Final Review NUR2520 Practice Questions

Termination of a therapeutic nurse-patient relationship with a patient has been successful when the nurse: 1. avoids upsetting the patient by shifting focus to other patients before the discharge. 2. gives the patient a personal telephone number and permission to call after discharge. 3. discusses with the patient changes that have happened during the relationship and evaluates the outcomes. 4. offers to meet the patient for coffee and conversation three times a week after discharge.

3. discusses with the patient changes that have happened during the relationship and evaluates the outcomes.

A 36-year-old nurse who has worked in an inner city emergency department for 10 years feels burnt out. He seems to be taking more sick time than normal over the past 2 years. What might be the underlying cause of his situation? A. The nurse is bored after 10 years of being in an emergency department and needs to change to a different specialty. B. The nurse is experiencing the effects of chronic anxiety. C. The nurse probably was exposed to a virus or bacteria and has not yet been diagnosed. D. The nurse is showing signs of PTSD.

B. The nurse is experiencing the effects of chronic anxiety.

Which statement about tricyclic antidepressant medications is accurate? A. Strong or aged cheese should not be eaten while taking them. B. Their full therapeutic potential may not be reached until 4 weeks. C. They may cause hypomania or recent memory impairment. D. They should not be given with antianxiety agents.

B. Their full therapeutic potential may not be reached until 4 weeks.

A voluntary client is asking for discharge. What is the nurse's first consideration? A. Notifying the physician. B. What is the required action? C. What are the needs of the nursing staff? D. Are there are enough staff to keep the client on the unit?

B. What is the required action?

A patient diagnosed with schizophrenia believes evil spirits are being summoned by a local minister and verbally threatens to bomb a local church. The psychiatrist notifies the minister. The psychiatrist has: A. released information without proper authorization. B. demonstrated the duty to warn and protect. C. violated the patient's confidentiality. D. avoided charges of malpractice.

B. demonstrated the duty to warn and protect.

A client presents in the mental health clinic saying, "I didn't expect it. They just told me this morning that I don't have a job any more. I can't think straight. I feel like I'm going crazy." The nurse should conclude that the client is experiencing which type of crisis 1. Adventitious 2. Maturational 3. Situational 4. Personal

3. Situational

A client is diagnosed with Anxiety Disorder. Which medication is prescribed for anxiety? A. Chlorpromazine (Thorazine) B. Clozapine (Clozaril) C. Diazepam (Valium) D. Methylphenidate (Ritalin)

C. Diazepam (Valium)

The patient's family reports that the patient has become irritable, is not sleeping, and tells them he cannot relax. This has been going on for 2 days. The family says he has not left the house in 2 weeks. A family member tells you there are empty beer cans all over the place. He assures you that he looked everywhere and there is no alcohol in the house, just the empty cans. What problem does the patient exhibit? A. Alcohol abuse B. Agoraphobia C. Substance abuse anxiety disorder D. Panic attack

C. Substance abuse anxiety disorder

The nurse is assessing a client who has a diagnosis of Schizophrenia and takes an antipsychotic agent daily. Which finding requires further nursing assessment? A. Respirations of 22 beats/minute B. Weight gain of 8 pounds in 2 months C. Temperature of 101°F D. Excess salivation

C. Temperature of 101°F

Each morning before going to work, a 43-year-old man spends 2 hours cleaning the outside and inside of his car even if the car is already clean. His wife is concerned and comes to you for help. What is your best response? A. Your husband shows signs of complex obsessive-compulsive disorder (OCD). You should not be overly concerned since he will experience periods of exacerbation and remission. Consult with your primary care practitioner who might recommend cognitive behavioral therapy. B. Your husband shows signs of complex OCD. You should not be overly concerned because he continues to go to work. Consult with your primary care practitioner who might recommend cognitive behavioral therapy. C. Your husband shows signs of simple OCD. You should not be overly concerned because he continues to go to work. Consult with your primary care practitioner who might recommend cognitive behavioral therapy. D. Your husband shows signs of simple OCD. You should not be overly concerned because he continues to go to work. Consult with your primary care practitioner who might give prescription medication.

C. Your husband shows signs of simple OCD. You should not be overly concerned because he continues to go to work. Consult with your primary care practitioner who might recommend cognitive behavioral therapy.

Which is most likely to be a precursor to developing agoraphobia? A. Social phobia B. Bipolar disorder C. Panic disorder D. Anxiety disorder

C. panic disorder

Which individual with a mental illness may need emergency or involuntary hospitalization for mental illness? The individual who: A. resumes using heroin while still taking methadone. B. reports hearing angels playing harps during thunderstorms. C. throws a heavy plate at a waiter at the direction of command hallucinations. D. does not show up for an outpatient appointment with the mental health nurse.

