would the healthcare provider document in this manner? a. The word dementia is outdated and no longer used. b. The word dementia does not describe the patient's condition. c. The word dementia may increase stigma regarding the patient's condition. d. The word dementia may be confused with delirium.

c. The word dementia may increase stigma regarding the patient's condition.

The nurse is caring for a patient with mental illness. What should the nurse use to provide therapeutic care to individuals with mental illness? a. Empathy b. Sympathy c. Theories of human behavior d. Neurobiology of mental illness

c. Theories of human behavior

The nurse reviews information received about patients during hand-off communication. Which patient situation should the nurse recognize may support the need for involuntary commitment? a. History of incarceration b. Self-medication with marijuana c. Threats made against family members d. Presence of auditory hallucinations

c. Threats made against family members

The nurse makes a medication error, reports the error, and apologizes to the patient. Which ethical principle was used to guide the nurse's actions? a. Justice b. Fidelity c. Veracity d. Beneficence

c. Veracity

A patient who has been prescribed a selective serotonin-reuptake inhibitor (SSRI) asks how it works. What is the best response by the nurse? a. "SSRIs maintain the drug in its bound form, allowing more of the drug to attach to the neurotransmitter." b. "SSRIs increase enzymatic action in the blood-brain barrier." c. "SSRIs improve acid-base balance, enhancing the penetration of the blood-brain barrier." d. "SSRIs target blood-brain barrier transporters and prevent the reuptake of the neurotransmitter."

d. "SSRIs target blood-brain barrier transporters and prevent the reuptake of the neurotransmitter."

The nurse is caring for a patient who is a poor historian and cannot give much detail about broken sleep. When evaluating the disorder and developing a treatment plan, what would be the most helpful? a. The results of a sleep study b. A list of the patient's allergies to medications c. The results of the Epworth Sleepiness Scale d. A conversation with the patient's bed partner

d. A conversation with the patient's bed partner

The nurse is subpoenaed to provide information about injuries a patient sustained in a criminal case. Which statement best describes how the nurse should respond? a. Plead the Fifth Amendment in this case. b. Refuse to give any information about the patient. c. Disclose any information she knows about the patient. d. Answer questions with the minimum information needed.

d. Answer questions with the minimum information needed.

The nurse is caring for a patient in an outpatient clinic who has selected and obtained lethal measures to commit suicide. What nursing intervention is most appropriate for this patient? a. Encourage the patient to attend psychotherapy. b. Encourage coping skills, such as stress reduction. c. Facilitate assessment in the emergency department to determine the appropriate level of care. d. Arrange for transportation to the emergency department and plan for admission to the behavioral health unit.

d. Arrange for transportation to the emergency department and plan for admission to the behavioral health unit.

The nurse is caring for a patient with bulimia nervosa (BN). Which intervention should the nurse expect as the first-line treatment for this disorder? a. Art therapy b. SSRI therapy c. Dialectical behavior therapy d. Cognitive-behavioral therapy

d. Cognitive-behavioral therapy

The nurse is caring for a patient who is at risk for psychosis. Which therapeutic modality might be the most effective for this patient? a. Hypnosis b. Psychoanalysis c. Brief solution focused therapy d. Cognitive-behavioral therapy (CBT)

d. Cognitive-behavioral therapy (CBT)

A patient is demonstrating manifestations of obsessive-compulsive disorder. Which action should the nurse take if unfamiliar with the assessment data and behaviors associated with this disorder? a. Document all subjective and objective data provided by the patient. b. Ask the primary health provider to identify needed subjective and objective assessment data. c. Research obsessive-compulsive disorder in the medical dictionary. d. Consult the Diagnostic and Statistical Manual of Mental Disorders for diagnostic criteria.

d. Consult the Diagnostic and Statistical Manual of Mental Disorders for diagnostic criteria.

The nurse actively uses self to achieve the moral ideal when caring for a patient with mental illness. Which nursing theorist is the nurse implementing? a. Patricia Benner b. Martha Rogers c. Hildegard Peplau d. Florence Nightingale

d. Florence Nightingale

The nurse obtains a prescription to apply restraints to a patient who is agitated, aggressive, and has threatened two staff members. Which action should the nurse take regarding the use of the restraints? a. Assess the patient every 6 hours. b. Ensure that the order is written as "PRN confusion." c. Remind the healthcare provider to assess the patient every other day. d. Instruct the patient on the use of the restraints.

d. Instruct the patient on the use of the restraints.

A patient stops attending religious services and socializing with friends after a sibling with schizophrenia exhibits disturbing behaviors at a local shopping mall and is arrested. Which behavior should the nurse identify the patient is demonstrating? a. Resiliency b. Vulnerability c. Enacted stigma d. Internalized stigma

d. Internalized stigma

The nurse is reviewing the stress response. Which neurotransmitter should the nurse identify as most involved in this response? a. GABA b. Serotonin c. Dopamine d. Norepinephrine

d. Norepinephrine

The clinician leading the family therapy session asks the family members to reenact the problem they are having. What is the primary purpose of this action? a. Observe the differences in the portrayals among the family members. b. Understand current conflicting interactions among the family members. c. Understand intergenerational patterns of behavior among the family members. d. Observe the types of interactions that occur among the family members

d. Observe the types of interactions that occur among the family members

A patient taking lithium has a level of 0.8 mmol/L. Which criteria should the nurse use to document that the patient's level is appropriate? a. Potency b. Target effect c. Drug dependence d. Therapeutic range

d. Therapeutic range

The nurse is caring for a patient with severe mania. Which neuromodulation therapy should the nurse expect to be ordered for maintenance treatment? a. Light therapy b. Deep brain stimulation (DBS) c. Electroconvulsive therapy (ECT) d. Repetitive transcranial magnetic stimulation (rTMS)

c. Electroconvulsive therapy (ECT)

A patient is experiencing acute anxiety. Which action should the nurse make a priority? a. Explain about anxiety. b. Teach ways to decrease anxiety. c. Ensure the patient's safety. d. Provide a physical activity to redirect patient focus.

c. Ensure the patient's safety.

A patient is prescribed a stimulant and two scheduled naps per day. For which sleep-wake disorder should the nurse plan care for this patient? a. Narcolepsy b. Central sleep apnea c. Hypersomnolence disorder d. Circadian rhythm disorder

c. Hypersomnolence disorder

The nurse is preparing to assess a patient with mental illness. On which area should the nurse focus when assessing the patient's cognitive functioning? (Select all that apply.) a. Memory b. Judgment c. Emotional status d. Thought processes e. State of consciousness

a. Memory b. Judgment e. State of consciousness

An older patient is prescribed a benzodiazepine for agitation. For which factor should the nurse assess the patient following administration of the benzodiazepine? (Select all that apply.) a. Mobility issues b. Physical decline c. Tardive dyskinesia d. Cognitive impairment e. Long-term memory loss

a. Mobility issues d. Cognitive impairment

The nurse is leading a psychotherapy group. What is the best way the nurse can create a safe and trusting environment? (Select all that apply.) a. Modeling empathy b. Creating dialogue that allows for feedback c. Modeling sympathy d. Ensuring confidentiality e. Encouraging out-of-session subgrouping

a. Modeling empathy b. Creating dialogue that allows for feedback d. Ensuring confidentiality

A staff nurse states that adolescents are too young to develop a mental illness. Which information should the nurse manager include in response? a. More than 12 million adolescents were treated for a mental illness in 2016. b. Adolescents are not usually diagnosed with a mental illness until they are older. c. Mental illness in adolescents is really an undiagnosed physical illness. d. Mental illness develops in adolescents who live in toxic environments.

a. More than 12 million adolescents were treated for a mental illness in 2016.

The nurse is planning care for a patient admitted for treatment of injuries sustained during a rape. On which areas should the nurse focus for this patient? (Select all that apply.) a. Safety b. Finances c. Legal counsel d. Empowerment e. Confidentiality

a. Safety d. Empowerment e. Confidentiality

The nurse is evaluating the effectiveness of a patient's medications. What reactions to medications should the nurse identify that are influenced by chemical biotransformations in the liver's enzymatic pathways? (Select all that apply.) a. Tolerance b. Toxicity c. Potency d. Resistance e. Therapeutic range

a. Tolerance b. Toxicity d. Resistance

A patient suspected of using a hallucinogen. Which should the nurse expect to note on assessment? (Select all that apply.) a. Tremors b. Sweating c. Constricted pupils d. Tachycardia e. Dilated pupils

a. Tremors b. Sweating d. Tachycardia e. Dilated pupils

The nurse is researching the genetic link to sexual dysfunction and sexual disorders. Which sexual dysfunction syndromes or disorders does the nurse identify are directly related to chromosomal inheritance? (Select all that apply.) a. Turner syndrome b. Gender dysphoria c. Kleinfelter syndrome d. Paraphilic disorder e. Intersex condition

a. Turner syndrome c. Kleinfelter syndrome

The nurse is caring for a patient with schizotypal personality disorder. For which type of medication should the nurse prepare teaching for the patient? a. Typical antipsychotic b. Atypical antipsychotic c. Tricyclic antidepressant d. Mood stabilizer

a. Typical antipsychotic

A middle-aged patient is very upset because a college-aged child is protesting corporate lobbying during a campus demonstration. Which of Kohlberg's stages of moral development is this patient exhibiting? a. Adaptation b. Assimilation c. Conventional d. Pre-conventional

c. Conventional

The nurse plans to use motivational interviewing when talking with a patient. Using the acronym RULE, which action by the nurse will best demonstrate active listening? a. Conveying sympathy b. Accepting the patient c. Conveying empathy d. Validating the patient

c. Conveying empathy

The nurse is planning care for a patient who is in the recovery phase of illness. On which area should the nurse focus? a. Patient safety b. Stability of symptoms c. Coping skills and problem solving d. Impact of symptoms on quality of living

c. Coping skills and problem solving

A patient who was grieving the death of one parent learns the remaining parent passed away unexpectedly. For which primary type of loss should the nurse plan care for this patient? a. Multiple b. Expected c. Cumulative d. Unanticipated

c. Cumulative

A patient with Alzheimer disease is no longer able to make or plan meals and is having difficulty managing her personal finances. For which stage of Alzheimer disease should the nurse plan care for this patient? a. Preclinical b. Mild cognitive impairment c. Dementia d. Asymptomatic

c. Dementia

A patient being discharged from a substance abuse rehabilitation facility plans to join Nar-Anon to find new connections and avoid former associates. Which stage of hope is this patient demonstrating? a. Bracing for negative outcomes b. Continuously evaluating signs to reinforce selected goals and the revision of these goals c. Developing a realistic appraisal of personal resources and external conditions and resources d. Making a realistic appraisal of an event and the threat to self

c. Developing a realistic appraisal of personal resources and external conditions and resources

A patient of Hispanic descent is reporting abdominal pain and fatigue. Which type of mood should the nurse consider this patient might be expressing? a. Tired b. Euthymic c. Dysphoric d. Anhedonic

c. Dysphoric

The nurse is providing patient education about addiction. Which patient statement indicates that teaching was effective? a. "Addiction is a biopsychosocial problem." b. "Addiction is an emotional attachment." c. "Addiction is a behavioral habit." d. "Addiction is a moral disease."

a. "Addiction is a biopsychosocial problem."

A nurse is performing a spirituality assessment with a patient experiencing acute mania. What question should the nurse ask during the initial assessment of the patient's spirituality? (Select all that apply.) a. "Do you have a religious preference?" b. "What is your source of support or meaning in this experience?" c. "Are there any spiritual or religious practices that are important to you?" d. "Would you like me to contact your clergy member or religious leader?" e. "In what ways has your illness affected your view of yourself or of others or your faith?"

a. "Do you have a religious preference?" c. "Are there any spiritual or religious practices that are important to you?" d. "Would you like me to contact your clergy member or religious leader?"

The nurse is assessing a patient. Which questions should the nurse ask to determine if the patient has an underlying sleep-wake disorder? (Select all that apply.) a. "Do you have issues with snoring?" b. "Do you wake feeling tired and not restored?" c. "Do you suffer from excessive daytime sleepiness?" d. "Do you apply appropriate sleep hygiene to your routine?" e. "Do you think your sleep is affecting your daytime functioning"

a. "Do you have issues with snoring?" b. "Do you wake feeling tired and not restored?" c. "Do you suffer from excessive daytime sleepiness?" e. "Do you think your sleep is affecting your daytime functioning"

A patient whose mother died recently is distressed because a sibling returned to work immediately after their mother's funeral. Which is the best response by the nurse? a. "Every person grieves in their own way." b. "I guess your family member is just not emotional." c. "Yes, that is a problem. I think you should suggest a therapist." d. "There is an association between a lack of expression of grief and negative psychological outcomes."

a. "Every person grieves in their own way."

A patient with a sleep disorder is considering drinking chamomile tea at night to help with sleep. With which class of medication should the nurse instruct the patient to avoid using chamomile? a. Anticoagulant b. Anticholinergic c. Antidepressant d. Antiemetic

a. Anticoagulant

The nurse is reviewing theories that examine the concept of self. When learning about Patricia Benner's theory of the concept of self, which should the nurse recognize as the definition of a novice nurse? a. Any nurse who is unfamiliar with both the patients and the tools required to provide patient care. b. Any nurse who is unfamiliar with both the disease process and treatment plan required to provide patient care. c. Any nurse who is unfamiliar with both the assessment and planning required to provide patient care. d. Any nurse who is unfamiliar with both the pharmacologic and the nonpharmacologic therapies required to provide patient care.

a. Any nurse who is unfamiliar with both the patients and the tools required to provide patient care.

The nurse is instructing a patient on sleep hygiene for a sleep-wake disorder. Which guidelines will the nurse include for this patient? (Select all that apply.) a. Arise at the same day every day, including weekends. b. Cut down on any food or beverage that contains caffeine. c. Take periodic naps to avoid becoming stressed. d. Eat healthy meals and do not go to bed hungry. e. Drink one glass of wine before bed to aid relaxation.

a. Arise at the same day every day, including weekends. b. Cut down on any food or beverage that contains caffeine. d. Eat healthy meals and do not go to bed hungry.

A patient who is recently unemployed is concerned about having financial resources to pay the mortgage and provide for the family's needs. Which action should the nurse take to promote resiliency in this patient? (Select all that apply.) a. Assess the patient's strengths. b. Encourage participation in pleasant activities. c. Recommend the patient list previous disappointments. d. Suggest ways to align the patient's strengths with goals. e. Help the patient identify what provides a sense of well-being.

a. Assess the patient's strengths. b. Encourage participation in pleasant activities. d. Suggest ways to align the patient's strengths with goals. e. Help the patient identify what provides a sense of well-being.

A patient reports taking a serotonin reuptake inhibitor. For which health problem should the nurse suspect this medication has been prescribed for the patient? a. Depression b. Bipolar disorder c. Schizophrenia d. Sexual dysfunction

a. Depression

The nurse caring for a patient with a somatic symptom disorder. Which activity is the most important when planning this patient's care? a. Determine patient needs in each of the five domains. b. Determine patient willingness to try new interventions. c. Review patient daily journal to obtain a realistic view of the patient's activities. d. Encourage interactions with family and friends to distract the patient from somatic issues.

a. Determine patient needs in each of the five domains.

The nurse notes that the support group for depression has twice as many female participants than males. Which should the nurse consider as a reason for the number of females attending the group sessions? (Select all that apply.) a. Hormonal influences b. Burdens of the caregiving role c. Perceived lack of social support d. Expectation to be the family high wage earner e. Susceptibility to the impact of negative life events

a. Hormonal influences b. Burdens of the caregiving role c. Perceived lack of social support e. Susceptibility to the impact of negative life events

The nurse is planning care for a patient with a feeding and eating disorder. Which factor should the nurse keep in mind that makes it challenging to care for this patient? (Select all that apply.) a. Hormone dysregulation b. Peer influences c. Co-morbid medical illness d. Exposure to different forms of media e. Social stigma

a. Hormone dysregulation b. Peer influences d. Exposure to different forms of media e. Social stigma

The nurse is planning a presentation on crisis intervention to faculty and staff at a local high school. What information should the nurse include? (Select all that apply.) a. How to identify colleagues who are approaching exhaustion b. How to conduct a psychological debriefing c. How to reinforce basic coping skills with students d. How to recognize common cultural responses to crisis e. How to encourage social connectivity among other faculty and staff

a. How to identify colleagues who are approaching exhaustion c. How to reinforce basic coping skills with students e. How to encourage social connectivity among other faculty and staff

A 42-year-old patient seeks medical attention for memory changes and changes in facial and body movements. For which disorder should the nurse assess the patient? a. Huntington disease b. Parkinson disease c. Traumatic brain injury d. Human Immunodeficiency Virus

a. Huntington disease

The nurse prepares to assess a patient. Which aspect of nonverbal communication conveys the nurse's positive attitude toward the patient? (Select all that apply.) a. Leaning slightly forward b. Orienting to face the patient c. Maintaining physical proximity d. Formulating a reply while the patient is speaking e. Maintaining good eye contact while the patient is speaking

a. Leaning slightly forward b. Orienting to face the patient c. Maintaining physical proximity e. Maintaining good eye contact while the patient is speaking

The nurse is assessing a patient who is experiencing a relapse of symptoms of schizophrenia. Which patient abilities should the nurse identify that will have the greatest impact on the plan of care? (Select all that apply.) a. Listening b. Concentration c. Decision making d. Retaining new information e. Maintaining adequate coping strategies

a. Listening b. Concentration c. Decision making d. Retaining new information

The nurse is conducting a community risk assessment of the relationship between mental health and violence in the community. Which components should the nurse to include in the assessment? (Select all that apply.) a. Prevalence of violence within the community b. Diverse sampling of individuals across various communities c. Prevalence of mental disorders within the community d. Numbers of individuals currently in treatment for mental illness. e. Numbers of individuals with mental illness currently not in treatment.

a. Prevalence of violence within the community c. Prevalence of mental disorders within the community d. Numbers of individuals currently in treatment for mental illness. e. Numbers of individuals with mental illness currently not in treatment.

The nurse is assessing a patient's neurological functioning. Which assessment should be completed to determine the patient's motor ability? (Select all that apply.) a. Reflexes b. Romberg test c. Point location d. Tandem walking e. Finger to finger test

a. Reflexes b. Romberg test d. Tandem walking e. Finger to finger test

The nurse is caring for a patient with schizophrenia spectrum disorder (SSD). Which impairment should the nurse identify in the patient as a hard sign? (Select all that apply.) a. Reflexes b. Grimacing c. Asterognosis d. Increased blink rates e. Oculomotor abnormalities

a. Reflexes e. Oculomotor abnormalities

The nurse is using the nursing process when caring for a patient with mental illness. Which tasks should be accomplished during the evaluation phase of the nursing process? (Select all that apply.) a. Renegotiating patient needs to be addressed b. Identifying new, different, or additional goals and outcomes c. Redefining the roles of the patient and nurse in achieving outcomes d. Choosing appropriate interventions according the patient assessment e. Determining what progress has been made relevant to the plan of care

a. Renegotiating patient needs to be addressed b. Identifying new, different, or additional goals and outcomes c. Redefining the roles of the patient and nurse in achieving outcomes e. Determining what progress has been made relevant to the plan of care

A patient is experiencing a panic attack. What did the nurse assess to make this clinical determination? (Select all that apply.) a. Sweating b. Trembling c. Nausea d. Checking e. Breathing difficulty

a. Sweating b. Trembling c. Nausea e. Breathing difficulty

The healthcare provider approves of a patient taking an herbal supplement to help with a sleep disorder. Which should the nurse teach the patient about taking the supplement? a. Take the smallest amount when starting. b. Take the supplement with all prescribed medication. c. Take a double dose if expected effects are not occurring. d. Take the supplement for a year before expecting effects to occur.

a. Take the smallest amount when starting.

A patient with bipolar disorder is prescribed lithium carbonate (Lithobid). Which information should the nurse provide when teaching the patient about this medication? a. Test serum levels regularly. b. Decrease salt and fluid intake. c. Increase the dose if fine hand tremors appear. d. Discontinue the medication when feeling better.

a. Test serum levels regularly.

The nurse plans care for a patient with an eating disorder. The nurse should encourage the patient to maintain connections with friends and family to help the patient avoid developing which belief? a. That the eating disorder will bring happiness b. That forgiveness of inadequacies is acceptable c. That maintaining the disorder leads to a loss of spirit d. That despite the sacrifice of dieting, happiness will never come

a. That the eating disorder will bring happiness

A patient who survived a tornado wants to recover and rebuild the home. For which patient statement should a referral to a social worker be made? a. "I almost feel as though God has abandoned me." b. "I don't know where to begin to get back on my feet." c. "I don't think I can go back to my old work since the nerves in my hand were damaged." d. "No matter how hard I try, I can't get to sleep at night and I seem to be crying most of the time."

b. "I don't know where to begin to get back on my feet."

The nurse is conducting a follow-up assessment on a patient who lost a best friend several months ago. What patient statement would indicate that interventions have been effective? a. "I just can't get over it." b. "I think I'm sleeping better lately." c. "I don't care about my loss anymore." d. "I think that I am fine and don't really need treatment."

b. "I think I'm sleeping better lately."

The nurse is caring for a patient with diabetes. Which patient statement would lead the nurse to suspect the patient may be experiencing depression? a. "I'm concerned about the swelling in my ankles." b. "I'm tired all the time and I really hate my life." c. "My spouse and I can't seem to agree on anything." d. "Growing old is hard. Have you got a pill for that?"

b. "I'm tired all the time and I really hate my life."

During a group therapy session, a member talks incessantly and is disrupting the group's dynamics. Which response by the nurse encourages effective communication with the disruptive member? a. "Why are you acting in this manner?" b. "In one sentence, tell us what you want us to hear." c. "It is important to consider the help that the group members are suggesting." d. "What question can we ask that will make you want to participate in the group?"

b. "In one sentence, tell us what you want us to hear."

A patient with a mental illness asks, "What is complementary health?" Which response should the nurse make? a. "It is a group of diverse medical and healthcare practices and products that may be used but that are not considered evidence-based medicine." b. "It is a group of diverse medical and healthcare practices and products not generally considered part of conventional medicine." c. "It is a group of diverse medical and healthcare practices and products that are not generally considered useful in treating mental illness." d. "It is a group of diverse medical and healthcare practices and products that are used only in the treatment of mental illness."

b. "It is a group of diverse medical and healthcare practices and products not generally considered part of conventional medicine."

An older patient who has recently moved into a skilled nursing facility is displaying anxiety, fear, and loneliness after the change in living environment. Which actions by the nurse will help to decrease the patient's stress of transition? (Select all that apply.) a. Direct the patient's decisions. b. Accommodate the patient's normal routines and preferences. c. Provide the patient with resources to help in making decisions. d. Encourage the patient to discuss feelings related to relocation. e. Help the patient communicate with family members.

b. Accommodate the patient's normal routines and preferences. c. Provide the patient with resources to help in making decisions. d. Encourage the patient to discuss feelings related to relocation. e. Help the patient communicate with family members.

A student is referred to the school nurse because of an inability to engage in play with the other children, constantly playing alone with a particular toy, and apparent delayed language development. What disorder might the nurse suspect? a. Conduct disorder b. Autism spectrum disorder (ASD) c. Posttraumatic stress disorder (PTSD) d. Attention-deficit/hyperactivity disorder (ADHD)

b. Autism spectrum disorder (ASD)

The nurse is planning care for a patient who is experiencing a situational crisis. What is the most effective way for the nurse to plan care for this patient? a. Organized with follow-up b. Based on complete assessment c. Focused on long-term problems d. Developed prior to meeting with the patient

b. Based on complete assessment

The nurse understands that the patient with somatic symptom disorder may have an increased sensitivity to pain. This explanation of the patient's symptoms is based in which domain? a. Genetic domain b. Biological domain c. Humanistic domain d. Psychological domain

b. Biological domain

The nurse, caring for an adolescent patient with a personality disorder, expects the patient to experience improvement or remission of symptoms associated with the disorder. For which disorder should the nurse plan care for this patient? (Select all that apply.) a. Schizoid b. Borderline c. Obsessive-compulsive d. Schizotypal e. Avoidance

b. Borderline e. Avoidance

The spouse of a patient who is dying states, "I hope my husband finds Nirvana quickly." Which religion is most commonly associated with belief in Nirvana? a. Islam b. Buddhism c. Hinduism d. Christianity

b. Buddhism

A patient who has abused alcohol for many years experiences alterations in movement coordination. Which area of the brain should the nurse suspect is damaged due to the long-term use of alcohol? a. Hippocampus b. Cerebellum c. Cerebral cortex d. Frontal lobe

b. Cerebellum

The nurse is preparing to use integrated problem-solving during a family therapy session. Which action should the nurse complete first? a. Increasing family members' awareness of their own affective reactions to the problematic situation b. Evaluating repeated transactions that establish patterns of how, when, and to whom individuals relate within the family system c. Evaluating the family system's power distribution, communication of affect, quality of structural boundaries, and assignment of roles d. Identifying and working on unresolved conflicts from earlier relationships and personality defects that interfere with present functioning

b. Evaluating repeated transactions that establish patterns of how, when, and to whom individuals relate within the family system

The nurse is caring for a patient diagnosed with severe depression. Reflecting on the diathesis-stress model, the nurse recognizes that which event is most likely to be a factor in the development of depression? a. Losing his job last week b. His mother's suicide when he was ten years old c. Breaking up with his girlfriend the week before his diagnosis d. The death of his 12-year-old dog three years ago

b. His mother's suicide when he was ten years old

The nurse is notified of a patient who has been ordered outpatient commitment. For which eligibility criteria should the nurse assess the patient? (Select all that apply.) a. Difficulty swallowing large capsules or tablets b. History of nonadherence with adverse consequences c. Significant mental illness that interferes with participation in treatment d. Lives alone and needs someone to monitor taking medications as prescribed e. Significant risk of future deterioration that would cause harm to self or others

b. History of nonadherence with adverse consequences c. Significant mental illness that interferes with participation in treatment e. Significant risk of future deterioration that would cause harm to self or others

The nurse is leading a psychotherapy group and is establishing the norms for the group. What norms will the nurse establish that will help the group function in a productive manner? (Select all that apply.) a. Empathy for one another b. Honest communication c. Respect for one another d. Arriving on time e. Self-disclosure

b. Honest communication c. Respect for one another d. Arriving on time e. Self-disclosure

The nurse is planning care for a male patient who is homeless and diagnosed with bipolar disorder. Based on a wellness model, which service would support this patient's sociological domain? a. Medication monitoring b. Housing assistance c. Nutrition counseling d. Individual psychotherapy

b. Housing assistance

A patient is not adhering to treatment prescribed for obstructive sleep apnea (OSA). For which health problem should the nurse monitor this patient? a. Hypotension b. Hyperglycemia c. Acute renal failure d. Hypnogogic hallucinations

b. Hyperglycemia

The nurse is planning patient education on obstructive sleep apnea (OSA)? Which will the nurse include as a risk factor for OSA? a. Opioid addiction b. Hypertension c. Narcolepsy d. Hypersomnolence

b. Hypertension

The stepparent of a school-age patient with a conduct disorder wants to know the reason for attending family therapy sessions. What should the nurse explain as the goal of family therapy? a. Help the patient relive past events and related feelings. b. Increase the probability that the patient's mental health will improve. c. Speak for the patient so the parents can become more aware of the patient's potential. d. Provide an opportunity for the parents to interact with the patient in a safe environment.

b. Increase the probability that the patient's mental health will improve.

