MH Quiz
39. the RN must continuously assess the restraint patient every __ hour(s)
1
28. Identify the examples of non-facilitative statements made by the nurse to the client. Select all that apply: a. If it were me, id try another more successful coping skill b. Just a minute. Ill be back in just a minute c. You should know the policies of the unit by now d. Why don't you stop feeling those negative feelings? e. I think you should contact your uncle
All the above
1. An outpatient with a history of major depression states that he is happy and thinks he no longer needs his anti-depressant. What is the best response by the nurse? a. Your medicine is working. If you discontinue your anti depressant your depression will come back b. This issue needs to be discussed with your healthcare provider c. If you discontinue your anti-depressant, you must wean off or you will experience undesirable effects. d. Don't stop your anti-depressant. You need it for your depression
a
12. A patient with rule out bipolar disorder diagnosis is admitted to the unit. Orders include lithium, regular diet, CBC, and thyroid function tests. What action should the nurse take to insure accurate patient outcomes? a. T3 and t4 should be obtained before lithium is started b. CBC should be drawn before lithium is started c. CBC should be obtained while patient is NPO d. TSH should be drawn after lithium is started
a
13. A child who wants to play football is too small to be successful but found to have marvelous skills in chorus. Which coping skill does this represent? a. Sublimation b. Projection c. Intellectualization d. Rationalization
a
13. A client is pacing in the hall. The nurse overhears theclient say, "leave me alone—don't infect me with ebola" the best response from the nurse would be: a. Please tell me what you are hearing right now b. Just ignore the voices, they aren't real c. I will get you a mask and gloves so you feel safe d. You need to stop watching the tv news
a
19. A depressed client presents to the nurse's station complaining of extreme fatigue and dry mouth and ask if he can lay down in his room rather than go to the group session this morning. What is the best response by the nurse? a. Your medication is causing your dry mouth and fatigue. Get some water and go to group, which is a part of your contract we covered on admission b. I am so sorry you are tired and know you must want to sleep. I am also sorry that you must go to group, but it is necessary for your recovery c. Depression causes fatigue and so does your medication. Go lie down and get some needed rest d. No! you cannot sleep through group therapy. You must go!
a
23. The nurse is caring for a client who with HIV/AIDS, the client comes to the HIV clinic accompanied by his mother who states, "its like he's become someone else." The nurses first response should be: a. How has he changed b. Is he depressed c. What do you expect? d. This disease would change you too
a
25. A man learns that the company he works for is reducing employees to save money and he is one of those people. Which of the following man's behaviors demonstrates denial? a. The man fails to file for unemployment b. The man talks with his wife about the incident c. The man starts searching for a future job d. The man talks about the situation with other employees
a
32. a seasoned RN is critiquing the new graduate's ability to admit the psychiatric patient. The new RN notices the patient has a t-shirt from Delta-Nu an says "I'm a delta nu too." Later the experienced RN says this was inappropriate. What is the new grad's best response? a. I was attempting to build trust by pointing out a similarity we have b. I can see how that might be perceived as sharing too much information. I won't do that again c. The girl is so scared. I was trying to reduce her anxiety d. This is a theory I learned in school that works. You must be an AND
a
34. A patient makes a near lethal suicide attempt on the unit. After addressing the life-threatening injury, what should the nurses delegate the CNA to do after calling a code? a. Move all the patients to the day room and stay with them b. Meet the individuals arriving for the code at the door and direct them to the patient's room c. Come back to the room and help with the patient who is injured d. Immediately conduct a check of all patients on the unit
a
41. A client on olanzapine gains ten pounds in four weeks after its initiation. The client asks the nurse if the weight gain is related to this medication. What is the best reasponse by the nurse? a. This medication is associated with weight gain in some clients b. Your scales probably need to be recalibrated because this drug usually causes weight loss c. You are probably eating more now that you feel better d. Olanzapine most always causes significant weight gain