C. throws a heavy plate at a waiter at the direction of command hallucinations.

As part of discharge teaching, which guideline regarding lithium therapy will the nurse plan to include? A. Avoid excessive use of beverages containing caffeine. B. Maintain a consistent sodium intake. C. Consume at least 2500 to 3000 mL of fluid per day. D. All of the above

D. All of the above

Bandi has been observed in the seclusion room for the past 2 hours. His hygiene is very poor. He is drowsy with slurred speech, vital signs are stable, and he states that he is hungry. What is the nurse manager's best intervention(s) at this time? A. Ask the mental health technician (MHT) to bring Bandi to the day room, seat him at a table, and offer him a snack. B. Offer Bandi a snack, and ask the MHT to offer fluids and toileting; then medicate the patient again as a precaution against his aggression. C. Ask the MHT to assist Bandi with a shower. Return him to the seclusion room, and then offer him a snack. D. Offer Bandi a snack, and then assist the MHT in taking Bandi to his assigned room to lie down. Document the interventions and outcomes.

D. Offer Bandi a snack, and then assist the MHT in taking Bandi to his assigned room to lie down. Document the interventions and outcomes.

Which medication does not require periodic blood-level monitoring? A. Eskalith (lithium carbonate) B. Depakote (valproic acid) C. Clozaril (clozapine) D. Paxil (paroxetine)

D. Paxil (paroxetine)

Which statement should a nurse identify as correct regarding a client's right to refuse treatment? A. Clients can refuse pharmacological but not psychological treatment. B. Clients can refuse any treatment at any time. C. Clients can refuse only electroconvulsive therapy (ECT). D. Professionals can override treatment refusal by an actively suicidal or homicidal client.

D. Professionals can override treatment refusal by an actively suicidal or homicidal client.

The nurse is caring for a severely depressed client who has just been admitted to the in-client psychiatric unit. Which of the following is a PRIORITY of care? A. Nutrition B. Elimination C. Rest D. Safety

D. Safety

Jessie has missed three sessions at the mental health center and sporadically attends AA meetings. She is drinking heavily this weekend and has sustained a 2-inch gash in her forehead after swerving off the road into a shallow ditch. She is taken by rescue to the ED. You are her nurse. She tells you, "I hope I just go to sleep and never wake up." What is your best intervention? A. Tell Jessie, "You are just tired and have had too much alcohol in your system." B. Clear the area of any items that Jessie may use to inflict self-harm. C. Immediately activate the mental health protocol to have Jessie admitted to a psychiatric unit. D. Stay with Jessie, call the supervisor, and arrange for continuous monitoring.

D. Stay with Jessie, call the supervisor, and arrange for continuous monitoring.

A 65-year-old woman reports periods of palpitations, sweating, and slight shortness of breath. She feels like she's going to die. You speak with her daughter who reports that her father recently passed away and her mother lives alone. How would you respond? A. Tell the daughter that her mother is likely experiencing panic attacks and will develop depressive disorder. B. Tell the daughter that her mother is likely experiencing depressive disorder. C. Tell the daughter that her mother is likely experiencing panic attacks. D. Tell the daughter that her mother is likely experiencing panic attacks and that she should tell her primary practitioner about it so she can be treated soon.

D. Tell the daughter that her mother is likely experiencing panic attacks and that she should tell her primary practitioner about it so she can be treated soon.

A 15-year-old client presents in the emergency department requesting voluntary admission to the psychiatric unit. What should the nurse consider? A. Whether a bed is available on the unit B. Whether the unit will accept adolescent clients C. Whether there is 1:1 staffing available D. The age of the individual

D. The age of the individual

Eleanor is treated with a _____, which helps to slow the destruction of acetylcholine. A. 5-HT2A (serotonin) antagonist B. GABA C. D2 (dopamine) antagonist D. cholinesterase inhibitor

D. cholinesterase inhibitor

For a nurse working in crisis intervention, which belief would be least helpful? A. A person in crisis is incapable of making his or her own decisions. B. The crisis counseling relationship is one between partners. C. Crisis counseling helps the patient refocus to gain new perspectives on the situation. D. Anxiety reduction techniques are used to enable the patient's inner resources to be accessed.

A. A person in crisis is incapable of making his or her own decisions.

A nurse cares for an older adult patient admitted for treatment of depression. The health care provider prescribes an antidepressant medication, but the dose is more than the usual adult dose. The nurse should: A. implement the order. B. consult a drug reference. C. give the usual geriatric dosage. D. hold the medication and consult the health care provider.

D. hold the medication and consult the health care provider.

A patient says, "I've done a lot of cheating and manipulating in my relationships." Select a nonjudgmental response by the nurse. 1. "How do you feel about that?" 2. "It's good that you realize this." 3. "That's not a good way to behave." 4. "Have you outgrown that type of behavior?"

1. "How do you feel about that?"