The nurse suspects that a patient who recently returned home from deployment in the Middle East is experiencing posttraumatic stress disorder (PTSD). Which finding caused the nurse to make this clinical determination? (Select all that apply.) a. Planning to search for employment in a few weeks b. Increasing the intake of alcoholic beverages since returning home c. Falling to the floor and covering the head when hearing a door bang d. Reporting being afraid to fall asleep because of recurrent nightmares e. Stating an inability to concentrate when reading or watching television

b. Increasing the intake of alcoholic beverages since returning home c. Falling to the floor and covering the head when hearing a door bang d. Reporting being afraid to fall asleep because of recurrent nightmares e. Stating an inability to concentrate when reading or watching television

An older patient takes medications prescribed by several different providers. Which will the nurse discuss with the patient as risks of polypharmacy? (Select all that apply.) a. Neuropathy b. Poor quality of life c. Decreased mobility d. Difficulties thinking e. Increased morbidity and mortality

b. Poor quality of life c. Decreased mobility d. Difficulties thinking e. Increased morbidity and mortality

The nurse is caring for an adolescent who survived a tornado and is diagnosed with posttraumatic stress disorder (PTSD). What therapy might be used to emphasize positive outcomes of trauma? a. Somatic experiencing b. Posttraumatic growth (PTG) c. Cognitive-behavioral therapy (CBT) d. Eye movement desensitization and reprocessing (EMDR)

b. Posttraumatic growth (PTG)

The nurse is caring for the family of a child diagnosed with leukemia. Which nursing interventions are most appropriate? (Select all that apply.) a. Offer financial advice b. Provide active listening c. Offer referral to a spiritual advisor d. Work with physicians to provide information e. Provide information on available support groups

b. Provide active listening c. Offer referral to a spiritual advisor d. Work with physicians to provide information e. Provide information on available support groups

The nurse has determined that a parent is experiencing chronic sorrow following the diagnosis of a child with cerebral palsy. Which action should the nurse? a. Suggest the possibility of residential care. b. Provide information about support services and groups. c. Caution the parent not to neglect the other children in the family. d. Suggest that the parent work to disengage from the emotional intensity of the experience.

b. Provide information about support services and groups.

The parents of a young adult patient who is hospitalized for depression asks what they should be doing to help. What is the most appropriate response the nurse should make? a. Refuse to talk with family members because of confidentiality restrictions. b. Provide the family with education, information, and referral resources. c. Tell the family members that their son is too old for them to be involved in his care. d. Inform the family that only the psychiatrist can discuss their son's care.

b. Provide the family with education, information, and referral resources.

The interprofessional team is discussing interventions for a patient with recurring suicidal thoughts. Which psychotherapy modalities should be considered for this patient? (Select all that apply.) a. Group therapy b. Psychodynamic therapy c. Electroconvulsive therapy d. Interpersonal psychotherapy e. Cognitive-behavioral therapy

b. Psychodynamic therapy d. Interpersonal psychotherapy e. Cognitive-behavioral therapy

The nurse is performing a family assessment. What aspect of the family assessment will assess the family's conflict management skills? a. Communication style b. Psychological c. Social functioning d. Family and community interface

b. Psychological

The nurse is reviewing the mechanism of action of medications. Which drugs should the nurse recognize as having a primary action of targeting the transporters in the presynaptic portion on the neuronal cell? (Select all that apply.) a. Opioid receptor agonists b. Serotonin-reuptake inhibitors c. Norepinephrine-reuptake inhibitors d. Selective serotonin-reuptake inhibitors e. Norepinephrine-dopamine-reuptake inhibitors.

b. Serotonin-reuptake inhibitors c. Norepinephrine-reuptake inhibitors d. Selective serotonin-reuptake inhibitors e. Norepinephrine-dopamine-reuptake inhibitors.

The nurse is caring for a school-age patient diagnosed with OCD. What medication should the nurse expect to be prescribed for this patient? a. Clomipramine (Anafranil) b. Sertraline (Zoloft) c. Methylphenidate (Ritalin) d. Olanzapine (Zyprexa)

b. Sertraline (Zoloft)

The nurse is caring for patients in the aftermath of a tornado that has damaged several homes and the local elementary school. On which area should the nurse focus when planning for the patients' care needs? a. Basic coping skills b. Short-term interventions c. Patient-nurse collaboration d. Therapeutic communication

b. Short-term interventions

The psychiatric-mental health nurse is caring for a patient with mental illness. What action by the nurse best exemplifies authenticity? a. Sitting quietly with patient b. Showing empathy toward the patient c. Showing sympathy toward the patient d. Sharing personal information with the patient

b. Showing empathy toward the patient

The nurse is concerned that a patient is at risk for suicide. Which information collected during a health history caused the nurse to have this concern? (Select all that apply.) a. Meets with friends weekly b. Spouse asked for a divorce c. Financial issues because of a job loss d. Signs of interpersonal violence e. Treatment for a chronic health problem

b. Spouse asked for a divorce c. Financial issues because of a job loss d. Signs of interpersonal violence e. Treatment for a chronic health problem

The nurse is interviewing a flood victim whose partner was killed in the disaster. What possible response should the nurse anticipate in planning patient care? a. Anticipatory grief b. Survivor guilt c. Unresolved grief d. Ambiguous loss

b. Survivor guilt

A patient's husband is dying of cancer. Which statements by the nurse are appropriate? (Select all that apply.) a. "He's going to a better place." b. "Don't worry. Everything will be okay." c. "Please let me know if I can help in any way." d. "Would you like to talk about what's happening?" e. "Do you have any questions about what is happening with your husband?"

c. "Please let me know if I can help in any way." d. "Would you like to talk about what's happening?" e. "Do you have any questions about what is happening with your husband?"

The nurse is assessing a child with depression. What is the best approach the nurse will use when assessing the child's socialization? a. "How many friends do you have at school?" b. "So you spend a lot of time with your friends?" c. "Tell me about the friends you enjoy being with." d. "You seem like a person who would have a lot of friends."

c. "Tell me about the friends you enjoy being with."

The nurse is preparing a teaching tool about the development of delirium throughout the lifespan. Which should the nurse recognize as a risk factor for the development of delirium in older adults? a. A lack of rigorous exercise that leads to decreased cerebral blood flow b. Decreased social interaction that leads to profound isolation and psychosis c. Administration of multiple medications that may cause medication interactions or toxicity d. Age-related cognitive changes that make older adults more susceptible to changes in mental status

c. Administration of multiple medications that may cause medication interactions or toxicity

The nurse is asked to differentiate delirium from dementia. Which change in mental status should the nurse explain is consistently seen in patients with delirium that is not seen in patients with dementia? a. Apraxia b. Disorientation to self c. Altered level of consciousness d. Impaired short-term memory

c. Altered level of consciousness

An adolescent patient with a major depressive disorder tells the nurse, "I used to love swimming, but I don't enjoy it at all anymore." What condition is the patient displaying? a. Aphasia b. Atypical c. Anhedonia d. Antagonism

c. Anhedonia

A patient is considering acupuncture. For which health problems has acupuncture been effective in treating? (Select all that apply.) a. Personality disorder b. Insomnia c. Anxiety d. Depression e. Schizophrenia

c. Anxiety d. Depression

The nurse assesses a patient experiencing moderate anxiety. Which finding should indicate to the nurse that the patient is experiencing a biological response to the anxiety? (Select all that apply.) a. Crying b. Irritability c. Chest pain d. Diaphoresis e. Blurred vision

c. Chest pain d. Diaphoresis e. Blurred vision

The nurse is assessing a patient with schizophrenia. Which symptoms should the nurse identify are characteristics of a formal thought disorder? (Select all that apply.) a. Echolalia b. Anosognosia c. Circumstantiality d. Cognitive constancy e. Loose associations

c. Circumstantiality e. Loose associations

A patient who recently relocated from another city reports feeling depressed but has no previous history of depression. Which therapy should be considered for this patient? a. Pharmacotherapy b. Psychological first aid c. Cognitive-behavioral therapy d. Critical incident stress debriefing

c. Cognitive-behavioral therapy

A patient with a schizophrenia spectrum disorder (SSD) is not responding to medication. Which therapy should the nurse anticipate being prescribed for this patient? a. Exercise therapy b. Social skills therapy c. Cognitive-behavioral therapy d. Alternative medication therapy

c. Cognitive-behavioral therapy

A school nurse wants to design an in-school program to help improve the mental health of the students. What topic would be an appropriate choice that would affect the most students? a. Weight control b. Drug abuse prevention c. Collaborative antibullying d. Effective studying techniques

c. Collaborative antibullying

The nurse is reviewing the different types of communication. Which should the nurse identify as a primary function of verbal communication? a. Convey immediacy b. Communicate interpersonal attitudes c. Communicate information d. Convey personality

c. Communicate information

The nurse is assessing a patient with anorexia nervosa. Which compensatory behavior should the nurse expect? a. Repeated regurgitation of food b. Episodes of binging and purging c. Excessive exercise and diuretic misuse d. Lack of interest in food and in eating food

c. Excessive exercise and diuretic misuse

During an interprofessional meeting, the nurse ensures that the placement of a patient with serious mental illness is appropriate to the patient's needs and interests. Which ethical principle is the nurse demonstrating? a. Justice b. Veracity c. Fidelity d. Beneficence

c. Fidelity

The nurse is conducting a patient education session on major depression. Which factor will the nurse explain has a strong association with major depression? a. Being male b. Schizophrenia c. First-degree relatives d. Environmental influences

c. First-degree relatives

The nurse is caring for a family of a child with a conduct disorder. What type of therapy will most benefit this family? a. Dialectical behavior therapy (DBT) b. Structural family therapy c. Functional family therapy (FFT) d. Cognitive-behavioral therapy (CBT)

c. Functional family therapy (FFT)

The nurse manager is teaching the staff nurses about the various roles assumed by members of therapeutic groups. What role will the manager identify as the person who is keeping the flow of communication open in the group? a. Elaborator b. Encourager c. Gatekeeper d. Coordinator

c. Gatekeeper

The nurse tells a patient that meeting new people sometimes causes the nurse anxiety. What is the nurse demonstrating by acknowledging feelings to the patient? a. Empathy b. Sympathy c. Genuineness d. Superficiality

c. Genuineness

The nurse is caring for a patient who fears being in social settings. What will the nurse recommend as an intervention strategy to help the patient face the fear? a. Meditation b. Physical exercise c. Group therapy d. Yoga

c. Group therapy

A patient in recovery for alcohol addiction refuses to quit smoking because it relieves stress. Having assessed that the patient is at the pre-contemplation stage of change, what would be an appropriate action for the nurse to take? a. Help the patient make a plan to stop smoking. b. Offer information regarding therapies and treatment options. c. Help the patient identify specific stressors and some alternative ways to manage them. d. Tell the patient that he is risking his life by smoking and must find a way to stop soon.

c. Help the patient identify specific stressors and some alternative ways to manage them.

The nurse is using self as a tool to enhance the therapeutic relationship with a patient experiencing a mental illness. Which theorist should the nurse recall as having introduced this concept? a. Patricia Benner b. Ida Jean Orlando c. Hildegard Peplau d. Florence Nightingale

c. Hildegard Peplau

The nurse is reviewing the pathophysiology and etiology of major depressive disorder. Which should the nurse identify about neurological structure alterations and the development of major depressive disorder? (Select all that apply.) a. An increase in the central nervous system (CNS) volume is associated with major depressive disorder. b. Excessive levels of serotonin and norepinephrine have been associated with major depressive disorder. c. Impairments to cerebral structural plasticity and neuronal cellular resilience have been noted with major depressive disorder. d. An increase in the numbers and sizes of glia and neurons in some areas of the brain have been noted with major depressive disorder. e. Dysfunction of cerebral blood flow and glucose metabolism in some areas of the brain has been noted with major depressive disorder.

c. Impairments to cerebral structural plasticity and neuronal cellular resilience have been noted with major depressive disorder. e. Dysfunction of cerebral blood flow and glucose metabolism in some areas of the brain has been noted with major depressive disorder.

During a group session, a patient expresses anger at the nurse. The nurse agrees with the patient verbally but sits with the arms and legs crossed. Which message is the nurse sending? a. Tolerance b. Empathy c. Incongruence d. Compassion

c. Incongruence

A school-age patient reports having an adolescent friend who spends time with the family and brings the patient special gifts. What should the nurse suspect may be occurring with this patient? a. Is at risk for human trafficking b. Has few friends of the same age c. Is being groomed by a pedophile d. Desires to spend time with older people

c. Is being groomed by a pedophile

A patient with a sleep phase disorder seeks medical attention for the health problem. Which medication should the nurse anticipate being prescribed for this patient? a. Zolpidem (Ambien) b. Zaleplon (Sonata) c. Ramelteon (Rozerem) d. Chloral hydrate (Noctec)

c. Ramelteon (Rozerem)

The nurse is caring for a malnourished patient with anorexia nervosa. For which potentially fatal health problem should the nurse monitor this patient? a. MAOI toxicity b. Vitamin deficiency c. Refeeding syndrome d. SSRI-induced suicidality

c. Refeeding syndrome

The nurse suggests the use of meditation before bedtime for a patient diagnosed with a sleep-wake disorder. Which type of cognitive-behavioral therapy is the nurse suggesting? a. Sleep hygiene b. Cognitive therapy c. Relaxation training d. Stimulus control therapy

c. Relaxation training

The nurse is preparing to complete an initial psychiatric assessment. What should the nurse realize is the most important part of this process? a. Providing the DSM-5 diagnosis b. Gathering information from the family c. Ruling out a medical causation of symptoms d. Evaluating the need for psychotropic medication

c. Ruling out a medical causation of symptoms

The nurse is caring for a patient with a personality disorder. For which reason should the nurse focus on safety with this patient? a. Fall injuries from antipsychotic medications are common. b. Patients with personality disorders lack safety awareness. c. Self-injurious behaviors and suicide are common. d. Patients with personality disorders are unable to make safe decisions.

c. Self-injurious behaviors and suicide are common.

The nurse is assessing a male patient who is suspected of having an eating disorder. What additional information is most important in the assessment of this patient? a. Ethnic origin b. Relationship with peers c. Serum testosterone level d. Cholesterol level

c. Serum testosterone level

The nurse is planning to assess a patient's vision and eye movements. Which action should the nurse take during this assessment? (Select all that apply.) a. Touch the cornea with a cotton wisp. b. Ask the patient to raise the eyebrows. c. Shine a light into each of the patient's eyes. d. Ask the patient to read from a card one eye at a time. e. Have the patient move the eyes through six directions.

c. Shine a light into each of the patient's eyes. d. Ask the patient to read from a card one eye at a time. e. Have the patient move the eyes through six directions.

An older patient reports feeling lonely because old friends are dying and the patient has few people to call for help. Which domain should the nurse identify as being affected in this patient? a. Cultural b. Spiritual c. Sociological d. Psychological

c. Sociological

During the assessment of a patient with a serious mental illness, the nurse learns that the patient's mother has the same disorder. Which domain is the nurse using to assess the patient? a. Cultural b. Biological c. Sociological d. Psychological

c. Sociological

The nurse is leading a group therapy session when the nurse notes some regression of learned techniques among some members of the group. What stage of group development is likely occurring? a. Conflict b. Divergent c. Termination d. Deterioration

c. Termination

The nurse is caring for a patient with somatic symptom disorder. What information is most important for the nurse to include in the report to the staff on the next shift? a. The trigger for the patient's worries b. The original source of the patient's anxiety c. The amount of time the patient talked about physical complaints d. The patient's use of abdominal breathing at the first sign of anxiety

c. The amount of time the patient talked about physical complaints

The nurse is caring for a patient with obsessive-compulsive personality disorder. Which should the nurse discuss with the patient? a. The effect of anger on perfectionism b. The need to feel superior c. The link between anxiety and perfectionism d. The need for medication

c. The link between anxiety and perfectionism

The nurse confirms that a patient who has threatened to kill a family member has a gun and ammunition at home. Which statement best describes the nurse's legal and ethical obligation? a. The nurse may not break confidentiality because of HIPAA. b. The nurse cannot disclose the information because it is considered privileged. c. The nurse has a duty to warn the patient's family member and law enforcement of the patient's plans. d. The nurse may not discuss the assessment with anyone except those caring for the patient.

c. The nurse has a duty to warn the patient's family member and law enforcement of the patient's plans.

A patient who is morbidly obese and diagnosed with somatic symptom disorder reports having a mother who was treated for alcohol use disorder. Which domain should the nurse recognize as the most useful in explaining the patient's health problems? a. Cultural domain b. Spiritual domain c. Biological domain d. Psychological domain

d. Psychological domain

Ten hours after admission following a motor vehicle crash, a patient begins to exhibit mild tachycardia, irritability, and tremors, which are followed three hours later by a grand mal seizure. Which should the nurse suspect is occurring with this patient? a. Wernicke encephalopathy b. Korsakoff syndrome c. Undetected internal bleeding d. Alcohol withdrawal syndrome

d. Alcohol withdrawal syndrome

A patient with nausea and diarrhea has not eaten anything since losing a pet to a car accident. The patient also reports having a migraine and demonstrates the inability to grieve for the pet along with a flat affect. Which personality trait should the nurse identify for this patient? a. Negative Affectivity b. Hypochondriasis c. Dysthymia d. Alexithymia

d. Alexithymia

The nurse is caring for a patient with bipolar disorder who is agitated and telling everyone he is the king of England. Which nursing diagnosis should the nurse identify as appropriate for the patient at this time? a. Self-care deficit b. Ineffective coping c. Disturbed sleep pattern d. Alteration in thought processes

d. Alteration in thought processes

An adolescent who has been "acting strangely" for the past three hours has an elevated blood pressure, tachycardia, and some arrhythmias. Which substance should the nurse suspect that the patient has been using? a. Alcohol b. Marijuana c. Heroin d. Amphetamines

d. Amphetamines

The nurse is scheduled to provide care in a rural clinic that sees patients who have been displaced. For which reason should the nurse assess the cultural domain of a patient who escaped from a home country during the NATO-Bosnian conflict? a. Determine effects of secondary trauma b. Identify symptoms of posttraumatic stress disorder c. Analyze the number and amount of support persons d. Assess for marginalization because of being an immigrant

d. Assess for marginalization because of being an immigrant

After the death of a child, a patient is experiencing depression and anxiety. For which type of therapy should the nurse prepare teaching material? a. Hypnosis b. Desensitization c. Benzodiazepines d. Psychotherapy

d. Psychotherapy

A patient reports a lack of interest in most things, but especially food. After a comprehensive examination, which disorder should the nurse suspect the patient is experiencing? a. Pica b. Bulimia nervosa c. Rumination disorder d. Avoidant/restrictive food intake disorder

d. Avoidant/restrictive food intake disorder

The nurse is caring for a patient with a history of aggressive behavior. For which reason should the nurse suspect a cardiac medication has been prescribed for this patient? a. Calcium channel blockers increase dopamine levels, decreasing the risk of violence. b. Calcium channel blockers decrease dopamine levels, decreasing the risk of violence. c. Beta-adrenergic agonists decrease norepinephrine levels, decreasing the risk of violence. d. Beta-adrenergic antagonists decrease norepinephrine levels, decreasing the risk of violence.

d. Beta-adrenergic antagonists decrease norepinephrine levels, decreasing the risk of violence

The nurse is practicing self-reflection when caring for a patient with a serious mental illness. In which way should the nurse measure the effect of self-reflection? a. By the nurse's ability to use self-disclosure b. By the patient's ability to use self-disclosure c. By changes in the patient's thoughts and behaviors d. By changes in the nurse's own thoughts and behaviors

d. By changes in the nurse's own thoughts and behaviors

An older patient who cares for a middle-aged son who is ill is concerned about personal health and who will provide the son with care if the patient becomes ill. Which factor should the nurse discuss with the patient? a. Depression b. Elder abuse c. Palliative care d. Caregiver burden

d. Caregiver burden

The nurse is planning education for a group of battered women. At which stage of the group's development will the nurse lead a discussion regarding legal solutions and alternative living arrangements? a. Conflict b. Orientation c. Termination d. Cohesiveness

d. Cohesiveness

The nurse is participating in self-reflection. Which characteristics or experiences indicate the nurse is in the third stage of this process? a. Struggle between comfort and discomfort b. Theoretical reflectivity c. Focus on thoughts and feelings d. Commitment to change

d. Commitment to change

A patient with schizophrenia takes herbal supplements along with prescribed medication to treat the condition. What type of complementary health approach (CHA) is the patient utilizing? a. Allopathic medicine b. Integrative medicine c. Alternative medicine d. Complementary medicine

d. Complementary medicine

A patient in hospice care asks the nurse to contact an estranged son and inform him of the patient's impending death. Which response to the patient's request is most appropriate? a. Refuse because the son might not be interested. b. Contact the son because he has an obligation to his dying parent. c. Refuse because contacting the son is not part of the nurse's responsibilities. d. Contact the son and attempt to assist the patient with end-of-life tasks.

d. Contact the son and attempt to assist the patient with end-of-life tasks.

The nurse is learning how to communicate effectively within a therapeutic nurse-patient relationship. What struggle is most harmful when the nurse is new to this type of relationship? a. Feeling uncomfortable with the relationship b. Feeling anxious about developing the relationship c. Falling back on knowledge learned from nursing school and not accounting for practical knowledge d. Falling back on relationship skills learned in friendships, family relationships, or other personal relationships

d. Falling back on relationship skills learned in friendships, family relationships, or other personal relationships

A nurse is caring for a patient with schizophrenia. Which accurately describes genetic and environmental causes of schizophrenia? a. One single gene is responsible for producing schizophrenia. b. The chance of both monozygotic twins having schizophrenia is 100%. c. Environmental factors do not affect the risk of developing schizophrenia. d. First-degree relatives have an increased risk of developing schizophrenia.

d. First-degree relatives have an increased risk of developing schizophrenia.

The nurse is planning a therapeutic communication session with a patient. For which reason should the nurse consider using a process recording? a. It records the nurse-patient interaction and provides a guideline for therapeutic care. b. It allows the patient to hear what the nurse stated in the nurse-patient interaction. c. It allows the nurse to hear what the patient heard in the nurse-patient interaction. d. It will be useful to reflect on and evaluate the dynamics of a specific interaction and to provide a sample of interaction for consideration in supervision or consultation with others.

d. It will be useful to reflect on and evaluate the dynamics of a specific interaction and to provide a sample of interaction for consideration in supervision or consultation with others.

The nurse is caring for a patient with a sexual disorder. What factors should the nurse self-assess periodically when caring for this patient? (Select all that apply.) a. Professional standards of care about sex b. Personal sexual practices c. Educational practices about sex d. Knowledge about sex e. Personal attitudes about sex

d. Knowledge about sex e. Personal attitudes about sex

The nurse is researching violence in the community as part of a community health assessment. Using the broken windows theory, which factor will the nurse research? a. Level of finances of the community members b. Level of parental guidance in the community members c. Level of education of both the community members and the larger society d. Level of engagement by both the community members and the larger society

d. Level of engagement by both the community members and the larger society

A patient is having trouble learning from the past, difficulty putting on clothes, and cannot recognize written words. In which lobe of the brain should the nurse suspect the patient is experiencing a dysfunction? a. Frontal b. Temporal c. Parietal d. Occipital

d. Occipital

A patient taking medication for schizophrenia asks if there are any natural supplements to help with the disorder. Which supplement should be considered for the patient? a. Kava b. Chamomile c. St. John's wort d. Omega-3 fatty acids

d. Omega-3 fatty acids

A patient with a mood disorder asks if there are any complementary therapies to help with the symptoms. For which complementary therapy should the nurse prepare teaching for this patient? a. Kava b. Ginger root c. B-12 supplements d. Omega-3 fatty acids

d. Omega-3 fatty acids

An older patient with an anxiety disorder asks why the healthcare provider is reluctant to prescribe an antianxiety medication. Which should the nurse explain as an adverse effect of this type of medication commonly seen in older adults? a. Dizziness b. Decreased libido c. Gastrointestinal distress d. Paradoxical reaction

d. Paradoxical reaction

The nurse is caring for a patient diagnosed with posttraumatic stress disorder (PTSD). In this disorder, which element of the nervous system should the nurse identify as malfunctioning? a. Central b. Peripheral c. Sympathetic d. Parasympathetic

d. Parasympathetic

The nurse is caring for a patient with a somatic symptom disorder. What is the best action by the nurse to intervene effectively with this patient? a. Address patient anxiety at a later time. b. Help the patient express a decreased degree of comfort regarding physical symptoms. c. Encourage the patient's expression of feelings symbolically through physical symptoms. d. Recognize and understand the patient conceptualizes the symptoms to be physical in nature.

d. Recognize and understand the patient conceptualizes the symptoms to be physical in nature.

A patient with a history of depression intends to take sleeping pills and "just end it all." In which level of the Murphy-Moller wellness model is the patient demonstrating characteristics? a. Recovery b. Restoration c. Rehabilitation d. Relapse

d. Relapse

A patient who has just lost all family photos in a flood asks why the suffering is as intense as a neighbor, who lost an entire house and all possessions. What should the nurse say to help the patient understand the intensity of a loss? a. The age of the person is the most important factor in determining the intensity of the loss. b. The gender of the person is the most important factor in determining the intensity of the loss. c. The value of the loss is the most important factor in determining the intensity of a person's loss. d. The meaning of the loss is the most important factor in determining the intensity of the response to loss.

d. The meaning of the loss is the most important factor in determining the intensity of the response to loss.

The nurse reviews the Murphy-Moller wellness model before assessing a patient. On which element should the nurse focus when assessing the sociological domain? (Select all that apply.) a. Environment b. Relationships with others c. Religious faith d. Moral development e. Nutrition

a. Environment b. Relationships with others

The nurse is performing an initial suicide risk assessment. What questions will the nurse include in this assessment? (Select all that apply.) a. "Have you ever felt like wanting to hurt yourself?" b. "Do you have thoughts about how you would harm yourself?" c. "Have you ever thought about how you would commit suicide?" d. "Do you have thoughts about the consequences that result from suicide?" e. "Do you have thoughts about how your family will react if you commit suicide?"

a. "Have you ever felt like wanting to hurt yourself?" b. "Do you have thoughts about how you would harm yourself?" c. "Have you ever thought about how you would commit suicide?"

The nurse is caring for a group of patients who are all active duty military. Which patient statement should the nurse identify as increasing the patient's risk for suicide? a. "I drink alcohol when I need to relax." b. "My children stress me out sometimes." c. "I graduated college, but my grades were not great." d. "I have never been deployed to a war zone."

a. "I drink alcohol when I need to relax."

The nurse determines that a patient is experiencing anxiety. Which patient statement caused the nurse to make this clinical decision? (Select all that apply.) a. "I feel jumpy most of the time." b. "I am worried that I will get fired at work." c. "I am planning a trip to visit family in a few weeks." d. "I can't watch television because it makes me nervous." e. "I avoid flowers because I'm afraid I'll get stung by a bee."

a. "I feel jumpy most of the time." b. "I am worried that I will get fired at work." d. "I can't watch television because it makes me nervous." e. "I avoid flowers because I'm afraid I'll get stung by a bee."