a
42. Clients who participate in out-patient mental health groups often follow a recovery model of care. What information might the nurse each during social skills training? a. How to make eye contact when speaking with someone b. How to apply for a job c. How to develop a list of important phone numbers for an emergency d. How to use deep breathing exercises to minimize hallucinations
a
50. A patient with intermittent explosive disorder starts subtly rocking and clenching his teeth during lunctime. What is the best action by the nurse? a. Ask the patient to step out of the room with you b. Ask the patient if he is ok c. Document the patients behavior and share in the end of the shift report d. Prepare a PRN benzodiazepine
a
6. Which of the following patients would be the best room assignment for a new admission depressed suicidal patient with a history of alcohol abuse? a. Major depression patient b. Bipolar disorder-manic phase c. Substance (alcohol) withdrawal d. Schizophrenia of the paranoia type
a
1. 5Which of the following nursing assessments used by the new graduate demonstrates adequate understanding when assessing an anorxic disordered patient. Select all that apply a. Weight patients with their backs to the scales b. Have patient void before he/she weighs c. Have patients wear a patient gown only when weighing d. Have the patient keep a weight diary e. Awaken patients a different times early in the morning before patients arise to weigh
a, b, c
11. Which of the following behaviors describe a conduct disorder? Select all that apply a. Stealing from others b. Drowns kittens c. Sets a fire inside a movie theater d. No remorse for harming others or animals e. Does not violate the rights of others
a, b, c, d
11. Which of the following discharge teaching points should be included when instructing a patient about lithium? Select all that apply a. Come to the clinic for regular blood level checks b. Contact your provider if you experience nausea, vomiting and/or diarrhea c. Drink plenty of fluids d. Exercise in climate-controlled environment on steady routine e. Eat a steady diet in green vegetables
a, b, c, d
18. Which of the following must the RN document regarding a restraing patient? Select all that apply: a. Contacted HCP for new restraint orders as required every 24 hours. b. Time and date restraints starte c. Each date and time assessments are conducted d. Type of restraints used e. Family visitation outcomes f. Events leading to restraint use and methods attempted beforehand
a, b, c, d, f
32. Which of the following behaviors describe an autistic child? Select all that apply a. Tactile defensiveness b. Altered speech development c. Oral tactile defensiveness d. Altered social relationships e. Aggressiveness f. Overstimulated by spinning objects
a, b, c, d, f
37. if restraints are required the nurse recognizes that the following patients are at higher risk of complications that the general population: select all that apply a. diabetic b. developmentally delayed c. obese d. psychotic e. elderly
a, b, c, e
10. Which of the following behaviors indicate possible sexual abuse? Select all that apply a. Playing with dolls in an inappropriate/sexual manner b. Young school age quiet and withdrawn c. Frequent urinary tract infections d. Early teen flirtatiousness e. Early teen, sexually boistorious f. Difficulty with gait
a, b, c, e, f
18. After discharge teaching regarding the drug tranylcypromine, which of the following patient statements/outcomes indicates a need for further instruction? Select all that apply a. I can have coke b. I can have soy sauce c. I can have chicken d. I can have beef jerky e. I can have roast beef
a, b, d
41. Which of the following exemplify rationalization? Select all that apply a. I didn't do well on that exam because the teacher didn't cover that material b. I didn't do well on the test because the teacher writes bad test questions c. I didn't do well on that test because I waited too late to study and stayed up all night d. I didn't do well on that exam because that wasn't the material I studied e. I didn't do well on that test because I didn't study enough
a, b, d
49. Which of the following are behaviors of a borderline personality disorder? Select all that apply a. Suicidal thoughts b. Chronic low self esteem c. Low anxiety d. Self mutilation
a, b, d