A patient says, "Please don't share information about me with the other people." How should the nurse respond? 1. "I won't share information with others without your permission, but I will share information about you with other staff members." 2. "A therapeutic relationship is just between the nurse and the patient. It's up to you to tell others what you want them to know." 3. "It really depends on what you choose to tell me. I will be glad to disclose at the end of each session what I will report to others." 4. "I cannot tell anyone about you. It will be as though I am talking about my own problems, and we can help each other by keeping it between us."

1. "I won't share information with others without your permission, but I will share information about you with other staff members."

Which statement shows a nurse has empathy for a patient who made a suicide attempt? 1. "You must have been very upset when you tried to hurt yourself." 2. "It makes me sad to see you going through such a difficult experience." 3. "If you tell me what is troubling you, I can help you solve your problems." 4. "Suicide is a drastic solution to a problem that may not be such a serious matter."

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

Which client should the nurse anticipate to be most receptive to psychiatric treatment? 1. A Jewish, female social worker. 2. A Baptist, homeless male. 3. A Catholic, black male. 4. A Protestant, Swedish business executive.

1. A Jewish, female social worker.

Which of the following is an example of normal anxiety? Select all that apply. 1. A mother experiences dread when she discovers evidence that her teenage daughter has missed two menstrual periods. 2. Long after a minor car accident, a man continues to experience tachycardia on revisiting the scene of the accident. 3. To help decrease her fear, an elderly woman at- tends daily Mass and prays the rosary for her grandson, who is on active duty in the army. 4. A police officer has to apply for a leave of absence because of the feelings experienced after a near fatal car chase. 5. An individual who recently lost a parent due to a long chronic illness now cannot leave the home.

1. A mother experiences dread when she discovers evidence that her teenage daughter has missed two menstrual periods. 3. To help decrease her fear, an elderly woman attends daily Mass and prays the rosary for her grandson, who is on active duty in the army.

A client diagnosed with schizophrenia receives fluphenazine decanoate (Prolixin Decanoate) from a home health nurse. The client refuses medication at one regularly scheduled home visit. Which nursing intervention is ethically appropriate? 1. Allow the client to decline the medication and document the decision. 2. Tell the client that if the medication is refused, hospitalization will occur. 3. Arrange with a relative to add the medication to the client's morning orange juice. 4. Call for help to hold the client down while the injection is administered.

1. Allow the client to decline the medication and document the decision.

Which medication would be a first-line consideration in the treatment of anxiety? 1. Buspirone (BuSpar) 2. Alprazolam (Xanax) 3. Chlordiazepoxide (Librium) 4. Clonazepam (Klonopin)

1. Buspirone (BuSpar)

The client is in a crisis state after a flood destroyed the client's home, which resulted in immediate homelessness. During the assessment interview, what should the nurse assist the client to identify? Select all that apply. 1. Current feelings 2. The precipitating event (precipitant) 3. The client's appraisal of the event 4. Exploration of alternative solutions to the problem 5. The realistic nature of the crisis event

1. Current feelings 2. The precipitating event (precipitant) 3. The client's appraisal of the event

A medications as appropriate treatment for a client diagnosed with post-traumatic stress disorder (PTSD)? Select all that apply. 1. Fluoxetine (Prozac) 2. Alprazolam (Xanax) 3. Propranolol (Inderal) 4. Lithium carbonate (Lithobid) 5. Riprasidone (Geodon)

1. Fluoxetine (Prozac) 5. Riprasidone (Geodon)

A client is to take Eskalith (lithium) regularly after he is discharged from the hospital. The nursing care plan includes discharge planning. The most important information to impart to the client and his family is that the client should 1. Have an adequate intake of sodium. 2. Limit his fluid intake. 3. Have a limited intake of sodium. 4. Not eat foods that have a high tyramine content (e.g., cheese, wine, liver, yeast) or drink alcohol.

1. Have an adequate intake of sodium.

A nurse should expect that an increase in dopamine activity might play a significant role in the development of which mental illness? 1. Schizophrenia spectrum disorder 2. Major depressive disorder 3. Body dysmorphic disorder 4. Parkinson's disease

1. Schizophrenia spectrum disorder

The nurse states to a client on an in-patient unit, "Tell me what's been on your mind. "Which describes the purpose of this therapeutic communication technique? 1. To have the client initiate the conversation. 2. To present new ideas for consideration. 3. To convey interest in what the client is saying. 4. To provide time for the nurse and client to gather thoughts and reflect.

1. To have the client initiate the conversation.

A nurse is teaching a client who has an anxiety disorder and is scheduled to begin classical psychoanalysis. Which of the following client statements indicates an understanding of this form of therapy? 1. "Even if my anxiety improves, I will need to continue this therapy for 6 weeks." 2. "The therapist will focus on my past relationships during our sessions." 3. "psychoanalysis will help me reduce my anxiety by changing my behaviors." 4. "This therapy will address my conscious feelings about stressful experiences."