The nurse is caring for a patient diagnosed with dissociative identity disorder (DID). Which statement by the patient best describes the manifestations of this disorder? (Select all that apply.) a. "I feel like my body is here but my mind is not." b. "I have chronic pain, not a psychological problem." c. "I can't really find any words to describe my feelings." d. "I sometimes feel like I am floating in the air looking down at myself." e. "I cannot recall the events that happened during certain periods of time."

a. "I feel like my body is here but my mind is not." d. "I sometimes feel like I am floating in the air looking down at myself." e. "I cannot recall the events that happened during certain periods of time."

The nurse is teaching skills used to improve communication among family members. Which statement made by the family member indicates that the teaching has been effective? a. "I feel sad when you talk to me like that." b. "You talk down to me and that makes me sad." c. "We need to stop talking to each other like that." d. "You always talk to me like that and it makes me sad."

a. "I feel sad when you talk to me like that."

The nurse is assessing patients for risk for suicide. According to the Level of Suicidal Severity Index, which patient statement indicates the greatest risk for suicide? a. "I have no reason to live anymore, and suicide is my only option." b. "I think committing suicide will help to solve all the problems I have." c. "I plan to commit suicide by overdosing on prescription pain medication." d. "I sometimes think about how suicide might solve my problems, but I would never do it."

a. "I have no reason to live anymore, and suicide is my only option."

The nurse cares for patients on a mental health unit. Which statement by the nurse indicates that deontology is being used to provide care? (Select all that apply.) a. "I need to report this error because it is the right thing to do." b. "I think patients have a right to refuse certain psychotropic medications." c. "All patients need flu shots so that we can all be healthy during flu season." d. "All patients should be treated equally whether they have insurance or not." e. "The doctor needs to obtain informed consent so the patient can make a good decision."

a. "I need to report this error because it is the right thing to do." b. "I think patients have a right to refuse certain psychotropic medications." d. "All patients should be treated equally whether they have insurance or not." e. "The doctor needs to obtain informed consent so the patient can make a good decision."

The nurse instructs a patient about a newly prescribed antidepressant medication. Which patient statement indicates that teaching has not been effective? a. "I should expect heartburn and abdominal pain." b. "I should report itching to the healthcare provider." c. "I will report any changes in ability to participate in my treatment." d. "I will contact the healthcare provider if I notice a change in mental functioning."

a. "I should expect heartburn and abdominal pain."

he nurse starts a new job on an inpatient mental health care unit. Which statement best demonstrates that the nurse has engaged in the process of self-reflection? a. "I will ask for support from colleagues when I need it." b. "I took a course in self-defense so I can take care of myself." c. "I know there is a fine line between the patients and the staff." d. "I can maintain proper distance by engaging in therapeutic interventions."

a. "I will ask for support from colleagues when I need it."

A patient who is of Native American descent wants to have a shaman come to the hospital to perform a healing ceremony at the bedside. Using Leininger's theory, in which way should the nurse respond? a. "I will help arrange the visit for you." b. "That is not an acceptable part of hospital procedures." c. "It might interfere with your current course of treatment." d. "It is not a good idea because it might upset the other patients."

a. "I will help arrange the visit for you."

A patient with postpartum depression says, "I can't seem to get out of bed and take care of my baby." Which responses by the nurse best demonstrate therapeutic communication? (Select all that apply.) a. "It sounds like you are having a hard time." b. "The baby blues are normal for every woman after birth." c. "Have you felt like this before, after the birth of your oldest child?" d. "Would I be correct in saying that you are sleeping more than usual?" e. "I had this condition after my son's birth. It is best to seek help from family members."

a. "It sounds like you are having a hard time." c. "Have you felt like this before, after the birth of your oldest child?" d. "Would I be correct in saying that you are sleeping more than usual?"

A patient with an anxiety disorder wants to know if a complementary approach would be helpful. Which factors should the nurse use to determine whether a complementary health approach (CHA) may be beneficial? (Select all that apply.) a. Current treatment regimen b. History of use and success of CHA c. Assessment of the patient's current level of anxiety d. History of patient adherence to a treatment regimen e. Assessment of the patient's beliefs regarding CHA

a. Current treatment regimen b. History of use and success of CHA c. Assessment of the patient's current level of anxiety

The nurse is caring for a patient who is experiencing dysfunctional grieving following the traumatic death of spouse due to an automobile accident. The nurse also experienced the death of a loved one in the same manner. What statement made by the nurse best exemplifies the nurse using empathy toward the patient? a. "Many people may feel angry when faced in this situation. How do you feel?" b. "Many people may feel angry when faced in this situation. I know I felt very angry." c. "I am so sorry you feel angry about this situation. How do you diffuse your anger?" d. "I am so sorry you feel angry about this situation. I feel bad you have to experience this."

a. "Many people may feel angry when faced in this situation. How do you feel?"

The nurse is working in the emergency department (ED) of a local hospital. Which response by a family member would alert the nurse to the greatest risk for displaying aggression? a. "My brother is in a lot of pain and can't get comfortable." b. "I am worried about my husband's condition after his heart attack." c. "I am nervous about the upcoming surgery to repair my broken arm." d. "My mother is very short of breath, but the medication seems to be helping."

a. "My brother is in a lot of pain and can't get comfortable."

A patient having difficulty focusing at work has cuts on the arms in various stages of healing. Which statements by the patient indicate that an evaluation for a borderline personality disorder should be conducted? (Select all that apply.) a. "My grades and work performance have always been erratic." b. "I often drink alcohol to relieve stress." c. "It's hard to maintain friendships. People seem to get tired of me." d. "I get bored really easily." e. "I get so anxious sometimes, I feel like I can't breathe."

a. "My grades and work performance have always been erratic." b. "I often drink alcohol to relieve stress." c. "It's hard to maintain friendships. People seem to get tired of me."

A parent is concerned because a school-age child who experienced a crisis is wetting the bed at night. Which statements should the nurse make about possible therapies? (Select all that apply.) a. "School-based interventions may help your child." b. "Cognitive-behavioral therapy may be beneficial for your child." c. "Interventions that support parental involvement may help your child." d. "Cognitive therapy that addresses thought processes involved in crisis may help your child." e. "Behavioral therapy to address the relationship between mood and behavior may help your child."

a. "School-based interventions may help your child." b. "Cognitive-behavioral therapy may be beneficial for your child." c. "Interventions that support parental involvement may help your child."

A patient is accompanied by the spouse to a healthcare provider appointment. Which statements by the spouse indicate to the nurse that the patient is in stage 3 of Alzheimer disease? (Select all that apply.) a. "She sometimes forgets to take her medicine." b. "All she does is lie in bed and cry." c. "She's always been good at math, but she has trouble sometimes with things like counting the correct change." d. "She'll ask me the same question several times in a row." e. "Yesterday she forgot the word for coffee."

a. "She sometimes forgets to take her medicine." b. "All she does is lie in bed and cry." c. "She's always been good at math, but she has trouble sometimes with things like counting the correct change." d. "She'll ask me the same question several times in a row."

A family member of a patient with Alzheimer disease (AD) asks if the disease is genetic. Which response should the nurse make? (Select all that apply.) a. "Some forms of AD have a genetic pattern." b. "Early-onset AD is more likely familial than late-onset AD." c. "One-third to one-half of all AD may be the genetic form." d. "One-quarter to one-third of all AD may be the genetic form." e. "There is not any evidence of a genetic link with AD."

a. "Some forms of AD have a genetic pattern." b. "Early-onset AD is more likely familial than late-onset AD." c. "One-third to one-half of all AD may be the genetic form."

An older patient is worried about having dementia because it takes longer to solve problems, perform multiple tasks, and remember while grocery shopping. Which is the appropriate response by the nurse? (Select all that apply.) a. "The ability to multitask might decline with age, but this is not an indication of dementia." b. "Many people have episodic memory problems as they age. These symptoms do not indicate serious cognitive dysfunction." c. "If it is taking you longer to solve problems than it used to, you may need to be assessed for other signs of dementia." d. "Forgetting what you wanted to get at the store is a matter of concern. I think you should have a cognitive evaluation." e. "A decline in mental processing speed is a normal part of aging, so taking longer with problem solving is not unusual as we get older."

a. "The ability to multitask might decline with age, but this is not an indication of dementia." b. "Many people have episodic memory problems as they age. These symptoms do not indicate serious cognitive dysfunction." e. "A decline in mental processing speed is a normal part of aging, so taking longer with problem solving is not unusual as we get older."

The nursing is preparing a presentation on the relationship of ligands to receptors. Which explanation should the nurse include in the presentation? a. "The drug ligand works like a key that fits into a lock, which is the receptor protein in the neuron." b. "The drug ligand is the door that opens into the house, which is the neuron." c. "The receptor protein is like a flame that ignites the stove, which is the drug ligand." d. "The drug ligand works like a comforter, providing a protective cover for the receptor protein."

a. "The drug ligand works like a key that fits into a lock, which is the receptor protein in the neuron."

A spouse of a patient recovering from a head injury asks why the patient easily agitated, impulsive, and cannot focus. Which response should the nurse make? a. "The injuries may have damaged the prefrontal cortex of the brain, causing these symptoms." b. "The injuries may have damaged the occipital lobe of the brain, causing these symptoms." c. "The injuries may have damaged the parietal lobe of the brain, causing these symptoms." d. "The injuries may have damaged the cerebellum of the brain, causing these symptoms."

a. "The injuries may have damaged the prefrontal cortex of the brain, causing these symptoms."

A patient newly diagnosed with dementia due to Parkinson disease asks what causes the disorder. What should the nurse explain is the etiology of this disorder? a. Death of neurons b. Presence of Lewy bodies c. Inheritance of a dominant gene d. Inappropriately treated traumatic brain injury (TBI)

a. Death of neurons

The nurse learns that a patient continues to work full-time despite having a physical disability. Which characteristic of the health belief model is this patient exhibiting? a. Resiliency b. Vulnerability c. Barriers to action d. Benefits to action

a. Resiliency

The nurse is participating in psychological debriefing of a patient who is experiencing a crisis. Which statements will the nurse include when providing education to the patient? (Select all that apply.) a. "Transportation is available if you cannot drive." b. "You may want to use a calendar to help you track your response to the crisis." c. "Do you have a spiritual leader that you would like me to contact for you?" d. "The sedative that the healthcare provider prescribed is a common treatment." e. "The relaxation techniques that the healthcare provider suggested are a common treatment."

a. "Transportation is available if you cannot drive." b. "You may want to use a calendar to help you track your response to the crisis." c. "Do you have a spiritual leader that you would like me to contact for you?" e. "The relaxation techniques that the healthcare provider suggested are a common treatment."

The nurse who is leading a psychotherapy group has established a therapeutic and trusting environment. What questions will the nurse ask to encourage the group to reflect on its functioning? (Select all that apply.) a. "What was your role in the meeting today?" b. "What was the least engaging part of the meeting?" c. "What was the most engaging part of the group for you today?" d. "With which members did you feel most comfortable speaking?" e. "With which members did you feel least comfortable speaking?"

a. "What was your role in the meeting today?" b. "What was the least engaging part of the meeting?" c. "What was the most engaging part of the group for you today?"

The nurse is participating in an interprofessional team conference. Which statement indicates that a care provider has a societal attitude that can influence care? a. "You people always seem to think you know more than me, and I'm the doctor." b. "The patient agrees to stay in the hospital for treatment despite wanting to go home." c. "I appreciate having an opportunity to review the patient's physical therapy treatment plan." d. "Although the prescribed medications are often used for this disease process, the results have not been very good for this patient."

a. "You people always seem to think you know more than me, and I'm the doctor."

A patient diagnosed with a mental illness dropped out of high school, lives with an unemployed mother, and is unable to maintain employment. Which social determinants of health should the nurse identify that could impact this patient's long-term health status? (Select all that apply.) a. Access to education b. Quality of job training c. Residential segregation d. Access to job opportunities e. Access to emerging technologies

a. Access to education b. Quality of job training d. Access to job opportunities

The nurse is planning care for a patient with depression. Which should the nurse identify as the long-term goal for this patient? a. Achieving complete remission b. Maintaining adherence with therapy c. Promoting regular patterns of activity d. Restoring to appropriate weight

a. Achieving complete remission

During a community visit, the nurse notes that ashtrays are absent from the home of a patient who smokes. Which stage of change does this patient's action demonstrate? a. Action b. Preparation c. Maintenance d. Contemplation

a. Action

A patient is homeless as a result of an addiction to alcohol. Which should the nurse consider about this patient's health problem? a. Addictive behavior involves the limbic system. b. Addictive behavior indicates character flaws. c. Addictive behavior has a variety of neurological patterns. d. Addictive behavior is related to dysfunctional parent-child relationships.

a. Addictive behavior involves the limbic system.

The nurse is caring for a patient with a history of violent behaviors. Which nursing interventions are most likely to prevent the patient from responding with aggressive or violent behavior? (Select all that apply.) a. Address the patient's anxiety as needed. b. Determine the patient's coping mechanisms. c. Ensure the patient's needs are met in a timely manner. d. Assess the patient's family history of violent behaviors. e. Avoid intervention with the patient if the patient is displaying aggression.

a. Address the patient's anxiety as needed. b. Determine the patient's coping mechanisms. c. Ensure the patient's needs are met in a timely manner.

The nurse is conducting research on violence in the community for a community health assessment. Which socioeconomic factors should the nurse include in the research? (Select all that apply.) a. Age b. Race c. Poverty d. Inequality e. Substance use

a. Age c. Poverty d. Inequality e. Substance use

The school nurse is preparing to meet with the parent of a student to discuss increasing aggressive behavior. Which risk factors should the nurse be prepared to discuss? (Select all that apply.) a. Age b. Ethnicity c. Substance use d. Parental occupation e. History of head injury

a. Age c. Substance use e. History of head injury

The nurse is asked which personality characteristics are associated with increased rates of suicide. Which characteristics should the nurse include in the response? (Select all that apply.) a. Aggressiveness b. Impulsivity c. Passivity d. Compulsivity e. Assertiveness

a. Aggressiveness b. Impulsivity

The nurse is planning care for a newly admitted patient. Which concepts are considered essential in establishing a therapeutic nurse-patient relationship? (Select all that apply.) a. An emphasis on patient-centered care b. The patient's view of health and mental health c. The nurse's ability to sympathize with the patient d. Unconditional positive regard for the patient and family e. The nurse's ability to make judgments regarding the patient's condition

a. An emphasis on patient-centered care b. The patient's view of health and mental health d. Unconditional positive regard for the patient and family

The nurse is creating a teaching tool about the various theoretical frameworks that promote the provision of culturally competent care. Which concept of the Giger and Davidhizar's Transcultural Assessment Model should the nurse include in the tool? (Select all that apply.) a. Analysis of genetic and ethnic variations b. Assessment of both the nuclear and extended family c. Assessment of the ways the patient performs self-care d. Assessment of the influence of environment on self-control e. Encourage the patient to freely offer what might improve the patient's health

a. Analysis of genetic and ethnic variations b. Assessment of both the nuclear and extended family d. Assessment of the influence of environment on self-control

The nurse is participating in a group of peers to address patient safety. What purpose will this group most likely serve? a. Analyzing issues b. Practicing new skills c. Increasing knowledge d. Developing interpersonal skills

a. Analyzing issues

An adolescent patient has been raised from infancy in a series of foster homes and has difficulty forming significant and stable emotional connections. For which potential responses or disorders should the nurse assess this patient? (Select all that apply.) a. Anxiety b. Suicidality c. Drug abuse d. Depression e. Schizophrenia

a. Anxiety b. Suicidality c. Drug abuse d. Depression

The nurse reviews the ANA Code of Ethics. In which way should the nurse apply this code to the care of individuals with mental illness? (Select all that apply.) a. As a framework to help nurses solve ethical dilemmas. b. As an affirmation of nursing's nonnegotiable ethical standards. c. As an answer to specific ethical challenges which nurses face in clinical practice. d. As a reference for how the nursing profession sees itself in terms of its obligation to society. e. As a brief description of the ethical obligations and duties of all persons who enter the nursing profession.

a. As a framework to help nurses solve ethical dilemmas. b. As an affirmation of nursing's nonnegotiable ethical standards. d. As a reference for how the nursing profession sees itself in terms of its obligation to society. e. As a brief description of the ethical obligations and duties of all persons who enter the nursing profession.

The nurse is beginning a therapeutic relationship with a patient. Which nursing action is an example of the orientation phase of this relationship? (Select all that apply.) a. Assessing the patient's limitations b. Clarifying the patient's expectations for care c. Educating the patient about the patient's health problem d. Identifying resources that will be used in the first interaction e. Reviewing the patient's history in the patient's medical record

a. Assessing the patient's limitations c. Educating the patient about the patient's health problem

The nurse is preparing a teaching tool about shift work disorder to be shared during the next unit staff meeting. Which information should the nurse include in this tool? (Select all that apply.) a. Avoid working excessive overtime. b. Arrive to work as rested as possible. c. Use caffeine to stay awake while driving home. d. Exercise regularly, especially if job is sedentary. e. Allow at least a 5-hour sleep period without interruption.

a. Avoid working excessive overtime. b. Arrive to work as rested as possible. d. Exercise regularly, especially if job is sedentary. e. Allow at least a 5-hour sleep period without interruption.

The nurse is observing a family therapy session that is structured to emphasize working on unresolved emotional reactivity to the parents. Which theoretical framework best describes this approach to family therapy? a. Bowenian b. Structural c. Cognitive-behavioral d. Integrated problem-solving

a. Bowenian

A patient who lost a grandchild over a year ago recently stopped taking antidepressant medication. When assessing the patient, which finding would suggest a relapse of the patient's depression? a. Changes in the patient's sleep patterns b. Increased patient talk about her grandchild c. Continuing patient participation in a grief support group d. Patient involvement in creating a memorial scholarship fund

a. Changes in the patient's sleep patterns

A patient has a PRN order for a medication to promote sleep. Which action should the nurse take when providing this medication? (Select all that apply.) a. Check the PRN protocol. b. Assess the patient's need. c. Assess the patient's safety. d. Review the patient's diagnosis. e. Explore the patient's expectations.

a. Check the PRN protocol. b. Assess the patient's need. c. Assess the patient's safety.

The nurse is planning a patient teaching session on relaxation techniques and stress management. What technique should the nurse use when providing this education? (Select all that apply.) a. Cognitive b. Effective c. Affective d. Behavioral e. Psychological

a. Cognitive c. Affective d. Behavioral

While leading a group therapy session for adults with substance use disorders, the nurse notes that one patient defies the nurse and questions the nurse's authority. In which stage is this group functioning? a. Conflict b. Challenge c. Opposition d. Disagreement

a. Conflict

The nurse reviews the various theories of psychological development and the understanding of self. Which should the nurse identify as a purpose of Harry Stack Sullivan's self-system? (Select all that apply.) a. Connection b. Protection c. Self-esteem d. Self-definition e. Communication

a. Connection b. Protection d. Self-definition

The nurse is caring for a patient with an eating disorder. For which domain should the nurse plan interventions to address stigma and myths associated with this disorder? a. Cultural b. Spiritual c. Sociological d. Psychological

a. Cultural

The nurse is caring for a patient who is experiencing a crisis. What is the priority during the patient's initial crisis assessment? a. Ensuring safety b. Classifying the type of trauma c. Identifying treatment and referral needs d. Assessing the risks associated with the crisis

a. Ensuring safety

The nurse is caring for a patient with neurocognitive disease (NCD) who is suspected of having depression. Which should the nurse keep in mind regarding depression and neurocognitive decline? (Select all that apply.) a. Depression may occur as a result of frustration associated with neurocognitive decline. b. Depression is a universal finding in patients with neurocognitive decline. c. Depression is easy to diagnose in those with neurocognitive decline. d. Depression may occur as a result of the pathology of neurocognitive decline. e. Depression is difficult to diagnose in those with neurocognitive decline.

a. Depression may occur as a result of frustration associated with neurocognitive decline. d. Depression may occur as a result of the pathology of neurocognitive decline. e. Depression is difficult to diagnose in those with neurocognitive decline.

The nurse is planning care for a patient with anorexia nervosa (AN). Which action is most important prior to implementing this patient's plan of care? a. Determining patient readiness b. Developing a therapeutic relationship c. Educating the patient about the disorder e. Establishing specific, realistic, and measurable goals

a. Determining patient readiness

The nurse is caring for a patient in crisis who has recently returned from military service in an active war zone. When initially assessing this patient, which concepts will the nurse apply regarding the type of crisis the patient is experiencing? (Select all that apply.) a. Determining the client's adaptation to the crisis guides the priority nursing actions. b. Determining the trauma category the client is experiencing guides the priority nursing action. c. Providing the client with education regarding type I trauma related to his or her military service. d. Providing the client with education regarding type II trauma related to his or her military service. e. Determining the client's degree of trust in trusted authorities during his or her military service.

a. Determining the client's adaptation to the crisis guides the priority nursing actions. b. Determining the trauma category the client is experiencing guides the priority nursing action. d. Providing the client with education regarding type II trauma related to his or her military service. e. Determining the client's degree of trust in trusted authorities during his or her military service.

The nurse is completing an assessment on a patient with a serious mental illness. Which type of intervention best illustrates the nurse's action? a. Diagnostic b. Evaluative c. Therapeutic d. Educational

a. Diagnostic

The nurse is assessing a patient with obsessive-compulsive personality disorder. Which should the nurse expect to assess in this patient? a. Difficulty completing projects b. A sense of spontaneity c. Open expression of feelings d. Ability to tolerate mistakes

a. Difficulty completing projects

The nurse realizes that a patient has recently experienced several losses. Which loss should the nurse identify as intangible? (Select all that apply.) a. Dignity b. Privacy c. Property d. Freedom e. Self-esteem

a. Dignity b. Privacy d. Freedom e. Self-esteem

The nurse is assessing a patient with a bipolar disorder. Which factor should the nurse recall that can interact with individual biology to cause recurrences of bipolar illness? (Select all that apply.) a. Disruption in social rhythms b. Adequate family functioning c. Social support from peers and family d. Availability of someone to speak with e. Nonadherence with medication regimen

a. Disruption in social rhythms e. Nonadherence with medication regimen

The nurse is caring for a patient with Alzheimer disease. Which medication should the nurse anticipate being prescribed to help delay the rate of cognitive decline? a. Donepezil (Aricept) b. Quetiapine (Seroquel) c. Valproic acid (Depakote) d. Escitalopram (Lexapro)

a. Donepezil (Aricept)

The nurse is reviewing medications prescribed for a patient. What aspects of medication administration should the nurse realize are influenced by the expected half-life of the drug? (Select all that apply.) a. Dosage b. Acid-base balance c. Frequency of administration d. Expected duration of drug in the body e. Anticipated duration of targeted effects

a. Dosage c. Frequency of administration d. Expected duration of drug in the body e. Anticipated duration of targeted effects

The home health nurse is assigned to a new patient with a major neurocognitive disorder (NCD). Which will the nurse include in the initial assessment when visiting the patient at home? (Select all that apply.) a. Eating habits b. Ability to pay bills c. Ability to shower and shave d. Internet use e. Medication adherence

a. Eating habits b. Ability to pay bills c. Ability to shower and shave e. Medication adherence

The nurse is reviewing data collected during the assessment of a patient with an eating disorder. Which information should indicate to the nurse that the patient is experiencing binge-eating disorder (BD)? (Select all that apply.) a. Eating more rapidly than normal b. Bingeing due to feelings of boredom c. Bingeing as a dietary restraint d. Eating alone because of embarrassment e. Feeling disgusted about a lack of control over food consumed

a. Eating more rapidly than normal d. Eating alone because of embarrassment e. Feeling disgusted about a lack of control over food consumed

The nurse is planning care for a patient with anorexia nervosa (AN). Which interventions should the nurse include to help reduce this patient's level of stress? (Select all that apply.) a. Encourage listening to favorite music. b. Talk about a favorite pastime. c. Ask patient to limit the intake of sodas. d. Help with confronting the issue that causes stress about eating. e. Permit patient to be alone when feeling overwhelmed.

a. Encourage listening to favorite music. b. Talk about a favorite pastime. c. Ask patient to limit the intake of sodas.

The nurse is planning care for a patient with depression. Which interventions should the nurse implement to promote safety for this patient? (Select all that apply.) a. Encourage self-help. b. Listen nonjudgmentally. c. Give reassurance and information. d. Engage families in the treatment plan. e. Encourage appropriate professional help.

a. Encourage self-help. b. Listen nonjudgmentally. c. Give reassurance and information. e. Encourage appropriate professional help.

The nurse is caring for a patient with schizophrenia. Which intervention will increase the patient's likelihood of taking the prescribed psychotropic medications? a. Encourage the patient to use measures to manage side effects. b. Encourage the patient to take all medications at the same time. c. Give family members information about the patient's medication. d. Give the patient a pamphlet explaining the positive effects of psychotropic medication.

a. Encourage the patient to use measures to manage side effects.

The nurse is planning care for a patient with bipolar disorder. Which should the nurse make a priority when planning patient care goals? a. Establishing a therapeutic alliance b. Improving mood symptoms through psychotherapy c. Educating patient about the trajectory of improvement d. Determining the therapeutic efficacy of the patient's lithium therapy

a. Establishing a therapeutic alliance

The nurse reviews the various types of psychotherapy. Which should the nurse identify as a universal practice principle among the different theories and methodologies? (Select all that apply.) a. Establishing goals b. Using effective medications c. Establishing a treatment time frame d. Determining behavioral objectives e. Establishing a therapeutic alliance

a. Establishing goals e. Establishing a therapeutic alliance

The nurse is serving as the co-leader of a psychotherapeutic group. What is the purpose of revealing distortions in interpersonal relationships during group psychotherapy? a. Examine and resolve issues. b. Effectively handle emotions. c. Learn how to stifle emotions. d. Process and examine emotions.

a. Examine and resolve issues.

The nurse is reviewing the stages of the sexual response cycle. In which stage are the neurotransmitters acetylcholine, dopamine, and nitric oxide released? a. Excitement b. Plateau c. Orgasm d. Resolution

a. Excitement

The nurse is establishing a therapeutic relationship with a patient. For which reason should the nurse use nonverbal communication with this patient? a. Express emotion. b. Detract from verbal messages c. Avoid the use of verbal messages. d. Terminate the therapeutic relationship.

a. Express emotion.

The nurse is discussing the benefits of play therapy with the parents of a preschool-age patient. Which skills should the nurse explain that play therapy helps to develop? (Select all that apply.) a. Expressing feelings b. Working through conflicts c. Interrupting patterned behavior d. Improving problem-solving skills e. Improving eye-hand coordination

a. Expressing feelings b. Working through conflicts d. Improving problem-solving skills

A patient on suicide precautions who was not assessed every 15 minutes jumps off the bed and breaks an ankle. For which reason should thee nurse be charged with negligence? (Select all that apply.) a. Failure to properly monitor b. Failure to communicate risk c. Failure to assess risk of suicide d. Failure to maintain proper boundaries e. Failure to provide sufficient documentation

a. Failure to properly monitor c. Failure to assess risk of suicide

The nurse is planning a teaching tool that focuses on medication safety for older patients. Which information should the nurse include? a. Falls, drowsiness, or confusion can occur as side effects. b. Sedation is a desirable side effect. c. Standard dosages are well tolerated by older adults. d. Older adults are less prone to side effects of medications than other age groups.

a. Falls, drowsiness, or confusion can occur as side effects.