7. A school age child is having trouble passing math. Which of the following statements made by the mother concerns you most regarding the childs developmental needs? Select all that apply a. He does very well in all other subjects so his average grade will be fine b. His father and I are going to ask him why he cant seem to get math concepts c. Im really not worried, but want him to have every opportunity to succeed so were talking t ohis math teacher d. His aunt thinks he should have IQ and learning disability testing so were looking into that e. Were checking into getting him a tutor in math
a, b, d
35. Which of the following are characteristics of a manic state? Select all that apply a. Hyperactivity b. Pressured speech c. Hallucinations d. Delusions e. Sexual acting out
a, b, d, e
6. Which of the following are characteristics of an abuser? Select all that apply a. Ineffective coping b. Severe stress reactions c. Generally always substance abusers d. Perceives spouse as a personal possession e. Pathologically jealous f. Low self esteem
a, b, d, e, f (everything except c)
38. multiple factors may precipitate a client to develop delirium. Identify those factos that may be responsible. Select all that apply a. sepsis b. visual disturbances c. trauma d. electrolyte imbalance
a, c, d
31. Which of the following symptoms your patient is exhibiting supports depression? Select all that apply a. sleep pattern changes b. compulsive acts c. changed physical appearance (unkempt, slumped, etc.) d. indecisiveness e. constipation
a, c, d, e
44. Which of the following are symptoms of PTSD? Select all that apply a. Emotional detachment b. Hallucinations c. Nightmares d. Flashbacks of the experience e. Intrusive thoughts
a, c, d, e
47. Which of the following are signs and symptoms of an antisocial personality disorder? Select all that apply a. Very charming b. Regrets illegal actions c. Manipulative d. Lies for personal gain and pleasure e. No remorse for hurting others
a, c, d, e
5. A client taking olanzapine complains of a sore throat this morning. What actions should the nurse take? Select all that apply a. Assess fro lymphadenopathy b. Assess for EPS c. Obtain vital signs d. Contact the pcp e. Obtain an order for cbc with differential f. Document the complaint
a, c, d, e, f
24. Discharge teaching for a patient started on duloxetine should include which of the following points. Select all that apply. a. It will take 2-3 weeks for this drug to reach therapeutic levels b. Weight gain may occur c. You may experience sexual dysfunction d. Fluid retention is common e. Take every day and do not stop abruptly
a, c, e
20. Medications used for long term anxiety problems include the following: select all that apply a. Paroxetine b. alprazolam c. chlordiazepoxide HCL d. buspirone e. fluoxetine HCL
a, d, e
45. During group therapy a patient with a history of violent outbursts begins to rock, mumble, and state he was afraid he was going to hurt somebody. What actions should the nurse take and in what order? First? Second? Etc a. Attempt to talk the patient down using a soft quiet voice b. Remove the patient from the group - decrease external stimuli c. Physically restrain client d. Walk around the unit or try another form of exercise to release the energy e. Administer lorazepam 2mg po every 2-4 hours PRN agitation
a. 2 b. 1 c. 5 d. 3 e. 4
19. Match the communication facilitator with its definition: a. Recognizing the clients options and statements without placing your own values or judgements b. Pointing out inconsistencies in behavior c. Sharing observations of patients behavior d. The process of insuring you understand the meaning of the clients message e. Exploring a specific topic
a. Acknowledgement b. Confrontation c. Information giving d. Clarifying e. Focusing
23. Match the phobia with its appropriate definition a. Fear of heights b. Fear of the dark c. Fear of death d. Fear of crowds or open spaces/places e. Fear of water
a. Acrophobia b24. Discharge teaching for a patient started on duloxetine should include which of the following points. Select all that apply.. Nyctophobia c. Thantophobia d. agoraphobia e. Hydrophobia
43. Match the communication acilitator with its definition a. Paraphrasing b. Offering alternatives c. Exploring a specific topic
a. Reflection/restating b. Suggesting c. Focusing
10. The driver of an MVA is admitted unconscious to the ICU. The passenger is able to report that the patient "Drinks a lot". Which question should the nurse ask next? a. What does your friend like to drink? b. When was your friends last drink c. How much have you had to drink? d. How much did your friend drink today?