2. "The therapist will focus on my past relationships during our sessions."

According to Maslow's hierarchy of needs, which situation on an inpatient psychiatric unit would require priority intervention by a nurse? 1. A client rudely complaining about limited visiting hours 2. A client exhibiting aggressive behavior toward another client 3. A client stating that no one cares 4. A client verbalizing feelings of failure

2. A client exhibiting aggressive behavior toward another client

A client with the diagnosis of schizophrenia has orders for Clozaril (clozapine). The nurse will evaluate the drug's effect as positive if the 1. Client develops leukopenia. 2. Monthly liver function studies change moderately. 3. Psychotic symptoms, such as hearing voices, are reduced. 4. Client's energy level and involvement in activities goes up.

3. Psychotic symptoms, such as hearing voices, are reduced.

Which of the following matches the definition: the justification of behaviors using reason other than the real reason? 1. Compensation 2. Projection 3. Rationalization 4. Dysphoria

3. Rationalization

A nurse assesses a confused older adult. The nurse experiences sadness and reflects, "The patient is like one of my grandparents, so helpless." What feelings does the nurse describe? 1. Transference 2. Countertransference 3. Catastrophic reaction 4. Defensive coping reaction

2. Countertransference

An unconscious psychological mechanism that reduces anxiety arising from unacceptable or potentially harmful stimuli is called as? 1. Homeostasis 2. Defense mechanism 3. Ego centralism 4. Intrinsic mechanism

2. Defense mechanism

A client is admitted to a psychiatric unit with the diagnosis of catatonic schizophrenia. Which of the client's neurotransmitters should a nurse expect to be elevated? 1. Serotonin 2. Dopamine 3. Gamma-aminobutyric acid (GABA) 4. Histamine

2. Dopamine

For the third time within a month, a client with borderline personality disorder took a handful of pills, called 911, and was admitted to the emergency department. The nurse overhears an unlicensed staff member say, "Here she comes again. If she was serious about committing suicide, she'd have done it by now." The nurse determines there is a need to teach the staff member which of the following? 1. Clients with personality disorders rarely have completed suicides. 2. Each suicidal attempt should be taken seriously. 3. Exploration of suicidal ideation and intent should be avoided. 4. The nurse should prepare the client for direct inpatient admission.

2. Each suicidal attempt should be taken seriously.

A 58-year-old client on a mental health unit has lost control, despite having been properly medicated, and is threatening to harm himself and others. He has been placed in four-point restraints. Which nursing measure should be taken next? 1. Release one restraint every 15 minutes. 2. Have a staff member stay with the client at all times. 3. Leave the client alone to reduce his sensory stimulation and allow him to regain control. 4. Restrict fluids until the restraint period is over.

2. Have a staff member stay with the client at all times.

When assessing a client for possible suicide, an important clue would be if the client 1. Is hostile and sarcastic to the staff. 2. Identifies with problems expressed by other clients. 3. Seems satisfied and detached. 4. Begins to talk about leaving the hospital.

3. Seems satisfied and detached.

Which cerebral structure should a nursing instructor describe to students as the "emotional brain"? 1. The cerebellum 2. The limbic system 3. The cortex 4. The left temporal lobe

2. The limbic system

At what point should the nurse determine that a client is at risk for developing a mental illness? 1. When thoughts, feelings, and behaviors are not reflective of the DSM-5 criteria. 2. When maladaptive responses to stress are coupled with interference in daily functioning. 3. When a client communicates significant distress. 4. When a client uses defense mechanisms as ego protection.

2. When maladaptive responses to stress are coupled with interference in daily functioning.

A nurse should introduce the matter of a contract during the first session with a new patient because contracts: 1. specify what the nurse will do for the patient. 2. spell out the participation and responsibilities of each party. 3. indicate the feeling tone established between the participants. 4. are binding and prevent either party from prematurely ending the relationship.

2. spell out the participation and responsibilities of each party.

A patient with a diagnosis of major depression who has attempted suicide says to the nurse, "I should have died! I've always been a failure. Nothing ever goes right for me." Which response demonstrates therapeutic communication? 1."You have everything to live for." 2."Why do you see yourself as a failure?" 3."Feeling like this is all part of being depressed." 4."You've been feeling like a failure for a while?"

2."Why do you see yourself as a failure?"