The nurse in a clinic is caring for a patient whom she suspects has a somatic symptom or related disorder. Which risk factors will the nurse include in the assessment? (Select all that apply.) a. Female gender b. High achieving c. Lower socioeconomic status d. Older age e. Recently divorced

a. Female gender c. Lower socioeconomic status d. Older age

The nurse is caring for a patient admitted with a dissociative identity disorder. Which symptoms should the nurse expect to assess? (Select all that apply.) a. Flashbacks b. Self-mutilation c. Urinary retention d. Seizures e. Inability to hear

a. Flashbacks b. Self-mutilation

The nurse is caring for a patient with bulimia nervosa (BN). Which medication should the nurse expect to be prescribed for this patient? a. Fluoxetine (Prozac) b. Methylphenidate (Ritalin) c. Fluphenazine (Prolixin) d. Diphenhydramine (Benedryl)

a. Fluoxetine (Prozac)

The nurse prepares teaching for a patient prescribed an anticholinesterase medication. Which information should the nurse include? (Select all that apply.) a. Foods to avoid b. Potential side effects c. Cost of the medication d. How the medication works e. Reason for taking the medication

a. Foods to avoid b. Potential side effects d. How the medication works e. Reason for taking the medication

A patient with a dissociative disorder was missing for two weeks and returned home, not knowing any time had passed. Which condition associated with dissociative disorders should the nurse identify that this patient experienced? a. Fugue b. Amnesia c. Alexithymia d. Derealization

a. Fugue

The nurse is caring for a school-age female patient diagnosed with leukemia. Using Piaget's cognitive theory of development, in which way should the nurse interact with this patient? (Select all that apply.) a. Give clear information regarding treatment. b. Recognize and respect her need for increased privacy. c. Show the child items or equipment that will be used in treatment. d. Assess for and encourage the child to participate in favorite activities. e. Provide opportunity to touch or play with medical equipment prior to assessments and procedures.

a. Give clear information regarding treatment. c. Show the child items or equipment that will be used in treatment. d. Assess for and encourage the child to participate in favorite activities.

The nurse is establishing a therapeutic nurse-patient relationship. Which barrier should the nurse avoid when interacting with the patient? a. Giving advice b. Voicing doubt c. Giving information d. Seeking clarification

a. Giving advice

A patient is suspected of having a somatic symptom or related disorder. Which symptoms should the nurse expect to assess that are consistent with the psychological domain of this disorder? (Select all that apply.) a. Hallucinations b. Compulsions c. Flashbacks d. Irritability e. Withdrawal

a. Hallucinations d. Irritability e. Withdrawal

A patient with a sleep disorder reports taking valerian to sleep at night. For which adverse effect should the nurse assess the patient? (Select all that apply.) a. Headache b. Dizziness c. Renal toxicity d. Hepatotoxicity e. Gastrointestinal disturbances

a. Headache b. Dizziness e. Gastrointestinal disturbances

The nurse suspects that a patient who was treated for posttraumatic stress disorder (PTSD) in the past is experiencing a relapse. Which findings did the nurse use to make this clinical determination? (Select all that apply.) a. Heavy smoking b. Difficulty sleeping c. Working overtime d. Unusual weight gain e. Excessive alcohol intake

a. Heavy smoking b. Difficulty sleeping d. Unusual weight gain e. Excessive alcohol intake

The nurse is caring for a patient with an anxiety disorder. Which action should the nurse plan to minimize the risk of relapses? (Select all that apply.) a. Help the patient identify triggers b. Identify symptoms of a pending attack c. Actions to take when symptoms occur d. Individuals to contact when symptoms occur e. Immediately take an extra dose of medication

a. Help the patient identify triggers b. Identify symptoms of a pending attack c. Actions to take when symptoms occur d. Individuals to contact when symptoms occur

A patient with dissociative identify disorder (DID) is prescribed complementary and alternative therapy. Which should the nurse expect to be used with this patient? (Select all that apply.) a. Hypnosis b. Art therapy c. Music therapy d. Dance therapy e. Acupuncture

a. Hypnosis b. Art therapy c. Music therapy d. Dance therapy

The nurse knows that depression is the primary abnormal mood state for patients who are diagnosed with bipolar disorder. What other mood state might the nurse recognize in the patient with bipolar disorder? a. Hypomania b. Hypersexuality c. Inappropriate intimacy d. Exaggerated sense of importance

a. Hypomania

The nurse is assessing a patient with bulimia nervosa (BN). Which characteristics should the nurse associate with the psychological domain? a. Impulsivity b. Rituals c. Loss of libido d. Early menarche

a. Impulsivity

A nurse is caring for patient with depression who is exhibiting vegetative signs. Which symptom is associated with vegetative signs of depression? a. Insomnia b. Helplessness c. Hopelessness d. Suicidal ideation

a. Insomnia

An older adult patient is distressed because of not accomplishing planned life goals. Based on Erikson's developmental stages, which conflict should the nurse suspect this patient is experiencing? a. Integrity vs. despair b. Generativity vs. stagnation c. Identity vs. identity confusion d. Autonomy vs. shame and doubt

a. Integrity vs. despair

The nurse is developing a relationship with a patient. Which key concept should the nurse recall that ensures the establishment of professional boundaries? a. Intentional development of the relationship b. Use of caring in the relationship c. Shared goals of the relationship d. Shared knowledge occurring in the relationship

a. Intentional development of the relationship

The nurse is preparing to interview a patient. Which process should the nurse use as a tool when developing a therapeutic relationship with this patient? a. Interaction b. Equal sharing c. Mutual knowledge d. The process of intimate disclosures

a. Interaction

The nurse is caring for a patient with restless leg syndrome (RLS). Which symptoms or complications in the psychological domain should the nurse monitor in this patient? (Select all that apply.) a. Irritability b. Disruption of bed partner's sleep c. Inability to concentrate due to discomfort d. Fragmented sleep e. Anxiety and mood changes

a. Irritability c. Inability to concentrate due to discomfort

A patient is diagnosed with generalized anxiety disorder. Which manifestation should the nurse expect to assess in this patient? (Select all that apply.) a. Irritability b. Indulgence c. Withdrawal d. Perspiration e. Constricted pupils

a. Irritability c. Withdrawal d. Perspiration

A patient approaches the nurse in a public area and asks why notices for upcoming preventive appointments have stopped being sent to the patient's home address. What should the nurse suspect once it is validated that these notices were mailed to the patient as planned? a. Isolation b. Intimidation c. Using privilege d. Emotional abuse

a. Isolation

The nurse at a community health clinic is conducting a mental health assessment on a patient with a history of depression. Which environmental factor should the nurse recognize as a risk factor for suicide? a. Isolation from others b. Chronic illness c. Apprehensive anxiety d. Working two jobs

a. Isolation from others

The nurse is assessing an adolescent with depression Which action demonstrates the nurse is being sensitive to this patient's needs? a. Listening to the patient discuss feelings b. Using closed-ended questions with the patient c. Asking for details to demonstrate interest in the patient d. Avoiding the use of silence with the patient to decrease anxiety

a. Listening to the patient discuss feelings

A patient taking medication for bipolar disorder develops slurred speech and muscle weakness. Which health problem should the nurse consider is occurring with this patient? a. Lithium toxicity b. Steven-Johnson syndrome c. Aplastic anemia d. QT interval prolongation

a. Lithium toxicity

The nurse caring for a patient with a schizophrenia spectrum disorder (SSD). For which event in the sociological domain should the nurse anticipate for this patient? a. Loss of job b. Re-establishment of identity c. Return to independent functioning d. Distraction from symptoms

a. Loss of job

The nurse is preparing a presentation on serious mental illness. Which health problem should be included? (Select all that apply.) a. Major depressive disorder b. Schizophrenia c. Adjustment reaction d. Bipolar disorder e. Social phobia

a. Major depressive disorder b. Schizophrenia d. Bipolar disorder

The nurse is caring for a patient with a schizophrenia spectrum disorder (SSD). Which areas should the nurse include when assessing this patient? (Select all that apply.) a. Medical history b. Pain assessment c. Home safety check d. Suicide assessment e. Height and weight assessment

a. Medical history d. Suicide assessment e. Height and weight assessment

A nurse at the local health department has been asked to give a presentation on stress and anxiety to a group of seniors at the local senior center. Which event should the nurse include as an example of a common stressor among older adults? (Select all that apply.) a. Medicare cutting benefits b. Local grocery store closing c. A friend fell and broke a hip d. Grandchild ran away from home e. Bridge tournament starts tomorrow

a. Medicare cutting benefits b. Local grocery store closing c. A friend fell and broke a hip d. Grandchild ran away from home

The nurse is caring for a patient suspected of having Alzheimer disease. In which area should the nurse assess the patient for alteration in functioning? (Select all that apply.) a. Memory b. Executive function c. Visual acuity d. Language e. Behavior and personality

a. Memory b. Executive function d. Language e. Behavior and personality

The nurse is caring for a patient with somatic symptom disorder. Which order should the nurse question before completing? (Select all that apply.) a. Morphine 4 mg PO prn pain b. Alprazolam 2 mg PO prn anxiety c. Teach patient breathing techniques d. Psychotherapy with family involvement 5. Walk 15-30 minutes per day in neighborhood

a. Morphine 4 mg PO prn pain b. Alprazolam 2 mg PO prn anxiety

A patient asks for assistance to stop using illegal substances. Which technique should the nurse use prior to planning this patient's treatment approach? a. Motivational interviewing b. Establish therapeutic goals c. Identify social determinants of care d. Locate support persons in the patient's community

a. Motivational interviewing

The nurse is working in a facility that uses music as therapy. Which should the nurse expect from this therapy? a. Music therapy decreases blood pressure and heart rate in patients with coronary heart disease. b. Music therapy uses high frequency music that is played for an hour at a time. c. Music therapy decreases cholesterol and homocysteine levels in patients with coronary heart disease. d. Music therapy uses low frequency music that is played for two hours at a time.

a. Music therapy decreases blood pressure and heart rate in patients with coronary heart disease.

The nurse is planning care for a patient with mental illness. When formulating the patient's nursing diagnosis, which element should the nurse include? (Select all that apply.) a. Naming the problem b. Etiology of the problem c. Identifying the disease or disorder d. Providing appropriate intervention according to the identified problem e. Providing data regarding the problem or the signs and symptoms present

a. Naming the problem b. Etiology of the problem e. Providing data regarding the problem or the signs and symptoms present

The nurse is caring for a patient who was sexually abused repeatedly while being held hostage. For which manifestation should the nurse assess to determine if the patient is experiencing complex posttraumatic stress disorder (CPTSD)? (Select all that apply.) a. Negative self-concept b. Fear of going outdoors alone c. Severe emotional dysregulation d. Refusal to eat food prepared by others e. Persistent disturbances in relationships

a. Negative self-concept c. Severe emotional dysregulation e. Persistent disturbances in relationships

The nurse cares for a patient with a schizophrenia spectrum disorder (SSD). Which intervention is most important when planning lifestyle interventions for this patient? a. Nicotine replacement b. Spiritual counseling c. Reduction of triggers d. Reminders and repetition

a. Nicotine replacement

The nurse is caring for a patient with a personality disorder who has manifestations of emotional reactivity. According to the biological perspective, which neurotransmitter is most likely affected? a. Norepinephrine b. Serotonin c. Acetylcholine d. Dopamine

a. Norepinephrine

The nurse is caring for a patient with a binge-eating disorder. In which way should the nurse characterize this patient's appearance? a. Obesity b. Hunger c. Anorexia d. Emaciation

a. Obesity

An older Hispanic female patient is concerned that her spouse who has dementia is no longer able to speak English and will therefore not be able to get care if she dies. Which is the best response by the nurse? a. Offer to try to locate services that provide Spanish-speaking clinicians. b. Suggest that the family might want to pray for a solution to the problem. c. Explain that the family will need to provide the care because care for Spanish-speaking patients is not readily available. d. Explain that the idea of care that addresses a dementia patient's declining language abilities is unreasonable and it is important that the spouse adjust her expectations.

a. Offer to try to locate services that provide Spanish-speaking clinicians.

The nurse is caring for a patient with borderline personality disorder (BPD) who is experiencing psychotic symptoms. Which medication should the nurse anticipate being prescribed for the patient? (Select all that apply.) a. Olanzapine (Zyprexa) b. Lorazepam (Ativan) c. Ripiprazole (Abilify) d. Haloperidol (Haldol) e. Thiothixene (Navane)

a. Olanzapine (Zyprexa) c. Ripiprazole (Abilify)

The nurse is interacting with a patient. During which stage does the nurse make an introduction and identify the purpose of the interaction? a. Orienting b. Evaluating c. Identifying d. Implementing

a. Orienting

The nurse is caring for a patient with somatic symptom disorder. Which biological symptoms should the nurse expect to assess in this patient? (Select all that apply.) a. Pain b. Anxiety c. Gastrointestinal distress d. Paralysis e. Blurred vision

a. Pain c. Gastrointestinal distress e. Blurred vision

A patient is being evaluated for a mental health disorder. Which sensory function should the nurse assess as part of the initial examination? (Select all that apply.) a. Pain b. Smell c. Pressure d. Temperature e. Proprioception

a. Pain c. Pressure d. Temperature e. Proprioception

The nurse is planning care for a patient with a dissociative disorder. Which nursing intervention helps promote stress reduction and healthy coping in this patient? a. Perform safety checks at each healthcare interaction. b. Discuss activities that patients can do that eliminate the need for safety provisions. c. Review the patient's daily personal journal to assess appetite. d. Teach nonpharmacologic strategies for reducing pain.

a. Perform safety checks at each healthcare interaction.

The nurse is caring for a patient with schizophrenia spectrum disorder who is taking olanzapine (Zyprexa). Which food or drug should the nurse instruct the patient to avoid while taking this medication? a. Phenytoin b. Grapefruit juice c. Dexamethasone d. Garlic supplements

a. Phenytoin

The nurse is preparing a teaching tool about the nursing process. Which elements should the nurse include? (Select all that apply.) a. Planning b. Diagnosis c. Evaluation d. Assessment e. Communication

a. Planning b. Diagnosis c. Evaluation d. Assessment

A patient with posttraumatic stress disorder (PTSD) agrees to eye movement desensitization and reprocessing (EMDR) therapy. Which should the nurse explain that the therapist will do during a therapy session? (Select all that apply.) a. Play musical tones b. Apply tone tapping c. Use finger movement d. Provide reading material e. Employ mindfulness strategies

a. Play musical tones b. Apply tone tapping c. Use finger movement

A patient reports having a test to examine brain function. Which type of test should the nurse recognize the patient is describing? a. Positron emission test (PET) b. Computerized tomography (CT) c. Magnetic resonance imaging (MRI) d. Transcranial doppler (TCD)

a. Positron emission test (PET)

The nurse is caring for a baby who has been abandoned. Which alternative form of attachment linked to sexual identify may occur in this child? (Select all that apply.) a. Preoccupied b. Authoritarian c. Fearful d. Permissive e. Dismissive

a. Preoccupied c. Fearful e. Dismissive

The nurse wants to use self when caring for a patient. Which strategy should the nurse use if the patient is suffering? a. Presence b. Empathy c. Sympathy d. Mindfulness

a. Presence

The nurse is planning care for a patient with an eating disorder. Which should the nurse identify as goals of therapy for this patient? (Select all that apply.) a. Prevent relapse b. Treat medical comorbidities c. Maintain safety d. Restore the patient to a healthy weight e. Monitor and restrict family interactions

a. Prevent relapse b. Treat medical comorbidities c. Maintain safety d. Restore the patient to a healthy weight

The nurse is interviewing a patient whose spouse recently died. For which symptoms should the nurse anticipate a referral to a mental health provider? (Select all that apply.) a. Prolonged insomnia b. Crying c. Severe weight loss d. Anger e. Suicidal ideation

a. Prolonged insomnia c. Severe weight loss e. Suicidal ideation

A patient with moderate Alzheimer disease (AD) is prescribed memantine (Namenda). Which should the nurse understand about the mechanism of action for this medication? a. Protects cells against excess glutamate by partially blocking NMDA c-receptors. b. Slows the degradation of acetylcholine, thereby increasing concentration of the neurotransmitters in the cerebral cortex. c. Protects cells against excess NMDA by partially blocking glutamate c-receptors. d. Slows the degradation of dopamine, thereby increasing concentration of the neurotransmitters in the cerebral cortex.

a. Protects cells against excess glutamate by partially blocking NMDA c-receptors.

The nurse is caring for a patient with depression who expresses hopelessness. How can the nurse use spirituality to comfort the patient? (Select all that apply.) a. Provide a quiet place for prayer or for reading religious texts. b. Schedule activities around designated times for prayer or religious observances. c. Encourage the patient to use his or her beliefs to deal with the feelings of hopelessness. d. Encourage the patient to seek the reason for the feelings of hopelessness by attending group therapy. e. Suggest the patient discuss the reason for the feelings of hopelessness with the patient's clergy member or spiritual advisor.

a. Provide a quiet place for prayer or for reading religious texts. b. Schedule activities around designated times for prayer or religious observances. c. Encourage the patient to use his or her beliefs to deal with the feelings of hopelessness.

The nurse is meeting with the parents of a patient recently diagnosed with autism spectrum disorder (ASD). What is an appropriate goal for this first meeting? a. Provide information on ASD. b. Improve the child's school behavior. c. Determine the causes of the child's ASD. d. Determine an appropriate medication regimen for the child.

a. Provide information on ASD.

The nurse is caring for a patient with acute anxiety. What interventions are most beneficial for preventing escalation of anxiety to aggression? (Select all that apply.) a. Provide needed food and drink. b. Assist the patient without delay. c. Show a calm, positive, friendly demeanor. d. Express sympathy and concern for the patient. e. Provide education on reducing anxiety.

a. Provide needed food and drink. b. Assist the patient without delay. c. Show a calm, positive, friendly demeanor.

A patient is experiencing gender dysphoria. Which action should the nurse take when caring for this patient? a. Provide nonjudgmental care. b. Encourage living as the individual's assigned gender. c. Avoid patient discussions of hormonal treatment. d. Discourage gender reassignment surgery.

a. Provide nonjudgmental care.

An older patient reports having had panic attacks "for years." Which actions should the nurse take to help this patient? (Select all that apply.) a. Provide relaxation training. b. Suggest an exercise program. c. Recommend a medication consultation. d. Teach the patient how to use diversion tactics. e. Tell the patient that benzodiazepines would be helpful.

a. Provide relaxation training. b. Suggest an exercise program. c. Recommend a medication consultation. d. Teach the patient how to use diversion tactics.

The nurse is preparing information about the Tidal Model of care. Which should the nurse identify as a commitment in this model? (Select all that apply.) a. Provide transparency. b. Become the apprentice. c. Develop genuine curiosity. d. Teach appropriate language. e. Determine the next steps in recovery.

a. Provide transparency. b. Become the apprentice. c. Develop genuine curiosity. e. Determine the next steps in recovery.

The nurse is caring for a patient who is having a great deal of difficulty going to sleep and staying asleep. Which sleep hygiene strategies should the nurse implement for this patient? (Select all that apply.) a. Providing relaxation with music before bed b. Making sure the room is dark to facilitate sleeping c. Ensuring that the environment is quiet by reducing staff noise d. Arranging for the provider to order benzodiazepines at bedtime e. Coordinating care to avoid waking the patient during the night if possible

a. Providing relaxation with music before bed b. Making sure the room is dark to facilitate sleeping c. Ensuring that the environment is quiet by reducing staff noise e. Coordinating care to avoid waking the patient during the night if possible

The nurse is planning care for an older patient with depression. Which should the nurse make a priority? a. Screening the patient for suicide risk b. Assessing the patient for low-grade depressive symptoms c. Assessing to distinguish depressive symptoms from a grief response d. Promoting physical activity and maintain meaningful social connections for wellness

a. Screening the patient for suicide risk

The nurse is preparing a teaching tool to be distributed during a group session of community members being treated for posttraumatic stress disorder (PTSD). Which information about resilience should the nurse include? (Select all that apply.) a. Seek out support from others b. Avoid large groups of people c. Adopt positive coping strategies d. Continue participation in a support group e. Take additional medication doses when stressed

a. Seek out support from others c. Adopt positive coping strategies d. Continue participation in a support group

The nurse is caring for a patient who is from a different culture than the nurse. According to Campinha-Bacote, what is the nurse's first action when providing culturally aware care to the patient? a. Self-examination b. Self-promotion c. Self-recognition d. Self-introduction

a. Self-examination

The nurse is caring for a patient who is diagnosed with depression. Which areas of the brain should the nurse recall are involved in the regulation of both mood and emotion? (Select all that apply.) a. Septum b. Amygdala c. Basal ganglia d. Hippocampus e. Pre-frontal

a. Septum b. Amygdala d. Hippocampus

The nurse is caring for a patient experiencing severe symptoms of posttraumatic stress disorder (PTSD). Which medication should the nurse anticipate being prescribed for this patient? a. Sertraline b. Gabapentin c. Propranolol d. Hydroxyzine

a. Sertraline

he nurse is asked to discuss the use of boundaries in the therapeutic nurse-patient relationship. What examples should the nurse include as boundary violations? (Select all that apply.) a. Sexual misconduct b. Last-minute appointment changes c. Inappropriate self-disclosure d. Giving or receiving small gifts e. Disclosing bits of personal information

a. Sexual misconduct c. Inappropriate self-disclosure

The nurse visits the home of a patient being treated for obsessive-compulsive disorder. Which observation indicates to the nurse that interventions to help the patient have been effective? a. Sits and reads the newspaper b. Moves books around a shelf c. Washes hands every 5 minutes d. Aligns loose coins on a counter according to size

a. Sits and reads the newspaper

A grieving patient asks what to expect if participating in a support group. What benefits can the nurse include when responding? (Select all that apply.) a. Social support b. Connection to resources c. Validation of experience d. Direction on how to grieve e. The opportunity to share his story

a. Social support b. Connection to resources c. Validation of experience e. The opportunity to share his story

The nurse is planning care for a patient with narcolepsy. Which should the nurse keep in mind regarding medication choices for this disorder? (Select all that apply.) a. Sodium oxybate decreases daytime sleepiness. b. Traditional stimulants are given to increase wakefulness. c. Modafinil is used as a first-line treatment. d. Diphenhydramine is often the first line drug because of its safety profile. e. Antipsychotics may be prescribed to reduce cataplexy.

a. Sodium oxybate decreases daytime sleepiness. b. Traditional stimulants are given to increase wakefulness. c. Modafinil is used as a first-line treatment.

The nurse is preparing to assess a patient who may have dementia. On which area will the nurse focus when assessing the patient's mental status? (Select all that apply.) a. Speech b. Attitude c. Emotional status d. Substance use e. Cognitive functioning

a. Speech b. Attitude c. Emotional status e. Cognitive functioning

The nurse is preparing a training program for newly hired hospice nurses. What end-of-life needs are should the nurse address in this training? (Select all that apply.) a. Spiritual b. Housing c. Physical d. Financial e. Emotional

a. Spiritual c. Physical e. Emotional

The nurse is discussing different options for therapy with a patient who has been diagnosed with bipolar disorder. Which should the nurse explain as a characteristic of interpersonal and social rhythm therapy? a. Stabilize the daily routine b. Motivating through planning c. Gaining an understanding of self d. Providing support and feedback to peers

a. Stabilize the daily routine

A long-term care facility is undergoing renovations, which will be a problem for patients with dementia. What particular patient need is most likely to be affected? a. Stable environment b. Patient comfort c. Scheduling of admissions d. Patient safety

a. Stable environment

The leadership team of a mental health facility is meeting to discuss the budget for the next fiscal year. Which issue should be a priority to ensure patients receive safe and ethical care? a. Staffing patterns b. Patient admission process c. Access to healthcare providers d. Follow-up process after discharge

a. Staffing patterns

The nurse is asked to provide a brief presentation comparing the types of biologically based therapies. Which will the nurse include in the presentation? (Select all that apply.) a. Supplements b. Herbal products c. Naturopathic medicine d. Homeopathic medicine e. Ayurveda

a. Supplements b. Herbal products

The nurse caring for a patient with a schizophrenic spectrum disorder (SSD) notes that the patient imitates the nurse's movements during the assessment. Which symptom is the patient demonstrating? a. Echolalia b. Echopraxia c. Loose associations d. Automatic obedience

b. Echopraxia

Family members of a patient on life support are unable to decide whether to continue or withdraw the patient's life support. Which ethical skill does the nurse implement when discussing the situation with the charge nurse and nurse manager? (Select all that apply.) a. The ability to IDENTIFY ethical issues b. The ability to find needed RESOURCES c. The ability to ANTICIPATE ethical issues d. The ability to work within defined professional LIMITATIONS e. The ability to understand how PERSONAL experiences impact care

a. The ability to IDENTIFY ethical issues b. The ability to find needed RESOURCES c. The ability to ANTICIPATE ethical issues

The nurse is reviewing the etiology of schizophrenia. What statement is accurate regarding the brain structure of individuals with schizophrenia? a. The brain displays changes in the hippocampal area. b. The brain displays no changes in the mesocortical pathway. c. The brains display no changes from those without schizophrenia. d. The brain displays changes in the bilateral occipital lobe cortical gray matter.

a. The brain displays changes in the hippocampal area.

The nurse is reviewing Maslow's hierarchy of needs and its relationship to the theories of human development and the concept of self. What concepts are true regarding self-actualization? (Select all that apply.) a. The level is multi-dimensional. b. It is the lowest level on the hierarchy of needs. c. It is the highest level on the hierarchy of needs. d. The level can be achieved after basic needs are met. e. The level involves comfort with one's life meaning.

a. The level is multi-dimensional. c. It is the highest level on the hierarchy of needs. d. The level can be achieved after basic needs are met. e. The level involves comfort with one's life meaning.

The nurse is caring for a patient who has been diagnosed with sexual masochism. Which information about this paraphilia should the nurse keep in mind when planning care for this patient? a. The main components are pain, loss of control, and humiliation. b. The erotic target is an object or body part other than the genitals. c. It includes touching or rubbing against another person without consent. d. Sexual arousal is associated with causing mental or physical suffering to another person.

a. The main components are pain, loss of control, and humiliation.

The nurse is considering reporting suspected abuse by a patient's stepfather, but does not want to jeopardize relationship with the patient's mother. What legal ramifications should the nurse consider? a. The nurse could lose the nursing license. b. If a report is made, the stepfather could sue the nurse for false arrest. c. If a report is made, the mother could accuse the nurse of alienation of affection. d. If a report is not made, the agency could be liable for any medical expenses.

a. The nurse could lose the nursing license.

The nurse suspects that a patient described as having "a sudden case of Alzheimer disease" may have general amnesia. Which characteristics make the nurse suspect general amnesia? (Select all that apply.) a. The patient cannot remember any personal information. b. The patient has been wandering away from home. c. The patient describes a "detachment" from her mind. d. The patient feelings of "disconnection" with her home. e. The patient has developed an alternate personality.

a. The patient cannot remember any personal information. b. The patient has been wandering away from home.