b
14. A bipolar patient in a manic state, admitted 2 days ago, comes to group dressed ina shirt without pants. What action by the nurse is most appropriate? a. Tell the patient to go to her room and finish getting dressed b. Ask a patient to assist the bipolar patient to complete dressing c. Tell the patient she is inappropriately dressed d. Lead the patient back to her room and help her finish dressing
b
14. Which of the following behavior best represents repression? a. An abused school age child who starts bed wetting b. A sexually abused teen who cannot remember the traumatic event(s) c. An abused teen who refuses to talk about the abusive events. d. A sexually abused child now as an adult work with sexually abused children
b
15. An ADHD childs mom complains her son is losing weight. Which of the following recommendations will be most helpful for the mother? a. Give the ADHD medication with a small snack b. Give the ADHD medication with food so he will be more hungry c. Give the ADHD medication when he first rises d. Give the ADHD medication on an empty stomach so he will be less hungry
b
16. A patient on risperidone exhibits symptoms of akathisia. Which medication from the MAR should the nurse administer to address this side effect a. Ziprasidone PO every 6 hours PRN b. Lorazepam 2 mg po every 2 hours prn c. Lorazepam 1 mg IV every 2 hours PRN d. Haloperidol 5 mg every 4 hours IM PRN
b
16. A person gets a speeding ticket and comes home and throws a lamp across the room. What coping skill is this? a. Reaction formation b. Displacement c. Sublimation d. Projection
b
2. A young male college student, working as a substitute teacher at a high school, wants to be recognized as a teacher rather than a student so uses the coping skill identification. Which of the following behaviors exemplifies identification? a. He notes one of the students is coming on to him and he asks her out b. The student wears adult leather tie up shoes, a button-down shirt and tie to work. c. The student wears same type clothes as the students to relate to them. d. The student attempts to speak business type jargon
b
21. a patient admitted for depression and suicidal ideation 5 days ago, suddenly displays a happier affect this morning. How should the nurse interpret this change in behavior? a. The group therapy sessions are effective with this client b. The patient may be suicidal. A suicidal assessment is critical c. The patient is feeling more comfortable with peers on the unit d. The antidepressant(s) are starting to work
b
29. A woman who was drinking and driving and seriously injured a young man joins MADD to prevent such incidents. Which coping skill does this represent a. Reaction formation b. Undoing c. Intellectualization d. Sublimation
b
30. A patient is admitted to the ER for anorexia nervosa. The psychiatric unit calls and says her bed is ready. The ER nurse assesses the BP: 90/54 HR 124 RR: 28; Labs outcomes pending. What is the best action the ER nurse should take next? a. Turn up the IV fluids, give report to the psychiatric unit and transfer patient b. Turn up the IV fluids. Inform the MD and the tell the psychiatric unit that there are medical issues that need attention first c. Contact the md, turn up iv fluids, and then call the psychiatric unit to give report re: the patient to transfer d. Give report to the psychiatric unit and transfer the patient
b
34. A client with schizophrenia is being changed from a typical to an atypical antipsychotic med and asks, "why am I being switched? The psychiatrist said something about negative symptoms." Which is the best response by the nurse? a. New medicines will help minimize delusions b. Newer antipsychotic medicines help with positive symptoms like hallucinations and negative symptoms like lacking motivation c. Negative symptoms interrupt your life, like hallucinations d. You probably heard wrong medications are not switched because of negative symptoms
b
37. A patient with an anxiety disorder should be admitted to a room closest to the nurse's station a. True b. False
b
43. A patient is being prepped for heart valve replacement surgery. His BP is up to 138/86, HR 98, RR 22, T97.4 F, and he complains of one episode of a loose stool this morning. What is the best next action by the nurse? a. Continuing prepping the patient for the surgery b. Assess the patient's feelings about the upcoming surgery c. Conduct a thorough GI assessment d. Obtain a surgical permit