A client is angry, pacing, and muttering obscenities. A staff member is asking the nurse to consider restraints. What should the nurse consider first? 1. If there are enough staff for a show of force 2. Calling the physician for a PRN medication 3. Assess reasons why the client is agitated before looking at any interventions 4. The needs of the nursing staff

3. Assess reasons why the client is agitated before looking at any interventions

Which nursing action is inappropriate during a crisis situation? 1. Taking an active role in problem solving and making decisions for the client 2. Guiding the client to appropriate resources 3. Encouraging independent thinking to promote insight 4. Creating a highly structured environment for the client

3. Encouraging independent thinking to promote insight

A client newly admitted to an inpatient psychiatric unit is diagnosed with obsessive-compulsive disorder. Which correctly stated nursing diagnosis takes priority? 1. Anxiety R/T regression of ego development AEB ritualistic behaviors 2. Powerlessness R/T ritualistic behaviors AEB state-ments of lack of control 3. Fear R/T a traumatic event AEB stimulus avoidance 4. Social isolation R/T increased levels of anxiety AEB not attending groups

3. Fear R/T a traumatic event AEB stimulus avoidance

A jilted college student is admitted to a hospital following a suicide attempt and states, "No one will ever love a loser like me." According to Erikson's theory of personality development, a nurse should recognize that this patient has a deficit in which developmental stage? 1. Trust versus mistrust 2. Initiative versus guilt 3. Intimacy versus isolation 4. Ego integrity versus despair

3. Intimacy versus isolation

A nurse is performing a mental health assessment on an adult client. According to Maslow's hierarchy of needs, which client action would demonstrate the highest achievement in terms of mental health? 1. Maintaining a long-term, faithful, intimate relationship 2. Achieving a sense of self-confidence 3. Possessing a feeling of self-fulfillment and realizing full potential 4. Developing a sense of purpose and the ability to direct activities

3. Possessing a feeling of self-fulfillment and realizing full potential

A nurse is providing teaching for a client who is scheduled to receive ECT for the treatment of major depressive disorder. Which of the following client statements indicates understanding of the teaching? 1. "It is common to treat depression with ECT before trying medications." 2. "I can have my depression cured if I receive a series of ECT treatments." 3. "I should receive ECT once a week for 6 weeks." 4. "I will receive a muscle relaxant to protect me from injury during ECT."

4. "I will receive a muscle relaxant to protect me from injury during ECT."

A charge nurse is discussing TMS with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching? 1."TMS is indicated for clients who have schizophrenia spectrum disorders." 2."I will provide postanesthesia care following TMS." 3."TMS treatments usually last 5 to 10 minutes." 4."I will schedule the client for TMS treatments 3 to 5 times a week for the first several weeks."

4. "I will schedule the client for TMS treatments 3 to 5 times a week for the first several weeks."

The nurse's lack of verbal communication for therapeutic reasons is to "silence" as the nurse's ability to process information and examine reactions to the messages received is to: 1. "Focusing." 2. "Offering self." 3. "Restating." 4. "Listening."

4. "Listening."

Jon, an emergency department (ED) nurse, has just worked an 8-hour shift in the ED. After a five-car wreck during his midshift, five patients have been transported to the hospital with multiple injuries and one fatality. Jon looks exhausted, and his hands are tremulous. He insists that he is scheduled to work another 6 hours. As the nurse manager, what is your best action? A. Tell him that he needs to end his shift right away. B. Tell him he needs to nap for 30 minutes and then return to work. C. Tell him to go to the cafeteria, relax, and drink strong coffee. D. Tell him to eat a high carbohydrate snack, take a 30-minute break, and then return to work.

A. Tell him that he needs to end his shift right away.

The most effective nursing intervention for a severely anxious client who is pacing vigorously would be to: 1. Instruct her to sit down and quit pacing. 2. Place her in bed to reduce stimuli and allow rest. 3. Allow her to walk until she becomes physically tired. 4. Give her prn medication and walk with her at a gradually slowing pace.

4. Give her prn medication and walk with her at a gradually slowing pace.

A nurse should recognize that a decrease in norepinephrine levels would play a significant role in which mental illness? 1. Bipolar disorder: mania 2. Schizophrenia spectrum disorder 3. Generalized anxiety disorder 4. Major depressive episode

4. Major depressive episode

An inpatient psychiatric client suddenly becomes loud and visibly anxious. What is the best action for the nurse to take? 1. Summon help and escort the client to his room. 2. Face the client squarely and say, "You must be quiet." 3. Say, "Calm down; you're safe here." 4. Say, "Let's go talk in your room."

4. Say, "Let's go talk in your room."

A health-care team, an Asian American client, and several members of the client's family are meeting together to discuss the client's imminent discharge. During this time, the client does not speak and makes eye contact only with family members. From a cultural perspective, which nursing assessment accurately describes the client's behavior? 1. The client has a lack of understanding of the disease process. 2. The client is experiencing denial related to the client's condition. 3. The client is experiencing paranoid thoughts toward authority figures. 4. The client has respect for members of the health-care team.