A patient needs to change an unwanted or undesired behavior. Which response indicates to the nurse that the patient is in the pre-contemplation stage of the stages of change model? (Select all that apply.) a. The patient denies having a problem. b. The patient acknowledges the problem. c. The patient has no desire to change the problem. d. The patient begins to make plans to change the problem. e. The patient begins to seriously consider changing the problem.

a. The patient denies having a problem. c. The patient has no desire to change the problem.

A patient with depression taking paroxetine (Paxil) 10mg PO daily for the past month reports restlessness and abdominal pain. Which factor should the nurse consider during the assessment? a. The patient has been taking medication with grapefruit juice at breakfast. b. The patient is experiencing severe side effects and will be taken off the medication. c. The patient is taking too much of the drug and is experiencing unexpected side effects. d. The patient expresses that she is nervous that the side effects will increase with continued use.

a. The patient has been taking medication with grapefruit juice at breakfast.

The nurse is assessing the patient with schizophrenia. Which should the nurse recognize as negative symptoms associated with the disorder? (Select all that apply.) a. The patient is withdrawn. b. The patient has a blunted affect. c. The patient reports auditory hallucinations. d. The patient reports lack of motivation. e. The patient introduces himself as Pope Francis.

a. The patient is withdrawn. b. The patient has a blunted affect. d. The patient reports lack of motivation.

The nurse is caring for a patient with acute mania and is planning goals and outcomes for the patient's care. Which goal meets all the requirements for a properly stated patient goal? a. The patient will sleep 6 hours a night within 3 days. b. The nurse will assess the patient for acute mania daily. c. The nurse will provide the patient at least 3 meals per day. d. The patient will have a normal mood pattern by October 15.

a. The patient will sleep 6 hours a night within 3 days.

A nurse manager experiences symptoms of anxiety when preparing for staff meetings. Which nonpharmacologic treatment should be considered to help with the manager's symptoms? a. Thiamine therapy b. Low-fat diet c. Omega-3 fatty acids d. Calcium supplements

a. Thiamine therapy

A patient has been court-ordered to take antipsychotic medications due to concerns of being a danger to self. In which situation might this action be justified? (Select all that apply.) a. To alleviate suffering b. In an emergency situation c. When in the patient's best interest d. To foster the therapeutic relationship e. To care a patient who cannot care for himself

a. To alleviate suffering b. In an emergency situation c. When in the patient's best interest e. To care a patient who cannot care for himself

The nurse is caring for a patient with binge-eating disorder (BED). For which reason should the nurse expect the healthcare provider to prescribe orlistat (Xenical) in conjunction with cognitive-behavioral therapy for this patient? a. To help reduce dietary fat absorption and, therefore, binge-eating disorder (BED) symptoms b. To increase the ability to lose weight and help with disordered thinking c. To reduce the depression that is associated with the inability to lose weight d. To provide significant weight reduction and provide adequate remission from binging

a. To help reduce dietary fat absorption and, therefore, binge-eating disorder (BED) symptoms

The nurse is caring for patients who have experienced traumatic events. Which should the nurse identify as a goal of care for these patients? (Select all that apply.) a. Understand symptoms as attempts to cope. b. Provide regular medication education and monitoring. c. Collaborate between provider and consumer at all phases of service delivery. d. Protect patients with a history of trauma from physical harm and re-traumatization. e. Focus on what has happened to the person rather than what is wrong with the person.

a. Understand symptoms as attempts to cope. c. Collaborate between provider and consumer at all phases of service delivery. d. Protect patients with a history of trauma from physical harm and re-traumatization. e. Focus on what has happened to the person rather than what is wrong with the person.

The nurse is caring for a patient with a schizophrenia spectrum disorder (SSD). Which neurochemical explanation should the nurse recall about the risk of symptoms increasing? (Select all that apply.) a. Use of drugs that increase dopaminergic activity b. A decrease in dopaminergic activity in the brain c. An increase in gray matter in the anterior cingulate and hippocampus d. A reduction in the structural gray matter of the bilateral frontal lobe and amygdala e. Mitochondrial reduction of density and volume, including defective mitochondrial energy production

a. Use of drugs that increase dopaminergic activity d. A reduction in the structural gray matter of the bilateral frontal lobe and amygdala e. Mitochondrial reduction of density and volume, including defective mitochondrial energy production

The nurse is planning care for a patient. Which therapeutic approach should the nurse use to demonstrate personal awareness? a. Use of self b. Use of empathy c. Use of open-ended questions d. Use of therapeutic communication

a. Use of self

A patient with a schizophrenia spectrum disorder (SSD) takes olanzapine. Which should be routinely monitored in this patient? a. Weight b. Anxiety c. Vital signs d. Physical competence

a. Weight

The nurse prepares to assess a patient using the Cultural Formulation Interview (CFI) form. Which should the nurse keep in mind that might influence the patient's responses to the questions? (Select all that apply.) a. Worldview b. Upbringing c. Cultural values and beliefs d. Personal values and beliefs e. Healthcare provider expectations

a. Worldview b. Upbringing c. Cultural values and beliefs d. Personal values and beliefs

A staff member who is unlicensed assistive personnel (UAP) is overheard saying that a patient with a mental illness is not really "sick." Which response should the nurse make to the UAP? a. "Patients with mental illness believe they are ill." b. "A mental illness disrupts thinking and daily functioning." c. "Mental illnesses are more debilitating than physical illnesses." d. "Since so few people have mental illnesses, it really does not matter."

b. "A mental illness disrupts thinking and daily functioning."

The nurse manager is providing education to staff regarding the prevention of workplace aggression. Which statement, made by a staff nurse, demonstrates that teaching has been effective? a. "Cyberbullying does not typically occur in the hospital environment." b. "Bullying may occur in social groups as well as professional groups." c. "Type 4 aggression may occur if a staff member is injured by a patient." d. "Type 1 aggression may occur if a staff member is injured by another staff member."

b. "Bullying may occur in social groups as well as professional groups."

A patient with Alzheimer disease is prescribed memantine (Namenda). Which statement should the nurse include when teaching about this medication? a. "Memantine works by increasing activation of glutamine transmission." b. "Memantine works by reducing activation of glutamine transmission." c. "Memantine will enhance breakdown of acetylcholine." d. "Memantine will inhibit breakdown of acetylcholine."

b. "Memantine works by reducing activation of glutamine transmission."

The nurse manager is reviewing risk factors for workplace aggression and risk factors for aggression related to the psychiatric patient population. Which statement by the staff nurse indicates that teaching has been effective? a. "Patients who are being treated for depression have an increased risk for aggression." b. "Patients who have been diagnosed with dementia have an increased risk for aggression." c. "Patients who are receiving group therapy for somatic symptom disorders have an increased risk for aggression." d. "Patients who are receiving cognitive-behavioral therapy for eating disorders have an increased risk for aggression."

b. "Patients who have been diagnosed with dementia have an increased risk for aggression."

The nurse is engaged in a discussion about cultural competence. Which statement should the nurse make to differentiate race from ethnicity? a. "Race is determined by the color of the individual's skin, whereas ethnicity is genetically determined." b. "Race is determined by genetics and characteristics based on geography, whereas ethnicity includes race." c. "Race is determined by common characteristics, whereas ethnicity is based on geographical characteristics." d. "Race is determined by cultural heritage, whereas ethnicity is determined by the color of the individual's skin."

b. "Race is determined by genetics and characteristics based on geography, whereas ethnicity includes race."

A patient who takes Advil PM (ibuprofen plus diphenhydramine) every night for sleep along with the use of CPAP for sleep apnea reports feeling "hung over" in the morning. What response should the nurse make? a. "Are you using the CPAP regularly the way it was ordered?" b. "That medication is not recommended for people with sleep apnea." c. "That's a safe over-the-counter medication. What other meds do you take?" d. "I will let the physician know so that a new sleep study can be prescribed for you."

b. "That medication is not recommended for people with sleep apnea."

A patient with Alzheimer disease (AD) is prescribed donepezil (Aricept). What medication teaching will the nurse include to both the patient and patient's family? a. "The medication should be taken twice daily, once in the morning and once at night." b. "The dose will be started low and will be gradually increased until the medication is no longer helpful." c. "The medication should be taken three times daily with every meal." d. "The dose will be started high and will be gradually decreased to make sure that side effects from the medication are tolerable."

b. "The dose will be started low and will be gradually increased until the medication is no longer helpful."

A patient who is prescribed an antidepressant asks how the drug works. Which is the best response by the nurse? a. "The medication will target neurotransmitters in the stomach." b. "The medication will target specific cells in the central nervous system." c. "The medication will enter your bloodstream and find the targeted area." d. "The medication will target your central nervous system as a whole."

b. "The medication will target specific cells in the central nervous system."

The nurse educator is reviewing the impact and risk factors for situational crisis among the psychiatric patient population with the staff. Which statements indicate that the staff members are able to identify patients at risk for this type of crisis? (Select all that apply.) a. "The teenager who is graduating high school in 3 weeks." b. "The older adult who recently immigrated from Mexico." c. "The middle-aged adult who just received a diagnosis of depression." d. "The young adult who is arrested and incarcerated for driving under the influence." e. "The young adult who is experiencing psychosis after giving birth to a healthy baby."

b. "The older adult who recently immigrated from Mexico." c. "The middle-aged adult who just received a diagnosis of depression." d. "The young adult who is arrested and incarcerated for driving under the influence." e. "The young adult who is experiencing psychosis after giving birth to a healthy baby."

It is reported during an interprofessional conference that a patient being treated for a mental health disorder refuses to continue group therapy. Which response should the nurse make? a. "Recovery is probably unlikely for this patient." b. "The patient is experiencing a setback, not an end to recovery." c. "The patient should be told that group therapy is the only route to recovery." d. "The patient should be punished for refusing to participate."

b. "The patient is experiencing a setback, not an end to recovery."

The nurse is caring for a patient who is verbally aggressive. Which response should the nurse make to the patient? a. "Why are you so mad at me?" b. "This behavior is unacceptable. I am here to help you." c. "If you continue with this behavior, I will have to restrain you." d. "I am going to call your healthcare provider for medication to calm you down."

b. "This behavior is unacceptable. I am here to help you."

The nurse is assessing a patient's suicidal ideations and level of risk. Which question should the nurse use to convey empathy? a. "Do you have any firearms?" b. "What struggles in your life are upsetting you?" c. "Do you ever feel like you want to hurt yourself?" d. "Is there anything you could do now to make yourself feel better?"

b. "What struggles in your life are upsetting you?"

A patient with anxiety seeks treatment in the community clinic. Which question should the nurse ask about the patient's use of complementary health approaches (CHAs)? a. "You don't take any herbal supplements, do you?" b. "Which herbal or dietary supplements are you taking?" c. "Don't laugh, but do you take any herbal supplements to relax?" d. "I don't believe in them but you might, so do you use any herbal supplements?"

b. "Which herbal or dietary supplements are you taking?"

The nurse is assessing a patient who recently lost a spouse. Which patient statement should indicate to the nurse that the patient is experiencing spiritual distress? a. "Who is responsible for this?" b. "Why did this happen to me?" c. "What should I do about this?" d. "Who will take care of this problem?"

b. "Why did this happen to me?"

The nurse is establishing a therapeutic environment with a newly admitted patient with a serious mental illness. Which statement should the nurse use to demonstrate empathetic communication? a. "I feel really bad that you have this disorder." b. "You appear upset. Do you want to talk about it?" c. "You appear upset. Why do you feel this way?" d. "Many people have this disorder. You will feel better in no time."

b. "You appear upset. Do you want to talk about it?"

The nurse is caring for a patient with Alzheimer disease. Which category of medication should the nurse anticipate being prescribed for this patient? (Select all that apply.) a. Anticholinesterase agonist b. Cholinesterase inhibitor c. Anticholinergic inhibitor d. NMDA receptor agonist e. NMDA receptor antagonist

b. Cholinesterase inhibitor e. NMDA receptor antagonist

A patient taking an opioid medication reports not feeling addicted. However, the patient does experience hand tremors if a dose is missed. What is the nurse's best response? a. "You may be addicted to the medication, but not necessarily physically dependent." b. "You may be physically dependent on the medication, but not necessarily addicted." c. "The symptoms you describe are indicative of addiction, whether you feel you are or not." d. "The symptoms you describe relate to your disease state and are not normal."

b. "You may be physically dependent on the medication, but not necessarily addicted."

The nurse uses the ANA's Code of Ethics for Nurses as a reference for an ethical dilemma. What does the ANA's Code of Ethics provide for this situation? a. The answer to the ethical dilemma b. A framework for addressing the ethical dilemma c. A choice for various decisions regarding the ethical dilemma d. The evaluation of the decision made regarding the ethical dilemma

b. A framework for addressing the ethical dilemma

A patient who was administered a benzodiazepine one hour ago is now agitated and angry. What does the nurse suspect the patient is experiencing? a. A target effect b. A paradoxical response c. An anaphylactic reaction d. An idiosyncratic response

b. A paradoxical response

The nurse is asked to explain the relationship between the nervous system and substance abuse and addiction. Which information should the nurse include in response? (Select all that apply.) a. Changes in neuroanatomy cause the behavior seen in addiction. b. Addictive substances act on the mesolimbic system of the brain. c. Addictive substances stimulate surges of dopamine. d. Addictive substances act on the mesocerebral system of the brain. e. Changes in neurochemistry cause behaviors seen in addiction.

b. Addictive substances act on the mesolimbic system of the brain. c. Addictive substances stimulate surges of dopamine. e. Changes in neurochemistry cause behaviors seen in addiction.

The nurse at an outpatient substance abuse treatment facility that uses methadone is giving a patient education session. Which should the nurse explain as the goal of methadone treatment? a. Address the physiological symptoms associated with dependency of opioids/opiates b. Address the cravings associated with withdrawal from opioids/opiates c. Address the cravings associated with withdrawal from amphetamines d. Address the physiological symptoms associated with dependency of amphetamines

b. Address the cravings associated with withdrawal from opioids/opiates

A patient has been brought to the emergency department (ED) with a Stevens-Johnson rash. What might the nurse consider as a possible cause? a. Target reaction to a drug b. Allergic reaction to a drug c. Paradoxical reaction to a drug d. Idiosyncratic reaction to a drug

b. Allergic reaction to a drug

A patient who attends group therapy feels good when offering something to help another person in the group. What therapeutic factor of group dynamics is the patient describing? a. Catharsis b. Altruism c. Universality d. Instillation of hope

b. Altruism

The nurse is hired to care for patients on a mental health care unit. Which emotion should the nurse expect when using authenticity when providing patient care? a. Sadness b. Anxiety c. Confusion d. Confidence

b. Anxiety

The nurse is caring for a patient who has gender dysphoria. What is the nurse's best action to reduce and eliminate discrimination when caring for this patient? a. Ask close-ended questions to elicit direct answers when talking about sex with the patient. b. Ask open-ended questions that encourage the patient to actively participate in care. c. Ask the charge nurse to reassign the nurse if the nurse is uncomfortable. d. Ask the nurse's co-worker to discuss the patient's condition, in order to avoid direct questions with the patient.

b. Ask open-ended questions that encourage the patient to actively participate in care.

The nurse is conducting a mental status exam on a patient with suspected dementia. In which way should the nurse assess the patient's fund of general information? a. Asking the patient what year it is b. Asking the patient the name of the president c. Asking the patient to interpret a commonly known proverb d. Asking the patient to spell the word "world" both forward and backward

b. Asking the patient the name of the president

The nurse plans to record a conversation with a patient. In which way will this help the therapeutic relationship? a. Assist the nurse in memorizing useful habits and mannerisms. b. Assist the nurse in identifying communication habits and mannerisms. c. Offer a way for feedback on communication skills and dynamics to be provided when direct observation is not an option. d. Offer a way for feedback on communication skills and dynamics to be provided when indirect observation is not an option.

b. Assist the nurse in identifying communication habits and mannerisms.

An older patient with bipolar disorder is concerned about receiving care with aging and does not want to receive certain types of care. Which is the best response by the nurse? a. Suggest that a lawyer is consulted to make a will. b. Assist with creating an advanced directive. c. Suggest telling family members types of care desired. d. Assure the patient that the healthcare system will provide appropriate care.

b. Assist with creating an advanced directive.

The nurse is reviewing the various theories that support mental health practice. In which way should the nurse describe the relationship between mental health treatment and humanism? a. Science is the core consideration of humanistic philosophy. b. Caring practices and compassion must be approached holistically. c. Mental health clients must rely on clinicians for difficult decision-making and care. d. Limitations of life in today's world have little effect on planning effective interventions.

b. Caring practices and compassion must be approached holistically.

A patient diagnosed with dissociative identity disorder is in the emergency department after attempting suicide. After a thorough assessment, the nurse determines the attempted suicide was likely in response to which event? a. Drug abuse and living homeless on streets b. Childhood sexual abuse by biological father c. Unidentified continuous abdominal and neck pain d. Multiple somatic and psychological issues over the past 6 months

b. Childhood sexual abuse by biological father

The nurse is researching methods for maintaining resilience in stressful clinical situations. Which actions should the nurse use that demonstrate resilience? (Select all that apply.) a. Reading professional journals and maintaining continuing education b. Choosing to work at a facility where the nurse enjoys the environment c. Participating in a staff debriefing after a difficult interaction in the unit d. Joining a unit-based council that focuses on quality improvement e. Teaching a seminar to a group of peers on a topic that the nurse enjoys

b. Choosing to work at a facility where the nurse enjoys the environment c. Participating in a staff debriefing after a difficult interaction in the unit d. Joining a unit-based council that focuses on quality improvement

The nurse is assessing an older patient with cardiovascular disease who has been prescribed a calcium channel blocker. For which reason should the nurse consider this patient at risk for depression? a. Use of a calcium channel blocker increases risk for depression. b. Chronic illness increases risk for depression. c. Older age increases risk for depression. d. Cardiac rehabilitation increases risk for depression.

b. Chronic illness increases risk for depression.

The nurse is hired to work with a police department. Which action should the nurse expect to complete when functioning as a forensic nurse? a. Prove insanity b. Collect evidence c. Collect data to prevent conviction d. Determine if malpractice occurred

b. Collect evidence

The school nurse recommends that the parents of a student seek help because the student is constantly in trouble and recently has set several small fires on school grounds. What health problem does the school nurse suspect? a. Depression b. Conduct disorder c. Oppositional defiant disorder d. Attention-deficit/hyperactivity disorder

b. Conduct disorder

The nurse recommends that a patient with a major mental illness who is experiencing distress join a support group for patients with the disease. In which way could the group setting bring comfort to the patient? (Select all that apply.) a. Discussing individual goals b. Confronting unhealthy ideas c. Addressing physical symptoms of the disease d. Receiving support from others with the disease e. Addressing issues of stigma and dysfunctional beliefs

b. Confronting unhealthy ideas d. Receiving support from others with the disease e. Addressing issues of stigma and dysfunctional beliefs

A patient has had what appeared to be an epileptic seizure, but the patient's test results do not show seizure activity. After a thorough assessment and appropriate tests by the patient's healthcare professional, which disorder should the nurse suspect this patient is experiencing? a. Factitious disorder b. Conversion disorder c. Illness anxiety disorder d. Somatic symptom disorder

b. Conversion disorder

The nurse is caring for a patient with gender dysphoria. When promoting open communication with the patient, what is the nurse's best action? a. Use closed questions. b. Convey willingness to help. c. Present as an expert to the patient. d. Convey sympathy.

b. Convey willingness to help.

The nurse is observing a patient whose spouse just died. Which almost universal response to loss should the nurse understand has many cultural determinants? a. Anger b. Crying c. Depression d. Distancing

b. Crying

An older patient with a urinary tract infection (UTI) points to the smoke alarm inside the room and asks for the radio to be turned on. For which alteration should the nurse assess the patient? a. Agnosia b. Delirium c. Dementia d. Pseudodementia

b. Delirium

A patient refuses to take a specific medication because it is "manufactured by terrorists." Which symptom of schizophrenia should the nurse identify this patient is exhibiting? a. Alogia b. Delusion c. Ambivalence d. Avolition

b. Delusion

The nurse is assessing a patient with a sleep disorder. For which alteration within the psychological domain should the nurse assess this patient? a. Decreased immune function b. Depressed or anxious mood c. Inability to perform work tasks d. Decreased enjoyment in social activities

b. Depressed or anxious mood

During an assessment, a patient reports hearing voices in the head. What should be the priority for the nurse? a. Determine if the voices are fantasy hallucinations. b. Determine if the voices are command hallucinations. c. Determine if the patient has a disturbance in orientation. d. Determine if the patient has a disturbance in thought process.

b. Determine if the voices are command hallucinations.

A patient with gender dysphoria desires gender reassignment surgery. What does the nurse recognize as the first phase of this type of treatment? a. Hormonal therapy b. Diagnostic testing c. Nutritional therapy d. Therapeutic testing

b. Diagnostic testing

The nurse suspects that a patient with a schizophrenia spectrum disorder (SSD) who is taking antipsychotic medication has neuroleptic malignant syndrome (NMS) because of a temperature of 103.5°F. For which other symptoms of NMS will nurse assess? (Select all that apply.) a. Grimacing b. Diaphoresis c. Muscle rigidity d. Increased blink rate e. Autonomic dysfunction

b. Diaphoresis c. Muscle rigidity e. Autonomic dysfunction

The nurse is caring for a patient experiencing a relapse of a schizophrenia spectrum disorder (SSD). As the nurse considers the plan of care, which type of nursing intervention will the nurse give priority? a. Patient education b. Direct action c. Disease prevention d. Family involvement

b. Direct action

The nurse says to a patient whose home was destroyed by fire, "I know just how you feel. We had a fire in our home when I was a little girl." What type of communication is the nurse using? a. Active listening b. Disabling communication c. Informational communication d. Therapeutic communication

b. Disabling communication

A patient is experiencing auditory hallucinations and paranoid delusions. Which neurotransmitter should the nurse suspect is implemented in these manifestations? a. Serotonin b. Dopamine c. Acetylcholine d. Norepinephrine

b. Dopamine

The nurse is caring for a patient with major depressive disorder. Which therapy will the nurse expect to be recommended to help the patient gain a greater understanding of self and awareness of behaviors? a. Social rhythm therapy b. Dynamic psychotherapy c. Neuromodulation therapy d. Interpersonal psychotherapy

b. Dynamic psychotherapy

The nurse is caring for a patient with Alzheimer disease. Which technique should the nurse use when interacting with this patient? a. Setting strict time limits and rephrasing misunderstood questions. b. Encouraging verbal and nonverbal communication while maintaining a calm demeanor. c. Correcting errors made by the patient and speaking in a loud, clear voice. d. Using multiple memory cues and giving several directions at once.

b. Encouraging verbal and nonverbal communication while maintaining a calm demeanor.

The nurse suspects that a pregnant patient has a substance use disorder (SUD). Which action should the nurse take first when planning care for this patient? a. Provide a list of support services b. Engage in motivational interviewing c. Refer the patient to a treatment center d. Discuss the impact of the substance on the fetus

b. Engage in motivational interviewing

The nurse is preparing to lead a group therapy session. Why is it important for the nurse to use universality when leading the session? a. Ensure that the patients share a common sense of belonging with the group. b. Ensure that the patients understand that they are not alone or unique in their suffering. c. Ensure that the patients learn to cope by observing others. d. Ensure that the patients understand that the therapy will be helpful for everyone in the group.

b. Ensure that the patients understand that they are not alone or unique in their suffering.

The nurse caring for a patient with a mental illness completes an assessment and formulates nursing diagnoses. What is the purpose of the next phase of the nursing process? a. Evaluating stated outcomes b. Establishing measurable goals c. Implementing measurable interventions d. Assessing mental status compared to nursing assessment

b. Establishing measurable goals

The nurse notes that a patient with schizophrenia has a reduction in symptoms. Which complementary health approach should the nurse ask if the patient is using? a. Folate b. Exercise c. Vitamin D d. Acupuncture

b. Exercise

The nurse is the leader of a psychotherapy group. After establishing the norms of the group, what action will the nurse take to establish a therapeutic environment? a. Encourage detailed member discussion. b. Familiarize the group members to the purpose of the group. c. Encourage the group members to take ownership of its function. d. Ask open-ended questions regarding the quality of the group's function.

b. Familiarize the group members to the purpose of the group.

The nurse is caring for an adolescent patient with a substance abuse disorder. What type of therapy is priority for this patient? a. Group b. Family c. Individual d. Electroconvulsive

b. Family

The nurse is completing a suicide risk assessment with a patient. For which factor should the nurse assess based on an understanding of the psychiatric causal factor in suicide? a. Anticipatory grief b. Fearful anxiety c. Acute illness d. Increased productivity

b. Fearful anxiety

A patient with depression is demonstrating symptoms of anxious distress. Which characteristic should the nurse expect to observe in this patient? (Select all that apply.) a. Overeating b. Feeling tense c. Being unusually restless d. Waking up early in the morning e. Having hallucinations and thought disturbances

b. Feeling tense c. Being unusually restless

The nurse manager is identifying the approach that will be used when caring for patient experiencing a crisis. Which should the manager identify as an advantage of using the assessment, crisis intervention, and trauma treatment (ACT) approach? a. Plans for future problems b. Focuses on the current situation c. Helps the person socially reengage d. Views crisis as a learning experience

b. Focuses on the current situation

The nurse is caring for a patient with depression. Which intervention should the nurse complete that best demonstrates using mindfulness with the patient? a. Explaining medication effects to the patient b. Focusing on the patient's immediate needs c. Letting the patient know that time heals all sorrow d. Caring for the patient with an honest and nonjudgmental attitude

b. Focusing on the patient's immediate needs

During a community health clinic visit, a patient is "missing home," but has no way of ever returning there because of ongoing violence and ethnic persecution. For which type of trauma should the nurse plan care for this patient? a. Emotional abuse b. Forced displacement c. System-induced trauma d. Traumatic grief of separation

b. Forced displacement

An adolescent recovering from a motor vehicle crash is angry and demonstrating poor impulse control. Which lobe of the brain should the nurse suspect may have been injured in the accident? a. Temporal b. Frontal c. Occipital d. Parietal

b. Frontal

A patient with a mental illness is deemed incompetent and requires an elective surgical procedure. Which individual should sign the consent form for the patient? a. Spouse b. Guardian c. Oldest child d. Hospital administrator

b. Guardian

The nurse is caring for a family seeking family therapy. What is the primary purpose of the family assessment? a. Determine the family dysfunction. b. Guide the family's personalized plan of care. c. Promote the therapeutic nurse-family relationship. d. Determine the appropriate clinical diagnosis of the family.

b. Guide the family's personalized plan of care.