b
44. A friend who hass difficulty depending on others and took months to become friends with, double locks doors, double checks irons etx. Which developmental level did your friend possibly fail to accomplish successfully? a. Identity vs role confusion b. Trust vs mistrust c. Industry vs inferiority d. Autonomy vs inferiority e. Autonomy vs shame and doubt f. Initiative vs guilt
b
46. A new nurse working on a psychiatric unit finds that none of the patients respond positively to her - seek out to talk about problems etc. what is the best way to learn about this issue a. Ask her family about her nonverbal signs b. Discuss with peers what non-verbal signals she might be sending that is creating this response c. Talk to the patient about herself and needs d. Just ignore the issue as it will resolve itself as she gets more experience
b
46. The nurse is documenting information about a client with schizophrenia. Which of the following documentation is discussing the negative symptoms schizophrenia? a. The patient reports, "I have to call the president—I have high security information" b. Client displays blunted affect, poor eye contact and shows no interest in unit activities c. The client is talking to self and covering ears d. The client is running through the unit shouting "I am the king of you tube"
b
47. A former patient calls the unit complaining that the antidepressant isn't working. You determine the medication was started 2 weeks ago. What is the best response by the nurse a. Don't worry. Is should be ok by the end of next week b. It takes 2-3 weeks to get therapeutic level. Let's give it another week c. You shouldn't begin to worry until after 3 weeks d. Why don't you wait another week and then let us know what is going on with your medication?
b
48. An A high school student learns he did not get in the college of choice. Which of the following behaviors represents the most severe form of regression a. Cries b. Curls up in bed c. Sucks his thumb d. Throws items
b
2. Which of the following nursing actions indicate the RN caring for apatient in restraints needs further teaching? a. Assesses the patients respiratory and cardiac status to prevent hypoxia b. Places a pt with a history of CHF in supine position in restraints c. Releases one restraint ever 2 hours clockwise d. Leaves the lights off for comfort e. Places a CNA at the door to continuously watch the patient for problems f. Offers toileting ever 4 hours
b, c, d
24. The nurse is teaching a patient recently started on clozapine. The nurse should include which of the following teaching points about the medication before discharge. Select all that apply a. You will need a monthly clozapine level b. You must report if you develop a shuffled gait or pill rolling remors to your healthcare provider c. You will need weekly lab work to assess white blood cell count d. You must report a fever > 100 to healthcare provider
b, c, d
48. Which of the following patient responses indicate adequate understanding from a teaching session on the newly prescribed drug disulfiram? Select all that apply: a. I should avoid soy sauce b. I must be cautious with whitening toothpastes c. I cannot use most mouthwashes d. I cannot use any vanilla extract even if used in a cake e. I cannot use over the counter cough medicine
b, c, e
36. a woman is admitted to the ER. Her injuries do not fit the history described. Which of the following assessment criteria would further support abuse? Check all that apply a. is proud of her cooking skills b. low self esteem c. is an active member of her church d. grew up in an abusive home e. is a member of PTA
b, d
3. Which of the following behaviors exemplifies passive-aggressive coping skills? Select all that apply a. A teenage girl who likes the quarterback, tells her friends he's coming on to her. b. A supervisor states that you are performing well but makes cutting remarks about you in front of your peers c. A local candidate running for office says that the well-respected governor is offering his support d. An employee is informed his tardiness to meetings is problematic, the next meeting the employee if 5 minutes later than usual e. The mother in law arrived uninvited 2 hours early to her daughter in laws dinner party to help