4. The client has respect for members of the health-care team.

Which client statement should alert a nurse that a client may be responding maladaptively to stress? A. "I've found that avoiding contact with others helps me cope." B. "I really enjoy journaling; it's my private time." C. "I signed up for a yoga class this week." D. "I made an appointment to meet with a therapist."

A. "I've found that avoiding contact with others helps me cope."

Which statement about crisis theory provides a basis for nursing intervention? A. A crisis is an acute, time-limited phenomenon experienced as an overwhelming emotional reaction to a problem perceived as unsolvable. B. A person in crisis usually has had adjustment problems and has inadequately coped in his or her usual life situations. C. Crisis is precipitated by an event that enhances the person's self-concept and self-esteem. D. Nursing intervention in crisis situations rarely has the effect of ameliorating the crisis.

A. A crisis is an acute, time-limited phenomenon experienced as an overwhelming emotional reaction to a problem perceived as unsolvable.

When Bandi was apprehended by the police, he was handcuffed and placed in the police car. Care was taken to ensure that he was not injured during the process. The officers told Bandi that he was being taken to a safe place. Upon arrival at the facility, Bandi was escorted to the emergency services area where he was assessed and admitted to the crisis stabilization unit. He was frightened, paranoid, and physically struggling with the mental health technicians, yelling, "I ain't finished my mission. The grocery carts are still covered in rust! I'm gonna die!" Upon entry to the crisis stabilization unit, Bandi was taken to the seclusion room and chemically restrained. What does this mean? A. He was medicated against his will. B. He was forced to swallow drugs. C. He was a victim of assault and battery. D. He was a victim of false imprisonment.

A. He was medicated against his will.

Which structure of the brain is involved in learning, processing information into memories, and assigning the time and the place to memories? A. Hippocampus B. Olfactory bulb C. Limbic system D. Occipital lobe

A. Hippocampus

While assessing your patient, Simon, a 63-year-old man in the psychiatric unit with a diagnosis of generalized anxiety disorder, he asks you, "Can you tell me why my family thinks that I am just acting sick to get attention?" Drawing from your knowledge of the impact of mental illness on families, which of the following would you include in your discussion to help Simon see his illness as a real illness? (Select all that apply.) A. Mental health is fundamental to health. B. Mental disorders are real health conditions that have an immense impact on individuals and families. C. The efficacy of mental health treatment is well documented. D. A range of treatments exists for most mental disorders.

A. Mental health is fundamental to health. B. Mental disorders are real health conditions that have an immense impact on individuals and families. C. The efficacy of mental health treatment is well documented. D. A range of treatments exists for most mental disorders.

A mental health technician asks the nurse, "How do psychiatrists determine which diagnosis to give a patient?" Which of these responses by the nurse would be most accurate? A. Psychiatrists use pre-established criteria from the APA's Diagnostic and Statistical Manual of Mental Disorders (DSM-5). B. Hospital policy dictates how psychiatrists diagnose mental disorders. C. Psychiatrists assess the patient and identify diagnoses based on the patient's unhealthy responses and contributing factors. D. The American Medical Association identifies 10 diagnostic labels that psychiatrists can choose from.

A. Psychiatrists use pre-established criteria from the APA's Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

Which principle takes priority for the psychiatric inpatient staff when addressing behavioral crises? A. Resolve behavioral crises using the least restrictive intervention possible. B. Rights of the majority of patients supersede the rights of individual patients. C. Swift intervention is justified to maintain the integrity of the therapeutic milieu. D. Allow patients opportunities to regain control without intervention if the safety of other patients is not compromised.

A. Resolve behavioral crises using the least restrictive intervention possible.

Eileen works with youth in a residential treatment center. When Amber, a new patient of hers, does not want her parents to visit, Eileen says, "I know how you feel. Did your dad molest you too?" Eileen's reaction is an example of which behavior? A. Empathy B. Verbal tracking C. Countertransference D. Positive reinforcement

C. Countertransference

A psychiatric nurse working on an inpatient unit receives a call asking if an individual has been a client in the facility. Which nursing response reflects appropriate legal and ethical obligations? A. The nurse refuses to give any information to the caller, citing rules of confidentiality. B. The nurse hangs up on the caller. C. The nurse confirms that the person has been at the facility but adds no additional information. D. The nurse suggests that the caller speak to the client's therapist.

A. The nurse refuses to give any information to the caller, citing rules of confidentiality.

To whom can information be released without the client's consent? A. To public officials responsible for responding to child abuse B. To insurance companies C. To school personnel D. To public health agencies that track HIV status

A. To public officials responsible for responding to child abuse

The client refuses to take medication. What is the next decision? A. Withhold the medication. B. The client must accept the medication. C. The provider should consider whether the medication is appropriate. D. The court can order the medication to be administered.