The nurse is caring for a patient with a personality disorder who is acutely aggressive and is a danger to self and others. What pharmacologic therapy should the nurse anticipate being prescribed for this patient? a. Valproic acid (Depakote) b. Haloperidol (Haldol) c. Clozapine (Clozaril) d. Carbamazepine (Tegretol)

b. Haloperidol (Haldol)

The nurse is participating in a community task force to address substance use disorders (SUD) in the homeless population. Which strategies should the nurse recommend to engage these individuals in treatment? (Select all that apply.) a. SUD screening b. Harm reduction c. Stepwise approach d. Relapse prevention e. Prevention programs

b. Harm reduction d. Relapse prevention

A patient with early Alzheimer disease has been taking ginkgo biloba. For which potential effect should the nurse assess this patient? (Select all that apply.) a. Edema b. Headaches c. Lung infections d. Abdominal pain e. Increased blood pressure

b. Headaches c. Lung infections e. Increased blood pressure

A patient states that the apartment building of residence is installing bars on the windows and wonders where food can be purchased since the local grocery store is closing. Which should the nurse consider as an eventual outcome from these social determinants of health? a. Increase in rent b. Health disparity c. Exposure to crime d. Loss of employment

b. Health disparity

The nurse is planning care for a newly admitted patient with mental illness. According to the nursing process, what action should the nurse take after formulating the nursing diagnosis? a. Evaluate goals for their appropriateness b. Identify care needs and their priority in care c. Assess the patient according to the stated diagnosis d. Implement interventions according to the stated diagnosis

b. Identify care needs and their priority in care

The nurse is performing an admitting assessment on a patient who has been diagnosed with depression. What is the purpose of this process? a. Determine mutual goals of care. b. Identify patient information and history. c. Establish and document the nursing diagnosis. d. Establish a therapeutic nurse-patient relationship.

b. Identify patient information and history.

The nurse is caring for an older patient experiencing delirium. For which health problem should the nurse assess the patient? (Select all that apply.) a. Drug abuse b. Infection c. Drug toxicity d. Hypoxemia e. Fluid volume deficit

b. Infection c. Drug toxicity d. Hypoxemia e. Fluid volume deficit

A patient with depression uses prescribed antidepressants, yoga, and meditation. Which type of complementary health approach (CHA) is the patient using? a. Allopathic medicine b. Integrative medicine c. Alternative medicine d. Complementary medicine

b. Integrative medicine

The nurse has traveled overseas to provide relief for a community experiencing crisis after a natural disaster. Which concept should the nurse use in planning care for these individuals? a. Crisis is a universal human experience with manifestations similar in all cultures. b. Interventions should be centered on the involvement of local community leadership. c. Assessment of abnormal expressions of emotional pain should be the nurse's priority. d. Interventions should be centered on the treatment of posttraumatic stress disorder (PTSD).

b. Interventions should be centered on the involvement of local community leadership.

The nurse is assessing a patient who has been diagnosed with a serious mental illness. For which reason should the nurse use a timeline during this assessment? (Select all that apply.) a. It can be used to evaluate the success of nursing interventions. b. It can be used as both an assessment tool and an intervention. c. It can be used to identify significant events across the lifespan. d. It involves the patient in providing historical information. e. It helps the patient gain perspective on problems that have not been resolved.

b. It can be used as both an assessment tool and an intervention. c. It can be used to identify significant events across the lifespan. d. It involves the patient in providing historical information. e. It helps the patient gain perspective on problems that have not been resolved.

The nurse is caring for a patient with a mental illness. Which should the nurse keep in mind when using mindfulness with this patient? (Select all that apply.) a. It is a form of self-esteem. b. It is a form of self-awareness. c. It is a state of being aware but not acting automatically. d. It is a state of being aware but also acting automatically. e. It is a state of accepting things as they are without judgment.

b. It is a form of self-awareness. c. It is a state of being aware but not acting automatically. e. It is a state of accepting things as they are without judgment.

The nurse is preparing teaching for a patient with sexual dysfunction. Which information about orgasm will the nurse include in the session? a. It is mediated by dopamine, produced by the brain. b. It is mediated by norepinephrine, produced by the sympathetic nervous system. c. It is mediated by nitric oxide, produced by the vascular system. d. It is mediated by epinephrine, produced by the parasympathetic nervous system.

b. It is mediated by norepinephrine, produced by the sympathetic nervous system.

The nurse is caring for a patient who is Muslim. What does the nurse recognize as typical core beliefs of the Islamic faith? (Select all that apply.) a. The universe has no beginning and no end. b. It is the fastest growing religion worldwide. c. There are three paths to spiritual fulfillment: knowledge, insight, and wisdom; action; and ecstatic devotion. d. Suffering is a part of human growth and change, but Allah (God) does not test people beyond what they can bear. e. On the last day Allah (God) will judge people based on what they have done and assign them to either heaven or hell.

b. It is the fastest growing religion worldwide. e. On the last day Allah (God) will judge people based on what they have done and assign them to either heaven or hell.

A patient with a circadian rhythm sleep disorder wants to use melatonin for the treatment of the condition. In which way should the nurse explain melatonin works for circadian rhythm sleep disorders? a. It works by helping the individual stay asleep. b. It works by helping the individual fall asleep. c. It works by stimulating the pineal gland to improve sleep. d. It work by suppressing the pineal gland to improve sleep.

b. It works by helping the individual fall asleep.

A patient with a mood disorder is admitted to the medical-surgical unit for postoperative care. Which actions are appropriate therapeutic strategies for use with a patient with a mood disorder? (Select all that apply.) a. Offering a variety of choices in order to keep communication open b. Keeping communication simple by offering limited choices c. Reminding patients of delusional material when symptoms have resolved d. Questioning the patient's belief system when it conflicts with the nurse's e. Not reminding patients of inappropriate behaviors that occurred when in an altered state of mental health

b. Keeping communication simple by offering limited choices e. Not reminding patients of inappropriate behaviors that occurred when in an altered state of mental health

A patient in a residential treatment facility who was behaving aggressively was prescribed risperidone. How should this patient be monitored? (Select all that apply.) a. IQ test b. Lab panels c. Physical exam d. Baseline ECG e. Pulmonary function evaluation

b. Lab panels c. Physical exam d. Baseline ECG

The nurse is preparing a teaching tool on sleep disorders. Which disorder should the nurse include that is most likely to cause significant disruption to a patient's employment? a. Insomnia b. Narcolepsy c. Restless legs syndrome d. Breathing-related sleep disorders

b. Narcolepsy

A nurse is performing a spiritual assessment with a patient with depression. What does the nurse recognize as the key concept to a spiritual assessment? a. Learn how the patient answers questions about his or her religion and how satisfied the patient is with those answers. b. Learn how the patient answers questions about the meaning of life and how satisfied the patient is with those answers. c. Assess how the patient answers questions about formal spiritual practices and how his or her symptoms interfere with these practices. d. Assess how the patient answers a series of standardized questions that reveal the patient's choices of healthcare practices and religious choices.

b. Learn how the patient answers questions about the meaning of life and how satisfied the patient is with those answers.

The nurse is performing a family assessment. Which factor will the nurse include in the family and community interface portion of the assessment? a. Family norms b. Legal problems c. Marital patterns d. Family strengths

b. Legal problems

The nurse is planning care for a patient with a personality disorder. Which interventions should the nurse consider in the plan of care? (Select all that apply.) a. Patient teaching about vegetative symptoms b. Limit setting to enforce boundaries c. Patient teaching about healthy coping skills d. Discussing the importance of memory prompts e. Strengthening reality orientation

b. Limit setting to enforce boundaries c. Patient teaching about healthy coping skills e. Strengthening reality orientation

The nurse is caring for a patient who is experiencing severe depression. In which way should the nurse best help the patient find meaning in the experience of suffering from mental illness? a. Suggest answers when the patient questions the meaning of life. b. Listen and be present when the patient questions the meaning of life. c. Listen and offer answers when the patient questions the meaning of life. d. Encourage the patient to discuss well-formulated answers to the meaning of life.

b. Listen and be present when the patient questions the meaning of life.

The nurse is caring for a patient who repeatedly talks about the role of religion in curing depression. Which approach best demonstrates the nurse's acceptance of the patient? a. Disregard the patient's focus on religion. b. Listen to the patient in a supportive manner. c. Encourage the patient to consider other therapeutic factors. d. Share opinions regarding the role of religion in daily life.

b. Listen to the patient in a supportive manner.

The nurse manager is teaching the staff nurses in the emergency department about violence in healthcare settings. What information will the nurse include when teaching about hospital risk factors that increase the risk of violence? (Select all that apply.) a. High census levels b. Low staffing levels c. Characteristics of staff d. Characteristics of services delivered e. Waiting times for services delivered

b. Low staffing levels d. Characteristics of services delivered e. Waiting times for services delivered

The nurse is explaining the differences between bipolar disorder and major depressive disorder. Which factor should be discussed as being a defining feature of bipolar disorder that is not present in major depressive disorder? a. Suicidal ideation b. Mania c. Short duration of symptoms d. No history of depressive symptoms

b. Mania

The nurse is learning how different nursing theorists developed philosophies on the concept of self. Which theorist will be emulated when the nurse reflects on the revolving self and evaluating the suffering of a patient with mental illness? a. Hildegard Peplau b. Martha Rogers c. Ida Jean Orlando d. Patricia Benner

b. Martha Rogers

The nurse is preparing to assess a patient with an eating disorder. Which information source should the nurse recognize as presenting many societal influences on the perception of attractiveness, which is detrimental to the patient with an eating disorder? a. Articles about eating disorders b. Media that glamorizes thinness c. Information about coping behaviors d. Programs that emphasize good nutrition

b. Media that glamorizes thinness

A patient recently diagnosed with schizophrenia is taking antipsychotic medication to control hallucinations. Which is an appropriate activity for level 2 of wellness that could be included in this patient's treatment? (Select all that apply.) a. Referral to a job training program b. Medication management education c. Group therapy d. Inpatient admission e. Family support group

b. Medication management education c. Group therapy e. Family support group

The nurse is caring for a male patient who is experiencing a crisis. Which factor should the nurse consider when planning care for this patient? a. Men are less likely to resist help during times of crisis. b. Men are more likely to resist help during times of crisis. c. Men usually access intervention only when the acute crisis has ended. d. The most successful intervention for men during times of crisis is individual psychotherapy.

b. Men are more likely to resist help during times of crisis.

The nurse is preparing a teaching tool on suicide. Which information will the nurse include? (Select all that apply.) a. Women commit suicide more than men. b. Men commit suicide more than women. c. Women have a higher rate of attempted suicide. d. Older single Caucasian men have a high rate of suicide. e. African American women have the lowest rate of suicide.

b. Men commit suicide more than women. c. Women have a higher rate of attempted suicide. d. Older single Caucasian men have a high rate of suicide. e. African American women have the lowest rate of suicide.

An older patient with Parkinson disease was recently admitted to a nursing home after the death of the patient's spouse, who was the primary caregiver. What issues should the nurse plan to address with this patient? (Select all that apply.) a. Financial stress b. Mobility challenges c. Overwhelming grief d. Loss of support system e. Sense of disconnection from a familiar life

b. Mobility challenges c. Overwhelming grief d. Loss of support system e. Sense of disconnection from a familiar life

An adolescent whose mother recently died is delaying college because of the need to care for younger siblings. For which reason should the nurse assess the patient for depression? a. All adolescents suffer from depression. b. Multiple losses increase the likelihood of depression c. Lack of support increases the likelihood of depression. d. Pressure to function increases the likelihood of depression.

b. Multiple losses increase the likelihood of depression

A nurse is caring for a patient who is experiencing visual hallucinations. Which lobe of the brain should the nurse recognize as the source of the patient's manifestations? a. Parietal b. Occipital c. Temporal d. Right frontal

b. Occipital

The nurse is caring for a patient with anorexia nervosa. Which medication should the nurse anticipate being prescribed for this patient? a. Amitriptyline (Elavil) b. Olanzapine (Zyprexa) c. Bupropion (Wellbutrin) d. Tranylcypromine (Parnate)

b. Olanzapine (Zyprexa)

The hospice nurse is exposed to a great deal of emotional suffering. How could the nurse respond effectively to these pressures? a. Take courses on grieving. b. Organize a peer support group. c. Take antidepressant medications. d. Talk to her patients about her feelings.

b. Organize a peer support group.

The nurse is caring for a patient with schizophrenia. In which stage of the nurse-patient relationship will the nurse assess the patient's needs, symptoms, and strengths? a. Working b. Orientation c. Identification d. Pre-orientation

b. Orientation

A patient refuses to participate in a health history because of hunger. Bringing the patient a meal tray supports which nursing theory? a. Peplau b. Orlando c. Neuman d. Leininger

b. Orlando

The nurse is asked to describe the stages of the sexual response cycle. Which system should the nurse describe as controlling excitement or arousal? a. Sympathetic nervous system b. Parasympathetic nervous system c. Renin-angiotensin-aldosterone system d. Peripheral nervous system

b. Parasympathetic nervous system

The nurse is providing community mental health services to families identified as at risk for attachment disorder. What treatment should the nurse consider as most effective? a. Mindfulness education b. Parenting skills education c. Brief solution-focused therapy d. Cognitive-behavioral therapy

b. Parenting skills education

A patient who is a professional dancer recently lost a limb in a motor vehicle accident. When planning care for this patient, which factor should the nurse focus on? a. Nurse's self-concept b. Patient's self-concept c. Nurse's self-perception d. Patient's support system

b. Patient's self-concept

The nurse educator is planning various seminars for the staff nurses regarding care of the patient in physical restraints. Which essential nursing interventions will the educator include in the staff seminar? (Select all that apply.) a. Turn patient every 4 hours. b. Permit toileting as needed. c. Assign one-to-one observation. d. Assess skin integrity every hour. e. Assess circulation, sensation, and movement every 6 hours.

b. Permit toileting as needed. c. Assign one-to-one observation. d. Assess skin integrity every hour.

The nurse is asked to explain the mechanism of a psychotropic medication. Which should the nurse explain assists the medication to penetrate the blood-brain barrier (BBB)? a. Psychotropic medications are acidic. b. Psychotropic medications are lipophilic. c. Psychotropic medications are water soluble. d. Psychotropic medications have large molecules.

b. Psychotropic medications are lipophilic.

The nurse has been hired to work in a milieu management program. With which techniques should the nurse be familiar? (Select all that apply.) a. Hypnotherapy b. Reinforcement c. Psychoanalysis d. Pattern interruption e. Affect management

b. Reinforcement d. Pattern interruption e. Affect management

A patient in the activity room of the inpatient mental health facility begins to get upset, raises the voice, paces the room, and stands with clenched fists. Which action should the nurse make a priority? a. Reorient the patient to person, place, and time. b. Remove other patients from the room to provide more space. c. Call the healthcare provider to obtain an order for anti-anxiety medication. d. Call security and promptly isolate the patient and apply physical restraints.

b. Remove other patients from the room to provide more space.

The nurse looks at the patient's wrist tag when entering the room to administer medication. Which of the "rights" of medication administration is the nurse verifying? a. Right time b. Right patient c. Right medication d. Right documentation

b. Right patient

The nurse is caring for a patient who is suspected of having an obsessive-compulsive personality disorder. Which characteristics of the disorder should the nurse expect to observe in the patient? a. Order in all areas of the patient's life and that of the patient's relatives b. Rigid perfectionism and control c. The need for perfection in others but not self d. Order in the patient's work life but the ability to relax when away from work

b. Rigid perfectionism and control

The nurse is caring for a patient with depression who takes St. John's wort. What class of medication should concern the nurse if the patient reports taking a medication in that class? a. MAOI b. SSRI c. Antipsychotics d. Barbiturate

b. SSRI

A patient who is extremely agitated and presents a danger to others is prescribed 5 mg haloperidol IM to be administered immediately. What kind of order is this? a. PRN b. STAT c. Single order d. Standing order

b. STAT

A patient with a substance use disorder (SUD) asks if there is a difference between substance use disorder and addiction. Which information should the nurse use in response? a. SUD leads to chemical dependency; addiction does not. b. SUD is a diagnostic term; addiction is an active disease state. c. SUD does not refer to chemical dependency; addiction does. d. SUD is an active disease state; addiction is a diagnostic term.

b. SUD is a diagnostic term; addiction is an active disease state.

The nurse is receiving a report on a patient who is being transferred to the hospital from a local emergency department. What is important for the receiving nurse to remember during this pre-interaction with the patient? a. Determine the patient's state of mind. b. Suspend expectations about the patient. c. Determine how the patient will present. d. Suspend reflection about the patient's condition.

b. Suspend expectations about the patient.

The patient who expresses thoughts of suicide denies interest in acting on it because of loving children and family too much. Which nursing interventions are most appropriate for this patient? (Select all that apply.) a. Place the patient on constant observation for safety. b. Teach the use of the National Suicide Prevention Lifeline. c. Admit the patient to the behavioral health hospital immediately. d. Encourage the patient to use internal and external support systems. e. Be aware that the patient is likely to reject any attempt at intervention, including teaching

b. Teach the use of the National Suicide Prevention Lifeline. d. Encourage the patient to use internal and external support systems.

The nurse is identifying diagnoses to address a patient's problems. What should the nurse identify in the second portion of the nursing diagnosis? a. Steps to resolve the problem b. The cause of the problem c. The focal pattern, problem, or behavior that is observed d. Data that indicate or support the problem statement

b. The cause of the problem

The nurse is caring for a terminally ill patient who is Christian. Which core belief central to Christianity should the nurse identify that is being challenged by the patient's suffering? a. The idea of repentance b. The idea that God is love c. The idea of reincarnation d. The idea that God is all-powerful

b. The idea that God is love

A patient who was admitted voluntarily to the hospital verbally refuses medication. However, the nurse proceeds to give the medication over the patient's objections. What is the legal significance of the nurse's actions? a. The nurse cannot be held accountable. b. The nurse could be charged with battery. c. The nurse could be charged with negligence. d. The nurse could be charged with malpractice.

b. The nurse could be charged with battery.

The nurse is learning about protective measures in patients displaying hopelessness to prevent suicide. Which patient should the nurse recognize as displaying external protective measures? a. The patient who is passive during a dispute. b. The patient who requests assistance when needed. c. The patient who remains calm during an argument. d. The patient who displays problem-solving capabilities.

b. The patient who requests assistance when needed.

The nurse is caring for a patient of Asian descent who is newly diagnosed with an anxiety disorder. Which factor should the nurse consider when planning care for this patient? (Select all that apply.) a. Adherence to treatment b. The patient's cultural beliefs c. The spiritual component of treatment d. Anxiety may be expressed differently e. Medical history

b. The patient's cultural beliefs c. The spiritual component of treatment d. Anxiety may be expressed differently e. Medical history

The nurse is caring for an adolescent patient with a suspected personality disorder. Why must the healthcare provider be cautious about diagnosing this patient? a. Adolescents are too young to develop a personality disorder. b. The patterns of behavior and thinking could reflect adolescent experimentation. c. Adolescents develop different types of personality disorder. d. The patterns of behavior and thinking cannot be assessed in an adolescent patient.

b. The patterns of behavior and thinking could reflect adolescent experimentation.

A parent reports a sibling as having Tourette syndrome and is concerned that a male child may be at risk for the same disorder. Which is the most appropriate reply? a. A genetic association in Tourette syndrome has not been identified. b. There may be a genetic predisposition for developing Tourette syndrome. c. A person whose uncle has Tourette syndrome will definitely develop the condition. d. Tourette syndrome is caused by a chemical imbalance.

b. There may be a genetic predisposition for developing Tourette syndrome.

The nurse is caring for a female patient with a suspected sexual dysfunction. In order for the healthcare provider to diagnose sexual dysfunction, which must be true of the symptoms? (Select all that apply.) a. They always prevent desired participation in sexual activity. b. They frequently prevent desired participation in sexual activity. c. They have been present for at least 12 months. d. They have been present for at least 6 months. e. They are not caused by some other mental, behavioral, or medical condition.

b. They frequently prevent desired participation in sexual activity. d. They have been present for at least 6 months. e. They are not caused by some other mental, behavioral, or medical condition.

When a school-age patient says, "I did bad things today," the nurse responds, "Tell me about the bad things you did today." What is the nurse doing to connect to the patient's experience? a. Talking about the patient's problem behavior. b. Using the patient's own language to engage in conversation. c. Asking for specific information about the patient's activity. d. Repeating what the patient to reflect the statement.

b. Using the patient's own language to engage in conversation.

The nurse is caring for patients in the emergency department. Which ethical principle should the nurse use to care for a patient who is suicidal before caring for a patient with a chronic health problem? a. Deontology b. Utilitarianism c. Ethics of care d. Virtue ethics

b. Utilitarianism

The nurse suspects that a patient on active duty military is at risk for suicide. Which laboratory value should the nurse assess in this patient? a. Vitamin K level b. Vitamin D level c. Serum calcium level d. Serum potassium level

b. Vitamin D level

After providing safety for a patient with suicidal ideation, the nurse wishes to determine the patient's starting point of treatment and commitment for change. Which tool should the nurse use to determine this information? a. Cultural Formulation Interview (CFI) b. WHO Disability Assessment Schedule (WHODAS) c. Culturally and Linguistically Appropriate Services (CLAS) d. Diagnostic and Statistical Manual of Mental Disorders (DSM-5)

b. WHO Disability Assessment Schedule (WHODAS)

The nurse administers lithium carbonate (Lithobid) to a patient with obsessive-compulsive disorder (OCD). For which adverse effect should the nurse monitor this patient? a. Weight loss b. Weight gain c. Elevated mood d. Decreased agitation

b. Weight gain

A patient taking a selective serotonin-reuptake inhibitor (SSRI) is experiencing a decrease in sexual functioning. What medication might be considered to help restore the patient's sexual functioning? a. Ativan b. Wellbutrin c. Trazadone d. Propranolol

b. Wellbutrin

A patient with an abdominal ailment will drink only warm liquids because of the belief that cold liquids will exacerbate the health problem. Which response should the nurse make that demonstrates cultural humility? a. "The cold liquids will not make your condition worse." b. "The warm liquids will not make your condition better." c. "Can you tell me why the cold liquids will make your condition worse?" d. "Can you tell me why you do not follow the healthcare provider's suggestion?"

c. "Can you tell me why the cold liquids will make your condition worse?"

The nurse is asked to identify the most important skill in psychiatric-mental health nursing. Which response should the nurse make? a. "Making correct nursing diagnoses." b. "Supporting advocacy." c. "Developing a therapeutic relationship and the corresponding therapeutic use of self." d. "Involving the patient in treatment planning."

c. "Developing a therapeutic relationship and the corresponding therapeutic use of self."

During the winter, an older patient is brought to the office wearing a light sweater and sandals. What question should the nurse ask to collect data to confirm a suspicion of abuse/neglect? a. "Do you like your attendant?" b. "Does your attendant do any nice things for you?" c. "Did your attendant decide what clothing you should wear?" d. "Does your attendant ever make you feel bad about yourself?"

c. "Did your attendant decide what clothing you should wear?"

The nurse is performing an assessment on a newly admitted patient. Which question should the nurse ask to assess the patient's biological domain? (Select all that apply.) a. "How old are you?" b. "Are you experiencing any pain today?" c. "Have you used any substances?" d. "What type of exercise do you engage in?" e. "Do you have a history of cardiac disease?"

c. "Have you used any substances?" d. "What type of exercise do you engage in?" e. "Do you have a history of cardiac disease?"

The nurse wants to assess if a patient with suicidal thoughts has any internal protective measures. Which question is most appropriate for this purpose? a. "How well do you relate to others?" b. "Do you request assistance when needed?" c. "How do you handle conflicts with others?" d. "Do you relationships with others that you value?"

c. "How do you handle conflicts with others?"

The nurse is completing an admission assessment on a patient experiencing mental health issues. Which question should the nurse ask to best assess the patient's perception of self? a. "How do you think you look?" b. "How would others describe you?" c. "How would you describe yourself?" d. "What activities make you most happy?"

c. "How would you describe yourself?"

The nurse is caring for a patient of the Muslim faith who prays ritually several times daily. The patient tells the nurse, "I don't know how I can possibly pray here in the hospital using my prayer rugs." What is the nurse's best response? a. "Prayer is an important part of healing for every patient. I will make sure you can have your prayer rugs here in the hospital." b. "Prayer using a prayer rug is not usually encouraged in the hospital. I will ask my nursing supervisor about your request." c. "I understand that this ritual is important to you. I will do my best to make sure you have your prayer rugs here in the hospital." d. "I understand that this ritual is important to you. While prayer using a prayer rug is not encouraged in the hospital, I will see what I can do."

c. "I understand that this ritual is important to you. I will do my best to make sure you have your prayer rugs here in the hospital."

The nurse educator instructs a group of staff nurses on environmental risk factors that may lead to violence in the psychiatric setting. Which response by the staff nurse demonstrates that teaching has been effective? a. "I will maintain the established patient routines." b. "I will carefully manage patient transitions of care." c. "I will allow visitors in the patient's room as permitted." d. "I will assist the patient to maintain self-care."

c. "I will allow visitors in the patient's room as permitted."

The parent of a toddler paddling the child asks that the action not be reported because the child might be taken away. Which response should be made when the nurse assesses bruises and welts on the child? a. "I won't tell anyone. HIPAA protects this information." b. "I will not report this if you sign a contract stating that you won't hit the child again." c. "I will have to report this because it is my legal obligation to do so as a nurse." d. "I will refer you to social services so they can discuss it with you."

c. "I will have to report this because it is my legal obligation to do so as a nurse."

The nurse is planning care for a patient with depression and who has severe cerebral palsy, communicates only with a computer, and is quadriplegic. Which statement best demonstrates that the nurse has engaged in self-reflection prior to caring for this patient? a. "It is important to interview the patient's family before I meet the patient." b. "The first thing I will do is thoroughly assess the patient's needs and abilities." c. "I will need to be aware of my feelings and any potential fears related to caring for this patient." d. "I will read the patient's health record and talk with the healthcare provider to understand the patient's disabilities."

c. "I will need to be aware of my feelings and any potential fears related to caring for this patient."

An adolescent admits to being burned by a parent when misbehaving but does not want the parent to be reported to the authorities. Which statement should the nurse make? a. "Don't worry, I won't break your confidence." b. "I have to tell the authorities or I'll get in big trouble myself." c. "I'm sorry, but it is my responsibility to report that your mother is burning you with a cigarette." d. "OK, but can I get your permission to tell your doctor this is happening?"

c. "I'm sorry, but it is my responsibility to report that your mother is burning you with a cigarette."

A patient from a different culture than the nurse is experiencing pain. For which conceptual model should the nurse ask the patient to identify a treatment and potential benefits from the treatment? a. Leininger's Sunrise Enabler Model b. Leininger's transcultural nursing theory c. Campinha-Bacote's conceptual framework d. Giger and Davidhizar's Transcultural Assessment Model

c. Campinha-Bacote's conceptual framework

An older patient reports pain in the legs were dismissed by a new physician as "something that happens to everyone." What is an appropriate response for the nurse to make? a. "Are you really in that much pain? Perhaps you just need to be more active." b. "I think the doctor is just trying to help you get used to the effects of old age." c. "It might be useful for you to tell the physician how you feel. Do you feel comfortable doing that?" d. "That doctor shouldn't treat you so poorly. You should complain to the office manager." Answer: 3

c. "It might be useful for you to tell the physician how you feel. Do you feel comfortable doing that?"

A patient expresses an interest in the use of Kava for the treatment of anxiety. Which response should the nurse make? a. "Kava may be effective for long-term treatment of mild anxiety symptoms." b. "Kava may be effective for the treatment of anxiety symptoms." c. "Kava may be effective for short-term treatment of mild anxiety symptoms." d. "Kava may be effective for short-term treatment of severe anxiety symptoms."

c. "Kava may be effective for short-term treatment of mild anxiety symptoms."

A school-age child experiences nocturnal bed-wetting several times each month. Which response should the nurse make when the child's parent asks if the problem will cure itself? a. "This problem responds only to treatment with family therapy." b. "Unless you consider using medications, the problem will continue." c. "Most children stop wetting the bed at night by the time they reach adolescence." d. "Most cases of enuresis are a result of organic causes and require medical treatment."

c. "Most children stop wetting the bed at night by the time they reach adolescence."