b, d, e
15. A suicidal inpatient refuses to comply with a "no harm to self or others" verbal contract. What is the priority nursing action? a. Administer a PRN medication b. Document the patient's response c. Place the patient on 1:1 observation d. Contact the primary care provider
c
17. A bipolar patient in a manic state is not eating the food sent by dietary. What is the best plan by the nurse to address this issue a. Obtain dietary preferences from the family b. Obtain a 24-hour dietary recall c. Order pre-wrapped/sealed finger foods. d. Ask the patient foods he/she likes and order these foods
c
21. A veteran admitted with sever PTSD, is paraplegic, suffers serious flashback and is fighting back during a flashback that wont stop. The patient does not respond to voice or touch and is hitting the staff violently and head banging. After a MR. Strong is called and chemical restraints are given he is still hurting himself and others. What action should the nurse take next? a. Place the patient in isolation b. Give another dose of the PRN med in 2 hours c. Place the patient in 2 point restraints d. Place the patient in 4 point restraints
c
22. Who does abuse most frequently affect? a. Low self esteem b. Low socio-economic groups due to stress c. All groups and peoples d. Those who were abused are abusers—Learning theory
c
30. A patient says I'm finished with it all. What is the best response by the nurse? a. Remain silent so the client may continue b. Lunch is here. We can finish our discussion later c. What do you mean when you say that d. Don't worry everything will be better soon
c
31. A college student quit attending classes, locked himself in his dorm room and was yelling out the window at students passing by and threatening to "take them out" with a hunting rifle. Based upon this background information, which nursing intervention will be a priority when the client is admitted to the psychiatric unit? a. Seclude the patient in a locked room b. Involve the patient in group therapy c. Provide a safe environment for the patient with minimal stimulation d. Immediately administer haloperidol 5 mg IM
c
33. An admitted client with COPD has a co-existing diagnosis of panic attacks especially when exposed to spiders. The patient starts hyperventilating uncontrollably when she sees a spider on television. What action should the nurse take first? a. Give the patient a benzodiazepine b. Explain that there is nothing to panic about c. Place a brown paper bag over the patients mount to increase co2 levels d. Use slow, deep breathing exercises to help the patient relax
c
33. The nurse is teaching an education group about extrapyramidal side effects. Which of the antipsychotic medications are most likely to cause EPS? a. Long-acting medication, such as risperidone depot injection b. Atypical antipsychotics, such as clozapine c. Typical antipsychotics, such as haloperidol d. Lithium
c
35. An elderly client is admitted to a medical-surgical unit for a confirmation and management of his probably dementia. Which statement made by his daughter supports a diagnosis of delirium? a. Doesn't everyone start getting confused in their 80s b. Dad is very independent and has lived alone since mom died 6 years ago c. I wasn't sure what was happening to Dad - hid behavior seemed to change overnight d. Dad has been becoming more forgetful over the past 9-10 months
c
36. A patient enters the ER drunk. Two of his 3 children are dead on arrival and the third has a severe head injury. You are assigned to the father. Which coping skill is most necessary to give this patient safe, competent care a. Denial b. Rationalization c. Isolation d. Intellectualization
c
38. Which of the following responses are the communication techniques acknowledgement and clarification? a. After listening to your situation, have you considered other options? b. You have had some bad things happen, but you really shouldn't worry c. So am I hearing you say that you believe a woman has a right to make her own choice when it comes to abortion d. So, you are saying you are a vegan?