A. Withhold the medication.

A patient being treated in an alcohol rehabilitation unit reveals to the nurse, "I feel terrible guilt for sexually abusing my 6-year-old child before I was admitted." Based on state and federal law, the best action for the nurse to take is to: A. anonymously report the abuse by telephone to the local child abuse hotline. B. reply, "I'm glad you feel comfortable talking to me about it." C. respect the nurse-patient relationship of confidentiality. D. file a written report on the agency letterhead.

A. anonymously report the abuse by telephone to the local child abuse hotline.

A nurse assesses an inpatient psychiatric unit, noting that exits are free from obstruction, no one is smoking, the janitor's closet is locked, and all sharp objects are being used under staff supervision. These observations relate to: A. management of milieu safety. B. coordinating care of patients. C. management of the interpersonal climate. D. use of therapeutic intervention strategies.

A. management of milieu safety.

Planning for patients diagnosed with mental illness is facilitated by understanding that inpatient hospitalization is generally reserved for patients who: A. present a clear danger to self or others. B. are noncompliant with medications at home. C. have no support systems in the community. D. develop new symptoms during the course of an illness.

A. present a clear danger to self or others.

A client was recently admitted to the inpatient unit after a suicide attempt and has not responded to SSRIs or tricyclic antidepressants. The client asks the nurse, "I heard about MAOIs (monoamine oxidase inhibitors). Why can't they be added to what I am on now? Wouldn't adding one help?" Which is the most appropriate nursing response? A. "Electroconvulsive therapy (ECT) is your best option at this point." B. "Combined use can lead to a life-threatening condition called a hypertensive crisis." C. "There is no reason why an MAOI couldn't be added to your therapy." D. "They can't be used together because their mechanisms of action are very different."

B. "Combined use can lead to a life-threatening condition called a hypertensive crisis."

Jessie had a blood alcohol level (BAL) of 0.11% upon arrival at the emergency department (ED). She is now your patient in the hospital psychiatric unit, day 4. She tells you, "I wasn't drunk. I just had a few beers." What is an appropriate response? A. "Jessie, of course you were drunk. You always are." B. "Jessie, your BAL was 0.11%. That clearly indicates that you had alcohol intoxication." C. "You are in denial, and that will impede your recovery from alcoholism." D. "Until you recognize your problem, you will never win over this addiction."

B. "Jessie, your BAL was 0.11%. That clearly indicates that you had alcohol intoxication."

Your patient asks, "Will Antabuse really help me with my drinking problem?" What is your most appropriate response? A. "Yes, if you are motivated." B. "Yes, if you use it correctly." C. "That is totally up to you." D. "Antabuse works well for some."

B. "Yes, if you use it correctly."

Andrew, a hospice nurse for 5 years and a member of your nursing team, is demonstrating a blunted affect and is not completing patient care documentation in the required time frame. As a peer, what is your best action? A. Avoid mentioning these observations because you are only a peer. B. Ask Andrew what he feels is causing him to fall behind in his work. C. Immediately report your concerns to the nurse manager in charge of your team. D. Take Andrew to lunch and keep the conversation light and humorous.

B. Ask Andrew what he feels is causing him to fall behind in his work.

Mrs. H, 87, is anxious. She tells you she must go home immediately, saying: "My twins need me. They're barely a year old!" Select the best response. A. Help reorient her by explaining patiently that she is too old now to still have babies. B. Ask her questions to describe her need to go home and sympathize with how hard it can be to be away from home. C. Implement withdrawal and promise to return in 10 minutes when she is calmer and more rational. D. Reward her with attention when she focuses on reality.

B. Ask her questions to describe her need to go home and sympathize with how hard it can be to be away from home.

A nurse is conducting education on anxiety and stress management. Which of the following should be identified as the most important initial step in learning how to manage anxiety? A. Diagnostic blood tests B. Awareness of factors creating stress C. Relaxation exercises D. Identifying support systems

B. Awareness of factors creating stress

Bandi lives in a cemetery under a tarp. He scavenges for food around the local supermarket. Today, the manager of the supermarket calls the police. Upon arrival, they find Bandi pushing multiple grocery carts, agitated, his fingers bleeding. He tells the police, "I have to scrub all the rust off these carts and all the carts in the world. Then I can be saved and go to heaven." The police bring Bandi to the community mental health center. Which one of the following applies to Bandi's rights as a citizen? A. His rights were violated. B. His rights were upheld. C. His rights were not considered. D. His rights were misinterpreted.

B. His rights were upheld. He was deemed at risk for harm to self.

A patient with bulimia nervosa has become dehydrated from self-induced vomiting. This is most likely to result in: A. Hyperchloremia. B. Hypokalemia. C. Tachycardia. D. Parotid gland atrophy.