A patient is having an annual physical and shares information with the nurse. Which statement should the nurse indicates that the patient is experiencing workplace bullying? a. "My manager has not given me a raise in over 10 years." b. "My manager criticizes my work all the time, despite the fact that my annual performance review is always positive." c. "My manager does not invite me to team meetings, and I miss out on important information, affecting my annual performance review." d. "My manager does not provide any positive feedback on my work at all and my annual performance review remains unchanged."

c. "My manager does not invite me to team meetings, and I miss out on important information, affecting my annual performance review."

The nurse is asked to explain coping mechanisms for older patients experiencing a crisis. Which response should the nurse make? a. "Older adult patients generally do not have well-established coping mechanisms." b. "Older adult patients generally use physiological coping due to their advanced age." c. "Older adult patients in crisis are more likely to suffer from a lack of social support." d. "Older adult patients in crisis are more likely to suffer from a lack of belief-based coping."

c. "Older adult patients in crisis are more likely to suffer from a lack of social support."

The community health nurse is teaching a group of adults about crisis experienced by various populations. Which statement by one of the group members indicates that the nurse's teaching has been effective? a. "A good example of an adventitious crisis is a complicated divorce." b. "I will be aware that maturational crisis may occur more frequently among my older adult patients." c. "Patients with chronic illness are at greater risk for situational crisis than individuals without chronic illness." d. "Adventitious crisis may occur in patients who have miscarried during pregnancy or have delivered a preterm infant."

c. "Patients with chronic illness are at greater risk for situational crisis than individuals without chronic illness."

A patient says, "I don't think I can deal with feeling so sad much longer." What is the nurse's best response? a. "We all have times of sadness." b. "Are you saying you feel sad?" c. "Tell me about your feelings of sadness." d. "Is there a history of depression in your family?"

c. "Tell me about your feelings of sadness."

A patient is extremely unhappy work and does not know what to do. Using Rogerian therapeutic techniques, in which way should the nurse respond? a. "Let's make a plan for how you can handle this situation." b. "This situation sounds really awful. I think you should quit." c. "Tell me more about what is happening and how it makes you feel." d. "You really need to think about whether you are contributing to the difficulties you are having."

c. "Tell me more about what is happening and how it makes you feel."

The nurse is providing patient teaching to a patient newly diagnosed with sleep apnea. In which way should the nurse explain how continuous positive airway pressure (CPAP) corrects this disorder? a. "The machine is set up to breathe for you when you stop breathing during the night." b. "The machine's positive airway pressure provides a reminder to breathe during periods of apnea. " c. "The machine's positive airway pressure keeps the upper airway structures from collapsing during sleep." d. "The machine is set to give you oxygen during the times when you stop breathing and keep you from snoring."

c. "The machine's positive airway pressure keeps the upper airway structures from collapsing during sleep."

The spouse of a patient with a neurocognitive disorder (NCD) asks why a mental status examination is being completed on the patient? In which way should the nurse respond? a. "The mental status exam is the only way to assess the cognitive decline of a patient with early stage Alzheimer disease." b. "The mental status exam is used to assess depression in a patient with early stage Alzheimer disease." c. "The mental status exam will reveal slow and progressive cognitive decline of a patient with early stage Alzheimer disease." d. "The status exam will reveal rapid and dramatic changes in cognition of a patient with early stage Alzheimer disease."

c. "The mental status exam will reveal slow and progressive cognitive decline of a patient with early stage Alzheimer disease."

A patient reports feeling the loss of a spouse that occurred two years ago as strongly as the day it occurred. Which should the nurse suspect the patient is experiencing? a. Delayed grief b. Anticipatory grief c. Complicated grief d. Disenfranchised grief

c. Complicated grief

The nurse educator reviews the use of seclusion in the mental health facility. Which statements by the nurses would indicate that teaching has been effective? (Select all that apply.) a. "The patient who throws a book on the ground in frustration." b. "The patient who is loud and disrupting the milieu of the unit." c. "The patient who attempts to cut herself with an object found on the unit." d. "The patient who hits another patient in the face during a therapy session." e. "The patient who is confused and disoriented with altered thought processes."

c. "The patient who attempts to cut herself with an object found on the unit." d. "The patient who hits another patient in the face during a therapy session."

A patient tells the nurse that he is experiencing gastrointestinal problems since he began taking a selective serotonin-reuptake inhibitor (SSRI) for depression. Which response by the nurse would be most appropriate? a. "Try taking the medication will a full glass of water." b. "Try taking the medication at bedtime." c. "Try taking the medication with food." d. "Try taking the medication at least an hour before eating."

c. "Try taking the medication with food."

The family of a patient with Alzheimer disease wants to start giving the patient vitamin E to cure the disorder. Which response should the nurse make? a. "Vitamin E improves cognitive functioning." b. "Vitamin E works better than ginkgo biloba for dementia." c. "Vitamin E does not impact the progression of the dementia." d. "Vitamin E should be taken with omega-3 fatty acids to be effective."

c. "Vitamin E does not impact the progression of the dementia."

During a therapy session, a preadolescent patient asks to leave the session. How should the nurse respond to the patient to understand why the patient wants to leave? a. "Is there somewhere you want to go?" b. "I guess you're upset about something." c. "What happened to make you feel the need to leave?" d. "Why don't you just sit down for a minute so we can talk some more?"

c. "What happened to make you feel the need to leave?"

A patient has been taking sertraline (Zoloft) for one month. What should the nurse anticipate as the patient's target reaction? a. Weight gain b. Decreased sexual interest c. A remission of depression d. A remission of hallucinations

c. A remission of depression

The nurse is helping a patient work through grief after the death of a spouse three years ago. When following Worden's stages of mourning, which controversial stage might the nurse decide to eliminate? a. Accept the reality of the loss. b. Experience the pain of grief. c. Adjust to an environment in which the deceased is missing. d. Withdraw from the lost relationship and reinvest energy in new relationships

c. Adjust to an environment in which the deceased is missing.

An older patient with stage 3 Alzheimer disease is reported to have fallen several times over the last year. Which symptom should the nurse suspect the patient is experiencing? a. Aphasia b. Amnesia c. Apraxia d. Agnosia

c. Apraxia

A healthcare organization has adopted Giger and Davidhizar's transcultural model for use in providing patient care. Which nursing action demonstrates the element of social organization? a. Assessing the patient's self-control b. Reviewing the patient's genetic history and alterations in genetic makeup c. Assessing the patient's family and what roles members assume in relation to each other d. Determining what the patient conveys with both speech and nonverbal communication

c. Assessing the patient's family and what roles members assume in relation to each other

A nurse is caring for a patient with schizophrenia who is prescribed antipsychotic medications. Which statement is accurate regarding schizophrenia and medication treatment? a. Typical antipsychotic medications block serotonin and dopamine. b. Dopamine receptors exist in only one region of the brain, making treatment difficult. c. Atypical antipsychotic medications cause fewer extrapyramidal side effects than traditional antipsychotic medications. d. Positive symptoms of schizophrenia respond more readily to atypical antipsychotic medications than traditional medications.

c. Atypical antipsychotic medications cause fewer extrapyramidal side effects than traditional antipsychotic medications.

A patient with dissociative identity disorder reports having intrusive thoughts. Which medication order should the nurse anticipate for this patient? a. Insulin b. Epinephrine c. Beta-blocker d. Benzodiazepine

c. Beta-blocker

The nurse develops a daily exercise program for patient in a mental health facility. Which wellness domain does this type of program address? a. Psychological b. Sociological c. Biological d. Cultural

c. Biological

During a home visit the nurse observes an outburst of anger and extreme agitation in a patient recovering from injuries sustained during a mass shooting. Which domains should the nurse identify that are being affected by this patient's traumatic experience? (Select all that apply.) a. Cultural b. Spiritual c. Biological d. Sociological e. Psychological

c. Biological e. Psychological

The nurse is observed checking the mirror constantly and asking others if the uniform "looks okay." Of which disorder is the nurse demonstrating symptoms? a. Obsessive-compulsive disorder b. Posttraumatic stress disorder c. Body dysmorphic disorder d. Reactive attachment disorder

c. Body dysmorphic disorder

An adolescent female patient with gender dysphoria is not interested in surgical interventions and asks what other options exists to help her become male. Which options should the nurse suggest to the patient? (Select all that apply.) a. Voice lessons b. Loose-fitting clothing c. Breast binding d. Weight training e. Puberty suppression hormones

c. Breast binding e. Puberty suppression hormones

The nurse wants to use active listening techniques to improve nurse-patient relationships. In which way should these techniques influence communication? a. By acknowledging the nurse's interest in a nonjudgmental attitude b. By facilitating spontaneous responses and interactive conversation c. By offering a way to hear, observe, and understand what patients communicate d. By offering a way to seek information or clarification of the patient's thoughts or ideas

c. By offering a way to hear, observe, and understand what patients communicate

The nurse is caring for a patient with delusional verbalizations. Which is an appropriate intervention for patients exhibiting this symptom? a. Allow patient to determine delusion and truth through reflection. b. Provide family members with educational material regarding medication adherence. c. If delusions are expressed, present patient with reality without arguing. d. Provide teaching related to titration of medication based on patient perception of symptoms.

c. If delusions are expressed, present patient with reality without arguing.

The nurse cares for a patient with a substance use disorder who is admitted to the rehabilitation unit of the inpatient treatment facility. What is the primary purpose for the nurse to collaborate with the patient to establish and redefine mutual goals of treatment? a. It develops the nurse-patient relationship. b. It allows the nurse to self-reflect. c. It encourages patient responsibility. d. It provides evaluation of outcomes.

c. It encourages patient responsibility.

The nurse is assessing a patient's spirituality. What does the nurse recognize as one of the most important aspects of a belief system, according to Sharon Parks? a. It is based on a foundation of truth and evidence as proved by science. b. It is based on a foundation that is strong enough to handle the changes in religious beliefs. c. It is based on a foundation that is strong enough to handle the changes and challenges of life. d. It is based on a foundation of religious belief and practices as performed by those who follow it.

c. It is based on a foundation that is strong enough to handle the changes and challenges of life.

The nurse is preparing patient education for parents of children who have experienced trauma. In which way should the nurse explain that yoga helps victims of childhood trauma? a. It can improve problem-solving skills. b. Yoga practice supports an improved self-image. c. It may help trauma victims feel safe and grounded. d. Yoga practice improves social skills and interactions.

c. It may help trauma victims feel safe and grounded.

The nurse is preparing a presentation on cognitive and behavioral perspectives of personality disorders. Which information will the nurse include in the presentation? a. Behaviors result from an imbalance in brain chemistry. b. Behaviors occur due to a history of childhood trauma and parental dysfunction. c. Learned behaviors become inflexible and maladaptive. d. Learned behaviors result from cultural influences.

c. Learned behaviors become inflexible and maladaptive.

The nurse is caring for patient with depression. What information will the nurse include when teaching the patient about phenelzine (Nardil)? a. May use with opioids. b. Maintain a low glycemic diet. c. Maintain a low tyramine diet. d. May use with a selective serotonin reuptake inhibitor (SSRI).

c. Maintain a low tyramine diet.

The nurse is caring for a patient with major depressive disorder (MDD) who is taking DHEA in addition to antidepressant medications. Which potential adverse effect will the nurse be most concerned about the patient developing? a. Suicidal ideation b. Hypertension c. Mania d. Hypoglycemia

c. Mania

Members of a community are experiencing an increase in emotional symptoms after a mass shooting event in a local movie theater. Which type of trauma should the nurse use to guide interventions for this community? (Select all that apply.) a. Military trauma b. Historical trauma c. Manmade disaster d. System-induced trauma e. Traumatic grief of separation

c. Manmade disaster e. Traumatic grief of separation

An older adult is admitted for exacerbation of symptoms of bipolar disorder. Which should the nurse recognize as a common complication in the management of bipolar disorder in the older adult patient? a. Sensory deficit b. Cognitive changes c. Medical comorbidities d. Oppositional personality

c. Medical comorbidities

An older patient with an anxiety disorder wants to use complementary health approaches (CHAs) to help treat the disorder. Which mind and body practices should the nurse recommend to the patient? (Select all that apply.) a. Kava b. DHEA c. Meditation d. Biofeedback e. Progressive muscle relaxation

c. Meditation d. Biofeedback e. Progressive muscle relaxation

The nurse is caring for a patient with suspected delirium. In addition to the sudden onset of symptoms, the nurse can expect to find alterations in which functions during the assessment? (Select all that apply.) a. Changes in gait b. Altered vision c. Memory d. Motor decline e. Consciousness

c. Memory e. Consciousness

The nurse prepares to assess a patient with a dissociative disorder. On which areas should the nurse focus this assessment? a. Pain, bowel sounds, behaviors b. Anxiety, vitamin B12 level, heart sounds c. Memory difficulties, patient safety, and level of anxiety d. Facial expression, body image, pupillary reactivity

c. Memory difficulties, patient safety, and level of anxiety

A patient with a mental health disorder refuses to comply with treatment expectations because the payment by the health insurance plan for the services is low and the patient has limited financial resources. Which federal law should the nurse investigate that would be helpful for this patient? a. Mental Health Bill of Rights b. Patient Self-Determination Act (PSDA) c. Mental Health Parity and Addiction Equity Act (MHPAE) d. Protection and Advocacy for Mentally Ill Individuals Act of 1986

c. Mental Health Parity and Addiction Equity Act (MHPAE)

When caring for a patient with a sleep-wake disorder, the nurse notes that the patient takes an MAO inhibitor for depression. Which medication prescription should the nurse question? (Select all that apply.) a. Zaleplon (Sonata) b. Zolpidem (Ambien) c. Mirtazapine (Remeron) d. Nortriptyline (Aventyl) e. Chloral hydrate (Noctec)

c. Mirtazapine (Remeron) d. Nortriptyline (Aventyl)

The nurse is researching theories to explain the etiology of personality disorders. Which should the nurse identify regarding parenting and the development of personality disorders? a. Engulfing parenting may force a child to separate before he or she is ready. b. Indifferent parenting does not allow a child to separate and individuate. c. Narcissism may develop due to a parental lack of empathy. d. Pessimism may develop due to inconsistent parenting.

c. Narcissism may develop due to a parental lack of empathy.

An older patient is experiencing a sudden onset of disorientation, confusion, and lack of attention. For which health problem should the nurse assess the patient? a. Depression b. Dementia c. Schizophrenia d. Delirium

d. Delirium

The nurse is assessing a patient suspected of having a substance use disorder (SUD). Which symptoms should the nurse include in the assessment? (Select all that apply.) a. Disregard for religious beliefs while abusing the substance b. Absence of desire to quit abusing the substance c. Need for greater amounts of the substance to achieve the same effect d. Neglect of normal activities due to focus on obtaining or using more of the substance e. Persistent craving for the substance

c. Need for greater amounts of the substance to achieve the same effect d. Neglect of normal activities due to focus on obtaining or using more of the substance e. Persistent craving for the substance

The patient tells the nurse, "The world will end tonight at midnight. Armageddon is upon us!!" This statement indicates the patient is experiencing which type of delusion? a. Religious b. Grandiose c. Nihilistic d. Persecutory

c. Nihilistic

A patient with end-stage pancreatic cancer and dementia is assigned to a nurse for hospice care. In which way should the nurse assess this patient for pain? a. Periodically ask the patient to rank the pain on a scale of one to ten. b. Observe the patient regularly and write anecdotal reports. c. Observe the patient regularly and score on a scale of observable reactions. d. Periodically ask the patient to rank the pain on a visual scale from high to low.

c. Observe the patient regularly and score on a scale of observable reactions.

The nurse is planning care for a patient diagnosed with a sexual disorder. Which nursing action is important during the preinteraction phase of the nurse-patient relationship? a. Discuss the nurse's beliefs with the patient. b. Agree with the patient's sexual values. c. Participate in values clarification. d. Provide appropriate sexual health care.

c. Participate in values clarification.

A patient with paraplegia reports some advantages of having the disorder. To which secondary gain might the patient be referring? (Select all that apply.) a. Attention b. Sympathy c. Personal services d. Disability benefits e. Escape from some responsibilities

c. Personal services d. Disability benefits e. Escape from some responsibilities

The community health nurse is concerned about risky adolescent behavior online. What might be an appropriate subject for a parent workshop to help address this issue? a. How to use social media b. How to keep children off the internet c. Strategies that promote internet safety d. Techniques for getting access to children's internet communications

c. Strategies that promote internet safety

A patient who has recently been diagnosed with a personality disorder has returned for a follow-up appointment. Which potential co-morbid disorder will the nurse include as a priority for assessment? a. Cardiovascular disease b. Insomnia c. Substance abuse d. Schizophrenia

c. Substance abuse

The nurse is reviewing developmental theories for a staff presentation. Which two theories should the nurse identify that form the foundation for interpersonal psychotherapy? a. Freud and Maslow b. Pavlov and Skinner c. Sullivan and Bowlby d. Piaget and Kohlberg

c. Sullivan and Bowlby

The nurse and patient are discussing various groups settings and how they might benefit the patient. Which group should the nurse describe as being led by members of the group and not a healthcare provider? a. Activity group b. Psychodynamic group c. Support group d. Psychoeducational group

c. Support group

The nurse is preparing material regarding basic safety monitoring and status reporting of a patient in crisis. Which information should the nurse include? a. Basic coping skills b. Common emotional responses c. Surveillance for common illness d. Behavioral stress reduction techniques

c. Surveillance for common illness

A nurse became close to a patient and stays awake at night wondering about the patient's current status. In which way should the nurse's concern about the patient be interpreted? a. The nurse is experiencing burnout. b. The nurse is experiencing insomnia. c. The nurse has crossed professional boundaries. d. The nurse has compromised professional licensure.

c. The nurse has crossed professional boundaries.

The nurse is caring for an adolescent female patient with bulimia nervosa. What experience in the nurse's life could interfere most with nurse's objectivity? a. The nurse has a poor body image. b. The nurse has a friend who was bulimic. c. The nurse was bulimic as an adolescent. d. The nurse has never had any personal experience of bulimia.

c. The nurse was bulimic as an adolescent.

The nurse is determining diagnoses appropriate for a patient's care. When formulating these diagnoses, on which element should the nurse focus? (Select all that apply.) a. The patient's disease or condition b. The severity of the patient's disease or condition c. The patient's adaptation to the disease or condition d. How the patient's disease or condition will be treated e. How the patient's disease or condition affects the patient's life

c. The patient's adaptation to the disease or condition e. How the patient's disease or condition affects the patient's life

A patient with an alcohol use disorder asks if the disorder can be passed down to children. What does the nurse explain as the role of genetics in the development of a substance use disorder (SUD)? a. The role of genetics is minor in comparison to the role of the environment. b. Genetics does not seem to play a role in the development of SUDs. c. The role of genetics in SUDs has not been determined. d. Genetics plays a major role in the development of SUDs.

c. The role of genetics in SUDs has not been determined.

The family of a patient with a serious mental illness requests hospitalization for the patient because of refusing to get dressed every day. For which reason should the nurse determine that the patient does not qualify for involuntary commitment? a. The patient has used up hospital coverage. b. The patient has not voluntarily requested hospitalization. c. There is no evidence that patient is a danger to self or others. d. It is less than two weeks since the patient's most recent hospital discharge

c. There is no evidence that patient is a danger to self or others.

The nurse is attending a city council meeting where zoning issues are being discussed. Which should the nurse identify is occurring when community members voice concerns over the placement of a group home for patients with mental health disorders? a. Violation of the Patient Self-Determination Act (PSDA) b. Concern about the cost of having a group home in the community c. Vocalization of a stigma against people with mental health disorders d. Refusal to adhere to the Health Insurance Portability and Accountability Act (HIPAA)

c. Vocalization of a stigma against people with mental health disorders

The nurse is planning care for a patient with a sleep-wake disorder. Which question should the nurse ask the patient while planning this care? (Select all that apply.) a. Is the patient exhibiting drug-seeking behavior? b. Does the patient really have a sleep-wake disorder? c. Which symptom is most distressing or upsetting to the patient? d. Is the patient able to work with the team to develop his care plan? e. What specific goal is the patient wanting to achieve with his sleep?

c. Which symptom is most distressing or upsetting to the patient? d. Is the patient able to work with the team to develop his care plan? e. What specific goal is the patient wanting to achieve with his sleep?

A nurse is researching the trends of maturational crisis. Which patients will the nurse determine are at greatest risk for developing a maturational crisis? (Select all that apply.) a. Young child whose parent is murdered b. Older adult whose spouse recently passed away c. Young adult single parent of two young children d. College student who is attending an out-of-state university e. Exchange student whose family has been killed in a terrorist attack overseas

c. Young adult single parent of two young children d. College student who is attending an out-of-state university

The nurse is asked to explain different ethical principles. Which statement should indicate that the nurse understands the concept of autonomy? a. "All patients should be given their due." b. "We must always be honest with patients." c. "Part of our profession is doing good things for others." d. "After I provide information, I will respect my patient's right to make a decision."

d. "After I provide information, I will respect my patient's right to make a decision."

A patient with a sleep-wake disorder reports drinking a couple glasses of wine before bed to get sleepy. What is the best response by the nurse? a. "That's a reasonable thing to do if it makes you sleepy at bedtime." b. "If that works for you, try to drink red wine for the antioxidant benefit." c. "If you drink wine to go to sleep, make sure you don't take it with medication." d. "Alcohol might make you sleepy, but it contributes to waking later in the night."

d. "Alcohol might make you sleepy, but it contributes to waking later in the night."

A patient with a history of suicide attempt has been participating in the treatment plan and is not actively suicidal, but continues to express feelings of hopelessness. Which statements by the nurse would best promote hope for this patient? (Select all that apply.) a. "Tell me about the struggles in your life." b. "How are you trying to solve some of your problems?" c. "Have you ever felt like you wanted to hurt yourself?" d. "Are you getting any regular exercise?" e. "You are doing a great job by participating in the ordered therapy."

d. "Are you getting any regular exercise?" e. "You are doing a great job by participating in the ordered therapy."

The nurse is reviewing information collected during a patient assessment. Which question should the nurse ask to clarify one of the patient's responses? a. "See, the medicine does work." b. "Everything seems to work out eventually." c. "I knew it would work for you; it just takes time." d. "Are you saying you feel the medicine is helping you?"

d. "Are you saying you feel the medicine is helping you?"

The nurse is planning care for a patient who is suspected of being at risk for suicide. Which question would be most appropriate for the nurse to ask when determining the presence of protective measures? a. "Do you have any thoughts of suicide?" b. "Do you have a history of trauma in your past?" c. "What symptoms of depression are you experiencing?" d. "Do you identify with a religious or spiritual group?"

d. "Do you identify with a religious or spiritual group?"

The nurse is caring for a patient who has expressed a desire to commit suicide. Which statement by the nurse is most appropriate? a. "Your problems will get better. Hurting yourself is not the answer." b. "Your family and friends will be very upset at you if you hurt yourself." c. "I am shocked that you would consider hurting yourself. You have so much to live for." d. "I am here for you. I know you want to hurt yourself, but there are things we can do to help you."

d. "I am here for you. I know you want to hurt yourself, but there are things we can do to help you."

A patient experiencing psychosis says, "I am in charge. Who are you and why are you here?" What is the most therapeutic response by the nurse? a. "You know who I am." b. "You don't know who I am?" c. "You are not in charge; you are a patient in the hospital." d. "I am your nurse and I will be here to help you until dinner."

d. "I am your nurse and I will be here to help you until dinner."

The nurse is performing a crisis assessment on a patient who is experiencing crisis due to a recent divorce. Which statement indicates to the nurse that the patient is experiencing the exhaustion phase of crisis? a. "I can't believe this is happening to me." b. "I have called my mom to help me with the kids." c. "I am tired from moving all of my belongings into a new house. " d. "I just can't seem to cope anymore. I am not sure what I am going to do."

d. "I just can't seem to cope anymore. I am not sure what I am going to do."

A patient who has no problems with sleeping reports having trouble because of "all the commotion" in the hospital. Which response should the nurse make? a. "You should go on a brisk walk right before bed." b. "You should turn on the TV to mask the noises on the unit." c. "I'll talk to the doctor and ask him to order you a sleeping pill." d. "I will get you some ear plugs so that you won't hear as much noise at night."

d. "I will get you some ear plugs so that you won't hear as much noise at night."

The patient admitted to the mental health unit is concerned that health information given to the nurse remains confidential. What is the nurse's best response? a. "We can keep the information just between the two of us if you prefer." b. "I will share the information with staff members only with your approval." c. "You can choose whether your physician needs this information for your care." d. "If the information is important to your care, I will need to share it with the staff."

d. "If the information is important to your care, I will need to share it with the staff."

The nurse educator is presenting information to staff regarding negative emotions that may occur when caring for patients who are anxious, angry, and aggressive. Which staff member statement indicates that the teaching has been effective? a. "Self-awareness prevents the nurse's negative emotions." b. "Self-awareness allows the nurse to express sympathy for the patient." c. "Intense negative emotions guide the nurse to plan appropriate interventions." d. "Intense negative emotions interfere with the nurse's assessment and judgment."

d. "Intense negative emotions interfere with the nurse's assessment and judgment."

A patient with a history of alcohol abuse asks for information about Alcoholics Anonymous. Which response should the nurse make? a. "It is a group that learns about drinking from a group leader." b. "It is a form of group therapy led by a psychiatrist." c. "It is a group that advocates strong punishment for drunk drivers." d. "It is a self-help group that emphasizes sobriety."

d. "It is a self-help group that emphasizes sobriety."

The community health nurse is providing education about various community services that patients and family members can use to prevent suicide. Which statement made by the nurse best exemplifies secondary prevention resources? a. "Here is a brochure that lists the signs of suicide." b. "Let me tell you the various resources available to help prevent suicide." c. "The hospital has a support group for survivors of suicide that meets every Tuesday." d. "Let me discuss with you the benefits of early intervention for the prevention of suicide."

d. "Let me discuss with you the benefits of early intervention for the prevention of suicide."

The nurse is delegating tasks to unlicensed assistive personnel (UAP). Which statement made by the nurse indicates a power differential between the two care providers? a. "I'm here to answer any questions to might have." b. "It is really nice to be here as we serve our patients and meet their needs." c. "Keep in mind that we are to support our patients' efforts to achieve maximum wellness." d. "Let me see your intake and output totals before documenting them so I can fix your math."

d. "Let me see your intake and output totals before documenting them so I can fix your math."

A patient who abuses heroin wants to know why methadone is used in treatment. Which response should the nurse make? a. "Methadone is safe even in large doses." b. "Methadone replaces a more potent drug." c. "Methadone is a deterrent to using other drugs." d. "Methadone blocks the craving for and the action of opiates."

d. "Methadone blocks the craving for and the action of opiates."