c
4. The class of drugs prescribed most often for alcohol withdrawal is a. Phenothiazines b. Fluphenazines c. Benzodiazepines d. Sedatives
c
4. The nurse is admitting a new patient to the unit and needs to complete the patient's history. Which of the following communication techniques will be most useful to complete this task? a. Non-facilitative techniques b. Reflecting-restating techniques c. Closed-ended communication techniques d. Open-ended communication techniques
c
40. Physical symptoms that can be associated with delirium include all of the following except: a. Disphoresis b. Dilated pupils c. Decreased blood pressure d. Flushed face
c
40. The new graduate notices the RN, admitting an uncooperative, making no eye contact, patient to the psychiatric unit. You notice the RN immediately starts the nursing admission assessment and the patient becomes more agitated. You interpret this behavior as? a. The patient needs a benzodiazepine before the behavior gets out of control b. The patient needs a 1:1 to attempt to establish trust with this patient c. The RN failed to attempt to establish trust with this patient d. This patient needs to be placed in a private room furthest from the nurse's station
c
42. On the third day of admission a depressed psychiatric patient is noted spending more time with the patients than staff. How does the nurse interpret this behavior? a. The patient is moving from the staff to the patient population- a negative move b. The patient is moving to a more social relationship and this needs to be stopped and interventions carried out c. The patient is moving from the staff to the patient population - a positive move d. The patient is moving to a more social relationship
c
5. On admission whom should the RN assign the task of searching the patient's belongings for sharps and other harmful paraphernalia? a. A separate RN. b. The RN him/herself should do this during the admission assessment period. c. CNA d. LPN
c
50. A patient displaying physical outbursts that are non-responsive to de-escalating techniques. Which of the following medications from the MAR would be most appropriate to administer a. Sertraline b. Fluvoxamine c. Lorazepam d. Buspirone
c
8. A newly admitted patient in a psychotic state actively psychotic and head banging. The rn and entire staff attempt many methods to stop the harmful activity without success and the patient ends up in restraints. When must the RN contact the HCP a. Within 2 hours of admission b. Within 24 hours of restraint use c. Within the hour of the restraint application d. Within the hour of the admission
c
9. The mother of a teen who is seriously injured from an MVA runs into the ER. She is standing in shock and is not allowed to see her son yet. What actions by the nurse will nest help the mother through this crisis? a. Contact family members for the mother and explain the situation. b. Contact the mother's PCP to obtain medication for the mother. c. Give simple short commands that are not life long decisions -ex. "Who do you need to call now? Where is your phone?" etc. d. Help the mother determine if she wants the child to be an organ donor.
c
9. The nurse is teaching a family about the antipsychotic medication that a client has started in the hospital. In determining if the family understands the education, the nurse asks how the medication will help the client. Which response suggests understanding by the family? a. She only takes the medicine when she hears voices b. She can stop her medicine when she has not heard voices for 3 months c. The medicine should help with her strange thinking, but she still may not want to go out with friends d. She takes the medicine every day and then those voices will go away and she will be cured
c
12. A patient with intermittent explosive disorder starts subtly rocking and clenching his teeth during lunchtime. What is the best action by the nurse? a. Ask the patient if he is ok b. Prepare a prn benzodiazepine. c. Document the patients behavior and share in the end of the shift report d. Ask the patient to step out of the room with you.
d
17. The nurse is teaching an education group about extrapyramidal side effects. Which of the antipsychotic medications are most likely to cause EPS? a. Lithium b. Long-acting medication, such as risperidone depot injection c. Atypical antipsychotics, such as clozapine d. Typical antipsychotics, such as haloperidol
d
22. When is the best time to draw blood for a lithium level? a. Thirty minutes before the next dose is due b. Thirty minutes after the last dose was given c. Immediately before the next dose is given d. Twelve hours after the last does was given
d
25. Patients experiencing delirium may have disorientation, misperceptions about the environment and physical agitation. These symptoms lead the nurse to identify the following intervention as the priority: a. Provide the client freedom to move about his room b. Provide medication, as ordered, for sedation c. Provide re-orientation to the environment d. Provide safety measures
d