B. Hypokalemia

The role of a psychiatric nurse on an inpatient unit would include which one of the following? A. Prescribing medication B. Maintaining a therapeutic milieu C. Analyzing patient behavior D. Providing psychotherapy

B. Maintaining a therapeutic milieu

Because he works with young men in a treatment center for domestic abuse, Ernesto is always careful to be respectful of both patients and staff—"especially women," he tells a coworker. Which educational tool is Ernesto demonstrating most clearly? A. Empathy B. Modeling C. Transference D. Value teaching

B. Modeling

An aging client with chronic schizophrenia takes an antipsychotic and propranolol, a beta-adrenergic blocking agent, for hypertension. Given the combined side effects of these drugs, which client teaching should the nurse provide? A. "Make sure you concentrate on taking slow, deep, cleansing breaths." B. "Watch your diet and try to engage in some regular physical activity." C. "Rise slowly when you change position from lying to sitting or sitting to standing." D. "Wear sunscreen and try to avoid midday sun exposure."

C. "Rise slowly when you change position from lying to sitting or sitting to standing."

A client began taking lithium for the treatment of bipolar disorder approximately 1 month ago and asks why he has gained 12 pounds since then. Which is the most appropriate nursing response? A. "I'm surprised you have gained; weight loss is the typical pattern when taking lithium." B. "Your weight gain is more likely related to food intake than medication." C. "Weight gain is a common, but troubling side effect. Let's talk about some strategies for safely improving your nutrition and exercise habits." D. "There's not much you can do about the weight gain. It's better than being emotionally unstable though."

C. "Weight gain is a common, but troubling side effect. Let's talk about some strategies for safely improving your nutrition and exercise habits.

A client diagnosed with schizophrenia refuses to take medication, citing the right of autonomy. Under which circumstance would a nurse have the right to medicate the client against the client's wishes? A. A client makes inappropriate sexual innuendos to a staff member. B. A client constantly demands attention from the nurse by begging, "Help me get better." C. A client physically attacks another client after being confronted in group therapy. D. A client refuses to bathe or perform hygienic activities.

C. A client physically attacks another client after being confronted in group therapy.

Which situation reflects violation of the ethical principle of veracity? A. A nurse discusses with a client another client's impending discharge. B. A nurse refuses to give information to a physician who is not responsible for the client's care. C. A nurse tricks a client into seclusion by asking the client to carry linen to the seclusion room. D. A nurse does not treat all of the clients equally, regardless of illness severity.

C. A nurse tricks a client into seclusion by asking the client to carry linen to the seclusion room.

Ms. T., a single mother of four, comes to the crisis center 24 hours after an apartment fire in which all the family's household goods and clothing were lost. Ms. T. has no family in the area. Her efforts to mobilize assistance have been disorganized, and she is still without shelter. She is distraught and confused. The nurse assesses the situation as which of the following types of crisis? A. Maturational crisis B. Situational crisis C. Adventitious crisis D. Evidence of an inadequate personality

C. Adventitious crisis

Which of these brain structures puts emotional meaning on a stimulus, forms emotional memories, and is involved with rage and fear? A. Hippocampus B. Temporal lobe C. Amygdala D. Midbrain

C. Amygdala

A patient has decreased circulating levels of GABA. Which health problem is this most likely to suggest? A. Alzheimer's disease B. Parkinson's disease C. Anxiety disorders D. Insomnia

C. Anxiety disorders

Which of the following is necessary when considering a medication for a consenting client? A. Client must have input into medication choice. B. Client must agree to report side effects. C. Client must be competent. D. Client must be willing to accept the medication.

C. Client must be competent.

The spouse of a patient who has delusions asks the nurse, "Are there any circumstances under which the treatment team is justified in violating the patient's right to confidentiality?" The nurse must reply that confidentiality may be breached: A. under no circumstances. B. at the discretion of the psychiatrist. C. when questions are asked by law enforcement. D. if the patient threatens the life of another person.

D. if the patient threatens the life of another person.

The following patients are seen in the emergency department. The psychiatric unit has one bed available. Which patient should the admitting officer recommend for admission to the hospital? The patient who: A. is experiencing dry mouth and tremor related to side effects of haloperidol (Haldol). B. is experiencing anxiety and a sad mood after a separation from a spouse of 10 years. C. self-inflicted a superficial cut on the forearm after a family argument. D. is a single parent and hears voices saying, "Smother your infant."

D. is a single parent and hears voices saying, "Smother your infant."

Jessie is attending AA meetings three times a week for the past 6 weeks. She has been sober during this time and visits bi-weekly the community mental health outpatient clinic. Jessie's nurse counselor wants to talk with her about the AA meetings. Which initial question or statement is most appropriate? A. "I am so excited that you are attending the AA sessions!" B. "Do you enjoy attending the AA meetings?" C. "Are the members of the group friendly and accepting?" D. "Tell me about the last AA meeting you attended."

D. "Tell me about the last AA meeting you attended."