A patient with insomnia asks about possible complementary health approaches (CHAs) to improve sleep. How should the nurse respond to the patient? a. "DHEA has been shown to be effective in sleep-wake disorders." b. "Acupuncture has been shown to be effective in all sleep-wake disorders." c. "Natural products have been shown more effective in sleep-wake disorders than mind and body practices." d. "Mind and body interventions, such as meditation, have demonstrated a positive effect on sleep quality."

d. "Mind and body interventions, such as meditation, have demonstrated a positive effect on sleep quality,"

A patient with obstructive sleep apnea (OSA) is unhappy using continuous positive airway pressure (CPAP) therapy and asks if there is any other treatment. Which response should the nurse make? a. "Perhaps a class in sleep hygiene would be helpful." b. "Certain classes of sleeping pills are sometimes effective in OSA." c. "Cognitive-behavioral therapy works for some people with OSA." d. "Oral-pharyngeal surgery, some appliances, and weight loss are sometimes utilized."

d. "Oral-pharyngeal surgery, some appliances, and weight loss are sometimes utilized."

The nurse is caring for a patient with early-onset dementia. Which statement should the nurse use to assess the patient's abstraction capacity? a. "Please tell me the name of our president." b. "Please spell the word 'world' forward and backward." c. "Please tell me your name, the date, and where you are right now." d. "Please tell me the meaning of the statement, 'A picture paints a thousand words.'"

d. "Please tell me the meaning of the statement, 'A picture paints a thousand words.'"

A patient who lost a child in an auto accident says, "God has abandoned me." What is an appropriate statement for the nurse to make? a. "I will go and get a clergy member to help you." b. "God has nothing to do with what happened to you." c. "You need to strengthen your faith if you want to be able to survives this tragedy." d. "Tell me more about what your faith means to you. If you like, I will get a clergy member to come speak with you."

d. "Tell me more about what your faith means to you. If you like, I will get a clergy member to come speak with you."

The nurse is caring for a patient who appears anxious and is pacing the room and clenching his fists. Which core principle should the nurse use to provide interventions to this patient? a. Administering a medication to the patient b. Deciding to promptly isolate the patient from others c. Assessing the patient's perception of his level of anxiety d. Demonstrating therapeutic communication with the patient

d. Demonstrating therapeutic communication with the patient

A patient newly diagnosed with obstructive sleep apnea (OSA) is afraid of dying while asleep despite the use of continuous positive airway pressure (CPAP). What should the nurse respond to this patient? a. "It does happen sometimes, but you should be fine with the CPAP." b. "That is not likely because the CPAP can breathe for you if you stop breathing." c. "Don't worry, we'll be monitoring your oxygen saturation and we'll wake you up before that happens." d. "That is not likely, because when your body has is not getting enough oxygen, it sends an awakening alert."

d. "That is not likely, because when your body has is not getting enough oxygen, it sends an awakening alert."

An older patient is being examined for suspected delirium. Which statement by the patient's adult child best supports the diagnosis? a. "Dad has always been so independent. He's lived alone for years since my mom died." b. "Dad just hasn't seemed to know what he's been doing lately. He has been very forgetful these last few months." c. "Maybe it's just caused by aging." d. "The changes in his behavior came on so quickly. I wasn't sure what was happening."

d. "The changes in his behavior came on so quickly. I wasn't sure what was happening."

The nurse is asked about psychological issues related to childhood abuse. Which statement should the nurse make? a. "It doesn't matter where the abuse occurs." b. "Children under 10 can't be diagnosed with PTSD." c. "Most abused children develop long-term psychological problems." d. "The frequency and number of abusive events influences the severity of the psychological distress."

d. "The frequency and number of abusive events influences the severity of the psychological distress."

The nurse is asked to explain the pathophysiology and etiology of depression. Which response should the nurse make? a. "Cerebral structure is responsible for depression." b. "We know that heredity is the single cause of depression." c. "Because all patients respond the same to serotonin reuptake inhibitors, we have a thorough understanding of the neurochemistry of depression." d. "There is no unified hypothesis regarding pathophysiology and etiology of depression, in part because patients demonstrate individualized responses to treatments."

d. "There is no unified hypothesis regarding pathophysiology and etiology of depression, in part because patients demonstrate individualized responses to treatments."

The nurse is assessing a patient in an assisted living facility. What statement by the patient would indicate disconnection from familiar life? a. "I always like to eat dinner at the same time every day." b. "My family really doesn't have a lot of time to visit me." c. "This place would be better if there were more musical activities." d. "This place has nothing like the beautiful porch that I used to sit on in my home."

d. "This place has nothing like the beautiful porch that I used to sit on in my home."

The nurse cares for patients with mental health problems. Which statement should the nurse make when following the ethics of care? a. "We should always tell the truth." b. "We are expected to always do the right thing." c. "We should do whatever provides the greatest benefit." d. "We are all interconnected and part of the same global family."

d. "We are all interconnected and part of the same global family."

A patient exhibiting manifestations of depression hesitates to discuss the disorder or answer any assessment questions. Which question should the nurse ask to understand the patient's culture? a. "Where do you live?" b. "Where did you go to high school?" c. "How many siblings do you have?" d. "Would you please describe your family?"

d. "Would you please describe your family?"

The nurse is caring for a patient with dementia due to Alzheimer disease. In which way should the nurse explain the etiology of this disease? a. A presence of eosinophilic inclusion bodies in the cortex and brain stem results in impaired cognitive function. b. An infectious form of a normally harmless type of protein, called a prion, interferes with neuronal health, leading to dementia. c. Multiple vascular lesions occur in the cerebral cortex and subcortical structures, resulting from the decreased blood supply to the brain, and lead to a decline in cognitive function. d. A buildup of beta amyloid plaques and tangled strands of tau protein interferes with neuronal health, communication, and transport functions, leading to dementia.

d. A buildup of beta amyloid plaques and tangled strands of tau protein interferes with neuronal health, communication, and transport functions, leading to dementia.

The nurse is caring for a patient with suspected shift work disorder. In order for the patient to be diagnosed with this disorder, what must criteria must the patient meet? a. The criteria for at least one other physiological disorder b. Sleep loss of more than 2 hours per day due to the shift work c. The criteria for other sleep circadian-rhythm disorders d. Absence of any physiological disorders that may cause the symptoms

d. Absence of any physiological disorders that may cause the symptoms

A patient begins to pace the room and glare at staff members while waiting to be discharged. Which action should the nurse take to prevent patient aggression? a. Call hospital security to be prepared if the patient becomes aggressive. b. Ask the patient to remain seated and retrieve the patient's discharge paperwork. c. Acknowledge the patient's feelings and leave the room in order to avoid confrontation. d. Acknowledge the patient's feelings and determine the status of the patient's discharge paperwork.

d. Acknowledge the patient's feelings and determine the status of the patient's discharge paperwork.

The nurse observes a member of the group clarifying relationships between various ideas. What role is the member assuming? a. Teacher b. Orienter c. Manager d. Coordinator

d. Coordinator

The nurse equates a patient's behavior as being similar to that of a family member. In which way should the nurse's opinion be categorized? a. Transference b. Ethnocentrism c. Cultural relativism d. Countertransference

d. Countertransference

The nurse is caring for a patient with severe dementia. What nursing intervention best promotes orientation to time and space? a. Provide good lighting, especially on stairs. b. Acknowledge the patient's feelings. c. Break instructions into short time frames. d. Cover mirrors to decrease fear.

d. Cover mirrors to decrease fear.

The nurse is planning care for a patient with dissociative disorder. What is the most appropriate initial nursing intervention to promote stress reduction and healthy coping in this patient? a. Encourage the patient to increase contact with friends and family. b. Disregard the patient's other personalities. c. Help the patient create distance from family members who do not believe the patient is sick. d. Determine patient's level of safety and encourage the patient to recognize triggers.

d. Determine patient's level of safety and encourage the patient to recognize triggers.

A parent asks when their school-age child will "grow out" of clumsiness. For which neurodevelopmental disorder should this patient be assessed? a. Tic b. Autism spectrum c. Stereotypic movement d. Developmental coordination

d. Developmental coordination

The nurse is planning care for a male patient. Which model would most support the development of depression in this patient whose mother was sentenced to jail for 15 years when the patient was 3 months old? a. Genetic b. Environmental c. Neuroendocrine d. Diathesis-stress

d. Diathesis-stress

An older adult is diagnosed with a sleep-wake disorder. Which over-the-counter medication should the nurse counsel the patient to avoid? a. Zolpidem b. Ramelteon c. Trazodone d. Diphenhydramine

d. Diphenhydramine

The nurse is providing information to the spouse of a patient who has been diagnosed with bipolar disorder. What treatment will the nurse share as being most effective for a patient with acute mania? a. Group therapy b. Fluoxetine (Prozac) c. Seclusion and restraint d. Electroconvulsive therapy (ECT)

d. Electroconvulsive therapy (ECT)

A patient holds a knife to the throat and tells a family member that voices are telling the patient to commit suicide. In which way should this patient be admitted to the hospital? a. Commitment b. Temporary admission c. Observational admission d. Emergency involuntary admission

d. Emergency involuntary admission

The nurse is caring for a patient who attempted suicide a year ago but expresses no desire to do so now. On what will the nurse focus during patient education? a. Emphasizing that the patient seek and use resources to prevent a suicide attempt b. Encouraging the patient to call family members for support when having feelings of suicide c. Developing a pamphlet of information that the patient will use to increase knowledge on suicide prevention d. Encouraging the patient attend a support group with other individuals who have attempted suicide

d. Encouraging the patient attend a support group with other individuals who have attempted suicide

A patient looks forward to spending time at a local place of worship each week because of the other people who attend. What benefit might this have for the patient? a. Provides hope b. Supports believing c. Encourages growth d. Enhances belonging

d. Enhances belonging

The nurse is reviewing the ANA's Code of Ethics for Nurses and its influence on providing patient care. What concept should the nurse keep in mind regarding ethical and legal standards? a. Ethical standards outweigh legal standards. b. Legal standards outweigh ethical standards. c. Ethical and legal standards are separate, yet similar. d. Ethical and legal standards are intertwined, yet distinct.

d. Ethical and legal standards are intertwined, yet distinct.

A patient with a chronic illness arrives for a routine wellness evaluation. For which reason should the nurse determine that this patient has a high level of resilience? a. Uses a stationary bicycle daily b. Views new experiences as challenges c. Explains that weight loss has improved the ability to function daily d. Expresses gratitude for being able to walk without having symptoms

d. Expresses gratitude for being able to walk without having symptoms

The nurse is caring for a patient with a sexual dysfunction and is referring to the DSM-5 as guide of reference. What subtype of sexual dysfunction does the DSM-5 refer to as occurring regardless of partner, situation, or type of stimulation? a. Situational b. Lifelong c. Acquired d. Generalized

d. Generalized

The nurse is discussing the various types of workplace aggression. Which action should be recommended for nurses to take to prevent type 1 aggression while at work? a. Recognize escalating anxiety in visitors and family members of patients. b. Report to the charge nurse when a healthcare provider gets angry at the nurse. c. Report to the charge nurse any threats that a colleague or peer makes to the nurse. d. Have a security guard escort the nurse outside if it is dark when the nurse leaves.

d. Have a security guard escort the nurse outside if it is dark when the nurse leaves.

A nursing student is writing a research paper on ways to improve psychiatric nursing outcomes for serious mental illness. Which type of research would be most useful? a. Nursing b. Psychosocial c. Educational d. Improved functioning

d. Improved functioning

The nurse is caring for a patient who is an intravenous drug user. For which potential cardiac complication should the nurse assess this patient? a. Cardiac tamponade b. Myocardial infarction c. Congestive heart failure d. Infective endocarditis

d. Infective endocarditis

A patient becomes upset when touched by a staff member who is attempting to obtain the patient's blood pressure. What has the staff member overlooked? a. Privacy b. Confidentiality c. Duty to protect d. Informed consent

d. Informed consent

The nurse flying home is called to the front of the airplane by a flight attendant because a passenger in the first row is having a panic attack and is demanding to get off the plane. Which action should the nurse take? a. Instruct the passenger to close the eyes. b. Ask if there is any alprazalom (Xanax) in the plane's first aid it. c. Administer an emergency epinephrine shot to counteract the panic symptoms. d. Instruct the passenger to breathe in through the nose and blow out through the mouth.

d. Instruct the passenger to breathe in through the nose and blow out through the mouth.

The nurse asks to meet with a healthcare provider and patient to discuss altering the patient's prescribed medication after the provider prescribes a placebo, which the nurse refuses to give. Which element of decision-making did the nurse implement? a. Values clarification b. Stakeholder identification c. Moral hierarchy exploration d. Integrity-preserving compromise

d. Integrity-preserving compromise

The nurse is evaluating the goals and outcomes of patient who is being discharged with a diagnosis of major depressive disorder. Which should the nurse identify as a limitation when using the met versus not-met framework when evaluating goals and outcomes? a. It is less effective at defining the specific goal or outcome. b. It less effective at identifying a specific goal or outcome. c. It is less effective at documenting the results of the goal or outcome. d. It is less effective at specifying progress toward meeting the goal or outcome.

d. It is less effective at specifying progress toward meeting the goal or outcome.

The nurse is using the nursing process to care for a patient with mental illness. At what point of the nurse-patient interaction will the nurse complete the assessment phase of the nursing process? a. It begins at the first face-to-face meeting with the patient and continues until the evaluation phase. b. It begins at the first face-to-face meeting with the patient and continues until the patient leaves the setting. c. It may begin prior to the first face-to-face meeting with the patient and continue until the diagnosis phase. d. It may begin prior to the first face-to-face meeting with the patient and continue until the patient leaves the setting.

d. It may begin prior to the first face-to-face meeting with the patient and continue until the patient leaves the setting.

A patient who was fired because of habitual tardiness believes the boss was making a big deal out of nothing. Which cognitive distortion should the nurse identify that this patient is exhibiting? a. Arbitrary inference b. Selective abstraction c. Overgeneralization d. Magnification/minimization

d. Magnification/minimization

The nurses on a medical-surgical floor disagree with the care being provided to a patient by a particular healthcare provider and contact the ethics committee at the hospital. Which action should they expect the committee to take? a. Assume primary care of the patient. b. Censure the physician for inappropriate care. c. Turn the information over to a judge. d. Make recommendations to resolve conflict.

d. Make recommendations to resolve conflict.

A patient who is a senior in high school fails two classes and is unable to graduate. Which type of crisis is the patient likely experiencing? a. Biological crisis b. Situational crisis c. Adventitious crisis d. Maturational crisis

d. Maturational crisis

A preadolescent patient with ADHD is experiencing insomnia. For which treatment should the nurse prepare teaching for this patient? a. Fluoxetine (Prozac) b. Atomoxetine (Strattera) c. Amphetamine sulfate (Adderall) d. Melatonin

d. Melatonin

A patient with anorexia nervosa has a BMI of 16.5 kg/m2. For which stage of severity should the nurse plan care for this patient? a. Mild b. Severe c. Extreme d. Moderate

d. Moderate

The nurse is planning a presentation to the staff at a senior center. What factor that affects mental health in older adults should the nurse emphasize in the discussion? a. Job loss b. Divorce c. Work stressors d. Multiple losses

d. Multiple losses

The nurse is preparing a teaching tool for new employees. Which information about the role of neurotransmitters in neurobiology should the nurse include in the tool? a. There are two classes of neurotransmitters. b. Each neurotransmitter functions in the same manner. c. Neurotransmitters and receptors do not vary in their affinity for each other. d. Neurotransmitters consistently act in either an excitatory or inhibitory manner.

d. Neurotransmitters consistently act in either an excitatory or inhibitory manner.

A patient reports a significant reduction in energy level. What neurotransmitter might the nurse suspect is involved in this change? a. GABA b. Dopamine c. Serotonin d. Norepinephrine

d. Norepinephrine

A patient who reports having been raped seeks medical attention at the local emergency department. Which action should the nurse take to ensure that evidence is correctly collected from the patient? a. Report the assault to the police b. Discuss actions to prevent pregnancy c. Place the client's clothing in plastic bags d. Notify the sexual assault nurse examiner (SANE)

d. Notify the sexual assault nurse examiner (SANE)

The nurse prepares to assess a patient with anorexia nervosa. Which behavior should the nurse expect to assess? a. Positive self-image b. Constant overeating c. Flexible rules regarding food d. Obsessive rituals regarding food

d. Obsessive rituals regarding food

The nurse is planning care for a patient newly diagnosed with an anxiety disorder. Which should the nurse keep in mind when caring for this patient? a. Adhering to the healthcare professional's orders for the patient b. Importance of information from the patient's high school counselor c. Patient's response during the initial phase of treatment d. Personal anxiety level and how it may affect the patient's care

d. Personal anxiety level and how it may affect the patient's care

A spouse is concerned that a patient with memory loss is experiencing dementia. What other indicator described by the spouse would indicate the need for further evaluation for dementia? a. Pain b. Insomnia c. Depression d. Personality changes

d. Personality changes

The nurse is advocating for culturally diverse patient issues. What information should the nurse use as a basis for promoting cultural competence and sensitivity? a. Life experiences b. Patient assessment c. Uniformity training d. Population diversity

d. Population diversity

A preadolescent patient in foster care experiences recurrent nightmares about a past violent event that affect the patient's ability to remember and concentrate. Which disorder should the nurse suspect the patient is experiencing? a. Depression b. Separation anxiety c. Pediatric bipolar disorder (PBD) d. Posttraumatic stress disorder (PTSD)

d. Posttraumatic stress disorder (PTSD)

The nurse realizes that it is almost one year since a patient's spouse died. What should the nurse do? a. Ignore it unless the patient mentions it. b. Tell the patient to visit the spouse's grave that day. c. Suggest that the patient make plans to go away that day. d. Prepare the patient for a possible anniversary reaction and help the patient plan for it.

d. Prepare the patient for a possible anniversary reaction and help the patient plan for it.

A nurse diagnosed with acute anxiety is scheduled to take the CCRN exam for the second time in 2 weeks after being unsuccessful the first time. Which medication would be helpful to reduce the nurse's anxiety? a. Buspirone (Buspar) b. Citalopram (Celexa) c. Alprazolam (Xanax) d. Propranolol (Inderal)

d. Propranolol (Inderal)

A patient with a substance abuse disorder and addiction is being treated at a Level III treatment facility for substance detoxification. What nursing intervention is most likely to be the focus of care at this level of treatment? a. Providing daily outpatient care and monitoring b. Providing a referral to a halfway house in the patient's community c. Providing the patient with intensive medical and psychiatric care d. Providing safe, round-the-clock care that supports wellness and recovery

d. Providing safe, round-the-clock care that supports wellness and recovery

The nurse is conducting teaching on stress management for a group of adults. Which should the nurse realize is the purpose of this group? a. Activity b. Support c. Psychodynamic d. Psychoeducational

d. Psychoeducational

During an assessment, the nurse notes that the patient's speech is rapid and incoherent at times. Which domain is the nurse assessing? a. Social b. Spiritual c. Biological d. Psychological

d. Psychological

The nurse is planning care for a patient. Which intervention best supports the concept that the nursing process is dynamic in nature? a. Reviewing the patient's health care chart b. Agreeing with the patient on stated treatment goals c. Providing the patient with information on the ordered medication d. Re-addressing patient interventions after a change in the patient's status

d. Re-addressing patient interventions after a change in the patient's status

The nurse is caring for a patient recovering from a psychotic episode. Which should the nurse identify as a critical feature for psychological adjustment? a. Reflection on psychological milestones b. Insight into learning how to cope with life c. Progressive goal direction through thought processes d. Re-engagement in normal daily interactions

d. Re-engagement in normal daily interactions

The nurse suspects that an older patient who purchased a new car for a neighbor to help with transportation is experiencing financial abuse. Which action should the nurse take? a. Ask for the neighbor's name. b. Suggest that the patient stop relying on the neighbor. c. Recommend the patient to move to a skilled nursing facility d. Report the suspected abuse to the protective agency.

d. Report the suspected abuse to the protective agency.

A patient is diagnosed with an anxiety disorder. For which reason should the nurse expect a selective serotonin-reuptake inhibitor (SSRI) to be prescribed for this patient? a. SSRIs have a short half-life. b. SSRIs are metabolized by the liver. c. SSRIs are adrenergic blocking agents. d. SSRIs have fewer side effects than other antianxiety medications.

d. SSRIs have fewer side effects than other antianxiety medications.

A patient is taking a selective serotonin-reuptake inhibitor (SSRI) and wonders if adding St. John's wort would help the symptoms of depression. Which potential adverse effect should the nurse explain can occur if St. John's wort is taken with an SSRI? a. Gastrointestinal distress b. Increased depressive symptoms c. Dementia d. Serotonin syndrome

d. Serotonin syndrome

A patient with bipolar disorder is being treated with lithium. What laboratory test should be used to evaluate the effectiveness and toxicity of the patient's lithium levels? a. Complete blood count b. Basic metabolic panel c. Urinalysis d. Serum blood level test

d. Serum blood level test

The nurse is assessing a patient suspected of having bipolar disorder. Which information related to the physiology of circadian rhythms should the nurse consider during this assessment? a. Personality patterns b. Psychiatric diagnosis c. Negative thought patterns d. Sleep pattern

d. Sleep pattern

A patient with dysfunctional grieving after the traumatic loss of a spouse is "mad at God." What nursing diagnosis would be most appropriate for this patient? a. Hopelessness b. Powerlessness c. Risk for violence d. Spiritual distress

d. Spiritual distress

The nurse is assessing a patient seeking medical treatment for injuries that are reported to have occurred during a riot. For which observation should the nurse suspect the patient is actually a victim of intimate partner violence (IPV)? a. Clothing torn and streaked with dirt and blood b. Patient explains falling after being sprayed with tear gas c. Visible cuts and bruises over both arms and legs d. Spouse demands to stay during the physical examination

d. Spouse demands to stay during the physical examination

The nurse cares for a patient diagnosed with schizophrenia. For which reason should the nurse use an eclectic approach with this patient? a. There is a lack of care philosophies to direct nursing practice. b. It is difficult to determine a final plan of care for a patient with a psychotic disorder. c. There is limited scientific evidence about treatment for schizophrenia, so a variety of medications and interventions must be tried over time. d. Strategies from one or a combination of psychiatric theories and therapies are used to determine interventions and evaluation criteria for working with each patient.

d. Strategies from one or a combination of psychiatric theories and therapies are used to determine interventions and evaluation criteria for working with each patient.

A patient with a somatic symptom disorder enjoys playing the piano. Which area should be discussed first when the patient arrives for a cognitive-behavioral therapy (CBT) session? a. New songs the patient is learning b. Length of time the patient plays each day c. Plans to play the piano for friends and family d. Symptoms experienced since the last therapy session

d. Symptoms experienced since the last therapy session

A patient whose employment includes frequent travel asks for assistance with the fear of flying. Which behavioral treatment approach should be considered for this patient? a. Psychoanalysis b. Aversion therapy c. Cognitive therapy d. Systematic desensitization

d. Systematic desensitization

The nurse is planning on providing primary intervention education for patients at risk for suicide. Which action will the nurse take? a. Teaching first responders the signs of increased risk for suicide b. Teaching a group of parents about the signs of suicidal gestures c. Teaching a patient about re-establishing a healthy sense of self d. Teaching community members about resources available to prevent a suicide attempt

d. Teaching community members about resources available to prevent a suicide attempt

A When offering assistance to a patient in a shelter for hurricane victims, the patient says, "I don't need your help." Using therapeutic communication, in which way should the nurse respond? a. Move away from the patient. b. Call the nursing supervisor. c. Tell the patient that anger won't help her situation. d. Tell the patient that anger is understandable in her situation.

d. Tell the patient that anger is understandable in her situation.

The nurse reviews data collected during the assessment of a patient with a mental illness. For which reason should a nursing diagnosis instead of a DSM diagnosis be used as a guide to plan this patient's care? a. The nursing diagnosis is more general. b. The nursing diagnosis is more effective. c. The nursing diagnosis is more accurate. d. The nursing diagnosis is more specific.

d. The nursing diagnosis is more specific.

The nurse is preparing to discharge a patient diagnosed with anxiety. Which outcome indicates that care has been effective? a. The patient reports a decrease in physical symptoms. b. The patient is able to verbalize anxiety-causing activities. c. The patient is able to stay focused for a limited amount of time. d. The patient is sleeping six hours 5 days/week.

d. The patient is sleeping six hours 5 days/week.

A patient with schizophrenia has delusions that are religious in nature. What is most important for the nurse to remember when caring for this patient? a. The delusions manifest as a result of spiritual distress. b. The delusions are intertwined with the patient's religion. c. The patient may not be mentally ill if the delusions are not persecutory. d. The patient may be expressing personal beliefs as well as having delusions.

d. The patient may be expressing personal beliefs as well as having delusions.

The nurse is meeting with an adolescent female patient who reports frequent cutting. In which way should the nurse interpret the patient's information? a. The patient is depressed. b. The patient needs an immediate medication evaluation. c. This is typical behavior adolescent behavior and not really a big problem. d. The patient needs to feel safe and develop new coping skills.

d. The patient needs to feel safe and develop new coping skills.

The nurse is caring for four patients at risk for suicide. Which patient would benefit most from tertiary prevention of suicide? a. The patient who presents to the primary care clinic for an annual wellness exam b. The patient who presents to the local urgent care expressing hopelessness c. The patient who presents to the emergency department after surviving a suicide attempt d. The patient who presents to the outpatient clinic who has a history of suicide attempt

d. The patient who presents to the outpatient clinic who has a history of suicide attempt

A patient who abuses alcohol has been placed on naltrexone (Trexan). What information about the effects of this medication should the nurse include in the patient education? a. The patient needs to avoid use of over-the-counter decongestants. b. If alcohol is ingested, the patient may experience a lethal reaction. c. The patient needs to avoid use of over-the-counter products that contain alcohol. d. The patient will feel less pleasure from using alcohol while taking the medication.

d. The patient will feel less pleasure from using alcohol while taking the medication.

The nurse is caring for a patient with a sleep-wake disorder. What outcome would be the most appropriate for this patient? a. The patient will state feeling rested upon awakening. b. The patient will increase amount of time spent asleep within 3 days. c. The patient will increase sleep time from 5 hours per night to 7 hours per night. d. The patient will increase sleep time from 5 hours per night to 7 hours per night in 3 days.

d. The patient will increase sleep time from 5 hours per night to 7 hours per night in 3 days.

The nurse validates the patient's response to an intervention prior to documenting in the progress note. What does validation ensure? a. The patient's request is clarified. b. The patient's affect is appropriate to the situation. c. The patient's need for further intervention is understood. d. The patient's perception of the response is communicated

d. The patient's perception of the response is communicated

A patient with bipolar disorder asks what caused the illness. What should the nurse respond about the genetic transmission of the disorder? a. Bipolar disorder is caused by environmental factors. b. There is one single gene responsible for bipolar disorder. c. There is no known cause for the development of bipolar disorder. d. There appears to be a genetic link in the transmission of bipolar disease.

d. There appears to be a genetic link in the transmission of bipolar disease.

A healthcare organization is considering using the theory of reasoned action to assist patients in changing lifestyle behaviors. Which should the nurse administrator identify as a shortcoming of this theory before the organization begins implementation? a. An outcome evaluation is absent. b. Motivation to comply is highlighted. c. The behavior belief drives the action. d. There is no distinction between a goal and a behavioral intention.

d. There is no distinction between a goal and a behavioral intention.

The nurse caring for patients with mental illness wants to use empathy as a therapeutic tool. In which way should empathy be used as a therapeutic tool for nurses? a. To validate the nurse's expertise b. To validate the nurse's perceptions c. To validate the nurse-patient relationship d. To validate the experiences of the patient

d. To validate the experiences of the patient