26. A TTU student nurse is expected not to cheat. As the same TTU graduate nurse has the opportunity to hide a medication error. Being a TTU graduate nurse the graduate reports the error because he/she feels it is expected of her. What coping skill is this? a. Repression b. Intellectualization c. Denial d. Introjection
d
26. How is intimacy vs isolation best described a. Intimacy is when an individual is determining who he/she is and what they have to offer their community b. Intimacy is when an individual is wanting to give back to his/her community c. Intimacy is when an individual is ready to be sexual d. Intimacy is when one is capable of establishing a long term relationship
d
27. A 24 year old client is admitted with a diagnosis of schizophrenia. The nurse is assessing the sychomotor behavior of the client and notes that the client has essentially no motor activity. The nurse documents: a. Emotional ambivalence b. Autism c. Anhedonia d. Anergia
d
27. A direct admission with no orders enters the psychiatric unit wearing a sheer black negligee, rings that appear to be diamonds on all 10 fingers and no shoes and accompanied by two hospital security personnel. Which of the following rooms would be most appropriate for this patient? a. Sharing a room with a depressed, suicidal patient close to the nurses' station b. Sharing a room with a substance abuse client who overdosed. c. A private room closest to the nurses' station d. A private room furthest from the nurses' station
d
28. A patient presents to the nurses' station complaining of a stiff neck and difficulty speaking. He states it started within the last 5 minutes. What is this patent experiencing? a. Tardive dyskinesia b. Bizarre behavior associated with schizophrenia c. Akathisia d. Dystonic reaction
d
29. You are working at a rehabilitation substance abuse agency where four newly admitted patients are withdrawing from substances. Which client is highest priority? a. Acute withdrawal from heroin b. Acute withdrawal from prescribed hydrocodone c. Acute withdrawal from methamphetamines d. Acute withdrawal from alcohol
d
3. A client has been admitted for detox from the opiod hydrocodone. Which medication will be most effective in treating the withdrawals symptoms? a. Buspirone b. Benztropine c. Chlordiazepoxide d. Buprenorphine
d
39. Which of the following behaviors represent the coping behavior suppression? a. A woman diagnosed with Parkinson's disease tells her family her tests were all clear for Parkinson's b. A man who hunted wild animals joins a committee to protect animals c. Someone who dislikes animals works at an animal shelter d. The father of a family of 5 has yet to make out a will. He keeps saying "I'll do that later"
d
45. Which of the following behaviors of a wife married to an alcoholic exemplifies intellectualization a. The wife accepts the implications of her husband's disease. b. The wife has difficulty accepting the implications of her husband's disease c. The wife acknowledges her husband's disease and does not interfere with his employer d. The wife recognizes her husband is an alcoholic but calls his employer and reports him ill when he has a hangover
d
49. A patient in the ER with a fractured femur request pain medication. His admission assessment reports he takes phenelzine sulfate daily. Which order for pain should be questioned first a. 1mg morphine sulfate IV per minute up to 8 mgs until pain relieved b. Ibuprofen 500 mgs po every 6-8 hours as needed for pain c. Acetaminophen 500 mgs po every 6-8 hours as needed for pain d. Meperidine 10 mgs IM now for pain
d
7. Which of the following statements made by the nurse to the patient is top priority on admission to a psychiatric unit? a. What is your plan of action to harm yourself b. Do you have current access to a gun? c. Why did you bring a gun to the hospital? d. Are you having thoughts of harming yourself or others
d
8. Which of the following exemplifies reaction formation coping behavior? a. The new graduate really dislikes geriatrics and is offered this area of practice at graduation. She decides there is no problem with this area. b. The new graduate is offered a geriatric unit at graduation. She selects it deciding she can learn many basic skills in this area c. A new graduate who hates geriatrics is offered a new position in geriatrics, so she asks her mom who is season nurse, what she would do. d. The new graduate nurse really dislikes geriatrics but decides to work in a geriatric setting to improve her outlook.
d
20. A newly admitted patient with dissociative identity disorder is fighting everyone who comes near her, especially males. She knocked out a security guard who helped escort her from the ER to the psychiatric unit. Select the most appropriate nursing interventions: select all that apply a. Place the patient in four point restraints if the chemical restraint is unsuccessful b. Assign a female LPN to admit the patient c. If patient is violent call a Mr. strong and administer either a benzodiazepine or antipsychotic IV as ordered d. Attempt to talk the patient down e. Assign a female RN to admit the patient
d, e
